[Illustration]

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THE PEOPLE'S

COMMON SENSEMEDICAL ADVISERIN PLAIN ENGLISH:OR, MEDICINE SIMPLIFIED. 

BYR. V. PIERCE, M. D. 

ONE OF THE STAFF OF CONSULTING PHYSICIANS AND SURGEONSAT THE INVALIDS' HOTEL AND SURGICAL INSTITUTE, ANDPRESIDENT OF THE WORLD'S DISPENSARYMEDICAL ASSOCIATION. 

FIFTY-FOURTH EDITION. 

ONE MILLION, SIX HUNDRED AND FIFTY THOUSAND. 

_Carefully Revised by the Author, assisted by his full Staff ofAssociate Specialists in Medicine and Surgery, the Faculty of theInvalids' Hotel and Surgical Institute. _

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Entered according to Act of Congress, in the year 1895, by the WORLD'SDISPENSARY MEDICAL ASSOCIATION, In the office of the Librarian ofCongress, at Washington, D. C. 

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TOMY PATIENTS, WHO HAVE SOLICITED MY PROFESSIONAL SERVICES, FROM THEIR HOMESIN 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 OTHERFOREIGN LANDS, I RESPECTFULLY DEDICATETHIS 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 beenreceived has required the production of such a vast number of copies, that the original electrotype plates from which it has heretofore beenprinted, have been completely worn out. 

The book has been re-produced in London, England, where six editionshave already been necessary to supply the demand for it. 

In order to continue its publication to meet the demand which is stillactive in this country, it has been necessary, inasmuch as the originalelectrotype plates have become worn and useless, to re-set the workthroughout. This has afforded the Author an opportunity to carefullyrevise the book and re-write many portions, that it may embody thelatest discoveries and improvements in medicine and surgery. Inperforming this labor he has been greatly assisted by contributions andvaluable aid kindly supplied by his staff of associate specialists inmedicine and surgery who constitute the Faculty of the Invalids' Hoteland Surgical Institute. 

That part of the book treating of Diseases and Their Remedies will befound to be thoroughly reliable; the prescriptions recommended thereinhaving all received the sanction and endorsement of medical gentlemen ofrare 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 frequentinquiries from his numerous patients throughout the land, suggested tothe Author the importance and popular demand for a reliable work of thiskind. Consequently, he has been induced to prepare and publish anextensive dissertation on Physiology, Hygiene, Temperaments, Diseasesand 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 ofthe common ailments of life. 

The frequency of accidents of all kinds, injuries sustained bymachinery, contusions, drowning, poisoning, fainting, etc. , and also ofsudden attacks of painful diseases, such as headache, affections of theheart and nerves, inflammation of the eye, ear and other organs, rendersit necessary that non-professionals should possess sufficient knowledgeto enable them to employ the proper means for speedy relief. To impartthis important information is the aim of the author. 

Moreover, this volume treats of Human Temperaments, not only of theirinfluence upon mental characteristics and bodily susceptibilities, butalso of their vital and non-vital combinations, which transmit to theoffspring either health, hardihood, and longevity, or feebleness, disease, and death. It clearly points out those temperaments which arecompatible with each other and harmoniously blend, and also those which, when united in marriage, result in barrenness, or produce in theoffspring imbecility, deformity, and idiocy. These matters are freelydiscussed from original investigations and clinical observations, thusrendering 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 aconsequence of certain abuses, usually committed through ignorance. Thatthese ills do exist is evident from the fact that the Author isconsulted by multitudes of unfortunate young men and women, who aredesirous of procuring relief from the weaknesses and derangementsincurred by having unwittingly violated physiological laws. 

Although some of these subjects may seem out of place in a work designedfor _every_ member of the family, yet they are presented in a stylewhich cannot offend the most fastidious, and with a studied avoidance ofall language that can possibly displease the chaste, or disturb thedelicate susceptibilities of persons of either sex. 

This book should not be excluded from the young, for it is eminentlyadapted to their wants, and imparts information without which millionswill suffer untold misery. It is a _false_ modesty which debars theyouth of our land from obtaining such information. 

As its title indicates, the Author aims to make this book a useful andpractical Medical Adviser. He proposes to express himself in plain andsimple language, and, so far as possible, to avoid the employment oftechnical words, so that all his readers may readily comprehend thework, and profit by its perusal. Written as it is amid the many caresattendant upon a practice embracing the treatment of thousands of casesannually, and therefore containing the fruits of a rich and variedexperience, some excuse exists for any literary imperfections which thecritical 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 publicgain. Upon the health of its people is based the prosperity of a nation;by it every value is increased, every joy enhanced. Life is incompletewithout the enjoyment of healthy organs and faculties, for these giverise to the delightful sensations of existence. Health is essential tothe accomplishment of every purpose; while sickness thwarts the bestintentions and loftiest aims. We are continually deciding upon thoseconditions which are either the source of joy and happiness or whichoccasion pain and disease. Prudence requires that we should meet thefoes and obviate the dangers which threaten us, by turning all ourphilosophy, 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 tomeet the grim monster, "break the jaws of death, and pluck the spoil outof his teeth. " _His_ ear is ever attentive to entreaty, and within hisfaithful breast are concealed the disclosures of the suffering. Successmay elate him, as conquest flushes the victor. Honors are lavished uponthe brave soldiers who, in the struggle with the foe, have coveredthemselves with glory, and returned victorious from the field of battle;but how much more brilliant is the achievement of those who overwhelmdisease, that common enemy of mankind, whose victims are numbered bymillions! Is it meritorious in the physician to modestly veil hisdiscoveries, regardless of their importance? If he have light, why hideit from the world? Truth should be made as universal and health-givingas sunlight. We say, give light to all who are in darkness, and a remedyto the afflicted everywhere. 

We, as a people, are becoming idle, living in luxury and ease, and inthe gratification of artificial wants. Some indulge in the use of foodrendered unwholesome by bad cookery, and think more of gratifying amorbid appetite than of supplying the body with proper nourishment. Others devote unnecessary attention to the display of dress and agenteel figure, yielding themselves completely to the sway of fashion. Such intemperance in diet and dress manifests itself in the generalappearance of the unfortunate transgressor, and exposes his folly to theworld, with little less precision than certain vices signify theirpresence by a tobacco-tainted breath, beer-bloated body, rum-emblazonednose, and kindred manifestations. They coddle themselves instead ofpracticing self-denial, and appear to think that the chief end of lifeis gratification, rather than useful endeavor. 

I purpose to express myself candidly and earnestly on all topicsrelating to health, and appeal to the common sense of the reader forjustification. Although it is my aim to simplify the work, and render ita practical common-sense guide to the farmer, mechanic, mariner, andday-laborer, yet I trust that it may not prove less acceptable to thescholar, in its discussion of the problems of Life. Not only does themethod adopted in this volume of treating of the Functions of the Brainand Nervous System present many new suggestions, in its application tohygiene, the management of disease, generation and the development andimprovement of man, but the conclusions correspond with the results ofthe latest investigations of the world's most distinguished _savants_. My object is to inculcate the facts of science rather than the theoriesof philosophy. 

Unto us are committed important health trusts, which we hold, not merelyin our own behalf, but for the benefit of others. If we discharge theobligations 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 ofwhich is pain and death. Let us, then, prove worthy of this generouscommission, that we may enjoy the sweetest of all pleasures, thedelicious 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 primitivemanifestations. _Biology_ is the science of living bodies, or thescience 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 withoutorgans. Every living thing has a structure, and _Anatomy_ treats of thestructures of organized bodies. Several chapters of this work aredevoted to _Physiological Anatomy_, which treats of the human organismand its functions. 

The beginning of life is called _generation_; its perpetuation, _reproduction_. By the former function, individual life is insured; bythe latter, it is maintained. Since nutrition sustains life, it has beenpertinently termed _perpetual reproduction_. 

LATENT LIFE is contained in a small globule, a mere atom of matter, inthe sperm-cell. This element is something which, under certainconditions, develops into a living organism. The entire realm of natureteems with these interesting phenomena, thus manifesting that admirableadjustment of internal to external relations, which claims our profoundattention. We are simply humble scholars, waiting on the threshold ofnature's glorious sanctuary, to receive the interpretation of her divinemysteries. 

Some have conjectured that chemical and physical forces account for allthe phenomena of life, and that organization is not the result of vitalforces. Physical science cannot inform us what the beginning was, or howvitality is the result of chemical forces; nor can it tell us whattransmutations will occur at the end of organized existence. Thismysterious life-principle eludes the grasp of the profoundestscientists, and its presence in the world will ever continue to be anastonishing and indubitable testimony of Divine Power. 

The physical act of generation is accomplished by the union of twocells; and as this conjugation is known to be so generally indispensableto the organization of life, we may fairly infer that it is a universalnecessity. Investigations with the microscope have destroyed thehypothesis of "spontaneous generation. " These show us that even theminutest living forms are derived from a parent organization. 

GENERATION. So long as the vital principle remains in the sperm-cell, itlies dormant. That part of the cell which contains this principle iscalled the _spermatozoön_, which consists of a flattened body, having along appendage tapering to the finest point. If it be remembered that aline is the one-twelfth part of an inch in length, some idea may beformed 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 thefiliform tail 1/50 of a line, in length. This life-atom, which can bediscerned only with a powerful magnifying glass, is perfectlytransparent, and moves about by executing a vibratile motion with itslong appendage. Within this speck of matter are hidden the multifariousforces which, under certain favorable conditions, result inorganization. Magnify this infinitesimal atom a thousand times, and nocongeries of formative powers is perceived wherewith to work out thewonders of its existence. Yet it contains the principle, which is thecontribution on the part of the male toward the generation of a newbeing. 

The _ovum_ or germ-cell, is the special contribution on the part of thefemale for the production of another being. The human ovum, thoughlarger than the spermatozoön, is also extremely small, measuring notmore than from 1/20 to 1/10 of a line, or from 1/240 to 1/120 of aninch, 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 organicstructures, and both possess the special qualities and conditions bywhich they may evolve organic beings. Every cell is composed of minutegrains, within which vital action takes place. The interior of a cellconsists of growing matter; the exterior, of matter which has assumedits form and is less active. 

When the vital principle is communicated to it, the cell undergoes arapid transformation. While this alteration takes place within the cell, deteriorating changes occur in the cell-wall. Although vital operationsbuild up these structures, yet the animal and nervous functions arecontinually disintegrating, or wasting, them. 

Throughout the animal kingdom, germ-cells present the same externalaspect when carefully examined with the microscope. No difference can beobserved between the cells of the flowers of the oak and those of theapple, but the cells of the one always produce oak trees, while those ofthe other always produce apple trees. The same is true of the germs ofanimals, there being not the slightest apparent difference. We areunable to perceive how one cell should give origin to a dog, whileanother exactly like it becomes a man. For aught we know, the ultimateatoms of these cells are identical in physical character; at least wehave no means of detecting any difference. 

SPECIES. The term species is generally used merely as a convenient nameto designate certain assemblages of individuals having various strikingpoints of resemblance. Scientific writers, as a rule, no longer holdthat what are usually called _species_ are constantly unvarying andunchangeable quantities. Recent researches point to the conclusion that_all species vary more or less_, and, in some instances, that thevariation is so great that the limits of general specific distinctnessare sometimes exceeded. 

Our space will not permit us to do more than merely indicate the twogreat fundamental ideas upon which the leading theories of the timerespecting the origin of species are based. These are usually termed thedoctrine of _Special Creation_ and the doctrine of _Evolution_. According to the doctrine of Special Creation, it is thought thatspecies are practically immutable productions, each species having a_specific centre_ where it was originally created, and from which itspread over a certain area until its further progress was obstructed byunfavorable conditions. The advocates of the doctrine of Evolution hold, on the contrary, that species are not permanent and immutable, but thatthey are subject to modification, and that "the existing forms of lifeare descendants by true generation of pre-existing forms. "[1] Mostnaturalists are now inclined to admit the general truth of the theory ofevolution, but they differ widely respecting the mode in which itoccurred. 

THE PROCESS OF GENERATION. 

The vital _principle_, represented in the _sperm_-cell by aspermatozoön, must be imparted to a _germ_-cell in order to effectimpregnation. After touching each other, separate them immediately, andobserve the result. If, with the aid of a powerful lens, we directlyexamine the spermatozoön, it will be perceived that, for a short time, it preserves its dimensions and retains all its material aspects. But itdoes not long withstand the siege of decay, and, having fulfilled itsdestiny, loses its organic characteristics, and begins to shrink. 

If we examine the fertilized germ, we discover unusual activity, theresult of impregnation. Organic processes succeed one another withwonderful 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 contactwith a germ that fecundation may follow. If a spermatic cell, orspermatozoön, together with several unimpregnated ova, no matter hownear to one another, if not actually touching, be placed on the concavesurface of a watch-crystal, and covered with another crystal, keepingthem warm, and even though the vapor of the ova envelops it, noimpregnation will occur. Place the spermatozoön in contact with an ovum, and impregnation is instantly and perfectly accomplished. Should thisvitalizing power be termed nerve-force, electricity, heat, or motion? Itis known that these forces may be metamorphosed; for instance, nervousforce may be converted into electricity, electricity into heat, and heatinto motion, thus illustrating their affiliation and capability oftransformation. But nothing is explained respecting the real nature ofthe 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 theadult individuals of both sexes, or in their development, but, tocomplete this series, supplementary individuals, as it were, of one orof several preceding generations, are required. The son may not resemblethe father, but the grandfather, and in some instances, the likenessre-appears only in latter generations. Agassiz states: "Alternategeneration was first observed among the Salpae. These are marinemollusks, without shells, belonging to the family Tunicata. They aredistinguished by the curious peculiarity of being united together inconsiderable 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 isdeveloped in the body of the parent, and from which is hatched a littlemollusk. 

"Fig. 3, which remains solitary, and differs in many respects from theparent. This little animal, on the other hand, does not produce eggs, but propagates, by a kind of budding, which gives rise to chains alreadyseen in the body of their parent(a), and these again bring forthsolitary individuals, etc. "

It therefore follows that generation in some animals require? twodifferent bodies with intermediate ones, by means of which and theirdifferent modes of reproduction, a return to the original stock iseffected. 

UNIVERSALITY OF ANIMALCULAR LIFE. --Living organisms are universallydiffused over every part of the globe. The gentle zephyr wafts fromflower to flower invisible, fructifying atoms, which quicken beauty andfragrance, giving the promise of a golden fruitage, to gladden andnourish a dependent world. Nature's own sweet cunning invests all livingthings constraining into her service chemical affinities, arranging theelements and disposing them for her own benefit, in such numberless waysthat we involuntarily exclaim, "The course of Nature is the art of God. "

The microscope reveals the fact that matter measuring only 1/120000 ofan inch diameter may be endowed with vitality, and that countlessnumbers of animalcules often inhabit a single drop of stagnant water. These monads do not vary in form, whether in motion or at rest. The lifeof one, even, is an inexplicable mystery to the philosopher. Ehrenbergwrites: "Not only in the polar regions is there an uninterrupteddevelopment of active microscopic life, where larger animals cannotexist, but we find that those minute beings collected in the Antarcticexpedition of Captain James Ross exhibit a remarkable abundance ofunknown, and often most beautiful forms. "

Even the interior of animal bodies is inhabited by animalcules. Theyhave been found in the blood of the frog and the salmon, and in theoptic fluid of fishes. Organic beings are found in the interior of theearth, into which the industry of the miner has made extensiveexcavations, sunk deep shafts, and thus revealed their forms; likewise, the smallest fossil organisms form subterranean strata many fathomsdeep. Not only do lakes and inland seas abound with life, but also, fromunknown depths, in volcanic districts, arise thermal springs whichcontain living insects. Were we endowed with a microscopic eye, we mightsee myriads of ethereal voyagers wafted by on every breeze, as we nowbehold drifting clouds of aqueous vapor. While the continents of earthfurnishes evidences of the universality of organic beings, recentobservations prove that "animal life predominates amid the eternal nightof the depths of the liquid ocean. "

THE ORIGIN OF LIFE. 

The ancients, rude in many of their ideas, referred the origin of lifeto divine determination. The thought was crudely expressed, but wellrepresented, 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 dustof the ground, and then, by fire stolen from heaven, animated it with aliving soul. Spontaneous generation once held its sway, and now the ideaof natural evolution is popular. Some believe that the inpenetrablemystery of life is evolved from the endowments of nature, and buildtheir imperfect theory on observations of her concrete forms and theirmanifestations, to which all our investigations are restricted. Butevery function indicates purpose, every organism evinces intelligentdesign, and _all_ proclaim a Divine Power. Something cannot come out ofnothing. With reason and philosophy, _chance_ is an impossibility. We, therefore, accept the display of wisdom in nature as indicative of thedesigns of God. Thus "has He written His claims for our profoundestadmiration and homage all over every object that He has made. " If youask: Is there any advantage in considering the phenomena of nature asthe result of DIVINE VOLITION? we answer, that this belief correspondswith the universally acknowledged ideas of accountability; for, with awise, 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 naturevicegerent forces. Is it not preferable to say that she responds tointelligent, loving Omnipotence? Our finiteness is illustrated by ourinitiation into organized being. Emerging from a rayless atom, toodiminutive for the sight, we gradually develop and advance to thematurity of those _conscious powers_, the exercise of which furnishesindubitable evidence of our immortality. We are pervaded with invisibleinfluences, which, like the needle of the compass trembling on itspivot, point us to immortality as our ultimate goal, where in the sunnyclime of Love, even in a spiritual realm of joy and happiness, we mayeternally reign with Him who is all in all. 

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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 thispeculiarity of structure. The _bones_ of animals, as well as their fleshand fat, are composed of tissues, and all alike made up of cells. Whenviewed under a microscope, each cell is seen to consist of threedistinct parts, a _nucleolus_, or dark spot, in the center of the cell, around which lies a mass of granules, called the _nucleus;_ and this, inturn, is surrounded with a delicate, transparent membrane, termed the_envelope_. Each of the granules composing the nucleus assimilatesnourishment, thereby growing into an independent cell, which possesses atriple organization similar to that of its parent, and in like mannerreproduces other cells. 

[Illustration: Fig. 4. Nucleated cell. From Goeber. 1. Periphery of thecell, or cell-wall. 2. Nucleus. 3. Nucleolusin the center. ]

A variety of tissues enters into the composition of an animal structure, yet their differences are not always distinctly marked, since thecharacteristics 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 delicatefibers, spread over the body, and serves to bind the various organs andparts together. The fibrous and serous tissues are modifications of theareolar. 

The _Nervous Tissue_ is of two kinds: The gray, which is pulpy andgranulated, and the white fibrous tissue. The _Adipose Tissue_ is anextremely thin membrane, composed of closed cells which contain fat. Itis found principally just beneath the skin, giving it a smooth, plumpappearance. 

[Illustration: Fig. 5. Arrangement of fibers in theAreolar Tissue. Magnified 135 diameters. ]

The _Cartilaginous Tissue_ consists of nucleated cells, and, with theexception of bone, is the hardest part of the animal frame. The _OsseousTissue_, or bone, is more compact and solid than the cartilaginous, forit contains a greater quantity of lime. The _Muscular Tissue_ iscomposed of bundles of fibers, which are enclosed in a cellularmembrane. 

[Illustration: Fig. 6. Human Adipose Tissue. ]

Various opinions have been entertained in regard to the formation, orgrowth, of bone. Some anatomists have supposed that all bone is formedin cartilage. But this is not true, for there is an _intra-membranous_, as well as an _intra-cartilaginous_, formation of bone, as may be seenin the development of the cranial bones, where the gradual calcificationtakes place upon the inner layers of the fibrous coverings. Intra-cartilaginous deposit is found in the vicinity of theblood-vessels, within the cartilaginous canals; also, there are certainpoints first observed in the shafts of long bones, called _centers ofossification_. These points are no sooner formed than the cartilagecorpuscles arrange themselves in concentric zones, and, lying in contactwith one another, become very compact. As ossification proceeds, thecup-shaped cavities are converted into closed interstices of bone, withextremely thin lamellæ, or layers. These, however, soon increase indensity, and no blood-vessels can be observed within them. 

[Illustration: Fig. 7. Vertical section of cartilage near the surface ofossification. _1_. Ordinary appearance of the temporarycartilage. _1_'. Portion of the same morehighly magnified. _2_. The cells beginning to forminto concentric zones. _2_'. Portion more magnified. _3_. The ossification is extending in the inter-cellularspaces, and the rows of cells are seenresting in the cavities so formed, the nuclei beingmore separated than above. _3_'. Portion of thesame more highly magnified. ]

[Illustration: Fig. 8. Thigh-bone, sawn openlengthwise. ]

[Illustration: Fig. 9. Lower end of the thigh-bonesawn across, showing its centralcavity. ]

The bony plates form the boundaries of the _Haversian_, or nutritivecanals of the bones. In the _second stage of ossification_, thecartilage corpuscles are converted into bone. Becoming flattened againstthe osseous lamellæ already formed, they crowd upon one another so as toentirely obliterate the lines that distinguish them; and, simultaneouslywith these changes, a calcareous deposit takes place upon theirinterior. Bones grow by additions to their ends and surfaces. In thechild, their extremities are separated from the body of the bone bylayer of cartilage, and the cancellated, or cellular structure, whichremains for a time in the interior, represents the early condition ofthe ossifying substances. 

The bones contain more earthy matter in their composition than any otherpart of the human body, being firm, hard, and of a lime color. Theycompose the skeleton or frame work, and, when united by naturalligaments, form what is known as the _natural_ skeleton; when they arewired together, they are called an _artificial_ skeleton. The number ofbones in the human body is variously estimated; for those regarded assingle by some anatomists are considered by others to consist of severaldistinct pieces. There are two hundred distinct bones in the humanskeleton 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, onlyhalf 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-shapedbone, is seen. Another bone assisting to formthe skull, but not here seen, is called the _ethmoid_(sieve-like, from being full of holes), and is situatedbetween the sockets of the eyes, forming theroof of the nose. ]

THE BONES OF THE HEAD are classed as follows: eight belonging to theCranium, 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 _superiormaxillary, _ two _lachrymal_, two _malar_ two _palate_, two _inferiorturbinated, vomer_, and _inferior maxillary_. The cranial bones arecomposed of two dense plates, between which there is, in most places acancellated or cellular tissue. The external plate is fibrous, theinternal, compact and vitreous. The skull is nearly oval in form, convexexternally, the bone being much thicker at the base than elsewhere, andit is, in every respect admirably adapted to resist any injury to whichit may be exposed, thus affording ample protection to the brainsubstance which it envelops. The internal surface of the craniumpresents eminences and depressions for lodging the convolutions of thebrain, and numerous furrows for the ramifications of the blood-vessels. The bones of the cranium are united to one another by ragged edgescalled _sutures_, which are quite distinct in the child but which in oldage are nearly effaced. Some authorities suppose that by thisarrangement the cranium is less liable to be fractured by blows; othersthink that the sutures allow the growth of these bones, which takesplace 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, andserve for the attachment of powerful muscles which assist in the processof mastication. Although the soft parts of the face cover the bonystructure, yet they do not conceal its principal features, or materiallychange its proportions. The form of the head and face presents someremarkable 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_. Thefirst dorsal vertebra (a bone of the spinalcolumn). _5_. The last dorsal vertebra. _6_. The first rib. _7_. Its head. _8_. Its neck. _9_. Its tubercle. _10_. The seventh or last truerib. _11_. The cartilage of the third rib. _12. _The floating ribs. ]

[Illustration: Fig. 12. A vertebra of the neck. _1_. Thebody of the vertebra. _2_. The spinalcanal. _4_. The spinous processcleft at its extremity. _5_. Thetransverse process. _7_. The interiorarticular process. _8_. Thesuperior 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 theSpinal Column, the _Sacrum_, the _Coccyx_, and two _Ossa Innominata_. The _Os Hyoides_, situated at the base of the tongue, is the mostisolated bone of the skeleton, and serves for the attachment of muscles. The _Sternum_, or breast-bone, in a child is composed of six pieces, inthe adult of three, which in old age are consolidated into one bone. The_Ribs_ are thin, curved bones, being convex externally. There are twelveon each side, and all are attached to the spinal column. The seven upperribs, which are united in front of the sternum, are termed _true_ ribs;the next three, which are not attached to the sternum, but to oneanother are called _false_ ribs; and the last two, which are joined onlyto the vertebræ, are designated as _floating_ ribs. The first rib is theshortest, and they increase in length as far as the eighth, after whichthis order is reversed. 

[Illustration: Fig. 13. _1_. The cartilaginous substancewhich connects the bodies ofthe vertebræ. _2_. The body of thevertebra. _3_. The spinous process. _4, 4_. The transverse processes. _5, 5_. The articular processes. _6, 6_. A portion of the bony bridgewhich assists in forming the spinalcanal (7). ]

[Illustration: Fig. 14. Backbone, spinalcolumn, or vertebralcolumn. Allanimals possessingsuch a row of bonesare called _vertebrates_. Above _b_ arethe cervical (neck)vertebræ; _b_ to _c_, dorsal (back) orchest 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 aperpendicular appearance, but a side view shows four distinct curves. The bones composing it are called _vertebræ_. The body part of avertebra is light and spongy in texture, having seven projections called_processes_, four of which are the _articular_ processes, which furnishsurfaces to join the different vertebræ of the spinal column. Two arecalled _transverse_, and the remaining one is termed the _spinous_. Thetransverse and spinous processes serve for the attachment of the musclesbelonging to the back. All these processes are more compact than thebody of the vertebra, and, when naturally connected, are so arranged asto form a tube which contains the _medulla spinalis_, or spinal cord. Between the vertebræ is a highly-elastic, cartilaginous and cushion-likesubstance, which freely admits of motion, and allows the spine to bendas occasion requires. The natural curvatures of the spinal columndiminish the shock produced by falling, running or leaping, which wouldotherwise be more directly transmitted to the brain. The ribs at thesides, the sternum in front, and the twelve dorsal bones of the spinalcolumn behind, bound the thoracic cavity, which contains the lungs, heart, and large blood-vessels. 

[Illustration: Fig. 15. A representation of the pelvic bones. _e_. Thelumbo-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 toform one bone. It is light and spongy in texture, and the upper surfacearticulates with the lowest vertebra, while it is united at its inferiormargin to the coccyx. The _Coccyx_ is the terminal bone of the spinalcolumn. In infancy it is cartilaginous and composed of several pieces, but in the adult these unite and form one bone. The _Innominata_, ornameless bones, during youth, consist of three separate pieces on eachside; but as age advances they coalesce and form one bone. A deepsocket, called the _acetabulum_, is found near their junction, whichserves for the reception of the head of the thigh-bone. 

[Illustration: Fig. 16. 1. Portions of the backbone. 2. Cranialbones. _4_. Breast-bone. _5_. Ribs. _7_. Collar-bone. _8_. Arm-bone (humerus). _9_. Shoulder-joint. _10, 11_. Bones of the fore-arm (ulna andradius). _12_. Elbow-joint. _13_. Wrist-joint. _14_. Bones of the hand. _15, 16_. Pelvic bones. _17_. Hip-joint. _18_. Femur. _19, 20_. Bones of theknee-joint. _21, 22_. Fibula and tibia. _23_. Anklebone. _24_. Bones of the foot. ]

THE BONES OF THE UPPER EXTREMITIES are sixty-four in number, and areclassified as follows: The Scapula, Clavicle, Humerus, Ulna, Radius, Carpus, Metacarpus, and Phalanges. The _Scapula_, or shoulder-blade, isan irregular, thin, triangular bone, situated at the posterior part ofthe 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 formresembles that of the italic letter _f_, and it prevents the arms fromsliding 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 ofthe fore-arm. It is the longer and larger of the two bones, and in itsarticulation with the humerus, forms a perfect hinge-joint. The_Radius_, so called from its resemblance to a spoke, is on the outerside of the fore-arm, and articulates with the bones of the wrist, forming a joint. The ulna and radius also articulate with each other attheir extremities. The _Carpus_, or wrist, consists of eight bones, arranged in two rows. The _Metacarpus_, or palm of the hand, is composedof five bones situated between the carpus and fingers. The _Phalanges_, fourteen in number, are the bones of the fingers and thumb, the fingerseach having three and the thumb two. 

THE BONES OF THE LOWER EXTREMITIES, sixty in number, are classed asfollows: The Femur, Patella, Tibia, Fibula, Tarsus, Metatarsus, andPhalanges. The _Femur_, or thigh-bone, is the longest bone in the body. It has a large round head, which is received into the acetabulum, thusaffording a good illustration of a ball and socket joint. The _Patella, _or knee-pan, is the most complicated articulation of the body. It is ofa round form, connects with the tibia by means of a strong ligament, andserves to protect the front of the joint, and to increase the leverageof the muscles attached to it, by causing them to act at a greaterangle. The _Tibia_, or shin bone, is enlarged at each extremity andarticulates with the femur above and the astragalus, the upper bone ofthe tarsus, below. The _Fibula_, the small bone of the leg, is situatedon the outer side of the tibia, and is firmly bound to it at eachextremity. The _Tarsus_, or instep, is composed of seven bones, andcorresponds to the carpus of the upper extremities. The _Metatarsus_, the middle of the foot, bears a dose resemblance to the metacarpus, andconsists of five bones situated between the tarsus and the phalanges. The tarsal and the metatarsal bones are so united as to give an archedappearance to the foot, thus imparting elasticity. The _Phalanges_, thetoes, consist of fourteen bones, arranged in a manner similar to that ofthe fingers. 

We are not less interested in tracing the formation of bone through itsseveral stages, than in considering other parts of the human system. Theformation of the Haversian canals for the passage of blood-vessels tonourish the bones, the earlier construction of bony tissue by ametamorphosis of cartilaginous substance, and also the commencement ofossification at distinct points, called _centers of ossification_, areall important subjects, requiring the student's careful attention. Thebones are protected by an external membranous envelope, which, from itssituation is called the _periosteum_. The bones are divided into fourclasses, _long, short, flat_ and _irregular_, being thus adapted tosubserve a variety of purposes. 

The Long Bones are found in the limbs, where they act as levers tosustain the body and aid in locomotion. Each_long_ bone is composed of acylinder, known as the _shaft_, and two _extremities_. The shaft ishollow, its wails being _thickest_ in THE middle and growing thinnertoward the extremities. The _extremities_ are usually considerablyenlarged, for convenience of connection with other bones, and to afforda 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 ofthe skeleton is limited, the individual bones are short and compressed, as the bones of the carpus and tarsus. The structure of these bones isspongy, except at the surface, where there is a thin crust of compactmatter. 

[Illustration: Fig. 17. Anatomy of a joint, _1, 1_. Bones of a joint. _2, 2_. Cartilage. _3, 3, 3, 3_. Synovialmembrane. ]

[Illustration: Fig. 18. Anatomy of knee joint. _1. _ Lower end of thigh-bone. _3. _ Knee-pan. _2, 4_ Ligamentsof the knee-pan. _5_. Upperend of the tibia, or shin-bone. _6, 12_. Cartilages. ]

When protection is required for the organs of the body, or a broad flatsurface for the attachment of the muscles, the bones are expanded intoplates, as in the cranium and shoulder-blades. 

The _irregular_ or _mixed_ bones are those which, from their peculiarshape, cannot be classed among any of the foregoing divisions. Theirstructure is similar to the others, consisting of cancellar tissue, surrounded by a crust of compact matter. 

The vertebræ, sacrum, coccyx, temporal, sphenoid, ethmoid, malar, twomaxillary, palate, inferior turbinated, and hyoid are known as irregularbones. 

The formation of the joints requires not only bones, but alsocartilages, ligaments, and the synovial membrane, to complete thearticulation. _Cartilage_ is a smooth, elastic substance, softer thanbone, and invested with a thin membrane, called _perichondrium_. Whencartilage is placed upon convex surfaces, the reverse is true. The_Ligaments_ are white, inelastic, tendinous substances, softer thancartilage, but harder than membrane. Their function is to bind togetherthe bones. The _Synovial Membrane_ covers the cartilages, and is thenreflected upon the ligaments, thus forming a thin, closed sac, calledthe _synovial capsule. _

All the synovial membranes secrete a lubricating fluid, termed_synovia_, which enables the surfaces of the bones and ligaments to movefreely upon one another. When this fluid is secreted in excessivequantities, it produces a disease known as "dropsy of the joints. " Thereare 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 intwo directions only, as the elbows, while others do not admit of anymovement. The bones, ligaments, cartilages, and synovial membrane, aresupplied with nerves, arteries, and veins. 

When an animal is provided with an internal bony structure, it indicatesa high rank in the scale of organization. An elaborate texture of boneis found in no class below the vertebrates. Even in the lower order ofthis 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 inall classes below that of the cartilaginous fishes, the inflexiblesubstance which sustains the soft parts is either shell or somemodification of bone, and is usually found on the outside of the body. True bone, on the contrary, is found in the interior, and, therefore, inhigher animals, the skeleton is always internal, while the soft partsare placed external to the bony frame. While many animals of the lowestspecies, being composed of soft gelatinous matter, are buoyant in water, the highest type of animals requires not only a bony skeleton, but alsoa flexible, muscular system, for locomotion in the water or upon theland. Each species of the animal kingdom is thus organically adapted toits condition and sphere of life. 

 * * * * *

CHAPTER III. 

PHYSIOLOGICAL ANATOMY. 

THE MUSCLES. 

[Illustration: Fig. 19. Muscular fillers highlymagnified. ]

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 insize, of a reddish color, and inclosed in a cellular, membranous sheath. Each _fasciculus_ contains a number of small fibers, which, whensubjected to a microscopic examination, are found to consist of_fibrillae_, or little fibers; each of these fibrillae in turn beinginvested with a delicate sheath. The fibers terminate in a glistening, white _tendon_, or hard cord, which is attached to the bone. So firmlyare they united, that the bone will break before the tendon can bereleased. When the tendon is spread out, so as to resemble a membrane, it is called _fascia_. Being of various extent and thickness, it isdistributed over the body, as a covering and protection for the moredelicate parts, and aids also in motion, by firmly uniting the muscularfibers. The spaces between the muscles are frequently filled with fat, which gives roundness and beauty to the limbs. The muscles are ofvarious forms; some are longitudinal, each extremity terminating in atendon, 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 tendinousterminations. 2. Fan-shaped muscle. 3. Penniform muscle. 4. Bipenniformmuscle. ]

[Illustration: Fig. 21. Striped muscular fibre showing cleavage inopposite directions. 1. Longitudinal cleavage. 2. Transverse cleavage. 3. Transverse section ofdisc. 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_ isapplied to the more fixed or central attachment of a muscle, and theterm _insertion_ to the movable point to which the force of the muscleis directed; but the origin is not absolutely fixed, except in a smallnumber of muscles, as those of the face, which are attached at oneextremity to the bone, and at the other to the movable integument, orskin. In most instances, the muscles may act from either extremity. Themuscles are divided into the Voluntary, or muscles of animal life, andthe Involuntary, or muscles of organic life. There are, however, somemuscles which cannot properly be classified with either, termedIntermediate. The _Voluntary Muscles_ are chiefly controlled by thewill, relaxing and contracting at its pleasure, as in the motion of theeyes, mouth, and limbs. The fibers are of a dark red color, and possessgreat strength. These fibers are parallel, seldom interlacing, butpresenting a striped or striated appearance; and a microscopicexamination of them shows that even the most minute consist of parallelfilaments marked by longitudinal and transverse _striae_, or minutechannels. The fibers are nearly the same length as the muscles to whichthey belong. Each muscular fiber is capable of contraction; it may actsingly, though usually it acts in unison with others. By a closeinspection, it has been found that fibers may be drawn apartlongitudinally, in which case they are termed _fibrillae_, or they maybe separated transversely, forming a series of discs. The _Sarcolemma_, or investing sheath of the muscles, appears to be formed even beforethere are any visible traces of the muscle itself. It is a transparentand delicate membrane, but very elastic. The _Involuntary Muscles_ areinfluenced by the sympathetic nervous system, and their action pertainsto the nutritive functions of the body. They differ from the voluntarymuscles in not being striated, having no tendons, and in the net-workarrangements of their fibers. The _Intermediate Muscles_ are composed ofstriated and unstriated fibers; they are, therefore, both voluntary andinvoluntary in their functions. The muscles employed in respiration areof this class, for we can breathe rapidly or slowly, and, for a shorttime, even suspend their action; but soon, however, the organic musclesassert their instinctive control, and respiration is resumed. 

[Illustration: Fig. 22. Unstriated muscular fiber; at _b_, in its naturalstate; at _a_, showing the nuclei after the action ofacetic acid. ]

[Illustration: Fig. 23. A view of the under side of the diaphragm. ]

THE DIAPHRAGM, or midriff, is the muscular division between the thoraxand the abdomen. It has been compared to an inverted basin, theconcavity of which is directed toward the abdomen. The muscles receivetheir nourishment from the numerous blood-vessels which penetrate theirtissues. The voluntary muscles are abundantly supplied with nerves, while the involuntary are not so numerously furnished. The color of themuscles is chiefly due to the blood which they contain. They vary insize according to their respective functions. For example, the functionsof the heart require large and powerful muscles, and those of the eye, small and delicate ones. There are between four hundred and sixty andfive hundred muscles in the human body. 

[Illustration: Fig. 24. A representation of the superficial layer of muscles on the anteriorportion of the body. ]

[Illustration: Fig. 25. A representation of the superficial layer of muscles on the posteriorportion of the body. ]

Very rarely is motion produced by the action of a single muscle, but bythe harmonious action of several. There is infinite variety in thearrangement of the muscles, each being adapted to its purpose, instrength, tenacity, or elasticity. While some involuntarily respond tothe wants of organic life, others obey, with mechanical precision, theedicts of the will. The peculiar characteristic of the muscles is theircontractility; for example, when the tip of the finger is placed in theear, an incessant vibration, due to the contraction of the muscles ofthe ear, can be heard. When the muscles contract, they become shorter;but what is lost in length is gained in breadth and thickness, so thattheir actual volume remains the same. Muscles alternately contract andrelax, and thus act upon the bones. The economy of muscular power thusdisplayed is truly remarkable. In easy and graceful walking, the forwardmotion of the limbs is not altogether due to the exercise of muscularpower, but partly to the force of gravity, and only a slight assistanceof the muscles is required to elevate the leg sufficiently to allow itto oscillate. 

Motion is a characteristic of living bodies. This is true, not only inanimals, but also in plants. The oyster, although not possessing thepower of locomotion, opens and closes its shell at pleasure. The coralinsect appears at the door of its cell, and retreats at will. All thevaried motions of animals are due to a peculiar property of the muscles, termed _contractility_. Although plants are influenced by externalagents, as light, heat, electricity, etc. , yet it is supposed that theymay move in response to inward impulses. The sensitive stamens of thebarberry, when touched at their base on the inner side, resent theintrusion, by making a sudden jerk forward. Venus's fly-trap, a plantfound in North Carolina, is remarkable for the sensitiveness of itsleaves; which close suddenly and capture insects which chance to alightupon them. The muscles of the articulates are situated within the solidframework, unlike the vertebrates, whose muscles are external to thebony skeleton. All animals have the power of motion, from the lowestradiate to the highest vertebrate, from the most repulsive polyp to thattype of organized life made in the very image of God. 

The muscles, then, subserve an endless variety of purposes. By their aidthe farmer employs his implements of husbandry, the mechanic deftlywields his tools, the artist plies his brush, while the fervid oratorgives utterance to thoughts glowing with heavenly emotions. It is bytheir agency that the sublimest spiritual conceptions can be brought tothe sphere of the senses, and the noblest, loftiest aims of to-day canbe made glorious realizations of the future. 

 * * * * *

CHAPTER IV. 

PHYSIOLOGICAL ANATOMY. 

THE DIGESTIVE ORGANS. 

_Digestion_ signifies the act of separating or distributing, hence itsapplication to the process by which food is made available for nutritivepurposes. The organs of digestion are the Mouth, Teeth, Tongue, SalivaryGlands, Pharynx, Esophagus, the Stomach and the Intestines, with theirglands, 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 ofthe lower jaw. _m_. Molar teeth. _b_. Bicuspids, _c_. Cuspids. _i_. Incisors. ]

The _Mouth_ is an irregular cavity, situated between the upper and thelower jaw, and contains the organs of mastication. It is bounded by thelips in front, by the cheeks at the sides, by the roof of the mouth andteeth of the upper jaw above, and behind and beneath by the teeth of thelower jaw, soft parts, and palate. The soft palate is a sort of pendulumattached only at one of its extremities, while the other involuntarilyopens and closes the passage from the mouth to the pharynx. The interiorof the mouth, as well as other portions of the alimentary canal, islined with a delicate tissue, called _mucous membrane_. 

The _Teeth_ are firmly inserted in the alveoli or sockets, of the upperand the lower jaw. The first set, twenty in number, are temporary, andappear during infancy. They are replaced by permanent teeth, of whichthere are sixteen in each jaw; four incisors, or front teeth, fourcuspids, or eye teeth, four bicuspids, or grinders, and four molars, orlarge grinders. Each tooth is divided into the crown, body, and root. The _crown_ is the grinding surface; the _body_, the part projectingfrom the jaw, is the seat of sensation and nutrition; the _root_ is thatportion of the tooth which is inserted in the alveolus. The teeth arecomposed of dentine, or ivory, and enamel. The ivory forms the greaterportion of the body and root, while the enamel covers the exposedsurface. The small white cords communicating with the teeth are thenerves. 

The _Tongue_ is a flat oval organ, the base of which is attached to theos hyoides, while the apex, the most sensitive part of the body, isfree. Its surface is covered with a membrane, which, at the sides andlower part, is continuous with the lining of the mouth. On the lowersurface of the tongue, this membrane is thin and smooth, but on theupper 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 theparotid 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 themouth. Their function is to secrete a fluid called _saliva_, which aidsin mastication. The largest of these glands, the _Parotid_, is situatedin front and below the ear; its structure, like that of all the salivaryglands, is cellular. The _Submaxillary_ gland is circular in form, andsituated midway between the angle of the lower jaw and the middle of thechin. The _Sublingual_ is a long flattened gland, and, as its nameindicates, is located below the tongue, which when elevated, disclosesthe saliva issuing from its porous openings. 

The _Pharynx_ is nearly four inches in length, formed of muscular andmembranous cells, and situated between the base of the cranium and theesophagus, in front of the spinal column. It is narrow at the upperpart, distended in the middle, contracting again at its junction withthe 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 runninglongitudinally, and an interior layer of transverse fibers; second, thecellular, which is interposed between the muscular and the mucous coat;third, the mucous membrane, or internal coat, which is continuous withthe mucous lining of the pharynx. 

[Illustration: Fig. 28. A representation of the interior of the stomach. _1_. The esophagus. _2_. Cardiac orifice opening intothe stomach. _6_. The middle or muscular coat. _7_. The interior or mucous coat. _10_. The beginningof the duodenum. _11_. The pyloric orifice. ]

The _Stomach_ is a musculo-membranous, conoidal sac, communicating withthe esophagus by means of the cardiac orifice (see Fig. 28). It issituated obliquely with reference to the body, its base lying at theleft side, while the apex is directed toward the right side. The stomachis between the liver and spleen, subjacent to the diaphragm, andcommunicates with the intestinal canal by the pyloric orifice. It hasthree coats. The peritoneal, or external coat is composed of compact, cellular tissue, woven into a thin, serous membrane, and assists inkeeping the stomach in place. The middle coat is formed of three layersof muscular fibers: in the first, the fibres run longitudinally; in thesecond, in a circular direction; and in the third, they are placedobliquely to the others. The interior, or mucous coat, lines this organ. The stomach has a soft, spongy appearance, and, when not distended, liesin folds. During life, it is ordinarily of a pinkish color. It isprovided with numerous small glands, which secrete the gastric fluidnecessary for the digestion of food. The lining membrane, when divestedof mucus, has a wrinkled appearance. The arteries, veins, andlymphatics, of the stomach are numerous. 

[Illustration: Fig. 29. Small and large intestines. _1, 1, 2, 2_. Small intestine. _3_. Its termination in thelarge 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 canalinto which the food is received after being partially digested, and inwhich the separation and absorption of the nutritive materials and theremoval of the residue take place. The coats of the intestines areanalogous to those of the stomach, and are, in fact, only extensions ofthem. For convenience of description, the intestines may be divided intothe _small_ and the _large_. The small intestine is from twenty totwenty-five feet in length, and consists of the Duodenum, Jejunum, andIleum. The _Duodenum_, so called because its length is equal to thebreadth of twelve fingers, is the first division of the small intestine. If the mucous membrane of the duodenum be examined, it will be foundthrown into numerous folds, which are called _valvulæ conniventes_, thechief function of which appears to be to retard the course of thealimentary matter, and afford a larger surface for the accommodation ofthe absorbent vessels. Numerous _villi_, minute thread-like projections, will be found scattered over the surface of these folds, set side byside, like the pile of velvet. Each _villus_ contains a net-work ofblood-vessels, and a lacteal tube, into which the ducts from the liverand pancreas open, and pour their secretions to assist in the conversionof the chyme into chyle. The _Jejunum_, so named because it is usuallyfound empty after death, is a continuation of the duodenum, and is thatportion of the alimentary canal in which the absorption of nutritivematter is chiefly effected. The _Ileum_, which signifies somethingrolled up, is the longest division of the small intestine. Althoughsomewhat thinner in texture than the jejunum, yet the difference isscarcely perceptible. The large intestine is about five feet in length, and is divided into the Caecum, Colon, and Rectum. The _Caecum_ is aboutthree inches in length. Between the large and the small intestine is avalve, which prevents the return of excrementitious matter that haspassed into the large intestine. There is attached to the cæcum anappendage about the size of a goose-quill, and three inches in length, termed the _appendix vermiformis_. The _Colon_ is that part of the largeintestine which extends from the cæcum to the rectum, and which isdivided into three parts, distinguished as the ascending, thetransverse, and the descending. 

[Illustration: Fig. 30. Villi of the small intestine greatlymagnified. ]

[Illustration: Fig. 31. A section of the Ileum, turned inside out, so as to show the appearance and arrangementof the villi on an extended surface. ]

The _Rectum_ is the terminus of the large intestine. The intestines areabundantly supplied with blood-vessels. The arteries of the smallintestine are from fifteen to twenty in number. The large intestine isfurnished with three arteries, called the _colic arteries_. The_ileo-colic artery_ sends branches to the lower part of the ileum, thehead of the colon, and the appendix vermiformis. The _right colicartery_ forms arches, from which branches are distributed to theascending colon. The _colica media_ separates into two branches, one ofwhich is sent to the right portion of the transverse colon, the other tothe left. In its course, the _superior hemorrhoidal artery_ divides intotwo branches, which enter the intestine from behind, and embrace it onall sides, almost to the anus. 

The _Thoracic Duct_ is the principal trunk of the absorbent system, andthe canal through which much of the chyle and lymph is conveyed to theblood. It begins by a convergence and union of the lymphatics on thelumbar vertebræ, in front of the spinal column, then passes upwardthrough the diaphragm to the lower part of the neck, thence curvesforward and downward, opening into the subclavian vein near its junctionwith 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_. Entranceof the thoracic duct into the leftsubclavian vein. _4_. Mesenteric glands, through which the lacteals pass to thethoracic 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 fourpounds in the adult, and is located chiefly on the right side, immediately below the diaphragm. It is a single organ, of a dark redcolor, its upper surface being convex, while the lower is concave. Ithas two large lobes, the right being nearly four times as large as theleft. The liver has two coats, the _serous_, which is a completeinvestment, with the exception of the diaphragmatic border, and thedepression for the gall-bladder, and which helps to suspend and retainthe organ in position; and the _fibrous_, which is the inner coat of theliver, and forms sheaths for the blood-vessels and excretory ducts. Theliver is abundantly supplied with arteries, veins, nerves, andlymphatics. Unlike the other glands of the human body, it receives twokinds of blood; the arterial for its nourishment, and the venous, fromwhich it secretes the bile. In the lower surface of the liver is lodgedthe gall-bladder, a membranous sac, or reservoir, for the bile. Thisfluid is not absolutely necessary to the digestion of food, since thisprocess is effected by other secretions, nor does bile exert any specialaction upon, starchy or oleaginous substances, when mixed with them at atemperature of 100° F. Experiments also show that in some animals thereis a constant flow of bile, even when no food has been taken, and thereis consequently no digestion to be performed. Since the bile is formedfrom the venous blood, and taken from the waste and disintegration ofanimal tissue, it would appear that it is chiefly an excrementitiousfluid. It does not seem to have accomplished its function whendischarged from the liver and poured into the intestine, for there itundergoes various alterations previous to re-absorption, produced by itscontact with the intestinal juices. Thus the bile, after beingtransformed in the intestines, re-enters the blood under a new form, andis carried to some other part of the system to perform its mission. 

The _Spleen_ is oval, smooth, convex on its external, and irregularlyconcave on its internal, surface. It is situated on the left side, incontact with the diaphragm and stomach. It is of a dark red color, slightly tinged with blue at its edges. Some physiologists affirm thatno organ receives a greater quantity of blood, according to its size, than the spleen. The structure of the spleen and that of the mesentericglands are similar, although the former is provided with a scanty supplyof lymphatic vessels, and the chyle does not pass through it, as throughthe mesenteric glands. The _Pancreas_ lies behind the stomach, andextends transversely across the spinal column to the right of thespleen. It is of a pale, pinkish color, and its secretion is analogousto that of the salivary glands; hence it has been called the _AbdominalSalivary Gland_. 

[Illustration: Fig. 34. Digestive organs. _3_. The tongue. _7_. Parotidgland. _8_. Sublingual gland. _5_. Esophagus. _9_. Stomach. _10_. Liver. _11_. Gall-bladder, _14_. Pancreas. _13, 13_. The duodenum. The small and large intestinesare represented below the stomach. ]

Digestion is effected in those cavities which we have described as partsof the alimentary canal. The food is first received into the mouth, where it is masticated by the teeth, and, after being mixed with mucusand saliva, is reduced to a mere pulp; it is then collected by thetongue, which, aided by the voluntary muscles of the throat, carries thefood backward into the pharynx, and, by the action of the involuntarymuscles of the pharynx and esophagus, is conveyed to the stomach. Herethe food is subjected to a peculiar, churning movement, by the alternaterelaxation and contraction of the fibers which compose the muscular wallof 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 tubesupon its inner surface is discharged a colorless fluid, called the_gastric juice_, which mingles with the food and dissolves it. When thefood is reduced to a liquid condition, it accumulates in the pyloricportion of the stomach. Some distinguished physiologists believe thatthe food is kept in a gentle, unceasing, but peculiar motion, called_peristaltic_, since the stomach contracts in successive circles. In thestomach the food is arranged in a methodical manner. The undigestedportion is detained in the upper, or cardiac extremity, near theentrance of the esophagus, by contraction of the circular fibers of themuscular coat. Here it is gradually dissolved, and then carried into thepyloric portion of the stomach. From this, then, it appears, that thedissolved and undissolved portions of food occupy different parts of thestomach. After the food has been dissolved by the gastric fluid, it isconverted into a homogeneous, semi-fluid mass, called _chyme_. Thissubstance passes from the stomach through the pyloric orifice into theduodenum, in which, by mixing with the bile and pancreatic fluid, itschemical properties are again modified, and it is then termed _chyle_, which has been found to be composed of three distinct parts, areddish-brown sediment at the bottom, a whey-colored fluid in themiddle, and a creamy film at the top. Chyle is different from chyme intwo respects: First, the alkali of the digestive fluids, poured into theduodenum, or upper part of the small intestine, neutralizes the acid ofthe chyme; secondly, both the bile and the pancreatic fluid seem toexert an influence over the fatty substances contained in the chyme, which assists the subdivision of these fats into minute particles. Whilethe chyle is propelled along the small intestine by the peristalticaction, the matter which it contains in solution is absorbed in theusual manner into the vessels of the villi by the process called_osmosis_. The fatty matters being subdivided into very minuteparticles, but not dissolved, and consequently incapable of being thusabsorbed by osmosis, pass bodily through the epithelial lining of theintestine into the commencement of the lacteal tubes in the villi. Thedigested substances, as they are thrust along the small intestines, gradually lose their albuminoid, fatty, and soluble starchy andsaccharine matters, and pass through the ileo-caecal valve into thecæcum and large intestine. An acid reaction takes place here, and theyacquire the usual fæcal smell and color, which increases as theyapproach the rectum. Some physiologists have supposed that a seconddigestion takes place in the upper portion of the large intestine. Thelacteals, filled with chyle, pass into the mesenteric glands with whichthey freely unite, and afterward enter the _receptaculum chyli_, whichis the commencement of the thoracic duct, a tube of the size of agoose-quill, which lies in front of the backbone. The lymphatics, thefunction of which is to secrete and elaborate lymph, also terminate inthe _receptaculum chyli_, or receptacle for the chyle. From thisreservoir the chyle and lymph flow into the thoracic duct, through whichthey are conveyed to the left subclavian vein, there to be mingled withvenous blood. The blood, chyle, and lymph, are then transmitted directlyto 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 theprocess by which every part of the body assimilates portions of theblood distributed to it. In return, the tissues yield a portion of thematerial which was once a component part of their organization. The bodyis constantly undergoing waste as well as repair. One of the mostinteresting facts in regard to the process of nutrition in animals andplants is, that all tissues originate in cells. In the higher types ofanimals, the blood is the source from which the cells derive theirconstituents. Although the alimentary canal is more or less complicatedin different classes of animals, yet there is no species, however low inthe 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 theinterior of the body. In some animals circulation is not distinct fromdigestion, in others respiration and digestion are performed by the sameorgans; but as we rise in the scale of animal life, digestion andcirculation are accomplished in separate cavities, and the functions ofnutrition 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 areselected and imbibed for the sustenance of the body. Absorption, likeall other functional processes, employs agents to effect its purposes, and the _villi_ of the small intestine, with their numberless projectingorgans, are specially employed to imbibe fluid substances; this they dowith a celerity commensurate to the importance and extent of theirduties. They are little vascular prominences of the mucous membrane, arising from the interior surface of the small intestine. Each villushas two sets of vessels. (1. ) The blood-vessels, which, by theirfrequent blending, form a complete net-work beneath the externalepithelium; 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 ofthe 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 verynumerous in the small intestine, and, passing between the laminae of themesentery, they terminate in the _receptaculum chyli_, or reservoir forthe chyle. The mesentery consists of a double layer of cellular andadipose tissue. It incloses the blood-vessels, lacteals, and nerves ofthe small intestine, together with its accessory glands. It is joined tothe posterior abdominal wall by a narrow _root_; anteriorly, it isattached to the whole length of the small intestine. The lacteals areknown as the absorbents of the intestinal walls, and after digestion isaccomplished, are found to contain a white, milky fluid, called _chyle_. The chyle does not represent the entire product of digestion, but onlythe fatty substances suspended in a serous fluid. 

Formerly, it was supposed that the lacteals were the only agentsemployed in absorption, but more recent investigations have shown thatthe blood-vessels participate equally in the process, and are frequentlythe more active and important of the two. Experiments upon livinganimals have proved that absorption of poisonous substances occurs, evenwhen all communication by way of the lacteals and lymphatics isobstructed, the passage by the blood-vessels alone remaining. Theabsorbent power which the blood-vessels of the alimentary canal possess, is not limited to alimentary substances, but through them, solublematters of almost every description are received into the circulation. 

The _Lymphatics_ are not less important organs in the process ofabsorption. Nearly every part of the body is permeated by a secondseries 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 theirconverging trunks arise. They are composed of minute tubes of delicatemembrane, and from their net-work arrangement they successively uniteand finally terminate in two main trunks, called the _great lymphaticveins_. The lymphatics, instead of commencing on the intestinal walls, as do the lacteals, are distributed through most of the vascular tissuesas well as the skin. The lymphatic circulation is not unlike that of theblood; its circulatory apparatus is, however, more delicate, and itsfunctions are not so well understood. 

[Illustration: Fig. 36. A general view of the Lymphatic System. ]

The _lymph_ which circulates through the lymphatic vessels is analkaline fluid composed of a plasma and corpuscles. It may be consideredas blood deprived of its red corpuscles and, diluted with water. Nothingvery definite is known respecting the functions of this fluid. A largeproportion of its constituents is derived from the blood, and the exactconnection of these substances to nutrition is not properly understood. Some excrementitious matters are supposed to be taken from the tissuesby the lymph and discharged into the blood, to be ultimately removedfrom the system. The lymph accordingly exerts an important function byremoving a portion of the decayed tissues from the body. 

[Illustration: Fig. 37. 1. A representation of a lymphaticvessel highly magnified. 2. Lymphaticvalves. 3. A lymphatic gland and its vessels. ]

In all animals which possess a lacteal system there is also a lymphaticsystem, the one being the complement of the other. The fact that lymphand chyle are both conveyed into the general current of circulation, leads to the inference that the lymph, as well as the chyle, aids in theprocess of nutrition. The body is continually undergoing change, andvital action implies waste of tissues, as well as their growth. Thoseorgans which are the instruments of motion, as the muscles, cannot beemployed without wear and waste of their component parts. Renovatedtissues must replace those which are worn out, and it is a part of thefunction of the absorbents to convey nutritive material into the generalcirculation. Researches in microscopical anatomy have shown that theskin contains multitudes of lymphatic vessels and that it is a powerfulabsorbent. 

Absorption is one of the earliest and most essential functions of animaland vegetables tissues. The simpler plants consist of only a few cells, all of which are employed in absorption; but in the flowering plantsthis function is performed by the roots. It is accomplished on the samegeneral principles in animals, yet it presents more modifications and agreater number of organs than in vegetables. While animals receive theirfood into a sac, or bag called the _stomach_, and are provided withabsorbent vessels such as nowhere exist in vegetables, plants plungetheir absorbent organs into the earth, whence they derive nourishingsubstances. In the lower order of animals, as in sponges, this functionis performed by contiguous cells, in a manner almost as elementary as inplants. In none of the invertebrate animals is there any _special_absorbent system. Internal absorption is classified by some authors asfollows: _interstitial_, _recrementitial_, and _excrementitial_; byothers as _accidental_, _venous_, and _cutaneous_. The general cutaneousand mucous surfaces exhale, as well as absorb; thus the skin, by meansof its sudoriferous glands, exhales moisture, and is at the same time asbefore stated, a powerful absorbent. The mucous surface of the lungs iscontinually throwing off carbonic acid and absorbing oxygen; and throughtheir surface poisons are sometimes taken into the blood. The continualwear and waste to which living tissues are subject, makes necessary theprovision of such a system of vessels for conveying away the worn-outmaterials and supplying the body with new. 

 * * * * *

CHAPTER VI. 

PHYSICAL AND VITAL PROPERTIES OF THE BLOOD. 

[Illustration: Fig. 38. Red corpuscles of human blood, representedat _a_, as they are seen whenrather _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-corpusclesinto red corpuscles of blood. _A_. A lymph, or whiteblood-corpuscle. _B_. The same in process of conversioninto a red corpuscle. _C_. A lymph-corpuscle with thecell-wall raised up around it by the action of water. _D_. A lymph-corpuscle, from which the granules havealmost disappeared. _E_. A lymph-corpuscle, acquiringcolor; a single granule, like a nucleus, remains. _F_. Ared corpuscle fully developed. ]

_Blood_ is the animal fluid by which the tissues of the body arenourished. This pre-eminently vital fluid permeates every organ, distributes nutritive material to every texture, is essentially modifiedby respiration, and, finally, is the source of every secretion andexcretion. Blood has four constituents: Fibrin, Albumen, Salts (whichelements, 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 moreabundant. They are circular in form and have a smooth exterior, and areon an average 1/3200 part of an inch in diameter, and are aboutone-fourth of that in thickness. Hence more than ten millions of themmay lie on a space an inch square. If spread out in thin layers andsubjected to transmitted light, they present a slightly yellowish color, but when crowded together and viewed by refracted light, exhibit a deepred color. These blood-corpuscles have been termed _discs_, and are not, as some have supposed, solid material, but are very nearly fluid. Thered corpuscles although subjected to continual movement, have a tendencyto approach one another, and when their flattened surfaces come incontact, so firmly do they adhere that they change their shape ratherthan submit to a separation. If separated, however, they return to theirusual form. The colorless corpuscles are larger than the red and differfrom them in being extremely irregular in their shape, and in theirtendency to adhere to a smooth surface, while the red corpuscles floatabout and tumble over one another. They are chiefly remarkable for theircontinual variation in form. The shape of the red corpuscles is onlyaltered by external influences, but the white are constantly undergoingalterations, the result of changes taking place within their ownsubstance. When diluted with water and placed under the microscope theyare found to consist of a spheroidal sac, containing a clear or granularfluid and a spheroidal vesicle, which is termed the _nucleus_. They havebeen regarded by some physiologists as identical with those of the lymphand chyle. Dr. Carpenter believes that the function of these cells is toconvert albumen into fibrin, by the simple process of cell-growth. It isgenerally believed that the red corpuscles are derived in some way fromthe colorless. It is supposed that the red corpuscle is merely thenucleus of a colorless corpuscle enlarged, flattened, colored andliberated by the bursting of the wall of its cell. When blood is takenfrom an artery and allowed to remain at rest, it separates into twoparts: a solid mass, called the clot, largely composed of fibrin; and afluid known as the _serum_, in which the clot is suspended. This processis termed _coagulation_. The serum, mostly composed of _albumen_, is atransparent, straw-colored fluid, having the odor and taste of blood. The whole quantity of blood in the body is estimated on an average to beabout one-ninth of its entire weight. The distinctions between thearterial and the venous blood are marked, since in the arterial systemthe blood is uniformly bright red, and in the venous of a very dark redcolor The blood-corpuscles contain both oxygen and carbonic acid insolution. When carbonic acid predominates, the blood is dark red; whenoxygen, scarlet. In the lungs, the corpuscles give up carbonic acid, andabsorb a fresh supply of oxygen, while in the general circulation theoxygen disappears in the process of tissue transformation, and isreplaced, in the venous blood, by carbonic acid. The nutritive portionsof food are converted into a homogeneous fluid, which pervades everypart of the body, is the basis of every tissue, and which is termed the_blood_. This varies in color and composition in different animals. Inthe polyp the nutritive fluid is known as _chyme_, in many mollusks, aswell as articulates, it is called _chyle_, but in vertebrates, it ismore highly organized and is called blood. In all the higher animaltypes it is of a red color, although redness is not one of its essentialqualities. Some tribes of animals possess true blood, which is not red;thus the blood of the insect is colorless and transparent; that of thereptile yellowish; in the fish the principle part is without color, butthe blood of the bird is deep red. The blood of the mammalia is of abright scarlet hue. The temperature of the blood varies in differentspecies, as well as in animals of the same species under differentphysiological conditions; for this reason, some animals are called_cold-blooded. _ Disease also modifies the temperature of the blood; thusin fevers it is generally increased, but in cholera greatly diminished. THE blood has been aptly termed the "vital fluid, " since there is aconstant flow from the heart to the tissues and organs of the body, anda continual return after it has circulated through these parts. Itspresence in every part of the body is one of the essential conditions ofanimal 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 thedigestive process, seen its transmission into the _vena cava_, and, finally, its conversion into blood, we shall now describe how it isdistributed to every part of the system. This is accomplished throughorgans 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 amembranous sac, called the _pericardium_, is the great force-pump of thesystem, the heart. This organ, to which all the arteries and veins ofthe body may be either directly or indirectly traced, is roughlyestimated to be equal in size to the closed fist of the individual towhom 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_, turneddownwards, forwards, and to the left side, and lying beneath a pointabout an inch to the right of, and below, the left nipple, or just belowthe fifth rib. Attached to the rest of the body only by the greatblood-vessels which issue from and enter it at its base, the heart isthe most mobile organ in the economy, being free to move in differentdirections. 

The heart is divided into two great cavities by a fixed partition, whichextends from the base to the apex of the organ, and which prevents anydirect communication between them. Each of these great cavities isfurther subdivided transversely by a movable partition, the cavity aboveeach transverse partition being called the _auricle_, and the cavitybelow, the _ventricle_, right or left, as the case may be. 

[Illustration: Fig. 40. General view of the heart and lungs, _t_. Trachea, orwindpipe, _a_. Aorta, _p_. Pulmonary artery, 1, 2. Branches of the pulmonary artery, one going to theright, 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 theleft, from the fact that the ventricles have more work to perform thanthe 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 outersurface of the heart is covered with the pericardium, which closelyadheres to the muscular substance. Inside, the cavities are lined with athin membrane, called the _endocardium_. At the junction between theauricles and ventricles, the apertures of communication between theircavities are strengthened by _fibrous rings_. Attached to these fibrousrings are the movable partitions or valves, between the auricles and theventricles, the one on the right side of the heart being called the_tricuspid valve_, and the one on the left side the _mitral valve. _ Anumber of fine, but strong, tendinous chords, called _chordætendineæ_, connect the edges and apices of these valves withcolumn-like elevations of the fleshy substance of the walls of theventricles, called _columnæ carneæ_. 

[Illustration: Fig. 41. 1. The descending vena cava. 2. The ascending vena cava. 3. Theright auricle. 4. The opening betweenthe right auricle and the rightventricle. 5. The right ventricle. 6. The tricuspid valves. 7. The pulmonaryartery. 8, 8. The branchesof the pulmonary artery which passto the right and the left lung. 9. Thesemilunar valves of the pulmonaryartery. 10. The septum between thetwo ventricles of the heart. 11, 11. The pulmonary veins. 12. The leftauricle. 13. The opening betweenthe left auricle and ventricle. 14. The left ventricle. 15. The mitralvalves. 16, 16. The aorta. 17. Thesemilunar valves of the aorta. ]

The valves are so arranged that they present no obstacle to the freeflow of blood from the auricles into the ventricles, but if any isforced the other way, it gets between the valve and the wall of theheart, and drives the valve backwards and upwards, thus forming atransverse partition between the auricle and ventricle, through which nofluid can pass. 

At the base of the heart are given off two large arteries, one on theright side, which conveys the blood to the lungs, called the _pulmonaryartery_, and one on the left side, which conveys the blood to the systemin general, called the _aorta_. At the junction of each of these greatvessels 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 alevel and meeting in the middle line, they entirely prevent the passageof any fluid which may be forced along the artery towards the heart, but, flapping back, they offer no obstruction to the free flow of bloodfrom the ventricles into the arteries. 

[Illustration: Fig. 42. A representation of the venous and arterialcirculation of the blood. ]

The _Arteries_, being always found empty after death, were supposed bythe ancients, who were ignorant of the circulation of the blood, to betubes containing air; hence their name, which is derived from a Greekword and signifies an _air-tube. _ Arteries are the cylindrical tubeswhich carry blood to every part of the system. All the arteries, exceptthe coronary which supply the substance of the heart, arise from the twomain trunks, the pulmonary artery and the aorta. They are of ayellowish-white color, and their inner surface is smooth. The arterieshave three coats. (1. ) The external coat, which is destitute of fat, andcomposed chiefly of cellular tissue, is very firm and elastic, and canreadily be dissected from the middle coat. (2. ) The middle, or fibrouscoat, is thicker than the external, and composed of yellowish fibers, its chief property is contractility. (3. ) The internal coat consists ofa colorless, thin, transparent membrane, yet so strong that it can, itis thought, better resist a powerful pressure than either of the others. Arteries are very elastic as well as extensible, and their chiefextensibility 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 tothe auricles of the heart. They are more numerous than the arteries, andoriginate from numerous capillary tubes, while the arteries are givenoff from main trunks. In some parts of the body, the veins correspond innumber to the arteries; while in others, there are two veins to everyartery. The veins commence by minute roots in the capillaries, which areeverywhere distributed through the body, and gradually increase in size, until they unite and become large trunks, conveying the dark blood tothe 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 internalcoat is serous, and analogous to that of those vessels. The veins belongto the three following classes: (1. ) The systemic veins, which bring theblood from different parts of the body and discharge it into the venacava, by means of which it is conveyed to the heart; (2), the pulmonaryveins, which bring the arterial, or bright red blood from the lungs andcarry it to the left auricle; (3), the veins of the portal system, whichoriginate in the capillaries of the abdominal organs, then converge intotrunks and enter the liver, to branch off again into divisions andsubdivisions of the minutest character. 

The _Capillaries_ form an extremely fine net-work, and are distributedto every part of the body. They vary in diameter from 1/3500 to 1/2000of an inch. They are so universally prevalent throughout the skin, thatthe puncture of a needle would wound a large number of them. Thesevessels receive the blood and bring it into intimate contact with thetissues, which take from it the principal part of its oxygen and otherelements, and give up to it carbonic acid and the other waste productsresulting from the transformation of the tissues, which are transmittedthrough the veins to the heart, and thence by the arteries to the lungsand various excretory organs. 

The blood from the system in general, except the lungs, is poured intothe right auricle by two large veins, called the superior and theinferior _vena cava_, ' and that returning from the lungs is poured intothe left auricle by the _pulmonary veins. _

During life the heart contracts rhythmically, the contractionscommencing at the base, in each auricle, and extending towards the apex. 

Now it follows, from the anatomical arrangement of this organ, that whenthe auricles contract, the blood contained in them is forced through theauriculo-ventricular openings into the ventricles; the contractions thenextending to the ventricles, in a wave-like manner, the great proportionof the blood, being prevented from re-entering the auricles by thetricuspid and mitral valves, is forced onward into the pulmonary arteryfrom the right ventricle, and into the aorta from the left ventricle. 

When the contents of the ventricles are suddenly forced into these greatblood-vessels, a shock is given to the entire mass of fluid which theycontain, 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 thechest, a movement is perceptible, and, if the hand be applied, theimpulse may be felt. This is known as the throbbing, or beating of theheart. 

If the ear is placed over the region of the heart, certain sounds areheard, which recur with great regularity. First is heard a comparativelylong, dull sound, then a short, sharp sound, then a pause, and then thelong, dull sound again. The first sound is caused mainly by thetricuspid and mitral valves, and the second is the result of suddenclosure of the semilunar valves. 

No language can adequately describe the beauty of the circulatorysystem. The constant vital flow through the larger vessels, and theincessant activity of those so minute that they are almostimperceptible, fully illustrate the perfectness of the mechanism of thehuman body, and the wisdom and goodness of Him who is its author. 

Experiments have shown that the small arteries may be directlyinfluenced through the nervous system, which regulates their caliber bycontrolling the state of contraction of their muscular walls. The effectof this influence of the nervous system enables it to control thecirculation over certain areas; and, notwithstanding the force of theheart and the state of the blood-vessels in general, to materiallymodify the circulation in different spots. Blushing, which is simply alocal modification of the circulation, is effected in this way. Someemotion takes possession of the mind, and the action of the nerves, which ordinarily keep up a moderate contraction of the muscular coats ofthe arteries, is lost, and the vessels relax and become distended witharterial blood, which is a warm and bright red fluid; thereupon aburning sensation is felt, and the skin grows red, the degree of theblush depending upon the intensity of the emotion. 

The pallor produced by fright and by extreme anxiety, is purely theresult of a local modification of the circulation, brought about by anover-stimulation of the nerves which supply the small arteries, causingthem to contract, and to thus cut off more or less completely the supplyof 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 theirair-cells. The _Trachea_ is a vertical tube situated between the lungsbelow, and a short quadrangular cavity above, called the _larynx_, whichis part of the windpipe, and used for the purpose of modulating thevoice in speaking or singing. In the adult, the trachea, in itsunextended state, is from four and one-half to five inches in length, about one inch in diameter, and, like the larynx, is more fullydeveloped in the male than in the female. It is a fibro-cartilaginousstructure, 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 thewindpipe to each lung. Upon entering the lungs, they divide andsubdivide 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. _ Thelarynx. _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, situatedwithin the chest, and filling the greater part of it, since the heart isthe 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 theheart. 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 thediaphragm, and its apex behind the collar-bone. The right lung is largerthough shorter, than the left, not extending so low, and has three_lobes_, formed by deep fissures, or longitudinal divisions, while theleft has but two lobes. Each lobe is also made up of numerous _lobules_, or small lobes, connected by cellular tissue, and these contain greatnumbers of cells. The lungs are abundantly supplied with blood-vessels, lymphatics, and nerves. The density of a lung depends upon the amount ofair 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 largersurface, and are therefore more buoyant. Each lung is invested, as faras its root, with a membrane, called the _pleura_, which is thencontinuously extended to the cavity of the chest, thus performing thedouble office of lining it, and constituting a partition between thelungs. The part of the membrane which forms this partition is termed the_mediastinum_. Inflammation of this membrane is called _pleurisy_. Thelungs are held in position by the root, which is formed by the pulmonaryarteries, veins, nerves, and the bronchial tubes. Respiration is thefunction by which the venous blood, conveyed to the lungs by thepulmonary artery, is converted into arterial blood. This is effected bythe elimination of carbonic acid, which is expired or exhaled from thelungs, and by the absorption of oxygen from the air which is taken intothe lungs, by the act of inspiration or inhalation. The act ofexpiration is performed chiefly by the elevation of the diaphragm andthe descent of the ribs, and inspiration is principally effected by thedescent of the diaphragm and the elevation of the ribs. 

[Illustration: Fig. 44. A representation of the heart and lungs. 4. Theheart. 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 venacava. 3. Inferior vena cava. ]

When the muscles of some portions of the air-passages are relaxed, apeculiar vibration follows, known as snoring. Coughing and sneezing aresudden and spasmodic expiratory efforts, and generally involuntary. Sighing is a prolonged deep inspiration, followed by a rapid, andgenerally audible expiration. It is remarkable that laughing andsobbing, although indicating opposite states of the mind, are producedin very nearly the same manner. In hiccough, the contraction is moresudden and spasmodic than in laughing or sobbing. The quantity of oxygenconsumed during sleep is estimated to be considerably less than thatconsumed during wakefulness. 

[Illustration: Fig. 45. View of the pulmonary circulation. ]

It is difficult to estimate the amount of air taken into the lungs ateach inspiration, as the quantity varies according to the condition, size, and expansibility of the chest, but in ordinary breathing it issupposed to be from twenty to thirty cubic inches. The consumption ofoxygen is greater when the temperature is low, and during digestion. Allthe respiratory movements, so far as they are independent of the will ofthe individual, are controlled by that part of the brain called the_medulla oblongata_. The respiratory, or breathing process, is notinstituted for the benefit of man alone, for we find it both in thelower order of animals and in plant life. Nature is very economical inthe arrangement of her plans, since the carbonic acid, which is uselessto man, is indispensable to the existence of plants, and the oxygen, rejected by them, is appropriated to his use. In the lower order ofanimals, the respiratory act is similar to that of the higher types, though not so complex; for there are no organs of respiration, as thelungs and gills are called. Thus, the higher the animal type, the morecomplex its organism. The effect of air upon the color of the blood isvery noticeable. If a quantity be drawn from the body, thus beingbrought into contact with the air, its color gradually changes to abrighter hue. There is a marked difference between the properties of thevenous and the arterial blood. 

The venous blood is carried, as we have previously described, to theright side of the heart and to the lungs, where it is converted intoarterial blood. It is now of uniform quality, ready to be distributedthroughout the body, and capable of sustaining life and nourishing thetissues. Man breathes by means of lungs; but who can understand theirwonderful mechanism, so perfect in all its parts? Though every organ issubservient to another, yet each has its own office to perform. Theminute air-cells are for the aeration of the blood; the larger bronchialtubes ramify the lungs, and suffuse them with air; the trachea serves asa passage for the air to and from the lungs, while at its upperextremity is the larynx, which has been fitly called the organ of thehuman voice. At its extremity we find a sort of shield, called the_epiglottis_, the office of which is supposed to be to prevent theintrusion of foreign bodies. 

 * * * * *

CHAPTER IX. 

PHYSIOLOGICAL ANATOMY

THE SKIN. 

Through digestion and respiration, the blood is continually suppliedwith material for its renewal; and, while the nutritive constituents ofthe food are retained to promote the growth of the body, those which areuseless or injurious are in various ways expelled. There are, perhaps, few parts of the body more actively concerned in this removal than theskin. 

[Illustration: Fig. 46: An idealview 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 consistsof two layers, termed the Cutis Vera, or true skin, and the Epidermis, or cuticle. The _Cutis Vera_ is composed of fibers similar to those ofthe cellular tissue. It consists of white and yellow fibers, which aremore densely woven near the surface than deeper in the structure; thewhite give strength, the yellow strength and elasticity combined. Thetrue skin may be divided into two layers, differing in theircharacteristics, and termed respectively the superficial or papillarylayer, and the deep or fibrous layer. Upon the external surface, arelittle conical prominences, known as _papillae_. The papillae areirregularly distributed over the body, in some parts being smaller andmore numerous than in others, as on the finger-ends, where their summitsare so intimately connected as to form a tolerably smooth surface. It isowing to their perfect development, that the finger-tips are adapted toreceive the most delicate impressions of touch. Although every part ofthe skin is sensitive, yet the papillae are extremely so, for they arethe principal means through which the impressions of objects arecommunicated. Each papilla not only contains a minute vein and artery, but it also incloses a loop of sensitive nerves. When the body isexposed to cold, these papillae can be more distinctly seen in the formof prominences, commonly known as "goose-pimples. "

[Illustration: Fig. 47. A section of the skin, showing its arteries andveins. A, A. Arterial branches. B, B. Capillariesin which the branches terminate. C. The venoustrunk into which the blood from the capillariesflows. ]

The internal, or fibrous layer of the skin, contains numerousdepressions, each of which furnishes a receptacle for fat. While theskin is supplied with a complete net-work of arteries, veins, andnerves, which make it sensitive to the slightest touch, it also containsnumerous lymphatic vessels, so minute that they are invisible to thenaked eye. 

Among the agents adapted for expelling the excretions from the system, few surpass the _Sudoriferous Glands_. These are minute organs whichwind in and out over the whole extent of the true skin, and secrete theperspiration. Though much of it passes off as insensible transpiration, yet it often accumulates in drops of sweat, during long-continuedexercise or exposure to a high temperature. The office of theperspiration is two-fold. It removes noxious matter from the system, anddiminishes animal heat, and thereby equalizes the temperature of thebody. It also renders the skin soft and pliable, thus better adapting itto the movements of the muscles. The _Sebaceous Glands_, which areplaced in the true skin, are less abundant where the sudoriferous glandsare most numerous, and _vice versa_. Here, as elsewhere, nature actswith systematic and intelligent design. The perspiratory glands aredistributed where they are most needed, --in the eyelids, serving aslubricators; in the ear passages, to produce the _cerumen_, or wax, which prevents the intrusion of small insects; and in the scalp, tosupply the hair with its natural pomatum. 

[Illustration: Fig. 48. A perspiratory gland, highlymagnified. 1, 1. The gland. 2, 2. Excretory ducts uniting to forma tube which tortuously perforatesthe cuticle at 3, and opensobliquely on its surface at 4. ]

[Illustration: Fig. 49. A representation of oil-tubes from the scalpand nose. ]

[Illustration: Fig. 50. Anatomy of the skin. 5, 5. Cutis vera (true skin). 4, 4. Nervous tissue. 3, 3. Sensitive layer in which areseen the nerves. 2, 2. The layer containing pigmentcells. 1, 1. Epidermis (cuticle). ]

The _Epidermis_, or _Cuticle_, so called because it is _placed upon theskin, _ is the outer layer of the skin. Since it is entirely destitute ofnerves and blood-vessels, it is not sensitive. Like the cutis vera, ithas two surfaces composed of layers. The internal, or _Rete Mucosum, _which is made up chiefly of pigment cells, is adapted to theirregularities of the cutis vera, and sends prolongations into all itsglandular follicles. The external surface, or epidermis proper, iselastic, destitute of coloring matter, and consists of mere hornyscales. As soon as dry, they are removed in the form of scurf, andreplaced by new ones from the cutis vera. These scales may be removed bya wet-sheet pack, or by friction. The cuticle is constantly undergoingrenewal. This layer serves to cover and protect the nervous tissue ofthe true skin beneath. We may here observe that the cuticle contains thepigment for coloring the skin. In dark races, as the negro, the cuticleis very thick and filled with black pigment. The radiation of animalheat is dependent upon the thickness and color of this cuticle. Thus, inthe dark races, the pigment cells are most numerous, and in proportionas the skin is dark or fair do we find these cells in greater or lesserabundance. The skin of the Albino is of pearly whiteness, devoid even ofthe pink or brown tint which that of the European always possesses. Thispeculiarity 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 simplyabsurd. The Esquimaux, who live in Greenland and the arctic regions ofAmerica, are remarkable for the darkness of their complexion. Humboldtremarks that the American tribes of the tropical regions have no darkerskin 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 thetransverse striae and jagged boundary, caused by the imbrications of the scalycortex. _B_. Longitudinal section of the shaft, showing the fibrous character ofthe medullary substance, and the arrangement of the pigmentary matter. _C_. Transverse sections, showing the distinction between the cortical and medullarysubstances, and the central collection of pigmentary matter, sometimes found inthe latter. Magnified 310 diameters. ]

_Hairs_ are horny appendages of the skin, and, with the exception of thehands, the soles of the feet, the backs of the fingers and toes, betweenthe last joint and the nail, and the upper eyelids, are distributed moreor less abundantly over every part of the surface of the body. Over thegreater part of the surface the hairs are very minute, and in someplaces are not actually apparent above the level of the skin; but thehair of the head, when permitted to reach its full growth, attains alength of from twenty inches to a yard, and, in rare instances, even sixfeet. A hair may be divided into a middle portion, or _shaft_, and twoextremities; a peripheral extremity, called the _point;_ and a centralextremity, inclosed within the hair sac, or follicle, termed the _root_. The root is somewhat greater in diameter than the shaft, and cylindricalin form, while its lower part expands into an oval mass, called the_bulb_. The shaft of the hair is not often perfectly cylindrical, but ismore or less flattened, which circumstance gives rise to waving andcurling hair; and, when the flattening is spiral in direction, thecurling will be very great. A hair is composed of three different layersof cell-tissues: a loose, cellulated substance, which occupies itscenter, and constitutes the _medulla_, or pith; the fibrous tissue, which incloses the medulla, and forms the chief bulk of the hair; and athin layer, which envelops this fibrous structure, and forms the smoothsurface of the hair. The medulla is absent in the downy hairs, but inthe coarser class it is always present, especially in white hair. Thecolor of hair is due partly to the granules and partly to aninter-granular substance, which occupies the interstices of the granulesand the fibers. The quantity of hair varies according to the proximityand condition of the follicles. The average number of hairs of the headmay be stated at 1, 000 in a superficial square inch; and, as the surfaceof the scalp has an area of about one hundred and twenty superficialsquare inches, the average number of hairs on the entire head is120, 000. The hair possesses great durability, as is evinced by itsendurance of chemical processes, and by its discovery, in the tombs ofmummies more than two thousand years old. The hair is remarkable for itselasticity and strength. Hair is found to differ materially from horn inits chemical composition. According to Vauquelin, its constituents areanimal matter, a greenish-black oil, a white, concrete oil, phosphate oflime, a trace of carbonate of lime, oxide of manganese, iron, sulphur, and silex. Red hair contains a reddish oil, a large proportion ofsulphur, and a small quantity of iron. White hair contains a white oil, and phosphate of magnesia. It has been supposed that hair grows afterdeath, but this theory was probably due to the lengthening of the hairby the absorption of moisture from the body or atmosphere. 

The _nails_ constitute another class of appendages of the skin. Theyconsist of thin plates of horny tissue, having a root, a body, and afree extremity. The root, as well as the lateral portion, is implantedin the skin, and has a thin margin which is received into a groove ofthe true skin. The under surface is furrowed, while the upper iscomparatively 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 processby which substances are separated from the blood, either for thereparation of the tissues or for excretion. In the animal kingdom thisprocess is less complicated than in vegetables. In the former it isreally 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: thecells, 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 secretoryorgans is a copious supply of blood, in which the nutritive materialsare abundant. The nervous system also influences the process ofsecretion to a great extent. Intense emotion will produce tears, and thesight of some favorite fruit will generally increase the flow of saliva. 

The process of secretion depends upon the anatomical and chemicalconstitution 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), Pancreaticjuice; (9), Bile; (10), Milk. 

PERSPIRATION is a watery fluid secreted in minute glands, which aresituated in every part of the skin, but are more numerous on theanterior surfaces of the body. Long thread-like tubes, only 1/100th ofan inch in diameter, lined with epithelium, penetrate the skin, andterminate in rounded coils, enveloped by a net-work of capillaries, which supply the secretory glands with blood. It is estimated by Krausethat the entire number of perspiratory glands is two million threehundred and eighty-one thousand two hundred and forty-eight, and thelength of each glandular coil being 1/16 of an inch, we may estimate thelength of tubing to be not less than two miles and a third. Thissecretion 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 alsofound in the perspiration. It is the acid which imparts to thissecretion its peculiar odor, and acid reaction. The process of itssecretion is continuous, but, like all bodily functions, it is subjectto influences which augment or retard its activity. If, as is usuallythe case when the body is in a state of repose, evaporation prevents itsappearance in the _liquid_ form, it is called _invisible_ or _insensibleperspiration_. When there is unusual muscular activity, it collects uponthe skin, and is known as _sensible perspiration_. This secretionperforms an important office in the animal economy, by maintaining theinternal 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 internaltemperature from falling below this standard. On the contrary, if thecirculation is quickened by muscular exertion, the warmer blood flowingfrom the internal organs into the capillaries, raises the temperature ofthe skin, secretion is augmented, the moisture exudes from the pores, and perceptible evaporation begins. A large portion of the animal heatis thrown off in this process, and the temperature of the skin isreduced. A very warm, dry atmosphere can be borne with impunity but ifmoisture is introduced, evaporation ceases, and the life of the animalis endangered. Persons have been known to remain in a temperature ofabout 300° Fahr. For some minutes without unpleasant effects. Threeconditions may be assigned as effective causes in retarding oraugmenting this cutaneous secretion, variations in the temperature ofthe atmosphere, muscular activity, and influences which affect thenerves. The emotions exert a remarkable influence upon the action of theperspiratory glands. Intense fear causes great drops of perspiration toaccumulate on the skin, while the salivary glands remain inactive. 

TEARS. The lachrymal glands are small lobular organs, situated at theouter 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 theeyelid, called winking, and then collected in the _puncta lachrymalia_and discharged into the nasal passage. This process is constant duringlife. The effect of its repression is seen in the dim appearance of theeye after death. Grief or excessive laughter usually excite these glandsuntil there is an overflow. 

SEBACEOUS MATTER. Three varieties of this secretion are found in thebody. A product of the sebaceous glands of the skin is found in thoseparts of the body which are covered with hairs; also, on the face andthe external surface of the organs of generation. The _sebaceous glands_consist of a group of flask-shaped cavities, opening into a commonexcretory duct. Their secretion serves to lubricate the hair and softenthe skin. The _ceruminous glands_ of the _external auditory meatus_, orouter opening of the ear, are long tubes terminating in a glandularcoil, within which is secreted the glutinous matter of the ear. Thissecretion serves the double purpose of moistening the outer surface ofthe membrana tympani, or ear-drum, and, by its strong odor, ofpreventing the intrusion of insects. The _Meibomian glands_ are arrangedin the form of clusters along the excretory duct, which opens justbehind the roots of the eyelashes. The oily nature of this secretionprevents the tears, when not stimulated by emotion, from overflowing thelachrymal canal. 

MUCUS. The mucous membranes are provided with minute glands whichsecrete a viscid, gelatinous matter, called _mucus_. The peculiar animalmatter which it contains is termed _mucosin_. These glands are mostnumerous in the Pharynx, Esophagus, Trachea, Bronchia, Vagina andUrethra. They consist of a group of secreting sacs, terminating at oneextremity in a closed tube, while the other opens into a common duct. The mucus varies in composition in different parts of the body; but inall, it contains a small portion of insoluble animal matter. Itsfunctions are threefold. It lubricates the membranes, prevents theirinjury, and facilitates the passage of food through the alimentarycanal. 

SALIVA. This term is given to the first of the digestive fluids, whichis 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 whitishprecipitate is formed. Examinations with the microscope show it to becomposed of minute, granular cells and oil globules, mingled withnumerous scales of epithelium. According to Bidder and Schmidt, thecomposition 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 thesecretions of the parotid, submaxillary and sublingual glands; another, which is not glutinous, is distinguished by the property of coagulatingwhen subjected to heat. The saliva is composed of four elementarysecretions, derived respectively, from the mucous follicles of themouth, and the parotid, the submaxillary, and the sublingual glands. Theprocess of its secretion is constant, but is greatly augmented by thecontact of food with the lining membrane. The saliva serves to moistenthe triturated food, facilitate its passage, and has the property ofconverting starch into sugar; but the latter quality is counteracted bythe action of the gastric juice of the stomach. 

GASTRIC JUICE. The minute tubes, or follicles, situated in the mucousmembrane of the stomach, secrete a colorless, acid liquid, termed thegastric juice. This fluid appears to consist of little more than water, containing a few saline matters in solution, and a small quantity offree hydrochloric acid, which gives it an acid reaction. In addition tothese, however, it contains a small quantity of a peculiar organicsubstance, termed _pepsin_, which in chemical composition, is verysimilar to ptyalin, although it is very different in its effects. Whenfood is introduced into the stomach, the peristaltic contractions ofthat organ roll it about, and mingle it with the gastric juice, whichdisintegrates the connective tissue, and converts the albuminousportions into the substance called chyme, which is about the consistencyof pea-soup, and which is readily absorbed through the animal membranesinto the blood of the delicate and numerous vessels of the stomach, whence it is conveyed to the portal vein and to the liver. The secretionof the gastric juice is influenced by nervous conditions. Excess of joyor grief effectually retard or even arrest its flow. 

INTESTINAL JUICE. In the small intestine, a secretion is found which istermed the _intestinal juice_. It is the product of two classes ofglands situated in the mucous membrane, and termed respectively, the_follicles of Lieberkuhn_ and the _glands of Brunner_. The formerconsist of numerous small tubes, lined with epithelium, which secrete byfar the greater portion of this fluid. The latter are clusters of roundfollicles opening into a common excretory duct. These sacs are composedof delicate, membranous tissue, having numerous nuclei on their walls. The difficulty of obtaining this juice for experiment is obvious, andtherefore its chemical composition and physical properties are notknown. The intestinal juice resembles the secretion of the mucousfollicles of the mouth, being colorless, vitreous in appearance, andhaving an alkaline reaction. 

PANCREATIC JUICE. This is a colorless fluid, secreted in a lobular glandwhich is situated behind the stomach, and runs transversely from thespleen across the vertebral column to the duodenum. The most importantconstituent 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 trunkcalled the portal vein, which enters the liver. This organ also receivesarterial blood from a vessel called the _hepatic artery_, which is givenoff from the aorta below the diaphragm. If the branches of the portalvein and hepatic artery be traced into the substance of the liver, theywill be found to accompany one another, and to subdivide, becomingsmaller and smaller. Finally, the portal vein and hepatic artery will befound to terminate in capillaries which permeate the smallestperceptible subdivisions of the liver substance, which are polygonalmasses of not more than one-tenth of an inch in diameter, called the_lobules_. Every lobule rests upon one of the ramifications of a greatvessel termed the _hepatic vein_, which empties into the inferior venacava. There is also a vessel termed the _hepatic duct_ leading from theliver, the minute subdivisions of which penetrate every portion of thesubstance of that organ. Connected with the hepatic duct, is the duct ofa large oval sac, called the _gall-bladder_. 

Each lobule of the liver is composed of minute cellular bodies known asthe _hepatic cells_. It is supposed that in these cells the blood isdeprived of certain materials which are converted into bile. Thissecretion is a glutinous fluid, varying in color from a dark goldenbrown to a bright yellow, has a specific gravity ranging from 1018 to1036, and a slightly alkaline reaction. When agitated, it has a frothyappearance. Physiologists have experienced much difficulty in studyingthe character of this secretion from the instability of its constituentswhen subjected to chemical examination. 

[Illustration: Fig. 52. Section of the Liver, showing theramifications of the portal vein. 1. Twigof portal vein. 2, 2', 2", 2"'. Interlobularvein. 3, 3', 3", Lobules. ]

_Biliverdin_ is an organic substance peculiar to the bile, which impartsto that secretion its color. When this constituent is re-absorbed by theblood and circulates through the tissues, the skin assumes a brightyellow hue, causing what is known as the jaundice. _Cholesterin_ is aninflammable crystallizable substance soluble in alcohol or ether. It isfound in the spleen and all the nervous tissues. It is highly probablethat it exists in the blood, in some state or combination, and assumes acrystalline form only when acted upon by other substances or elements. Two other constituents, more important than either of the above, arecollectively termed _biliary salts_. These elements were discovered in1848, by Strecker, who termed them _glycocholate_ and _taurocholate ofsoda_. Both are crystalline, resinous substances, and, althoughresembling each other in many respects, the chemist may distinguish themby their reaction, for both yield a precipitate if treated withsubacetate of lead, but only the glycocholate will give a precipitatewith acetate of lead. In testing for biliary substances, the mostsatisfactory method is the one proposed by Pettenkoffer. A solution ofcane-sugar, one part of sugar to four parts of water, is mixed with thesuspected substance. Dilute sulphuric acid is then added until a whiteprecipitate falls, which is re-dissolved in an excess of the acid. Onthe addition of more sulphuric acid, it becomes opalescent, and passesthrough the successive hues of scarlet, lake, and a rich purple. Carefulexperiments have proved that it is a _constant_ secretion; but its flowis mere abundant during digestion. During the passage through theintestines it disappears. It is not eliminated, and Pettenkoffer's testhas failed to detect its existence in the portal vein. These facts leadphysiologists to the conclusion, that it undergoes some transformationin the intestines and is re-absorbed. 

After digestion has been going on in the stomach for some time, thesemi-digested food, in the form of chyme, begins to pass through the_pyloric orifice_ of the stomach into the duodenum, or upper portion ofthe small intestine. Here it encounters the intestinal juice, pancreaticjuice, and the bile, the secretion of all of which is stimulated by thepresence of food in the alimentary tract. These fluids, mingling withthe chyme, give it an alkaline reaction, and convert it into chyle. Thetransformation of starch into sugar, which is almost, if not entirely, suspended while the food remains in the stomach, owing to the acidity ofthe chyme, is resumed in the duodenum, the acid of the chyme, beingneutralized by the alkaline secretions there encountered. 

Late researches have demonstrated that the pancreatic juice exerts apowerful effect on albuminous matters, not unlike that of the gastricjuice. 

Thus, it seems that while in the mouth only starchy, and while in thestomach only albuminous substances are digested, in the small intestineall kinds of food materials, starchy, albuminoid, fatty and mineral, areeither completely dissolved, or minutely subdivided, and so preparedthat they may be readily absorbed through the animal membranes into thevessels. 

MILK. The milk is a white, opaque fluid, secreted in the lacteal glandsof the female, in the mammalia. These glands consist of numerousfollicles, grouped around an excretory duct, which unites with similarducts coming from other lobules. By successive unions, they form largebranches, termed the _lactiferous ducts_, which open by ten to fourteenminute orifices on the extremity of the nipple. The most importantconstituent of milk is _casein_; it also contains oily and saccharinesubstances. This secretion, more than any other, as influenced bynervous conditions. A mother's bosom will fill with milk at the thoughtof her infant child. Milk is sometimes poisoned by a fit of ill-temper, and the infant made sick and occasionally thrown into convulsions, whichin some instances prove fatal. Sir Astley Cooper mentions two cases inwhich terror instantaneously and permanently arrested this secretion. Itis also affected by the food and drink. Malt liquors and other mildalcoholic 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 berecommended unless the mother is extremely debilitated, and there is adeficiency of milk. 

 * * * * *

CHAPTER XI. 

PHYSIOLOGICAL ANATOMY. 

EXCRETION. 

The products resulting from the waste of the tissues are constantlybeing poured into the blood, and, as we have seen, the blood beingeverywhere full of corpuscles, which, like all living things, die anddecay, the products of their decomposition accumulate in every part ofthe circulatory system. Hence, if the blood is to be kept pure, thewaste materials incessantly poured into this fluid, or generated in it, must be as continually removed, or excreted. The principal sets oforgans concerned in effecting the separation of excrementitioussubstances from the blood are the lungs, the skin, and the kidneys. 

The elimination of carbonic acid through the lungs has already beendescribed 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 theabdominal cavity, in the region of the loins, one on each side of thespine. The convex side of each kidney is directed outwards, and theconcave side is turned inwards towards the spine. From the middle of theconcave side, which is termed the _hilus_, a long tube of small caliber, called the _ureter_, proceeds to the bladder. The latter organ is anoval bag, situated in the pelvic cavity. It is composed principally ofelastic muscular fibers, and is lined internally with mucous membrane, and coated externally with a layer of the _peritoneum_, the serousmembrane which lines the abdominal and pelvic cavities. The uretersenter the bladder through its posterior and lower wall, at some littledistance from each other. The openings through which the ureters enterthe bladder are oblique, hence it is much easier for the secretion ofthe kidneys to pass from the ureters into the bladder than for it to getthe other way. Leading from the bladder to the exterior of the body is atube, called the _urethra_, through which the urine is voided. 

The excretion of the kidneys, termed the _urine_, is an amber-colored orstraw-colored fluid, naturally having a slightly acid reaction, and aspecific gravity ranging from 1, 015 to 1, 025. Its principal constituentsare _urea_ and _uric acid_, together with various other animal mattersof less importance, and saline substances, held in solution in aproportionately large amount of water. The composition of the urine andthe quantity excreted vary considerably, being influenced by themoisture and temperature of the atmosphere, by the character of the foodconsumed, and by the empty or replete condition of the alimentary tract. On an average a healthy man secretes about fifty ounces of urine in thetwenty-four hours. This quantity usually holds in solution about oneounce of urea, and ten or twelve grains of uric acid. In the amount ofother 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 andphosphates of potassium, sodium, calcium, and magnesium. In addition tothe animal and the saline matters, the urine also contains a smallquantity of carbonic acid, oxygen and nitrogen. 

 * * * * *

CHAPTER XII. 

PHYSIOLOGICAL ANATOMY. 

THE NERVOUS SYSTEM. 

Hitherto, we have only considered the anatomy and functions of theorgans employed in Digestion, Absorption, Circulation, Respiration, Secretion and Excretion. We have found the vital process of nutrition tobe, in all its essential features, a result of physical and chemicalforces; in each instance we have presupposed the existence and activityof the nerves. There is not an inch of bodily tissue into which theirdelicate 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 thecomposition of nervous tissue. Ordinary nerve-fibers in the livingsubject, or when fresh, are cylindrical-shaped filaments of a clear, butsomewhat oily appearance. But soon after death the matter contained inthe fiber coagulates, and then the fiber is seen to consist of anextremely delicate, structureless, outer membrane, which forms a tubethrough the center of which runs the _axis-cylinder_. Interposed betweenthe axis-cylinder and this tube, there is a fluid, containing aconsiderable quantity of fatty matter, from which is deposited a highlyrefracting substance which lines the tube. There are two sets ofnerve-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 aretermed nerve trunks. All the larger nerve-fibers lie side by side in thenerve-trunks, and are bound together by delicate connective tissue, enclosed in a sheath of the same material, termed the _neurilemma_. Thenerve-fibers in the trunks of the nerves remain perfectly distinct anddisconnected from one another, and seldom, or never, divide throughouttheir entire length. However, where the nerves enter the nerve-centers, and near their outer terminations, the nerve-fibres often divide intobranches, or at least gradually diminish in size, until, finally, theaxis-cylinder, and the sheath with its fluid contents, are no longerdistinguishable. The investing membrane is continuous from the origin tothe termination of the nerve-trunk. 

[Illustration: Fig. 55. Division of anerve, showing aportion of a nervoustrunk (_a_)and separation ofits filaments (_b, c, d, e_. )]

In the brain and spinal cord the nerve-fibers often terminate in minutemasses of a gray or ash-colored granular substance, termed _ganglia_, or_ganglionic corpuscles_. 

The ganglia are cellular corpuscles of irregular form, and possessfibrous appendages, which serve to connect them with one another. Theseganglia form the cortical covering of the brain, and are also found inthe interior of the spinal cord. According to Kölliker, the larger ofthese nerve-cells measure only 1/200 of an inch in diameter. The brainis chiefly composed of nervous ganglia. 

Nerves are classified with reference to their origin, as_cerebral_--those originating in the brain, and _spinal_--thoseoriginating in the spinal cord. 

There are two sets of nerves and nerve-centers, which are intimatelyconnected, but which can be more conveniently studied apart. These arethe _cerebro-spinal_ system, consisting of the cerebro-spinal axis, andthe cerebral and spinal nerves; and the _sympathetic_ system, consistingof the chain of sympathetic ganglia, the nerves which they give off, andthe nervous trunks which connect them with one another and with thecerebro-spinal nerves. 

THE CEREBRO-SPINAL SYSTEM. 

THE CEREBRO-SPINAL AXIS consists of the brain and spinal cord. It liesin the cavities of the cranium and the spinal column. These cavities arelined with a very tough fibrous membrane, termed the _dura mater_, whichserves as the periosteum of the bones which enter into the formation ofthese parts. The surface of the brain and spinal cord is closelyinvested with an extremely vascular, areolar tissue, called the _piamater_. The numerous blood-vessels which supply these organs traversethe pia mater for some distance, and, where they pass into the substanceof the brain or spinal cord, the fibrous tissue of this membraneaccompanies them to a greater or less depth. The inner surface of thedura mater and the outer surface of the pia mater are covered with anextremely thin, serous membrane, which is termed the _arachnoid_membrane. Thus, one layer of the arachnoid envelopes the brain andspinal cord, and the other lines the dura mater. As the layers becomecontinuous with each other at different points, the arachnoid, like thepericardium, forms a shut sac, and, like other serous membranes, itsecretes a fluid, known as the _arachnoid fluid_. The space between theinternal and the external layers of the arachnoid membrane of the brainis much smaller than that enclosed by the corresponding layers of thearachnoid membrane of the spinal column. 

[Illustration: Fig. 56. Cross-section of spinal cord. ]

THE SPINAL CORD is a column of soft, grayish-white substance, extendingfrom 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 afilament. From this nerve are distributed fibers and filaments to themuscles and integument of at least nine-tenths of the body. 

The spinal cord is divided in front through the middle nearly as far asits center, by a deep fissure, called the _anterior fissure_, andbehind, in a similar manner, by the posterior _fissure_. Each of thesefissures is lined with the pia mater, which also supports theblood-vessels which supply the spinal cord with blood. Consequently, thesubstance of the two halves of the cord is only connected by a narrowisthmus, 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 nearlyequal parts, which are termed the anterior, lateral, and posteriorcolumns, by the lines which join together two parallel series of bundlesof nervous filaments, which compose the roots of the spinal nerves. Theroots of those nerves, which are found along that line nearest theposterior surface of the cord, are termed the posterior roots; thosewhich spring from the other line are known as the anterior roots. 

Several of these anterior and posterior roots, situated at about thesame height on opposite sides of the spinal cord, converge and combineinto what are called the _anterior_ and _posterior bundles_; then twobundles, anterior and posterior, unite and form the trunk of a spinalnerve. 

The nerve trunks make their way out of the spinal canal throughapertures between the vertebra, called the _inter-vertebral foramina_and then divide into numerous branches, their ramifications extendingprincipally to the muscles and the skin. There are thirty-one pairs ofspinal nerves, eight of which are termed cervical, twelve dorsal, fivelumbar, and six sacral, with reference to that part of the cord fromwhich they originate. 

When the cord is divided into transverse sections, it is found that eachhalf is composed of two kinds of matter, a white substance on theoutside, and a grayish substance in the interior. The _gray matter_, asit is termed, lies in the form of an irregular crescent, with one endconsiderably larger than the other, and having the concave side turnedoutwards. The ends of the crescent are termed the _horns_, or _cornua_, the one pointing forward being called the _anterior cornu_, the otherone the _posterior cornu_. The convex sides of these cornua approacheach other and are united by the bridge, which contains the centralcanal. 

There is a marked difference in the structure of the gray and the whitematter. The white matter is composed entirely of nerve fibers, heldtogether by a framework of connective tissue. The gray matter contains agreat number of ganglionic corpuscles, or nerve-cells, in addition tothe nerve-fibers. 

When the nerve-trunks are irritated in any manner, whether by pinching, burning, or the application of electricity, all the muscles which aresupplied with branches from this nerve-trunk immediately contract, andpain is experienced, the severity of which depends upon the degree ofthe irritation; and the pain is attributed to that portion of the bodyto which the filaments of the nerve-trunk are distributed. Thus, personswho have lost limbs often complain in cold weather of an uneasiness orpain, which they locate in the fingers or toes of the limb which hasbeen amputated, and which is caused by the cold producing an irritationof the nerve-trunk, the filaments, or fibers of which, supplied thefingers or toes of the lost member. 

On the other hand, if the anterior bundle of nerve-fibers given off fromthe spinal cord is irritated in precisely the same way, only half ofthese effects is produced. All the muscles which are supplied withfibers from that trunk contract, but no pain is experienced. Conversely, if the posterior bundle of nerve-fibers is irritated, none of themuscles to which the filaments of the nerve are distributed contract, but pain is felt throughout the entire region to which these filamentsare extended. It is evident, from these facts, that the fibers composingthe posterior bundles of nerve-roots only transmit sensory impulses, andthe filaments composing the anterior nerve-roots only transmit motorimpulses; accordingly, they are termed respectively the _sensory_ andthe _motor_ nerve-roots. This is illustrated by the fact that when theposterior root of a spinal nerve is divided, all sensation in the partsto which the filaments of that nerve are distributed is lost, but thepower of voluntary movement of the muscles remains. On the other hand, if the anterior roots are severed, the power of voluntary motion of themuscles is lost, but sensation remains. 

It appears from these experiments, that, when a nerve is irritated, achange in the arrangement of its molecules takes place, which istransmitted along the nerve-fibers. But, if the nerve-trunks aredivided, or compressed tightly at any point between the portionirritated, and the muscle or nerve-centre, the effect ceasesimmediately, in a manner similar to that in which a message is stoppedby the cutting of a telegraph wire. When the nerves distributed to alimb are subjected to a pressure sufficient to destroy the molecularcontinuity of their filaments, it "goes to sleep, " as we term it. Thepower of transmitting sensory and motor impulses is lost, and onlyreturns gradually, as the molecular continuity is restored. 

From what has been said, it is plain that a sensory nerve is one whichconveys a sensory impulse from the peripheral or outer part of a nerveto the spinal cord or brain, and which is, therefore, termed _afferent_;and that a motor nerve is one which transmits an impulse from the nervecentre, or is _efferent_. So difference in structure, or in chemical orphysical composition, can be discerned between the afferent and the_efferent_ nerves. A certain period of time is required for thetransmission of all impulses. The speed with which an impulse travelshas been found to be comparatively slow, being even less than that ofsound, which is 1, 120 feet per second. 

The experiments heretofore related have been confined solely to thenerves. We may now proceed to the consideration of what takes place whenthe spinal cord is operated upon in a similar way. If the cord bedivided with a knife or other instrument, all parts of the body suppliedwith nerves given off below the division will become paralyzed andinsensible, while all parts of the body supplied with nerves from thespinal cord _above_ the division will retain their sensibility and powerof motion. If, however, only the posterior half of the spinal cord isdivided, or destroyed, there is loss of sensation alone; and, if theanterior portion is cut in two, and the continuity of the posterior partis left undisturbed, there is loss of voluntary motion of the lowerlimbs, but sensation remains. 

REFLEX ACTION OF THE SPINAL CORD. In relation to the brain, the spinalcord is a great mixed motor and sensory nerve, but, in addition to this, it is also a distinct nervous centre, in which originate and terminateall those involuntary impulses which exert so potent an influence in thepreservation and economy of the body. That peculiar power of the cord bywhich it is enabled to convert sensory into motor impulse is that whichdistinguishes 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 whichpossesses this power. This reflex action is a special function of thespinal cord, and serves as a monitor to, and regulator of the organs ofnutrition and circulation, by placing them, ordinarily, beyond thecontrol of conscious volition. 

[Illustration: Fig. 57. ]

If the foot of a decapitated frog is irritated, there is an instantcontraction of the corresponding limb; if the irritation is intense theother limb also contracts. These motions indicate the existence, in somepart of the spinal cord, of a distinct nerve-centre, capable ofconverting and reflecting impulses. It has been found by experiment, that the same movements will take place if the irritation be applied toany portion of the body to which the spinal nerves are distributed, thusgiving undoubted evidence that the spinal cord in its entirety iscapable of causing these reflections. Fig. 57 represents the course ofthe nervous impulses. The sensory impulse passes upward along theposterior root, _a_, until it reaches the imbedded gray matter, _b_, ofthe cord, by which it is reflected, as a motor impulse, downward alongthe anterior root, _c_, to the muscles whence the sensation wasreceived. This is the reflex action of the spinal cord. There is noconsciousness or sensation connected with this action, and the removalof the brain and the sympathetic system does not diminish its activity. Even after death it continues for some time, longer in cold-blooded thanin warm-blooded animals, on account of the difference in temperature, thus showing this property of the spinal cord. By disease, or the use ofcertain poisons, this activity may be greatly augmented, as isfrequently observed in the human subject. A sudden contact with adifferent atmosphere may induce these movements. The contraction of themuscles, or cramp, often experienced by all persons, in stepping into acold bath, or emerging from the cozy sitting-room into a chilly Decembertemperature, are familiar illustrations of reflex movements. It has beendemonstrated that the irritability of the nerves may be impaired ordestroyed, while that of the muscles to which they are distributedremains unchanged; and that the motor and sensory classes of filamentsmay be paralyzed independently of each other. 

The reflex actions of the spinal cord have been admirably summed up byDr. Dalton, as exerting a general, protective influence over the body, presiding over the involuntary action of the limbs and trunk, regulatingthe action of the sphincters, rectum, and bladder, and, at the sametime, exercising an indirect influence upon the nutritive changes in allparts 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 iscontinuous with it below, and the brain above. It has distinct functionswhich are employed in the preservation and continuance of life. It hasbeen termed the "vital knot, " owing to the fact that the brain may beremoved and the cord injured and still the heart and lungs will continueto perform their functions, until the medulla oblongata is destroyed. 

The arrangement of the white and gray matter of the medulla oblongata issimilar to that of the spinal cord; that is to say, the white matter isexternal and the gray internal; whereas in the cerebellum and cerebrumthis order is reversed. The fibres of the spinal cord, before enteringthis portion of the brain, decussate, those from the right side crossingto the left, and those from the left crossing to the right side. By someauthors this crossing of the sensory and motor filaments has beensupposed to take place near the medulla oblongata. Dr. Brown-Sequardshows, however, that it takes place at every part of the spinal cord. The medulla oblongata is traversed by a longitudinal fissure, continuouswith that of the spinal cord. Each of the lateral columns thus formedare subdivided into sections, termed respectively the _CorporaPyramidalia_, the _Corpora Olivaria_, the _Corpora Restiformia_ and the_Posterior Pyramids_. 

The _Corpora Pyramidalia_ (see 1, 1, Fig. 58) are two small medullaryeminences or cords, situated at the posterior surface of the medullaoblongata; 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 thesebodies are considered as the nuclei, or vital points, of the medullaoblongata. 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 posteriorrounded projections of whitish medulla, which pass upward to thecerebellum and form the _crura cerebelli_, so called because theyresemble a leg. The filaments of the pneumogastric nerve originate inthe ganglia of these parts. 

The _Posterior Pyramids_ are much smaller than the other columns of themedulla oblongata. They are situated (4, 4, Fig. 59) upon the margin ofthe posterior fissures in contact with each other. 

The functions of the medulla oblongata, which begin with the earliestmanifestations of life, are of an instinctive character. If thecerebellum and cerebrum of a dove be removed, the bird will make noeffort 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 inrespiration the lungs continue to act after the intercostal muscles areparalyzed; 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 chamberof the skull, beneath the _tentorium_, a tent-like process of the duramater which separates it from the cerebrum. It is convex, with atransverse diameter of between three and one-half and four inches, andis little more than two inches in thickness. It is divided on its upperand lower surfaces into two lateral hemispheres, by the superior andinferior vermiform processes, and behind by deep notches. The cerebellumis composed of gray and white matter, the former being darker than thatof the cerebrum. From the beautiful arrangement of tissue, this organhas been termed the _arbor vitae_. 

The _peduncles of the cerebellum_, the means by which it communicateswith the other portions of the brain, are divided into three pairs, designated as the _superior_, _middle_ and _inferior_. The first passupward and forward until they are blended with the tubercles of the_corpora quadrigemina_. The second are the _crura cerebelli_, whichunite 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 thatharmony or associative power which co-ordinates all voluntary movements, and effects that delicate adjustment of cause to effect, displayed inmuscular action. This fact may be proved by removing the cerebellum of abird and observing the results, which are an uncertainty in all itsmovements, and difficulty in standing, walking, or flying, the birdbeing unable to direct its course. In the animal kingdom we find anapparent correspondence between the size of the cerebellum and thevariety and extent of the movements of the animal. Instances are cited, however, in which no such proportion exists, and so the matter is opento controversy. The general function of the cerebellum, therefore, cannot be explained, but the latest experiments in physiological andanatomical science seem to favor the theory that it is in some wayconnected with the harmony of the movements. This co-ordination, bywhich the adjustment of voluntary motion is supposed to be effected, isnot in reality a _faculty_ having its seat in the brain substance, butis the harmonious action of many forces through the cerebellum. 

The _Cerebrum_ occupies five times the space of all the other portionsof the brain together. It is of an ovoid form, and becomes larger as itapproaches the posterior region of the skull. A longitudinal fissurecovered by the dura mater separates the cerebrum into two hemispheres, which are connected at the base of the fissure, by a broad medullaryband, termed the _corpus callosum_. Each hemisphere is subdivided intothree lobes. The anterior gives form to the forehead, the middle restsin the cavity at the base of the skull, and the posterior lobe issupported by the tentorium, by which it is separated from the cerebellumbeneath. One of the most prominent characteristics of the cerebrum isits many and varied _convolutions_ These do not correspond in allbrains, nor even on the opposite sides of the same brain, yet there arecertain features of similarity in all; accordingly, anatomists enumeratefour _orders of convolutions_. The first order begins at the _substantiaperforata_ and passes upward and around the corpus callosum toward theposterior margin of that body, thence descends to the base of the brain, and terminates near its origin. The second order originates from thefirst, and subdivides into two convolutions, one of which composes theexterior margin and superior part of the corresponding hemisphere, whilethe other forms the circumference of the _fissure of Sylvius_. The thirdorder, from six to eight in number, is found in the interior portion ofthe brain, and inosculates between the first and second orders. Thefourth is found on the outer surface of the hemisphere, in the spacebetween the sub-orders of the second clasp. A peculiar fact relating tothese convolutions is observed by all anatomists: mental development isalways accompanied by an increasing dissimilarity between theirproportional size. 

The cerebral hemispheres may be injured or lacerated without any pain tothe patient. The effect seems to be one of stupefaction withoutsensation or volition. A well-developed brain is a very good indicationof intelligence and mental activity. That the cerebrum is the seat ofthe reasoning powers, and all the higher intellectual functions, isproved by three facts. (1. ) If this portion of the brain is removed, itis followed by the loss of intelligence. (2. ) If the human cerebrum isinjured, there is an impairment of the intellectual powers. (3. ) In theanimal kingdom, as a rule, intelligence corresponds to the size of thecerebrum. This general law of development is modified by differences inthe cerebral texture. Men possessing comparatively small brains may havea vast range of thought and acute reasoning powers. Anatomists havefound these peculiarities to depend upon the quantity of gray matterwhich enters into the composition of the brain. 

In the cerebro-spinal system there are three different kinds of reflexactions. (1. ) Those of the spinal cord and medulla oblongata areperformed without any consciousness or sensation on the part of thesubject. (2. ) The second class embraces those of the tuber annulare, where the perception gives rise to motion without the interference ofthe intellectual faculties. These are denominated purely _instinctive_reflex actions, and include all those operations of animals which seemto display intelligent forethought; thus, the beaver builds hishabitation over the water, but not a single apartment is different fromthe beaver homestead of a thousand years ago; there is no improvement, no retrogression. Trains of thought have been termed a third class ofreflex actions. It is evident that the power of reasoning is, in adegree, possessed by some of the lower-animals: for instance, a tribe ofmonkeys on a foraging expedition will station guards at different partsof the field, to warn the plunderers of the approach of danger. A cryfrom the sentinel, and general confusion is followed by retreat. Reasononly attains its highest development in man, in whom it passes thebounds of ordinary existence, and, with the magic wand of love, reachesoutward into the vast unknown, lifting him above corporeal being, intoan atmosphere of spiritual and divine Truth. 

[Illustration: Fig. 60. Section of the brain and an idealview of the pneumogastric nerveon one side, with its branches, _a_. Vertical section of the cerebrum. _b_. Section of the cerebellum, _c_. Corpus callosum. _d_. Lower sectionof medulla oblongata. Above_d_, origin of the pneumogastricnerve. 1. Pharyngeal branch. 2. Superior laryngeal. 5. Branchesto the lungs. 4. Branches to theliver. 6. Branches to the stomach. ]

THE CRANIAL NERVES. From the brain, nerves are given off in pairs, whichsucceed one another from in front backwards to the number of twelve. The_first_ pair, the _olfactory_ nerves, are the nerves of the sense ofsmell. The _second_ pair are the _optic_, or the nerves of the sense ofsight. The _third_ pair are called the _motores oculi_, the movers ofthe eye, from the fact that they are distributed to all the muscles ofthe 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 fourthextending to the superior oblique muscle, and the sixth to the externalrectus muscle. The nerves of the _fifth_ pair are very large; they areeach composed of two bundles of filaments, one motor and the othersensory, and have, besides, an additional resemblance to a spinal nerveby having a ganglion on each of their sensory roots, and, from the factthat 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 craniumand face, the motor nerves of the muscles of mastication, the_buccinator_ and the _masseter_, and their third branches, often calledthe _gustatory_, are distributed to the front portion of the tongue, andare 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 ofthe face, and are also distributed to a few other muscles; the _eighth_pair, termed the auditory nerves, are the nerves of the special sense ofhearing. As the _seventh_ and _eighth_ pairs of nerves emerge from thecavity of the skull together, they are frequently classed by anatomistsas one, divided into the _facial_, or _portio dura_, as it is sometimescalled, and the _auditory_, or _portio mollis_. The _ninth_ pair, calledthe _glosso-pharyngeal, _ are mixed nerves, supplying motor filaments tothe _pharyngeal muscles_ and filaments of the special sense of taste tothe back portion of the tongue. The _tenth_ pair, called the_pneumogastric_, or _par vagum_, are very important nerves, and aredistributed to the larynx, the lungs, the heart, the stomach, and theliver, as shown in Fig. 60. This pair and the next are the only cerebralnerves which are distributed to parts of the body distant from the head. The _eleventh_ pair, also called _spinal accessory_, arise from thesides of the spinal marrow, between the anterior and posterior roots ofthe dorsal nerves, and run up to the medulla oblongata, and leave thecranium by the same aperture as the pneumogastric and glosso-pharyngealnerves. They supply certain muscles of the neck, and are purely motor. As the glosso-pharyngeal, pneumogastric, and spinal accessory nervesleave the cranium together, they are by some anatomists counted as the_eighth_ pair. The _twelfth_ pair, known as the _hypoglossal, _ aredistributed 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 theinferior parts of the body, at the sides and in front of the spinalcolumn, and is termed, collectively, the system of the _greatsympathetic_. These ganglia are intimately connected by nervousfilaments, and communicate with the cerebro-spinal system by means ofthe motor and sensory filaments which penetrate the sympathetic. Thenerves of this system are distributed to those organs over whichconscious 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 lowerportions 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 itstransparent covering), and influences the contraction and dilation ofthe iris. The second division is situated in the angle formed by thesphenoid and maxillary bone, or just below the ear. It sends motor andsensory filaments to the palate, and _velum palati_. Its filamentspenetrate the carotid plexus, are joined by others from the motor rootsof the facial nerve and the sensory fibres of the superior maxillary. The third division is located on the submaxillary gland. Its filamentsare distributed to the sides of the tongue, the sublingual, andsubmaxillary glands. The otic ganglion is placed below the base of theskull, and also connects with the _carotid plexus_. Its filaments ofdistribution supply the internal muscles of the _malleus_, the largestbones 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 thelarynx, pharynx, trachea, and esophagus, and also penetrate the _thyroidgland_. The use of this gland is not accurately known. It is composed ofa soft, brown tissue, and consists of lobules contained in lobes oflarger size. It forms a spongy covering for the greater portion of thelarynx, and the first section of the trachea. That it is an importantorgan, 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 theterminations of the ribs, over which they are situated. Each ganglionreceives two filaments from the intercostal nerve, situated above it, thus forming a double connection. The thoracic ganglia supply with motorfibres that portion of the aorta which is above the diaphragm, theesophagus, 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 theorgans of generation. Four other pairs of abdominal ganglia connectedwith, the lumbar branches are united by filaments to form the semilunarganglion. 

The sympathetic ganglia of the pelvis consist of five pairs, which aresituated upon the surface of the sacrum. At the extremity of the spinalcolumn this system terminates in a single knot, designated as the_ganglion impar_. 

Owing to the position of the sympathetic ganglia, deeply imbedded in thetissues of the chest and abdomen, it is exceedingly difficult to subjectthem to any satisfactory experiments. A few isolated facts form thebasis of all our knowledge concerning their functions. They give offboth motor and sensory filaments. The contraction of the _iris_ is oneof the most familiar examples of the action of the sympathetic system. 

In the reflex actions of the nerves of special sense, the sensation istransmitted through the cerebro-spinal system, and the motor impulse issent to the deep-seated muscles by the sympathetic system. Physiologistsenumerate three kinds of reflex actions, which are either purelysympathetic, or partially influenced by the cerebro-spinal system. Dr. Dalton describes them as follows:

_First_. --"Reflex actions taking place from the internal organs, throughthe sympathetic and cerebro-spinal systems, to the voluntary muscles andsensitive surfaces. --The convulsions of young children are often owingto the irritation of undigested food in the intestinal canal. Attacks ofindigestion are also known to produce temporary amaurosis [blindness], double vision, strabismus, and even hemiplegia. Nausea, and a diminishedor 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 involuntarymuscles and secreting organs. --Imprudent exposure of the integument tocold and wet, will often bring on a diarrhea. Mental and moralimpressions, conveyed through the special senses, will affect themotions of the heart, and disturb the processes of digestion andsecretion. Terror, or an absorbing interest of any kind, will produce adilatation of the pupil, and communicate in this way a peculiarly wildand unusual expression to the eye. Disagreeable sights or odors, or evenunpleasant occurrences, are capable of hastening or arresting themenstrual discharge, or of inducing premature delivery. "

_Third_. --"Reflex actions taking place through the sympathetic systemfrom one part of the body to another. --The contact of food with themucous membrane of the small intestine excites a peristaltic movement inthe muscular coat. The mutual action of the digestive, urinary, andinternal generative organs upon each other takes place entirely throughthe medium of the sympathetic ganglia and their nerves. The variation ofthe capillary circulation in different abdominal viscera, correspondingwith the state of activity or repose of their associated organs, are tobe referred to a similar nervous influence. These phenomena are notaccompanied by any consciousness on the part of the individual, nor byany 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 ofexternal objects. 

The number, position, and perfection of the eyes, vary remarkably indifferent orders, in many instances corresponding to the mode of life, habitation, and food of the animal. A skillful anatomist may ascertainby the peculiar formation of the eye, without reference to the generalphysical structure, in what element the animal lives. Sight is one ofthe most perfect of the senses, and reveals to man the beauties ofcreation. The aesthetic sentiment is acknowledged to be the mostrefining 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 forthin the rhythm of immortal verse. 

In the vertebrates, the organs of vision are supplied with filamentsfrom the second pair of cranial nerves. In mammalia, the eyes arelimited to two in number, which in man are placed in circular cavitiesof the skull, beneath the anterior lobes of the cerebrum. Threemembranes form the lining of this inner sphere of the eye, calledrespectively the Sclerotic, Choroid, and Retina. 

The _Sclerotic_, or outer covering, is the white, firm membrane, whichforms the larger visible portion of the eyeball. It is covered in frontby a colorless, transparent segment, termed the _cornea_, which givesthe eye its lustrous appearance. Within the sclerotic, and lining itthroughout, is a thin, dark membrane termed the _Choroid_. Behind thecornea it forms a curtain, called the _iris_, which gives to the eye itscolor. The muscles of the iris contract or relax according to the amountof light received, thus enlarging or diminishing the size of thecircular opening called the _pupil_. The _Retina_ is formed by the opticnerve, which penetrates the sclerotic and choroid and spreads out into adelicate, grayish, semi-transparent membrane. The retina is one of themost _essential_ organs of vision, and consists of two layers. Aspheroidal, transparent body, termed the _crystalline lens_, is situateddirectly behind the pupil. It varies in density, increasing from withoutinward, and forms a perfect refractor of the light received. The spacein front of the crystalline lens is separated by the iris into twocompartments called respectively the _anterior_ and _posteriorchambers_. The fluid contained within them, termed the _aqueous humor_, is secreted by the cornea, iris, and ciliary processes. The space behindthe crystalline lens is occupied by a fluid, called the _vitreoushumor_. This humor is denser than the other fluids and has theconsistency of jelly, being perfectly transparent. "The function of thecrystalline lens is to produce distinct perception of form andoutline. "[3] The transparent humors of the eye also contribute to thesame 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 lightproceeding from an object _a b_, refracted by the lens, and forming theinverted 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_ pursuea parallel course, and form the center of the image. Rays of lightpassing 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 adistinct perception of the outline of a distant hill, and also of a booklying before us. The rays of light we receive from these objects cannothave the same focus. How, then, can we account for the evidentaccommodation of the eye to the varying distances? Various theories havebeen advanced to explain this adjustment; such as changes in thecurvature of the cornea and lens; a movement of the lens, or a generalchange in the form of the eyeball, by which the axis may be lengthenedor shortened. 

[Illustration: Fig. 63. ]

Two facts comprise all the positive knowledge which we possess on thissubject. Every person is conscious of a muscular effort in directing theeye to a near object" as a book, and of fatigue, if the attention isprolonged. If, now, the eyes be directed to a distant object, there willresult a sense of rest, or passiveness. By various experiments it hasbeen proved that the accommodation or adjustment of the eye for nearobjects requires a muscular effort, but for distant objects the musclesare in an essentially passive condition. An increase in the convexity ofthe crystalline lens is now admitted to be necessary for a distinctperception of near objects. We may give two simple illustrations, citedby Dr. Dalton in his recent edition of Human Physiology. If a candle beheld 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 eachof the anterior surfaces of the cornea and lens, and a third on theposterior surface of the latter. If the eye is directed to a nearobject, the reflection on the cornea remains unchanged, while that onthe anterior surface of the lens gradually diminishes and approximatesin size the reflection on the cornea, thus giving conclusive evidencethat, in viewing a near object, the anterior surface of the crystallinelens become _more convex_, and at the same time approaches the cornea. Five or six inches is the minimum limit of the muscular adjustment ofthe eye. From that point to all the boundless regions of space, to everystar and nebulae which send their rays to our planet, human vision canreach. It is the sense by which we receive knowledge of the myriads ofworlds and suns which circle with unfailing precision through infinitespace. 

HEARING. 

[Illustration: Fig. 64. Internal and external ear. 1. External ear. 2. Internalauditory meatus. 3. Tympanum. 4. Labyrinth. 5. Eustachian tube. ]

Hearing depends upon the sonorous vibrations of the atmosphere. Thewaves of sound strike the sensitive portions of the ear, and theirimpressions upon the auditory nerves are termed the sensations ofhearing. The ear is divided into three parts, called respectively theExternal, Middle, and Internal ear. 

The external organs of hearing are two in number, and placed on oppositesides of the head. In most of the higher order of vertebrates, they areso 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 prolongationof its orifice, termed the _external auditory meatus_. In man, thisgristly portion of the auditory apparatus is about one inch in length, lined by a continuation of the integument of the ear, and has numeroushairs 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 headof a drum. The _tympanum_, or ear-drum, communicates with the pharynx bythe _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 ofthe 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 themembrana tympani, throws its molecules into vibrations which arecommunicated to the chain of bones, which, in turn, transmits them tothe membrane of the _foramen ovale_. The three muscles which regulatethe tension of these membranes are termed the _tensor tympani, laxatortympani_, and _stapedium tympani. _

The _Labyrinth_, or _Internal_ ear, is a complicated cavity, consistingof three portions termed the _vestibule, cochlea_, and _semi-circularcanals_. The vestibule is the central portion and communicates with theother divisions. The labyrinth is filled with a transparent fluid, termed _perilymph_, in which are suspended, in the vestibules andcanals, small membranous sacs, containing a fluid substance, termed_endolymph_ (sometimes called _vitrine auditive_ from its resemblance tothe vitreous humor of the eye). The filaments of the auditory nervepenetrate the membranous tissues of these sacs, and also of thosesuspended at the commencement of the semi-circular canals. These littlesacs are supposed to be the seat of hearing, and to determine, in somemysterious 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 isin some way connected with this sensation. But this supposition, together with the theory of the transmission of sound through thevarious portions of the cranial bones, has been exploded. 

From the foregoing description, it will be seen that the labyrinth andtympanum are the most essential parts of the organs of hearing. Indelicacy and refinement this sense ranks next to sight. The emotions ofbeauty and sublimity, excited by the warbling of birds and the roll ofthunder, are scarcely distinguishable from the intense emotions arisingfrom sight. It is a remarkable fact, that the refinement or cultivationof these senses is always found associated. Those nations which furnishthe best artists, or have the highest appreciation of painting andsculpture, produce the most skillful musicians, those who reduce musicto a science. 

SMELL. 

[Illustration: Fig. 65. 1. Frontal sinus. 2. Nasal bone. 3. Olfactoryganglion and nerves. 4. Nasal branchof the fifth pair. 5. Spheno-palatine ganglion. 6. Soft palate. 7. Hard palate, _a_. Cerebrum, _b_. Anterior lobes, _c_. Corpuscallosum. _d_. Septum lucidum. _f_. Fornix. _g_. Thalami optici. _h_. Corpora striata. ]

Next in order of delicacy, and more closely allied with the physicalfunctions, is the sense of smell. Delicate perfumes, or the fragrance ofa flower, impart an exhilarating sensation of delight, while numerousodors excite a feeling of disgust. The organ of smell is far lesscomplicated in its structure than the eye or the ear. It consists of twocavities having cartilaginous walls, and lined with a thick mucous coat, termed the _pituitary membrane_, over which are reflected the olfactorynerves. Particles of matter, too minute to be visible even through themicroscope, are detached from the odorous body and come in contact withthe nerves of smell, which transmit the impressions or impulses thusreceived to the brain. Fig. 65 shows the distribution of the olfactorynerves in the nasal passages. The nose is supplied with two kinds offilaments which are termed respectively nerves of _special_ and nervesof _general sensation_. Compared with the lower animals, especially withthose belonging to the carnivorous species, the sense of smell in man isfeeble. The sensation of smell is especially connected with thepleasures and necessities of animal life. 

TASTE. 

The sense of taste is directly connected with the preservation andnutrition of the body. A delicious flavor produces a desire to eat asavory substance. Some writers on hygiene have given this sense aninstinctive character, by assuming that all articles having an agreeabletaste are suitable for diet. The nerves of taste are distributed overthe surface of the tongue and palate, and their minute extremitiesterminate in well developed _papillae_. These _papillae_ are dividedinto three classes, termed, from their microscopic appearance, _filiform_, _fungiform_ and _circumvallate_. The organ of taste is themucous membrane which covers the back part of the tongue and the palate. The papillae of the tongue are large and distinct, and covered withseparate coats of epithelium. The filiform papillae are generally longand pointed and are found over the entire surface of the tongue. Thefungiform are longer, small at the base and broad at the end. Thecircumvallate are shaped like an inverted V and are found only near theroot of the tongue; the largest of this class of papillae have othervery small papillae upon their surfaces. It is now pretty satisfactorilyestablished that the circumvallate, or fungiform papillae are the onlyones concerned in the special sense of taste. 

The conditions necessary to taste are, that the substance be in solutioneither by artificial means, or by the action of the saliva; and that itbe brought in contact with the sensitive filaments imbedded in themucous membrane. The nerves of taste are both _general_ and _special_ intheir functions. If the general sensibility of the nerves of taste isunduly excited, the function of sensibility is lost for some time. If apeppermint lozenge is taken into the mouth, it strongly excites thegeneral sensibilities of taste, and the power of distinguishing betweenspecial flavors is lost for a few moments. A nauseous drug may then beswallowed without experiencing any disagreeable taste. 

Paralysis of the facial nerve often produces a marked effect in thesensibility of the tongue. Where this influence lies has not been fullyexplained; probably it is indirect, being produced by some alteration inthe 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 abody, such as form consistency, roughness, or smoothness of surface, etc. The tip of the tongue possesses the most acute sensibility of anyportion of the body, and next in order are the tips of the fingers. Thehands are the principal organs of tactile sensation. The nerves ofgeneral sensibility are distributed to every part of the cutaneoustissue. The contact of a foreign body with the back, will produce asimilar _tactile_ sensation, as with the tips of the fingers. Thesensation, however, will differ in _degree_ because the back is suppliedwith a much smaller number of sensitive filaments; in _quality_ it isthe same. 

 * * * * *

CHAPTER XIV. 

CEREBRAL PHYSIOLOGY. 

By means of the nervous system, an intimate relation is maintainedbetween mind and body, for nervous energy superintends the functions ofboth. The fibres of nervous matter are universally present in theorganization, uniting the physical and spiritual elements of man'sbeing. Even the minutest nerve-rootlets convey impressions to the domeof thought and influence the intellectual faculties. We recognize_muscular_ force, the strength of the body, _molecular_ force, moleculesin motion, as heat, light, chemical force, electricity, and _nervous_force, a certain influence which reacts between the animal functions andthe cerebrum, thus connecting the conditions of the body with those ofthe mind. We cannot speak of the effects of mind or body separately, butwe must consider their action and reaction upon each other, for they arealways associated. There are many difficulties in understanding thisrelationship, some of which may be obviated by a study of thedevelopment of nervous matter, and its functions in the lower orders oforganization. 

Within the plant-cells is found a vital, vegetable substance termedbioplasm, or protoplasm; which furnishes the same nutritive power as thetissues of the polyp and jelly fish. Many families of animals have pulpybodies, and slight instinctive motion and sensibility, and in proportionas the nervous system is developed, both of these powers are unfolded. Plants have a low degree of sensibility, limited motion, respiratory andcirculatory organs. Animals possess quicker perceptions andsensibilities, the power of voluntary motion, and, likewise a rudimentalnervous system. Some articulates have no bony skeleton, their musclesbeing attached to the skin which constitutes a soft contractingenvelope. One of the simplest forms of animal life in which a nervoussystem is found, is the five-rayed star-fish. In each ray there arefilaments which connect with similar nerve-filaments from other rays, and form a circle around the digestive cavity. It probably has noconscious perception, and its movements do not necessarily indicatesensation or volition. In some worms a rudimentary nervous system issparingly distributed to the cavities of the thorax and abdomen, and, asin the star-fish, the largest nerve-filament is found around theesophagus, presiding over nutrition. 

[Illustration: Fig. 66. ]

A higher grade of organization requires a more complete arrangement ofnervous substance. Stimulus applied to one organ is readily communicatedto, and excites activity in another. 

[Illustration: Fig. 67. A. Nervous system of a Crab, showing itsganglia. 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 atintervals into knots, consisting of collections of nerve-cells, calledganglia. They are really nerve-centers, which receive and transmitimpulses, originate and impart nervous influence according to the natureof their organic surroundings. The ganglia situated over the esophagusof insects correspond to the medulla oblongata in man, in whichoriginate the spinal accessory, glosso-pharyngeal, and pneumogastricnerves. The latter possess double endowments, and not only participatein the operations of deglutition, digestion, circulation, andrespiration, but are also nerves of sensation and instinctive motion. The suspension of respiration produces suffocation. In insects, theseganglia are scarcely any larger than those distributed within theabdomen, 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, theamount of the nervous substance is greater, the organic functions aremore complex, and the actions begin to display intelligence. 

Man possesses not only a complete sympathetic system, the rudiments ofwhich are found in worms and insects, and a complete spinal system, lessperfectly displayed in fishes, birds, and quadrupeds, but, superadded toall these is a magnificent cerebrum, and, as we have seen, all parts ofthe body are connected by the nervous system. The subtle play of sensoryand motor impulses, of sentient and spiritual forces, indicates aperfection of nervous endowments nowhere paralleled, and barelyapproached by inferior animals. This meager reference to brainlessanimals, whoso knots of ganglia throughout their bodies actautomatically as little brains, shows that instinct arisessimultaneously with the development of the functions over which itpresides. Here begins rudimentary, unreasoning intelligence. Itoriginates within the body as an inward, vital impulse, is manifested inan undeviating manner, and therefore displays no intention ordiscretion. While Dr. Carpenter likens the human organism "to a keyedinstrument, from which any music it is capable of producing can becalled forth at the will of the performer, " he compares "a bee or anyother insect to a barrel organ, which plays with the greatest exactnessa certain number of tunes that are set upon it, but can do nothingelse. " Instinct cannot learn from experience, or improve by practice;but it seems to be the prophetic germ of a higher intelligence. It isnearly as difficult to draw the dividing line between instinct and a lowgrade of intelligence, as it is to distinguish between the psychical andpsychological[4] functions of the brain. 

The intimate relation of instinct to intelligence is admirablyillustrated in the working honey-bee. With forethought it selects ahabitation, constructs comb, collects honey, provides a cell for theova, covers the chrysalis, for which it deposits special nourishment, and is disposed to defend its possessions. It is a social insect, livesin colonies, chastises trespassers, fights its enemies, and defends itshome. It manifests a degree of intelligence, but its sagacity isinstinctive. Reason, though not so acute as instinct, becomes, byeducation, discerning and keenly penetrative, and reveals the verysecrets of profound thought. We recall the aptness of Prof. Agassiz'sremark: _"There is even a certain antagonism between instinct andintelligence, so that instinct loses its force and peculiarcharacteristics, whenever intelligence becomes developed. "_ Animalshaving larger reasoning powers manifest less instinct, and some, as theleopard, exercise both in a limited degree. This double endowment withinstinct and low reasoning intelligence, is indicated by his lying inambush awaiting his prey, the hiding-place being selected near the hauntof other animals, where nature offers some allurement to gratify theappetite. 

Simple reflex action is an instinctive expression, manifesting anintuitive perception, almost intelligent, as shown by the contraction ofthe stomach upon the food, simply because it impinges upon the innercoats, and thus excites them to action. A better illustration, becauseit displays sympathy, is when the skin, disabled by cold, cannot act, and its duties are largely performed by the kidneys. Though reflexaction is easily traced in the lower organic processes, some writershave placed it on a level with rational deliberation. Undoubtedly, allanimals having perception have also what perceptionimplies--consciousness--and this indicates the possession, in somedegree, of reason. _Compound_ reflex action extends into the domain ofthought. _Simple_ reflex action, or instinct, answers to the animalfaculties, 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, butalso with the highest psychological faculties. Instinct is therepresentative of animal conditions, just as the highest spiritualfaculties are indicative of qualities and principles. The consistentmean of conduct is an equilibrium between these ultimate tendencies ofour being. The psychological functions render the animal naturesubservient to the rule of purity and holiness, and deeply influence itby the essential elements of spiritual existence. The psychical organssustain an intermediate relation, receiving the impressions of thebodily propensities, and, likewise, of the highest emotions. Obviously, these extreme influences, the one growing out of animal conditions, theother, the result of spiritual relations, pass into the psychical mediumand are refracted by it, or made equivalent to one force. The bodyrequires the qualifying influences of mind. The tendencies of the animalfaculties are selfish and limiting, those of the emotive, general, universal. The propensities, like gravity, expend their force uponmatter; the emotions pour forth torrents of feeling, and producerhapsodies of sentiment. The propensities naturally restrict theirexpression to a specific object of sense; the emotions respond toimmaterial being. The tendencies of the former are acquisitive, selfish, gratifying; of the latter, bestowing, expanding, diffusing. The oneclass is restricted to the orbits of time and matter, the other flows onthrough the limitless cycles of infinity and immortality. The former issatiated in animal gratification, the latter in spiritual beatification. The one culminates in animal enjoyment, the other expands to itsultimate conceptions in the perfections of Divine Love. 

In the present life, mind and body are intimately connected by nervousmatter. In this dual constitution, the spiritual mental, and animalfunctions are made inseparable, and modify one another. The ultimatetendencies of each extreme exist, not absolutely for themselves, but forqualifying purposes, to establish a basis for the deeper economy oflife. By the employment of reason, animal and spiritual experiences aremutually benefited, and the consciousness rendered accountable. Thebodily and mental workings are in many senses one, and help to interpreteach other. 

Every fact of mind has many aspects. A brain force, which results inthought, is simultaneously a physiological force, if it influences thebodily functions. Likewise, spiritual conceptions take their rise in thesame blood that feeds the grosser tissues. This vital fluid ismomentarily imparting and receiving elements from all the bodily organs, and these, in turn, must influence the process of thought, and, in adegree, determine its quality. The delicate outline, yea, even thesubstance of an idea, may depend upon the condition of the animalorgans. Thought is subject to the laws of biology, and, therefore, is asymbol of health. Morbid conditions of the system hang out their signsin words and utterances. Words which express fear are as true symptomsof functional difficulty as is excessive palpitation. The organrepresenting fear sustains a special relation to the functions of theheart both in health and disease. Bright hopes characterize pulmonarycomplaints as certainly as cough. Exquisite susceptibility of mindindicates equally extreme sensibility of body, and those persons capableof fully expressing the highest emotions are especially susceptible tobodily sensations. Tears are physical emblems of grief, andfellow-feeling calls forth sympathetic tears. Excessive anxiety of mindproduces general excitability of body, which soon results in chronicdisease. Pleasurable emotions stimulate the processes of nutrition, andare restorative. This concomitance of mental and bodily states is veryremarkable. Joy and Love, as well as jealousy and anger, flash in theeye and mould the features to their expression. Grief excites thelachrymal, and rage the salivary glands. Shame reddens the ears, dropsthe eyelids, and flushes the face; but profligacy destroys theseexpressions. The blush which suffuses the forehead of the bashful maidenbetrays her love, and _maternal_ love, stirred by the appeals of anidolized infant, excites the mammary gland to the secretion of milk. Thesigh of melancholia indicates hepatic torpor, thus showing a specialrelation between the liver and respiratory organs. These conditions ofmind and body react upon one another. Even the thought of a lusciouspeach may cause the mouth to water. The thought of tasting a lemon fillsthe mouth with secretions, and a story with unsavory associations maycompletely turn the stomach. 

The relationship of mental and physical functions may be illustrated byentirely removing the spleen of an animal, as that of a dog. Aninvariable result of its extirpation is an unusual increase of theappetite, for at times the animal will eat voraciously any kind of food. The dog will devour, with avidity, the warm entrails of recently killedanimals, and thrive in consequence of such an appetite. Another symptom, which usually follows the removal of the spleen, is an unnaturalferocity of disposition. Without any apparent provocation, the animalwill attack others of its own, or of a different species. In someinstances, these outbursts of irritability and violence are onlyoccasional, but the experiments show quite conclusively that the spleenmoderates combativeness, restrains the appetite, and co-operates withthe will and judgment in controlling them. 

We shall briefly consider the practical question whether the elements ofmind can be ideally arranged and presented, so as to more completelyreveal their relations to, and disclose their effects upon the bodilyfunctions. Modern philosophers conceive that mind consists of a triad ofessentials; _Intellect, Emotion, _ and _Volition_. Physiologists assignto the cerebrum its functions, and neurological, as well asphrenological writers, have located them as represented in Fig. 68. True, there is no structural division between the parts of the cerebrumto indicate this diversity of function, nor is there any perceptiblelimit between the sensory and motor filaments of the game nerve. As noone has any reason for denying that separate portions of the brain maymanifest distinct functions of the mind, we shall assume it as aconceded proposition. The regions of the cerebrum, thus ideallyrepresented, 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, andis equally entitled to our consideration. In the posterior chamber ofthe skull is the cerebellum, anterior to, and below which, is themedulla oblongata, connecting with the spinal cord and sympatheticsystem. These various parts are essential to the harmonious blending ofmind and body. To this end, two conditions are necessary. (1. ) All thenervous forces must be so related that action and reaction may be fullyestablished. (2. ) A complete nervous circuit is requisite for thereciprocal influence of mind and body. 

[Illustration: Fig. 68. ]

[Illustration: Fig. 69. ]

Nature answers to mind in physical correspondences. The planetary systemis fashioned after a circle. Life itself springs from a spherule offorces. The perfection of an idea, or the completeness of a conceptionmay be expressed by a circle. The elements of Science, Astronomy, Geology, and Natural History, are pictorially represented in thismanner. How appropriately and logically can a fragment of naturalhistory, this epitome of all nature and science--_the mind_--beillustrated by a simple circle! Every element must act and react, and beequal and opposite. Thus may the existence of the opposing energies andfunctions of each faculty be equally represented. The contrast aids usin understanding their ultimate tendencies, and enables us to correctlyvalue and define their nature. Faculties of kindred qualities may begrouped together, and their antagonisms represented in the opposite arcof the circle. Let us employ a circle to represent mind. The conceptionof the abstract quality of _good_, requires contrast with one of aconverse nature, _bad_, (see Fig. 69). Opposite faculties may beportrayed in the same manner. The functions of the cerebrum and spinalsystem may be symbolically represented as those of the highest andlowest organs, thus giving rise to the positive and negative extremes offeeling. The writer conceives of no other way in which the widelycontrasted facts of human experience can be so perfectly symbolized. _Good_ (Fig. 69) may represent moral faculties, and _bad_, theiropposites. Undoubtedly, nature is not so arbitrary in her arrangementsas we are in shadowing forth our imperfect conceptions, yet is not thisa decided improvement in determining cerebral faculties and theirrelations? We observe how scholars and philosophers confound the noblestand most exalted emotions with the animal propensities instead ofdistinguishing between them. "_The emotions are a department of thefeelings, formed by the intervention of intellectual processes. Severalof them are so characteristic that they can be known only by individualexperiences; as Wonder, Fear, Love, Anger_. " See Logic: Deductive andInductive, 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 animalpropensity. Is it not more practical and philosophical to group theemotional faculties together, and upon an opposite arc represent theirantagonistic energies, the ultimate tendencies of which are criminal?Both groups are mutually modifying and restraining; the one relatesinstinctively to the bodily wants, the other to the requirements ofmind, and each is essential to a consistent life. Accordingly, we deemit philosophical to consider words as symbols of mental faculties, andto classify together such spiritual unities as joy, hope, faith, andlove, the tendencies of which are to quicken and transform the ultimatesof carnal life into the rudiments of an immortal one, the beginning ofheaven on earth. These restrain those opposites, which lead to crime anddeath. Love and Hate are as antagonistic as heat and cold, and theusefulness of both depends upon their _proper_ temperament. Fig. 70represents the antagonism of the Intellectual faculties to the Animal, the Emotional to the Criminal, the Volitive to the Enfeebling. It is notessential to discover in the nerve-substance the precise power fromwhich an impulse originates. We may reasonably interpret the functionsof the brain, and yet be unable to disclose the duties of any ganglioniccorpuscle composing it. We may foretell what each season of the yearwill bring forth, when we cannot forecast the history of a blade ofgrass or a single grain of any kind. We may predict the amount of rainfor a month, and be unable to prognosticate correctly, the character ofany storm, or give the history of a special drop of water. Although wecannot follow the movements of individuals in a battle, yet we maypredict the result of the combat; and thus, we judge of the functions ofthe brain without the ability to reveal the actions of one of theorganic molecules of which it is composed. We aim to give a general, reasonable, and popular description of cerebral functions and theirbearing upon health and disease. 

[Illustration: Fig. 70. ]

REGIONAL DIVISIONS. 

[Illustration: Fig. 71. ]

The anterior portion of the cerebrum is devoted to intellectualprocesses, which freely expend the vital energies. The Intellectualfaculties are classified as represented in Fig. 71. The lower portion ofthe brain, bounded exteriorly by the superciliary ridge, corresponds tothe Perceptive, the middle region to the Recollective, and the upper tothe Reflective faculties. (See also Fig. 65, _b_. ) If we divide theforehead by vertical lines, as shown in Fig. 71, the divisions thusformed represent respectively, the Active, Deliberative, andContemplative departments of the intellect, all the processes of whichare sustained by vital changes, the transformation of organizedmaterials. 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 animalorganism. Otherwise, nutrition would be unnecessary for the adult. Theproduction of thought wears away the cerebral substance. In ordinaryuse, the brain requires one-fifth of the blood to support its growth andrepair. Great mental efforts are attended by a corresponding expenditureof vital treasures, which are abstracted from the total forces availablefor the necessities of the system. To repair the losses thus occasioned, materials are appropriated from the blood, which furnishes supplies inproportion to the demands made by the mental activities. The productionof thought wears away the gray matter of the cerebrum as surely as thedigging of a canal wears away the iron particles of the spade. The brainwould soon wear out did not the nutritive functions constantly make goodthe waste. The intellect, whether engaged in observation, generalization, or profound study consumes the brain and blood, henceintellectual activity implies VITAL EXPENDITURE. _Expenditure_ is anemphatic word because all functions are essential to the production ofthis nerve-energy, which returns to the system no equivalent. Physicalexercise, although attended by structural waste, is advantageous to thecirculation of the blood, nutrition, secretion, and, in fact, beneficialto all the organic processes. This is not true of vigorous and prolongedmental labor, which is not attended by any of these incidentaladvantages. If a child attends a school in which mental developmentsupersedes physical culture, an inordinate ambition sways the youthfulmind, 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 pallorcovers the face, and the eyes sparkle with a hectic radiance. The familyphysician pronounces the condition _Anæmia_ (a deficiency of redcorpuscles in the blood), and this change in the quality of the blood isowing to the undue appropriation by the brain. Conversely, if the bloodbe destroyed, or its vitality reduced, in the same proportion will themental energies be weakened and all the functional powers of thephysical system enfeebled. In brief, if the intellect be undulyexercised, the red corpuscles of the sanguine fluid will be graduallydestroyed, and the serum allowed to predominate. The blood becomes weakand watery, the subject is nervous, dropsical, consumptive andderangement 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 easyprey to disease. This mental cause and its bodily results may beclassified in the following order. Mental Cause: EXCESSIVE MENTALEXERTION, 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 inscribeINTELLECT, ACTIVITY, and VITAL EXPENDITURE. Intellectual employment isusually accompanied by sedentary habits, neglect of healthful exercise, and a deprivation of pure air, to all of which ill health may beattributed. Were the intellectual expenditure arrested, and the forcesturned into recuperative channels, many a person would become beautifulwith the ruddy glow of health. Without health there is no use forthought; cultivation of the mind is just as natural and essential as theculture of the body, and the trained development of both is needed formutual improvement. 

EMOTIVE FACULTIES. 

[Illustration: Fig. 72. ]

What results follow the _natural_ and the _excessive_ exercise of theEMOTIVE FACULTIES? AS distinct organs of the body have diversefunctions, so, in like manner, different parts of the brain perform theseparate operations of the mind. It is easier to discriminate betweenthe products of these dissimilar endowments than to determine thelocation of the faculties. The intellect deals with concrete subjects, and the emotions with abstractions; the intellect is exercised withmaterial things, the emotions dwell upon attributes; the intellectconsiders the forces of matter, the emotions, the powers of the soul;the former deliberates upon the truths of science, the latter isconcerned with duties, obligations, or moral responsibilities; the firstis satisfied only with new truths, original ideas, and rational changes, the last rest securely on fundamental principles, moral certainties, andthe absolute constancy of perfect love. The intellectual faculties arewakeful, 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 theother. 

The quality of the emotional faculties is represented by Benevolence, Sympathy, Joy, Hope, Confidence, Gratitude, Love, and Devotion, all ofwhich are the very antitheses of the attributes of animal feeling, described as Melancholy, Fear, Anger, Hate, Malevolence, and Despair. Tothe emotions we refer the highest qualities of character, while theiropposites represent the animal or baser impulses. True, the emotionsmodify the propensities, as sympathy softens grief. They may subdue andrefine the animal feelings, and thus veil them with a delicacycharacteristic of their own purity; but the unrestrained influences ofgrief find vent in loud lamentations, and the bitter disappointments ofthe selfish faculties are passionate and violent. 

The _Emotive Faculties_--the organs of spiritual perceptions--areimpersonal, outflowing, bestowing. The function represented byBenevolence, is willing, giving. Devotion expresses dedication, consecration; Gratitude manifests a warm and friendly feeling toward abenefactor. 

 "The depth immense of endless gratitude. "--MILTON. 

Love flames toward its object, is out-pouring, blessing; indeed, all theemotions are gushing, effusive, impetuous, and profusely flowing; grand, torrent-like, overwhelming; employing ideal, immaterial, spiritualexpressions, developing principles and perfections while aspiring tohappiness and immortality. Though beginning with humanity, they embodythe Divine. They expand to their ultimate conceptions in the sublimeattributes: the perfections of the God of Love; associating withmortality a divine destiny commencing on earth, extending through time, pausing not at the portals of death, the gateway to eternity, butflowing onward into the realms of eternal day. 

We may consider their counteracting influences, for, without doubt, bychecking the selfish tendencies and restraining the animal propensities, they assist in controlling the sensual passions, and thus balance themind and body. Such an equilibrium we call _happiness_. If the emotionsbe acute and vehement, they will absorb all other impressions and revelin their culminating and delightful experiences. They exhaust all thebodily energies, and a functional suspension, termed _ecstasy_, follows. It is a swooning, or fainting, a temporary loss of sensation andvolition, accompanied by involuntary movements of the arms, smiting ofthe hands, sighing, and short ejaculatory expressions of rapture. Thiscondition, occasioned by excessive emotion, as in praying, singing, exhortations, and sympathetic appeals, is contagious, often spreadingwith mysterious rapidity. Its culmination, ecstasy, is popularly termed"_the power_. " When gradually induced, it is called _trance_, and eachstate is regarded by many as supernatural, caused by the immediateinfluence of the Holy Spirit. The explanation is this: when the emotivefaculties are suddenly and powerfully excited, they quickly expend theorganic forces, so that the individual swoons from sheer exhaustion. Undue expenditure of this class of brain functions not only consumes thebodily powers, but exhausts and prevents other mental operations. Thesudden collapse of all voluntary functions resembles the faintingproduced by blood-letting. We may sum up this rapid expenditure ofenergy 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 theorder 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 andthe immoderate exercise of the VOLITIVE FACULTIES?

The generic term _will_, comprehends those faculties, the action ofwhich is termed _volition_. The faculties of the will are Determination, Firmness, Decision, Ambition, Authority, and Vigilance, all of whichindicate strength and continuity of purpose. Bordering upon the emotionsare Patience and Perseverance, while adjoining the animal faculties arePower, Coarseness, and Love of Display. The former exhibit moral, thelatter animal heroism. A sense of power urges forward, whether it behigher or lower, just as the sense of greatness makes a man _great_ byinspiring him with confidence to put forth exertion. Nature is truthfulin her aspirations. We know that courage, assurance, and conscious powerare necessary for the fulfillment of purpose, because intention precedesaction. Will-power is an indication of HEALTH, and the constant exerciseof these mental faculties exerts a steady, regular, and strengtheninginfluence over the bodily functions. We translate mental energies intophysiological industry. These faculties impart tone to the system, sustain the processes of nutrition, circulation, assimilation, secretionand excretion, and their distinguishing characteristics are vigor, tension, and elasticity. They temper each element of character, as wellas every vital act. They infuse the organism with a resisting powerwhich renders it proof against the influence of miasma and malaria, andovercomes that passivity and impressionability so favorable to disease. Firmness expresses a physiological cohesiveness which strongly bindstogether the fibers of the tissues, and renders the organization compactand powerful. He, who can skillfully employ these energies, is alreadymaster of half of the diseases incident to mankind, and wields anindispensable adjunct to medicine, in the practice of the healing art. It is the key to success, for it unlocks difficulties and opens wide thedoor which leads to favorable results. 

Surplus energy sustains the circulation, increases capillary action, asif the excess of nerve-power were discharged from the distant extremityof each nerve and pervaded every tissue. The voluntary muscles indicatetheir participation in this energy, and, indeed, the whole organism isexalted by the influence of the mental faculties. They oppose thetendencies of Feebleness, Relaxation, and Derangement, and modify theirproclivities to Disease. The will is the servant of the intellect, emotions, and propensities, and the executive agent of all thefaculties. When the volitive faculties are in excess, they may overdothe other functions, prematurely break down the bodily organs, and, byovertaxing the system, subject it to pain and disorder. 

_VOLITIVE FACULTIES. _

The natural effect of FIRMNESS is physiological stability. The exerciseof 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 conformationof Alexander VI. , exhibiting a full development of the conservativefaculties. His character, according to history, brought reproach uponthe papal chair. ]

[Illustration: Fig. 74. Represents Zeno, a profound thinker and moralphilosopher. The contrast in their cranial developments was no greaterthan that of their lives. ]

Under this generic term we will group those cerebral powers which arecommon to the inferior animals, and closely allied to bodily conditionsand necessities. As denoting a group of animal faculties they relate notonly to the organic functions and self-preservation, but combat theaction of the intellect, oppose the evolution of new ideas, resistinvestigation, and discredit the value of truth. Adhesiveness, beingblindly conservative, clings to old ideas and traditionary opinions. Theanimal faculties tend to stifle investigation, and put authority abovetruth and science. Having a fixity of nature, a stationary attachment, they treat all intellectual developments as absurd. When these facultiespredominate, thought is obscured, intolerance of disposition ismanifested, and mental progress is arrested. Thus they evince theirconservative nature, and, since they relate to individual interests, they represent the elements of instinct. Such are the functions ofAcquisitiveness, Secretiveness, Selfishness, and Combativeness, as wellas the Generative powers. If these faculties predominate, allintellectual advancements are treated as experiments or theoreticalnovelties, and rejected as evanescent and worthless. If the promptingsof these be followed, there will be no innovation, and the orthodoxy ofthe dark ages will remain the standard for all time. The animalfaculties coincide with Lethargy, Sleep, and Nutrition, thus favoringorganic restoration. The intellectual faculties are wakeful, active, irrepressible, while the animal powers tend to repose, sleep, andrenovation, and thus suspend the activities of thought, sense, andmotion. The intellect expends the energy of the sensorial centers, induces fatigue and suffering, whereas the animal faculties overcome thevigils of thought, and produce refreshing slumber. Dr. Young stylessleep "tired nature's sweet restorer. " Swedenborg declared that, "insleep the brain folded itself up, and the soul journeyed through thebody, 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, readilycombining with those of the violent class, the ultimate tendencies ofwhich 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 inmedicine and religion. The animal faculties, since they are staid andregular, are naturally antagonistic to genius, sensibility, andoriginality. Their mental tendencies have been fairly described andtheir 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 posteriorbase of the cerebrum, are violent and criminal. Being contiguous to thejunction of the cerebrum and spinal system, they are subject to theinfluence of animal experiences. A large development of these facultiesis indicated by an unusual breadth and depth of the back part of thebase of the brain, and a full, thick neck, both of which denote goodalimentary and digestive powers. Active nutrition, plethora of thecirculation, vigorous secretion, a well developed muscular system, alarge heart and lungs, are accessory conditions. We do not associatecorpulence or surplus of vitality with a long, slender neck. Thecharacter of cerebral manifestations is represented by the baserfaculties of mind, such as Combativeness, Destructiveness, Desperation, Turbulence, Hatred, and Revenge. If unrestrained, these culminate inviolent and criminal acts; if _regulated_, they are employed in personaldefense. When _unduly excited_, they lead to dissipation, obscenity, swearing, rowdyism, and licentiousness; when _perverted_, they are thesource of recklessness, quarrels, frauds, falsehoods, robberies, andhomicides. They are unlike instinct, inasmuch as they are notself-limiting. The intimate relation which they sustain to the stomachand nutritive functions is strikingly displayed in the habit ofalcoholic intoxication. Spirituous drinks deprave the appetite, derangeand destroy the stomach, poison the blood, and pervert all the functionsof mind and body; and their injurious influence upon the nerves andbasilar faculties is equally remarkable. They excite combativeness, selfishness, irritability, and exaggerate the influence of the animalorgans. Intemperance results in disputes, fights, brawls, andmurders--the legitimate consequences of which are misunderstandings, suits at law, criminal proceedings, imprisonment, and the gallows. Itis, therefore, evident that the ultimate tendencies of these facultiesare tyrannical, cruel, violent, and atrocious. They are opposed to thenoble, moral faculties--Faith, Love, and Devotion--and, whenevertemptation inordinately allures, the course of life is likely to becharacterized 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 toseek first for the gratification of his appetite. Some persons, instigated by carnivorous desires, yearn for raw meat, and will not besatisfied unless their food is flavored with the flesh of animals. Theirbodies increase and thrive, even to repletion. Contrast theseindividuals with pale, lean, anæmic people, who crave innutritiousarticles of diet, and eat soft stones, slate, chalk, blue clay, and softcoal. Such perversions of the appetite are manifested only when there iseither a diminution in the volume of blood, deficient alimentation, defective assimilation, or a general depravity of the nutritivefunctions. Morbid conditions generate vitiating tendencies and destroythe natural appetite. 

While alcoholic stimulants affect the medulla oblongata principally, opium acts chiefly on the cerebrum, and excites reverie, dreamyideality, optical delusions, and the creative powers of the imagination;some of these hallucinations are said to be grotesquely beautiful andenjoyable. The effects of this agent differ from those of alcoholicintoxication by not deadening the moral sensibilities, or arousing theanimal propensities. Opium smokers are dreamy and abstracted, notquarrelsome or violent. Those who use ardent spirits lose their moraldelicacy, their intellect becomes dull, the reason cloudy, and thejudgment is overruled by appetite. It is conceded that the _trophiccenter_ is principally in the medulla oblongata; the cerebellum andlower cerebral ganglia, however, favorably influence the nutritivefunctions, and, when these organs are large and active, a plethoriccondition is the natural consequence. Redundancy of blood in the bodyindicates preponderance of the basilar organs. These faculties beingvehement in character, an excess of animal characteristics producesthose conditions which result in acute and inflammatory diseases. We mayexpress these conditions of the system as follows:

The _Animal Faculties_ correspond to the lower instinctivemanifestations. 

 / 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, pursuea violent course. 

REGION OF FEEBLENESS. 

Although the middle lobe of the cerebrum, at the base of the brain, doesnot denote decided force of character, or energy of constitution, yet ithas a certain sphere of normal action which is essential to the harmonyof mind and body. If this region is largely developed, the constitutionis languid, inefficient, sensitive, and abnormally disposed. But if itbe deficient, the volitive energies preponderate, and there is a lack ofthose susceptibilities of constitution, which prevent excessive waste. The cerebral faculties are Fear, Anxiety, Sensibility, Servility, Relaxation, and Melancholy, and their excessive predominance indicates aweak, vacillating, irresolute character, and the existence of thosebodily conditions which produce _general excitability_ and chronicderangement. A full development of this portion of the brain indicatesthat the person is naturally dependent, inferior, and subservient tostronger characters. Such a one is fearful, fretful, complaining, irritable, dejected, morose, and, sooner or later, becomes a fit subjectfor chronic disease. [5] The ultimate result of excessive fear, excitability, and irritability, is functional or organicderangement, --the morbid conditions represented by the word Disease. Themedulla oblongata and portions of the middle lobe of the brain, thefunctions of which represent Excitability, Anxiety, Fear, andIrritability (symbols of physical profligacy), are located just betweenthe ears (see Fig. 60). Inferior animals distinguished for breadthbetween the ears are not only cunning and treacherous, but veryexcitable and irritable. The head of the Fox is remarkable for itsextreme width at the region of Fear. He is proverbially crafty andtreacherous, always excitable, and so variable in temper that he cannever be trusted. He is a very timid thief, exceedingly suspicious, irregular in habits, and frequently driven by hunger into mischievousdepredations. 

[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 arousedby excessive hunger, exerts a debasing influence upon this and all ofthe adjacent organs, and is demoralizing to both body and mind. Inobedience to the instinct of hunger, children will slyly plunder gardensand orchards, displaying profligate, if not reckless tendencies in thegratification of the appetite. In this regional division we include themedulla, the posterior and middle portions of which give rise to thepneumogastric nerve. This nerve receives branches from the spinalaccessory, facial, hypoglossal, and the anterior trunks of the first andsecond cervical, and its filaments are distributed to the lungs, stomach, liver, spleen, pancreas, and gall bladder (see Fig. 60, withexplanation) Its agency is necessary to maintain the circulation, andthe respiration, since, as the medium of communication, it conveys fromthe brain large supplies of nervous force to sustain these vitalfunctions. It likewise instantly reports the impressions of thesephysiological processes to the brain, and especially to those partswhich, by analogy of functions. It likewise instantly reports theimpressions of these physiological processes of the brain, andespecially to those parts which, by analogy of functions, are intimatelyrelated to the stomach. Hence, we observe that the conditions of thestomach give rise to reflex impulses, which involuntarily excite theanimal faculties to the gratification of the appetite. That the stomachhas an intimate connection with the rest of the organism is evident fromthe fact that when it is inflamed the body is completely prostrated. 

We have already alluded to the perverting tendencies of alcoholicstimulants. Their peculiar influence upon the cerebellum causes thesubject to reel and stagger, as though a portion of that organ wereremoved; the group of energetic faculties is stupefied, and mental aswell as corporeal lethargy is the result. The reaction, which inevitablyfollows, is almost unbearable, and relief is sought by repeating andincreasing the poisonous draughts, the primary influence of which isstimulating, the ulterior, depressing. Alcoholic stimulants undulyexcite the nervous centers, the heart, and the arteries, and, consequently, the blood is carried to the surface of the body, where itcounteracts the influence of cold and exposure, the frequent attendantsupon 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 asthe consequences of habitual, alcoholic intoxication. 

That ordinary alimentation, which includes the process of digestion, thesubsequent vital changes involved in the conversion of food into blood, and its final transformation into tissue, causes mental languor anddullness, as well as bodily exhaustion, is attested by universalexperience. A torpid condition of the liver, one of the most inveterateof 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 theneck, denotes tendencies to somnambulism, delirium, and insanity. Ifsuch characteristics of the organization do not culminate in mentalderangement, they exhibit childishness, helplessness, and greatdependence. Age abates the vigor of the executive faculties, and oldpeople manifest not only bodily infirmities, but the relaxing andenfeebling influences proceeding from the lower portions of the brain. They totter about in their second childhood, mentally and physicallyenervated. Those who become dissipated by the use of intoxicatingbeverages are not only weak, trifling, and foolish, but walk with anunsteadiness which betrays their condition. These illustrations showthat this part of the brain is destitute of energy. Diseases of thedigestive organs also indicate it. Cholera, whether induced by invisibleanimalcules in the air, or in water, takes the route of the alimentarycanal, opens the vital gates, and myriads of victims are swept down todeath. It proves remarkably fatal to those having this cerebralconformation. Perhaps enough has been said to indicate the relaxing andenfeebling tendencies of this region of the brain. They may beclassified 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 asa "mucous substance of no great importance. " Its functional significancewas so slightly appreciated that some people hardly suspected they hadany brains, until an _accident_ revealed their existence. Latterly, however, it is generally understood that the perfection of an animaldepends upon the number and the development of the organs controlled bythe nervous system, the sovereign power of which is symbolized by agrand cerebrum, the throne of Reason. That animal which is so low in thescale of organization as to resemble a vegetable, belongs to anascending series ending in man. The lowest species have no consciousperception, and their movements do not necessarily indicate sensation orvolition. Instinct culminates in the _Articulates_, especially inInsects; while created intelligence reaches its acme in man, the highestrepresentative 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 forinstinct; some of the lower animals, however, seem to share his rationalnature, and to a certain degree become responsible to him. Finally, themanifestations of mind bear a relation to the development of cerebralsubstance, and to the bodily organization which supplies the brain withblood. Fig. 76 shows the relative amount of brain matter in the loweranimals, compared with that of man; the peculiarities of each agreeingwith its cerebral conformation. It is easier to measure the capacity ofskulls in different races than to procure and weigh their brains. Thefollowing 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 hundredcranial specimens obtained from different quarters of the globe, ascertained the relative volume of brain in different races, by fillingthe skulls with dry sand. He found that the European averaged 92 cubicinches, the Oceanic 89, the Asiatic 88, the African 86, the Australian81. Dr. Morton, of Philadelphia, had a collection of over one thousandskulls, and his conclusions were that the Caucasian brain is thelargest, the Mongolian next in size, the Malay and American Indiansmaller, and the Ethiopian smallest of all. The average weight of brain, in 278 Europeans, was 49. 50 oz. , in 24 White American soldiers, 52. 06oz. , 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 idiotsfrom 12 to 36 40 oz. The average of 273 male European brains was 49½oz. , while that of 191 females was 44 oz. If we compare the weight ofthe female brain with that of the body, the ratio is found to be as1:36. 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 norrelative size of the cerebrum, but the amount of gray matter which itcontains, is the criterion of mental power. Although a large cerebrum isgenerally indicative of more gray matter than a small one, yet it isascertained that the grey substance depends upon the number, and depthof the convolutions of the brain, and the deeper its fissures, the moreabundant is this tissue. It is this substance which is the source ofthought, while the white portion only transmits impressions. 

We do not wish to underrate any attempt heretofore made to classify thefunctions of mind and assign to them an appropriate nomenclature. It isnot unusual for scientists to give advice to phrenologists and point outthe fallacies of their system; but it is hardly worth while to indulgein destructive criticism, unless something better is offered, as the dayhas passed for ridiculing endeavors to understand and interpret thephysiology of the brain. The all important question is, not whetherphrenologists have properly located and rightly earned all the facultiesof mind, but have their expositions been useful in the development oftruth. While endeavoring to connect each mental power with a localhabitation in the brain, the system of phrenology may be chargeable withsome incongruous classification of the faculties, and yet it hasfurnished an analysis of the mind which has been of incalculable serviceto writers upon mental philosophy. Phrenology, in popularizing itsviews, has interested thousands in their own organizations and powers, who would otherwise have remained indifferent. It has called attentionto mental and bodily unities, has served as a guide to explain thephysical and psychical characteristics of individuals, and has beeninstrumental in applying physiological and hygienic principles to thehabits of life, thus rendering a service for which the world is greatlyindebted. Samuel George Morton, M. D. , whose eminent abilities andscholarship 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 itsstructure and functions have been studied in our time; for, althoughmuch remains to be explained, much has certainly been accomplished. Wehave reason to believe, not only that the brain is the center of thewhole series of mental manifestations, but that its several parts are somany organs, each one of which performs its peculiar and distinctiveoffice. But the number, locality, and functions of these several organsare far from being determined; nor should this uncertainty surprise us, when we reflect on the slow and devious process by which mankind hasarrived at some of the simplest physiological truths, and thedifficulties that environ all inquiries into the nature of the organicfunctions. "

[Illustration: Fig. 77. Side view of the brain of a Cat. A. Crucial sulcusdividing anterior convolutions. B. Fissure ofSylvius. C. Olfactory bulb. ]

We may here allude to the recent experimental researches with referenceto the functions of various portions of the brain, prosecuted by Dr. Ferrier, of England. He applied the electric current to different partsof the cortical substance of the cerebrum in lower animals which hadbeen rendered insensible by chloroform, and by it could call forthmuscular actions expressive of ideas and emotions. Thus, in a cat, theapplication of the electrodes at point 2, Fig. 77, caused elevation ofthe shoulder and adduction of the limb, exactly as when a cat strikes aball with its paw; at point 4, corrugation of the left eye-brow, and thedrawing inward and downward of the left ear; when applied at point 5, the animal exhibited signs of pain, screamed, and kicked with both hindlegs, especially the left, at the same time turned its head around andlooked behind in an astonished manner; at point 6, clutching movement ofthe left paw, with protrusion of the claws; at point 13, twitchingbackward of the left ear, and rotation of the head to the left andslightly upward, as if the animal were listening; at point 17, restlessness, opening of the mouth, and long-continued cries as if ofrage or pain; at a point on the under side of the hemisphere, not shownin this figure, the animal started up, threw back its head, opened itseyes widely, lashed its tail, panted, screamed and spit as if in furiousrage; and at point 20, sudden contraction of the muscles of the front ofthe chest and neck, and of the depressors (muscles) of the lower jaw, with panting movements. The movements of the paws were drawn inward bystimulating the region between points 1, 2, and 6; those of the eyelidsand face were excited between 7 and 8; the side movements of the headand ear in the region between points 9 and 14; and the movements of themouth, 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 ofthe cerebrum. Dr. Ferrier made similar experiments on dogs, rabbits, andmonkeys. The series of experiments made on the brain of the monkey issaid to be the most remarkable and interesting, not only because of thevariety of movements and distinctly expressive character of this animal, but on account of the close conformity which the simple arrangement ofthe convolutions of its brain bears to their more complex disposition inthe human cerebrum. It is premature to say what import we shall attachto these experiments, but they have established the correctness of thedoctrine, advanced on page 105, that thought, the product of cerebralfunctions, is a class of _reflex actions_. The cerebrum is not only thesource of ideas but also of those co-ordinate movements which correspondto and accompany these ideas. Certain cerebral changes call forth mentalstates and muscular movements which are mutually responsive. Theyindicate that various functions are automatic, or dependent upon thewill, and, as we have seen, experiments indicate that the electriccurrent, when applied to the cerebrum, excites involuntary reflexaction. We cannot say how far these experimental results justify thephrenological classification of the faculties of mind, by establishing a_causative_ relation between the physical and psychical states. Thisshort and unsatisfactory account furnishes one fact which seems tosupport the claim of such a relation: the apparent similarity betweenthe motor center of the lips and tongue in lower animals, and thatportion of the human cerebrum in which disease is so often found to beassociated with _Aphasia_, or loss of voice. While these experiments areby no means conclusive in establishing a theory, yet they favor it. 

It is wonderful that nervous matter can be so arranged as not only toconnect the various organs of the body, but at the same time to be theagent of sensation, thought, and emotion. It is amazing, that a ray oflight, after traversing a distance of 91, 000, 000 miles, can, by fallingupon the retina, and acting as a stimulus, not only produce acontraction of the pupil, but excite thoughts which analyze that ray, instantly spanning the infinitude of trackless space! The samepenetrative faculties, with equal facility, can quickly and surelydiscern the morbid symptoms of body and mind, become familiar with theindications of disease, and classify them scientifically among thephenomena of nature. The symptoms of disease which follow certainconditions as regularly as do the signs of development, and mind itselfis no exception to this uniformity of nature. Thoughts result fromconditions, and manifest them as evidently as the falling of rainillustrates the effect of gravity. The perceptive and highest emotivefaculties of man depend upon this simple, but marvelously endowednervous substance, which blends the higher spiritual with the lowerphysical functions. The functions of the body are performed by separateorgans, distinguished by peculiar characteristics. To elucidate thedistinctions between dissimilar, mental faculties, we have assignedtheir functions, with characteristic names, to different regions of thehead. As they unquestionably influence the bodily organs, we aresustained by physical analogy, in our classification. Our knowledge ofthe structure and functions of the nervous system is yet elementary, andwe are patiently waiting for scientists to develop its facts, and verifythem by experimental investigations and such researches as time alonecan bring to perfection. While real progress moves with slow andmeasured foot-steps, the inspirations of consciousness and theinferences of logic prepare the popular mind for cerebral analysis. Notrue system can contradict the facts of our inner experience; it canonly furnish a more complete explanation of their relation to the bodilyorgans. It should be expected that such careful and pains-takingexperiments, as are necessary to establish a science, will be precededby intuitive judgments and accredited observations, which may be, for atime, the substitutes of those more abstruse in detail. 

We have, in accordance with popular usage, treated the organs of thoughtas having anatomical relations. The views which we have presented inthis chapter may seem speculative, but the facts suggesting the theorydemand attention, and we have attempted to gather a few of the scatteredfragments and arrange them in some order, rather than leave them touncertainty and greater mystery. It is by method and classification thatwe are enabled to apply our knowledge to practical purposes. Possibly, to some, especially the non-professional, an allusion to the fact thatcerebral physiology contributes to successful results in the practice ofmedicine, may seem to be an exaggerated pretension. None, however, whoare conversant with the facts connected with the author's experience, will so regard this practical reference, for the statement might begreatly amplified without exceeding the bounds of truth. Physiciansgenerally undervalue the nervous functions, and overlook the importanceof the brain as an indicator of the conditions of the physical system, because they are not sufficiently familiar with its influence over thebodily functions. Pathological conditions are faithfully represented bythe thoughts, and words, when used to describe symptoms, become thesymbols of feelings which arise from disease. How few physicians thereare who can interpret the thoughts, and glean, from the expressions andsentences of a letter, a correct idea of the morbid conditions which thewriter wishes to portray! Each malady, as well as every temperament, hasits 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 onthe Neurological System of Anthropology, " are presented original ideaspre-eminently useful to the physician. His researches, and those oflater writers, together with our own investigations, have greatlyincreased our professional knowledge. It is by such studies andinvestigations that we have been prepared to interpret, with greaterfacility, the indications of disease, and diagnose accurately fromsymptoms, which have acquired a deeper significance by the light ofcerebral physiology. We are enabled to adapt remedies to constitutionsand their varying conditions, with a fidelity and scientific precisionwhich has rendered our success in treatment widely known and generallyacknowledged. We annually treat thousands of invalids whom we have neverbeheld, and relieve them of their ailments. This has been accomplishedchiefly through correspondence. When patients have failed to delineatetheir symptoms currently, or have given an obscure account of theirailments, we have been materially assisted in ascertaining the characterof the disease by photographs of the subjects. The cerebral conformationindicates the predisposition of the patient, and enables us to estimatethe strength of his recuperative energies. Thus we have a valuable guidein the selection of remedies particularly suited to differentconstitutions. In the treatment of chronic diseases, the successattending our efforts has been widely appreciated, not only in this, butin other countries where civilization, refinement, luxurious habits, andeffeminating customs, prevail. This fact is mentioned, not only as anillustration of the personal benefits actually derived from a thoroughknowledge of the nervous system, but to show how generally andextensively these advantages have been shared by others. 

A careful study of cerebral physiology leads us deeper into themysteries of the human constitution, and to the philosophicalcontemplation of the relations of mind and body. Self-culture impliesnot only a knowledge of the powers of the mind, but also how to directand use them for its own improvement, and he who has the key toself-knowledge, can unlock the mysteries of human nature and beeminently serviceable to the worlds For centuries the mind has beenspreading out its treasury of revelations, to be turned to practicalaccount, in ascertaining the constitution, and determining bettermethods of treating disease. Since comparative anatomists andphysiologists have revealed the structure of animals and the functionsof their organs, from the lowest protozoan to the highest vertebrate, the physician may avail himself of this knowledge, and thus gain adeeper insight into the structure and physiology of man. An intimateacquaintance with the physical, is a necessary preparation for the studyof the psychical life, for it leads to the understanding of their mutualrelations and reactions, both in health and disease. 

Consciousness, or the knowledge of sensations and mental operations, hasbeen variously defined. It is employed as a collective term to expressall the psychical states, and is the power by which the soul knows itsown existence. It is the immediate knowledge of any object whatever, andseems to comprise, in its broadest signification, both matter and mind, for all objects are inseparable from the cognizance of them. Hence, thesignificance of the terms, subjective-consciousness andobjective-consciousness. People are better satisfied with theirknowledge of matter than with their conceptions of the nature of mind. 

THE NATURE OF MIND. 

Since this subject is being discussed by our most distinguishedscientists, we will conclude this chapter with an extract from a lecturedelivered by Prof. Burt G. Wilder, at the American Institute:

"There now remains to be disposed of, in some way, the question as tothe nature and reality of mind, which was rather evaded at thecommencement of the lecture. The reason was, that I am forced to differwidely from the two great physiologists whom I have so often quoted thisevening. Most people, following in part early instruction, in partrevelation, in part spiritual manifestations, and in part trusting totheir own consciousness, hold that the human mind is a spiritualsubstance which is associated with the body during the life of thelatter in this world, and which remains in existence after the death ofthe body, and forms the spiritual clothing or embodiment of the immortalsoul; and that the individual, therefore, lives after death as a spiritin the human form; that of this spiritual man, the soul is the essentialbeing, 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 thenatural life. 

Together with the above convictions respecting themselves, most people, when thinking independently of theological sublimations, feel willing toadmit that animals have, in common with man, fewer or more naturalaffections and thoughts which make up their minds, but that the innerand immortal soul, which would retain them as part of an individualafter death of the body, is not possessed by the beasts that perish. Inshort, the vast majority of mankind, when thinking quietly, andespecially in seasons of bereavement, feel well assured of the real andsubstantial existence of the human mind, independently of its temporaryassociation with the perishable body. 

But in antagonism to this simple and comforting faith, stand theologicalincomprehensibilities on the one hand, and scientific skepticism on theother. The former would have us believe that the soul is a mere vapor, acloud of something ethereal, of which can be expected nothing moreuseful than 'loafing around the Throne, ' while the latter asks us torecognize the existence of nothing which the eyes cannot see and fingerstouch; to cease imagining that there is a soul, and to regard the mindas merely the product of the brain; secreted thereby as the liversecretes 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 thisstatement would imply that the mind exists as a force, independent ofthe brain; but the mind is produced by the brain substance; andintellectual force, if we may term the intellect a force, can beproduced only by the transmutation of a certain amount of matter; therecan be no intelligence without brain substance. '--FLINT. 

'The mind may be regarded as a force, the result of nervous action, andcharacterized by the ability to perceive sensations, to be conscious, tounderstand, to experience emotions, and to will in accordance therewith. Of these qualities, consciousness resides exclusively in the brain, butthe others, as is clearly shown by observation and experiment, cannot berestricted 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 commonground of dreamy emptiness, and we who confess our comparative ignoranceare comforted by the thought that some other things have been 'hid fromthe 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 notyet seem capable of logical demonstration. The denial of their existenceis not incompatible with a profound acquaintance with material forms andtheir operations; and, on the other hand, the belief in their existenceand substantial nature, and in their powers as first causes, have neverinterfered with the recognition of the so-called material forces, and ofthe organisms through which they are manifested. At present, at least, these are purely matters of faith; but although the Spiritualist (usingthe term in its broadest sense as indicating a belief in spirits), mayfeel that his faith discloses a beauty and perfection in the union, otherwise imperceptible by him, there is no reason why this differencein faith should make him despise or quarrel with his materialistco-worker, for the latter may do as good service to science, may be astrue a man, and live as holy a life, although from other motives. 

The differences between religious sects are mainly of faith, not ofworks, and the wise of all denominations are gradually coming to theconviction that they will all do God more service by toleration andco-operation than by animosity and disunion. And so I hold that, untilthe spiritualist feels himself able to demonstrate to the unbeliever theexistence of spirit and of God, as convincingly as a mathematicalproposition, there should be no hard words or feelings upon thesepoints. 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 dealswith his fellow men as he would be done by, so long will I work withhim, side by side, knowing, even though I cannot tell him so, thatwhether or not he joins me in this world, we shall meet in the otherworld to come, where his eyes will be opened, and where his lips will atleast acquit me of bigotry and intolerance. "

 * * * * *

CHAPTER XV. 

THE HUMAN TEMPERAMENTS. 

Organization implies vital energy, since there can be no organizationwithout it. The sperm cell, as we have previously seen, exists beforethe initiation of the life of every individual organism. The earlyhistory of this fertilizing cell, which is composed of infinitesimalmolecules which contain the embryo powers of life, is only partiallywritten. It is a fact, authenticated by Faraday, that one drop of watercontains, and may be made to evolve, as much electricity as, under adifferent mode of display, would suffice to produce a lightning-flash. Chemical force is of a higher order than physical, and vital force is ofa still higher order. Within the microscopic compass of the sperm cellare a great number of forces acting simultaneously, which require theanswering conditions of a germ cell, and are so blended as to occupy aminimum of space. The union of these subtle elements through the agencyof their physical, chemical, and vital forces, constitutes theinitiation of life. Elementary matter is transformed into chemical andorganic compounds, by natural forces, upon the cessation of which, it isliberated by nature's great destroyer, and re-appears in the world ofelements. Thus, man is formed out of the very dust by means of energieswhich reconstruct the crude, inert matter, and to dust he returns whenthose energies cease. 

When we enter upon the consideration of the temperaments, we should bearin mind one peculiarity of life: that it combines, in a small space, many complex powers. In the process of reproduction, there is a complexcombination of organic elements. Structures differ as greatly as theirfunctions. 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 obliteratethem. Within race-limits are found enduring peculiarities, and, althougheach individual is weaving out some definite pattern of organization, itfollows the type of the race, as well as the more immediate, antecedentcondition. 

What then is a _Temperament_ but a _mixing together_ of thesedetermining forces, a certain blending manifested in the constitution bysigns, or traits, which we denominate _character_. The different racesof mankind must have their several standards of temperament, for thepeculiarities of one are not fully descriptive of, and applicable to theother. 

The term temperament is defined by Dunglison, as being "a name given tothe remarkable differences that exist between individuals, inconsequence of the variety of relations and proportions between theconstituent 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 ACOMBINATION OF ORGANIC ELEMENTS SO ARRANGED AS TO CHARACTERIZE THECONSTITUTION. 

This leads us to consider some of the elements, conditions and forceswhich give character to the organization. External circumstances supplynecessary conditions to inward activity, for without air, food, orsunlight all living animals would perish. Everywhere, life is dependentupon conditions and circumstances; it is _not_ self-generating. But theconditions of reproduction are very complex. External forces aretransformed, and, in turn, become vital or formative powers. Developmentis a transmutation of physical and chemical forces into vital energy. Although unable to compute the ultimate factors of life, yet we mayillustrate their reproductive possibilities and results by comparingthem 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 intotheir composition, but are found in much smaller quantities. From theseelements is fabricated an organism which manifests peculiar propertiesand marvelous functions. If the proportion of these chemical elements bevaried, the organic compound will be changed, or, the proportionsremaining the same, if the _grouping_ of the elements be altered, different compounds will be produced, showing that the properties oforganized substances depend upon the _molecular_ constitution of matter. 

Rising in the scale of organization, we observe that every variation ofthe physical and chemical processes implies a corresponding modificationof the vital. This is verified by the peculiarities of the several racesof mankind. Individual differences are likewise modifications of theseprocesses. Dynamical or vital differentiation depends upon thesemodifications for the display of vital energy, and is always associatedwith molecular changes. But it should be borne in mind that an effectmay not resemble its cause in _properties_, and the _qualities_ of achemical compound may be quite different from those of its individualconstituents. Organic matter, although more complex, may exhibitproperties, both like and unlike its constituent elements. Withincertain boundaries, the elements seek to satisfy their affinities. Wediscover that there are limits between the genera of animals, as well asthe races of mankind. Not less really, though perhaps not as absolutely, are there individual precincts within the sphere of the humantemperaments, which cannot be passed. 

If we cannot satisfactorily explain, we can at least discover a reasonfor temperamental limitation. It is not designed to circumscribehealthful reproduction, but to serve as an effectual hindrance toabnormal 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 furnishedbecause the conditions on which it depends are wanting; again, susceptibility may exist at one time and not at another. Stimuli andsusceptibility may be present in different degrees, but for the purposeof healthful reproduction they must not be impaired. No single class offoods, albuminous, starchy, saccharine, or mineral, is sufficient forthe nutrition of the body, but the food must contain substancesbelonging to each of the different classes. If an animal be fedexclusively upon albumen, though this substance constitutes the largestpart of the bodily mass, exhaustion will rapidly follow, since the fooddoes not contain all the essential, nutritive elements. Again, when thesolids of the body have been wasted, they lose their susceptibility tostimuli, and the food does no good. Thus patients become emaciatedduring acute attacks of disease, upon the cessation of which they aretoo feeble to recover, simply because they have lost the power to digestand assimilate their food. 

In inanimate bodies, as in crystals, forces come to rest, but the veryidea of life implies action and continual change. Hence diversity ofconstitutions and different temperaments are essential in order thatmarriage 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 blendingof mind and body by means of the nervous system, and we now propose toexemplify the physical conditions of the organism by certaincorrespondences, observed in the development and conditions of thatsystem. If nature answer to mind in physical correspondences, she willobserve the same regularity in physical development. The simplestclassification of the temperaments is represented in Fig. 78. Not onlyis mental activity dependent upon a vital activity in the brain, but thedevelopment of the cerebrum is dependent upon the supply of blood. Thegrowth of the intellect requires the same conditions that aided in thedevelopment of Vulcan's right arm: waste and supply; disintegration andreparation of tissue. Our modern iron forges produce many an artisanwhose great right arm proclaims him to be a son of power as well as offire. Thus the fervid intellect, while forging out its thoughts, increases in size and strength. The difference between the developmentof the two is this; that the exercise of the blacksmith's right armquickens the activities of all the bodily functions, whereas theemployment of the intellect does not offer any healthy equivalent. Physical exercise is a hygienic demand, but intellectual employmentexerts no salutary influence on the body, while it is constantlyexpending the nutritive energies of the blood. The emotions, likewise, make exhaustive draughts upon nutrition to supply the waste of brainsubstance, just as certainly as physical labor causes muscular change, and demands reparation. One expends cerebral, the other, muscularsubstance. 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 atonicregion--the source of those languid, deranging influences which coincidewith morbidity and disease. A disturbance of the corporeal organs, whichespecially influence this portion of the brain, naturally tends to thedevelopment of insanity or imbecility. Morel has traced, through fourgenerations, the family history of a youth who was admitted to theasylum at Rouen while in a state of stupidity and semi-idiocy. Thefollowing summary of his investigations illustrates the natural courseof degeneracy as it extends through successive generations: immorality, depravity, alcoholic excess, and moral degradation, in thegreat-grandfather, who was killed in a tavern brawl; hereditarydrunkenness, maniacal attacks, ending in general paralysis, in thegrandfather; sobriety, but hypochondriacal tendencies, delusions ofpersecutions, and homicidal tendencies in the father; defectiveintelligence 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 theson's reproductive organs were as little developed as those of a childof twelve years of age. He had two sisters who were both defectivephysically and morally, and were classed as imbeciles. To complete theproof of heredity in this case, Morel adds that the mother had a childwhile the father was confined in the asylum, and that this childexhibited no signs of degeneracy. Statistics show that multitudes ofhuman beings are born with a destiny against which they have neither thewill nor the power to contend; they groan under the worst of alltyrannies, the tyranny of a bad organization, which is theirs byinheritance. We may represent the tendencies of the anterior portion ofthe brain by Fig. 79. The functional exercise of the anterior andsuperior portions of the cerebrum is _disintegrating_ and_devitalizing_, while the anterior and inferior portions coincide withmental and physical derangement, unless counteracted by opposing forces. It is therefore evident that in any organization, upon which is entaileda perverted or excessive action of this portion of the cerebrum, thetendencies are NON-VITAL, _i. E. _, unfavorable to fertility and physicalhealth. 

If the antagonizing regions are well developed, the tendencies arefavorable 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 ofsuch a temperament that it is VITAL, because the functions of itsnerve-centers are favorable to evolution. As degeneration observesconditions, so endurance and development conform to certain laws, and itis the duty of all truthful inquirers, who believe not only in theprogress of human intelligence, but in physical improvement fromgeneration to generation, to ascertain and comply with these essentialconditions. When the anterior and middle lobes of the brain are fullydeveloped at their inferior surfaces, it is regarded as an insanetemperament, _i. E. _ containing the germs of mental and bodilyderangement. 

How shall we distinguish the combination of organic elements, if not bythe manner in which they characterize the constitution? Every humanbeing is distinguished by natural peculiarities, both mental andphysical. These are indicated not only by the color of the eyes, hair, and skin, and the mental expressions, but in the conformation andcapabilities of the corporeal system. The color, form, size, and textureof a leaf indicate to the expert pomologist the nature of the fruitwhich the tree will bear, but how much more important is it tounderstand the harmonies of human development. If Prof. Agassiz coulddetermine 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 ofits fossil, why should not the physician understand the language oftemperaments, since it opens to him the revelations of humandevelopment? The sculptor blends character with form, the artist endowsthe face with natural expression, the anatomist accurately traces thenerves and arteries, the physiognomist reads character, which thenovelist delineates and the actor personates, because there are factsbehind all these, the materials wherewith to construct a science. Inorganization there are permanent forces which operate uniformly, thusrevealing the order of nature. 

THE TEMPERAMENTS CLASSIFIED. 

[Illustration: Fig. 80]

We propose to speak of four constitutional variations entitled toseparate consideration; the lymphatic, the sanguine, the volitive, andthe encephalic. The brain controls all the voluntary, and modifies theinvoluntary functions of the body. A particular cerebral developmentmodifies the functions of all the bodily organs, and thus tempers theconstitution. We shall, therefore, base our classification oftemperaments upon the mental and physiological characteristics, whichare portrayed by cerebral development. Such an arrangement isillustrated by Fig. 80. 

THE LYMPHATIC TEMPERAMENT. 

The lymphatic temperament predominates when the anterior base of thebrain and the middle lobe are developed so as to exert a preponderatinginfluence over the bodily functions. The character of this influence wehave described in cerebral physiology. It is difficult to stateprecisely the normal influences and nerve-forces which arise from thesefaculties, but it is evident that they are specially related tonutritive attraction, in opposition to volitive repulsion. It is onlytheir excessive influence which produces worthless, miserable, morbidcharacters. A constitution marked by this development is indolent, relaxative, and an easy prey to epidemics. This treatment is alsocharacterized by a low grade of vitality or resistance. When life issustained by the volitive powers, it is distinguished by a softness ofthe bodily tissues, and the prevalence of lymph. The fact that all theorganic functions are performed indolently, indicates lack of vitalpower. An excellent illustration of this temperament is found in Fig. 81, which represents a Chinese gentleman of distinction. In the lowerorder of animals, as in sponges, absorption is performed by contiguouscells, which are quite as effortless as in plants. Because of theirorganic indolence, sponges are often classed as vegetables. A bodyhaving an atonic or a lymphatic temperament is abundantly supplied withabsorbent organs, which are very sluggish in their operations. In thelymphatic temperament, there seems to be less constructive energy, slower elaboration, and greater frugality. Lymph is a colorless oryellow fluid containing a large proportion of water. It is not so highlyorganized as the blood, but resembles it, when that fluid is deprived ofits red corpuscles. In the sanguine temperament, circulation in theblood-vessels is the most active, in the lacteals next, and in thelymphatics the least so, but in the lymphatic temperament, this order isreversed. 

[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, areconvertible, one following the other, _i. E. , _ "a repletion consisting offat may be removed, and one of lymph may replace it, and _vice versa_. "He could not account for these alternations. The bear goes into hiswinter quarters sleek and fat, and comes forth in the spring just asplump with lymph, but he loses this fat appearance soon after obtainingfood. This simply indicates that, during lymphatic activity, thedigestive organs are comparatively quiescent. But when these arefunctionally employed again, lymphatic economy is not required. It isthe duty of the lymphatics to slowly convert the fat by suchtransformation, that when it reaches the general circulation, it maythere unite with other organic compounds, the process being aided byatmospheric nitrogen, introduced during the act of respiration. In thisway it may become changed into those chemically indefinite, artificialproducts, called proteid compounds. This view is supported by thedisappearance of fat as an organized product in the lymph of thelymphatic vessels, indicating that such transformation has occurred. Inthis way, by uniting with other organic compounds, it appears that lymphmay serve as a weak basis for blood; that atmospheric nitrogen is alsoemployed in forming these artificial compounds, is indicated by the factthat 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, palecomplexion, watery blood, slow and soft pulse, oval head, and broadskull, showing breadth at its base. Fig. 82 illustrates this temperamentcombined with sanguine elements. In all good illustrations of thistemperament, there is a breadth of the anterior base of the skullextending forward to the cheek bones. There is likewise a correspondingfullness of the face under the chin, and in the neck, denoting a largedevelopment of the anterior base of the cerebrum. The cerebralconformation of the Hon. Judge Green indicates mental activity, and wehave no reason to suppose that lymph was particularly abundant in hisbrain. 

[Illustration: Fig. 83. ]

While this description of the lymphatic temperament is correct, whenillustrated by the civilized races of men who are accustomed to luxury, ease, and an abundance of food, it does not apply with equal accuracy tothe cerebral organization of the American Indian. His skull, thoughbroad 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 morbidsusceptibilities, yet these, in the Indian, are opposed by a superiorheight of the posterior part of the skull. Consequently, he is restless, impulsive, excitable, passionate, a wanderer upon the earth. The basilarfaculties, however, are large, and he is noted for instinctiveintelligence. His habits alternate from laziness to heroic effort, fromidleness and quiet to the fierce excitement of the chase, fromvagabondism to war, sometimes indolent and at other times turbulent, butunder all circumstances, irregular and unreliable. In this case, lactealactivity 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 theblood. Figs. 84 and 85 represent the brain of an American Indian, andthat of a European, and show the remarkable difference in theiranatomical configuration. Evidently it is a race-distinction. Observethe greater breadth of the brain of the Indian, which according tocerebral physiology indicates great alimentiveness, indolence, morbidsensibility, irritability, profligacy, but also note that it _differsmaterially 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 verysusceptible to diseases of the bowels and blood. His appetite isungovernable, and his love of stimulants is strong. Syphilitic poison, small-pox, and strong drink will annihilate all these tribes sooner thangunpowder. Their physical traits of constitution are no lesscontradictory than their extremes of habit and character, for whilethere is evidence of _lymphatic elements_, yet it is contradicted by thecolor of the hair, eyes, and skin. This peculiar organization will notblend in healthful harmony with that of the European, and thisdemonstrates that the race-temperaments require separate and carefulanalytical 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 themiddle, lying between _BB_ and _CC_. In the American Indian, theposterior lobe, lying between _C_ and _D_ Is much smaller than in theEuropean. In the Indian, the cerebral convolutions on the anteriorlobe and upper surface of the brain, are smaller than the European. Ifthe anterior lobe manifests the intellectual faculties--the middlelobe the propensities common to man with the lower animals--and theposterior lobe, the conservative energies, the result seems to be, that the intellect of the American Indian is comparatively feeble--theEuropean, strong; the animal propensities of the Indian will begreat--in the European, more moderate; while reproduction, vitalenergy, and conservation of the species in the Indian is not as greatas with the European. The relative proportions of the different partsof the brain differ very materially. ]

By physical culture and regulation of the habits, the excessivetendencies of this temperament may be restrained. Solid food should besubstituted for a watery diet. If it be limited in quantity, this changewill not only diminish the size, but increase the strength of the body. The body should be disciplined by daily percussion until the imperfectlyconstructed cells, which are too feeble to resist this treatment, arebroken and replaced by those more hardy and enduring. Add to thistreatment brisk, dry rubbing, calisthenic exercises, and daily walks, which should be gradually extended. Continue this treatment for threemonths, and its favorable effects upon the temperament will surprise themost skeptical; if continued for a year, a radical alteration will beeffected, and the hardihood, health, and vigor of the constitution willbe greatly increased. 

This temperament may be improved physiologically, by being blended withthe sanguine and volitive. The offspring will be stronger, thestructures firmer, the organization more dense. Nutrition, assimilation, and all the constructive functions will be more energetic in weavingtogether the cellular fabric of the body. The sanguine temperament willadd a stimulus to the organic activities, while the volitive willcommunicate manly, brave, and enduring qualities. When this temperamentis united with the encephalic, if such a union does not result inbarrenness, it adds _expending_ and _exhaustive_ tendencies to the_enfeebling_'ones already existing, and, consequently, the offspringlacks both physical power and intellectual activity. 

The peculiarities of this temperament are observed in the diseases whichcharacterize it. It is specially liable to derangements of digestion, nutrition, and blood-making. The blood is easily poisoned by morbidproducts formed within the body, as well as by those derived from thebody of another. This is seen in pyæmia, produced by the introduction ofdecomposing pus, or "matter, " into the blood. This condition is mostlikely to occur when the vital powers are low and the energies weak, forthen the fibrin decreases, the red corpuscles diminish in number, thecirculation becomes languid, the pulse grows fluttering and weak, andthis increases until death ensues. An individual of this temperament ismore easily destroyed than any other "by the poison of syphilis, small-pox, and other contagious diseases. If the blood has received anyhereditary taint, the lymphatic glands not only reproduce it but oftenincrease the virulency of the original disease. This temperamentindicates a necessity for the employment of stimulating, alterative, andantiseptic medicines. The torpid functions need arousing, the bloodneeds depuration, i. E. , the elimination of corrupting matter, and thesystem requires alteratives to produce these salutary changes. Thesecretions need the correcting influence of cleansing remedies for thepurification of the blood. 

Persons of this temperament are more liable to absorption of morbidproducts 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 thusproduced. This kind of poisoning sometimes takes place from theabsorption of decomposed exudation in diphtheria, and, though rarely, from decomposing organic products collected in the lungs. Whenever theabsorption of poison does take place, fatal consequences usually follow. 

This passive temperament is more likely to sink under acute attacks ofdisease, especially alimentary disorders, such as diarrhea, dysentery, and cholera. It quickly succumbs to their prostrating effects, such asdepression, congestion, and fatal collapse which rapidly succeed oneanother. Venesection and harsh purgatives are contra-indicated, and thephysician who persists in their employment kills his patient. Howgrateful are warmth and stimulating medicines! The most powerful, diffusible, and nervous stimulants are required in cholera, when thesystem is devastated by the disease, as the plain is laid waste by thefierce tornado. 

THE SANGUINE TEMPERAMENT. 

Lymph is the characteristic of the lymphatic temperament, and itsspecific gravity, temperature, and standard of vitality are all lowerthan that of red blood. In the sanguine temperament all the vitalfunctions are more active, the blood itself has a deeper hue, itscorpuscles carry more oxygen, the complexion is quite florid, and thearterial currents impart to every faculty a more hopeful vigor. Theblood-vessels are the most active absorbents, eagerly appropriatingnutritive materials for the general circulation, while the respirationadds to it oxygen, that agent which makes vital manifestation possible. This temperament exhibits greater sensibility, the conceptions arequicker, the imagination more vivid, the appetite stronger, the passionsmore violent, and there is found every display of animal life andenjoyment. 

A full development of the basilar faculties, indicated by an unusualbreadth and depth of the base of the brain, accompanies thistemperament. Its cerebral area includes the posterior and inferiorportions of the cerebrum, the entire cerebellum, and that part of themedulla which connects with the spinal cord, all of which sustainintimate relations to vital conditions. Accordingly, such a developmentindicates good digestion, active nutrition, vigorous secretion, largeheart and lungs, powerful muscles, and surplus vitality. The violentfaculties, such as Combativeness, Destructiveness, and Hatred, arenatural adjuncts, and their excess tends to sensuality and crime. Theyare not only secretive, appropriative, selfish, and self-defensive, butwhen redundant are aggressive and tend to destructiveness, thegratification of animal indulgence, intemperance, and debauchery. Thecorrespondence between the cerebral conformation and the physicaldevelopment is very obvious. Lower orders of animals possess thesefaculties, and their spontaneous exhibition is called instinct. Theypossess the acquisitive, destructive, and propagative propensities, which lead them to provide for their wants and secure to themselves aposterity. The exercise of their bodies causes a continual waste whichdemands incessant reparation, and they are governed measurably by theseanimal impulses. 

All of these lower psychical faculties have a physiologicalsignificance. Acquisitiveness functionally expresses assimilation, accretion, animal growth, and tends to bodily repletion. Secretivenessexpresses concealing, separating, withdrawing, and functionallysignifies secretive action. Secretion is the separating and withdrawingfrom the blood some of its constituents, as mucus, bile, saliva, etc. This latter process indicates complex conditions of organization, sothat the higher and more complex the tissue, the greater the number ofsecretory organs. Unrestrained selfishness, while it naturally conservesthe individual interests, in its ultimate tendencies, is the veryessence of human depravity. Without qualification, clearly, it is crime, for blind devotion to the individual must be in utter disregard for thegood of others. The ultimate tendencies of these faculties are, therefore, criminal. 

Exaggerate the faculty of acquisitiveness, and it becomesavariciousness. Develop secretiveness and selfishness, and they becomecunning and profligacy, desperation and crime. Their functionaldevelopment tends to produce physical disorder and violent disease. Allof these faculties are vehement, contentious, thriving by opposition. Life itself has been called a forced state, because it wars with theelements it appropriates, and transmutes their powers into vitality. 

[Illustration: Fig. 86. ]

We find men and women of this temperament, who are models of characterand organization. George Washington is an excellent illustration. Theimpression that his presence made upon the Marquis de Chastellux, isgiven in the following words: "I wish only to express the impressionGeneral Washington has left on my mind; the idea of a perfect whole, brave without temerity, laborious without ambition, generous withoutprodigality, noble without pride, virtuous without severity. " Gen. Scott, Lord Cornwallis, Dr. Wistar, Bishop Soule John Bright, Jenny LindGoldsmidt, and Dr. Gall are good representatives of this temperament. Fig. 86 is an excellent illustration of it, finely blended and wellbalanced, in the person of Madame de Stael. This temperament requiresfewer tonics and stimulants than the lymphatic. This constitution isbest able to restore vital losses. It is a vital temperament, in otherwords, it combines favorably with all the others, and better adaptsitself to their various conditions. Some regard it as the best adjustedone in all its organs and tissues, and as the most satisfactory andserviceable. 

[Illustration: Fig. 87. ]

Excess of nutrition tends to plethora, to animal indulgence, and grosssensuality. Not only do the propensities rouse desire, but they excitethe basilar faculties, and portray their wants in the outlines of theface, mould the features to their expression, and flash theirsignificance from the eye. Who can mistake the picture of sensualityrepresented by Fig. 87? It is enough to shock the sensibility of a dumbanimal, and to say that such a face has a beastly look, is an unkindreflection upon the brute creation. A large neck and correspondingdevelopment of the occipital half of the brain indicate nervous energy, yet nutrition is not absolutely dependent upon it, for the nutritiveprocesses are active before a nervous system is formed. The lowerfaculties of the mind exert a remarkable influence over nutrition, secretion, and the molecular changes incident to life. Anger or fear maytransmute the mother's nourishing milk into a virulent poison. Thefollowing incident, taken from Dr. Carpenter's Physiology, illustratesthis statement: "A carpenter fell into a quarrel with a soldier billetedin his house, and was set-upon by the latter with his drawn sword. Thewife of the carpenter at first trembled from fear and terror, and thensuddenly threw herself between the combatants, wrested the sword fromthe soldier's hand, broke it in pieces, and threw it away. During thetumult, some neighbors came-in and separated the men. While in thisstate of strong excitement, the mother took up her child from thecradle, where it lay playing, and in the most perfect health, neverhaving had a moment's illness; she gave it the breast, and in so doingsealed its fate. In a few minutes the infant left-off sucking, becamerestless, panted, and sank dead upon the mother's bosom. The physicianwho was instantly called-in, found the child lying in the cradle, as ifasleep, and with its features undisturbed; but all resources werefruitless. It was irrecoverably gone. In this interesting case, the milkmust have undergone a change, which gave it a powerful sedative actionupon the susceptible nervous system of the infant. "

Anxiety, irritation, hatred, all tend to the vitiation of thedisposition and bodily functions, perverting the character andconstitution at the same time. Depravity of thought and secretion gotogether. Degradation of mind and corruption of the body areconcomitants. There is a very close affinity between mental and moralperversion and physical prostitution, of which fact too many areunconscious. Nervous influence preserves the fluidity of the blood andfacilitates its circulation, for it appears that simple _arrestment_ ofthis influence favors the coagulation of the blood in the vessels; clotsbeing found in their trunks within a few minutes after the brain andspinal marrow are broken down. Habitual constipation is the source ofmany ills. Perversion of the functions of the stomach, and of thecirculation of the blood, produce general disaster. 

Diseases which characterize this temperament are acute, violent, orinflammatory, indicating repletion and active congestion; intenseinflammation, burning fevers, severe rheumatism, a quick, full pulse, great bodily heat, and functional excitement are its morbidaccompaniments. These diseases will bear thorough depletion of thealimentary canal, active, hydragogue cathartics being indicated. Sedatives and anodynes are also essential to modify the circulatoryforces, and to relieve pain. Violent disturbance must be quelled, andamong the remedial agents required for this duty we may includeVeratrum, Ipecac, Digitalis, Opium, Conium, and Asclepias. Whileequalizing the circulatory fluids, restoring the secretions, andthoroughly evacuating the system, and thus endeavoring to removedisturbing causes, we find that the conditions of this temperament areexceedingly favorable for restoration to health. True, many chronicdiseases are obstinate, yet a course of restorative medicationpersistently followed, promises a fortunate issue in this tractiletemperament. 

Hygienic management of the lymphatic and sanguine temperaments consistsin the vigorous toning of the former, while restraint of the latter willgreatly exempt it from the anxieties, contentions, and vexations whichexcite the mind, disturb the bodily functions, and end in chronicdisease. People of the latter organization love mental and physicalstimulants, are easily inflamed by passion, and their excitabilitydegenerates into irritability, succeeded by serious functionalderangements, which prematurely break down the individual withinveterate, deep-seated disorder. Serenity, hope, faith, as well asfirmness, are natural hygienic elements. It is a duty we owe ourselvesto promptly relinquish a business which corrodes with its cares, anddepresses with its increasing troubles. Constant solicitude, and theapprehension of financial disaster, frustrate the bodily functions, disconcert the organic processes, and lead to mental aberration as wellas physical degeneracy. Melancholy is chronic, while despair is acutemania, whose impulses drive the victim desperately towardself-destruction. The chronic derangement of these organs exerts withless force the same morbid tendency. Hence the necessity for exercisingthose hygienic and countervailing influences born of resolution, assurance, and confident trust, and the belief which strengthens all ofthe vital operations. 

Doubtless, this temperament is the source of the reproductive powers. Itis the corner-stone essential to the foundation of all othertemperaments. It has been supposed by some that the cerebellum is theseat of sexual instinct. The fact appears that an ample development ofthe posterior base of the cerebrum and the cerebellum indicatesnutritive activity, which is certainly a condition most favorable to thedisplay of amativeness. In a double sense, then, this temperament is avital one; both by nutritive repletion, and by reproduction. It is theblood-manufacturing, tissue-generating, and body-constructingtemperament, causing growth to exceed waste, and promptly repairing thewear which follows continual labor. 

While the sleazy structures of the lymphatic temperament are favorableto the functions of transudation, exhalation, and mutual diffusion ofliquids, the sanguine, as its name indicates, is adapted to promote thecirculation of the blood, to favor nutrition and reproduction. Theformer temperament does not move the world by its energies, or impressit vividly with its wisdom, and the latter is more enthusiastic, enjoyable, and quickening. Each temperament, however, possesses salientqualities and advantages. 

THE LIFE LINE. 

Dr. W. B. Powell, in his work on "The Human Temperaments, " announces thediscovery of a measurement which indicates the tenacity of life, and thevital possessions of the individual. He has observed that some personsof very feeble appearance possess remarkable powers of resistance todisease, and continue to live until the machinery of life literallywears out. Others, apparently stronger and more robust, die before theusual term of life is half completed. He also noticed that some familieswere remarkable for their longevity, while others reached only a certainage, less than the average term of life, and then died. He remarked alsothat some patients sank under attacks of disease, when, to allappearances, 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 moredefinitely fixed by the organization than is supposed, but he sethimself to work to discover the line of life, and the measure of itsduration. 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 sanguinetemperament; and _vital tenacity_ to be measured by the _depth_ of thebase of the brain. Dr. Powell was an indefatigable student of nature, and followed his theory through years of observation, and measuredhundreds of heads of living persons, in order to verify the correctnessof the hypothesis. His method of measuring the head may be stated asfollows: He drew a line from the occipital protuberance on the back ofthe head to the junction of the frontal and malar bones, extending it toa point above the center of the external orbit of the eye, near thetermination of the brow. Then he measured the distance between this lineand the orifice of the ear and thus obtained the measure indicating thevital tenacity or duration of, life. Fig. 88 is a representation of theskull of Loper, who was executed for murder in Mississippi. He mighthave attained a great age, had not his violent and selfish faculties ledhim into the commission of crime. In this illustration, B represents theoccipital protuberance, and A the junction of the frontal and malarbones 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 thelife-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 thefollowing scale of measurements: three-fourths of an inch from theorifice of the ear to the life-line, is the average length in the adult, and indicates _ordinary_ tenacity of life. As the distance decreases tofive-eighths, one-half, or three-eighths of an inch, vital tenacitydiminishes. If the distance is more than three-quarters of an inch, itdenotes great vital endurance, excellent recuperative powers, and isindicative of longevity. If it measures less than half an inch, it showsthat the constitution has a feeble, uncertain hold upon life, and anacute disease is very likely to sunder the vital relations. Dr. Powellcontended that "life force and vital force are not equivalent terms, because much more vital force is expended upon our relations, than uponour organization in the preservation of life. Every muscularcontraction, every thought, and every emotion requires an expenditure ofvital force. " He asserted that we _inherit_ our life force orconstitutional power, and that we can determine by this _life-line, _ theamount which we so receive. And he believed that it could be increasedby _intellectual_ effort, just as we can increase vital force by_physical_ exercise. Fig. 89 represents the skull of a man who died, atnearly the same age as Loper, of consumption, in the Charity Hospital, at New Orleans. The measurement of the skull in this case gives a spacebetween the life-line and the orifice of the ear of one-sixteenth of aninch, 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 increasedafter maturity; muscular effort, mental activity, and a sense ofresponsibility being favorable to longevity, while idleness anddissipation are adverse to it. In justice to the Doctor, we have statedfully his theory and his method of determining the hardihood andendurance of the constitution, and we bespeak for it a candidexamination. Without doubt it embodies a great deal of truth. Hereafterwe shall endeavor to indicate by cerebral configuration, a better systemof judging of the vital tenacity, hardihood, and constitutionalenergies, both inherited and acquired. 

THE VOLITIVE TEMPERAMENT. 

By reference to Figs. 72 and 80, the reader will be able to locate theregion of the volitive faculties, previously described under the genericterm _will_. This temperament is characterized by ambition, energy, industry, perseverance, decision, vigilance, self-control, arrogance, love of power, firmness, and hardihood. These faculties expressconcentration of purpose and their functional equivalents are power ofelaboration, 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 andskin dark, the temporal region is not broadly developed, the face isangular, its lines denoting both power of purpose and strength ofconstitution, 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 bycorresponding breadth from side to side. The rule given by Dr. J. R. Buchanan applies not only to the convolutions, but to the generaldevelopment 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 asconstant and copious in its manifestation as when it is associated withbreadth. An individual having a narrow, high head, may determine readilyenough upon a course of action, but he requires a longer period for itscompletion than one whose head is both high and broad. Such a cerebralconformation cannot accomplish its objects without enjoying regularrest, and maintaining the best of habits. Breadth of this region of thebrain indicates ample resources of energy, both psychical and physical. It denotes greater vigor of constitution, one that continually generatesvolitive forces, and its persistency of purpose may be interpreted asfunctional tenacity. Inflexibility of will and purpose impart theirtenacious qualities to every bodily function. The _will_ to recover isoften far more potent than medicine. We have often witnessed its powerin restraining the ravages of disease. The energetic faculties, locatedat the upper and posterior part of the head, are the invigorating, or_tonic_ elements of the constitution, imparting hardy, firm, steady, andefficient influences, checking excess of secretion, repressingdissipation, and tending to maintain self-possession, as well as healthyconditions of life. Fig. 90 is a portrait of U. S. Grant, which shows awell-balanced organization, with sufficient volitive elements tocharacterize the constitution. 

[Illustration: Fig. 90. ]

The old term _bilious temperament_ might possibly be retained indeference to long usage, did it not inculcate a radical error. _Bilious_is strictly a medical term, relating to bile, or to derangementsproduced by it, and it was used originally to distinguish a temperamentsupposed to be characterized by a predominance of the biliary secretion. In the volitive temperament, the firm, tenacious, toning, andrestraining faculties _repress_, rather than _encourage_ biliarysecretion, and hence the necessity for administering large doses ofcholagogues, remedies which stimulate the secretion of bile. When thesystem is surcharged with bile, from a congested condition of the liver, we use these agents in order to obtain necessary relief. In thistemperament there is moderate hepatic development, lack of biliaryactivity, deficiency in the secretion of bile, and a sluggish portalcirculation. Therefore, to apply the term bilious to this temperament isnot only unreasonable, but it is calculated to mislead. The condition ofthe bowels is generally constipated, the skin dark and sometimes sallow. For these and other obvious reasons, we dismiss the word _bilious_, andsubstitute one which is more characteristic. 

We will not dwell upon the volitive as _psychical_ organs, except toshow that, when their influence is transmitted to the body, they act as_physiological_ organs, and thus demonstrate that all parts of the brainhave their physiological, as well as mental functions. When AndrewJackson uttered with great emphasis the memorable words, "BY THEETERNAL, " the effect was like a shock from a galvanic battery, thrillingthe cells in his own body, and paralyzing with fear every one inCalhoun's organization. This is an illustration of the power or range ofaction 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 ALLSUMMER. " Such a temperament has a profusion of constitutional power, great durability of the life-force, and, in our opinion, the combinedheight and breadth of this region correctly indicate the naturalhardihood of the body and its _retentiveness of life_. No one need doubtits influence upon the sympathetic system, and, through that system, itspower over absorption, circulation, assimilation, and secretion, as wellas the voluntary processes. Mental hardihood seems wrought into concreteorganization. It checks excess of glandular absorption, restrains theimpulses of tumultuous passion, tones and regulates the action of theheart, and helps to weave the strands of organization into a morecompact fabric. The toning energies of the volitive faculties are betterthan quinine to fortify the system against _miasma_ or _malaria_, andthey co-operate with all tonic remedies in sustaining organic action. Fig. 91 is a portrait of Prof. Tyndall, the eminent chemist, whoselikeness indicates volitive innervation, showing great strength ofcharacter and of constitution; he is an earnest, thorough, and intensemental 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 countenanceindicates his honest intentions, and displays strength of conscientiouspurpose; his physical constitution may be correctly interpreted in allof its general characteristics by the analysis of his energetictemperament, 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 thistemperament with large mental and emotional faculties. Fig. 92 is arepresentation of the martyred President Abraham Lincoln. During aneventful career, his temperament and constitution experienced markedchanges, and while always distinguished for strength of purpose andcorresponding physical endurance, he was governed by noble, moralfaculties, manifesting the deepest sympathy for the down-trodden andoppressed, blending tenderness and stateliness without weakness, exhibiting a human kindness, and displaying a genuine compassion, whichendeared him to all hearts. He was hopeful, patriotic, _magnanimous_even, while upholding the majesty of the law and administering thecomplicated affairs of government. The balances of his temperamentoperated with wonderful delicacy, through all the perturbatinginfluences of the rebellion, showing by their persistence that he wasnever for a moment turned aside from the great end he had in view; theprotection and perpetuation of republican liberty. His life exhibited asublime, moral heroism, elements of character which hallow his name, andkeep it in everlasting remembrance. 

We have treated the brain, not as a mass of organs radiating from themedulla oblongata as their real center, but as two cerebral masses, eachof which is developed around the great ventricle. We have freely appliedan easy psychical and physiological nomenclature to the functions of itsorgans, knowing that there is no arbitrary division of them by specificnumber, for the cerebrum, in an anatomical sense, is a single organ. Thedoctrine of cerebral unity is true, and the doctrine of its plurality offunction is true also. Whatever effect an organ produces when acting inentire predominance, is regarded as the function of that organ and isexpressed by that name. Although our names and divisions are arbitraryand designed for convenience, yet they facilitate our consideration ofthe psychical, and their corresponding physiological functions. Everycerebral manifestation denotes a _psychical_ organ, and in proportion asthese acts are transmitted to the body it becomes a _physiological_organ. We have ventured to repeat this proposition for the sake of thenon-professional reader, that he may be able to distinguish between' thetwo results of the manifestation of one organ. The transmission of theinfluence of the brain into the body enables the former to actphysiologically, whereas, if its action were confined within thecranium, it would only be psychical. In the language of Prof. J. R. Buchanan, "every organ, therefore, has its mental and corporeal, itspsychological and physiological functions--both usually manifestedtogether--_either capable of assuming the predominance_. " We havealready seen to what degree the _Will_ operates upon the organism, orhow "the soul imparts special energy to single organs, so that theyperform their functions with more than usual efficiency, " and thusresist the solicitations of morbific agents. Doubtless our best thoughtsare deeply tinged by the healthful or diseased conditions of such organsas the stomach, the lungs, the heart, or even the muscular orcirculatory systems, and these impressions, when carried to thesensorium, are reflected by the thoughts, for reflex action is the thirdclass of functions, assigned to the cerebrum. These reflex actions areeither hygienic and remedial, or morbid and pernicious. Hence, it isphilosophical not only to interpret the thoughts as physiological andpathological indications, but to consider the cerebrum as exerting realhygienic and remedial forces, capable of producing salutary reparative, and restorative effects. When a boiler carries more steam than can beadvantageously employed, it is subjected to unnecessary and injuriousstrain, and is weakened thereby; so, when the body is overtasked byexcessive pressure of the volitive faculties, it is prematurelyenfeebled and broken down. There are many individuals who need to makeuse of some sort of safety valve to let off the surplus of theirinordinate ambition; they need some kind of patent brake to slackentheir speed of living; they should relieve the friction of theirfunctional powers by a more frequent lubrication of the vital movements, and by stopping, for needed refreshment and rest, at some of the manyway-stations of life. 

THE ENCEPHALIC TEMPERAMENT. 

The encephalic temperament is distinguished by prominence and breadth ofthe forehead, or by a full forehead associated with height and breadthat its coronal junction with the parietal bones, and extending towardthe volitive region. (See Fig. 10, the space between 1 and 2 representsthe 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 therelation and the agreement of principles. The former classifies andarranges facts, the latter invests them with moral and spiritual import. The one treats of matter, its physical properties, and chemicalcomposition, the other of thoughts and intentions which involve rightand wrong, relating to spiritual accountability. The intellect isemployed upon an observable order of things, while the emotive facultiesarrange the general laws of being into abstract science. 

Fig. 93, a portrait of Prof. Tholuck, is a remarkable example of anencephalic organization. Figs. 72 and 79 fairly indicate the effects ofundue mental activity, the intellect causing vital expenditure resultingin the devitalization of the blood. While the intellect displays keenpenetration, subtle discrimination, and profound discernment, theemotions exhibit intense sensitiveness, acute susceptibility, andinspirational impressibility. The encephalic temperament ischaracterized by mental activity, great delicacy of organization, a highand broad forehead, expressive eyes, fine but not very abundant hair, great sensitiveness, refined feelings, vividness of conception, andintensity of emotion. If the brain is developed on the sides, there ismanifested Ideality, Modesty, Hope, Sublimity, Imagination, andSpirituality. If the brain and forehead project, the Perceptive, Intuitive, and Reasoning faculties predominate. If it rises high, andnearly perpendicularly, Liberality, Sympathy, Truthfulness, andSociability are manifested. When the emotive faculties are large, Faith, Hope, Love, Philanthropy, Religion, and Devotion characterize theindividual. It is an artistic, creative, and aesthetic temperament, beautiful in conception and grand in expression, yet its sensitivenessis enfeebling, and its crowning excellence, when betrayed by thepropensities, trails in defilement. Its purity is God-like, itsdebauchment, Perdition!

[Illustration: Fig. 93. ]

Fig. 94 is the likeness of Prof. George Bush. His forehead is amplydeveloped in the region of Foresight, Liberality, Sympathy, Truthfulness, and Benevolence; his mouth expresses Amiability andCheerfulness, and the whole face beams with Kindness and Generosity. This philanthropist, who is both a preacher and an author, has publishedseveral works upon theology, which distinguish him for great researchand originality. 

[Illustration: Fig. 94. ]

Fig. 95 represents the sanguine-encephalic temperament, the two elementsbeing most happily blended. The portrait is that of Emmanuel Swedenborg, the great scholar and spiritual divine. The reader will observe how highand symmetrical is the forehead, and how well balanced appears theentire organization. He was remarkable for vivid imagination, greatscientific acquirements, and all his writings characterize him as asubtle reasoner. 

When the encephalic predominates, and the sanguine is deficient in itselements, we find conditions favorable to _waste_ and _expenditure_, andadverse to a generous _supply_ and _reformation_ of the tissues. A childinheriting this cerebral development is already top-heavy, and supports, at an immense disadvantage, this disproportionate organization. Thenutritive functions are overbalanced; consequently there is apredisposition to scrofulous diseases and disorders of the blood, various degenerating changes taking place in its composition; loss ofred 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 specialcogency to the maintenance of health. When the mind dwells on onesubject to the exclusion of all others, we call such a conditionmonomania. If we have an excessive development of mind, and deficientsupport of body, the result is corporeal derangement. It is unfortunatefor any child to inherit unusually large brain endowments, unless he ispossessed of a vigorous, robust constitution. Such training should bedirected to that body as will encourage it to grow strong, hearty, andthrifty, and enable it to support the cerebral functions. The mentalproclivities should be checked and the physical organization cultivated, to insure to such a child good health. Cut off all unnecessarybrain-wastes, attend to muscular training and such invigorating gamesand exercises as encourage the circulation of the blood; keep the skinclean and its functions active, the body warm and well protected, thelungs supplied with pure air, the stomach furnished, with wholesomefood, besides have the child take plenty of sleep to invigorate thesystem, and thus, by regular habits, maintain that equilibrium whichtends to wholesome efficiency and healthful endurance. 

TRANSMISSION OF LIFE. 

As has been already stated in the chapter on Biology, reproduction ofthe species depends upon the union of a sperm-cell with a germ-cell, themale furnishing the former and the female the latter. It is a well-knownfact that the marriage of persons having dissimilar temperaments is morelikely to be fertile than the union of persons of the same temperaments;consanguineous marriages, or the union of persons nearly related byblood, diminish fertility and the vigor of the offspring. Upon thissubject Francis Galton has given some very interesting historicalillustrations in his well-known work, entitled "Hereditary Genius. " Thehalf-brother of Alexander the Great, Ptolemy I, King of Egypt, hadtwelve descendants, who successively became kings of that country, andwho were also called Ptolemy. They were matched in and in, but in nearlyevery case these near marriages were unprolific and the inheritancegenerally passed through other wives. Ptolemy II married his niece, andafterwards his sister; Ptolemy IV married his sister. Ptolemy VI and VIIwere brothers, and they both consecutively married the same sister;Ptolemy VII also subsequently married his niece; Ptolemy VIII marriedtwo of his sisters in succession. Ptolemy XII and XIII were brothers, and both consecutively married their sister, Cleopatra. Mr. Galton andSir Jas. Y. Simpson have shown that many peerages have become extinctthrough the evil results of inter-marriage. Heiresses are usually onlychildren, the feeble product of a run-out stock, and statistics haveshown that one-fifth of them bear no children, and fully one-third neverbear more than one child. Sir J. Y. Simpson ascertained that out of 495marriages in the British Peerage, 81 were unfruitful, or nearly one inevery six; while out of 675 marriages among an agricultural andseafaring population, only 65 were sterile or barren, or a little lessthan one in ten. 

While the marriages of persons closely related, or of similartemperaments are frequently unfruitful, we would not have the readerunderstand that sterility, or barrenness, is usually the result of suchunions. It is most frequently due to some deformity or diseasedcondition of the generative organs of the female. In the latter part ofthis work may be found a minute description of the conditions whichcause barrenness, together with the methods of treatment, which haveproved most effectual in the extensive practice at the Invalids' Hoteland Surgical Institute. 

The temperaments may be compared to a magnet, _the like poles of whichrepel, and the unlike poles of which attract each other. _ Thussimilarity of temperament results in barrenness while dissimilaritymakes the vital magnetism all the more powerful. Marriageable personsmoved by some unknown influence, have been drawn instinctively towardeach other, have taken upon themselves the vows and obligations ofwedlock, and have been fruitful and happy in this relation. Alliancesfounded upon position, money, or purely arbitrary considerations, merecontracts of convenience, are very apt to prove unhappy andunproductive. 

Men may unconsciously obey strong instinctive impulses without beingconscious of their existence, and by doing so, avoid those ills, whichotherwise might destroy their connubial happiness. The _philosophy_ ofmarriage receives no consideration, because the mind is pre-occupiedwith newly awakened thoughts and feelings. Lovers are charmed by certainharmonies, feel interior persuasions, respond to a new magneticinfluence 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 moresuitable for them to form a nuptial alliance with an unlike combination. The cause of the wretchedness attending many marriages may be traced toa too great similarity of organization, ideas, taste, education, pursuits, and association, which similarity almost invariably terminatesin domestic unhappiness. The husband and wife should be as different asthe positive and negative poles of a magnet. When life is begotten underthese circumstances we may expect a development bright withintelligence. 

 * * * * *

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 ofthe human spirit, is the rudimental element of the human soul. It is, therefore, a Divine gift, a blessing which the Creator did not withdrawfrom his erring children, when they were driven from a paradise ofinnocence and loveliness into a world of desolation and strife. He leftit as an invisible cord by which to draw the human heart ever upward, toa brighter home--the heavenly Eden. Love is the very essence of Divinelaw, the source of inspiration, even the fountain of life itself. It isspontaneous, generous, infinite. To its presence we are indebted for allthat is good, true, and beautiful in Art and Nature. It endows humanitywith countless virtues, and throws a mystic veil over our many faults. It is this feeling, this immutable law, which controls the destiny ofthe race. From its influence empires have fallen, scepters have beenlost. Literature owes to Love its choicest gems. The poet's lay issweeter when Cupid tunes the lyre. The artist's brush is truer whenguided by Love. Greece was the cradle of letters and art. Her daughterswere 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; todefine it as purely physical. The result has been a correspondingdegradation of art, and even literature has lost much of its loftyidealism. Nudity has become a synonym of vulgarity; Love, of lust. "Evilbe to him who evil thinks. " True Love never seeks to degrade its object;on the contrary, it magnifies every virtue, endows it with divinestattributes, and guards its chastity, or honor, at the sacrifice of itsown life. It increases benevolence by opening the lover's heart to thewants of suffering humanity. Ideality is the canvas, and imagination thebrush with which Love delineates the beauties of the adored. Loveheightens spirituality, awakens hope, strengthens faith, and enhancesdevotion. It quickens the perceptions, intensifies the sensibilities, and redoubles the memory. It augments muscular activity, and impartsgrace 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, Lovemay be considered as the very foundation of our spiritual existence, asbone and reason are the essential bases of our physical and intellectualbeing. Every man or woman feels the influence of this emotion, sooner orlater. It is the Kadesh-barnea of human existence; obedience to itsintuitions insures the richest blessings of life, while neglect orperversion enkindles God's wrath, even as did the disobedience of thewandering Israelites. 

The one great fact which pervades the universe is _action_. The veryexistence of Love demands its activity, and, hence, the highesthappiness is attained by a normal and legitimate development of thiselement of our being. The heart demands an object upon which to lavishthe largess of its affection. In the absence of all others, a star, aflower, or even a bird, will receive this homage. The bird warbles a gayanswer to the well-known voice, the flower repays the careful cultivatorby displaying its richest tints, the star twinkles a bright "goodevening" to the lonely watcher, and yet withal there is an unsatisfiedlonging in the lover's heart, to which neither can respond; the desireto be loved! Hence, the perfect peace of reciprocated love. If its lawsare violated, nature seeks revenge in the utter depression orprostration of the vital energies. Thus has the Divine Law-giverengraven 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 whichis filial affection, the natural harmonizer of society. Paternal loveincludes a new element--protection. Greater than either, and second onlyin 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 trulyconjugal, 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 bea union of Love and Wisdom. The fundamental law of conjugal love is_fidelity to one love_. God created but one Eve, and the essentialelements of paternal and maternal love pre-suppose and necessitate, fortheir normal development, the Love of _one_ only. Again, Love is the sunof woman's existence. Only under its influence does she unfold thenoblest powers of her being. Woman's intuitions should therefore betaken as the true love-gauge. If she desire a plurality of loves, itmust be a law of her nature; but is communism the desire of our wivesand daughters? No! Every act which renders woman dear to us, denouncessuch an idea and reveals the exclusive sacredness of her Love. Ascondemning promiscuity in this relation, we may cite the lovers' pledgesand oaths of fidelity, the self-perpetuity of Love itself, the commoninstincts of mankind, as embodied in public sentiment, and the inherentconsciousness that first love should he kept inviolable forever. Again, Love is conservative. It clings tenaciously to all the memoriesconnected with its first object. The scenes consecrated to "Love's youngdream" are sacred to every heart. The woodland with its winding pathsand arbors, the streamlet bordered with drooping violets and dreamypimpernel, the clouds, and even "the very tones in which we spoke, " areindelibly imprinted on the memory. There is also the "mine and thine"intuition of love. This sentiment is displayed in every thought and actof the lover. Every pleasure is insipid unless shared by the beloved;selfish and exacting to all others, yet always generous and forgiving tothe adored. "Mine and thine, dearest, " is the language of Conjugal Love. 

The consummation desired by all who experience this affection, is theunion of souls in a true marriage. Whatever of beauty or romance theremay be in the lover's dream, is enhanced and spiritualized in theintimate communion of married life. The crown of wifehood and maternityis purer, more divine, than that of the maiden. Passion is lost; theemotions predominate. 

The connubial relation is not an institution; it was born of thenecessities and desires of our nature. "It is not good for man to bealone, " was the Divine judgment, and so God created for him "anhelpmate. " Again, "Male and female created He them;" therefore, sex isas divine as the soul. It is often perverted, but so is reason, aye, sois devotion. 

The consummation of marriage involves the mightiest issues of life. Itmay 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-assortedunions. Many unhappy marriages are traceable to one or both of twosources, Physical Weaknesses and Masquerading. Many are the candidatesfor marriage who are rendered unfit therefor from weaknesses of theirsexual systems, induced by the violation of well-established physicallaws. 

We cannot too strongly urge upon parents and guardians the imperativeduty of teaching those youths who look to them for instruction, in allmatters which pertain to their future well-being such lessons as areembraced in the chapter of this book entitled, "Hygiene of theReproductive Organs. " By attending to such lessons as will give thechild a knowledge of the physiology and hygiene of his whole system, theerrors into which so many of the young fall, and much of the miserywhich 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 totheir health. At the age of seventeen or eighteen, our young ladies aresorry specimens of womankind, and "palpitators, " cosmetics, and all themodern paraphernalia of fashion are required to make them appear freshand blooming. Man is equally to blame. A devotee to all the absurddevices of fashion, he practically asserts that "dress makes the man. "But physical deformities are of far less importance than moralimperfections. Frankness is indispensable in love. Each should know theother's faults and virtues. Marriage will certainly disclose them; theidol falls and the deceived lover is transformed into a cold, unlovinghusband or wife. By far the greater number of unhappy marriages areattributable to this cause. In love especially, honesty is policy andtruth will triumph. 

HISTORY OF MARRIAGE. 

POLYGAMY AND MONOGAMY. We propose to give only a brief dissertation onthe principles and arguments of these systems, with special reference totheir representatives in the nineteenth century. Polygamy has existed inall ages. It is, and always has been, the result of moral degradation orwantonness. The Garden of Eden was no harem. Primeval nature knew nocommunity of love. There was only the union of two "and the twain weremade one flesh. " Time passed; "the sons of God saw the daughters of menthat they were fair; and they took them wives of all which they chose. "The propensities of men were in the ascendant, and "God repented Himthat He had created man. " He directed Noah to take into the ark, two ofevery sort, male and female. But "the imagination of man's heart is evilfrom his youth, " and tradition points to Polygamy as the generallyrecognized form of marriage among the ancients. The father of the Hebrewnation was unquestionably a polygamist, and the general history ofpatriarchal life shows that a plurality of wives and concubines werenational customs. In the earlier part of Egyptian history, Menes is saidto have founded a system of marriage, ostensibly monogamous, but inreality it was polygamous, because it allowed concubinage. Ascivilization advanced, the latter became unpopular, and "althoughlawful, was uncommon, " while polygamy was expressly forbidden. Solomon, according to polygamous principles, with his thousand women, should haveenjoyed a most felicitous condition. Strange that he exclaimed "A womanamong all these have I not found. " According to the distinguished Rabbi, Maimonides, polygamy was a Jewish custom as late as the thirteenthcentury. When Cecrops the Egyptian King, came to Athens (1550, B. C. ) heintroduced a new system, which proved to be another step toward therecognition of Monogamy. Under this code a man was permitted to have onewife and a concubine. Here dawned the era of Grecian civilization, theglory of which was reflected in the social and political principles ofWestern Europe. During the fourth and fifth centuries B. C. , concubinagedisappeared, but, under the new regime, the condition of the wife wasdegraded. She was regarded as simply an instrument of procreation and amistress of the household, while a class of foreign women, who devotedthemselves to learning and the fine arts, were the admired, and oftenthe beloved companions of the husbands. These were the courtesans whoplayed the same role in Athenian history, as did the chaste matron, inthe annals of Rome. When Greece became subject to Rome and the nationalcharacteristics of these nations were blended, marriage became a looseform of monogamy. In Persia, during the reign of Cyrus, about 560 B. C. , polygamy was sustained by custom, law, and religion. The Chinesemarriage system was, and is, practically polygamous, for, from theirearliest traditions, we learn that although a man could have but onewife, he was permitted to have as many concubines as he desired. 

In the Christian era the first religious system which incorporatedpolygamy as a principle was Mohammedanism. This system, which is soadmirably adapted to the voluptuous character of the Orientals, haspenetrated Western Europe, Asia, and Africa. Hayward estimated thenumber of its adherents to be one hundred and forty millions. The heavenof the Mohammedan is replete with all the luxuries which appeal to theanimal propensities. Ravishing Houris attend the faithful, who reclineon downy couches, in pavilions of pearl. On the Western Continent asystem 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 inharmony with the Bible and a special revelation to its leading Saint. According to the Mormon code, "Love is a yearning for a higher state ofexistence, and the passions, properly understood, are feeders of thespiritual life;" and again, "nature is dual; to complete hisorganization a man must marry. " The leading error of Mormonism is thatit mistakes a legal permission for a Divine command. The Mormon logicmay be premised as follows: the Mosaic law allowed polygamy; the Biblerecords it; therefore, the Bible _teaches_ polygamy. 

A Mormon Saint can have not less than three wives but as many more as hecan conveniently support. The eight fundamental doctrines of the MormonChurch are stated as follows: 1. God is a person with the flesh and formof a man. 2. Man is a part of the substance of God and will himselfbecome a god. 3. Man is not created by God but existed from alleternity. 4. Man is not born in sin, and is not accountable for offensesother than his own. 5. The earth is a colony of embodied spirits, one ofmany such settlements in space. 6. God is president of the immortals, having under Him four orders of beings: (1. ) Gods--_i. E. _, immortalbeings, possessed of a perfect organization of soul and body, being thefinal state of men who have lived on earth in perfect obedience to thelaw. (2. ) Angels, immortal beings who have lived on earth in imperfectobedience to the law. (3. ) Men, immortal beings in whom a living soul isunited with a human body. (4. ) Spirits, immortal beings, still waitingto receive their tabernacle of flesh. 7. Man, being one of the race ofgods, became eligible, by means of marriage, for a celestial throne, andhis household of wives and children are his kingdom, not only on earthbut 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 theirown; but by virtue, not by violence; by industry, not by force. Thissect has met with stern and bitter opposition. It was successivelylocated in New York, Ohio, Missouri, and Illinois, from the last ofwhich it was expelled by force of arms, and in 1848 established in Utah. Its adherents number, at the present time, more than two hundredthousand. 

Another organization, differing from the Mormons, in many of its radicalprinciples, is that of the "Communists, " popularly termed "Free Lovers. "It is located at Lennox, Madison Co. , N. Y. Its members advocate a systemof "complex marriage" which they claim is instituted with aconscientious regard for the welfare of posterity. They disclaim"promiscuity, " and assert that the tie which binds them together is aspermanent and as sacred as that of marriage. Community of property iscommensurate with freedom of Love. They define love to be "socialappreciation, " and this element in their code of civilization, whichthey deem superior to all others, is secondary to "bodily support. " Theprinciples upon which their social status is founded may be brieflysummarized as follows: "Man offers woman support and love(unconditional). Woman enjoying freedom, self-respect, health, personaland mental competency, gives herself to man in the boundless sincerityof an unselfish union. State--, Communism. " In this, as in all forms ofpolygamous marriages, love is made synonymous with sexuality, and itspurely spiritual element is lost. In every instance this spiritualelement should constitute the basis of marriage, which, without it, isnothing more than legal prostitution. Without it, the selfish, degrading, animal propensities run rampant, while the emotions with alltheir boundless sweetness lie dormant. Woman is regarded as only aplaything to gratify the animal caprice. 

That Monogamy is a law of nature is evident from the fact that itfulfills the three essential conditions which form the basis of truemarriage: (1. ) The development of the individual (2. ) The welfare ofsociety. (3. ) The reproduction of the species. 

THE DEVELOPMENT OF THE INDIVIDUAL. 

PHYSICALLY. Reciprocated love produces a general exhilaration of thesystem. The elasticity of the muscles is increased, the circulation isquickened, and every bodily function is stimulated. The duties of lifeare performed with a zest and alacrity never before experienced. "It isnot possible for human beings to attain their full stature of humanity, except by loving long and perfectly. Behold that venerable man! He ismature in judgment, perfect in every action and expression, and saintlyin goodness. You almost worship as you behold. What rendered him thusperfect? What rounded off his natural asperities, and moulded up hisvirtues? Love mainly. It permeated every pore, so to speak, and seasonedevery fiber of his being, as could nothing else. Mark that matronlywoman. In the bosom of her family, she is more than a queen and goddesscombined. All her looks and actions express the outflowing of some orall of the human virtues. To know her is to love her. She became thusperfect, not in a day or a year, but by a long series of appropriateefforts. Then by what? Chiefly in and by love, which is specificallyadapted thus to develope this maturity. " But all this occurs only whenthere is a normal exercise of the sexual propensities. Excessiveindulgence in marital pleasures deadens all the higher faculties, loveincluded, and results in an utter prostration of the bodily powers. TheCreator has endowed man and woman with passions, the suppression ofwhich leads to pain, their gratification to pleasure, their satiety todisgust. Excessive marital indulgence produces abnormal conditions ofthe 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 systemprevails do we find a code of political and social ethics whichrecognizes the rights and claims of the individual. The condition ofwoman is that of the basest slave, a slave to the caprice and tyranny ofher master. Communism raises her from the slough of slavery, butsubjects her to the level of prostitution. An inevitable sequence ofpolygamy is a decline of literature and science. The natural tendency ofeach system is to _sensualism. _, The blood is diverted from its normalchannels and the result is a condition which may be appropriately termed_mental starvation_. Sensualism is in its very nature directly opposedto literary attainments or advancement. Happily there is a golden mean, an equalization of those elements which constitutes the acme ofindividual enjoyment. 

THE WELFARE OF SOCIETY. 

The general law of ethics, that "whatever is beneficial to theindividual, contributed to the highest good of society and _viceversa_, " applies with equal force to the hygienic conditions ofmarriage. Each family, like the ancient Roman household, is theprototype of the natural government under which it lives. Wherever themarriage relation is regarded as sacred, there you will find men of purehearts and noble lives. Of all foreign nations the Germans arecelebrated for their sacred regard of woman, and the duties of marriage, and all scholars from the age of Tacitus to the present day, haveconcurred in attributing the elevation of woman to the pure-mindedTeutons. In America, the law recognizes only Monogamy; but domesticunhappiness is a prominent feature of our national life; therefore, argues the would-be free-lover, monogamy does not accord with the bestinterests 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 comparativelylittle to banish from our midst this necessary (?) evil. They recoilwith disgust from this abyss of iniquity and disease. Within it iscoiled a hydra-headed monster, which invades our hearthstones, contaminates our social atmosphere, and whose very breath is laden withpoisonous vapors, the inexhaustible source of all evil. 

The perverted appetites of mankind are mistaken for the natural desiresand necessities of our being; and, accordingly, various arguments havebeen advanced to prove that monogamy is not conducive to socialdevelopement. It is curious that no one of these arguments refers to thehealth and well-being of the _individual_, thus overlooking, perhapswillfully, the great law of social economy. Even a few medical writerssometimes advocate the principles of this so-called liberalism. In arecently published work, there are enumerated only _two_ demerits ofpolygamy and _six_ of monogamy. These six demerits which the author ispleased to term a "bombshell, " he introduces on account of his moralconvictions no less than humanitarian considerations. The same authorterms monogamy a "worm-eaten and rotten-rooted tree. " The worm that isdevastating the fairest tree of Eden and draining its richest juices iswhat our contemporary thinks, may be "_plausibly termed, a necessaryevil_. " It is claimed that monogamy begets narrow sympathies and leadsto selfish idolatry. The fallacy of this argument lies in themisapprehension of the term _selfishness_. Self-preservation isliterally selfishness, yet who will deny that it is a paramount duty ofman. If perverted, it may be vicious, even criminal; but selfishness, inso far as it is generated by monogamy, is one of the chief elements ofsocial economy; furthermore, it favors the observance of the laws ofsexual hygiene. As we have said elsewhere, true love _increasesbenevolence_, and correspondingly expands and develops the sympathies. Selfish idolatry is preferable to social neglect. This argument will notbear 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" wereequally blessed, they would not suffer from this exclusiveness, and itis practically true that there is no higher incentive to love and obeyour Maker than the blessing of a happy marriage. 

THE PERPETUATION OF THE SPECIES. 

The third essential object of marriage is the perpetuation of thespecies. The desire for offspring is innate in the heart of every trueman or woman. It is thus a law of our nature, and, as such, must haveits legitimate sphere. The essential features of reproduction proclaimmonogamy to be the true method of procreation. Promiscuity would renderthe mother unable to designate the father of her children. Among loweranimals, pairing is an instinctive law whenever the female is incapableof protecting and nourishing her offspring alone. During at leastfifteen years, the child is dependent for food and clothing upon itsparents, to say nothing of the requisite moral training and lovingsympathy, which, in a great measure, mould its character. Fidelity toone promotes multiplication. It has been argued by the advocates ofpolygamy that such a system interferes with woman's natural right tomaternity. Of the many marriages celebrated yearly, comparatively feware sterile. The statement that many single women are desirous of havingchildren, would apply only to a very limited number, as it is seldomthat they would be able to support children without the aid andassistance of a father. Promiscuity diminishes the number and_vitiates_, the quality of the human products. "Women of pleasure nevergive to the world sons of genius, or daughters of moral purity. "

 * * * * *

CHAPTER XVII. 

REPRODUCTION. 

Every individual derives existence from a _parent_, which word literallymeans one who brings forth. We restrict the meaning of the term_reproduction_, ordinarily, to that function by which living bodiesproduce other living bodies similar to themselves. _Production_ means tobring forth; _reproduction_, the producing again, or renewing. Toprotract individual existence, nutrition is necessary, because all vitalchanges are attended by _wear_ and _waste_. Nutrition is always engagedin the work of reparation. Every organism that starts out upon itscareer of development depends upon nourishing materials for its growth, and upon this renewing process for its development. Nutrition is all thewhile necessary to prolong the life of the individual, but at length itsvigor wanes, its functions languish, and, finally, the light of earthlylife goes out. Although the single organization decays and passes away, nevertheless the species is uninterruptedly continued; the tidal wave oflife surges higher on the shores of time, for reproduction is asconstant and stable as the attractive forces of the planetary system. 

It is a fact, that many species of the lower order of animals which onceexisted are now extinct. It has been asserted and denied, that fossilremains of man have been found, indicating that races which once existedhave disappeared from the face of the earth. The pyramids are unfoldinga 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 correctlyaccounted for. The extinction of races is not at all improbable. At thepresent time, the aboriginal inhabitants of this continent seem to besurely undergoing gradual extinguishment! It, therefore, seems to bepossible for a weaker race to deteriorate, and finally become extinct, unless the causes of their decadence can be discovered and remedied. Allpeople are admonished to earnestly investigate the essential conditionsnecessary for their continuance, for the rise and fall of nations is inobedience to natural principles and operations. Viewed from thisstandpoint, it is possible that a careful study of the humantemperaments and their relations to reproduction may be of greatermoment than has hitherto been supposed, and a proper understanding ofthem may tend to avert that individual deterioration, which, if sufferedto become general, would end in national disaster and the extinction ofthe race. 

Until recently, even naturalists believed that descendants were strictlylike their parents in form and structure. Now it is known that theprogeny may differ in both form and structure from the parent, and thatthese may produce others still more unlike their ancestry. But all thesepeculiar and incidental deviations finally return to the original form, showing that these changes have definite limits, and that thealterations observe a specific variableness, which is finally completedby its assuming again the original form. (See page 16, Figs. 2 and 3). 

_Reproduction_ may be _sexual_ or _non-sexual. _ In some plants andanimals it is non-sexual. The propagation of species is accomplished bybuds. Thus the gardener grafts a new variety of fruit upon an old stock. The florist understands how to produce new varieties of flowers, andmake them radiantly beautiful in their bright and glowing colors. Thebud personates the species and produces after its kind. Some of the_annelides_, a division of articulate animals, characterized by anelongated body, formed of numerous rings or annular segments, multiplyby spontaneous division. A new head is formed at intervals in certainsegments of the body. (See Fig. 97). 

Something similar to this process of budding, we find taking place in alow order of animal organization. Divide the fresh water polyp intoseveral pieces, and each one will grow into an entire animal. Each piecerepresents a polyp, and so each parent polyp is really a compoundanimal, an organized community of beings. Just as the buds of a tree, when separated and engrafted upon another tree, grow again, eachpreserving its original identity, so do the several parts of thisanimal, when divided, become individual polyps, capable of similarreproduction. 

[Illustration: Fig. 97. An annelid dividing spontaneously, a new head having been formed toward thehinder part of the body of the parent. ]

The revolving volvox likewise increases by growth until it becomes asociety of animals, a multiple system of individuals. There areapertures from the parent, by which water gains a free access to theinterior of the whole miniature series. This monad was once supposed tobe a single animal, but the microscope shows it to be a group of animalsconnected by means of six processes, and each little growing volvoxexhibits his red-eye speck and two long spines, or horns. These animalsalso multiply by dividing, and thus liberate another series, which, intheir turn, reproduce other groups. 

Generation requires the concurrence of _stimuli_ and _susceptibility_, and, to perfect the process, two conditions are also necessary. Thefirst is the sperm, which communicates the principle of action; theother is the germ, which receives the latent life and provides theconditions necessary to organic evolution. The vivifying functionbelongs to the male, that of nourishing and cherishing is possessed bythe female; and these conditions are sexual distinctions. The formerrepresents _will_ and _understanding_; the latter, _vitality_ and_emotion_. The father directs and controls, the mother fosters andencourages; the former counsels and admonishes, the latter persuades andcaresses; and their union in holy matrimony represents one; that is, theblending of vitality and energy, of love and wisdom, --the elementsindispensable to the initiation of life under the dual conditions ofmale 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 perfecthermaphrodite possesses the attributes of both male and female--unitingboth sexes in one individual. Natural hermaphroditic reproduction occursonly among inferior classes of animals, and naturalists inform us thatthere are a greater number of these than of the more perfect varieties. These are found low in the scale of animal organization, and oneindividual is able to propagate the species. In the oyster and ascidiansno organs can be detected in the male, but in the female they aredeveloped. Polyps, sponges, and cystic entozoa, may also be includedamong hermaphrodites. 

It is only very low organisms indeed in which it is a matter ofindifference whether the united sperm-cells and germ-cells are those ofthe same individual, or those of different individuals. In moreelaborate structures and highly organized beings, the essential thing infertilization is the union of these cells specially endowed by_different_ bodies, the unlikeness of derivation in these unitedreproductive centers being the desideratum for perpetuating life andpower. 

In other classes, as _entozoa_, there appear to be special provisionswhereby the sperm-cells and germ-cells may be united; _i. E. _, the maleorgans are developed and so disposed as to fecundate the ova of the sameindividual. Sexual and non-sexual modes of reproduction are illustratedby 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 likewisehave what are called _complemental males_ attache to some of thehermaphrodites. In the whole animal kingdom, it may be doubted if thereexists another such class of rudimentary creatures as the parasiticmales, who possess neither mouth, stomach, thorax, nor abdomen. Afterexerting a peculiar sexual influence, they soon die and drop off; sothat in this class of animals may be found the sexual distinctions ofmale, female, and perfect hermaphrodites. 

[Illustration: Fig. 99. Rotiferia; Brachionus Urceolaris;largely magnified. ]

There is a class of wheel-animalcules termed _rotifera_, of which therevolving volvox is one example. They have acquired this name on accountof the apparent rotation of the disc-like organs which surround theirmouths and are covered with _cilia_, or little hairs. They are minutecreatures, and can best be viewed with a microscope, although the largerforms may be seen without such assistance. They are widely diffused onthe surface of the earth, inhabit lakes as well as the ocean, and arefound in cold, temperate, and tropical climates. The rotifera were oncesupposed to be hermaphrodites, but the existence of sexes in one specieshas been clearly established. The male, however, is much smaller, andfar less developed than the female. In some of these species, germ-cells, or eggs, are found, which do not require fecundation forreproduction or development, so that they belong to the non-sexualclass. 

The third variety of hermaphrodites embraces those animals in which themale organs are so disposed as not to fecundate the ova of the samebody, but require the co-operation of two individuals, notwithstandingthe co-existence in each of the organs of both sexes. Each in turnimpregnates 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 toexhibit the peculiarities of male or female, in proportion to the kindof sexual organs which predominates. Half of the body may be occupied bymale, the other half by female organs, and each half reflects itspeculiar sexual characteristics. Some butterflies are dimidiatehermaphrodites; _i. E. _ one side of the body has the form and color ofthe male, the other the form and color of the female. The wings show bytheir color and appearance these sexual distinctions. The stag-beetle isalso 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, wehave heard of no well-authenticated instance of hermaphrodism, or thecomplete union of _all_ the reproductive organs in one individual. True, the term _hermaphrodite_ is often applied to certain persons in whomthere is some malformation, deficiency, or excess, of the genitalorgans. These congenital deformities consisting of combined increase ordeficiency, supernumerary organs, or transposition of them, whichusually render generation physically impossible, have been called_bisexual hermaphrodism_ and classed as monstrosities. We have manypublished accounts of them, hence, further reference to them here isunnecessary. We would especially refer those readers who may desire tomake themselves further acquainted with this interesting subject, to thestandard 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 mayinfluence the sex of the offspring. One is that the right ovaryfurnishes the germs for males, the left for females that the righttesticle furnishes sperm capable of fecundating the germs of males, andthe left testicle, the germs of the left ovary, for females. Thatfecundation sometimes takes place from right to left and thus producesthese abnormal variations. We merely state the hypothesis, but do notregard it as accounting for the distinction of sex, or as causingmonstrosities, though it is somewhat plausible as a theory, and is noteasily disproved. In the lower order of animals, as sheep and swine, oneof the testicles has been removed, and there resulted afterward bothmale and female progeny, so that the theory seems to lack facts for afoundation. 

We sometimes witness in the child excessive development, as fivefingers, a large cranium, which results in dropsical effusion, ordeficient brain, as in idiots; sometimes a hand or arm is lacking, orpossibly there is a dual connection, as in the case of the Siamesetwins; or, two heads united on one body. It is difficult to give anysatisfactory explanation of these abnormal developments. From age toage, the type is _constant_, and preserves a race-unity. The crossingsof the races are only transient deviations, not capable of perpetuation, and quickly return again to the original stock. This force ispersistent, for inasmuch as the individual represents the race, so doeshis offspring represent the parental characteristics, in tastes, proclivities, and morals, as well as in organic resemblances. Thisconstancy is unaccountable, and more mysterious than the occasionalmalformation of germs in the early period of foetal life. If to everydeviation from that original form and structure, which gives characterto the productions of nature, we apply the term _monster_, we shall findbut very few, and from this whole class there will be a very smallnumber indeed of _sexual_ malformations. If the sexes be deprived of thegenerative organs, they approach each other in disposition andappearance. All those who are partly male and partly female in theirorganization, unite, to a certain extent, the characteristics of bothsexes. When the female loses her prolific powers, many of her sexualpeculiarities and attractions wane. 

DIOECIOUS REPRODUCTION. 

_Dioecious_ is a word derived from the Greek, and signifies _twohouseholds;_ hence, _dioecious reproduction_ is sexual generation bymale and female individuals. Each is distinguished by sexualcharacteristics. The male sexual organs are complete in one individual, and all the female organs belong to a separate feminine organization. Insome of the vertebrates, impregnation does not require sexual congress;in other words, fecundation may take place _externally_. The female fishof some species first deposits her ova, and afterwards the male swims tothat locality and fertilizes them with sperm. 

In higher orders of animals, fecundation occurs _internally_, theconjunction of the sperm and germ cells requiring the conjugation of themale and female sexual organs. The sperm-cells of the male furnish thequickening principle, which sets in play all the generative energies, while the germ-cell, susceptible to its vivifying presence, respondswith all the conditions necessary to evolution. The special laboratorywhich furnishes spermatic material is the _testes_, while the stroma ofthe _ovaries_ contributes the germ-cell. Several different modes ofreproducing are observed when fecundation occurs within the body, whichvary according to the peculiarities and organization of the female. 

MODES OF DIOECIOUS REPRODUCTION. --A very familiar illustration of onemode is found in the common domestic fowl, the egg of which vivifiedwithin the ovarium, is afterward expelled and hatched by the simpleagency of warmth. This mode of reproduction is called _oviparousgeneration_. 

The ovaries, as well as all their latent germs, are _remarkably_influenced by the first fecundation. It seems to indicate monogamy asthe rule of higher sexual reproduction. The farmer understands that ifhe wishes to materially improve his cows, the first offspring must bebegotten by a better, purer breed, and all that follow will beessentially benefited, even if not so well sired. Neither will the bestblood exhibit its most desirable qualities in the calves whose mothershave previously carried inferior stock. So that there are sexualante-natal influences which may deteriorate the quality of the progeny. The Jews understood this principle, in the raising up of sons anddaughters unto a deceased brother. The fact that the sexual influence ofa previous conception is not lost, is illustrated when, in a secondmarriage, the wife bears a son or daughter resembling bodily ormentally, or in both of these respects the former husband. Thisindicates a union for life by natural influences which never die out. 

With some species of fish and reptiles, the egg is impregnatedinternally, and the process of _laying_ commences immediately, but itproceeds so slowly through the excretory passages, that it is hatchedand born alive. This is called _ovo-viviparous generation_. 

As we rise in the scale of organization, animals are more completelydeveloped, and greater economy is displayed in their preservation. Thegerm passes from the ovary into an organ prepared for its reception andgrowth, to which, after fecundation, it becomes attached, and where itremains until sufficiently developed to maintain respiratory life. Thisorgan is called the _womb_, or _uterus_, and is peculiar to mostmammalia. This mode of reproduction is termed _viviparous generation_. 

The kangaroo and oppossum are provided with a pouch attached to theabdomen, which receives the young born at an early stage of development. They remain in contact with the mammæ, from which they obtain theirnourishment, until their growth is sufficiently completed to maintain anindependent existence. This is called _marsupial generation_. Thevariety of reproduction which is most interesting, is that of the humanspecies, and is called _viviparous generation_. It includes thefunctions of copulation, fecundation, gestation, parturition, andlactation. 

For the full and perfect development of mankind, both mental andphysical chastity is necessary. The health demands abstinence fromunlawful intercourse. Therefore children should not be allowed to readimpure works of fiction, which tend to inflame the mind and excite thepassions. Only in total abstinence from illicit pleasures is there moralsafety and health, while integrity, peace, and happiness, are theconscious rewards of virtue. Impurity travels downward withintemperance, obscenity, and corrupting diseases, to degradation anddeath. A dissolute, licentious, free-and-easy life is filled with thedregs of human suffering, iniquity, and despair. The penalties whichfollow a violation of the law of chastity are found to be severe andswiftly retributive. 

[Illustration: Fig. 100. Male]

[Illustration: Fig. 101. Female]

[Illustration: Fig. 102. Outline of the Female Urinary andGenerative Organs. ]

The union of the sexes in holy matrimony is a law of nature findingsanction in both morals and legislation. Even some of the lower animalsunite in this union for life, and instinctively observe the law ofconjugal fidelity with a consistency which might put to blush otheranimals more highly endowed. It is important to discuss this subject andunderstand our social evils, as well as the unnatural desires of thesexes, which must be controlled or they lead to ruin. Sexualpropensities are possessed by all, and they must be held in abeyance, until they are exercised for legitimate purposes. Hence parents ought tounderstand the value of mental and physical labor to elevate andstrengthen the intellectual and moral faculties of their children, todevelop the muscular system and direct the energies of the blood intohealthful channels. Vigorous employment of mind and body engrosses thevital energies and diverts them from undue excitement of the sexualdesires. 

[Illustration: Fig. 103. Outline of the Male Reproductive Organs. ]

Sexual generation by pairing individuals is the most economical mode ofpropagating the species. The lower orders of animals possess wonderfulmultiplicative powers and their faculty for reproduction is offset byvarious destructive forces. The increased ability for self-maintenanceimplies diminished reproductive energy; hence the necessity for greatereconomy and safety in rearing the young. As certain larvae and insectsincrease, the birds which feed upon them become more numerous. When thismeans of support becomes inadequate, these same birds diminish in numberin proportion to the scarcity of their food. Many have remarked thatvery prolific seasons are followed by unusual mortality, just as periodsof uncommon prosperity precede those of severe disaster. 

The increased mental and moral cultivation of mankind imposes upon themthe necessity for greater physical culture. "Wiser and weaker, " is atrite saying, and means that the exercise of the higher nature disclosesthe equivalent necessity of culturing the body, in order to support theincreasing expenditures of the former. Mental and moral discipline areessential for a proper understanding how to provide for the body, forphysical training increases the capacity of the individual forself-preservation. Constant vigilance is the price of health as well asof liberty. 

It is an interesting physiological fact that, while the growth anddevelopment of the individual are rapidly progressing, the reproductivepowers remain almost inactive, and that the commencement of reproductionnot only indicates an arrest of growth, but, in a great measure, contributes toward it. From infancy to puberty, the body and itsindividual organs, structurally as well as functionally, are in a stateof gradual and progressive evolution. Men and women generally increasein stature until the twenty-fifth year, and it is safe to assume thatperfection of function is not established until maturity of bodilydevelopment is completed. Solidity and strength are represented in theorganization of the male, grace, and beauty in that of the female. Hisbroad shoulders represent physical power and the right of dominion, while her bosom is the symbol of love and nutrition. The fatherencounters hardships, struggles against difficulties, and braves dangersto provide for his household; the mother tenderly supplies the infant'swants, finding relief and pleasure in imparting nourishment, andsurrounds helpless infancy with an affection which is unwearied in itscountless ministering attentions. Her maternal functions are indicatedby greater breadth of the hips. Physical differences so influence theirmental natures, that, "before experience has opened their eyes, thedreams of the young man and maiden differ. " The development of either isin close sympathy with their organs of reproduction. Any defect of thelatter impairs our fair ideal, and detracts from those qualities whichimpart excellence, and crown the character with perfections. Plainly hasNature marked out, in the organization, very different offices to beperformed by the sexes, and has made these distinctions fundamental. 

Likewise, Nature expresses the intention of reproduction by giving toplants and animals distinctive organs for this purpose. These areendowed with exquisite sensibility, so that their proper exerciseproduces enjoyment beneficial to both. Excessive sexual indulgence notonly prostrates the nervous system, enfeebles the body, and drains theblood of its vivifying elements, but is inconsistent with intellectualactivity, morality, and spiritual development. The most entrancingdelights and consummate enjoyments are of the emotive order, ideal, abstract, and pure, so inspiring that they overpower the grosser sensualpleasures and diffuse their own sweet chastity and refining influenceover all the processes of life. 

Hence, the gratification of the sexual instincts should always bemoderate. It should be regulated by the judgment and will, and keptwithin the bounds of health. No person has a moral right to carry thisindulgence so far as to produce injurious consequences to either party, and he who cannot refrain from it is in no proper condition to propagatehis species. In all culture there must be self-control, and the practiceof 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 andlaudable exultation to our political maxims, laws, and freeinstitutions. The family is the prototype of society. If self-restraintbe practiced in the marital relation, then the principle of self-controlwill carry health, strength, and morality into all parts of thecommonwealth. The leading characteristics of any nation are but thereflection of the traits of its individual members, and thus the familytruly typifies the practical morality and enduring character of apeople. 

OVULATION. 

The _Ovaries_ are those essential parts of the generative system of thehuman female in which the ova are matured. There are two ovaries, one oneach 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 1/120of 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, atthe 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 ofgranular substance, in which is found a miniature yolk surrounded by atransparent membrane, called the _zona pellucida_. This yolk contains agerminal vesicle in which can be discovered a nucleus, called the_germinal spot_. The process of the growth of the ovaries is verygradual, and their function of ripening and discharging an ovum everymonth into the Fallopian tubes and uterus is not developed until betweenthe twelfth and fifteenth years. 

This period, which indicates, by the feelings and ideas, the desires andwill, that the subjects are capable of procreation, is called _puberty_. The mind acquires new and more delicate perceptions, the person becomesplumper, the mammæ enlarge, and there is grace and perfection in everymovement, a conscious completeness for those relations of life for whichthis function prepares them. The period of puberty is also indicated by

MENSTRUATION. 

The catamenial discharge naturally follows the ripening and liberationof an ovum, and as the ovaries furnish one of these each month, thismonthly flow is termed the _menses_ (the plural of the Latin word_mensis_, which signifies a month). The menstrual flow continues fromthree to five days, and is merely the exudation of ordinary venous bloodthrough the mucous lining of the cavity of the uterus. At this time, thenervous system of females is much more sensitive, and from the fact thatthere is greater aptitude to conception immediately before and afterthis period, it is supposed that the sexual feeling is then thestrongest. When impregnation occurs immediately before the appearance ofthe menses, their duration is generally shortened, but not sufficientlyto establish the suspicion that conception has taken place. The germ isthe contribution of the female, which provides the conditions which onlyrequire the vivifying principle of the sperm for the development ofanother being. The period of aptitude for conception terminates at thetime both ovulation and menstruation cease, which, unless brought aboutearlier by disease, usually occurs about the forty-fifth year of herage. 

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 thatwhat was originated by creation must be continued by procreation. Theprocess 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, structuresand functions, which finally qualify the organism for independentexistence. The ovum, when expelled from the ovary, enters thefimbriated, or fringe-like extremity of the Fallopian tube, to commenceat once its descent to the uterus. The process of passing through thisminute tube varies in different animals. In birds and reptiles, the bulkof the expelled ova is so great as to completely fill up the tube, andit is assisted in its downward course, partly by its own weight andpartly by the peristaltic action of the muscular coat of the canal. Inthe human subject, however, the ova are so minute that nature hassupplied a special agent for their direct transmission; otherwise theymight be retained, and not reach their destination. Accordingly, thefimbriated, trumpet-shaped extremity of the Fallopian tubes, which isnearest to the ovaries, and, consequently from the ovary first receivesthe ovum when expelled; is provided with a series of small hairs, termed_cilia_, forming the lining or basement membrane of the tubes, and, themovements of these cilia being towards the uterus, transmit, by theirvibrating motion, the ovum from the ovary, through the Fallopian tubes, to the uterus. 

The mature ovum, however, is not by itself capable of being convertedinto the embryo. It requires fecundation by the spermatic fluid of themale, and this may take place immediately on the expulsion of the ovumfrom 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 expelledby the uterine secretions. It occasionally happens that the descent ofthe impregnated ovum is arrested, and the formation of the embryocommences 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 expelledfrom 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 slightinterstice of fiber, during its passage through the walls of the uterus, it may be detained long enough to fix itself there, and when thisoccurs, it is termed _interstitial pregnancy_. All these instances ofextra-uterine pregnancy may necessitate the employment of surgicalskill, in order that they may terminate with safety to the mother. Theiroccurrence, however, is very rare. 

The intense nervous excitement produced by the act of coition isimmediately followed by a corresponding degree of depression, and a toofrequent repetition of it is necessarily injurious to health. Thesecretions of the seminal fluid being, like other secretions, chieflyunder the influence of the nervous system, an expenditure of themrequires a corresponding renewal. This renewal greatly taxes thecorporeal powers, inducing lassitude, nervousness, and debility. It is awell known fact that the highest degree of mental and bodily vigor isinconsistent with more than a moderate indulgence in sexual intercourse. 

To ensure strength, symmetry, and high intellectual culture in the humanrace, requires considerable care. Consideration should be exercised inthe choice of a companion for life. Constitutional as well as hereditaryailments demand our closest attention. Age has also its judiciousbarriers. As before stated, when reproduction commences, growth, as arule, ceases, therefore, it is inexpedient that matrimony should beconsummated before the parties have arrived at mature stature. 

PREVENTION OF CONCEPTION. 

Much has been written upon the question whether married people have aright to decline the responsibilities of wedlock. The practice ofinducing abortion is not only immoral but criminal, because it isdestructive to both the health of the mother and the life of the embryobeing. If both the parties to a marriage be feeble, or if they be nottemperamentally adapted to each other, so that their children would bedeformed, insane, or idiotic, then to beget offspring would be aflagrant wrong. If the mother is already delicate, possessing feebleconstitutional powers, she is inadequate to the duties of maternity, _and it is not right to lay such burdens upon her_. Self-preservation isthe first law of nature, which all ought to respect. The woman may beable to discharge the duties of a loving wife and companion, when shecannot fulfill those of child-bearing. If the husband love his wife ashe ought, he will resign all the pleasure necessary to secure herexemption from the condition of maternity. It seems to us, that it is agreat wickedness, unpardonable even, to be so reckless of consequences, and so devoid of all feeling, as to expose a frail, feeble, affectionatewoman to those perils which almost insure her death. To enforcepregnancy under such circumstances is a crime. Every true man, therefore, should rather practice self-control and forbearance, thanentail on his wife such certain misery, if not danger to life. 

Undoubtedly, the trial is great, but if a sacrifice be required, let thehusband forbear the gratification of passions which will assuredly bethe means of developing in his delicate wife symptoms that may speedilyhurry her into a premature grave. Before she has recovered from theeffects of bearing, nursing, and rearing one child, ere she has regainedproper tone and vigor of body and mind, she is unexpectedly overtaken, _surprised_ by the manifestation of symptoms which again indicatepregnancy. Children thus begotten are not apt to be hardy andlong-lived. From the love that parents feel for their posterity, fromtheir wishes for their success, from their hopes that they may be usefulfrom every consideration for their future well-being, let them exerciseprecaution and forbearance, until the wife becomes sufficiently healthyand enduring to bequeath her own vital stamina to the child she bears. 

From what has been said on this subject, it behooves the prudent husbandto weigh well the injurious, nay criminal results which may follow hislust. Let him not endanger the health, and it may be the life, of hisloving and confiding wife through a lack of self-denial. Let himaltogether refrain, rather than be the means of untold misery and, perhaps, the destruction of the person demanding his most cherished loveand protection. On so important a subject, we feel we should commit anunpardonable wrong were we not to speak thus plainly and openly. Anopportunity has been afforded us, which it would be reprehensible toneglect. We shall indeed feel we have been amply rewarded, if thesesuggestive remarks of ours tend in any way to remove or alleviate thesufferings of an uncomplaining and loving wife. Our sympathies, alwayssusceptible to the conditions of sorrow and suffering, have beenenlisted to give faithfully, explicitly, and plainly, warnings of dangerand exhortations to prudence and nothing remains for us but to maintainthe principles of morality, and leave to the disposal of a wise andoverruling Providence the mystery of all seemingly untoward events. Inevery condition of life, evils arise, and most of those which areencountered are avoidable. Humanity should be held accountable for thoseevils which it might, but does not shun. 

By a statute of the national government, prevention of pregnancy isconsidered a punishable offense; whereas every physician is instructedby our standard writers and lecturers on this subject, that not onlyprevention is necessary in many instances, but even abortion mustsometimes be produced in order to save the mother's life. As we view thematter, the law of the national government asserts the ruling principle, and the exceptions to it must be well established by evidence, in orderto fully justify such procedure. The family physician may, with theconcurrence of other medical counselors, be justified, in rare cases, inadvising means for the prevention of conception, but he should exercisethis professional duty _only_ when the responsibility is shared by othermembers of the profession, and the circumstances fully and clearlywarrant such a practice. 

After fecundation, the length of time before conception takes place isvariously estimated. Should impregnation occur at the ovary or withinthe Fallopian tubes, usually about a week elapses before the fertilizedgerm enters the uterus, so that ordinarily the interval between the actof insemination and that of conception varies from eight to fourteendays. 

DOUBLE CONCEPTION. 

If two germs be evolved simultaneously, each may be impregnated byspermatozoa, and a twin pregnancy be the result. This is by no means arare occurrence. It is very unusual, however, to have one birth followedby another after an interval of three or four months, and each babepresent the evidences of full maturity. Perhaps such occurrences may beaccounted for on the supposition that the same interval of time elapsesbetween the impregnation of the two germs as there is differenceobserved in their birth; that after the act of insemination, sperm wascarried to each ovary; that one had matured a germ ready forfecundation, then impregnation and conception immediately followed, andthe decidua of the uterus hermetically sealed both Fallopian tubes, andthus securely retained the sperm within the other Fallopian canal. Thestimulus 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 isperfected, fertilized, and a second conception occurs within the uterus. If each embryo observe a regular period of growth and each be born atmaturity, there must be an interval of two or three months between theirbirths. But it is far more common for the parturition of the first, displaying signs of full maturity, to coincide with the birth of asecond which is immature and which cannot sustain respiratory life. Thebirth of the latter is brought about prematurely, by the action of theuterus in expelling the matured child. 

UTERINE PREGNANCY. 

There are many who manifest a laudable desire to understand thephysiology of conception, the changes which take place, and the order oftheir natural occurrence. When impregnation takes place at the ovariesor within the Fallopian tubes, there is exuded upon the inner surface ofthe womb a peculiar nutritious substance. It flows out of the minuteporous openings surrounding the termination of the Fallopian tube withinthe uterine cavity, and, thus, is in readiness to receive the germ, andretain it there until it becomes attached. Undoubtedly, the germ imbibesmaterials from this matter for its nurture and growth. This membranoussubstance is termed the _decidua_, and disappears after conception isinsured. Two membranes form around the embryo; the inner one is calledthe _amnion_, the outer one the _chorion_. Both serve for the protectionof the embryo, and the inner one contains the _liquor amnii, _ in whichit floats during intra-uterine life. Immediately after conception, thesmall glands in the neck of the uterus usually throw out a stickysecretion, filling the canal, or uniting its sides, so that nothing canenter or leave the uterine cavity. 

The fertilized ovum rapidly develops. After its conception it imbibesnourishment, and there is a disposition in fluids to pass into it, through its delicately-organized membranes. If this process is notinvoluntary, it is, at all events, at the convenience and use of thedeveloping germ. After three months the embryo is termed the _foetus_. Its fluids are then so much more highly organized, that some of them aretinged with sanguine hues, and thenceforward acquire the characteristicsof red blood. Out of red blood, blood-vessels are formed, and from theincipient development of the heart follow faint lines of arteries, andthe engineers of nutrition survey a circulatory system, perfecting thevascular connections by supplementing the arteries with a completenet-work of veins and capillaries. 

THE PLACENTA OR AFTERBIRTH. 

Whenever conception occurs, a soft, spongy substance is formed betweenthe uterus and the growing ovum, called the _placenta_. It is composedof membrane, cellular tissue, blood-vessels, and connecting filaments. The principal use of this organ seems to be to decarbonate the blood ofthe foetus, and to supply it with oxygen. It performs the same functionfor the foetus that the lungs do for the organism after birth. It allowsthe blood of the foetus to come into very close contact with that of themother, from which it receives a supply of oxygen, and to which it givesup carbonic acid. This interchange of gases takes place in the placenta, or between it and the uterus, through the intervening membranes. Thisdecarbonating function requires the agency of the maternal lungs, forthe purpose of oxygenating the mother's blood. 

The placenta is attached to the uterus by simple adhesion. True, in someinstances, morbid adhesion takes place, or a growing together inconsequence of inflammation, but the natural junction is one merely ofcontact, the membranes of the placenta spreading out upon the cavity ofthe uterus, so that, finally, the former may be entirely removed withouta particle of disturbance or injury to the latter. Formerly, it wassupposed that the placental vessels penetrated into the substance of theuterus. We know now there is no such continuation of the vessels of theone into the other. The decarbonation of the blood requires theplacental and uterine membranes to be in contact with each other. 

If the union were vascular, the mother's blood would circulate in thefoetal body, and the impulses of the maternal heart might prove toostrong for the delicate organism of the embryo. Besides, the separationof the placenta from the uterus might prove fatal to both parent andoffspring. The placenta is only a temporary organ, and when itsfunctions 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 childand the placenta, by a cord which contains two arteries and one vein. This is called the _umbilical cord_, because it enters the body at themiddle of the abdominal region, or _umbilicus_. It is composed, also, ofits own proper membranous sheath, or skin, and cellular tissues, besidesthe 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 aphysical impulse, which the mother can distinctly perceive, before it isregarded as having received life. This is a fallacy, for the germ has tobe endowed with life before organization can begin. The act ofimpregnation communicates the vital principle, and from that moment itstarts upon its career of development. A long period elapses after thisoccurs before it can make the mother feel its motions. Beforequickening, the attempt to destroy the foetus is not considered so gravea crime by our laws, but after this quickening takes place, it is deemeda felony. 

THE RIGHT TO TERMINATE PREGNANCY. 

The expediency and the moral right to prematurely terminate pregnancymust be admitted when weighty and sufficient reasons for it exist. Sucha course should never be undertaken, however, without the advice andapproval of the family physician, and, whenever it is possible, thecounsel of another medical practitioner should be obtained. There may beso great a malformation of the pelvic bones as to preclude delivery atfull term, or, as in some instances, the pregnant condition may endangerthe life of the mother, because she is not able to retain nourishmentupon the stomach. In such cases only, is interference warranted, andeven then the advice of some well-informed physician should be firstobtained, to make sure that the life of the mother is endangered beforeso extreme a measure is resorted to. 

Those who are qualified for maternal duties should not undertake todefeat the intentions of nature, simply because they love ease anddislike responsibility. Such persons may be considered genteel ladies, but, practically, they are indifferent to the claims of society andposterity. How such selfishness contrasts with the glorious, heroic, Spartan spirit of the young woman who consulted us in reference to theacceptance of a tempting offer of marriage! She was below medium sizeand delicately organized. She hesitated in her answer, because she wasuncertain as to her duty to herself, and to her proposed husband, and onaccount of the prospective contingencies of matrimony. After she wastold that it was doubtful whether she could discharge the obligations ofmaternity with safety to herself, and yet that she might prove to herintended husband a true and valuable wife, she quickly answered, herblack eyes radiant with the high purpose of her soul: "If I assent tothis offer, I shall accept the condition and its consequences also, evenif pregnancy be my lot and I know it will cost me my life!" She accededto the proposal, and years found them one in happiness; then a daughterwas born, but the bearing and nursing were too much for her delicateconstitution, and she continued to sink until she found rest in thegrave. Of all her beautiful and noble sayings, none reflect more moralgrandeur of spirit than the one in which she expressed her purpose toprove 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, distentionof the abdomen, and movement of the foetus. A married woman has reasonto suspect that she may have conceived, when, at the proper time, shefails to menstruate, especially when she knows that she is liable tobecome pregnant. A second menstrual failure strengthens this suspicion, although there are many other causes which might prevent the appearanceof the menses, such as disease of the uterus, general debility, ortaking cold, and all of these should be taken into account. In theabsence of all apparent influences calculated to obstruct the menses, the presumption ordinarily is that pregnancy is the cause of theirnon-appearance. The evidence is still more conclusive when the mammæ andabdomen enlarge after experiencing morning sickness. Notwithstanding allthese symptoms, the audible sound of the heart, or the movements of thefoetus, 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. Itis difficult to foretell exactly when a pregnancy will be completed, forit cannot be known precisely when it began. Some gestations are moreprotracted than others, but the average duration is the time we havegiven. A very reasonable way to compute the term, is to reckon threemonths back from the day when the menses ceased and then add five daysto that time, which will be the date of the expected time ofconfinement. It is customary, also, for women to count from the middleof 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 immediatelybefore the fast appearance of the catamenia. A few women can forecastthe time of labor from the occurrence of quickening, by allowingeighteen weeks for the time which has elapsed since conception, andtwenty-two more for the time yet to elapse before the confinement. Withthose in whom quickening occurs regularly in a certain week ofpregnancy, 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 threehundred days after the death or departure of the husband. There are asufficient number of cases on record to show that gestation may beprolonged two, and even three, weeks beyond the ordinary, or averageterm. The variation of time may be thus accounted for: afterinsemination, a considerable interval elapses before fecundation takesplace, and the passage of the fertilized germ from the ovary to theuterus is also liable to be retarded. There are many circumstances andconditions 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 whichgestation may terminate, and the child be able to survive. A child maybe born and continue to live for some months, after twenty-four ortwenty-five weeks of gestation; it was so decided, at least, in anecclesiastical trial. 

We have not the space to describe minutely, or at length, the formationand growth of the foetal structures, and trace them separately fromtheir origin to their completion at the birth of the child. The studentof medicine must gain information by consulting large works andexhaustive treatises on this interesting subject. 

What trifling contingencies defeat vitality! Conception may be preventedby 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 theexistence of the frail embryo. Accidents, injuries, falls, blows, acutediseases, insufficient nutrition and development, in fact, a greatvariety of occurrences may destroy the life of the embryo, or foetus. After birth, numerous diseases menace the child. By what constant caremust it ever be surrounded, and how often is it snatched from the veryjaws of death!

What, then, is man but simply a germ, evolving higher powers, anddestined for a purer and nobler existence! His latent life secretlyemerges from mysterious obscurity, is incarnated, and borne upon theflowing stream of time to a spiritual destination--to realms ofimmortality! 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 thegarden of paradise, the Eden of happiness, redeemed, perfected, and madeglorious 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 haveconsidered, at some length, the science of functions, or _Physiology_, and now, under the head of _Hygiene_, we will give an outline of themeans of maintaining the functional integrity of the system. It isdifficult to avoid including under this head Preventive Medicine, thespecial province of which is to abate, remove, or destroy the manycauses of disease. 

The Greeks bestowed divine honors upon Aesculapius, because he remediedthe evils of mankind and healed the sick. The word hygiene is derivedfrom Hygeia, the name of the Greek goddess of health. As male and femaleare made one in wedlock, so Medicine and Hygiene, restoration andpreservation, 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 salutaryagents, medicine assuages with rectifying properties and qualities;hygiene upholds and sustains, medical practice corrects and heals; theone is preservative and conservative, the other curative andrestorative. These discriminations are as radical as health andsickness, as distinct as physiology and pathology, and to confound themis as unnatural as to look for the beauties of health in the chamber ofsickness. 

The true physician brings to his aid Physiology, Hygiene, and Medicine, and combines the science of the former with the art of the latter, thatrestoration may be made permanent, and the health preserved by the aidof hygiene. But when any one makes Hygiene exclusively the physician, ordeals wholly in hygienic regulations with little respect for physiology, or lavishly advertises with hygienic prefixes, we may at once considerit a display, not of genuine scientific knowledge, but only of theignorance of a quack. Some of the modern twaddle about health is aconglomeration of the poorest kind of trash, expressing and inculcatingmore errors and whims than it does common sense. Many persons dilateupon these subjects with amazing flippancy, their mission seeming to beto traduce the profession rather than to act as help-mates andassistants. We do not believe that there is any real argument going onbetween the educated members of the medical profession but rather thatthe senseless clamor we occasionally hear comes only from the stampedeof some routed, demoralized company of quacks. 

In the following pages we shall introduce to the reader's attentionseveral important hygienic subjects, although there are many more thatought to receive special notice. Such as we do mention, demand universalattention, because a disregard of the conditions which we shallenumerate, is fraught with great danger. Our lives are lengthened orshortened by the observance or neglect of the rules of common sense, andthese do not require any great personal sacrifice, or the practice ofabsurd precautions. 

PURE AIR FOR RESPIRATION. 

Ordinary atmospheric air contains nearly 2, 100 parts of oxygen and 7, 900of nitrogen, and about three parts of carbonic acid, in 10, 000 parts;expired air contains about 470 parts of carbonic acid, and only between1500 and 1600 parts of oxygen, while the quantity of nitrogen undergoeslittle or no alteration. Thus air which has been breathed has lost aboutfive per cent. Of oxygen and has gained nearly five per cent. Ofcarbonic acid. In addition the expired air contains a greater or lessquantity of highly decomposable animal matter, and, however dry theatmospheric air may be, the expired air is always saturated with wateryvapor, 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 adultman on a average breathes about sixteen times in a minute and at everyinspiration takes in about thirty cubic inches of air, and at everyexpiration exhales about the same amount. Hence, it follows that about16-2/3 cubic feet of air are passed through the lungs of an adult manevery hour, and deprived of oxygen and charged with carbonic acid to theamount of nearly five per cent. The more nearly the composition of theexternal air approaches that of the expired air, the slower will be thediffusion of carbonic acid outwards and of oxygen inwards, and the morecharged with carbonic acid and deficient in oxygen will the blood in thelungs become. Asphyxia takes place whenever the proportion of carbonicacid in the external air reaches ten per cent. , providing the oxygen isdiminished in like proportion, and it does not matter whether thiscondition of the external air is produced by shutting out fresh air froma room or by increasing the number of persons who are consuming the sameair; or by permitting the air to be deprived of oxygen by combustion bya fire. A deficiency of oxygen and an accumulation of carbonic acid inthe atmosphere, produce injurious effects, however, long before theasphyxiating point is attained. Headache, drowsiness, and uneasinessoccur when less than one per cent. Of the oxygen of the atmosphere isreplaced by other matters, and the constant breathing of such anatmosphere 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 tohave at least 800 cubic feet of air-space to himself, and this spaceought to communicate freely with the external atmosphere by means ofdirect or indirect channels. Hence, a sleeping-room for one adult personshould not be less than nine by ten feet in breadth and length and ninefeet in height. What occurred in the Black Hole at Calcutta is anexcellent illustration of the effect of vitiated air. One hundred andforty-six Englishmen were confined in a room eighteen feet square, withtwo small windows on one side to admit air. Ten hours after theirimprisonment, only twenty-three were alive. 

VENTILATION OF SCHOOL ROOMS. The depression and faintness from whichmany students suffer, after being confined in a poorly ventilated schoolroom, is clearly traceable to vitiated air, while the evil is oftenascribed to excessive mental exertion. The effect of ventilation uponthe health of students is a subject of universal interest to parents andeducators, and at present is receiving the marked attention of schoolauthorities. Dr. F. Windsor, of Winchester, Mass. , made a few pertinentremarks upon this subject in the annual report of the State Board ofHealth, of Massachusetts, 1874. One of the institutions, which wasspoken of in the report of 1873, as a _model_, in the warming andventilation of which much care had been bestowed, was visited inDecember, 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 asone would imagine old boots, dirty clothes, and perspiration would makeif boiled down together;" again, in the new _model_ school-house the hotair enters at two registers in the floor on one side, and makes (or issupposed to make) its exit by a ventilator at the floor, on the otherside of the room. " The master said "_the air was supposed to have somedegree of intelligence, and to know that the ventilator was its properexit_. " Thorough ventilation has been neglected by many school officialson account of the increased expense it causes. In our climate, duringseven months at least, pure atmospheric air must be paid for. Theconstruction of vertical ducts, the extra amount of fuel, and theattendant expenditures are the objections which, in the opinion of manypersons, outweigh the health and happiness of the future generation. Itis necessary for the proper ventilation of our school rooms that anadequate supply of fresh air should be admitted, which should be warmedbefore being admitted to the room, and which should be discharged ascontaminated, after its expiration. The proper ventilation of the schoolroom consists in the warming and introduction of fresh air from without, and the discharge of the expired and unwholesome air from within. Thismay be accomplished by means of doors, windows, chimneys, and finally byventilators placed, one near the level of the floor, and the other nearthe ceiling of the room. The ventilators ought to be arranged on theopposite sides of the room, in order to insure a current, and anabundant supply of air. When trustees and patrons realize that pure airis absolutely essential to health, and that their children are beingslowly poisoned by the foul air of school rooms, then they willconstruct our halls of learning with a due regard for the laws ofhygiene, and students will not droop under their tasks on account of theabsence of Nature's most bountiful gift, _pure air_. 

VENTILATION OF FACTORIES AND WORKSHOPS. This is a subject which demandsthe immediate attention of manufacturers and employers. The odors ofoil, coal gas, and animal products, render the air foul and stagnant, and often give rise to violent diseases among the operatives. From twoto four hundred persons are often confined in workshops six hundred feetlong, with no means of ventilation except windows _on one side only_. The air is breathed and re-breathed, until the operatives complain oflanguor and headache, which they attribute to overwork. The _real_ causeof the headache is the inhalation of foul air at every expansion of thelungs. If the proprietors would provide efficient means for ventilatingtheir workshops, the cost of construction would be repaid with compoundinterest, in the better health of their operatives and the consequentincrease of labor. Our manufacturers must learn and practice the greatprinciple of political economy, namely, that the interests of thelaborer and employer are mutual. 

VENTILATION OF OUR DWELLINGS. Not less important is the ventilation ofour dwellings; each apartment should be provided with some channel forthe escape of the noxious vapors constantly accumulating. Most of thetenements occupied by the poor of our cities are literally dens ofpoison. Their children inhale disease with their earliest breath. Whatwonder that our streets are filled with squalid, wan-visaged children!Charity, indeed, visits these miserable homes, bringing garments andfood to their half-famished inmates; but she has been slow to learn thatfresh air is just as essential to life as food or clothing. Care shouldbe taken by the public authorities of every city, that its tenementhouses do not degenerate into foul hovels, like those of the poorEnglish laborer, so graphically portrayed by Dickens. But ill-ventilatedrooms are not found exclusively in the abodes of the poor. True, in thehomes of luxury, the effect of vitiated air is modified by food, etc. Men of wealth give far more attention to the architecture and adornmentof their houses, to costly decorations and expensive furniture, than toproper ventilation. Farmers, too, are careless in the construction oftheir cottages. Their dwellings are often built, for convenience, in tooclose proximity to the barn. Because they do not construct a suitablesewer or drain, the filth and refuse food is thrown out of the backdoor, where it accumulates and undergoes putrefaction; the vitiated airpenetrates the interior of the house, and, there being no means ofventilation, 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 inthe construction of necessary flues and sewers, the farmer often seesthe child he prizes far more than his broad acres gradually decline, orsuddenly fall a victim to fevers or malignant disease. Parents, makeyour homes healthy, let in the pure, fresh air and bright sunlight, sothat your conscience may never upbraid you with being neglectful of thehealth and lives of your little ones. 

SITE FOR HOMES. 

MALARIA. When about to construct our residences, besides securing properventilation and adequate drainage, we ought to select the location for ahome on dry soil. Low levels, damp surroundings, and marshy localitiesnot only breed malaria and fevers, but are a prolific cause of colds, coughs, and consumption. Care should be taken not to locate a dwellingwhere the natural currents of air, or high winds, will be likely tobring the poison of decayed vegetable matter from low lands. Certainbrooks, boggy land, ponds, foggy localities, too much shade, all theseare favorable to the development of disease. Then the walls of abuilding should be so constructed as to admit air between the exteriorand interior surfaces, otherwise the interior of the house will be dampand unwholesome. In the dead of winter in northern latitudes the houseought to be kept slightly tempered with warmth, both night and day, acondition very favorable to the introduction and change of atmosphericcurrents. The invigorating tendencies of a dry, pure atmosphere areremarkably beneficial, while air charged with moisture and decay isexceedingly baneful, introducing diseases under various forms. 

Neither should the dwelling be shaded by dense foliage. The dampness ofthe leaves tends to attract malaria. Trees growing a little distancefrom the house, however, obstruct the transmission of unhealthy vaporsarising beyond them. Malaria generally lurks near the surface of theearth, and seems to be more abundant in the night time. Persons sleepingin the upper story of a house may escape its morbid influence, whilethose 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 bysanitary measures. Those which come more subtly need for their defeatonly a higher detective ability and a closer study of causes, many ofwhich are known, but hidden under the cellars of our houses, and whichat last are only preventable by public authority and at public expensein letting out the imprisoned dampness which saturates the earth onwhich our dwellings are built. Where wood rots, men decay. This isclearly shown in the sanitary map printed in the _Times_. In the greatdistrict surrounding Central Park, and which participates in itsdrainage system, there are no cases. On the whole line of Fifth Avenuethere are none. The exempt districts are clearly defined by thecharacter of the soil, drainage, and sewerage, and by the topography, which either has natural or artificial drainage, but most of which is sodry that only surface-water and house-filth--which does not exist inthose palaces--can affect the health of the residents. But in thetenement houses and on the made lands where running streams have beenfilled in and natural springs choked up by earth fillings, diphtheriafinds a nidus in which to develop itself. The sanitary map coincidesprecisely with the topographic map made by Gen. Viele. Where he locatesburied springs and water-courses, there we find the plague spots ofdiphtheria and in the same places, on previous maps prepared by theBoard of Health, we find other low types and stealthy diseases, such astyphoid and irruptive fevers, and there we shall find them again whenthe summer and autumnal pestilences have yielded place to those whichbelong to the indoor poisoned air in the winter. The experience of othercities, notably London and Dublin, once plague spots and now as healthyas any spot on earth, proves that most of the causations of disease arewithin the control of the competent sanitary engineer, even inlocalities crowded beyond American knowledge, and houses built upon soilsaturated for centuries with the offal of successive and uncleanlygenerations. Wet earth, kept wet by the boiling up of imprisonedsprings, is a focus of disease. Dry earth is one of the most perfectdeodorizers, the best of oxydizers and absorbents, destroying the germsof disease with wonderful certainty. On those two facts rests the theoryof public hygiene. "

DUST AND DISEASE. 

The air we breathe is heavily loaded with minute particles of floatingdust, 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. 'Thesun, ' says Daniel Culverwell, 'discovers atoms, though they be invisibleby candle-light, and makes them dance naked in his beams. '"

After giving the details and results of a series of experiments in whichhe attempted to extract the dust from the air of the Royal Institute bypassing it through a tube containing fragments of glass wetted withconcentrated sulphuric acid, and thence through a second tube containingfragments of marble wetted with a strong solution of caustic potash, which experiments were attended with perfect failure, the Professorcontinues, "I tried to intercept this floating matter in various ways;and on the day just mentioned, prior to sending the air through thedrying apparatus, I carefully permitted it to pass over the tip of aspirit-lamp flame. The floating matter no longer appeared, having beenburnt up by the flame. It was, therefore, of _organic origin_. I was byno means prepared for this result; for I had thought that the dust ofour air was, in great part, inorganic and non-combustile. " In a footnote he says, "according to an analysis kindly furnished me by Dr. Percy, the dust collected _from the walls_ of the British Museumcontains fully fifty per cent of inorganic matter. I have everyconfidence in the results of this distinguished chemist; they show thatthe _floating_ dust of our rooms is, as it were, winnowed from theheavier matter. " Again he says: "the air of our London rooms is loadedwith this organic dust, nor is the country air free from its presence. However ordinary daylight may permit it to disguise itself, asufficiently powerful beam causes dust suspended in air to appear almostas a semi-solid. Nobody could, in the first instance, withoutrepugnance, place the mouth at the illuminated focus of the electricbeam and inhale the thickly-massed dust revealed there. Nor is therepugnance abolished by the reflection that, although we do not see thefloating particles, we are taking them into our lungs every hour andminute of our lives. " "The notion was expressed by Kircher and favoredby Linnaeus, that epidemic diseases are due to germs which float in theatmosphere, enter the body, and produce disturbance by the developmentwithin the body of parasitic life. While it was struggling against greatodds, this theory found an expounder and a defender in the President ofthis institution. At a time when most of his medical brethren consideredit a wild dream, Sir Henry Holland contended that some form of thegerm-theory was probably true. " Professor Tyndall proposes means by theapplication of which air loaded with noxious particles may be freed fromthem before entering the air passages. The following embodies hissuggestions on this point:

COTTON-WOOL RESPIRATOR. 

"I now empty my lungs as perfectly as possible, and placing a handful ofcotton-wool against my mouth and nostrils, inhale through it. There isno difficulty in thus filling the lungs with air. On expiring this airthrough a glass tube, its freedom from floating matter is at oncemanifest. From the very beginning of the act of expiration the beam ispierced by a black aperture. The first puff from the lungs abolishes theilluminated dust, and puts a patch of darkness in its place; and thedarkness continues throughout the entire course of the expiration. Whenthe tube is placed below the beam and moved to and fro, the samesmoke-like appearance as that obtained with a flame is observed. _Inshort, the cotton-wool, when used in sufficient quantity, and with duecare, completely intercepts the floating matter on its way to thelungs_. 

The application of these experiments is obvious. If a physician wishesto hold back from the lungs of his patient, or from his own, the germsor virus by which contagious disease is propagated, he will employ acotton-wool respirator. If perfectly filtered, attendants may breathethe air unharmed. In all probability the protection of the lungs andmouth will be the protection of the entire system. For it is exceedinglyprobable that the germs which lodge in the air-passages, or find theirway with the saliva into the stomach with its absorbent system, arethose which sow in the body epidemic disease. If this be so, thendisease can be warded off by carefully prepared filters of cotton-wool. I should be most willing to test their efficacy in my own person. Butapart from all doubtful applications, it is perfectly certain thatvarious noxious trades in England may be rendered harmless by the use ofsuch filters. I have had conclusive evidence of this from people engagedin such trades. A form of respirator devised by Mr. Garrick, a hotelproprietor in Glasgow, in which inhalation and exhalation occur throughtwo different valves, the one permitting the air to enter through thecotton-wool, and the other permitting the exit of the air direct intothe atmosphere, is well adapted for this purpose. But other forms mightreadily be devised. "

LIGHT AND HEALTH. 

Our dwellings ought freely to admit the sunlight. Diseases which havebaffled the skill of physicians have been known to yield when thepatients 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 childrenbrought up in dark rooms are pale, sallow, and rickety. It is a badpractice to avoid the sunlight through fear of spoiling the complexion, since the sun's rays are necessary to give to it the delicate tints ofbeauty and health. Air is necessary for the first inspiration and thelast expiration of our lives, but the purity and healthfulness of theatmosphere depend upon the warming rays of the sun, while our bodiesrequire light in order that their functions may be properly performed. We know that without solar light, there can be no proper vegetablegrowth, and it is equally necessary for the beauty and perfection ofanimal development. Our dwellings should therefore be well lighted andmade 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 inorder to hide their own faulty complexions. The skin of persons confinedin dungeons or in deep mines becomes pale or sickly yellow, the bloodgrows watery, the skin blotches, and dropsy often intervenes. On theother hand, invalids carried out from darkened chambers into the brightsunlight are stimulated, the skin browns, nutrition becomes more active, the blood improves, and they become convalescent. Light is especiallynecessary for the healthy growth of children. There is nothing morebeautiful and exhilarating than the glorious sunlight. Let its luminous, warming, and physiological forces come freely into our dwellings, enterinto the chemistry of life, animate the spirits, and pervade our homesand 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 withthe earliest dawn of existence and end only with death. The old andworn-out materials are constantly being removed to make room for thenew. Growth and development, as well as the elimination of worn-out anduseless matter, continually require new supplies, which are to bederived from our food. To fulfill these demands it is necessary that thenutriment should be of the proper quality, and of sufficient variety tofurnish all the constituents of the healthy body. In order that food maybe of utility, like other building materials, it must undergopreparation; the crude substance must be worked up into proper conditionand shape for use, in other words, it must be _digested_. But this doesnot end the process of supply, each different substance must be taken bythe different bands of workmen, after due preparation in the workshop, to its appropriate locality in the structure, and there fitted into itsproper place; this is _assimilation_. In reality it becomes a portion ofthe body, and is advantageous in maintaining the symmetry and usefulnessof the part to which it is assigned; this constitutes the ultimateobject of food, _nutrition_. 

EATING is the process of receiving the food into the mouth, _i. E. , prehension; mastication and insalivation_--minutely dividing and mixingit with the saliva; _deglutition_--conveying it to the stomach. Plentyof time should be taken at meals to thoroughly masticate the food andmix it with the saliva, which, being one of the natural solvents, favorsits farther solution by the juices of the stomach; the healthy action ofthe digestive powers is favored by tranquility of mind, agreeableassociations, and pleasant conversation while eating. It is proverbialof the American people that they bolt their food whole, washing it downwith various fluids, thus forcing the stomach to perform not only itsown duties, but also those of the teeth and salivary glands. This mannerof dispatching food, which should go through the natural process abovedescribed, is not without its baleful consequences, for the Americansare called a nation of _dyspeptics_. 

Eating slowly, masticating the food thoroughly, and drinking butmoderately during meals, will allow the juices of the stomach to fulfilltheir proper function, and healthy digestion and nutrition will result. If the food is swallowed nearly whole, not only will a longer time berequired for its solution, but frequently it will ferment and begin todecay before nutritive transformation can be effected, even when thegastric juice is undiluted with the fluids which the hurried eaterimbibes 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 itsenergies are soon exhausted, its functions impaired, and _dyspepsia_ isthe result. Nothing of the character of food should ever be taken exceptat regular meal times. Some persons are munching cakes, apples, nuts, candies, etc. , at all hours, and then wonder why they have weakstomachs. They take their meals regularly, and neither eat rapidly nortoo much, and yet they are troubled with indigestion. The truth is theykeep 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 ofour bodies does not depend upon the amount eaten, but upon the amountthat is digested. Eating too much is nearly as bad as swallowing thefood whole. The stomach is unable to digest all of it, and it fermentsand gives rise to unpleasant results. The unnatural distention of thestomach with food causes it to press upon the neighboring organs, interfering with the proper performance of their functions, and, iffrequently repeated, gives rise to serious disease. People morefrequently eat too much than too little, and to omit a meal when thestomach is slightly deranged is frequently the best medicine. It is anexcellent plan to rise from the table before the desire for food isquite satisfied. 

LATE SUPPERS. It is generally conceded that late suppers are injurious, and should never be indulged in. Persons who dine late have little needof 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 twoor three hours before retiring. Those who dine in the middle of the dayshould have supper, but sufficiently early so that a proper length oftime may elapse before going to bed, in order that active digestion maynot be required during sleep. On the other hand, it is not advisable togo wholly without this meal, but the food eaten should be light, easilydigestible, and moderate in quantity. Persons who indulge in heartysuppers at late hours, usually experience a poor night's rest, and wakethe 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 mostappropriate food for an infant is its mother's milk, which, when theparent is healthy, is rich in all the elements necessary for its growthand support. Next to the mother's milk, that of a healthy nurse shouldbe preferred; in the absence of both, milk from a cow that has recentlycalved is the most natural substitute, in the proportion of one partwater to two parts milk, slightly sweetened. The milk used should befrom but one cow. All sorts of paps, gruels, panadas, cordials, laxatives, etc. , should be strictly prohibited, for their employment asfood cannot be too severely censured. Vomiting, diarrhea, colic, greenstools, griping, etc. , are the inevitable results of their continueduse. The child should be fed at regular intervals, of about two hours, and be limited to a proper amount each time, which, during the firstmonth, is about two ounces. From 11 P. M. To 5 A. M. The child should benursed but once. As the child grows older the intervals should belengthened, and the amount taken at a time gradually increased. The planof gorging the infant's stomach with food every time it cries, cannot betoo emphatically condemned. 

After the sixth or seventh month, in addition to milk, bits of bread maybe allowed, the quantity being slowly increased, thus permitting thediet to change gradually from fluid to solid food, so that, when theteeth are sufficiently developed for mastication, the child has becomeaccustomed to various kinds of nourishment. Over-feeding, andcontinually dosing the child with cordial, soothing syrups, etc. , arethe most fruitful sources of infant mortality, and should receive thecondemnation of every mother in the land. 

PREPARATION OF FOOD. The production of pure blood requires that all thefood selected should be rich in nutritious elements, and well cooked. Toannounce a standard by which all persons shall be guided in theselection and preparation of their food is impossible. Especially isthis the case in a country the inhabitants of which represent almostevery nation on the face of the globe. Travelers are aware that there isas much diversity in the articles of food and methods of cookery, amongthe various nationalities, as in the erection of their dwellings, and intheir mental characteristics. In America we have a conglomeration of allthese peoples; and for a native American to lay down rules of cookeryfor his German, French, English, Welsh, and Irish neighbors, or _viceversa_, is useless, for they will seldom read them, and, therefore, cannot profit by them. There are, however, certain conditions recognizedby the hygienic writers of every nation. The adequate nutrition of theorganic tissues demands a plentiful supply of pure blood, or thedigestive apparatus will become impaired, the mental processes deranged, and the entire bony and muscular systems will lose their strength andelasticity, and be incapacitated for labor. 

DIFFERENT KINDS OF FOOD REQUIRED. The different periods andcircumstances of life require their appropriate food, and the welfare ofmankind demands that it should supply both the inorganic and organicsubstances employed in the development of every tissue. The inorganicelements employed in our construction, of which _Phosphorus, Sulphur, Soda, Iron, Lime, _ and _Potash_ are the most important, are notconsidered as aliments, but are found in the organic kingdom, variouslyarranged and combined with organic materials in sufficient quantitiesfor ordinary purposes. When, however, from any cause, a lack of any ofthese occurs, so that their relative normal proportions are deranged, the system suffers, and restoration to a healthy condition can only beaccomplished by supplying the deficiency; this may be done by selectingthe article of food richest in the element which is wanting, or byintroducing it as a medicine. It must be remembered that thosesubstances which enter into the construction of the human fabric, arenot promiscuously employed by nature, but that each and every one isdestined 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 quantitiesin early life, while the bone is undergoing development, thanafterwards. In childhood the bones are composed largely of animalmatter, being pliable and easily moulded. For this reason the limbs ofyoung children bend under the weight of their bodies, and unless care istaken they become bow-legged and distorted. Whenever there is acontinued deficiency of the earthy constituents, disease of the bonesensues. Therefore, during childhood, and particularly during the periodof dentition, or teething, the food should be nutritious and at the sametime contain a due proportion of lime, which is preferable in the formof a phosphate. When it cannot be furnished by the food, it should besupplied artificially. Delayed, prolonged, and tedious dentitiongenerally 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 inold age, the animal matter of bone becomes diminished, and lime takesits place, so that the bones become brittle and are easily broken. Limeexists 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 thebody, particularly in the brain and nervous system. Persons who performa large amount of mental labor require more phosphorus than thoseengaged in other pursuits. It exists largely in the hulls of wheat, infish, and in eggs. It should enter to a considerable extent into thediet of brain workers, and the bread consumed by them should be made ofunbolted flour. 

_Sulphur, Iron, Soda_, and _Potash_ are all necessary in the varioustissues of the body, and deficiency of any one of them, for anyconsiderable length of time, results in disease. They are all supplied, variously arranged and combined, in both animal and vegetable food; insome articles they exist to a considerable extent, in others in muchsmaller quantities. _Sulphur_ exists in eggs and in the flesh ofanimals, and often in water. _Iron_ exists in the yolk of eggs, inflesh, and in several vegetables. _Soda_ is supplied in nearly all food, and largely in common salt, which is a composition of sodium andhydrochloric acid, the latter entering into the gastric juice. _Potash_exists, in some form or other, in sufficient quantities for health, inboth vegetable and animal food. 

CLASSES OF FOOD. All kinds of food substances may be divided into fourclasses. _Proteids, Fats, Amyloids_, and _Minerals_. Proteids arecomposed of the four elements, carbon, hydrogen, oxygen, and nitrogen, sometimes combined with sulphur and phosphorus. In this class areincluded the _gluten_ of flour; the _albumen_, or white of eggs; and the_serum_ of the blood; the _fibrin_ of the blood; _syntonin_, the chiefconstituent of muscle and flesh, and _casein_, one of the chiefconstituents of cheese, and many other similar, but less frequentsubstances. 

Fats are composed of carbon, hydrogen, and oxygen only, and contain morehydrogen than would be required to form water if united with the oxygenwhich they contain. All vegetable and animal oils and fatty matters areincluded in this class. 

Amyloids consist of substances which are also composed of carbon, oxygen, and hydrogen only; but they contain just enough hydrogen toproduce water when combined with their oxygen, or two parts of hydrogento one of oxygen. This division includes _sugar, starch, dextrine_, and_gum_. The above three classes of food-stuffs are only obtained throughthe 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 eitherthe living or the non-living world. They include water and variousearthy, metallic, and alkaline salts. 

VARIETY OF FOOD NECESSARY. No substance can serve permanently for foodexcept it contains a certain quantity of proteid matter in the shape ofalbumen, fibrin, casein, etc. , and, on the other hand, any substancecontaining proteid matter in a shape in which it can be readilyassimilated, may serve as a permanent vital food-stuff. Every substance, which is to serve as a permanent food, must contain a sufficientquantity, ready-made, of this most important and complex constituent ofthe body. In addition, it must also contain a sufficient quantity of themineral ingredients which enter into the composition of the body. Itspower of supporting life and maintaining the weight and composition ofthe body remains unaltered, whether it contains fats or amyloids or not. The secretion of urea, and, consequently, the loss of nitrogen, goes oncontinually, and the body, therefore, must necessarily waste unless thesupply of proteid matter is constantly renewed, since this is the onlyclass of foods that contains nitrogen in any considerable quantity. There can be no absolute necessity for any other food-stuffs but thosecontaining the proteid and mineral elements of the body. From what hasbeen said, it will readily be seen that whether an animal be carnivorousor herbivorous, it begins to starve as soon as its vital food-stuffsconsist only of amyloids, or fats, or both. It suffers from what hasbeen termed _nitrogen starvation, _ and if proteid matters are withheldentirely, it soon dies. In such a case, and still more in the case of ananimal which is entirely deprived of vital food, the organism, as longas it continues to live, feeds upon itself, the waste productsnecessarily being formed at the expense of its own body. 

Although proteid matter is the essential element of food, and undercertain circumstances may be sufficient of itself to support the body, it is a very uneconomical food. The white of an egg, which may be takenas 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 ofexercise and maintaining his weight and body temperature, eliminatesabout thirteen times as much carbon as nitrogen. However, if he is toget his necessary quantity, about 4000 grains of carbon, out of albumen, he must eat 7, 547 grains of that substance; but this quantity of albumencontains nearly four times as much nitrogen as he requires. In otherwords, it takes about four pounds of lean meat, free from fat, tofurnish 4, 000 grains of carbon, the quantity required, whereas one poundyields the requisite quantity of nitrogen. Thus a man restrictedexclusively to a proteid diet, must take an enormous quantity of it. This would involve a large amount of unnecessary physiological labor, tocomminute, dissolve, and absorb the food, and to excrete the superfluousnitrogenous matter. Unproductive labor should be avoided as much inphysiological as in political economy. The universal practice ofsubsisting on a mixed diet, in which proteids are mixed with fats oramyloids, is therefore justifiable. 

Fats contain about 80 per cent. Of carbon, and amyloids about 40 percent. We have seen that there is sufficient nitrogen in a pound of meatfree from fat, to supply a healthy adult man for twenty-four hours, butthat it contains only one-fourth of the quantity of carbon required. About half a pound of fat, or one pound of sugar, will supply thequantity of carbon necessary. The fat, if properly subdivided, and thesugar, by reason of its solubility, pass with great ease into thecirculation, the physiological labor, consequently, being reduced to aminimum. 

Several common articles of diet contain in themselves all the necessaryelements. Thus, butchers' meat ordinarily contains from 30 to 50 percent. Of fat; and bread contains the proteid, gluten, and the amyloids, starch and sugar, together with minute quantities of fat. However, onaccount of the proportion in which these proteid and other components ofthe body exist in these substances, neither of them, by itself is such aphysiologically economical food, as it is when combined with the otherin the proportion of three to eight, or three quarters of a pound ofmeat to two pounds of bread a day. 

It is evident that a variety of food is necessary for health. Animalsfed exclusively upon one class, or upon a single article of diet, droopand die; and in the human family we know that the constant use of onekind of diet causes disgust, even when not very long continued. Consequently, we infer that the welfare of man demands that his food beof sufficient variety to supply his body with all of its componentparts. If this is not done the appetite is deranged, and often cravesthe very article which is necessary to supply the deficiency. After thecomponent parts of the organism have assimilated the nutritious elementsof particular kinds of food for a certain length of time, they lose thepower of effecting the necessary changes for proper nutrition, and asupply of other material is imperatively demanded. When the diet hasbeen long restricted to proteids, consisting largely of salt meats, fresh vegetables and fruits containing the organic acids, becomeindispensable; otherwise, the scorbutic condition, or scurvy, is almostsure to be developed. Fresh vegetables and fruits should be eaten inconsiderable quantities at the proper seasons. 

VALUE OF ANIMAL FOOD. The principal animal food used in this countryconsists of _Pork, Mutton, Beef_, and _Fish_. Beef and mutton are richin muscle-producing material. Although pork is extensively produced insome portions of this country, and enters largely into the diet of someclasses, yet its use, except in winter, is not to be encouraged. Thesame 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, areexcellent, and with the exception of geese and ducks, are easilydigested. _Wild Birds_ are considered much healthier food than thosewhich are domesticated. All of these contain more or less of theelements which enter into the composition of the four classes of foods. 

VEGETABLE FOODS. _Wheat_ is rich in all the elements which compose thefour classes, and, when the flour is unbolted, it is one of the bestarticles for supplying all the elements. 

_Barley_ stands next to wheat in nourishing qualities, but is not sopalatable. 

_Oats_ are rich in all the elements necessary for nutrition. Oatmeal isa favorite article of diet among the Scotch, and, judging from theirhardy constitutions, their choice is well founded. In consequence of thelarge proportion of phosphorus which they contain, they are capable offurnishing 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 throughoutthe United States, and is a truly valuable one, capable of beingprepared in a great variety of ways for food. It contains more carbonthan wheat, and less nitrogen and phosphorus, though enough of both tobe extremely valuable. 

_Rice_ is rather meagre in nutriment; it contains but little phosphorousmatter, with less carbon than other cereals, and is best and mostgenerally employed as a diet in tropical countries. 

_Beans and Peas_ are rich in nutritious matter, and furnish the manuallaborer with a cheap and wholesome diet. 

The _Potato_ is the most valuable of all fresh vegetables grown intemperate climates. Its flavor is very agreeable, and it contains veryimportant nutritive and medicinal qualities, and is eaten almost dailyby nearly every family in North America. Until very recently it, withthe addition of a little butter-milk or skim-milk, constituted almostthe sole diet of the Irish people. The average composition of the potatois stated by Dr. Smith to be as follows: Water 75 per cent. , nitrogen2. 1, starch 18. 8, sugar 3. 2, fat 0. 2, salts 0. 7. The relative values ofdifferent potatoes may be ascertained very correctly by weighing them inthe hand, for the heavier the tuber the more starch it contains. 

_Turnip and Cabbage_ are 92. 5 per cent. Water, and, consequently, poorin nutrition, though they are very palatable. The solid portions ofcabbage, however, are rich in albumen. 

It is evident that the quantity necessary to maintain the system inproper condition must be greatly modified by the habits of life, thecondition of the organism, the age, the sex, and the climate. The dailyloss of substance which must be replaced by material from without, as wehave seen, is very great. In addition to the loss of carbon andnitrogen, about four and a half pounds of water are removed from thesystem in twenty-four hours, and it is necessary that about thisquantity should be introduced into the system in some form or other, however much it may be adulterated. Professor Dalton states: "Fromexperiments performed while living on an exclusive diet of bread, freshmeat, and butter, with coffee and water for drink, we have found thatthe entire quantity of food required during twenty-four hours by a manin 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 offood required by the system. In northern latitudes the inhabitants areexposed to extreme cold and require an abundant supply of food, andespecially that which contains a large amount of fat. On this accountfat meat is taken in large quantities and with a relish. The quantity offood consumed by the natives of the Arctic zone is almost incredible. The Russian Admiral, Saritcheff, relates that one of the Esquimaux inhis presence devoured a mass of boiled rice and butter which weighedtwenty-eight pounds, at a single meal, and Dr. Hayes states that usuallythe daily ration of an Esquimau is from twelve to fifteen pounds ofmeat, one-third of which is fat, and on one occasion he saw a man eatten pounds of walrus flesh at a single meal. The intense cold creates aconstant craving for fatty articles of food, and some members of his ownparty were in the habit of drinking the contents of the oil-kettle withgreat apparent relish. 

DIGESTIBILITY OF FOOD. Unless an article of diet can be digested it isof no value, no matter how rich it may be in nutriment. The quantity offood taken, will influence to a considerable extent, the time consumedin its digestion. The stomachs of all are not alike in this respect, andthe subject of time has been a difficult one to determine. Theexperiments of Dr. Beaumont with the Canadian, St. Martin, whoaccidentally discharged the contents of a loaded gun into his stomach, creating an external opening through which the process of digestioncould be observed, have furnished us with the following table, which iscorrect enough to show relatively, if not absolutely, the time requiredfor 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. Itis very nutritious, and, on account of the variety of the elements whichit contains, it is extremely valuable an article of diet, especiallywhen the digestive powers are weakened, as in fevers, or duringconvalescence from any acute disease. Eggs are also very nutritious andeasily digested. Whipped eggs are digested and assimilated with greatease. Fish, as a rule, are more speedily digested than is the flesh ofwarm-blooded animals. Oysters, especially when taken raw, are veryeasily digested. We have known dyspeptics who were unable to digest anyother kind of animal food, to subsist for a considerable period upon rawoysters. The flesh of mammalia seems to be more easily digested thanthat of birds. Beef, mutton, lamb, and venison are easily digested, while fat roast pork and veal are digested with difficulty. According tothe foregoing table vegetables were digested in about the same time asordinary animal food, but it should be remembered that a great part ofthe digestion of these is effected in the small intestine. Soups are, asa rule, very quickly digested. The time required for the digestion ofbread is about the same as that required for the digestion of ordinarymeats. Boiled cabbage is one of the most difficult substances to digest. 

COOKERY. "Cookery, " says Mrs. Owen, "Is the art of turning every morselto the best use; it is the exercise of skill, thought, and ingenuity tomake every particle of food yield the utmost nourishment and pleasure, of which it is capable. " We are indebted to this practical woman formany valuable suggestions in this art; and some of our recommendationsare drawn from her experience. 

SOUPS. The nutritious properties, tone, and sweetness of soup depend inthe first place upon the freshness and quality of the meat; secondly onthe manner in which it is boiled. Soups should be nicely and delicatelyseasoned, according to the taste of the consumer, by using parsley, sage, savory, thyme, sweet marjoram, sweet basil, or any of thevegetable condiments. These may be raised in the garden, or obtained atthe drug stores, sifted and prepared for use. In extracting the juicesof meats, in order that soups may be most nutritious, it is importantthat the meat be put into _cold_ water, or that which is not so hot asto coagulate the albumen (which would prevent it from being extracted), and then, by slow heat and a simmering process, the most nutritiousproperties will be brought out. 

BEEF SOUP may be made of any bone of the beef, by putting it into coldwater, 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 thetaste. 

MUTTON SOUP may be made from the fore-quarter, in the same manner asdescribed above, thickened with pearl-barley or rice, and flavored tosuit the taste. 

BOILED FISH. Clean the fish nicely, then sprinkle flour on a cloth andwrap it around them; salt the water, and, when it boils, put in thefish; let them boil half an hour, then carefully remove them to aplatter, adding egg sauce and parsley. To _bake fish_, prepare bycleaning, scaling, etc. , and let them remain in salt water for a shorttime. Make a stuffing of the crumbs of light bread, and add to it alittle 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 fromburning, and baste often. A four pound fish will bake in fifty or sixtyminutes. 

BROILED STEAK. Sirloin and porter-house steaks should be broiledquickly. Preserve them on ice for a day or two and their tenderness ismuch 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 boilingwater, by which its juices are coagulated and its richness preserved. The slower it boils, the more tender, plump, and white it will be. Meatshould be removed as soon as done, or it will lose its flavor and becomesoggy. 

PORK STEAKS. The best steaks are cut off the shoulder--ham steaks beingrather too dry. They should be well fried, in order to destroy thelittle living parasites, called Trichinae which sometimes infest thiskind of meat. They are introduced into the stomach by eating ham, pork, or sausages made from the flesh of hogs infested by them. Thoroughcooking destroys them, and those who will persist in the use of swine'sflesh can afford to have it "_done brown. _"

BAKED MUTTON. To bake mutton well, a person should have a brisk, sharpfire, and keep the meat well basted. It requires two hours to bake a legof 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 greaterif it were only better prepared. We make the following extract from anarticle printed by the State Board of Health, concerning the food of thepeople of Massachusetts: "As an example of good bread we would mentionthat which is always to be had at the restaurant of Parker's Hotel, inBoston. It is not better than is found on the continent of Europe on allthe great lines of travel, and in common use by millions of people inGermany and France; but with us, it is a rare example of what bread maybe. It is made from a mixture of flour, such as is generally sold in ourmarkets, water, salt, and yeast--nothing else. The yeast is made frommalt, potatoes, and hops. _The dough is kneaded from one and a half totwo hours, and is then thoroughly baked. "_ The truth seems to be thatthe kneading, which in this country takes the housewife's time andmuscle, in Europe is done by the help of machinery. So here, in largevillages and cities, people might furnish themselves with good bread, bymeans 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 toall. It is the most abundant substance of which we have knowledge. Itcomposes four-fifths of the weight of vegetables, and three-fourths ofthat of animals. It is essential to the continuance of organic life. Water is universally present in all of the tissues and fluids of thebody. It is not only abundant in the blood and secretions, but it isalso an ingredient of the solids of the body. According to the mostaccurate computations, water is found to constitute from two-thirds tothree-fourths of the entire weight of the human body. The followingtable, compiled by Robin and Verdeil, shows the proportion of water perthousand 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. Noother liquid can supply its place. Its presence, however, in the body isnot permanent. It is discharged from the body in different ways; by theurine, the feces, the breath, and the perspiration. In the first two, itis in a liquid form, in the others in a vaporous form. It is estimatedthat about forty-eight per cent. Is discharged in the liquid, andfifty-two per cent. In the vaporous form; but the absolute as well asthe relative amount discharged depends upon a variety of circumstances. 

Water is never found perfectly pure, since it holds in solution more orless of almost every substance with, which it comes in contact. Rainfalling in the country remote from habitations is the purest water thatnature furnishes, for it is then only charged with the natural gases ofthe atmosphere. In cities it absorbs organic and gaseous impurities, asit falls through the air, and flowing over roofs of houses carries withit soot and dust. Water from melted snow is purer than rain-water, sinceit descends in a solid form, and is therefore incapable of absorbinggases. Rain-water is not adapted to drinking purposes, unless wellfiltered. All water, except that which has been distilled, contains air, and it is due to this fact, that aquatic animals can live in it; forexample, put a fish in distilled water and it will soon die. 

MINERAL IMPURITIES. Rain-water, which has filtered through the soil andstrata of the earth, dissolves the soluble materials, and carries themdown to lower levels, until they finally collect in the sea. Commonwell, spring, and mineral waters contain from 5 to 60 grains to thegallon; sea-water contains 2, 000 grains while in some parts of the DeadSea there are 20, 000 grams to the gallon. The principal mineralimpurities of well and spring water are lime, magnesia, soda, and oxideof 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 aconsiderable amount of saline matter. Those waters which abound in saltsof iron are called _chalybeate_ or _ferruginous_. Those containing saltare termed _saline_. Those in which contain sulphur are termed_sulphurous_. Water derives the quality of hardness from the salts oflime--chiefly the sulphates--which it contains. Hard water, being animperfect solvent, is unsuitable for washing purposes. There are twovarieties of hardness, one of which is temporary, being due to thepresence of carbonic acid gas in the water which holds the salts insolution and may be removed by merely boiling the water and thusexpelling the gas when the salts are deposited, while the other ispermanent and can only be removed by the distillation of the water. Ithas been ascertained that twelve pounds of the best hard soap must beadded to 10, 000 gallons of water of one degree of hardness before alather will remain and, consequently, 0. 12 lb. To 100 gallons of wateris a measure of one degree of hardness. Since hard water is not souseful in cooking and other domestic purposes, as soft water, causing agreat waste of labor and material, it is often highly desirable tosoften 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 1000gallons of water for each degree of hardness. It should be first slackedand stirred up in a few gallons and then thoroughly mixed with theentire quantity. Then it should be allowed to remain, and will becomeclear in about three hours, but should not be drunk for twelve hours. 

The purity of drinking water is a matter of much importance. That whichcontains a minute quantity of lead will give rise to all the symptoms oflead poisoning, if the use of it be sufficiently prolonged. An accountis given of the poisoning of the royal family of France, many of whomsuffered from this cause when in exile at Claremont. The amount of leadwas only one grain in the gallon. Care should therefore be taken toavoid drinking the water which has been contained in leaden pipes. Itshould 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 smallamount of putrescent matter habitually introduced into the system, as inthe use of food, is productive of the most serious results, which can betraced to the direct action of the poison introduced. A case is recordedof a certain locality favorably situated with regard to the access ofpure air, where an epidemic of fever broke out much to the astonishmentof the inhabitants. Upon observation it was found that the attacks offever were limited to those families who used water from a neighboringwell. The disagreeable taste of the water which had been observed, wassubsequently traced to the bursting of a sewer, which had discharged apart of its contents into the well. When the cause was removed, therewas no recurrence of the evil effects. 

ORGANIC IMPURITIES. "Water is liable to organic contamination from amultitude of causes, such as drainage from dwellings, dust, insects, thedecaying of vegetable and animal matter. These impurities may bemechanically suspended or held in solution in the water. Althoughorganic impurities, which are mechanically suspended in water, arepoisonous, yet they are generally associated with animalculea, and thesefeed upon, and finally consume them. Good water never containsanimalculæ. They are never found in freshly fallen rain-water, remotefrom dwellings, but abound, to a greater or less extent in cisterns, marshes, ponds, and rivers. These little workers serve a useful purposesince they consume the dead organic matter from the water, and, havingfulfilled their mission, sink to the bottom and die. Water whichcontains organic matter is exceedingly dangerous to health, and its useshould be carefully avoided. 

In low lands where the current of streams is sluggish, and shallow poolsabound, the water is apt to be more or less infected with decayingvegetable substances. Many people living in such localities, and wishingto obtain water with as little trouble as possible, dig a hole in theground, a few feet in depth, and allow the stagnant surface water toaccumulate. This water is used for drinking and cooking. The result isthat ague prevails in such localities. 

Care should be taken that wells, from which the water is used forhousehold 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. Itmay be accomplished by distillation, which is the most perfect method;by filtration through sand, crushed charcoal, and other poroussubstances, which deprives it of suspended impurities and livingorganisms; by boiling, which destroys the vitality of all animal andvegetable matters, drives out the gases and precipitates carbonate oflime, which composes the crust frequently seen upon the inside oftea-kettles or boilers; by the use of chemical agents, which may beemployed to destroy or precipitate the deleterious substances. Alum isoften used to cleanse roily water, two or three grains in solution, being sufficient for a quart. It causes the impurities to settle to thebottom, so that the clear water can be poured or dipped out for use. Oneor two grains of the permanganate of potassium will render wholesome agallon 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 assistin mastication. When these glands are aided with water to "wash down"the food, their functions become feeble and impaired. The gastric juiceis diluted and digestion is weakened. Large draughts of cold water oughtnever to be indulged in, since they cause derangement of the stomach. When the body is overheated, the use of much water is injurious. Itshould only be taken in small quantities. Thirst may be partiallyallayed, without injury, by holding cold water in the mouth for a shorttime and then spitting it out, taking care to swallow but very little. Travelers frequently experience inconvenience from change of water. Ifthe means are at hand, let them purify their drinking water, if not, they should drink as little as possible. Persons who visit the banks ofthe Ohio, Missouri, or Mississippi rivers and similar localities, almostinvariably suffer from some form of gastric or intestinal disease. Waterstanding in close rooms soon becomes unfit to drink and should not beused. A drink of cold water taken on going to bed, and another on risingare conducive to health, especially in the case of persons troubled withconstipation. "_Drink water_" said the celebrated Dubois to the youngpersons who consulted him, "_drink water, I tell you!_" Du Moulin, thegreat 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 asbeverages, and when properly employed, serve a four-fold purpose: theyquench thirst, excite an agreeable exhilaration, repress the waste ofthe system, and supply nourishment. In consequence of being generallyused at meal times, their stimulant properties are employed to promotedigestion, and consequently they are not so objectionable as they mightotherwise be. The liquids introduced into the stomach at meal timesshould not be cold. Tea and coffee are drunk warm, while water, exceptin a few instances, is always drunk cold, the effects of which havealready been shown. That their inordinate use may be injurious no bodycan deny, but this is equally true of other beverages, even pure, coldwater. Scientific investigators inform us that the use of these agentsas beverages, when judiciously employed, is not injurious. It has beenurged that they are poisonous, but if they are, they are very slow intheir operation. 

When properly prepared, they are very agreeable beverages, and as manwill drink more or less at meals, they are allowable; for if their usewere excluded, some other beverage would be sought after, and quitelikely one of an alcoholic character employed, so of two evils, if thisbe an evil, let us choose the least. Unlike alcoholic stimulants, theyexhilarate without a depressing reaction after their influence haspassed off. But one cup should be drunk at a meal, and it should be ofmoderate strength. The use of large quantities of drink at meals retardsdigestion by diluting the digestive fluids. The excessive use of largequantities of strong tea or coffee stimulates the brain and causeswakefulness, and produces irritability of the nervous system. When theyare productive of such effects, their use is injurious, and should beconsiderably moderated or wholly discontinued. No criterion can be givenby which the amount the system will tolerate can be regulated. What oneperson may take with impunity, may be deleterious to an other. Individuals differ greatly in this respect. There are some who cannottolerate them at all, either because of some peculiarity ofconstitution, or on account of disease. And sometimes when tea isagreeable and beneficial, coffee disagrees with the individual and _viceversa. _ Persons of nervous habits whether natural or acquired, are aptto 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 coffeedisagrees 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 abandontheir use. We find many persons who do not use either, and yet enjoyhealth, a fact which proves that they are not by any meansindispensable, 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 usingthem will be greatly imposed upon. This is an evil we cannot remedy. Ifpeople make use of them, their experience in selecting them must betheir guide; however, it is believed that the Black and Japan varietiesof tea are the least apt to be adulterated, and coffee, to insurepurity, should be purchased in the berry, and ground by the purchaser. 

In preparing tea an infusion should be made by adding boiling water tothe leaves, and permitting them to steep for a few minutes only, for aconcentrated decoction, made by boiling for a long time, liberates theastringent and bitter principles and drives off the agreeable aromawhich resides in a volatile oil. 

Coffee should be prepared by adding cold water to the ground berry, andraising it slowly to the boiling point. Long-continued boiling liberatesthe astringent and bitter principles upon which its stimulant effects toa great extent depend, and drives off with the steam the aromatic oilfrom 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, thegreat English authority on hygiene: "To say this man only drinks ale, that man only drinks wine, while a third drinks spirits, is merely tosay, when the apology is unclothed, that all drink the same danger. * *Alcohol is a universal intoxicant, and in the higher orders of animalsis capable of inducing the most systematic phenomena of disease. But itis reserved for man himself to exhibit these phenomena in their purestform, and to present, through them, in the morbid conditions belongingto his age, a distinct pathology. Bad as this is, it might be worse; forif the evils of alcohol were made to extend equally to animals lowerthan man, we should soon have, none that were tameable, none that wereworkable, and none that were eatable. " Researches have shown that theproportion of half a drachm of alcohol to the pound weight of the body, is the quantity which usually produces intoxication, and that anincrease of this amount to one drachm immediately endangers the life ofthe individual. The first symptom which attracts attention, when alcoholcommences to take effect upon the body, is an increase in the number ofthe pulsations of the heart. Dr. Parkes and Count Wolowicz conducted aseries of interesting experiments on young adult men. They counted thepulsations of the heart, at regular intervals, during periods when thesubject drank only water; and then they counted the beats of the heartin the same individual during successive periods in which alcohol wasdrunk in increasing quantities. 

The following details are taken from their report:

"The highest of the daily means of the pulse observed during the firstor water period was 77. 5; but on this day two observations weredeficient. The next highest daily mean was 77 beats. 

If instead of the mean of the eight days, or 73. 57, we compare the meanof this one day, viz. , 77 beats per minute, with the alcoholic days, soas 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 makea deduction, and to estimate the number of beats in that day as midwaybetween the twelfth and twenty-third days, or 18, 432. Adopting this, themean daily excess of beats during the alcoholic days was 14, 492, or anincrease of rather more than thirteen per cent. 

The first day of alcohol gave an excess of one per cent. , and the lastof twenty-three per cent. ; and the mean of these two gives almost thesame percentage of excess as the mean of the six days. 

Admitting that each beat of the heart was as strong during the alcoholicas in the water period (and it was really more powerful), the heart onthe last two days of alcohol was doing one-fifth more work. 

Adopting the lowest estimate which has been given of the daily work doneby the heart, viz. , as equal to 122 tons lifted one foot, the heart, during the alcoholic period, did daily work in excess equal to lifting15. 8 tons one foot, and in the last two days did extra work to theamount of twenty-four tons lifted as far. 

The period of rest for the heart was shortened, though, perhaps, not tosuch an extent as would be inferred from the number of beats; for eachcontraction was sooner over. The beat on the fifth and sixth days afteralcohol was left off, and apparently at the time when the last traces ofalcohol were eliminated, showed, in the sphygmographic tracing, signs ofunusual feebleness; and, perhaps, in consequence of this, when thebrandy quickened the heart again, the tracing showed a more rapidcontraction of the ventricles, but less power than in the alcoholicperiod. The brandy acted, in fact, on a heart whose nutrition had notbeen perfectly restored. "

The flush often seen on the cheeks of those who are under the influenceof alcoholic liquors, and which is produced by a relaxed and distendedcondition of the superficial blood vessels, is erroneously supposed bymany 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 foundwith their vessels injected; if the brain and spinal cord could be laidopen to view, they would be discovered in the same condition; if thestomach, the liver, the spleen, the kidneys, or any other vascularorgans or parts could be laid open to the eye, the vascular engorgementwould be equally manifest. In the lower animals I have been able towitness this extreme vascular condition in the lungs, and once I had theunusual, though unhappy opportunity of observing the same phenomenon inthe brain of a man who, in a paroxysm of alcoholic delirium, casthimself under the wheels of a railway carriage. The brain, instantaneously thrown out from the skull by the crash, was before mewithin three minutes after the accident. It exhaled the odor of spiritmost distinctly, and its membranes and minute structures were vascularin the extreme. It looked as if it had been recently injected withvermilion injection. The white matter of the cerebrum, studded with redpoints, could scarcely be distinguished when it was incised, it was sopreternaturally red; and the pia mater, or internal vascular membranecovering the brain, resembled a delicate web of coagulated red blood, sotensely were its fine vessels engorged. This condition extended throughboth the larger and the smaller brain, cerebrum, and cerebellum, but wasnot 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 vascularchanges, temporary only in the novitiate, become confirmed andpermanent. The bloom on the nose which characterizes the genial toper isthe 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 heartby stimulating it to increased motion; and from this idea, --false idea, I should say, --of the primary action of alcohol, many erroneousconclusions have been drawn. We have now learned that there exist manychemical bodies which act in the same manner as alcohol, and that theireffect is not to stimulate the heart, but to weaken the contractileforce of the extreme and minute vessels which the heart fills with bloodat each of its strokes. These bodies produce, in fact, a paralysis ofthe organic nervous supply of the vessels which constitute the minutevascular structures. The minute vessels when paralysed offer inefficientresistance to the force of the heart, and the pulsating organ thusliberated, like the main-spring of a clock from which the resistance hasbeen 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 quantityproduces irritation and inflammation of the stomach, and structuraldisease of the liver. Dr. Hammond has shown that alcohol has a specialaffinity for nervous matter, and is, therefore, found in greaterquantity in the brain and spinal cord than elsewhere in the body. Thegray matter of the brain undergoes, to a certain extent, a fattydegeneration, and there is a shrinking of the whole cerebrum, withimpairment of the intellectual faculties, muscular tremor, and ashambling gait. 

Large doses of alcohol cause a diminution of the temperature of thebody, which in fevers is more marked than in the normal state. 

In addition to the organic diseases enumerated above, and deliriumtremens, the following diseases are frequently the result of theexcessive 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 accordwith our own that we quote them in full:

"In the first place we gather from the physiological reading of theaction of alcohol that the agent is narcotic. I have compared itthroughout to chloroform, and the comparison is good in all respectssave one, viz. : that alcohol is less fatal than chloroform as an instantdestroyer. It kills certainly in its own way, but its method of killingis 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 importantsuggestions. The fact shows that alcohol does not in any sense act as asupplier of vital heat as is commonly supposed, and that it does notprevent the loss of heat as those imagine 'who take just a drop to keepout the cold, ' It shows, on the contrary, that cold and alcohol, intheir effects on the body, run closely together, an opinion confirmed bythe experience of those who live or travel in cold regions of the earth. The experiences of the Arctic voyagers, of the leaders of the greatNapoleonic campaigns in Russia, of the good monks of St. Bernard, alltestify that death from cold is accelerated by its ally alcohol. Experiments with alcohol in extreme cold tell the like story, while thechilliness of the body which succeeds upon even a moderate excess ofalcoholic indulgence leads directly to the same indication of truth. 

The conclusive evidence now in our possession that alcohol taken intothe animal body sets free the heart, so as to cause the excess of motionof which the record has been given above, is proof that the heart, underthe frequent influence of alcohol, must undergo deleterious change ofstructure. It may, indeed, be admitted in proper fairness, that when theheart is passing through these rapid movements it is working under lesspressure than when its movements are slow and natural; and thisallowance must needs be made, or the inference would be that the organought 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 tothe body at large; it subjects the heart to irregularity of supply ofblood, it subjects the body in all its parts to the same injuriousinfluence; it weakens, and, as a necessary sequence, degrades both theheart and the body. 

Speaking honestly, I cannot, by any argument yet presented to me, admitthe alcohols by any sign that should distinguish them from otherchemical substances of the paralysing narcotic class. When it isphysiologically understood that what is called stimulation or excitementis, in absolute fact, a relaxation, a partial paralysis, of one of themost important mechanisms in the animal body, the minute, resisting, compensating circulation, we grasp quickly the error in respect to theaction of stimulants in which we have been educated, and obtain a clearsolution 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 thetemporary 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 maylift up the forces of the animal body into true and firm and evenactivity, or that it may add something useful to the living tissues, areerrors as solemn as they are widely disseminated. In the scientificeducation of the people no fact is more deserving of special commentthan this fact, that excitement is wasted force, the running down of theanimal mechanism before it has served out its time of motion. 

It will be said that alcohol cheers the weary, and that to take a littlewine for the stomach's sake is one of the lessons that comes from thedeep recesses of human nature. I am not so obstinate as to deny thisargument, There are times in the life of man when the heart isoppressed, when the resistance to its motion is excessive, and whenblood flows languidly to the centres of life, nervous and muscular. Inthese moments alcohol cheers. It lets loose the heart from itsoppression; it lets flow a brisker current of blood into the failingorgans; it aids nutritive changes, and altogether is of temporaryservice to man. So far, alcohol may be good, and if its use could belimited to this one action, this one purpose, it would be amongst themost excellent of the gifts of science to mankind. Unhappily, the borderline between this use and the abuse of it, the temptation to extendbeyond the use, the habit to apply the use when it is not wanted asreadily as when it is wanted, overbalance, in the multitude of men, thetemporary value that attaches truly to alcohol as a physiological agent. Hence alcohol becomes a dangerous instrument even in the hands of thestrong and wise, a murderous instrument in the hands of the foolish andweak. Used too frequently, used too excessively, this agent, which inmoderation 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 ofthe evil, and ruins the mechanism of the healthy animal before its hourfor ruin, by natural decay, should be at all near. 

It is assumed by most persons that alcohol gives strength, and we hearfeeble persons saying daily that they are being 'kept up by stimulants. 'This means actually that they are being kept down; but the sensationthey derive from the immediate action of the stimulant deceives them andleads them to attribute passing good to what, in the large majority ofcases, is persistent evil. The evidence is all-perfect that alcoholgives no potential power to brain or muscle. During the first stage ofaction it may enable a wearied or a feeble organism to do brisk work fora short time; it may make the mind briefly brilliant; it may excitemuscle to quick action, but it does nothing substantially, and fills upnothing it has destroyed, as it leads to destruction. A fire makes abrilliant sight, but leaves a desolation. It is the same with alcohol. 

On the muscular force the very slightest excess of alcoholic influenceis injurious. I find by measuring the power of muscle for contraction inthe natural state and under alcohol, that so soon as there is a distinctindication of muscular disturbance, there is also indication of muscularfailure, and if I wished by scientific experiment to spoil for work themost perfect specimen of a working animal, say a horse, withoutinflicting mechanical injury, I could choose no better agent for thepurpose of the experiment than alcohol. But alas! the readiness withwhich strong, well-built men slip into general paralysis under thecontinued influence of this false support, attests how unnecessary itwould be to subject a lower animal to the experiment. The experiment isa 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 hisrestless energy under its shadow. The civilized man overburdened withmental labor, or with engrossing care, seeks the same shade; but it isshade, after all, in which, in exact proportion as he seeks it, theseeker retires from perfect natural life. To search for force in alcoholis, to my mind, equivalent to the act of seeking for the sun insubterranean gloom until all is night. 

It may be urged that men take alcohol, nevertheless, take it freely, andyet live; that the adult Swede drinks his average cup of twenty-fivegallons of alcohol per year and remains on the face of the earth. Iadmit force even in this argument, for I know under the persistent useof alcohol there is a limited provision for the continuance of life. Inthe confirmed alcoholic the alcohol is, in a certain sense, so disposedof that it fits, as it were, the body for a long season, nay, becomespart of it; and yet it is silently doing its fatal work. The organs ofthe body may be slowly brought into a state of adaptation to receive itand to dispose of it. But in that very preparation they are themselvesmade to undergo physical changes tending to the destruction of theirfunction, to perversion of their structure, and to all those variedmodifications of organic parts which the dissector of the human subjectlearns to recognize, --almost without concern, and certainly withoutanything more than commonplace curiosity, --as the devastations incidentto 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_ forDecember, 1870, must carry conviction to all minds of the correctness ofthe foregoing deductions:

"For the last ten years the use of spirits has, 1. Imposed on the nationa direct expense of 600, 000, 000 dollars. 2. Has caused an indirectexpense of 600, 000, 000 dollars. 3. Has destroyed 300, 000 lives. 4. Hassent 100, 000 children to the poorhouses. 5. Has committed at least150, 000 people into prisons and workhouses. 6. Has made at least 1, 000insane. 7. Has determined at least 2, 000 suicides. 8. Has caused theloss by fire or violence, of at least 10, 000, 000 dollars' worth ofproperty. 9. Has made 200, 000 widows and 1, 000 orphans. "

If these were the statistics twenty-four years ago, with our greatlyincreased population, what must they be to-day? We will let the readerdraw his own conclusions. 

MALTED LIQUORS. Under this head are included all those liquors into thecomposition of which malt enters, such as beer, ale, and porter. Theproportion of alcohol in these liquors varies greatly. In beer, it isfrom two to five per cent. ; in Edinburgh ale, it amounts to six percent. ; in porter, it is usually from four to six per cent. In additionto alcohol and water, the malted liquors contain from five to fourteenper cent. Of the extract of malt, and from 0. 16 to 0. 60 per cent. Ofcarbonic acid. They possess, according to Pereira, three properties:they quench thirst; they stimulate, cheer, and, if taken in sufficientquantity, intoxicate; and they nourish or strengthen. The first of thesequalities is due to the water entering into their composition; thesecond, to the alcohol; the third is attributed the nutritive principlesof the malt. 

OBJECTIONS TO THEIR USE AS BEVERAGES. These articles are either pure oradulterated. In their pure state the objection to their use for thispurpose lies in the fact that they contain alcohol. This, as we haveseen, is a poisonous substance, which the human system in a state ofhealth does not need. Its use, when the body is in a normal condition, is uncalled for, and can only be deleterious. Beverages containing thispoison are more or less deleterious to healthy persons, according to theamount of it which they contain. 

These liquors are frequently adulterated, and this increases theirinjurious effects. The ingenuity of man has been taxed to increase theirintoxicating properties; to heighten the color and flavor, to createpungency and thirst; and to revive old beer. To increase theintoxicating power, tobacco or the seeds of the Cocculus indicus areadded; to heighten the color and flavor, burnt sugar, liquorice, ortreacle, quassia, or strychnine, coriander, and caraway seeds areemployed; to increase the pungency, cayenne pepper or common salt isadded; to revive old beer, or ale, it is shaken up with green vitriol orsulphate of iron, or with alum and common salt. 

FERMENTED LIQUORS. These are cider and wine. Cider contains alcohol tothe amount of from five to ten per cent. , saccharine matter, lacticacid, and other substances. New cider may be drunk in large quantitieswithout inducing intoxication, but old cider is quite as intoxicating asale or porter. 

The composition of wine is very complex, the peculiar qualities whichcharacterize the different varieties cannot be ascertained by chemicalanalysis. Wine is a solution of alcohol in water, combined with variousconstituents of the grape. The amount of alcohol in wines ranges fromsix to forty per cent. As beverages, these are open to the sameobjections as those manufactured from malt. As a medicine, wine is auseful remedy. Concerning its use in this capacity, Prof. Liebig says:"Wine is a restorative. As a means of refreshment when the powers oflife are exhausted--as a means of compensation where a misappropriationoccurs in nutrition, and as a means of protection against transientorganic disturbances, it is surpassed by no product of nature or art. "That an article is useful in medicine, however, is no reason why itshould be used as a beverage by those in health. It is rather anargument against such a practice. For it is generally true that thedrugs used to restore the diseased system to health, are pernicious orpoisonous to it when in a normal condition. 

DISTILLED LIQUORS. These are whiskey, brandy, and the kindredproductions of the still. Whiskey is a solution of alcohol in water, mixed with various other principles which impart to it peculiar physicalproperties. The amount of alcohol which it contains varies fromforty-eight to fifty-six per cent. Old whiskey is more highly prizedthan the more recent product of the still, from the fact that when keptfor some years certain volatile oils are generated which, impart to it amellowness of flavor. 

Brandy is a solution of alcohol in water, together with various othersubstances. It contains from fifty to fifty-six per cent. Of alcohol. Pure brandy is distilled from wine, 1, 000 gallons of wine yielding from100 to 150 gallons of brandy, but a very large proportion of the brandyis made with little or no wine. It is made artificially from high winesby the addition of oil of Cognac, to give it flavor, burnt sugar to giveit color, and logwood or catechu, to impart astringency and roughness oftaste. The best brandy is obtained by distillation from the best qualityof 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 powerfulinfluence upon health and life, than the atmosphere. The climate inthese latitudes is exceedingly variable, ranging all the way from 110°Fahr. In summer to 40° below zero in the winter season. The body ofevery individual should be so protected from cold, that it can maintaina mean temperature of 98° Fahr. 

When the body is warm there is a free and equal circulation of the bloodthroughout all the structures. When the surface is subjected to cold, the numerous capillaries and minute vessels carrying the blood, contractand diminish in size, increasing the amount of this fluid in theinternal 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 andfullness of the distended blood-vessels, and the organic functions areembarrassed. Besides, cold upon the surface shuts up the pores of theskin, which are among the most active and important excretory ducts ofthe system. It is evident, then, that we require suitable clothing, notonly for comfort, but to maintain the temperature and functionsessential to health and life. 

The chief object to be attained by dress is the maintenance of a uniformtemperature of the body. To attain this end, it is necessary that theexhalations of the system, which are continually escaping through thepores of the skin, should be absorbed or conducted away from the person. These exudations occur in the form of sensible or insensibleperspiration, and the clothing, to be healthy, should be so porous as toallow them freely to escape into the air. 

A substance should also be chosen which is known to be a poor conductorof heat. That generated by the system will thus be retained where it isneeded, instead of being dispersed into the atmosphere. 

We might add that the better the material for accomplishing thesepurposes, the less will be needed to be worn; for we do not wish to wearor carry about with us any more material than is necessary. It sohappens that all of these qualities are found combined in _flannel_. Thevalue of this article worn next to the skin cannot be over-rated, forwhile it affords protection from cold during the winter months, it isequally beneficial during the heat of summer, because it imbibes theperspiration, and being very porous, allows it to escape. The skinalways feels soft, smooth, and pliable, when it is worn; but, whencotton takes its place, it soon becomes dry and harsh. Its naturaladaptability to these purposes, shows that it is equally a comfort and asource of health. Where the skin is very delicate, flannel sometimescauses irritation. In such cases a thin fabric of linen, cotton, orsilk, should be worn next the skin, with flannel immediately over it. Where there is a uniform and extreme degree of heat, cotton and linenare very conducive to comfort. But they are unsuitable in a climate orseason liable to sudden fluctuations in temperature. 

The value of furs, where people are exposed to extreme cold, cannot beoverestimated. They are much warmer than wool, and are chiefly used aswraps on going outdoors. They are too cumbrous and expensive forordinary wear in this latitude, but in places near the poles theyconstitute the chief clothing of the inhabitants. 

The quantity of clothing worn is another important item. The least thatis necessary to keep the body well protected and evenly tempered whenemployed is the rule of health. Some people, instead of wearing flannelsnext to the body, put on other material in greater abundance, thusconfining the perspiration to the skin and making the body chilly. Theamount of clothing is then increased, until they are so heavily cladthat they cannot exercise. It is far better to wear one thickness offlannel next to the skin, and then cotton, or woolen, for outsidegarments, and be able to exercise, thus allowing the blood to circulateand to assist in the warming process. 

One great fault in dress consists in neglecting to properly clothe theupper extremities. Some people do not reflect upon the necessity, whileothers are too proud to be directed by plain common sense. In the winterseason, the feet should be covered with woolen stockings. The nextmatter of importance, is to get a thick, broad-soled shoe, so large thatit 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 thereis snow on the ground, wear a flannel-lined rubber or "Arctic"over-shoe. _Be sure and keep the feet comfortable and warm at alltimes. _

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 anentertainment where the apartments were nicely warmed, and from thencehad walked home late in the evening. We inquired into the circumstancesof the case, and ascertained that she wore flannel about her chest, andthat she also wore rubbers over her shoes, but the other portions of thelower extremities were protected by cotton coverings. In short, her legswere not kept warm, and she took cold by going out from warm rooms intoa chilly atmosphere. A good pair of woolen leggings might have saved hermuch suffering. The results of insufficient protection of the lowerextremities are colds, coughs, consumption, headaches, pain in the side, menstrual derangements, uterine congestion and disorders, besidesdisablement for the ordinary and necessary duties of life. All these maybe prevented by clothing the legs suitably, and wearing comfortableflannels. 

Young people can bear a low temperature of the body better than oldpeople, because they possess greater power of endurance. But that is noreason for unnecessary exposure. 

The amount of clothing should be regulated according to theheat-generating power of the individual, and also according to thesusceptibility to cold. No two persons are exactly alike in theserespects. But it is never proper for young people to reject the counselsof experience, or treat lightly the advice to protect themselvesthoroughly against the cold. Many a parent's heart has ached as he hasfollowed the mortal remains of a darling child to the grave, knowingthat if good advice had been heeded, in all human probability, the lifewould have been prolonged. 

The most deleterious mechanical errors in clothing are those whichaffect the chest and body. Tight lacing still plays too important a partin dress. It interferes with the free and healthy movements of the body, and effects a pressure which is alike injurious to the organs ofrespiration, circulation, and digestion. The great muscle ofrespiration, the diaphragm, is impeded in its motion, and is, therefore, unable to act freely. The large blood-vessels are compressed, and whenthe pressure is excessive the heart and lungs are also subjected torestraint and thrown out of their proper positions. From the compressionof the liver and stomach, the functions of digestion are impeded, adistaste for solid food, flatulency and pain after eating are theunmistakable proofs of the injury which is being inflicted. 

The evil effects of such pressure are not confined to actual periods oftime during which this pressure is applied. They continue after it hasbeen removed and when the chest and trunk of the body have thus beensubjected 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 arenot uncommon. The leg is sometimes so indented by a tight garter thatthe returning flow of blood through the veins is prevented, and avaricose condition of these vessels is produced. 

Irregular and excessive pressure on the foot by imperfectly fittingshoes or boots produce deformities of the feet and cause much suffering. The high heels which are so common on the shoes of women and childreninflict more than a local injury. Every time the body comes down uponthe raised heel with its full weight a slight shock or vibration iscommunicated throughout the entire extent of the spinal column, and thenervous mechanism is thereby injured. Furthermore, displacements of thepelvic organs frequently result from these unnatural and absurd articlesof dress. Women of fashion are subjected to much annoyance from wearinglong, flowing skirts suspended from their waists to trail uselessly onthe floor and gather dust. It is impossible for the wearers of theseridiculous garments to exercise their limbs properly or to breathenaturally. Indigestion, palpitation, shortness of breath, and physicaldegeneracy are the inevitable consequences of their folly. The skirtsshould always be suspended from the shoulders and not from the hips. Itis especially important that the clothing of children should not fit tootightly. 

It is very important that the clothing should be kept clean. That whichis worn for a long time becomes saturated with the excretions andexhalations of the body, which prevent free transpiration from the poresof the skin, and thereby induce mental inactivity and depression of thephysical powers. Unclear clothing may be the means of conveying disease. Scarlet fever has been conveyed frequently by the clothing of a nurseinto a healthy family. All of the contagious diseases have beencommunicated by clothing contaminated in laundries. 

Certain dyes which are largely used in the coloring of wearing apparelare poisonous, and give rise to local disease of the skin, accompaniedin some instances, with constitutional symptoms. The principal poisonousdyes are the red and yellow aniline. A case of poisoning from wearingstockings colored with aniline dyes, in which there were severeconstitutional 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 authorhas said that "the nearer we approach Divinity, the more we reflect Hiseternal beauty. " The perfect expression of thought requires the physicalaccompaniments of language, gesture, etc. The human form is pliable, and, with proper culture, can be made replete with expression, grace andbeauty. The cultivation of the intellectual powers has been allowed tosupplant physical training to a great extent. The results are abnormallydeveloped 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 greatintellect is generally impaired when united with a weak and frail body. We have sought perfection in animals and plants. To the former we havegiven all the degree of strength and grace requisite to their peculiarduties; to the latter we have imparted all the delicate tints andshadings that fancy could picture. We have studied the laws of theirexistence, until we are familiar with every phase of their production;yet it remains for man to learn those laws of his own being, by aknowledge of which he may promote and preserve the beauty of the humanform, and thus render it, indeed, an image of its Maker. When the bodyis tenanted by a cultivated intellect, the result is a unity which isunique, commanding the respect of humanity, and insuring a successfullife to the possessor. Students are as a rule pale and emaciated. Mentalapplication is generally the cause assigned when, in reality, it is theresult of insufficient exercise, impure air, and dietetic errors. Anintelligent journalist has remarked that "many of our ministers weightoo little in the pulpit, because they weigh too little on the scales. "The Greek Gymnasium and Olympian Games were the sure foundations of thateducation from which arose that subtle philosophy, poetry, and militaryskill which have won the admiration of nineteen centuries. The laurelcrown of the Olympian victor was far more precious to the Grecian youththan the gilded prize is to our modern genius. A popular lecturer hastruly remarked, that "we make brilliant mathematicians and miserabledyspeptics; fine linguists with bronchial throats; good writers withnarrow chests and pale complexions; smart scholars, but not that union, which the ancients prized, of a sound mind in a sound body. The brainbecomes the chief working muscle of the system. We refine and re-refinethe intellectual powers down to a diamond point and brilliancy, as ifthey were the sole or reigning faculties, and we had not a physicalnature binding us to earth, and a spiritual nature binding us to thegreat heavens and the greater God who inhabits them. Thus the universitybecomes a sort of splendid hospital with this difference, that thehospital _cures_, while the university _creates_ disease. Most of themare indicted at the bar of public opinion for taking the finest youngbrain and blood of the country, and, after working upon them for fouryears, returning them to their homes skilled indeed to perform certainlinguistic and mathematical dexterities, but very much below par inhealth and endurance, and, in short, seriously damaged and physicallydemoralized. " We read with reverence the sublime teachings of Aristotleand Plato; we mark the grandeur of Homer and the delicate beauties ofVirgil; but we do not seek to reproduce in our modern institutions thegymnasium, which was the real foundation of their genius. Colleges whichare now entering upon their career, should make ample provision forthose exercises which develop the _physical man. _ This lack of bodilytraining is common with all classes, and its effects are written inindelible characters on the faces and forms of old and young. Constrained positions in sitting restrict the movements of the diaphragmand ribs and often cause diseases of the spine, or unnatural curvatures, which prove disastrous to health and happiness. The head should be helderect and the shoulders thrown backward, so that at each inspiration thelungs may be fully expanded. 

Physical exercise should never be too violent or too prolonged. Severephysical labor, and athletic sports, if indulged in to an extremedegree, produce undue excitability of the heart, and sometimes cause itto become enlarged. There is a form of heart disease induced by undueexertion which may be called a wearing out or wasting away of thatorgan. It is common in those persons whose occupations expose them toexcessive physical labor for too many hours together. This feebleness ofheart is felt but little by vigorous persons under forty years of age, but in those who have passed this age it becomes manifest. However, whenany person so affected is attacked by any acute disease, the heart ismore liable to fail, and thus cause a fatal termination. 

Aneurism of the aorta or the large arteries branching off from it, whichis a dilatation of the walls of these vessels, caused by the rupture ofone or two of their coats, is generally induced by excessive physicalstrain, such as lifting heavy weights, or carrying weights up longflights of stairs, violent horseback exercise, or hurrying to catch atrain or street car. 

[Illustration: Fig. 104. ]

AN ERECT CARRIAGE is not only essential to health, but adds grace andbeauty to every movement. Although man was made to stand erect, thusindicating his superiority over all other animals, yet custom has donemuch to curve that magnificent central column, upon the summit of whichrests the "grand dome of thought. " Many young persons unconsciouslyacquire the habit of throwing the shoulders forward. The spinal columnis weakened by this unnatural posture, its vertebræ become so sensitiveand distorted that they cannot easily support the weight of the body orsustain its equilibrium. It is generally believed that persons ofsedentary habits are more liable to become round-shouldered than anyother class of individuals. Observation shows, on the contrary, that themanual laborer, or even the idler, often acquires this stooping posture. It can be remedied, not by artificial braces, but by habitually throwingthe shoulders backwards. Deformed trunks and crooked spines, althoughsometimes the effects of disease are more frequently the results ofcarelessness. Jacques has remarked that "one's standing among hisfellow-men is quite as important a matter in a _physiological_, as in a_social_ sense. " _Walking_ is one of the most efficient means ofphysical culture, as it calls all the muscles into action and producesthe amount of tension requisite for their tonicity. Long walks orprotracted physical exercise of any kind should never be undertakenimmediately after meals. The first essential to a healthful walk is apleasurable object. Beautiful scenery, rambles in meadows rich withfragrant grasses, or along the flowery banks of water-courses, affordsan agreeable stimulus, which sends the blood through the vital channelswith unwonted force, and imparts to the cheeks the ruddy glow of health. Our poets acknowledge the silent influence of nature. Wordsworth hasexpressed 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 whenpracticed solely with a view to their hygienic advantages and as suchhave our approval. 

[Illustration: Fig. 105. ]

[Illustration: Fig. 109. ]

THE ART OF SWIMMING was regarded by the Greeks as an importantaccomplishment. As a hygienic agency, it occupies a high place inphysical culture. The varied movements impart strength and elasticity tothe muscles. It is as charming a recreation for women and girls as formen 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 andlongevity. The most important of these are balancing, leaping, climbing, wrestling, and throwing, all of which are especially adapted to thedevelopment of the muscles. In conclusion, we offer the followingsuggestions, viz: all gymnastic exercises should be practiced in themorning, and in the open air; extremes should be avoided; and it shouldbe always borne in mind, that their chief object is to combine, in aproper proportion, mental and physical development. In every relation oflife we should cultivate all those faculties which pertain to ourphysical, moral, and mental natures, subdue our passions, and naturewill bestow upon us her richest rewards of health, beauty, andhappiness. 

CYCLING. 

[Illustration]

If one were asked what athletic exercise deserves to be the most popularin America to-day, the answer would of necessity be cycling. The bicycleis being used by people of all ages and conditions of health in dailylife; its hygienic value as a means to healthy exercise cannot beoverestimated. In this, as in everything else, immoderation is to becondemned, particularly where persons have not had sufficient trainingto take long "spins, " or attempt racing. Beginners should ride only 10or 12 minutes at a time--resting then to permit the circulation tobecome equalized. In all cyclists, at all ages, in veteran riders aswell as those not practiced in the art, there is, in the beginning ofeach attempt, a quickened circulation; the pulse is full and bounding, and rarely falls under a hundred pulsations per minute. So long as theexercise is continued, an increase of cardiac motion is observable, anda vigorous circulation is kept up. This accounts for the astoundingjourneys a fully trained cyclist can accomplish, and also for hisendurance without sleep. In spite of the quickened motion of the heart, rarely have riders been known to grow giddy or show symptoms of cardiacembarrassment. A good rider may climb a hill without trouble, yet beunable to climb a flight of stairs without breathlessness andpalpitation. Bicycle riding as a means for acquiring strength and vigor, improving the circulation and developing the respiratory organs, isunexcelled. Fast riding, or "scorching, " among those not used tophysical exertion, and leaning over the handle-bars so as to ride in astooping position, are to be heartily condemned. The latter prevents thelungs from getting their full expansion, and cultivates a tendency toround shoulders. Men or women suffering from diseases of the sexualorgans should, before riding, consult the physician having their case incharge. 

[Illustration: Fig. 112. ]

RIDING ON HORSEBACK is a fine exercise for both sexes. It promotesdigestion, improves the circulation, and expands and develops therespiratory organs. The pure, fresh air, pleasant scenery, andpleasurable excitement, impart renewed vigor to the equestrian. In theSouthern States it is a universal accomplishment, and children aretaught to ride as well as to walk. 

DANCING. Notwithstanding the fact that dancing has been perverted to thebasest purposes, has been made the fruitful source of dissipation, andhas often laid the foundation for disease, it is yet capable of beingmade to minister to health and happiness. As a means of physicalculture, it favors the development of the muscular system, and promoteshealth and cheerfulness. When practiced for this purpose, Jacques termsit "the best of all indoor exercises, " as it brings to bear upon thephysical system a great number of energizing and harmonious influences. 

MENTAL CULTURE. 

The brain, like all other organs of the body, requires alternateexercise and repose; and, in physical endurance, it is subject togeneral physiological laws. When exercised with moderation it acquiresstrength, vigor, and an accelerated activity. Excessive mental exertionis liable to result in softening of the brain, and various nervousdiseases, sometimes culminating in insanity, and in many instancesproving fatal to life. The mere votaries of pleasure who avoid alleffort of the mind, fall into the opposite error. In all cases ofintellectual activity, the exertions should be directed to some subjectinteresting 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 oftime together, it becomes fatigued, and requires relaxation, recreation, rest. This may be obtained by directing the attention to some othersubject, either study or amusement, the latter of which is preferable. The amusement, however, may be of an intellectual or physical characteror both combined, and will, if properly conducted, restore vigor to bothmind and body. 

Prominent among physical phenomena is the mutual relation between thebrain and the organs of nutrition. Mental exertion should be avoided forat least one hour after a hearty meal, and all mental labor whichrequires concentration of thought ought to be accomplished in theearlier portion of the day, when the brain is refreshed and repaired bythe 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 intellectat the expense of the physical powers. 

MENTAL CULTURE DURING CHILDHOOD. One of the greatest mistakes whichpeople make in the management of their children, is to overtask theirmental faculties. Although it is exceedingly gratifying to see childrenacquire knowledge, and manifest an understanding far beyond their years, this gratification is often purchased too dearly, for precociouschildren are apt to die young. The tissue of the brain and nerves ofchildren is very delicate; they have not yet acquired the powers ofendurance which older persons possess. The greater portion of thenutriment assimilated, is required for growth and organic development, and they can ill afford its expenditure for mental manifestations. Theyreceive impressions easier and learn much more readily than in afterlife, but it is at the expense of the physical organization. Theirmental faculties continue to be developed by the expenditure of brainnutriment, while physical growth and the powers of endurance arearrested. It is much better to give physical development the precedencein order that the mental organism may be well supported and itsoperations carried into effect; for it must be apparent to all that anordinary intellect in a healthy body, is capable of accomplishinginfinitely more than a strong mind in a _weak_ body. Regularity shouldbe observed in exercising the mental functions. For this reason a fixedorder in the pursuit of any literary occupation is very essential. Thepursuit of the most abstruse studies will thus become habitual andcomparatively easy, a consequence of systematic application. Mentallabor should always cease when the train of thought becomes confused, and there is the slightest sensation of depression. All distractinginfluences should be absent from the mind, in order to facilitateintense study, for the intellect cannot attend perfectly to two subjectsat the same time. Painful sensations always have a tendency to paralyzemental exertion. Great care should be taken that the head is notsubjected to injury of any kind, as it is almost invariably accompaniedby some nervous derangement. Exposure to extreme heat should becarefully avoided. An attack of sun-stroke although it may not beimmediately fatal, may occasion tumors in the brain, or some organicdisease. 

SLEEP. 

For all animated beings sleep is an imperious necessity, asindispensable as food. The welfare of man requires alternate periods ofactivity and repose. It is a well-established physiological fact, thatduring the wakeful hours the vital energies are being expended, thepowers of life diminished, and, if wakefulness is continued beyond acertain limit, the system becomes enfeebled and death is the result. During sleep there is a temporary cessation of vital expenditures, and arecuperation of all the forces. Under the influence of sleep "the bloodis refreshed, the brain recruited, physical sufferings are extinguished, mental troubles are removed, the organism is relieved, and hope returnsto the heart. "

The severest punishment which can be inflicted upon a person, is toentirely deprive him of sleep. In China, a few years since, threecriminals were sentenced to be kept awake until they should die. To dothis it was necessary to keep a guard over them. The sentinels werearmed with sharp, pointed instruments, with which to goad the victimsand thus prevent them from sleeping. Life soon became a burden, and, although they were well fed during the time, death occurred sooner thanit 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 bedetermined by the health of the occupant. Besides maintaining a propertemperature in the room, a little fire is useful, especially if in agrate, for the purpose of securing good ventilation. The windows shouldnot 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 offanimal emanations of an injurious character, and impart a feeling oflassitude and debility to those sleeping on them. No more coveringsshould be used than are actually necessary for the comfort of theindividual. Cotton sheets are warmer than linen, and answer equally aswell. 

SLEEPING ALONE. Certain effluvia are thrown off from our persons, andwhen two individuals sleep together each inhales from the other more orless of these emanations. There is little doubt that _consumption_, andmany other diseases, not usually considered contagious, are sometimescommunicated in this manner. When it is not practicable for individualsto occupy separate beds, the persons sleeping together should be ofabout the same age, and in good health. Numerous cases have occurred inwhich healthy, robust children have gradually declined and died within afew 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 issubstituted for night, the sleep obtained does not fully restore theexhausted energies of the system. Nature does not allow her laws to bebroken with impunity. 

Children require more sleep than old persons. They are sometimesstupefied with "soothing syrups, " and preparations of opium, in order toget them temporarily out of the way. Such narcotics are very injuriousand dangerous. We have known a young child to be killed by a _singledrop_ of laudanum. This practice, therefore, cannot be too emphaticallycondemned. 

HOW TO PUT CHILDREN TO BED. The following characteristic lines are fromthe pen of Fanny Fern, and contain such good advice that we cannotrefrain from quoting them: "Not with a reproof for any of the day's sinsof 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, youcould never do this. Seal their closing eyelids with a kiss and ablessing. The time will come, all too soon, when they will lay theirheads upon their pillows lacking both. Let them at least have this sweetmemory of happy childhood, of which no future sorrow or trouble can robthem. Give them their rosy youth. Nor need this involve wild license. The judicious parent will not so mistake my meaning. If you ever met theman or the woman, whose eyes have suddenly filled when a little childhas crept trustingly to its mother's breast, you may have seen one inwhose childhood's home 'dignity' and 'severity' stood where love andpity should have been. Too much indulgence has ruined thousands ofchildren; 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 becomesheated, especially if the person sleeps on feathers, the circulation isobstructed and local congestions are encouraged. The face should neverbe covered during sleep, since it necessitates the breathing of the sameair 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 rulecan be given for the guidance of all. The average amount required, however, is eight or nine hours out of the twenty-four. Some personsneed more than this, while others can do with less. Since both body andmind are recuperated by sleep, the more they are exhausted the moresleep is required. A person employed at mental labor should have morethan one who is merely expending muscular strength. Six hours ofunbroken sleep do more to refresh and revive than ten when frequentlyinterrupted. If it is too prolonged it weakens and stupefies both bodyand mind. If an insufficient amount is taken the flagging energies arenot restored. Persons who eat much, or use stimulants generally requiremore than others. To sleep regularity is desirable. If a person goes tobed at a certain hour for several nights in succession, it will soonbecome a habit. The same holds true with regard to rising. If childrenare put to sleep at a stated hour for several days in succession, itwill soon become a habit with them. 

CLEANLINESS. 

"Cleanliness is next to godliness, " and is essential to the health andvigor of the system. Its importance cannot be overestimated, and itshould be inculcated early on the minds of the young. "Even from thebody's purity, the mind receives a secret sympathetic aid. "

When we consider the functions of the skin, with its myriads of minuteglands, innumerable little tubes, employed in removing the worn-out, useless matter from the system, we cannot fail to appreciate the utilityof frequent bathing with soap and water. Unless these excretions areremoved, the glands become obstructed, their functions are arrested, andunpleasant odors arise. Many persons think because they daily bathe theface, neck, and hands, dress the hair becomingly and remove the dirtfrom their clothing that the height of cleanliness has been reached. From a hygienic point of view, bathing the _entire_ body is of muchgreater importance. 

Notwithstanding the necessity for cleanliness of the body, weoccasionally meet with persons who, although particular about theirpersonal appearance, permit their bodies to be for weeks and even monthswithout a bath. Such neglect should never exceed one week. Plenty ofsunlight and at least one or two general baths every week are essentialto perfect health. Cleanliness is necessary to health, beauty, attractiveness, and a cheerful disposition. 

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CHAPTER IV. 

HYGIENE OF THE REPRODUCTIVE ORGANS. 

The structure and functions of organized bodies are subject to continualalteration. The changes of nutrition and growth, which are constantlytaking place in the tissues render them at the same time the seat ofrepair 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. Itis, therefore, essential to the perpetuation of life, that new organismsbe provided to take the place of those which are passing out ofexistence. There is no physiological process which presents moreinteresting phenomena than that of reproduction, which includes theformation, as well as the development of new beings. 

Since self-preservation is Nature's first law, the desire for food is amost powerful instinct in all living animals. Not inferior to this lawis that for the perpetuation of the race; and for this purpose, throughout the animal and vegetable kingdoms, we find the Biblicalstatement 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 wouldfind that much of the barbarism and crime, degradation and vice, as wellas their decline and final extinction, was due to licentiousness andsexual excesses. Since there is an intimate relation between mind andbody, when the body is enfeebled the mind becomes enervated. Morbidconditions of the body prevent the highest mental development, and, onthe other hand, when the mind is debilitated, general depravity, physical as well as mental, is the result. The highest development ofthe body results from the equal and harmonious cultivation of all themental powers. The perfect development and health of the physical organsis therefore essential to the happiness of mankind. But, before healthcan be insured the nature and general functions of the physical systemmust be understood. This being done, the question naturally arises: _Howcan 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 influenceupon the health of the generative organs. Excessive stimulation excitesthe sexual passions. For this reason, children should not beimmoderately indulged in highly seasoned foods. Those persons who havegreat muscular vigor are endowed with violent passions, and unlessrestrained by moral considerations, are very likely to be overcome bytheir animal propensities. 

_Alcoholic stimulants_ have a debasing influence upon the whole system, and especially upon the sexual organs; they excite the animal and debasethe moral nature; they exhaust the vitality, and, after the excitement, which they temporarily induce, has passed away, the body is left in aprostrated condition. 

PHYSICAL LABOR MODIFIES THE PASSIONS. Labor consumes the surplusvitality which a person may possess, and no better protective can befound against the gratification of the passions, unless it be high moraltraining, than daily toil extended to such a degree as to producefatigue. Labor determines the blood to the surface and to other parts ofthe 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 avoidthese social or solitary evils, they will be abated. Let them beeducated 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 peculiaritiescharacteristic of the nation to which they belong. Climate exerts apowerful influence upon mankind. In tropical regions the inhabitants areenervated, effeminate, and sensual. The rich live in luxury and ease, vice is unrestrained and license unbridled. When the animal propensitiesare allowed to predominate, the mental faculties are kept in subjection. Hence races that inhabit those latitudes rarely produce scholars orphilosophers. A warm climate hastens the development of the reproductiveorgans. Men and women become mature at a much earlier age in thoseregions, than in countries where the temperature is lower. In likemanner there is a tendency to premature enfeeblement, for the earlierthe system matures, the sooner it deteriorates. 

MAN IS A SOCIAL BEING. History demonstrates that when man is deprived ofthe society of women, he becomes reckless, vicious, depraved, and evenbarbarous in his habits, thus illustrating the maxim: "It is not goodfor man to be alone. " Social intercourse promotes mental and physicaldevelopment. The development of the individual implies the unfolding ofevery power, both physical and mental. Nothing so regulates andrestrains passion as a healthy condition of the organs through which itfinds expression. And every organ of the body is powerful in proportionto its soundness. The propensities play a prominent part in theeducation of the child. When properly disciplined and held insubordination to the higher faculties, they constitute an importantfactor in the economy of man. Boys are more liable to be morbidlyexcited when secluded from the society of girls, and vice versa. Again, when the sexes are accustomed to associate, the passions are not apt tobe aroused, because of the natural antagonistic constitutional elements. The influence of the one refines, and ennobles the other. Let childrenbe taught to understand their natures, and knowing them, they will learnself-government. "As man rises in education and moral feeling heproportionately rises in the power of self-restraint; and consequentlyas he becomes deprived of this wholesome law of discipline he sinks intoself-indulgence and the brutality of savage life. 

The passions may be aroused by the language, appearance or dress of theopposite sex. A word spoken without any impure intent is often construedin a very different sense by one whose passions color the thought, andis made to convey an impression entirely unlike that which was intendedby the speaker. Also, the dress may be of such a character as to excitethe sexual passion. The manner in which the apparel is worn is often soconspicuous as to become bawdy, thereby appealing to the libidinousdesires, rather than awakening an admiration for the mental qualities. 

OBSCENE LITERATURE. Literature is a powerful agent either for good orevil. If we would improve the morals, _choice_ literature must beselected, whether it be that which realizes the ideal, or idealizes thereal. Obscene literature, or books written for the express purpose ofexciting or intensifying sexual desires in the young, goads to anillicit gratification of the passions, and ruins the moral and physicalnature. 

It not unfrequently happens that a child is born with a vigorous, mentalorganism which promises a brilliant future, but manhood finds himincompetent, debilitated, and totally incapacitated for mental or manuallabor. This may be the result of youthful indiscretion, ignorantlycommitted, but not unfrequently it is the effect of a perniciousliterature which inflames the imagination, tramples upon reason, anddescribes to the youth a realm where the passions are the rulingdeities. 

Many persons are born into the world with disordered organizations forwhich they are not themselves responsible. Such individuals are entitledto the sympathy of humanity. Dyspepsia, scrofula, consumption, and athousand ills to which mankind is heir, are inherited from parents, theresults of ill-assorted marriages. Intoxicated parents often produceoffspring utterly demented. Children of healthy parents, with goodconstitutions, are usually healthy and intelligent. There are markedvarieties of character in children of the same parents. One manifestsgreat precocity, another is below the average in mental attainments; oneis amiable, another irritable in disposition; indeed, there are often asgreat differences between children of the same, as of differentfamilies. This is due to the physical and mental conditions of theparents, more especially the mother, not only at the time of theimpregnation but also during the period intervening between conceptionand the birth of the offspring. The ancients regarded courage as theprincipal virtue. By us, purity is so estimated. Moral purity is anessential 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 practicedmore or less by members of both sexes, and the habit once established, is overcome with the greatest difficulty. It is the source of numerousdiseases which derange the functional activity of the organs involved, and eventually impair the constitution. This vicious habit is oftenpracticed by those who are ignorant of its dangerous results. Statisticsshow 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. Notunfrequently does the marriage rite "cover a multitude of sins. " Theabuse of the conjugal relation produces the most serious results to bothparties, and is a prolific source of some of the gravest forms ofdisease. Prostatorrhea, spermatorrhea, impotency, hypochondria, andgeneral debility of the generative organs, arise from sexual excesses. 

The health of the reproductive organs can only be maintained by leadinga _temperate_ life. The food should be nourishing but not stimulating. Lascivious thoughts should be banished from the mind, and a tastecultivated for that literature which is elevating in its nature, and theassociations should be refining and ennobling. Let these conditions andthe rules of hygiene, be observed, and virtue will reward her subjectswith a fine physique and a noble character. 

Woman, from the nature of her organization, has less strength andendurance than man. Much, however, of the suffering and misery which sheexperiences arises from insufficient attention to the sexual organs. Themenstrual function is generally established between the ages of twelveand fourteen. For want of proper instruction, many a girl throughignorance HAS caused derangements which have enfeebled her womanhood orterminated her life. At this critical period the mother cannot be tooconsiderate of her daughter's health. Preceding the first appearance ofthe menses, girls usually feel an aching in the back, pains in thelimbs, chilliness, and general languor. The establishment of thisfunction relieves these symptoms. Every precaution should be takenduring the period to keep the feet dry and warm, to freely maintain ageneral circulation of the blood, to avoid exertion, and to refrain fromstanding or walking too much. Menstrual derangements should never beneglected, for they predispose to affections of the brain, liver, heart, and stomach, induce consumption and frequently end in death. Young womenshould, therefore, properly protect themselves, and avoid extremes ofheat and cold. 

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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 careshould be exercised with women who are in a way to become mothers. Thosewho are surrounded by all the luxuries which health can bestow, indulgetoo much in rich food, and take too little exercise; while the poor gettoo little nourishment, and work too hard and too long. A woman in thiscondition should avoid over-exertion, and all scenes which excite thepassions or powerful emotions. She should take moderate exercise in theopen air; eat moderately of wholesome food, and of meat not oftener thantwice a day; take tea or coffee in limited quantities, and avoid the useof all alcoholic liquors; she should go to bed early and take not lessthan nine hours sleep; her clothing should be loose, light in weight, and warm. She should take every precaution against exposure tocontagious or infectious diseases. 

2. There is no better method for preventing the spread of contagiousdiseases than perfect isolation of the infected, and thoroughdisinfection of all articles of clothing or bedding which have been incontact with the infected. Many persons erroneously believe that everychild must necessarily have the measles, and other contagious diseases, and they, therefore, take no precautions against the exposure of theirchildren. The liability to infection diminishes as age advances, andthose individuals are, as a rule, the strongest and best developed whohave never suffered from any of the contagious diseases. Although, vaccination is the great safeguard against-pox, yet it should neverprevent the immediate isolation of those who are suffering from thisdisease. 

3. To avoid the injurious effects of impure air, the following rules, should be carefully observed. The admission of air which containsanything that emits an unpleasant odor into closed rooms should beavoided. The temperature of every apartment should be kept as near 70°Fahr. As possible, and the air should not be overcharged with wateryvapor. Provisions should be made for the free admission into and escapeof air from the room at all times. When an apartment is not in use, itshould be thoroughly ventilated by opening the windows. Those who arecompelled to remain in an atmosphere tilled with dust, should wear acotton-wool respirator. 

4. To insure a healthy condition of the body, the diet of man ought tobe varied, and all excesses should be avoided. The total amount of solidfood taken in the twenty-four hours should not exceed two and a halfpounds, and not more than one-third of this quantity should consist ofanimal food. Many persons do not require more than one pound and a halfof mixed food. To avoid parasitic diseases, meat should not be eatenrare, especially pork. The amount of drink taken should not be more thanthree pints in twenty-four hours. The excessive use of tea and coffeeshould be avoided. Pickles, boiled cabbage, and other indigestiblearticles should never be eaten. 

5. To avoid the evil effects of alcoholic liquors, perfect abstinence isthe only safe course to pursue. Although one may use spirituous liquorsin moderation for a long period of time and possibly remain healthy, yetsuch an indulgence is unnecessary and exceedingly dangerous. A personwho abstains entirely from their use is safe from their perniciousinfluence; a person who indulges ever so moderately is in danger; aperson who relies on such stimulants for support in the hour of need islost. 

6. While the use of tobacco is less pernicious than alcohol in itseffects, et it exerts a profound disturbing influence upon the nervoussystem, and gives rise to various functional and organic diseases. Thisis the verdict of those who have given the subject the most study, andwho have had the best opportunities for extensive observation. Suddenlyfatal results have followed excesses in the use of tobacco. Therefore, the habit should be avoided, or if already acquired, it should beimmediately abandoned. 

7. The clothing should be light and porous, adapted in warmth to theseason. It is especially important that persons in advanced life shouldbe well protected against vicissitudes of heat and cold. Exposure is thecause of almost all those inflammatory diseases which occur duringwinter, and take off the feeble and the aged. The under-garments shouldbe kept scrupulously clean by frequent changes. Corsets or bands whichimpede the flow of blood, compress the organs of the chest or abdomen, or restrict the movements of the body, are very injurious, and shouldnot be worn. Articles of dress which are colored with irritatingdye-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 morework can be done by omitting these. No single occupation which requiresspecial mental or physical work, should be followed for more than eighthours out of the twenty-four. The physical organism is not constructedto run its full cycle of years and labor under a heavier burden thanthis. Physical and mental exercise is conducive to health and longevity, if not carried too far. It is erroneous to suppose that excessivephysical exertion promotes health. Man was never intended to be arunning or a jumping machine. In mental work, variety should beintroduced. New work calls into play fresh portions of the brain, andsecures repose for those parts which have become exhausted. Idlenessshould be avoided by all. Men should never retire from business as longas they enjoy a fair degree of health. Idleness and inactivity areopposed to nature. 

9. The average length of time which a person ought to sleep is eighthours out of the twenty-four, and, as a rule, those who take this amountenjoy the best health. The most favorable time for sleep is between thehours of 10 P. M. And 6 A. M. All excitement, the use of stimulants, andexcessive fatigue tend to prevent sleep. Sleeping rooms should be wellventilated, and the air maintained at a equable temperature of as near60° Fahr. As possible. An inability to sleep at the proper time, or aregular inclination to sleep at other than the natural hours for it, isa certain indication of errors of habit, or of nervous derangement. 

10. Prominent among all other measures for the maintenance of Health, ispersonal cleanliness. Activity in the functions of the skin is essentialto perfect health, and this can only be secured by thoroughly bathingthe entire body. Strictly, a person should bathe once every twenty-fouror forty-eight hours. The body should be habituated to contact with coldwater at all season of the year, so that warm water may not become anecessity. The simplest and most convenient bath, is the ordinarysponge-bath. An occasional hot-air, or Turkish bath, exerts a verybeneficial influence. It cleans out the pores of the skin and increasesits activity. 

11. The emotions and the passions exert a powerful influence over thephysical organism. It is important, therefore, that they be held underrestraint by the reasoning faculties. This rule applies equally to joy, fear, and grief; to avarice, anger, and hatred; and, above all, to thesexual passion. They are a prolific source of disease of the nervoussystem, and have caused the dethronement of some of the most giftedintellects. 

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PART III. 

RATIONAL MEDICINE. 

CHAPTER I. 

THE PROGRESS OF MEDICINE. 

During the last half century a great change has taken place in thetreatment of disease. Medicine has advanced with rapid strides, from thenarrow 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 truthsto the general fund of medical learning, but much more has been effectedby observation and empirical discovery. It is of little or no interestto the invalid to know whether the prescribed remedy is organic orinorganic, simple, compound, or complex. In his anxiety and distress ofbody, he seeks solely for relief, without regard to the character of theremedial agents employed. But this indifference on the part of thepatient does not obviate the necessity for a thorough, scientificeducation on the part of the practitioner. Notwithstanding all the lawsenacted to raise the standard of medicine, and thus protect the publicfrom quackery, there yet exists a disposition among many to cling to allthat savors of the miraculous, or supernatural. To insure the futureadvancement of the healing art, physicians must instruct mankind inPhysiology, Hygiene, and Medicine. When the people understand the natureof diseases, their causes, methods of prevention and cure, they will notbe easily deceived, and practitioners will be obliged to qualifythemselves better for their labors. The practice of medicine is everyyear becoming more successful. New and improved methods of treatingdisease are being discovered and developed, and the conscientiousphysician will avail himself of _all_ the means, by a knowledge of whichhe may benefit his fellow-men. The medical profession is divided intothree 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 thecredit of collecting and arranging the facts and discoveries which formthe foundation of the healing art. It has done, and is doing, much toplace the science of medicine on a firm basis. To the text-books of thisschool, every student who would qualify himself for medical practicemust resort, to gain that knowledge upon which depends his futuresuccess. The early practice of this branch of the profession wasnecessarily crude and empirical. Conservative in its character, it hasever been slow to recognize new theories and methods of practice, andhas failed to adopt them until they have been incontrovertiblyestablished. This conservatism was manifested in the opposition toHarvey when he propounded the theory of the circulation of the blood, and to Jenner when he discovered and demonstrated the beneficial effectsof vaccination. Thus has it ever defended its established opinionsagainst innovation; yet out of this very conservatism has grown muchreal good, for, although it has wasted no time or energy in theinvestigation of theories, yet it has accepted them when established. Inthis manner it has added to its fund of knowledge only those truthswhich 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 orastrologers administered drugs, concerning the properties of which theyhad no knowledge, to appease the wrath of mythological deities. In thesecond or heroic era, the lancet, mercury, antimony, opium, and theblister were employed indiscriminately as the _sine qua non_ of medicalpractice. The present, with all its scientific knowledge of the humanstructure and functions, and its vast resources for remedying diseasemay be aptly termed the liberal era of medicine. The allopathic differsfrom the other schools, mainly in the application of remedies. In itsranks are found men, indefatigable in their labors, delving deep intothe mysteries of nature, and who, for their scientific attainments andhumane principles are justly considered ornaments to society and totheir profession. 

HOMOEOPATHY. 

Although this school is of comparatively recent origin, yet it hasgained a powerful hold upon the public favor, and numbers among itspatrons very many intelligent citizens. This fact alone would seem toindicate that it possesses some merit. The homeopathic differs from theallopathic school principally in its _"law of cure, "_ which, accordingto Hahnemann, its founder, was the doctrine of _"similia similibuscurantur"_ or "like cures like. " Its method of treatment is founded uponthe assumption that if a drug be given to a healthy person, symptomswill occur which, if transpiring in disease, would be mitigated by thesame drug. While it may be exceedingly difficult for a member of anotherschool to accept this doctrine and comprehend the method founded uponit, yet no one can deny that it contains some elements of truth. 

Imbued with the spirit of progress, many of its most intelligent andsuccessful practitioners have resorted to the use of appreciablequantities of medicine. This school associates hydropathy with itspractice, and usually inculcates rigid dietetic and hygienicregulations. Many homoeopathic remedies are thoroughly triturated withsugar of milk, which renders them more palatable and efficacious. Whether we attribute their cures to the infinitesimal doses which manyhomoeopathists employ, to their "law of cure, " to good nursing, or tothe power of nature, it is nevertheless true that their practice ismeasurably successful. No doubt the homoeopathic practice has modifiedthat of the other schools, by proving that diseases may be alleviated bysmaller quantities of medicine than were formerly employed. 

THE ECLECTIC SCHOOL. 

This school, founded by Wooster Beach, instituted the most strenuousopposition to the employment of mercury, antimony, the blister, and thelancet. The members of this new school proclaimed that the action ofheroic and noxious medicines was opposed to the operation of the vitalforces, and proposed to substitute in their place safer and moreefficacious agents, derived exclusively from the vegetable kingdom. Theeclectics have investigated the properties of indigenous plants and havediscovered many valuable remedies, which a kind and bounteous nature hasso generously supplied for the healing of her children. Marked successattended the employment of these agents. In 1852, a committee on"Indigenous Medical Botany, " appointed by the "American MedicalAssociation, " acknowledged that the practitioners of the regular schoolhad been extremely ignorant of the medical virtues of plants, even ofthose of their own neighborhoods. The employment of podophyllin andleptandrin as substitutes for mercurials has been so successful thatthey are now used by practitioners of all schools. Although claiming tohave been founded upon liberal principles, it may be questioned whetherits adherents have not been quite as exclusive and dogmatic as thosewhom they have opposed. It cannot be denied, however, that the eclecticshave added many important remedies to the Materia Medica. Their writingsare 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 becurious to learn to what sect the physicians of the Invalids' Hotel andSurgical Institute belong. Among them are to be found graduates from thecolleges of all the different schools. They are not restricted by thetenets of any one sect, but claim the right and privilege, nay, considerit 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 andthose which are _noxious_. Many practitioners deplore the use ofpoisons, and advocate innocuous medicines which produce only curativeresults. We agree with them in one proposition, namely, that impropermedicines not only poison, but frequently utterly destroy the health andbody of the patient. Every physician should keep steadily in view thefinal effects, as well as present relief, and never employ any agentwithout regard to its ulterior consequences. However, an agent which isnoxious in _health_, may prove a valuable remedy in _disease_. Whenmorbid changes have taken place in the blood and tissues, when a generaldiseased condition of the bodily organs has occurred, then an agent, which is poisonous in health, may prove curative. For instance it isadmitted that alcohol is a poison; that it prevents healthfulassimilation, solidifies pepsin, begets a morbid appetite; that itproduces intoxication, and that its habitual use destroys the body. Itis, therefore, neither a hygienic nor a sanative agent, but strictly anoxious one; yet, its very distinct antiseptic properties render itvaluable for remedial purposes, since these qualities promptly arrestthat fatal form of decomposition of the animal fluids which isoccasioned by snake-venom, which produces its deadly effects in the samemanner as a drop of yeast ferments the largest mash. Alcohol checks thispoisonous and deadly process and neutralizes its effects. Thus, alcohol, although a noxious agent, possesses a special curative influence in amorbid state of the human system; but its general remedial effects donot entitle it to the rank of a hygienic agent. We believe that medicineis undergoing a gradual change from the darkness of the past, with itsignorance, superstition, and barbarism, to the light of a gloriousfuture. At each successive step in the path of progress, medicineapproaches one degree nearer the realm of an exact science. The commonobject of the practitioners of all medical schools is the alleviation ofhuman suffering. The only difference between the schools is in theremedies employed, the size of dose administered, and the resultsattained. These are insufficient grounds for bitter sectarianism. We areall fellow laborers in the same field. Before us lies a boundlessexpanse for exploration. There are new conditions of disease to belearned, new remedies to be discovered, and new properties of old onesto be examined. 

We do not deplore the fact, that there are different schools inmedicine, for this science has not reached perfection, and they tend tostimulate investigation. The remarks of Herbert Spencer on the"Multiplication of Schemes of Juvenile Culture, " may be pertinentlyapplied to the different schools in medicine with increased force. Hesays: "It is clear that dissent in education results in facilitatinginquiry by the division in labor. Were we in possession of the truemethod, divergence from it would, of course, be prejudicial; but thetrue method having to be found, the efforts of numerous independentseekers carrying out their researches in different directions, constitute a better agency for finding it than any that could bedevised. Each of them struck by some new thought which probably containsmore or less of basis in facts--each of them zealous on behalf of hisplan, fertile in expedients to test its correctness, and untiring in itsefforts to make known its success--each of them merciless in itscriticism on the rest--there cannot fail, by composition of forces, tobe a gradual approximation of all towards the right course. Whateverportion of the normal method any one of them has discovered, must, bythe constant exhibition of its results, force itself into adoption;whatever wrong practices he has joined with it must, by repeatedexperiment and failure, be exploded. And by this aggregation of truthsand elimination of errors, there must eventually be developed a correctand complete body of doctrine. Of the three phases through which humanopinion passes--the unanimity of the ignorant, the disagreement of theinquiring, and the unanimity of the wise--it is manifest that the secondis the parent of the third. "

We believe the time is coming when those maladies which are nowconsidered fatal will be readily cured--when disease will be disarmed ofits terrors. To be successful, a physician must be independent, freefrom all bigotry, having no narrow prejudice against his fellow-men, liberal, accepting new truths from whatever source they come, free fromrestrictions of societies, and an earnest laborer in the interests ofthe Great Physician. 

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CHAPTER II. 

REMEDIES FOR DISEASE. 

It will be our aim, throughout this book, to prescribe such remedies asare within the easy reach of all, and which may be safely employed. Manyof those of the vegetable class are indigenous to this country, and maybe procured in their strength and purity, at the proper season, by thoseresiding in the localities where they grow, while all others advised maybe obtained at any good drug-store. We shall endeavor to recommend suchas can be procured and prepared with the least trouble and expense tothe patient, when it is believed that they will be equally asefficacious as more expensive medicines. 

PROPRIETARY MEDICINES. 

Having the invalid's best interests in view, it will often happen thatwe cannot prescribe better or cheaper remedies nor those which are moreeffective 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, " owingto the small amount of merit which many of them possess. The term"Patent Medicine" does not apply to Dr. Pierce's remedies, as no patenthas ever been asked or obtained for them, nor have they been urged uponthe public as "cure alls. " They are simply favorite prescriptions, which, in a very extensive practice, have proved their superior remedialvirtues in the cure of the diseases for which they are recommended. 

From the time of Hippocrates down to the present day, physicians haveclassified diseases according to their causes, character or symptoms. Ithas been proved that diseases apparently different may often be cured bythe same remedy. The reason for this singular fact is obvious. A singleremedy may possess a variety of properties. Quinine, among otherproperties has a tonic which suggests its use in cases of debility; anantiperiodic, which renders it efficient in ague; and an anti-febrileproperty, which renders it efficacious in cases of fever. The resultproduced varies with the quantity given, the time of its administration, and the circumstances under which it is employed. Every practicingphysician has his favorite remedies, which he oftenest recommends oruses, because he has the greatest confidence in their virtues. Thepatient does not know their composition. Even prescriptions are usuallywritten in a language unintelligible to anybody but the druggist. Asmuch secrecy is employed as in the preparation of proprietary medicines. Does the fact that an article is prepared by a process known only to themanufacturer render that article less valuable? How many physicians knowthe elementary composition of the remedies which they employ, some ofwhich never have been analyzed? Few practitioners know how morphine, quinine, podophyllin, leptandrin, pepsin, or chloroform, are made, orhow nauseous drugs are transformed into palatable elixirs; yet they donot hesitate to employ them. Is it not inconsistent to use aprescription the composition of which is unknown to us, and discardanother preparation simply because it is accompanied by a printedstatement of its properties with directions for its use?

Various journals in this country, have at different times publishedabsurd formulae purporting to be receipts for the preparation of "Dr. Sage's Catarrh Remedy" and Dr. Pierce's standard medicines, which, inmost instances, have not contained a single ingredient which enters intothe composition of these celebrated remedies. 

In the manufacture of any pharmaceutical preparation, two conditions areessential to its perfection, viz: purity and strength of the materials, and appropriate machinery. The first is insured, by purchasing thematerials in large quantities, whereby the exercise of greater care inselecting the ingredients can be afforded; and the second can only beaccomplished where the business is extensive enough to warrant a largeoutlay of capital in procuring proper chemical apparatus. These factsapply with especial force to the manufacture of our medicines, theirquality having been vastly improved since the demand has become so greatas 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 withinsufficient judgment. We propose to obviate that difficulty byenlightening the people as to the structure and functions of theirbodies, the causes, character, and symptoms of disease, and byindicating the proper and judicious employment of our medicines, together with such auxiliary treatment as may be necessary. Such is oneof the designs of this volume. 

PROPERTIES OF MEDICINE. 

It is generally conceded that the action of a remedy upon the humansystem depends upon properties peculiar to it. The effects producedsuggest the naming of these qualities, which have been scientificallyclassified. We shall name the diseases from their characteristicsymptoms, and then, without commenting upon all the properties of aremedy, recommend its employment. Our reference to the qualities of anyremedy, when we do make a particular allusion to them, we shall endeavorto make as easy and familiar as possible. 

DOSE. All persons are not equally susceptible to the influence ofmedicines. As a rule, women require smaller doses than men, and childrenless than women. Infants are very susceptible to the effects ofanodynes, even out of all relative proportion to other kinds ofmedicines. The circumstances and conditions of the system increase ordiminish the effects of medicine, so that an aperient at one time mayact as a cathartic at another, and a dose that will simply prove to bean anodyne when the patient is suffering great pain will act as anarcotic when he is not. This explains why the same dose often affectsindividuals differently. The following table is given to indicate thesize 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, exceptwhen otherwise specified. 

THE PREPARATION OF MEDICINES. The remedies which we shall mention fordomestic use are mostly vegetable. Infusions and decoctions of thesewill often be advised on account of the fact that they are moreavailable than the tinctures, fluid extracts, and concentratedprinciples, which we prefer, and almost invariably employ in ourpractice. Most of these medical extracts are prepared in our chemicallaboratory under the supervision of a careful and skilled pharmaceutist. No one, we presume, would expect, with only a dish of hot water and astew-kettle, to equal in pharmaceutical skill the learned chemist withall his ingeniously devised and costly apparatus for extracting theactive, remedial principles from medicinal plants. Yet infusions anddecoctions are not without their value; and from the inferior quality ofmany of the fluid extracts and other pharmaceutical preparations in themarket, it may be questioned whether the former are not frequently asvaluable as the latter. So unreliable are a majority of the fluidextracts, tinctures, and concentrated, active principles found in thedrug-stores, that we long since found it necessary to have prepared inour laboratory, most of those which we employ. To the reliability of thepreparations which we secure in this way we largely attribute our greatsuccess in the treatment of disease. Tinctures and fluid extracts areoften prepared from old and worthless roots, barks, and herbs which havewholly lost their medicinal properties. Yet they are sold at just ashigh prices as those which are good. We manufacture our tinctures, fluidextracts, and concentrated, active principles from roots, barks, andherbs which are fresh, and selected with the greatest care. Many of thecrude roots, barks, and herbs found in the market are inactive becausethey have been gathered at the wrong season. These, together with thosethat 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 bemanufactured into fluid extracts and tinctures. Of course, thepreparations made from such materials are worthless. Whenever the doseof fluid extracts, tinctures, and concentrated, active principles, ismentioned in this chapter, the quantity advised is based upon ourexperience in the use of these preparations, as they are made in ourlaboratory, and the smallest quantity which will produce the desiredeffect is always given. When using most of the preparations found in thedrug-stores, the doses have to be somewhat increased, and even then theywill not always produce the desired effect, for reasons already given. 

THE LIST OF MEDICINES which we shall introduce in this chapter will bequite limited, as we cannot hope, by making it extensive, that thenon-professional reader would be able to prescribe with good judgmentany other than the simpler remedies. Hence, we prefer, since we have notspace in this volume to waste, to mention only a few of the most commonremedies under each head or classification. 

TINCTURES. Very uniform and reliable tinctures may be made of mostindigenous plants, by procuring the part to be employed, at the properseason, while it is green and fresh, bruising it well, and covering itwith good strong whiskey, or with alcohol diluted with one part of waterto three of alcohol, corking tightly, and letting it stand aboutfourteen days, when the tincture may be filtered or poured off from thedrugs, and will be ready for use. Prepared in this imperfect manner, they rill be found to be much more reliable than any of the fluidextracts found in the drug-stores. An excess of the crude drug should beused in preparing the tincture to insure a perfect saturation of thealcohol with its active principles. 

HOMOEOPATHIC TINCTURES. The tinctures prepared by several of the Germanand French pharmaceutists, and called by them "Mother Tinctures, " todistinguish them from the dilutions made therefrom, we have found to bevery reliable, so much superior to any similar preparations made in thiscountry that we purchase from them all we use of Pulsatilla, Staphisagria, Drosera and several others. They are prepared with greatcare from the green, crude material, and although high in price, whencompared with other tinctures, yet the greater certainty of action whichwe secure in our prescriptions by their employment more than repays forthe expense and trouble in procuring them, for of what account isexpense to the true physician when _life_ may depend upon the virtue ofthe agent he employs?

INFUSIONS. These are generally made by adding one-half ounce of thecrude medicine to a pint of water, which should be closely covered, keptwarm, and used as directed. Flowers, leaves, barks, and roots becomeimpaired by age, and it is necessary to increase or diminish the doseaccording to the strength of the article employed. 

DECOCTIONS. The difference between a decoction and an infusion is, thatthe plant or substance is boiled in the production of the former, inorder to obtain its soluble, medicinal qualities. Cover the vesselcontaining the ingredients, thus confining the vapor, and shutting outthe atmospheric air which sometimes impairs the active principles andtheir medicinal qualities. The ordinary mode of preparing a decoction isto use one ounce of the plant, root, bark, flower, or substance to apint of water. The dose internally varies from a tablespoonful to oneounce. 

ALTERATIVES. 

Alteratives are a class of medicines which in some inexplicable manner, gradually change certain morbid actions of the system, and establish ahealthy condition instead. They stimulate the vital processes to renewedactivity, and arouse the excretory organs to remove matter which oughtto be eliminated. They facilitate the action of the secretory glands, tone them up, and give a new impulse to their operations, so that theycan more expeditiously rid the system of worn-out and effete materials. In this way they alter, correct, and purify the fluids, tone up theorgans, and re-establish their healthy functions. Alteratives maypossess tonic, laxative, stimulant, or diuretic properties all combinedin one agent. Or we may combine several alteratives, each having onlyone of these properties in one remedy. We propose to enumerate only afew alteratives, and give the doses which are usually prescribed; thelist which we employ in our practice is very extensive, but it cannot bemade available for domestic use. 

MANDRAKE (_Podophyllum Peltatum_), also called May-apple, is a mostvaluable alterative. The root is the part used. _Dose_--Of decoction, one to two teaspoonfuls; of tincture, six to eight drops; of fluidextract, three to five drops; of its active principle, Podophyllin, one-twelfth to one-eighth of a grain. 

POKE (_Phytolacca Decandra_), also called Skoke, Garget, orPigeon-berry, is a valuable alterative. The root is the part used. _Dose_--Of decoction, one to three teaspoonfuls; of fluid extract, threeto ten drops; of concentrated principle, Phytolaccin, one-fourth to onegrain. 

YELLOW DOCK (_Rumex Crispus_), The part used is the root. _Dose_--Of theinfusion, 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 inscrofula, syphilis, cutaneous and all blood diseases. _Dose_--Ofdecoction, one or two tablespoonfuls from three to five times daily; oftincture, one or two teaspoonfuls; of fluid extract, one-half to oneteaspoonful; of concentrated principle, Alnuin, one-half to one grain. 

[Illustration: Fig. 114. Black Cohosh. ]

BLACK COHOSH (_Macrotys or Cimicifuga Racemosa_) The part used is theroot. Its other common names are Black Snake-root, or Squaw-root. BlackCohosh is an alterative stimulant, nervine, diaphoretic, tonic, and acerebro-spinal stimulant. It is a useful remedy. _Dose_--Of decoction, one-fourth to one ounce; of tincture, ten to fifteen drops; of fluidextract, 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. Thepart used is the root. In minute doses Blood-root is a valuablealterative, acting upon the biliary secretion and improving thecirculation and digestion. _Dose_--Of powdered root, one-fourth toone-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 welldiluted. 

BURDOCK (_Arctium Lappa_). The root is the part used. Burdock is avaluable alterative in diseases of the blood. _Dose_--Of tincture, fromone teaspoonful to a tablespoonful twenty minutes before meals; of fluidextract, one to two teaspoonfuls. 

BLUE FLAG (_Iris Versicolor_). The part used is the root. _Dose_--Of thetincture, five to ten drops; of fluid extract, three to ten drops; ofconcentrated principle, Iridin, one-half to two grains. 

SWEET ELDER (_Sambucus Canadensis_). Sweet Elder-flowers are a valuablealterative, diuretic, mucous and glandular stimulant, excellent ineruptive, cutaneous, and scrofulous diseases of children. An infusion, fluid extract, or syrup, may be used in connection with the "GoldenMedical Discovery. " Both will be found valuable for cleansing the bloodand stimulating the functions to a healthy condition. _Dose_--Of theinfusion of the flowers, from one-half to one ounce, if freely taken, will operate as a laxative; of fluid extract, one-fourth to one-halfteaspoonful. The flowers, or inner bark of the root, simmered in freshbutter, make a good ointment for most cutaneous affections. 

IODINE. This agent, in the several forms of Iodide of Potassium, Iodideof Ammonium, Iodide of Iron, and Iodide of Lime, is largely employed byphysicians, and often with most happy results. But for domestic use wecannot 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, whennot administered under the supervision of a competent physician. 

MERCURY. The various preparations of mercury have a profound, alterativeeffect upon the system. When taken for some time, they change thequality and composition of the blood; cause a diminution in the numberof red blood-corpuscles, and an increase in the various effetematerials. In the vast majority of cases we prefer the vegetablealteratives, but in rare instances they exert a beneficial influence, insmall doses. None of the preparations of mercury should be takeninternally without the advice of a skillful physician, therefore, weshall not give their doses. 

THE COMPOUNDING OF ALTERATIVES. 

The efficacy of this class of remedies can be greatly increased byproperly combining several of them into one compound. 

This requires a knowledge of Pharmaceutical Chemistry; i. E. , thepreparation of compounds founded on the chemical relation and action oftheir several remedial, active principles. Many practitioners makecombinations 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. Thiscompound is a highly nutritive and tonic preparation, combining theremedial properties of the best vegetable alteratives at present knownto the medical profession. In perfecting this alterative compound, andlikewise other standard preparations of medicine, we have made an outlayof many thousand dollars for chemical apparatus, and special machineryby the aid of which these remedies have been brought to their presentperfection. Great pains are taken to obtain the materials at the rightseason of the year, properly cured so that none of their remedialqualities may be impaired. We, therefore, can with great confidencerecommend Dr. Pierce's "Golden Medical Discovery" as one of the bestpreparations of the alterative class. Like all others of this type, itsaction is insensible, producing gradual changes, arousing the excretoryglands to remove morbid materials, and at the same time toning thesecretory organs. The manufacture of this compound is under the specialsupervision of a competent chemist and pharmaceutist, and it is now putup in bottles wrapped with full directions for its use. We canconfidently recommend this compound whenever an alterative is requiredto cleanse the blood, tone the system, increase its nutrition, andestablish a healthy condition. For these reasons we shall often adviseits employment. 

DR. PIERCE'S PLEASANT PURGATIVE PELLETS. These pellets combine the pure, concentrated, active principles of several vegetable alteratives, andthe result is, that within the small compass of a few grains he has mosthappily blended and chemically condensed these properties so that theiraction upon the ANIMAL ECONOMY is sanative and universal. They awakenthe latent powers, quicken the tardy functions, check morbid deposits, dissolve hard concretions, remove obstructions, promote depuration, harmonize and restore the functions, equalize the circulation, andencourage the action of the nervous system. They stimulate the glands, increase the peristaltic movement of the intestines, tone the nutritiveprocesses, while aiding in evacuating the bowels. All this theyaccomplish without corroding the tissues or vitiating the fluids. Theirassistance is genial, helping the system to expel worn out materials, which would become noxious if retained. Having expended their remedialpowers upon the various functions of the body, they are themselvesexpelled along with other waste matter, leaving behind them no traces ofirritation. This cannot be said of mercurials, or of other harsh, mineral alteratives. These Pellets may be safely employed when thesystem is feeble, frail, and delicate, by giving them in lessquantities. _Dose_--As an alterative, only one or two Pellets should betaken daily. 

ALKALIES. 

ALKALIES. These constitute an important list of remedial agents, theiradministration being frequently indicated. The employment of othermedicines frequently should be preceded by the administration of anagent of this class, to neutralize excessive acidity in the stomach andbowels. Unless this be done, many medicines will fail to produce theirspecific effects. 

SULPHITE OF SODA (_Sodæ Sulphis_). This salt, as well as theHyposulphite of Soda, is not only generally preferable foradministration on account of its unirritating character and thesmallness of the dose required, but also because it is a valuableantiseptic agent. The _Sulphite_ should not be confounded with the_Sulphate_ of Soda (Glauber's Salt). _Dose_--This is from three to tengrains. 

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 meetopposite conditions of the fluids of the system. 

HYDROCHLORIC OR MURIATIC ACID. This agent may be administered in dosesof from five to ten drops, largely diluted in water or gruel. 

AROMATIC SULPHURIC ACID, or Elixir of Vitriol, is the most agreeableform of Sulphuric Acid for administration, and may be given in doses offrom five to fifteen drops, largely diluted with water. 

In taking acids, they should be sucked through a straw, and not allowedto come in contact with the teeth, as otherwise the latter organs willbe injured by their effects; or should the acid come in contact with theteeth, the mouth should be immediately rinsed with a solution ofsaleratus or soda, to neutralize the acid. 

ANODYNES. 

Anodynes are those medicines which relieve pain by blunting thesensibility of the nerves, or of the brain, so that it does notappreciate the morbid sensation. An anodyne may be a stimulant in onedose, and a narcotic in a larger one. The properties of differentanodyne agents vary, consequently they produce unlike effects. The sizeof the dose required, differs according to circumstances and condition. An adult, suffering acute pain, requires a much larger dose to producean anodyne effect than one who is a chronic sufferer. An individualaccustomed to the use of anodynes, requires a much larger dose toprocure relief than one who is not. Doses may be repeated, until theircharacteristic effects are produced, after an interval of thirty orforty minutes. When the stomach is very sensitive and will not toleratetheir internal administration, one-sixth of a grain of Morphia can beinserted beneath the skin, by means of a hypodermic syringe. Relief ismore quickly experienced, and the anodyne effect is much more lastingthan when taken into the stomach. 

OPIUM (_Papaver Somniferum). _ Opium is a stimulant, anodyne, ornarcotic, according to the size of the dose administered. _Dose_--Of thedry powder, one-fourth to one grain; of tincture (Laudanum), five tofifteen drops; of camphorated tincture (Paregoric), one-half to oneteaspoonful; of

Morphine, one-eighth to one-fourth grain; of Dover's Powder three tofive grains. 

HYOSCYAMUS (_Hyoscyamus Niger_), commonly known as Henbane. The herb isused. It is a powerful narcotic, and unlike Opium, does not constipatethe bowels, but possesses a laxative tendency. Therefore, it may beemployed as an anodyne for allaying pain, calming the mind, inducingsleep and arresting spasms, when opiates are inadmissible. _Dose_--Ofalcoholic extract, one-half to two grains; of fluid extract, five to tendrops; of the concentrated principle, Hyoscyamin, one-twelfth toone-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, andan excellent alterative. _Dose_--Of fluid extract, two to six drops; ofsolid extract, one-fourth to one-half grain. 

BELLADONNA (_Atropa Belladonna_) or Deadly Nightshade. The herb orleaves are a valuable agent. In overdoses, it is an energetic, narcoticpoison. 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 bysome to be a prophylactic or preventive of Scarlet Fever. Its influenceupon the nerve centers is remarkable. It relaxes the blood vessels onthe surface of the body and induces capillary congestion, redness of theeye, scarlet appearance of the face, tongue, and body. _Dose_--Of fluidextract, one-half to one drop; of tincture, one to two drops; ofconcentrated principle, Atropin, one-thirtieth to one-sixteenth of agrain; of the _Alkaloid, Atropia_, one-sixtieth of a grain. Even themost skillful chemists are very cautious in compounding these latteractive principles, and the danger of an overdose is great. 

CAMPHOR. This drug is an anodyne, stimulant, and diaphoretic, and, inlarge doses, a narcotic and an irritant. It is an excellent stimulantfor liniments. _Dose_--Of the powder, one to five grains; of thetincture, 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 ananodyne. _Dose_--Of the infusion of the leaves, from one to four ounces;of the fluid extract, one-fourth to three-fourths of a teaspoonful; ofthe concentrated principle, Humulin, one to three grains. 

DR. PIERCE'S COMPOUND EXTRACT OF SMART-WEED. This anodyne compound ismade by uniting several of the most valuable agents of this class, andits medicinal qualities are rendered still more efficacious by theaddition of certain stimulating articles. It is free from narcoticproperties which are liable to produce deleterious results, and has beenfound to be not only harmless in its action, but very genial andeffectual withal, and most reliable as a stimulant and diaphoreticremedy. 

ANTHELMINTICS. 

Anthelmintic means "against a worm, " and is a term employed to designatethose medicines which destroy or expel worms. It means the same as_Vermifuge_. Little is understood concerning the origin of worms. Thereare five distinct varieties described by authors as being more commonthan others. There is the long worm, the short, or pin-worm, thethread-worm, the tape-worm, and the broad tape-worm peculiar to somecountries of Europe. Irritation of the alimentary canal, from whatevercause usually produces an abundant secretion of mucus, which is thoughtto be a condition favorable for their production. Therefore, thosemedicines which remove the cause of this irritation tend to diminish thenumber, if not to entirely destroy the worms. Some medicines kill theworms, others expel them alive. The remedies which successfully removeone kind of worm, have little effect upon another, and to meet thesedifferent conditions, we have a variety of worm-destroying medicines. The pin-worm, inhabits the rectum, and may be destroyed by injectinginto it a strong solution of salt, or decoction of aloes, and when it isallowed to pass away, the rectum should be anointed with vaseline, butter, or lard. The eggs of this worm are developed around the orificeof the large intestine, and when this latter precaution is not practicedevery time there is a passage from the bowels, they will multiply asrapidly as they can be destroyed. Generally, vermifuge remedies shouldbe taken when the stomach is empty, and should be followed by theadministration of a cathartic in two hours after the last dose isadministered. 

SANTONIN. This is decidedly the most reliable anthelmintic known to themedical profession. It is deservedly a popular remedy for worms, andwhen combined with Podophyllin, is very efficacious in removing thepin-worm. _Dose_--For an adult, two to three grains of the powderedSantonin, 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 domesticremedy for worms. Make an infusion of Sage and Senna leaves, and drinkfreely until it acts as a cathartic. 

[Illustration: Fig. 117. Pink Root. ]

PINK-ROOT (_Spigelia Marilandica_). Pink-root is one of the most activeand certain anthelmintics for children. It is indigenous to the UnitedStates. When taken in too large quantities, it is apt to purge, giverise to vertigo, dimness of vision, and even to convulsions; therefore, it should be combined with some cathartic. _Dose_--Of the infusion, oneounce at night, followed by physic in the morning. 

COMMON SALT (_Chloride of Sodium_). Common table salt is ananthelmintic, and may be used in an emergency. Salt water is a verycommon domestic remedy for worms. _Dose_--In solution, one-quarter toone-half teaspoonful. 

BALMONY (_Chelone Glabra_). This is also tonic and anthelmintic, and isvaluable in debility, dyspepsia, jaundice, and hepatic affections. Italso 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 isconsidered especially effectual in removing the tape-worm. _Dose_--Ofthe powder, one to two drachms, given morning and evening in syrup, followed by a brisk cathartic. The dose of the tincture of the buds inether is from eight to thirty drops. 

[Illustration: Fig. 118. Aspen. ]

POPLAR (_Populus Tremuloides_). The White or Aspen Poplar is a commontree, and contains active principles termed Populin and Salicin, both ofwhich 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 aperiodicity which indicates their nature. Antiperiodics prevent therecurrence of the periodic manifestations, and hence their name. 

QUININE (_Sulphate of Quinia_). Quinine is a tonic, febrifuge, andantiperiodic. It should generally be administered during the intervalsbetween the febrile paroxysms. It is beneficial also in all diseasesaccompanied by debility. The dose varies from one to six grainsaccording to indications. Frequently it is given in much largerquantities, but we cannot advise such for domestic use. 

PRUSSIAN BLUE (_Ferri Ferrocyanidum_). Ferrocyanide of Iron is anexcellent tonic and antiperiodic remedy, and often is combined withquinine. _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; thewarm infusion is emetic. _Dose_--Of the infusion, one to four ounces; ofthe fluid extract, from half to one teaspoonful; of the activeprinciple, Eupatorin, one to three grains. 

THE "GOLDEN MEDICAL DISCOVERY" has gained an enviable reputation inmalarial districts for the cure of ague. From observing its action inthe cure of this and other miasmatic diseases, and knowing itscomposition, we are thoroughly satisfied that it contains chemicalproperties which neutralize and destroy the miasmatic or ague poisonwhich is in the system, and, at the same time, produces a rapidexcretion of the neutralized poisons. One strong proof of this is foundin the fact that persons who are cured with it are not so liable torelapse as those in whom the chills are broken with Quinine or otheragents. No bad effects are experienced after an attack of ague which hasbeen cured with the "Golden Medical Discovery. " This cannot be said ofQuinine, Peruvian Bark, Arsenic, and Mercurials, which comprise nearlythe whole list of remedies usually resorted to by physicians forarresting ague. The "Golden Medical Discovery" not only has the merit ofbeing a certain antidote for miasmatic diseases, but is pleasant to thetaste, a matter of no small importance, especially when administered tochildren. To break the chills, this medicine should be taken in doses offour teaspoonfuls three times a day, and if this treatment pursued forthree days, does not entirely arrest the chills, these doses may berepeated in alternation with five-grain doses of quinine for the threesucceeding 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 isa natural disinfectant, but a powerful inciter of change. Although thiselement is the cause of animal and vegetable decay, yet oxidation is thegrand process by which the earth, air, and sea are purified. A fewsubstances are both antiseptic and disinfectant. Heat up to atemperature of 140° Fahr. Promotes putrescence, but above that point, isa drier or disorganizer, and destroys the source of infection. 

YEAST (_Cerevisiæ Fermentum_). Yeast is an antiseptic, and is effectivein 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 inwine or porter, once in two or three hours. 

CREASOTE. This is a powerful antiseptic. It is used in a solution ofglycerine, oil, water, or syrup. _Dose_--One to two drops, largelydiluted. 

CARBOLIC ACID is a crystalline substance resembling creasote in itsproperties. It is an antiseptic, and is used both internally andexternally. _Dose_--One-fourth to one-half drop of the melted crystals, very largely diluted. Externally, in solution, one to five grains of thecrystals to one ounce of the solvent. 

WHITE VITRIOL (_Zinci Sulphas_). White vitriol is a valuabledisinfectant, as it will arrest mortification. In solution it isemployed in ulcers and cancers and also as a gargle in putrid sorethroat. _Dose_--One-half to two grains in a pill; in solution, one toten grains in an ounce of water. 

PERMANGANATE OF POTASH (_Potassæ Permanganas_). This substance is anenergetic deodorizer and disinfectant. A solution containing from one totwenty 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. Thisplant possesses valuable antiseptic properties. It is an excellentlotion for ill-conditioned ulcers, malignant sore throat, nursingsore-mouth, syphilitic ophthalmia, etc. It is sometimes administered inscarlet and typhus fevers, and in all diseases in which there is atendency to putrescence. _Dose_--Of the infusion, one-fourth to one-halfounce; of the fluid extract, from three to ten drops, and of theconcentrated, active principle of the plant, Baptisin, from one to twograins. 

ANTISPASMODICS. 

Antispasmodics are a class of remedies which relieve cramps, convulsions, and spasms, and are closely allied to nervines. Indeed someauthors class them together. The following are a few of the mostimportant antispasmodics:

ASSAFETIDA (_Assafetida Ferula_). This is a powerful antispasmodic. Itis employed in hysteria, hypochondria, convulsions, and spasms, whenunaccompanied by inflammation. _Dose_--Of the gum or powder, from threeto ten grains, usually administered in the form of a pill; of thetincture, 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 theblood 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-professionalpersons should be attended with great caution. 

VALERIAN (_Valeriana Officinalis_). The root is the part used. Valerianis an effective remedy in cases of nervousness and restlessness. _Dose_--Of the infusion, (one-half ounce to a pint of water) one-halfounce; of the tincture, one-half to two tablespoonfuls; of theammoniated tincture of valerian, from one-half to two teaspoonfuls insweetened water or milk; of the valerianate of ammonia, one-half tothree grains. 

YELLOW LADY'S SLIPPER (_Cypripedium Pubescens_). The root is the partused. This is a useful remedy in hysteria, chorea, and all cases ofirritability. _Dose_--Of the powder, fifteen to thirty grains; of theinfusion, one ounce; of the fluid extract, fifteen to thirty drops; ofthe concentrated principle, Cypripedin, one-half to two grains. 

WILD YAM (_Dioscorea Villosa_). The root is the part used. This is apowerful antispasmodic, and has been successfully used in bilious colic, nausea, and spasm of the bowels. _Dose_--Of the infusion (two ounces toa pint of water), one to two ounces; of the fluid extract, five tofifteen drops; of the concentrated principle, Dioscorein, one-half toone grain. 

HIGH CRANBERRY (_Viburnum Opulus. _) The bark is the part used. It isalso known as Cramp Bark. This is a powerful antispasmodic, and iseffective in relaxing spasms of all kinds. It is a valuable agent inthreatened abortion. _Dose_--Of the infusion, one-half to one ounce; ofthe fluid extract, one-half to one teaspoonful; of the concentratedprinciple, Viburnin, one-half to two grains. These doses may beincreased if necessary. 

ASTRINGENTS. 

Astringents are medicines which condense and coagulate the tissues, thereby arresting discharges. When taken into the mouth, they producethe sensation known as puckering. They are used internally and locally. The term _styptic_ is used as a synonym of astringent, but is generallyemployed to designate those astringents which arrest hemorrhage, orbleeding. 

LOGWOOD (_Hæmatoxylon Campechianum_). Logwood is a mild astringent, well adapted to remedy the relaxed condition of the bowels after cholerainfantum. _Dose_--Of powdered extract, five to ten grains; of thedecoction, 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 andbark. This is a most valuable astringent and exerts a specific actionupon the nervous system. It arrests many forms of uterine hemorrhagewith 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 fluidextract, 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 alsoknown as Crow-foot, and Spotted Geranium. It is a pleasant, but powerfulastringent. _Dose_--Of the fluid extract, ten to thirty drops; of theconcentrated principle, Geranin, one to two grains. 

[Illustration: Fig. 123. Bugle-weed. ]

[Illustration: Fig. 124. Hardhack. ]

HARDHACK (_Spirea Tomentosa_), Spirea, or Meadow Sweet. The stem andleaves are used. It is a tonic and an astringent, and is used indiarrhea and cholera-infantum. _Dose_--Of the infusion, one-half to oneounce; of the fluid extract, three to six drops. 

BUGLE-WEED (_Lycopus Virginicus_). This is variously known asWater-hoarhound and Water-bugle. It is sedative and tonic, as well asastringent, 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 atintervals of from one to four hours. 

CATECHU (_Acacia Catechu_). A tincture of this plant is a pure, powerfulastringent, and is especially useful in chronic diarrhea, chroniccatarrh, and chronic dysentery. _Dose_--Of the powder, five to twentygrains; 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 inhemorrhages. _Dose_--Three to five grains. In severe hemorrhages, thisquantity should be administered every half hour, until the bleeding ischecked. 

CARMINATIVES. 

Carminatives are medicines which allay intestinal pain, arrest orprevent griping caused by cathartics and exert a general soothingeffect. They are aromatic, and to a certain extent, stimulant. 

ANISE-SEED (_Pimpinella Anisum_). Anise is a pleasant, aromaticcarminative, and is used in flatulent colic. _Dose_--Of the powderedseed, ten to fifteen grains; of the infusion (a teaspoonful of seed to agill of water), sweetened, may be given freely; of the oil, five to tendrops on sugar. 

FENNEL-SEED (_Anethum Foeniculum_). This is one of our most gratefularomatics, and is sometimes employed to modify the action of senna andrhubarb. _Dose_--Same as that of anise-seed. 

GINGER (_Zingiber Officinale_). The root is the part used. This is agrateful stimulant and carminative. _Dose_--Of the powder, ten to twentygrains; of the infusion, one teaspoonful in a gill of water; of thetincture, twenty to thirty drops; of the essence, ten to fifteen drops;of the syrup, one teaspoonful. 

WINTERGREEN (_Gaultheria Procumbens_). The leaves are used. This plantpossesses stimulant, aromatic, and astringent properties. The essence ofWintergreen is carminative, and is used in colics. _Dose_--Of theessence, 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. Theessence may be taken in doses of fifteen to thirty drops in sweetenedwarm water; of the oil, one to five drops on sugar. 

SPEARMINT (_Mentha Viridis_). The carminative properties of spearmintare inferior to those of peppermint, and its chief employment is for itsdiuretic and febrifuge virtues. _Dose_--Same as that of peppermint. 

COMPOUND EXTRACT OF SMART-WEED. Dr. Pierce's Extract of Smart-weed is avaluable carminative and aromatic stimulant, and has been employed withmarked success in all diseases in which this class of remedies isrequired. 

CATHARTICS. 

_Cathartics_, or _Purgatives_ are medicines which act upon the bowelsand increase the secretions and evacuations. In many parts of thecountry, these agents are known as purges, or physics. They have beenvariously divided and subdivided, usually with reference to the energyof their operations or the character of the evacuations produced. 

_Laxatives_, or _Aperients_, are mild cathartics. Purgatives act withmore energy and produce several discharges which are of a more liquidcharacter and more copious than the former. 

_Drastics_ are those cathartics which produce numerous evacuationsaccompanied by more or less intestinal irritation. 

_Hydragogues_ are those purgatives which produce copious, waterydischarges. 

_Cholagogues_ are those purgatives which act upon the liver, stimulatingits functions. Cathartics constitute a class of remedies which arealmost universally employed by families and physicians. 

JALAP (_Ipomoea Jalapa_). The root is used. It is a drastic and ahydragogue cathartic. Formerly it was combined with equal parts ofcalomel. From this fact it received the name of "ten and ten. "_Dose_--Of the powder, five to twenty grains; of the fluid extract, tento fifteen drops; of the solid extract, two to four grains; of theconcentrated 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 isemployed in dropsy. It should never be given alone, but combined withmilder cathartics. It accelerates their action while they moderate itsviolence. _Dose_--Of the powder, one-half to two grains. This substancecombined with aloes and sometimes with scammony, constitutes the basisof 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, TallSpeedwell, and Indian Physic, is a certain cholagogue, laxative, andcathartic. _Dose_--Of decoction, one to two fluid ounces; of fluidextract, ten to twenty drops; of tincture, twenty to thirty drops; ofthe concentrated, active principle, Leptandrin, which is but feeblycathartic, as a laxative, two to five grains. 

RHUBARB (_Rheum Palmatum_). This is much used as a domestic remedy, andby the profession, for its laxative, tonic, and astringent effects. Itis employed in bowel complaints. _Dose_--Of the powder, ten to thirtygrains; of the tincture, one-half to two teaspoonfuls; of the fluidextract, ten to thirty drops; of the solid extract, three to fivegrains; of the syrup, and aromatic syrup, an excellent remedy forchildren, one-half to one teaspoonful. 

CASCARA SAGRADA (_Rhamnus Purshiana_), is a very efficient remedy inchronic constipation. _Dose_--Of the fluid extract, from ten to twentydrops taken in a tablespoonful of water. The unpleasant taste may bedisguised with the extract of liquorice. 

CASTOR OIL (_Oleum Ricini_). _Dose_--From one to four teaspoonfuls. Itmay be disguised by rubbing it with an equal quantity of glycerine andadding one or two drops of oil of anise, cinnamon, or wintergreen. 

BUTTERNUT (_Juglans Cinerea_). The bark is the part used. Butternut is amild cathartic, which resembles rhubarb in its property of evacuatingthe bowels without irritating the alimentary canal. _Dose_--Of theextract, 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 issufficient. 

ALOES (_Aloe_) The gum is used. This cathartic acts upon the lower partof the bowels and sometimes causes piles; though some late authors claimthat in small doses it is a valuable remedy for piles. _Dose_--In powderor pill, three to ten grains; as a laxative, one to three grains. 

EPSOM SALTS (_Magnesia Sulphas_). Its common name is "Salts. " Much usedin domestic practice. _Dose_--One-fourth to one-half ounce. 

DR. PIERCE'S PLEASANT PELLETS, being entirely vegetable in theircomposition, operate without disturbance to the system, diet, oroccupation. Put up in glass vials. Always fresh and reliable. As _alaxative, alterative, _ or gently acting but searching _cathartic_, theselittle 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 relievedand permanently cured by the use of Dr. Pierce's Pleasant Pellets. Inexplanation of the remedial power of these Pellets over so great avariety of diseases, it may truthfully be said that their action uponthe system is universal, not a gland or tissue escaping their sanativeinfluence. 

Everybody, now and then, needs a gentle laxative to assist nature alittle; or, a more searching and cleansing, yet gentle cathartic, toremove offending matter from the stomach and bowels and tone up andinvigorate the liver and quicken its tardy action. Thereby the "PleasantPellets" cure biliousness, sick and bilious headache, costiveness, orconstipation 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 vialof the "Pleasant Pellets" at hand. In proof of their superior excellenceit can be truthfully said that they are always adopted as a householdremedy after the first trial. 

The "Pleasant Pellets" are far more effective in arousing the liver toaction than "blue pills, " the old-fashioned compound cathartic pills, calomel or other mercurial preparations, and have the further merit ofbeing purely vegetable in their composition and perfectly harmless inany condition of the system. Furthermore, no particular care is requiredwhile using them. 

Being composed of the choicest, concentrated vegetable extracts, theircost of production is much more than that of most pills found in themarket, yet from forty to forty-four of them are put up in each glassvial, as sold through druggists, and can be had at the price of the moreordinary and cheaper made pills. Once used, they are always in favor. Their secondary effect is to keep the bowels open and regular, not tofurther constipate, as is the case with other pills. Hence, their greatpopularity with sufferers from habitual constipation, piles and theirattendant discomfort and manifold derangements. 

For all laxative and cathartic purposes the "Pleasant Pellets" areinfinitely superior to all "mineral waters, " sediltz powders, "salts, "castor oil, fruit syrups (so-called), laxative "teas, " and the manyother purgative compounds sold in various forms. 

If people generally, would pay more attention to properly regulating theaction of their bowels, they would have less frequent occasion to callfor their doctor's services to subdue attacks of dangerous diseases. Hence it is of great importance to know what safe, harmless agent bestserves 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 bythe known susceptibility of the individual to the action of laxative andcathartic medicines. Some persons' bowels are readily acted upon bysmall doses, while others require more. As a general rule, the smallerdoses which we recommend, are quite sufficient, and produce the bestresults if persisted in for a reasonable length of time. 

FOR A GENTLE APERIENT, OR LAXATIVE, take one or not more than two andpreferably in the morning, on an empty stomach. 

FOR A GENTLE CATHARTIC, two or three are generally sufficient, if takenin the morning, on an empty stomach. 

FOR A VERY ACTIVE, SEARCHING CATHARTIC, four to six may be taken in themorning, on an empty stomach. 

FOR A CHILD OF TWO TO FOUR YEARS, one-half of a Pellet given in a littlesauce of some kind, or soft candy, will be sufficient for a laxative, orone for a mild cathartic. 

FOR A CHILD OF FOUR TO EIGHT YEARS, one for a laxative or two for acathartic will act nicely, if given on an empty stomach. 

AS A DINNER PILL. --To promote digestion and increase the appetite, takeonly one Pellet each day after dinner. 

_To overcome the disagreeable effects of a too hearty meal_, take twoPellets as soon as conscious of having overloaded the stomach. 

IN ALL CHRONIC DISEASES, it is of the utmost importance that the bowelsbe kept _regular_, yet thorough purgation should be avoided, as it tendsto debilitate the system. Small laxative doses of one or at most twoPellets, taken daily and continued for a long time, is the plan that wewould recommend to produce the best results. 

IN DROPSY, an occasional active cathartic dose of the Pellets of say 4to 6, taken once in a week or ten days, will do good, if, in theinterval between these doses, Dr. Pierce's Golden Medical Discovery betaken to invigorate and regulate the system. 

TO BREAK UP SUDDEN ATTACKS OF COLDS, FEVERS, AND INFLAMMATIONS. --It isonly in these sudden and severe attacks of _acute_ diseases that werecommend the Pellets to be taken in active purgative doses, and inthese cases _only one_ large or cathartic dose of say 5 or 6 Pelletsshould be taken. 

In colds, fevers, and inflammatory attacks, warm sweating teas should betaken freely, and hot foot baths, or a hot general bath, employed toassist in equalizing the circulation of the blood and restoring theequilibrium of the system. 

SUPPRESSED MENSTRUATION. --This combined treatment of an active dose ofPellets, coupled with the use of a hot bath, foot bath, or, betterstill, a hot sitz-bath, will bring on _menstruation_, when suppressedfrom taking cold. In the latter case the effect will be insured if, inaddition 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 ordisorganizing animal structures. By their action they destroy the tissueto which they are applied, and form a crust, which is thrown off by aseparation from the parts beneath. Their caustic property may bedestroyed by dilution with other substances, to such an extent that theywill only irritate or stimulate, and not destroy. Much care is necessaryin their employment, and it is not expected that the unprofessionalreader will have much to do with them; hence, we have deemed it best notto give a list of these agents. 

COUNTER-IRRITANTS. 

_Counter-irritants_ are substances which produce irritation of the partto which they are applied, varying in degree from a slight redness to ablister or pustule. They are applied to the surface with a view ofproducing an irritation to relieve irritation or inflammation in someother or deeper seated part. They are a class of agents which we veryseldom employ, and, hence, we shall notice only a couple of the mostsimple. 

MUSTARD (_Sinapis_). The flour of mustard, which is best adapted fordomestic use, is employed in the form of a paste spread on cloth. Ittakes effect in a few moments; the length of time it remains in contactwith the skin and the strength of the mustard determine the effectproduced. 

HORSE-RADISH (_Cochlearia Armoracia_). The leaves are the parts used. Let them wilt and bind them on the part affected. They act nearly asenergetically as mustard. 

DIAPHORETICS. 

_Diaphoretics_ are medicines which increase perspiration. Those whichoccasion profuse sweating are termed _Sudorifics_. The two termsindicate different degrees of the same operation. They constitute animportant element in domestic practice, on account of the salutaryeffects which generally follow their action. Their operation is favoredby warmth externally, and warm drinks, when they are not given in hotinfusion. 

[Illustration: Fig. 127. Pleurisy-root. ]

PLEURISY-ROOT (_Asclepias Tuberosa_), is also known as White-root, andButterfly-weed. It is a valuable remedy, well adapted to break upinflammations and disease of the chest. _Dose_--Of infusion, one to twoounces; of fluid extract, one-fourth to one-half teaspoonful; of theconcentrated principle, Asclepin, one to three grains. 

SAFFRON (_Crocus Sativus_). Golden Saffron. _Dose_--Of infusion (onedrachm to a pint of water), one to two ounces. 

Sage (_Salvia Officinalis_). The warm infusion drunk freely is avaluable, domestic diaphoretic. 

[Illustration: Fig. 128. Virginia Snake-root. ]

VIRGINIA SNAKE-ROOT (_Aristolochia Serpentaria_), is an efficientagent. _Dose_--Of infusion, one to two ounces; of tincture, one-fourthto one teaspoonful; of fluid extract, one-fourth to one-halfteaspoonful. 

JABORANDI (_Pilocarpus Pinnatus_). Jaborandi increases the flow ofsaliva, causes profuse perspiration, and lowers the temperature of thebody. 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 havefound it very effectual for breaking up recent colds. We have also foundit 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. Thefluid extract may be obtained at almost any drug-store. 

[Illustration: Fig. 129. May-flower. ]

MAY-WEED (_Maruta Cotula_), is also known as Wild Chamomile, andDog-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, alwaysacceptable, and certain in its action. The warm infusion is the bestform for its administration. It may be drunk freely. 

GINGER (_Zingiber Officinale_). The hot infusion may be sweetened anddrunk as freely as the stomach will bear. 

DR. PIERCE'S COMPOUND EXTRACT OF SMART-WEED. This is unsurpassed as adiaphoretic agent, and is much more certain in its operation than anysimple diaphoretic. 

DILUENTS. 

Any fluid which thins the blood or holds medicine in solution is calleda diluent. Pure water is the principal agent of this class. Itconstitutes about four-fifths of the weight of the blood, and is themost abundant constituent of the bodily tissues. Water is necessary, notonly for digestion, nutrition, and all functional processes of life, butit is indispensable as a menstruum for medicinal substances. It is anecessary agent in depuration, or the process of purifying the animaleconomy, for it dissolves and holds in solution deleterious matter, which in this state may be expelled from the body. In fevers, water isnecessary to quench the thirst, promote absorption, and incite the skinand kidneys to action. Its temperature may be varied according torequirements. Diluents are the vehicles for introducing medicine intothe system. We shall briefly mention some which prove to be verygrateful 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 foundto be refreshing to fever patients. 

SASSAFRAS-PITH, SLIPPERY-ELM BARK, FLAX-SEED, AND GUM ARABIC make goodmucilaginous drinks for soothing irritation of the bowels and otherparts. 

BREWERS' YEAST mixed with water in the proportion of from one-eighth toone-fourth is a stimulant and antiseptic. 

THE WHITE ASHES OF HICKORY OR MAPLE WOOD dissolved in water make anexcellent alkaline drink in fevers, or whenever the system seemssurcharged 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 ofthe 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, oneto 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 inaction, yet effective in allaying irritation of the

FOXGLOVE (_Digitalis purpurea_) slows the action of the heart, lowersthe temperature, and acts indirectly as a diuretic. It is especiallyvaluable in the treatment of scarlet fever and in dropsy. _Dose_--Ofinfusion, one-half drachm to one-half ounce; of the fluid extract orstrong tincture, from two to ten drops. It should be used with caution. A poultice made of the leaves and placed over the kidneys is aneffectual method of employing the drug. 

QUEEN OF THE MEADOW (_Eupatorium Purpureum_), is also known asGravel-weed, Gravel-root, or Trumpet-weed. This is a most valuablediuretic. _Dose_--Of the infusion, one to three ounces; of fluidextract, one-fourth to one-half teaspoonful; of the concentratedprinciple, Eupatorin (_Purpu_), one-half to two grains. 

BUCHU (_Barosma Crenata_). The leaves are used. This agent has beenextensively employed, generally in compounds. _Dose_--Of infusion, (steeped for two hours or more) one to two ounces; of fluid extract, thesame; of the concentrated principle, Barosmin, one to three grains. 

PIPSISSEWA (_Chimaphila Umbellata_), or Prince's Pine. This is a tonicto the kidneys, as well as a diuretic and alterative, and is a mild, butvery efficient remedy. _Dose_--Of decoction, one ounce from four to sixtimes a day; of fluid extract, one-fourth to one-half teaspoonful; ofthe concentrated principle, Chimaphilin, one to two grains. 

WATER-MELON SEEDS (_Cucurbita Citrullus_). _Dose_--Of infusion, thepatient may drink freely until the desired effect is secured. 

PUMPKIN SEEDS (_Cucurbita Pepo_). They are mild, unirritating, yeteffective diuretics. An infusion of these may be drunk freely. 

SWEET SPIRIT OF NITRE (_Spiritus Ætheris Nitros_), is diuretic andanodyne. _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 purposethan 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, producevomiting by a local action on the stomach, and do not affect this organwhen introduced elsewhere. Others, which may be termed systemic emetics, produce their effects through the nervous system, and, therefore, mustbe absorbed into the circulation before they can produce vomiting. Incases of poisoning, it is desirable to empty the stomach as quickly aspossible, hence irritant emetics should be employed, for they act morespeedily. Draughts of warm water favor the action of emetics. 

MUSTARD (_Sinapis_) acts promptly and efficiently as an emetic, and maybe employed in poisoning. _Dose_--From one to two teaspoonfuls ofpowdered mustard, stirred up in a glass of tepid water. It should bequickly swallowed and diluents freely administered. 

SULPHATE OF COPPER (_Cupri Sulphas_) is a prompt, irritant emetic. Itshould be given in doses of ten grains dissolved in half a glass ofwater, and its action assisted by the free use of diluents. 

SULPHATE OF ZINC (_Zinci Sulphas_) is similar in its effects to sulphateof copper, but less powerful, and may be taken in the same manner, andthe dose repeated if necessary in fifteen minutes. 

YELLOW SUBSULPHATE OF MERCURY (_Hydrargyri Sulphas flava_), commonlyknown as _Turpeth Mineral, _ is an efficient and most desirable emetic inmembranous croup. It is an active poison, but, as it is quickly thrownup with the contents of the stomach, there is no danger from itsadministration. _Dose_--It should be given to a child in doses of fromthree to five grains, in the form of powder, rubbed up with sugar ofmilk. 

IPECAC (_Cephælis Ipecacuanha). _In large doses Ipecac is a systemicemetic. In small doses, it exerts a specific influence upon the mucousmembranes, relieves nausea and irritation, and subdues inflammation. Incholera infantum it is an invaluable remedy, if given in very smalldoses. By allaying irritation of the stomach and restoring tone andfunctional activity to it and the bowels, it gradually checks thedischarges and brings about a healthy condition. It is also valuable indysentery, and is borne in large doses. As an emetic the dose is, ofpowder, five to ten grains in warm water; of fluid extract, ten totwenty drops. 

[Illustration: Fig. 132. Lobelia. ]

LOBELIA (_Lobelia Inflata_), sometimes known as Indian Tobacco, orEmetic-weed. The herb and seeds are used. This is a powerful, systemicemetic, but very depressing. _Dose_--Of the powdered leaves, fifteen totwenty grains; of the infusion, one to three ounces; of the fluidextract, ten to fifteen drops. 

BONESET (_Eupatorium Perfoliatum). _ _Dose_--Of the warm infusion ordecoction, two to three ounces; of the fluid extract, one teaspoonful inhot water: of the concentrated principle, Eupatorin, two to five grains. 

EMMENAGOGUES. 

Emmenagogue is a term applied to a class of medicines which have thepower of favoring the discharge of the menses. We shall mention only afew of those which are best adapted to domestic use. 

[Illustration: Fig. 133. Pennyroyal. ]

PENNYROYAL (_Hedeoma Pulegioides). _ Pennyroyal, used freely in the formof a warm infusion, promotes perspiration and excites the menstrualdischarge when recently checked. A large draught of the infusion shouldbe taken at bed-time. The feet should be bathed in warm water previousto taking the infusion. 

BLACK COHOSH (_Cimicifuga Racemosa). _ Black Cohosh, known also as BlackSnake-root, is an effective remedy in uterine difficulties. _Dose_--Ofthe tincture, twenty drops; of the fluid extract, ten drops. 

TANSY (_Tanacetum Vulgare). _ Tansy is beneficial in suppressedmenstruation. _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, ofthe 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 influenceupon the female reproductive organs, and for this reason has receivedthe name of Female Regulator It is very efficacious in promoting themenstrual flow, and is a valuable agent in the treatment of uterinediseases. _Dose_--Of the decoction, four fluid ounces three or fourtimes a day; of the fluid extract, from one-fourth to one-halfteaspoonful. 

MOTHERWORT (_Leonurus Cardiaca_). Motherwort is usually given in warminfusion, in suppression of the menses from cold. _Dose_--Of thedecoction, from two to three fluid ounces every one or two hours. 

DR. PIERCE'S FAVORITE PRESCRIPTION is an efficient remedy in casesrequiring a medicine to regulate the menstrual function. Full directionsaccompany 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 onmedicine which is very popular with the profession, says that he hasused the "Extract of Smart-weed" in twenty cases of amenorrhea(suppressed menstruation), and affirms "with no other remedy or mode oftreatment have I been so successful as with this. " Full directionsaccompany every bottle. It is sold by all druggists. 

EXPECTORANTS. 

Expectorants are medicines which modify the character of the secretionsof the bronchial tubes, and promote their discharge. Most of the agentsof this class are depressing in their influence and thus interfere withdigestion 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 benefitsarising from their use depend upon their derivative power, as well asupon the anodyne properties which many of them possess, rendering themefficacious for soothing pain. We cannot mention a more valuable agentof this class than

DR. PIERCE'S COMPOUND EXTRACT OF SMART-WEED. As an external applicationthis 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, forany and all ailments, whether afflicting man or beast, requiring adirect external application, either to allay inflammation or soothepain, the Extract of Smart-weed cannot be excelled. 

NARCOTICS. 

A narcotic is a remedy which, in _medicinal_ doses, allays morbidsensibility, relieves pain, and produces sleep; but which, in overdoses, produces coma, convulsions, and death. The quantity necessary to producethese results varies in different individuals. We shall mention a few ofthose most frequently employed. 

[Illustration: Fig. 134. Henbane. ]

HENBANE (_Hyoscyamus Niger_). The leaves and seeds are used. Henbane, inlarge doses, is a powerful narcotic and dangerously poisonous. Inmedicinal doses, it is anodyne and antispasmodic; it allays pain, induces sleep, and arrests spasms. _Dose_--Of the fluid extract, five toten drops; of the solid extract, from one-half to one grain; of theconcentrated principle, Hyoscyamin, from one-twelfth to one-fourth of agrain. 

INDIAN HEMP (_Cannabis Indica_). An East Indian plant. _Dose_--Of theextract, from one-fourth to one-half grain, of the tincture, from threeto eight drops; of the fluid extract, from two to five drops. The plantknown as Indian Hemp, growing in this country, possesses very differentqualities. 

[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 actsas an anodyne and antispasmodic

_Dose_--Of extract of the leaves, from one-half to one grain; of thefluid extract, from three to six drops. 

NERVINES. 

These are medicines which act on the nervous system, soothing excitementand quieting the condition known as "nervousness. "

HOPS (_Humulus Lupulus_). _Dose_--Of infusion, one to three ounces; ofthe fluid extract, one-fourth to one-half teaspoonful of theconcentrated principle, Humulin, two to three grains. 

[Illustration: Fig. 136. Scull-cap. ]

SCULL-CAP. (_Scutellaria Lateriolia_). The herb is used. It is alsoknown 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 theconcentrated principle, _Scutellarin_, one to two grains. 

LADY'S SLIPPER (_Cypripedium Pubescens_). The root is used. _Dose_--Ofthe infusion, one-half to one-ounce; of THE fluid extract, one-fourth toone-half teaspoonful; of the concentrated principle, Cypripedin, one totwo grains. 

PULSATILLA (_Pulsatilla Nigricans). _ We employ the German tincture, prepared from the green herb. In many of the distressing nervouscomplications to which both males and females are subject in certaindiseases of the generative organs, we have found it very effectual. Thedose is from two to eight drops. 

DR. PIERCE'S FAVORITE PRESCRIPTION. This is a tonic nervine ofunsurpassed efficacy, combined in such a manner, that, while it quietsnervous irritation, it strengthens the enfeebled nervous system, restoring it to healthful vigor. In all diseases involving the femalereproductive organs, with which there is usually associated an irritablecondition of the nervous system, it is unsurpassed as a remedy. It isalso a uterine and general tonic of great excellence. It is sold by alldruggists. 

SEDATIVES. 

Sedatives are a class of agents which control excitation of thecirculation, 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 thetemperature of the body in fevers. It is an effectual remedy in acuteinflammation of the tonsils and throat, in acute bronchitis, ininflammation of the lungs, and pleurisy, in the hot stage ofintermittent and remittent fevers, in the eruptive fevers, in feverarising from a cold, and in some forms of neuralgia. Acute suppressionof the menses from a cold, may be relieved by the tincture of aconite indrop doses every hour. _Dose_--Of the tincture of the root, fromone-half of a drop to two drops, in a spoonful of water, in acute feversand inflammations, from one-half drop to one drop should be administeredevery half hour or hour, according to the severity of the symptoms. 

PEACH TREE (_Amygdalus Persica_). Peach tree leaves and bark areslightly sedative, but the chief use which we have found for thesearticles is to control nausea and vomiting arising from irritability ofthe stomach. It also possesses mild, tonic properties. _Dose_--Ofinfusion at the bark of the small twigs or of the leaves, from two tosix 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 mostvaluable agent with which to control the frequent, strong, boundingpulse common to many febrile and inflammatory diseases. When the pulseis hard, incompressible, and bounding, this remedy is more effectualthan aconite. _Dose_--Of the tincture and fluid extract, from one to twodrops, repeated every half hour to two hours, according to the severityof the symptoms. This remedy should be given in very small doses, frequently repeated, if we would secure its best effects. Our favoritemode of administering both veratrum and aconite is to add ten drops ofthe tincture to ten or fifteen teaspoonfuls of water, of which oneteaspoonful may be administered every hour. 

YELLOW JESSAMINE (_Gelseminum Sempervirens_). The root is the part used. Through its controlling effect over the sympathetic nervous system, thisagent exerts a marked influence in controlling morbid excitability ofthe circulatory organs. It allays irritation, and determination of bloodto the brain, indicated by flushed face, contracted pupils, irritability, and restlessness, a frequent condition in diseasesincident to childhood. Its concentrated principle, Gelsemin, is anefficient remedy in bloody-flux or dysentery. It should be administeredin very small doses to secure the best results. Only one-sixteenth toone-eighth of a grain is required, repeated every two hours. It shouldbe triturated with sugar of milk or with common white sugar, in theproportion of one grain to ten of sugar. _Dose_--Of tincture, from fiveto fifteen drops; of fluid extract, three to six drops; of Gelsemin, asa sedative, one-fourth to one-half grain. 

STIMULANTS. 

Stimulants are medicines which have the power of increasing the vitalactivity of the body. Some have a very transient action, while othersare more permanent in effect. 

CAYENNE PEPPER (_Capsicum Annuum_). Cayenne Pepper is a powerfulstimulant. _Dose_--Of the powder, from one to six grains, administeredin milk; of the tincture, from five to ten drops, largely diluted inmilk or water. 

BLACK PEPPER (_Piper Nigrum_). Black Pepper is a warm, carminativestimulant. _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 stimulantand tonic. The parts used are the bark and leaves. _Dose_--Of the fluidextract, from five to fifteen drops; of the tincture, ten to twentydrops; of the active principle, Xanthoxylin, one to two grains. 

ALCOHOL is a powerful stimulant. It is never used in its pure state inmedicine, but when diluted forms a useful remedy in many diseases. It isgenerally employed in the form of whiskey, gin, rum, brandy, and wine. 

AMMONIA is an excellent stimulant. _Dose_--Of the carbonate, from threeto five grains; of the sesquicarbonate, from five to ten grains; this isthe same as the carbonate, which has been exposed to the air and slacked(powdered hartshorn); of the aromatic spirit, from one-half to oneteaspoonful. The Aqua Ammonia and Liquor Ammonia are of such variablestrength that they are seldom employed internally, but may be appliedexternally and taken by inhalation. 

DR. PIERCE'S COMPOUND EXTRACT OF SMART-WEED. This quickly diffusiblestimulant and genial anodyne we have spoken of under the head ofAnodynes. But its medicinal properties equally entitle it to a place andmention under the class of stimulants. As a stimulant it spurs thenervous system and arouses the circulatory forces. Congestion of thelungs, liver, bowels, or uterus, embarrasses the functions of theseorgans. Frequently this congestive difficulty may be entirely obviated, and the circulation of the blood restored to the surface of the body, bythe administration of a few doses of this pleasant remedy. Thus it oftenacts like magic in giving relief, promoting the circulation, andrestoring the organs to their accustomed functional activity. Fulldirections accompany every bottle. 

TONICS. 

Tonics are remedies which moderately exalt the energies of all parts ofthe body, without causing any deviation of healthy function. Whilestimulants are transient in their influence, tonics are comparativelypermanent. 

[Illustration: Fig. 139. White Poplar. ]

WHITE POPLAR (_Liriodendron Tulipfera_), called also American Poplar, orWhite Wood. The part used is the inner bark. This is a mild but valuabletonic for domestic use. _Dose_--Of the infusion, from one-half to oneounce; of tincture, from one to two teaspoonfuls. 

CHAMOMILE (_Anthemis Nobilis_). The part used is the flowers. This is amild, unirritating tonic. _Dose_--Of infusion (one-fourth ounce offlowers to a pint of water) one-half to one ounce. 

GENTIAN (_Gentiana Lutead_). The root is the part used. This is afavorite domestic tonic in many localities. _Dose_--Of powdered root, five to ten grains; of the tincture, ten to twenty drops; of the fluidextract, five to ten drops, four or five times a day. 

NUX VOMICA (_Strychnos Nux Vomica_), or Dog Button. This is a powerfultonic. It increases innervation and is particularly valuable in casesmarked by feeble circulation and general impairment of muscular power. In overdoses it is poisonous, and hence must be employed with muchcaution. _Dose_--Of the tincture, three to five drops; of the fluidextract, ONE TO THREE DROPS. 

WILLOW (_Salix Alba_). Willow is a tonic and an astringent. _Dose_--Ofthe decoction, from one to two fluid ounces; of the concentratedprinciple, 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, fromthree to five grains; of the infusion, from one to two ounces; of thefluid extract, from ten to twenty drops. 

WAFER-ASH (_Ptelea Trifoliata_), also called Swamp Dogwood. The bark isused. This is a pure, unirritating tonic. _Dose_--Of tincture, one-halfto one teaspoonful; of fluid extract ten to twenty drops; of theinfusion, one to two fluid ounces. 

[Illustration: Fig. 141. Golden Seal. ]

GOLDEN SEAL (_Hydrastis Canadensis_). Golden Seal is a powerful and mostvaluable tonic. It is a valuable local remedy when used as a generalinjection in leucorrhea. _Dose_--Of the powder, from ten to thirtygrains; of the tincture, from one-half to one fluid drachm; of the fluidextract, from ten to twenty drops; of the concentrated principle, Hydrastin, from two to three grains; of the muriate of hydrastia, fromone-half to one grain. 

[Illustration: Fig. 142. American Colombo. ]

AMERICAN COLOMBO (_Frasera Carolinensis_). American Colombo is a simpletonic. _Dose_--Of the powdered root, from ten to fifteen grains; of theinfusion one-half to one fluid ounce, three or four times a day; of theactive 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 agargle. _Dose_--Of the decoction, from two to six fluid drachms; of thetincture, from one-half to two teaspoonfuls; of fluid extract, from tento twenty drops. 

IRON (_Ferrum_). Different preparations of iron are frequentlyprescribed by physicians. They are particularly valuable in anæmicconditions of the system. The following are a few of the preparations ofthis 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 threegrains. 

TINCTURE OF MURIATE OF IRON (_Tinctura Ferri Chloridi). _ _Dose_--Threeto twenty drops. 

DR. PIERCE'S FAVORITE PRESCRIPTION. The Favorite Prescription, inaddition to those properties already described, likewise combines tonicproperties. In consequence of the never ceasing activities of the bodilyorgans, the system requires support, something to permanently exalt itsactions. In all cases of debility, the Favorite Prescriptiontranquilizes 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 alterativeproperties combined in this compound, it possesses important tonicqualities. While the Favorite Prescription exerts a tonic influence uponthe digestive and nutritive functions, the Golden Medical Discovery actsupon the excretory glands. Besides, it tends to retard unusual waste andexpenditure. This latter remedy tones, sustains, and, at the same timeregulates the functions. While increasing the discharge of noxiouselements accumulated in the system, it promptly arrests the wastesarising from debility, and the unusual breaking down of the cellsincident to quick decline. It stimulates the liver to secrete, changesthe sallow complexion, and transforms the listless invalid into avigorous and healthy being. At the same time, it checks the rapiddisorganization of the tissues and their putrescent change, while itsustains the vital processes. It is, therefore, and indispensable remedyin the treatment of many diseases. 

 * * * * *

CHAPTER III. 

BATHS AND MOTION AS REMEDIAL AGENTS. 

The remedial effects of bathing are generally underrated. This want ofappreciation is more often due to the improper manner in which it isperformed than to an insufficiency of curative virtues. The term_bathing_ not only implies a cleaning of the body or certain portions ofit, but also the application of water in such a manner as to influencethe nervous system, and regulate the functions of the secretory organs. Cleanliness, while it preserves health and promotes recovery, hasreference only to the hygienic influences of water and not to itscurative effects. There are several kinds of baths, the names of whichindicate their character, manner of application, or the part of the bodyto 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 anybath; thus the sponge, sitz, and alkaline baths may be employed warm orcold, according to the effect desired. 

THE COLD BATH, used at a temperature of from 40° to 60° Fahr. , ispowerfully sedative, and is employed for its tonic effects. If the vitalpowers are low, or the individual remains in it too long (two or threeminutes should be the limit), the reaction is slow and its effectsinjurious. While it is highly invigorating to robust persons, those whohave a low standard of vitality should be cautions in its employment. Alocal bath may be followed by beneficial results, when a general bathwould be inadmissible. For these reasons we advise the general use ofthe

COOL BATH, at a temperature of from 60° to 75° Fahr. If, in anyinstance, the _reaction_ is _slow_, we recommend the

TEMPERATE BATH, at a temperature of from 75° to 80° Fahr. The time ofremaining in the bath should be regulated by the strength of theinvalid. As a rule, it should not exceed three _minutes_, and the colderthe water the less time should the patient be immersed. Immediatelyafter emerging from any bath, the body should be thoroughly dried andrubbed with a moderately coarse towel until a glow is experienced andreaction is fully established. The attempt to toughen children byexposing them to low temperatures of either air or water, cannot be tooemphatically condemned. This caution, however, does not apply to theemployment of moderately cool water for ablutions. The cold or cool bathshould be taken in the early part of the day, but _never duringdigestion_. Whenever reaction does not follow bathing, artificial meansmust be resorted to, as stimulating drinks, dry warmth, or exercise. 

THE TEPID BATH, the temperature of which is from 85° to 92° Fahr. , isgenerally used for cleansing the body. It is prescribed in fevers andinflammatory affections for its cooling effects. It is usually medicatedwith some acid or alkali. The latter unites with the oily secretion ofthe skin and forms a soapy compound easily removed by the water. Thetemperature should be regulated according to the vitality of thepatient; and the bath may be repeated two or three times a day. Itremoves superfluous heat, and keeps the skin in a condition favorablefor excretion. 

THE WARM BATH, at a temperature varying from 92° to 98° Fahr. , is alwaysagreeable and refreshing. It equalizes the circulation and softens theskin, by removing all impurities. It moderates pain and soothes thewhole system. It does not weaken or debilitate the person, but is inevery way beneficial. It is an efficient, remedial agent in many chronicdiseases, convulsions, spasmodic affections of the bowels, rupture, rheumatism, and derangement of the urino-genital organs. It should beemployed immediately before going to bed unless urgent symptoms demandit 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 powerfulstimulant. It excites the nerves, and through them the entire system. Itcauses a sense of heat and a constriction of the secretory organs; butperspiration, languor, and torpor soon follow. In the suddenretrocession of cutaneous diseases, it restores the eruptions to thesurface and gives speedy relief. The hot bath may be applied locallywhen circumstances require. 

THE RUSSIAN BATH consists in the application of hot vapor, at atemperature varying from 112° to 200° Fahr. The patient is firstsubjected to a moderately warm temperature, which is gradually increasedas he becomes inured to it, the head being surrounded with cloths wet incold water. Upon emerging from it, the bather is plunged into cold wateror receives a cool, shower bath. In rheumatic and cutaneous diseases, chronic inflammations, and nervous affections, the Russian bath is aneffective remedy. 

THE TURKISH BATH is a, dry, hot-air bath. The bather passes from oneapartment to another, each one being of a higher temperature than thepreceding. He undergoes a thorough shampooing, and, although the personmay be scrupulously clean, he will be astonished at the amount of effetematter removed by this process. The bather then returns through thevarious apartments, and, upon emerging from that of the lowesttemperature, he experiences a delightful sensation of vigor andelasticity. 

As a hygienic agent, the hot-air bath has been' constantly growing infavor. Its value is now recognized by all physicians throughout theworld. The judicious use of the Turkish bath serves to secure perfectequalization of the circulation. Glandular activity is increased, elasticity and power given to the muscles, and a permanent, stimulatingand tonic influence imparted to the system, a condition at onceconducive 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 withincity walls, as amid the fields and meadows of the country. His bathwould be to him in the place of a country house or horse--it would givehim air, exercise, freshness, health, and life. "

"The bath that cleanses the inward as well as the outward man; that isapplicable to every age; that is adapted to make health healthier, andalleviate disease, whatever its stage or severity, deserves to beadopted as a national institution, and merits the advocacy of allmedical men; of those whose especial duty it is to teach how health maybe preserved, and how disease may be averted. "

The hot, _dry_ atmosphere of the Turkish bath promotes rapid evaporationfrom the surface of the body, and it is well known that rapidevaporation from the surface is a cooling process. A person's finger maybe frozen in one minute's time, by throwing upon it a constant, finespray of rhigolene or sulphuric ether. The rapid evaporation of thelight fluid congeals the liquids of the tissues and a film of ice israpidly formed upon the part. In a less intense degree the same coolingprocess is carried on over the whole surface of a person, when in thehot room, or _sudatorium_, of the Turkish bath. The evaporation from thesurface is so rapid that one can hardly appreciate the profuseness ofthe perspiration going on. The evaporation from the surface so rapidlycarries off the heat from the body that one finds himself able, withlittle or no inconvenience, to remain in a room heated to from 180° to200° or even 220° Fahr. 

As a hygienic measure to be regularly or occasionally employed bypersons in fair health, the Turkish or hot dry-air bath is far superiorto the Russian or vapor-bath. (1. ) It produces more profuseperspiration, and is therefore more depurating, or cleansing, in itseffects. (2. ) It does not relax the system, but rather produces a toniceffect, and fewer precautions are, therefore, necessary to guard againsttaking cold after employing it. (3. ) The Turkish bath can be betterventilated than the Russian. While the air is heated to a hightemperature, it can be readily kept pure by constant changes. In theTurkish hot-rooms, or _sudatorium_, of the Invalids' Hotel and SurgicalInstitute, provision is made for bringing underneath the floors acurrent of fresh air from without. This column of fresh air is carriedunder the centre of each room where it escapes from the conductor, iswarmed, and rises into the room, from which extraction of air isconstantly going on through registers opening into tubes, communicatingwith large ventilated shafts which are kept hot, summer and winter, toinsure a draught through them. In this manner, thorough ventilation ofour Turkish hot-rooms is insured. 

The Turkish bath not only combines a most agreeable luxury with adecidedly invigorating and tonic influence, but also, by its stimulatingpower, induces proper glandular and cellular activity, producing ahealthy condition. 

Sallowness, tan, and freckles, the result of local or general increaseof the pigment granules of the skin, soon disappear under thestimulating influence and regular use of the Turkish bath, which causesrapid development of new and transparent cells. The colored granules arethus gradually replaced and the skin assumes a beautiful clearness andpurity of appearance, which transcends immeasurably the unhealthy huethat follows the frequent employment of the various cosmetics. 

The value of an agent which thus improves the general health, insuresimmunity from coughs, colds, and other diseases, and at the same timeproduces a healthy and permanent beauty of complexion, is at onceapparent. The purity of person, perfect circulation, increase of healthynutrition and glandular activity produced by the Turkish bath, serve tomake it of the most lasting utility. 

The eminent Dr. Madden has said, and his experience is confirmed byevery regular patron of the bath, that, "Wherever the Turkish bath was anational institution the hair of the women was peculiarly luxurious andbeautiful. I can vouch for it that the use of the bath rendered thecomplexion more delicate and brilliant; that the eyes became clearer andbrighter; all the personal charms were enhanced. I can recommend nohygienic measure more beneficial or effectual in preserving the healthand an attractive personal appearance. "

Pimples, blotches, eruptions, and other disfigurations of the skin areremoved by the frequent use of the Turkish bath, leaving the integumentsmooth and soft. 

[Illustration: Fig. 144. First Hot-room of the Turkish Bath. ]

HOW THE TURKISH BATH IS ADMINISTERED AT THE INVALID'S HOTEL AND SURGICALINSTITUTE. The hot-rooms, of which there are two, are exactly similar inevery respect except as regards temperature. The first room has atemperature of from 110° to 120° Fahr. The bather is supplied by theattendant every few minutes with copious draughts of cool water. Gradually the relaxing influence of the elevated temperature manifestsitself. The capillaries slowly dilate, the veins enlarge under itsgentle stimulus, and small points of perspiration appear upon thesurface, which assumes a slight, rosy blush. A delightful calm, afeeling of perfect rest and luxurious ease is imparted to the senses. From this room, after an appropriate interval, the bather enters thesecond room, in which the atmosphere is higher by from 20° to 30°, andit 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 theskin, at first impure and loaded with the _débris_ of dead cells andextraneous matter, gradually become purer, and clearer, until, finally, all trace of color disappears and the pearly drops of sweat come fulland free. Soon the attendant appears and leads the way to theshampooing-room, where, lying upon a warm marble slab, _massage_ isapplied most thoroughly to every portion of the body. 

By the _massage_, shampooing, or rubbing, the superficial veins arethoroughly emptied of their contents, the muscles are given elasticityand tone, and glandular activity is promoted. Innumerable deadepithelial cells, together with other impurities, are rolled off inflakes under the skillful manipulation of the attendant. 

After a thorough shampooing, the shower bath is applied, to secure acontraction of the capillaries and a diminution of the perspiration. 

THE SPIRIT VAPOR-BATH is very effective when employed in the earlierstages of acute, febrile, inflammatory, and painful diseases. In manyforms of chronic diseases the administration of a spirit vapor-bath oncein from three to fifteen days, is a valuable adjunct to the treatment ofthese affections. It exerts an exceedingly beneficial influence upon theentire system, and, when habitually employed, may ward off disease. 

The body should be moistened with an alkaline solution before theadministration of a spirit vapor-bath. After the perspiration which itoccasions has subsided, which will usually be in from three to fourhours, sponge the body with a mixture of the following ingredients:water, three gills; alcohol, one gill; salt, one teaspoonful. By thismethod the patient experiences none of the unpleasant effects whichgenerally follow the employment of diaphoretics. Various kinds ofapparatus have been devised to facilitate the application of the spiritvapor-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 advantageouslyemployed. 

"The patient is undressed, ready for getting into bed, having removedthe clothing worn through the day and put on a night shirt or otherclothing to be worn while sweating, and during the night, if the bath istaken at bed-time. He is then seated on a high Windsor orwooden-bottomed chair, or instead thereof, a bench or board may beplaced on a common open-bottomed chair, care being taken that the bottomis so covered that the flame will not burn him. After seating himself, alarge coverlet or blanket is thrown around him from behind, covering theback of his head and body, as well as the chair, and another must bepassed 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 downfrom the face from time to time as occasion demands during the operationof the bath. The blankets must reach down to the floor, and cover eachother at the side, so as to retain the vapor. This having been done, asaucer or tin vessel, into which is put one or two tablespoonfuls ofwhiskey, brandy, alcohol, or any liquor that will burn, is then placedupon 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 lighta piece of paper, apply the flame to the liquor, and as soon as itkindles let down the part of the blanket which has been raised, andallow the liquor to burn until it is consumed, watching it from time totime to see that the blankets are not burned. As soon as consumed, putmore liquor into the saucer, about as much as before, and again set iton fire, being careful to put no liquor into the saucer while the flameexists, as there would be danger of setting fire to the blanket, andproducing injury to the patient. Continue this until the patientperspires freely, which, in a majority of cases, will be in five or tenminutes. "

"If, during the operation the patient feels faint or thirsty, cold watermust be sprinkled or dashed in his face, or he may drink one or twoswallows of it, --and in some cases the head may be bathed with coldwater. As soon as free perspiration is produced, wrap the blanketsaround him, place him in bed, and cover him up warm, giving him about apint of either some good store tea, ginger, or some diaphoretic herb teato drink, as warm as he can take it. After two or three hours, removethe covering, piece by piece, at intervals of twenty or twenty-fiveminutes each, that he may gradually cease perspiring. "

The above method may be improved by using an ordinary hoop skirt, ten totwelve inches below the bottom of which is suspended a larger andstronger hoop. The upper and smaller hoops should rest upon thepatient's shoulders. A woolen blanket, large enough to reach and restupon the floor, and envelop the whole person, is thrown over the hoops. Unless the bath is employed to diminish the quantity of fluids in thebody (as in dropsy), the patient may drink some simple, diaphoreticinfusion, to hasten or facilitate perspiration. When he perspiresfreely, small quantities of cold water may be frequently given. "Thereis little or no danger of taking cold after this process, if ordinaryprecaution is observed, and it is easy, agreeable, safe, and effectual. "

"Occasionally we will meet with patients, upon whom it is almostimpossible to produce the slightest moisture, much less perspiration. The skin of such persons is generally dry and harsh, communicating anunpleasant sensation to the touch. In most instances the skin may berestored to its normal condition, by adopting the following course: 1st. Anoint the whole surface of the body and limbs with olive oil everynight upon retiring to bed. 2nd. Every morning wash the whole surfacewith a warm, weak, alkaline solution, employing considerable frictionwhile drying. 3rd. Every two weeks administer a spirit vapor-bath. Aperseverance in this course for a few months will accomplish the desiredresult. "

Frequent reference to spirit vapor-baths will be made by the author ofthis work, in speaking of those diseases in which its employment willprove beneficial. 

SEA BATHING is an excellent, remedial agent in chronic disorders, particularly in those of an atonic character, such as nervousprostration, dyspepsia, and general debility. 

Much of the benefit attributed to this mode of bathing is undoubtedlydue to other influences, such as pure air, exercise, change of scenery, diet, and associations which surround the patient during his sojourn atthe sea-shore. 

At first, the duration of a sea-bath should not exceed three or fiveminutes, 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. Theyshould always be taken in the earlier portion of the day, beforebreakfast if possible, and _never during digestion_. 

Before entering this bath, a moderate degree of exercise should alwaysbe taken, enough to arouse the vital energies, but not to producefatigue. Suitably dressed, the patient plunges into the water, in whichhe remains during the prescribed time. Immediately after emerging fromthe bath, the patient should be thoroughly dried and dressed and thenmoderate exercise should be taken to induce reaction. If the reaction isslow, a mild stimulant may be taken and the duration of the bath must bediminished the next time. When sea-bathing is beneficial improvement issoon manifested. The blood becomes richer, the whole system isstrengthened and the functions are performed with more regularity. Tothe rich, sea-bathing is a luxury, but it is a remedy beyond the reachof the poorer classes unless they live near the sea-shore. 

THE SHOWER BATH produces a shock to the nervous system by suddenlycoming in contact with the skin. Numerous streams of cold water fallupon the neck, shoulders, and body of the patient who stands beneath thehose or reservoir. When the patient is plethoric, feeble, or nervous, orwhen some internal organ is diseased, the cold, shower bath should _not_be employed. In simple debility unaccompanied by inflammation orsymptoms of internal congestion, its use proves advantageous. Bymoderating the force of the shower, and substituting tepid water, themost delicate persons can endure it and profit thereby. The usual meansfor inducing a good reaction, friction, and exercise, should beemployed. 

THE DOUCHE BATH consists of a stream of water, dashed or thrown upon thepatient from a moderate height or distance, with considerable force. Thesize, temperature, and force of the stream may be modified to suit theexigencies of the case. It is locally employed as a remedy for sprains, weak or stiff joints, old swellings, etc. The cold, douche bath is morepowerful than the shower bath and should be given with the sameprecautions which govern the application of the latter. 

THE SPONGE BATH admits of extensive employment in both acute and chronicdiseases, and its simplicity renders it of untold value. It consists ina general or local application of water (medicated or not) at anydesired temperature. The quantity may be great or small to suit therequirements of the case. If it is applied in acute diseases at atemperature agreeable to the patient, it is exceedingly grateful and maybe repeated as often as necessary. It may be rendered alkaline by theaddition of some compound of soda, in the proportion of a teaspoonful toa quart of water. A portion of the body may be bathed at a time, andquickly dried, thus avoiding any exposure to cold. It removes excessiveanimal heat, relaxes the capillaries, equalizes the circulation, andproduces comfort, tranquility, and sleep. 

Nothing is more conducive to the health and comfort of laboring men insummer than a daily bath, and it is a matter of regret that there are sofew conveniences for the purpose in most homes, especially those in thecountry. Farmers in particular need bathing facilities, and yet in mostcases they are almost entirely without them. For their benefit we willdescribe a device which we can recommend to all who want a cheap, convenient, and easily managed apparatus for sponge bathing in thebed-room. 

The articles required are a piece of rubber-cloth a yard and a quartersquare, four slats, two inches wide and three feet long, notched at theends 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 overthem (there is no need of fastening it to the slats), forming a shallowsquare vessel a yard wide. In this the bather stands and applies thewater with a sponge from a basin or bowl on a stand placed convenientlynear. There need be no danger of wetting the carpet, or spoiling thefurniture. 

When the bath is finished, gather three corners of the rubber cloth inthe left hand, take the fourth corner in the right in such a way as toform a spout when lifted or held over the slop-jar or bucket. The watermay be poured out in a moment, when the cloth should be spread over theback 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 thehead or some internal organ. It is a powerful auxiliary in the treatmentof those chronic diseases in which inflammation, congestion, and afeeble circulation are prominent symptoms. The water should be as hot asit 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, orcayenne pepper. 

THE SITZ BATH. A tub is so arranged that the patient can sit down in itwhile bathing. In this manner the lower part of the abdomen, hips, andupper part of the thighs, are immersed in whatever fluid the bath iscomposed of. It is applicable in diseases of the pelvic organs, and maybe hot, warm, cool, cold, or medicated, according to the effect desired. 

The bath tub should be large enough to permit a thorough rubbing andkneading of the diseased parts, and the patient may remain in it fromten 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 thepelvis, in debility of the urino-genital organs, in piles, prolapsus ofthe rectum, and in constipation. 

THE HEAD BATH. A shallow basin contains the fluid for the bath; and thepatient, assuming a recumbent position, immerses a portion of the head, generally the back part. The temperature may be warm, cool, or cold, asdesired. 

MEDICATED BATHS are infusions of vegetable or other substances in water. They are sometimes applied with the sponge, though generally the patientis immersed. The temperature at which they are usually employed is thatof the tepid bath. The nature and strength of the medication dependsupon the character of the disease for which it is employed. 

THE ALKALINE BATH is prepared by dissolving half a pound of carbonate ofsoda in sixty gallons of water. It is useful in those diseases in whichthe fluids of the body are abnormally acid, as in rheumatism. 

THE ACID BATH is prepared by adding two pounds of muriatic orhydrochloric acid to sixty gallons of water. A much smaller quantity ofthe acid is sometimes used, and in some instances vinegar issubstituted. 

_Scott's Acid Bath_ is composed of nitro-muriatic acid (aqua regia) andwater. It should be prepared in a wooden tub, and a sufficient quantityof acid used to give the water a sour taste. It is extensively used inIndia as a remedy for disorders of the liver. 

THE IODINE BATH is composed of the following ingredients: tincture ofiodine, two drachms; iodide of potassium, four drachms; water, fortygallons. It should be prepared in a wooden tub. It reddens the skin. Forchildren, a much weaker solution must be employed. Its use is generallyrestricted to scrofulous and tubercular affections. 

THE SULPHUR BATH is prepared by dissolving eight ounces of sulphuret ofpotassium and two ounces of dilute sulphuric acid in sixty gallons ofwater. The acid may be omitted. 

A SULPHUR VAPOR-BATH is often employed in cities where the necessaryapparatus can be procured. It may be improvised by placing sulphur on ashovel over hot coals. The patient should be prepared as in the spiritvapor-bath, and burning sulphur substituted for the liquor. The patientis then enveloped in the fumes of sulphurous oxide. Heating a mixture ofsulphur and sulphuric acid, produces the same result. If the gas isinhaled in large quantities it causes irritation of the respiratorypassages, and suffocation. It is therefore necessary that the coveringsshould be securely fastened at the neck, and that the room be one whichcan 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 woolencloths wrung out of hot water. They should not be so light as to beineffectual, nor so heavy as to be burdensome. They should not be wetenough to drip, nor applied so as to expose the body to the surroundingair. A fresh cloth should be ready for application before the first oneis removed, and the change quickly effected. Fomentations are effectualin relieving congestion and inflammation. 

THE WET SHEET PACK. As this remedial appliance will be frequentlyrecommended in the pages following, its mode of application is heredescribed. Take a pail half filled with cold water, gather together oneend of a common cotton sheet, and immerse it, allowing it to remainwhile preparing the bed, which may be done as follows: remove all thebed-clothes except a coverlet and the pillows, then spread upon it, inthe following order, two ordinary comforters, one woolen blanket, onewoolen 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 assistantwraps him closely and tightly with it, as quickly as possible. Each armmay be thus covered by the wet sheet, or may lie outside of it, and becovered by wet towels, prepared in the same manner as the sheet. Thenquickly and tightly cover with the blankets and comforters, tuckingsnugly from head to foot. The head should also be covered with a wettowel, and a bottle of warm water placed to the feet, or near enough tokeep them warm. 

After the first shock of the chill is over, the pack is very pleasantand refreshing, and the patient should go to sleep, if possible. Theordinary 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 principalbenefits comes from the vigorous reaction induced by its coldtemperature. After remaining in the pack from thirty to sixty minutes, allow the patient to stand on his feet, if he is able, and have thewhole surface of his body bathed. Rub briskly, and dry with towels, orby throwing over the body a dry sheet and then rubbing him. The drysheet retains the bodily warmth and is more comfortable, but interfereswith the completeness and vigor of the rubbing of the body. Be sure andestablish full reaction, which may be known by the warmth of thesurface. Frequently, when the patient is released from the pack, and isbeing bathed, rolls of scales, scurf, and _skin-debris_ come off, thusgiving palpable evidence of the utility of the pack in freeing themyriads of pores of the skin of effete matter. It is efficient infevers, and for breaking up colds, and is a very valuable, remedialagent in most chronic diseases, assisting in removing causes whichdepress the bodily functions. 

MOTION IS A REMEDIAL AGENT. 

The stability of the planetary system depends upon the converted motionof its parts. So in the human system, motion is a fundamental principlewhich underlies every vital process. Health consists in normal, functional activity. The human system is the arena of various kinds ofmotions, both of fluids and of solids, and life and health depend uponthese 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 itcirculates through the lungs. Corresponding with the movements of thechest are the _motions of the abdominal walls_, which promote thefunctions of the organs of the abdominal cavity. 

There are _motions of the heart and arteries_, which urge the blood outto the extremities and diffuse it through every part of the system, andalso _motion of the blood in the capillaries_, by which the blood iscirculated through the tissues, that the latter may be built up from itsnutritive constituents. Then there is the _motion of the vital current_in the veins returning towards the heart, and urged forward by themuscular and pump-like action of the chest and abdominal walls. Theperistaltic _motions of the stomach and bowels_ urge onward digestingmaterials, exposing them successively to different solvents and aidingthe absorption of nutritive matter. No less essential to life and healthare numerous other minute operations or _motions_, on which vital powerin all its manifestations of muscular and nervous energy depends. Manyother _motions_ are consequent upon decay, growth, and repair. Oxygen, carbonic acid, watery vapors, and other gaseous matter are constantlybeing exchanged between the system and atmosphere. Then, the humansystem being a complex, chemical laboratory, there are _motionsconsequent upon chemical action_, constantly going on within it. 

_Muscular motion_, under the direction of the will, is also absolutelynecessary for the maintenance of good health. 

Animal heat and muscular and nervous power are dependent upon motions ofthe minutest particles composing the body. The body is composed of fluidand semi-fluid matter, permitting great freedom of motion. Healthrequires that there shall be _a constant change of place_, an activetransmission of material to and from vital organs and parts, through themedium 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, intovital energy, requires the simultaneous elimination from the system of alike amount of worn-out matter. Assimilation of nutritive materials isimpossible, unless a like amount of matter be eliminated from thesystem. Muscular and nervous energy are dependent upon activities whichcause waste. Not only is this true in a general way, but it is also truethat the energy produced by the operations of the vital system has astrict relation to the wasting products--that _full_ energy is onlyattained by _perfected_ waste. Use, waste, and power, then, sustaindefinite and dependent or corresponding relations, since waste is asessential to health as is supply. 

Without waste, disturbance is at once produced in the system similar tothat resulting from the introduction of foreign matter. Thesedisturbances constitute disease. The more obvious effects of lack ofwaste and elimination are mechanical. The circulation is loaded witheffete and useless matter, the vessels being thereby weakened anddistended, and the circulation retarded. The capillaries become cloggedand vital action is diminished. Local congestions, inflammations, effusions, morbid growths, and other pathological results follow. 

Deranged or suppressed action characterizes, and, indeed, constitutesall departures from health which we call disease. Suffering indicatesaction, but action which is perverted into wrong channels, or action inone part at the expense of motion in other parts, constituting adisturbance in the equilibrium of forces, from which the system suffers. 

VALUE OR MECHANICAL MOVEMENTS AND MANIPULATIONS FOR THE TREATMENT OFCHRONIC DISEASES. To correct and restore deranged movements, therebyproducing normal, functional activity of every organ and part of thesystem, must therefore be the chief object of the physician. Allremedies, of whatever school or nature, imply motion, and depend fortheir efficacy upon their ability to excite motion in some one or moreelements, organs, or parts of the system. 

While we do not wish to detract from the real merits of medicine as acurative agent, yet we must admit that the remedial power of motion, transmitted either manually or mechanically, is founded upon rationaland physiological principles. All systems of medicine, however much theymay differ superficially, propose, as the chief end to be attained bythe administration of medicine, or by other treatment, that _motions_identical with physiological activity should be incited or promoted. Howbest to accomplish this result, and with least cost to vitality, is animportant consideration. Bearing in mind the conservation of forces, that energy or power is as indestructible as matter, that it may bechanged into other forms but never lost, it is plain that mechanicalforce may be applied to the living system and transformed into vitalenergy; that chemical action, animal heat, and magnetism may representin the system the mechanical force transmitted to the body. Keeping inview the transformable nature of force, and the need that our systemshave of auxiliary power in different departments, when normal activityis impaired by disease, we can readily understand how undoubted, curative effects result from either the manual or the mechanicaladministration of motion. 

RUBBING is a process universally employed by physicians of every schoolfor the relief of a great diversity of distressing symptoms, isinstinctively resorted to by sympathizers and attendants upon the sick, and constitutes one of the chief duties of the nurse. Uncivilized peopleresort to this process as their principal remedy in all forms ofdisease. 

The difficulty in administering motion as a remedial agent by manualeffort, such as rubbing, kneading, oscillating, flexing, and extendingthe limbs, lies in the impossibility of supplying the _amount, intensity_, and _variety_ of movement required to make it mosteffective. The power of the arm and the strength of the operator areexhausted before the desired effect is produced. Inventive genius has atlast overcome the obstacles to the successful and perfect administrationof motion as a curative agent. We have now a series of machinespropelled by mechanical power, by the use of which we rub, knead, manipulate, and apply in succession a great variety of movements to allparts of the body. These machines transmit motion to the body frominexhaustible sources, never tire, but are ever ready for new, remedialconquests. The movements administered by their use, _while entirelyunder the control of the patient_, are never disagreeable, and are farmore rapid and intense than can possibly be given by the hands. By theapplication of short, quick movements of from _twelve to fifteen hundredvibrations a minute_, deep-seated organs and parts are reached, to whichmotion is transmitted and in which vital energy is thereby generated. The hands have not the power, by kneading, manipulating, or rubbing toimpress the system except in a very mild degree, and deep-seated organsand parts are scarcely influenced by the comparatively slow movementsthus administered. Among the most important, mechanical inventionsdevised for administering motion as a remedial agent, is one which hasreceived the name of the _manipulator_. 

THE MANIPULATOR. With this machine motion can be applied to any organ orpart of the system, and intensity of the application regulated to anicety. The rapidity of motion necessary to produce active exhilarationof 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 circulationgiven to the fluids, both inside and outside of the vessels, and ofenergy imparted to the organs and parts operated upon by themanipulator, is also unapproachable by the application of manual power. 

EFFECTS UPON THE CIRCULATION AND NUTRITION. The influence of motion onthese functions is as follows: The contents of the blood-vessels aremoved onward by the pressure and motion transmitted by the manipulator, all backward movement of the blood being prevented by the valves of theveins and by the propelling power of the heart and arteries. Fluidsoutside these vessels pass through their walls, to take the place of thestagnant blood that has been moved onward. Other blood flows into thepart, and thus active and healthy circulation is induced, and nutritivematerial, capable of affording vital support is also brought to refreshthe local part. 

We have found mechanical movements especially effectual in paralysis, neuralgia, sleeplessness, and other nervous affections; in derangementsof the liver, constipation, and dyspepsia; in displacements of theuterus, and congestion, and inflammation of the pelvic organs. 

For a complete description of the mechanical movements and the machineryemployed in the treatment of diseases at the Invalids' Hotel andSurgical 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 thesick: (1. ) Medical skill; (2. ) Good nursing. The former is necessary inorder that the condition of the patient be fully understood, and theproper means be employed to effect his recovery. The latter isessential, in order that all influences favoring the production anddevelopment of disease may be removed, the tendencies to restoration bepromoted by every possible means, and the directions of the physician beproperly 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 mostunqualified may succeed. If certain hygienic agencies are essential tothe maintenance of health, how much more necessary it is that they beemployed in sickness! If certain conditions cause disease, how great thenecessity is that such conditions be obviated and hygienic onessubstituted!

Notwithstanding the importance of good nursing, in the rural districtsit is frequently difficult to find a professional nurse, or, if one canbe obtained, it is often impossible for the invalid to procure suchservices, on account of the expense which must necessarily be incurred. Hence, this office usually devolves upon some relative who is consideredto 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. Awoman is generally selected for this important position. Her soft handand soothing voice, her kindly, sympathetic, and provident nature, together with her scrupulous cleanliness, render her man's equal, if nothis superior, in the capacity of nurse. There are circumstances, however, in which the services of a man are indispensable; hence thenecessity that all should be qualified to care for the sick. 

A nurse should be attentive to the requirements of physician andpatient, for she sustains an intimate relation to both. She shouldobserve the directions of the physician, and faithfully perform them. She should note all the symptoms of the patient, and do everything inher power to promote comfort and recovery. She should anticipate thewishes, and not cause the patient to ask for everything which isdesired. So far as practicable, let the wishes be gratified. The sensesof the sick often become morbidly acute, and those things which inhealth would pass unnoticed, in sickness are so magnified as to occasionannoyance and vexation. Sick persons are not all alike, and thepeculiarities of each must be studied separately. The nurse must be_kind_, but _firm_, and not yield to such whims of the patient as may bedetrimental to recovery; neither must she arouse dislike or anger byopposition, but endeavor to _win_ the patient from all delusions. Thefeelings of the patient should never be trifled with, for idealitiesbecome realities. 

The nurse should possess an inexhaustible store of patience. Diseaseaffects the mind of the patient and fills it with strange delusions. Thesick are often querulous, fretful, and unreasonable, and should betreated with kindness, forbearance, and sympathy. The nurse shouldalways be cheerful, look on the bright side of every circumstance, animate them with encouragement, and inspire them with hope. Hope is oneof the best of tonics. It stimulates the flagging, vital energies, andimparts new life to the weak and exhausted forces. Gloom, sadness, anddespondency depress the vital forces and lead to death. We have seenpatients rapidly sinking, who had given up all hope, and were quietlyawaiting the coming of death, snatched, as it were, from its grasp, andrestored to health, by words of cheer and encouragement. 

The nurse should possess _moral principles_, which alone can win theconfidence of the patient. She should have judgment, circumspection, intelligence, forethought, alacrity, carefulness, and neatness. In aword 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 beobserved, will soon be stricken low by its presence. She must berelieved occasionally and get rest, or she cannot long withstand thecombined influence of fatigue and disease. Her office is an arduous oneat best, and the long, weary hours of night-watching should becompensated by exercise in the open air, as well as by sleep during theday. Unless this be done, the system will become exhausted, and sleepwill intrude itself upon her at the time when the greatest diligence isrequired for the welfare of the patient, when the vital powers are attheir lowest ebb. She should be supplied with plenty of suitable foodduring the night, to sustain her and to serve as a safeguard against theinvasion of disease. She should be treated with kindness and respect, else her disposition may become morose and reflect itself upon thepatient, causing peevishness and despondency. 

THE SICK-ROOM should be as comfortable, cheerful, and pleasant, ascircumstances will allow. Let the room be large and airy, and furnishedwith a stove, or better still, a fireplace. All articles of clothing andfurniture, not necessary to the comfort of the patient, should beremoved from the room, and in _malignant_ or _contagious_ diseases thecarpets, even, should not be permitted to remain. The surroundings begethappiness or gloom, in proportion as they are pleasant or disagreeable. A tidy attendant, a few flowers and books, wonderfully enhance thecheerfulness 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, andbecome unfit for the purpose which they were intended to serve. Theirpresence gives the room an untidy appearance, suggestive of filth andslovenliness, and imparts to the patient a feeling of loathing anddisgust 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 orsea-grass mattress, or even a straw bed, covered with a cotton quilt, isfar preferable. The bedding should be changed frequently. It is betterthat the bed should be away from the wall, so as to admit of greaterfreedom 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. Theimportance, therefore, of a perfect and free ventilation of thesick-room cannot be too thoroughly impressed; and yet to properly securethis end, may call forth a considerable amount of ingenuity on the partof the nurse. A window should be open, but the current of air must notbe allowed to blow directly upon the patient. One window may be raisedfrom the bottom and another lowered from the top. This will permit theentrance of pure air from without, and the exit of the vitiated air fromwithin. The patient, if sufficiently covered in bed, is not liable totake cold from a proper ventilation of the room. Especially is thistrue, when the bodily temperature is raised by febrile or inflammatoryaffections. 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 iscold, the air must be pure. Cold air is as readily contaminated withimpurities as warm air, therefore, it is not sufficient that the room bekept cool, but the air should be frequently changed. Duringconvalescence, great care is necessary to protect the patient fromtaking cold. Air which is admitted into the sick-room should not becontaminated by passing over foul drains, privies, or other sources ofinfection, since, instead of invigorating, it depresses the physicalforces and generates disease. 

LIGHT is as necessary to health as is pure air. Banish either for anycontinuous 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, itwas found that absence of sunlight, together with moisture, not onlyfavor the development of tubercular consumption, but act as an excitingcause. It is well known that persons living in shaded dwellings oftensuffer from forms of disease which resist all treatment until properadmission of light is secured. 

The physician to the Emperor of Russia found upon examination thatpatients confined in well lighted wards, were four times as liable torecover as were those in poorly lighted rooms. Children reared away fromthe sunlight are apt to be deformed and idiotic, while those partiallydeformed have been restored by being admitted to the light. 

Patients sometimes wish to have their rooms darkened, because the lightis painful to their weak and sensitive eyes. It is far better to shadethe eyes and admit the sunlight into the room, since its rays causechemical changes to take place, which favor the return of health. Manyinvalids can ascribe their recovery to the influence of a sun bath. There are, however, conditions in which the patients should be screenedfrom the light. In such cases a little arrangement of the curtains orshutters 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 itseveral hours every day. Light and pure air stimulate a healthfuldevelopment, induce cheerfulness, hope, and recovery, while darknessbegets gloom, sadness, despondency, disease, and ultimately death. 

WARMTH is essential to the well-being of the patient, and it isnecessary that a proper temperature be maintained in the room. Except invery warm weather, a little fire should be kept in the room, and at thesame time fresh air should be admitted from without, and a uniformtemperature thus preserved. This arrangement is especially necessary inlocalities where great variations in temperature are experienced duringthe day and night. 

The normal temperature of the body ranges from 98° to 99° Fahr. Theminimum occurs from 2 to 6 A. M. ; the maximum, from 1 to 6 P. M. Thedeviation of a few degrees from this standard indicates disease, and thegreater the deviation, the greater is its severity. During the earlystages of acute diseases, the animal heat is generally increased, andshould be allayed by bathing, and cooling or acidulated drinks. In thelatter stages, the temperature becomes diminished and the condition ofthe system is favorable to congestions, which are most likely to occurbetween the hours of 2 and 6 A. M. , when the vital powers are lowest. Thepatient then becomes feeble, his extremities grow cold, and he has whatis termed a "sinking spell, " and perhaps dies. It is during these hoursthat additional covering, the application of hot bricks to the feet, andbottles of hot water to the limbs and body, friction upon the surface, stimulating drinks, and increased vigilance on the part of the nursewill often save the patient's life. But, unfortunately, at these hoursthe nurse is apt to get sleepy and inattentive, the demands of thepatient 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 wearingflannels next to the skin, and by carefully protecting the feet fromcold and moisture. 

CLEANLINESS cannot be too thoroughly impressed upon the minds of thosewho have the care of the sick. Filthiness is productive of disease andfavorable to its development. Bathing at least once a day, with pure, soft water and toilet-soap, is strongly urged, and as this is designedfor cleanliness, the temperature of the bath should be made agreeable tothe patient. 

THE CLOTHING AND BEDDING OF THE PATIENT in acute diseases, should bechanged frequently and thoroughly aired, if not washed. As soon asremoved, these articles should be taken from the room, replaced byothers _well aired and warmed. _ The hands and face of the patient shouldbe bathed frequently, the hair combed, the teeth brushed, the nailscleaned, the lips moistened, and everything about him kept clean andtidy. These observances, although in themselves trifling, promotecomfort and cheerfulness, and contribute largely to the recovery of thesick. All excretions from the patient should be buried, and notcommitted to privies to communicate disease to those who frequent them. 

THE DIET contains a very important relation to health. During theprocess of acute disease, the appetite is generally much impaired, ifnot entirely absent. It should then be the study of the nurse to devisesuch articles of nourishment as will be acceptable to the patient andsuitable to the condition. The food should be light, nutritious, andeasy of digestion. 

Each individual disease requires a diet adapted to its peculiarities. Those of an inflammatory character require an unstimulating diet, asgruel, barley-water, toast, etc. An exhausted or enfeebled condition ofthe brain, unattended by irritability, demands a stimulating diet, asbeef, eggs, fish, Graham bread, oysters, etc. In wasting diseases, inwhich the temperature of the system is low, beef, fatty substances, richmilk, sweet cream, and other carbonaceous articles of diet arerecommended. In the various forms of chronic ailments, the diet must bevaried according to the nature of the disease and the peculiarities ofthe patient. Deranged digestion is generally an accompaniment of chronicdisease. A return to normal digestion should be encouraged by selectingappropriate articles of food, paying due regard to its quantity andquality, as well as to the manner and time of eating. The appearance offood, and the manner in which it is offered, have much to do with itsacceptance, or rejection by the patient. Let the nourishment bepresented in a nice, clean dish, of a size and shape appropriate to thequantity. More food than can be eaten by the patient should not beplaced before him at one time, since a great quantity excites disgustand loathing. In taking nourishment, drink, or medicine, the patient, iffeeble, should not be obliged to change his position. 

MILK is one of the most important foods in fevers and acute diseasesattended with great prostration, and in which the digestive powers areenfeebled. It contains within itself all the elements of nutrition. 

BEEF TEA furnishes an excellent nourishment for the sick, but there arefew, 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 itin a porcelain or tin saucepan, cover it with _cold_ water, and bring itup to just below the boiling point, at which temperature _retain it_ forten minutes, then season and serve. Another method is similar to theforegoing, with this difference, that the juices of the meat aresqueezed through a piece of muslin or crash, making the tea richer. Another way, which we consider preferable to either of the above, is totake lean beef, cut it into fine bits, put them in a tightly coveredvessel, which is placed in a kettle of water kept boiling. Thus thewhole strength of the juice will be obtained from the meat withoutlosing any of its properties. It can be seasoned to the taste, andreduced with water to suit the needs of the patient. 

SLEEP is "Nature's grand restorer, a balm to all mankind; the bestcomforter of that sad heart whom fortune's spite assails. " It isnecessary in health, and doubly so in sickness. During sleep, the vitalenergies recuperate, the forces are less rapidly expended, and thestrength increases. It is the great source of rest and refreshment. Often a day's rest in bed, free from the cares and anxieties of anactive life, is sufficient to ward off the approach of disease. If quietand rest are essential to recuperation in health, their necessity indisease must be apparent. Life frequently depends on tranquility andrepose, and the least noise or confusion disturbs the sufferer anddiminishes the chances of recovery. Nothing annoys sick or nervouspersons more than whispering and the rustling of newspapers. Ifconversation be necessary, let the tones be modified, but never whisper. In sickness, when the vital forces are low, the more natural rest andsleep the patient obtains, the greater is the prospect for recovery. Asa rule, _a patient should never be awakened when sleeping quietly_, noteven to take _medicine_, unless in _extreme cases_. If the patient doesnot sleep, the cause should be ascertained and the appropriate remediesemployed; if it arise from rush of blood to the head, cooling lotionsshould be applied, and warmth to the feet; if, from restlessness orgeneral irritability, a sponge bath, followed by friction should beadministered; if the wakefulness is due to noise or confusion, quiet isthe remedy. When these means fail, anodynes, or nervines, should beemployed. Lying on the side instead of on the back should be practiced. Patients afflicted with chronic diseases, on rising, should take a coldbath, dry the surface quickly with a coarse towel, followed by frictionwith the hand. Great benefit may be derived by following thesesuggestions when the nature of the disease is not such as to forbid it. 

EXERCISE and rest necessarily alternate with each other. Exercise, sonecessary to health, in many forms of disease greatly contributes torecovery. It sends the sluggish blood coursing through the veins andarteries with increased force and rapidity, so that it reaches everypart of the system, supplying it with nourishment. It increases thewaste 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 theopen air. This should be done with regularity. The amount of exercisemust be regulated by the strength of the patient; never take so much asto produce fatigue, but, as the strength increases, the exercise may beincreased proportionately. Some interesting employment, commensuratewith the patient's strength, should be instituted, so that the mind maybe agreeably occupied with the body. 

When unable to take active exercise, the invalid, properly protected bysufficient clothing, should ride in a carriage or boat, and each day anew route should be chosen, so that a change of scenery may be observed, thus arousing new trains of thought, which will be exhilarating andprove beneficial to him. 

SEXUAL INFLUENCES. During the progress of disease or convalescence, entire continence must be observed. It is then necessary that all of thevital energies should be employed in effecting a recovery from disease, without having the additional tax imposed of overcoming the debilitatingeffects of sexual expenditure. This holds true with regard to alldiseases, and especially those of the nervous system and genitourinaryorgans. 

VISITING THE SICK may be productive of good or evil results. Mentalimpressions made upon the sick exert a powerful influence upon thetermination of disease. The chances of recovery are in proportion to theelevation or depression of spirits. Pleasant, cheerful associationsanimate the patient, inspire hope, arouse the vital energies, and aid inhis recovery; while disagreeable and melancholy associations begetsadness and despondency, discourage the patient, depress the vitalpowers, 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 acuteand chronic diseases. It does not matter what a visitor may _think_ withregard to the patient's recovery, _an unfavorable opinion should neverfind expression in the sick-room_. Life hangs upon a brittle thread, andoften that frail support is _hope_. Cheer the sick by words ofencouragement, and the hold on life will be strengthened; discourage, byuttering such expressions as, "How bad you look!" "Why, how you havefailed since I saw you last!" "I would have another doctor; one whoknows something!" "You can't live long if you don't get help!" etc. , andthe tie which binds them to earth is snapped asunder. The visitorbecomes a _murderer!_ Let all persons be guided by this rule: _Never gointo 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 toolong. The length of the visit should be graduated according to thestrength of the invalid. Never let the sufferer be wearied by toofrequent or too lengthy visits, nor by having too many visitors at once. Above all things, do not confine your visitations to Sunday. Many dothis and give themselves credit for an extra amount of piety on accountof it, when, if they would scrutinize their motives more carefully, theywould see that it was but a contemptible resort to save time. The sickare often grossly neglected during the week only to be visited to deathupon 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 theforce of the disease, and its use is, of necessity, discontinued; but inchronic ailments, the appetite remains unchanged, and the patientcontinues his indulgence greatly to the aggravation of the malady. 

The use of tobacco is a pernicious habit in whatever form it isintroduced into the system. Its active principle, Nicotin, which is anenergetic poison, exerts its specific effect on the nervous system, tending to stimulate it to an unnatural degree of activity, the finalresult of which is weakness, or even paralysis. The horse, under theaction of whip and spur, may exhibit great spirit and rapid movements, but urge him beyond his strength with these agents, and you inflict alasting injury. Withhold the stimulants, and the drooping head andmoping pace indicate the sad reaction which has taken place. Thisillustrates the evils of habitually exciting the nerves by the use oftobacco, opium, narcotic or other drugs. Under their action, the tone ofthe system is greatly impaired, and it responds more feebly to theinfluence of curative agents. Tobacco itself, when its use becomeshabitual and excessive, gives rise to the most unpleasant and dangerouspathological conditions. Oppressive torpor, weakness or loss ofintellect, softening of the brain, paralysis, nervous debility, dyspepsia, functional derangement of the heart, and diseases of theliver and kidneys are not uncommon consequences of the excessiveemployment of this plant. A sense of faintness, nausea, giddiness, dryness of the throat, tremblings, feelings of fear, disquietude, andgeneral nervous prostration must frequently warn persons addicted tothis habit that they are sapping the very foundation of health. Underthe 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 influenceantagonistic 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 oftobacco, or his physician should assume no responsibility in his case, further than to do the best he can for him. " In our own extensiveexperience in the treatment of chronic diseases, we have often found itnecessary to resort to the same restriction. 

The opium habit, to which allusion has also been made, is open to thesame 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 itsaccompanying high spirits, are larger elements of happiness than anyother things whatever, the teaching how to maintain them is a teachingthat yields to no other whatever. And therefore we assert that such acourse of physiology as is needful for the comprehension of its generaltruths and their bearings on daily conduct is an all-essential part of arational education. "

Believing that the diffusion of knowledge for the prevention of diseaseis quite as noble a work as the alleviation of physical suffering bymedical skill, we have devoted a large portion of this volume to thesubjects of physiology and hygiene. These we have endeavored to presentin as familiar a style as possible, that they may be understood by everyreader. Freely as we have received light upon these subjects have weendeavored to reflect it again, in hopes that a popular presentation ofthese matters made plain and easy of comprehension to all people, maylead the masses into greater enjoyment of life--the result of a betterpreservation of health. This we do in part as a public acknowledgment ofour 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 wellas receive advantages, return as well as accept benefits. We know of nobetter way to signify our appreciation of the public confidence andpatronage, so generously accorded to us, than to offer this volume tothe people at a price less than the actual cost for an edition ofordinary size. This we do as a token of the cordial reciprocation oftheir good will. In giving to the people wholesome advice, by which theymay be enabled to ward off disease and thus preserve the health ofmultitudes, we believe we shall receive their hearty approval, as wellas the approbation of our own conscience, both of which are certainlymunificent rewards. We believe that good deeds are always rewarded, andthat the physician who prevents sickness manifests a genuine and earnestdevotion to the common interests of humanity. 

We have no respect for the motives of those medical men who wouldwithhold that information from the people which will direct the masseshow to take care of themselves, and thereby prevent much sickness andsuffering. Nor is the diffusion of such knowledge antagonistic to thebest interests of the true and competent physician. The necessity forhis invaluable services can no more be set aside by popularizingphysiological, hygienic, and medical truths, than we can dispense withthose of the minister and lawyer by the inculcation of the principles ofmorality in our public schools. The common schools do not lessen thenecessity for colleges or universities, but rather contribute to theirprosperity. Nor are we so presumptuous as to anticipate that we couldpossibly make this volume so instructive as to render "every man his ownphysician. " No man can with advantage be his own lawyer, carpenter, tailor, and printer; much less can he hope to artfully repair his ownconstitution when shattered by grave maladies, which not only impair thephysical functions, but weaken and derange the mental faculties. Whatphysician presumes to prescribe for himself, when suddenly prostrated byserious illness? He very sensibly submits to the treatment of another, because he realizes that sickness impairs his judgment, and morbidsensations mislead and unfit him for the exercise of his skill. If thisis true of the physician, with how much greater force does it apply tothe unprofessional! If a sick sea-captain is unfit to stand at the helmand direct his ship, how utterly incompetent must the raw sailor be whensimilarly disqualified! Nor is the physician as competent to treat thosenear and dear to him, when they are suffering from dangerous illness, asanother medical man not similarly situated, whose judgment is not liableto be misled by intense anxiety and affectionate sympathy. 

Notwithstanding all these facts, however, a knowledge on the part of theunprofessional, of something more than physiology and hygiene, andappertaining more closely to medicine proper, will many times provevaluable. 

In the first stage of many acute affections which, if unheeded, gradually assume a threatening aspect, endangering life and demandingthe services of the most skilled physician to avert fatal results, theearly administration of some common domestic remedy, such as acathartic, or a diaphoretic herb, associated with a warm bath, a spiritvapor-bath, or a hot foot-bath, will very often obviate the necessityfor calling a family physician, and frequently save days and weeks ofsickness and suffering. 

So, likewise, are there numerous, acute diseases of a milder characterwhich are easily and unmistakably recognized without the possession ofgreat medical knowledge, and which readily yield to plain, simple, medical treatment which is within the ready reach of all who strive toacquaint themselves with the rudiments of medical science. But in suddenand painful attacks of acute disease, life may be suddenly andunexpectedly jeopardized, and immediate relief prove necessary. Whileunder these circumstances the prompt application of such domestictreatment as good common-sense may dictate, guided by a knowledge ofthose first principles of medical learning which we shall hereafterendeavor to make plain, may result in speedy and happy relief, yet atthe same time there should be no delay in summoning a competentphysician to the bedside of the sufferer. 

Then, and not the least important, there are the various chronic orlingering diseases, from all of which few individuals indeed, who passthe meridian of life, entirely escape. In this class of ailments thereis generally no immediate danger, and, therefore, time may be taken bythe invalid for studying his disease and employing those remedies whichare best suited for its removal. Or, if of a dangerous or complicatedcharacter, and, therefore, not so readily understood, he may consulteither personally or by letter, some learned and well-known physician, who makes a specialty of the treatment of such cases, and whose largeexperience enables him to excel therein. 

In consideration, therefore, of the foregoing facts, we deem it mostprofitable for our readers that Part Fourth of this volume should bearranged in the following manner:

The milder forms of uncomplicated, acute diseases, which may be readilyand unmistakably recognized, and successfully managed withoutprofessional aid, will receive that attention which is necessary to givethe reader a correct idea of them, and their proper remedial treatment. 

We shall devote only such attention to the severe and hazardous forms ofacute diseases as is necessary in order to consider their initial stage, with their proper treatment, not attempting to trace their numerouscomplications, or portray the many pathological conditions which areliable to be developed. For, even by devoting much space to the latter, we could not expect to qualify our unprofessional readers forsuccessfully treating such obscure and dangerous conditions. 

We shall devote the largest amount of space to a careful and thoroughconsideration of those chronic diseases, which, by a little study, maybe readily recognized and understood by the masses, and for the cure ofwhich we shall suggest such hygienic treatment and domestic remedies asmay be safely employed by all who are in quest of relief. In the moredangerous, obscure, or complicated forms of chronic diseases, thecorrect diagnosis and successful treatment of which tax all the skillpossessed by the experienced specialist, the invalid will not be misledinto the dangerous policy of relying upon his own judgment andtreatment, but will be counseled not to postpone until too late, theemployment of a skillful physician. 

The apportionment of space which is made in considering the variousdiseases and their different stages, as well as the course which thepeople are advised to pursue under the different circumstances ofaffliction, is not always in accordance with the plans andrecommendations which have been made by others who have written works ondomestic medicine. Most of these authors have attempted, by lengthydisquisitions, to teach their readers how to treat themselves withoutthe services of a physician, even in the most hazardous forms ofdisease. In such dangerous maladies as typhoid, typhus, yellow, andscarlet fevers, typhoid pneumonia, and many others, in which life isimminently imperiled, such instruction and advice is decidedlyreprehensible, as it may lead to the most serious consequences. We areconfident, therefore, that the manner of disposing of the differentsubjects which are discussed in the succeeding chapters, and the courseof action which is advised, will commend themselves to our readers asbeing such as are calculated to promote and subserve their bestinterests. 

MEDICAL DIAGNOSIS. 

Skill in the art of healing is indicated in three ways: (1. ) byascertaining the _symptoms, seat_, and _nature_ of the disease, which istermed _diagnosis_; (2. ) by foretelling the probable termination, whichis termed _prognosis_; (3. ) by the employment of efficacious andappropriate remedies, which is called _treatment_. Of these threerequisites to a prosperous issue, nothing so distinguishes the expertand accomplished physician from the mere pretender as his ready abilityto interpret correctly, the location, extent, and character of anaffection from its symptoms. By medical diagnosis, then, is understoodthe discrimination between diseases by certain symptoms which aredistinguishing signs. Every malady is accompanied by its characteristicindications, some of which are _diagnostic, i. E. _, they particularizethe affection and distinguish it from all others. 

Medical diagnosis is both a _science_ and an _art_; a science when thecauses and symptoms of a disease are understood, and an art when thisknowledge can be applied to determine its location and exact nature. Science presents the general principles of practice; art detects amongthe characteristic symptoms the differential signs, and applies theremedy. Da Costa aptly remarks: "No one aspiring to become a skillfulobserver can trust exclusively to the light reflected from the writingsof others; he must carry the torch in his own hands, and himself lookinto every recess. "

The critical investigation of symptoms, with the view of ascertainingtheir signs, is essential to successful practice. Without closelyobserving them, we cannot accurately trace out the diagnosis, and afailure to detect the right disease is apt to be followed by the use ofwrong medicines. 

General diagnosis considers the surroundings of the patient as well asthe actual manifestations of the disease. It takes into account thediathesis, _i. E. _, the predisposition to certain diseases in consequenceof peculiarities of constitution. We recognize constitutionaltendencies, which may be indicated by the contour of the body, itsgrowth, stature, and temperament, since all these facts greatly modifythe treatment. Likewise the sex, age, climate, habits, occupation, previous diseases, as well as the present condition, must be taken intoaccount. 

Auscultation, as practiced in detecting disease, consists in listeningto the sounds which can be heard in the chest. 

Percussion consists in striking upon a part with the view ofappreciating the sound which results. The part may be struck directlywith the tips of the fingers, but more generally one or more fingers ofthe other hand are interposed between the points of the fingers and thepart to be percussed, that they, instead of the naked chest, may receivethe 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 ofmedicine in perfecting this art. The _microscope_ assists the eye, andhelps to reveal the appearance and character of the excretions, detecting morbid degenerations; _chemistry_ discloses the composition ofthe urine, which also indicates the morbid alterations occurring in thesystem; by percussion we can determine the condition of an internalorgan, from the sound given when the external surface is percussed; theear, with the aid of the _stethoscope_, detects the strange murmurs ofrespiration, the fainter, more unnatural pulsations of life, and theobscurer workings of disease; with the _spirometer_ we determine thebreathing capacity of the lungs, and thus ascertain the extent of theinroads made by disease; the _dynamometer_ records the lifting abilityof the patient; the _thermometer_ indicates the morbid variation in thebodily temperature; various instruments inform us of the structuralchanges causing alterations in the specific gravity of fluids, _e. G_. , the _urinometer_ indicates those occurring in the urine; and thus, asthe facilities for correct diagnosis increase, the art of distinguishingand classifying diseases becomes more perfect, and their treatment morecertain. While physiology treats of all the natural functions, pathologytreats of lesions and altered conditions. 

[Illustration: Fig. 146. Dr. Brown's Spirometer. ]

By the term _symptoms_ we mean the evidence of some morbid effect orchange occurring in the human body, and it requires close observationand well-instructed experience to convert these symptoms into diagnosticsigns. Suppose "Old Probabilities" (as we commonly designate theinvaluable Signal Department) hangs out his warning tokens all along ourlake borders and ocean coasts; our sailors behold the fluttering symbolsindicating an approaching storm, but if no one understood their meaning, a fearful disaster might follow. But if these signals are understood, asafe harbor is sought and the mariner is protected. So disease may hangout all her signals of distress, in order that they may be seen, butunless correctly interpreted, and a remedial harbor is sought, thesesymptoms are of little practical value. 

Undoubtedly the reason why so many symptom-doctors blunder is becausethey prescribe according to the apparent symptoms, without any realreference to the nature of the affection. They fail to discover how fara symptom points out the seat, and also the progress of a disease. Theydo not distinguish the relative importance of the different symptoms. The practical purpose of all science is to skillfully apply knowledge tosalutary and profitable uses. The patient himself may carefully note theindications, but it is only the expert physician who can tell the importof each symptom. 

_Symptoms_ are within every one's observation, but only the physicianknows the nature and value of _signs_. We have read an anecdote ofGalen, who was a distinguished physician in his day, which illustratesthe distinction between sign and symptom. Once, when dangerously ill, heoverheard two of his friends in attendance upon him recount hissymptoms, such as "Redness of the face, a dejected, haggard, andinflamed appearance, " etc. He cried out to them to adopt every necessarymeasure forthwith, as he was threatened with delirium. The two friendssaw the _symptoms_ well enough; but it was only Galen himself, thoughthe _patient_, who was able to deduce the _sign_ of delirium--that is, he alone was able to translate those symptoms into signs. To determinethe value of symptoms, as signs of disease, requires close observation. 

INTERPRETATION OF SYMPTOMS. 

We shall refer to a few symptoms which any unprofessional reader mayreadily observe and understand. 

POSITION OF PATIENT. When a patient is disposed to lie upon his backcontinually 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 theprogress of continued fever, and is accompanied by involuntary twitchingof the muscles, picking of the bed-clothes, etc. , then danger isimminent and _the patient is sinking_. Fever, resulting from localinflammation, does not produce muscular prostration, and the patientseldom or never assumes the supine position. If this inflammation is inthe extremities, those parts are elevated, in order to lessen thepressure of the blood, which a dependent, position increases. 

For example, let us change the scene, and introduce a patient with headand shoulders elevated, who prefers to sit up, and who places his handsbehind him and leans back, or leans forward resting his arms and headupon a chair. The next week he is worse, and no longer tries to lie inbed, but sits up all the time; note the anxious expression ofcountenance, the difficult or hurried breathing, the dry and hackingcough, and observe that the least exertion increases the difficulty ofrespiration and causes palpitation of the heart. These plain symptomssignify 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 cannotforget the pale, sharp, contracted, and pinched features of thosepatients whose nostrils contract and expand alternately with the acts ofrespiration. How hard it was for them to breathe. The contraction andexpansion 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, atthe same time the eye is dull, the skin dusky or yellow, and the motionsare slow. But in lung diseases, the spirits are buoyant, the skin isfair, and the cheeks flushed with fever and distinctly circumscribedwith white, for delicacy and contrast, almost exceed the hues of healthin beauty. Note, too, the pearly lustre and sparkling light of the eye, the quivering motion of the lips and chin, all signs of pulmonarydisease. 

THE STORY OF SEXUAL ABUSE is plainly told by the downcast countenance, the inability to look a person fairly in the face, the peculiar liftingof the upper lip and the furtive glance of the eye. The state of themind and of the nervous system corroborates this evidence, for thereseems to be a desire to escape from conversation and to elude society. The mind seems engrossed and abstracted, the individual appears absorbedin a constant meditation, he is forgetful and loses nearly all interestin the ordinary affairs of life. The whole appearance of a patient, suffering from spermatorrhea, is perfectly understood by the experiencedphysician, for the facial expressions, state of mind, and movements ofthe body, all unconsciously betray, and unitedly proclaim his condition. 

TONGUE. Much may be learned from the appearance, color, and form of thetongue, and the manner of its protrusion. If pale, moist, and coatedwhite, it indicates a mild, febrile condition of the system. If coatedin 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 themucous membrane of the stomach. If the inflammation is in the largeintestine, the tip of the tongue presents a deep red color, while themiddle is loaded with a dark brown coating. When the tongue is elongatedand pointed, quickly protruded and withdrawn, it indicates irritation ofthe nerve-centers, as well as of the stomach and bowels. If tremulous, it denotes congestion and lack of functional ability; this may beobserved in congestive fevers. 

PULSE. Usually the pulse beats four times during one respiration, butboth 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 fortypulsations per minute. But when the heart beats from one hundred andtwenty to one hundred and forty times a minute, there is reason toapprehend danger, and the case should receive the careful attention of aphysician. 

Irregularity of the pulse may be caused by disease of the brain, heart, stomach, or liver; by the disordered condition of the nervous system; bylack of muscular nutrition, as in gout, rheumatism, or convulsions; bydeficiency of the heart's effective power, when the pulse-wave does notreach the wrist, or when it intermits and then becomes more rapid inconsequence of septic changes of the blood, as in diphtheria, erysipelas, and eruptive fevers. 

PAIN. The import of pain depends on its seat, intensity, nature, andduration. An acute, intense pain usually indicates inflammation of anerve as well as the adjacent parts. Sharp, shooting, lancinating painsoccur in inflammation of the serous tissues, as in pleurisy. A smarting, stinging pain attends inflammation of the mucous membrane. Acute pain isgenerally remittent and not fixed to one spot. Dull, heavy pain is morepersistent, and is present in congestions, or when the substance of anorgan is inflamed, and it often precedes hemorrhage. Burning paincharacterizes violent inflammations involving the skin and subjacentcellular tissue, as in case of boils and carbuncles. Deep, perforatingpain accompanies inflammation of the bones, or of their envelopingmembranes. Gnawing, biting, lancinating pain attends cancers. 

The location of pain is not always at the seat of the disease. Inhip-disease, the pain is not first felt in the hip, but in theknee-joint. In chronic inflammation of the liver, the pain is generallymost severe in the right shoulder and arm. Disease of the kidneysoccasionally produces numbness of the thigh and drawing up of thetesticle, and commonly causes colicky pains. Inflammation of themeninges of the brain is often indicated by nausea and vomiting beforeattention is directed to the head. These illustrations are sufficient toshow 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 isdisturbed, and wandering pains manifest themselves in different parts ofthe body. Fixed pain, which is increased by pressure, indicatesinflammation. If it be due only to irritation, pressure will notincrease it. Some rheumatic affections and neuralgia not only bearpressure, but the pain diminishes under it. Permanent pain shows thatthe structures of an organ are inflamed, while intermittent pain is asign of neuralgia, gout, or rheumatism. Absence of pain in any disease, where ordinarily it should be present, is an unfavorable sign. Internalpain, after a favorable crisis, is a bad omen. Or, if pains ceasesuddenly without the other symptoms abating, the import is bad. If, however, pain and fever remit simultaneously and the secretionscontinue, it is a favorable sign. 

A dull pain in the head indicates fullness of the blood-vessels fromweakness, low blood, or general debility. It may be caused by takingcold, thus producing passive congestion of the brain. It may proceedfrom gastric disturbance, constipation of the bowels, or derangement ofthe liver. Heaviness of the head sometimes precedes inflammation of thebrain, or chronic disease of its membranes. A dull, oppressive pain inthe head indicates softening of the brain, and is generally accompaniedby slowness of the pulse and of the speech. A pulsating pain of the headoccurs in heart disease, hysteria, and frequently accompanies some formsof insanity. 

THE EYE indicates morbid changes and furnishes unmistakable signs ofdisease. Sinking of the eye indicates waste, as in consumption, diarrhea, and cholera. In fevers it is regarded as a fatal symptom. Adark or leaden circle around the eye, seen after hard work, indicatesfatigue and overdoing. If the mucous covering of the inner surface ofthe lids and the ball of the eye is congested and inflamed, it exhibitsredness, and may indicate congestion or even inflammation of the brain. 

A dilated pupil is often observed in catarrhal consumption, congestionof the brain, low fevers, and chlorosis. 

The pupil contracts in inflammation of the meninges, when there isincreased sensibility and intolerance of light, also in spinalcomplaints. In some diseases the lustre of the eye increases, as inconsumption. But if it decreases with the attack of violent disease, itindicates great debility and prostration. 

EXAMINATION OF THE URINE. All medical authors and physicians ofeducation, freely admit and even insist upon the importance ofcritically examining the patient's urine, in all cases in which there isreason to suspect disease of the kidneys or bladder. In chronicaffections it is particularly serviceable, especially in derangements ofthe liver, blood, kidneys, bladder, prostate gland, and nervous system. Many scholarly physicians have sadly neglected the proper inspection ofthe urine, because they were afraid of being classed with the illiterate"uroscopian" doctors, or fanatical enthusiasts, who ignorantly pretendto diagnose correctly _all_ diseases in this manner, thus subjectingthemselves and their claims to ridicule. Nothing should deter one fromgiving to this excretion the attention it deserves. 

The urine which is voided when the system is deranged or diseased isaltered in its color and composition, showing that its ingredients varygreatly. So important an aid do examinations of the urine furnish indiagnosing many chronic ailments, that at the Invalids' Hotel andSurgical Institute, where many thousands of cases are annually treated, a chemical laboratory has been fitted up, and a skillful chemist isemployed, who makes a specialty of examining the urine, both chemicallyand microscopically, and reporting the result to the attendingphysicians. His extended experience renders his services invaluable. With his assistance, maladies which had hitherto baffled all efforts putforth to determine their true character, have frequently been quicklyand unmistakably disclosed. 

MICROSCOPICAL EXAMINATION. This method of examination affords a quickerand more correct idea of a deposit or deposits than any other method. The expert, by simply looking at a specimen, can determine the characterof the urine, whether blood, mucus, pus, uric acid, etc. , are present ornot. But when no deposit is present, then it is necessary to applychemical tests, and in many cases the quantity of the suspectedingredient must be determined by analysis. As a detailed account, of thevarious modifications which the urine undergoes in different diseases, would be of no practical use to the masses, since they could not availthemselves of the advantages which it would afford for correctdiagnosis, except by the employment of a physician who does not ignorethis aid in examining his patients, we shall omit all further detailsupon the subject. For the same reason we shall not often, in treating ofthe different diseases in which examinations of the urine furnish suchvaluable aid in forming a diagnosis, make mention of the changes whichare likely to have occurred. 

INFLAMMATION. 

The term _Inflammation_ signifies a state in which the infected part ishotter, redder, more congested, and more painful than is natural. Inflammation is limited to certain parts, while fever influences thesystem generally. Inflammation gives rise to new formations, morbidproducts, and lesions, or alterations of structure. The morbid productsof fever, and its modification of fluids are carried away by thesecretions and excretions. 

The susceptibility of the body to inflammation maybe _natural_ or_acquired_. It is natural when it is constitutional; that is, when thereis an original tendency of the animal economy to manifest itself in someform of inflammation. We may notice that some children are far moresubject to boils, croups, and erysipelatous diseases than others. Thissusceptibility, when innate, may be lessened by careful medication, although it may never be wholly eradicated. When acquired, it is theresult of the influence of habits of life, climate, and the state ofmind over the constitution

Phlegmonous inflammation is the active inflammation of the cellularmembrane, one illustration of which is a common boil. The four principalsymptoms are redness, swelling, heat, and pain; and then appears aconical, hard, circumscribed tumor, having its seat in the dermoidtexture. At the end of an indefinite period, it becomes pointed, whiteor 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 localinflammation, subsequent upon slight injury; or, in some cases, withoutany such provocation, as in gout, rheumatism, and scrofula. One of thefirst results of the inflammation, in such cases, is a weakening of theforces which distribute the blood to the surface and extremities of thebody. It is generally admitted that in scrofulous persons the vascularsystem is weak, the vessels are small, and because nutrition is faulty, the blood is _imperfectly organized_. The result is failure in thesystem, for if nutrition fails, there may be lacking earthy matter forthe bones, or the unctious secretions of the skin; the sebaceoussecretion is albuminous and liable to become dry, producing inflammationof the parts which it ought to protect. 

Disorder of the alimentary canal and other mucous surfaces are sometimesreflected upon the skin. We have occasionally observed cutaneouseruptions and erysipelas, when evidently they were distinct signs ofinternal disorder. 

Inflammation may be internal as well as external, as inflammation of thebrain, lungs, or stomach, and it is frequently the result of what iscalled a _cold_. No matter how the body is chilled, the blood retreatsfrom the surface, which becomes pale and shrunken, there is also nervousuneasiness, and frequently a rigor, accompanied with chattering of theteeth. After the cold stage, reaction takes place and fever follows. Thesudden change from a dry and heated room to a cool and moist atmosphereis liable to induce a cold. Riding in a carriage until the body isshivering, or sitting in a draft of air when one has been previouslyheated, or breathing a very cold air during the night when the body iswarm, especially when not accustomed to doing so, or exposing the bodyto a low temperature when insufficiently clothed, are all different waysof producing inflammation. 

Inflammation may result in consequence of local injury, caused by abruise, or by a sharp, cutting instrument, as a knife or an axe, or itmay 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 veryminute wound poisoned by the bite of a venomous reptile. Localinflammations may arise from scalds, burns, the application of caustics, arsenic, corrosive sublimate, cantharides, powerful acids, abrasions ofthe surface by injuries, and from the occurrence of accidents. 

The _swelling_ of the part may be caused by an increase of the quantityof blood in the vessels, the effusion of serum and coagulating lymph, and the interruption of absorption by the injury, or by the alteredcondition of the inflamed part. 

The character of the _pain_ depends upon the tissue involved, and uponthe altered or unnatural state of the nerves. Ordinarily, tendon, ligament, cartilage, and bone are not very sensitive, but when inflamedthey are exquisitely so. 

The heat of the inflamed part is not so great, when measured by thethermometer, as might be supposed from the patient's sensations. 

TERMINATION OF INFLAMMATION. Inflammation ends in one of six differentways. Inflammation may terminate in _resolution, i. E_. , spontaneousrecovery; by _suppuration_, in the formation of matter; by _effusion_, as the inflammation caused by a blister-plaster terminates by effusionof water; by _adhesion_, the part inflamed forming an attachment to someother 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, byresolution, by suppuration and raising of "matter, " by hardening andsolidification of the lung, or by gangrene. Inflammation of theendocardium, the lining membrane of the heart, may cause a thickening ofit, and ossification of the valves of the heart, thus impairing itsfunction. Inflammation of the pericardium may terminate in effusion, ordropsy, and inflammation of the liver may result in hardening andadhesion to adjacent parts. 

SEVERAL PRINCIPLES FOR TREATMENT OF INFLAMMATION. 

Remove the exciting causes as far as practicable. If caused by asplinter or any foreign substance, it should be withdrawn, and if theinjury is merely local, apply cold water to the parts to subdue theinflammation. If caused by a rabid animal, the wound should be enlargedand cupped, and the parts cleansed or destroyed by caustic. The patientshould remain quiet and not be disturbed. The use of tincture of aconiteinternally, will be found excellent to prevent the rise of inflammation. A purgative is also advised, and four or five of Dr. Pierce's PleasantPurgative Pellets will be sufficient to act upon the bowels. If there ispain, an anodyne and diaphoretic is proper. Dr. Pierce's CompoundExtract of Smart-weed will fulfill this indication. In localinflammation cold water is a good remedy, yet sometimes hot water, orcloths wrung out of it, will be found to be the appropriate application. When the inflammation is located in an organ within a cavity, as thelungs, hot fomentations will be of great service. Bathing the surfacewith alkaline water must not be omitted. Whenever the inflammation isserious the family physician should be early summoned. 

FEVER. 

In fever all the functions are more or less deranged. In everyconsiderable inflammation there is sympathetic fever, but in essentialfevers there are generally fewer lesions of structure than ininflammation. Fever occasions great waste of the tissues of the body, and the refuse matter is carried away by the organs of secretion andexcretion. The heat of the body in fever is generally diffused, thepulse is quicker, there is dullness, lassitude, chilliness, anddisinclination to take food. We propose to give only a general outlineof fevers, enough to indicate the principles which should be observed indomestic treatment. 

Most fevers are distinctly marked by four stages: 1st, the formingstage; 2d, the cold stage; 3d, the hot stage; 4th, the sweating ordeclining stage. During the first stage the individual is hardlyconscious of being ill, for the attack is so slight that it is hardlyperceptible. True, as it progresses, there is a feeling of languor, anindisposition to make any bodily or mental effort, and also a sense ofsoreness of the muscles, aching of the bones, chilliness, and adisposition to get near the fire. There is restlessness, disturbedsleep, bad dreams, lowness of spirits, all of which are characteristicof the formative stage of fever. 

The next is the cold stage, when there is a decided manifestation of thedisease, and the patient acknowledges that he is really sick. In typhusand typhoid fever the chills are slight; in other fevers they are moremarked; while in ague they are often accompanied by uncontrollableshaking. When the chill is not so distinct the nails look blue and theskin appears shriveled, the eye is sunken and a dark circlecircumscribes it, the lips are blue, and there is pain in the back. Thepulse is frequent, small, and depressed, the capillary circulationfeeble, 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 tothrow off the bed-clothes. 

Then follows the hot stage, for with the return of the circulation ofthe blood to the surface of the body, there is greater warmth, freerbreathing, and a more comfortable and quiet condition of the system. Theveins fill with blood, the countenance brightens, the cheeks areflushed, 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 isnot a good symptom. If there is considerable determination of blood tothe head it becomes hot, the arteries of the neck pulsate strongly, anddelirium may be expected. During the hot stage, if the fever runs high, the patient becomes restless, frequently changes his position, iswakeful, uneasy, and complains of pain in his limbs. In low grades, thesensibility is blunted, smell, taste, and hearing are impaired. 

The patient in the hot stage is generally thirsty, and if he is allowedto drink much, it may result in nausea and vomiting. Moderate indulgencein water, however, is permissible. There is aversion to food, and if anyis eaten, it remains undigested. The teeth are sometimes covered withdark _sordes_ (foul accumulations) early in the fever, and theappearance of the tongue varies, sometimes being coated a yellowishbrown, 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 generallydiminished in quantity, but shows higher color. 

The sweating stage in some fevers is very marked, while in others thereis very little moisture, but an evident decline of the hot stage, theskin becoming more natural and soft. The pulse is more compressible andless frequent, the kidneys act freely, respiration is natural, the painssubside, although there remains languor, lassitude, and weariness, apreternatural sensibility to cold, an easily excited pulse, and a paleand sickly aspect of the countenance. The appetite has failed and thepowers of digestion are still impaired. 

DOMESTIC MANAGEMENT OF FEVERS. It is proper to make a thorough study ofthe early, insidious symptoms of fever, in order to understand whatought to be done. If it arises in consequence of malaria, the treatmentmust be suited to the case. If from irritation of the bowels andimproper articles of diet, then a mild cathartic is required. If thereis much inflammation, a severe chill, and strong reaction, then thetreatment should be active. If the fever is of the congestive varietyand the constitution is feeble, the reaction imperfect, a small, weakpulse, a tendency to fainting, a pale countenance, and great pain in thehead, apply heat and administer diaphoretics, and procure the servicesof a good physician. 

As a general rule, it is proper to administer a cathartic, unless intyphoid fever, and for this Dr. Pierce's Purgative Pellets answer thepurpose, given in doses of from four to six, according to the state ofthe bowels. If these are not at hand, a tea of sage and senna may bedrunk until it produces a purgative effect, or a dose of Rochelle saltstaken. In nearly all fevers we have found that a weak, alkaline tea, made from the white ashes of hickory or maple wood, is useful, takenweak, three or four times daily, or if there be considerable thirst, more frequently. Some patients desire lemon juice, which enters thesystem as an alkali and answers all purposes. 

Diaphoretic medicines are also indicated, and the use of Dr. Pierce'sExtract of Smart-weed will prove very serviceable. Drinking freely ofpleurisy-root tea, or of a strong decoction of boneset is frequentlyuseful. After free sweating has been established, then it is proper tofollow by the use of diuretic teas, such as that of spearmint andpumpkin seed combined, or sweet spirits of nitre, in doses of twenty tothirty 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 ofaconite or veratrum may be given in water, every hour. During theintermission of symptoms, tonic medicines and a sustaining course oftreatment should be employed. If the tongue is loaded and theevacuations from the bowels are fetid, a solution of sulphite of soda isproper; or, take equal parts of brewer's yeast and water, mix, and whenthe yeast settles, give a tablespoonful of the water every hour, as anantiseptic. Administering a warm, alkaline hand-bath to a fever patientevery day, is an excellent febrifuge remedy, being careful not to chillor induce fatigue. If there is pain in the head, apply mustard to thefeet; 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 softstate of the skin, eruptions on the surface, a natural expression of thecountenance, moist tongue, free action of the kidneys, and regularsleep. If the domestic treatment which we have advised does not breakthe force of the disease and mitigate the urgency of the symptoms, itwill be safer to employ a good physician, who will prescribe such acoarse of treatment as the case specially requires. It is our aim toindicate what may be done before the physician is called, for frequentlyhis services cannot be obtained when they are most needed. Besides, ifthese attacks are early and properly treated with domestic remedies, itwill often obviate the necessity of calling upon a physician. If, on theother hand, fevers are neglected and no treatment instituted, theybecome more serious in character and are more difficult to cure. 

To recapitulate, our treatment recommends evacuation through nature'soutlets, the skin, kidneys, and bowels, maintaining warmth, neutralizingacidity, using antiseptics, tonics, and the hand-bath, and the fluidextract or tincture of aconite, or veratrum to moderate the pulse bycontrolling the accelerated and unequal circulation of the blood. It isa simple treatment, but if judiciously followed, it will often abort afever, 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 inthe other varieties. Weariness, lassitude, yawning, and stretching, abitter taste in the mouth, nausea, less of appetite, the uneasy state ofthe stomach and bowels are more marked in the premonitory stages ofintermittent fevers. The cold stage commences with a chilliness of theextremities and back, the skin looks pale and shriveled, the bloodrecedes from the surface, respiration is hurried, the urine is limpidand pale, sometimes there is nausea and vomiting, and towards theconclusion of the stage, the chilly sensations are varied with flushesof heat. The hot stage is distinguished by the heat and dryness of thesurface of the body and the redness of the face; there is great thirst, strong, full, and hard pulse, free and hurried respiration and increasedpain in the head and back. The sweating stage commences by perspirationappearing upon the forehead, which slowly extends over the whole body, and soon there is an evident intermission of all the symptoms. In theinflammatory variety of intermittent fever, all these symptoms areacute, short, and characterized by strong reaction. Gastric fever, themost frequent variety of intermittent fever, is marked by irritation ofthe stomach and bowels, and a yellow appearance of the white of the eye. 

CAUSES. The cause of the malarial fevers, intermittent, remittent, andcongestive, is supposed to be _miasm_, a poisonous, gaseous exhalationfrom decaying vegetation, which is generally most abundant in swamps andmarshes, 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 bottlesof hot water. The Compound Extract of Smart-weed should be administeredin some diaphoretic herb-tea. During the hot stage, the extra clothingand the bottles of hot water should be gradually removed and cold drinkstaken instead of warm. During the sweating stage the patient should beleft alone, but as soon as the perspiration ceases, from two to four ofthe Purgative Pellets should be administered, as a gentle cathartic. Asecond paroxysm should, if possible, be prevented. To accomplish this, during the intermission of symptoms, the Golden Medical Discovery shouldbe taken in doses of from two to three teaspoonfuls every four hours inalternation with three-grain doses of the sulphate of quinine. If theattack is very severe, and is not relieved by this treatment, aphysician should be summoned to attend the case. 

REMITTENT FEVER. (BILIOUS FEVER. )

The distinction between _intermittent_ and _remittent_ fever does notconsist in a difference of origin. In the former disease there is acomplete intermission of the symptoms, while in the latter there is onlya remission. 

TREATMENT. The treatment should consist in the employment of thoseremedial agents advised in intermittent fever, the Golden MedicalDiscovery and quinine being taken during the remission of symptoms. During the height of the fever, tincture of aconite maybe given and analkaline sponge-bath administered with advantage. As in intermittentfever, should the course of treatment here advised not promptly arrestthe disease, the family physician should be summoned. 

CONGESTIVE FEVER. (PERNICIOUS FEVER. )

This is the most severe and dangerous form of malarial fever. It may beeither intermittent or remittent in character. In some instances thefirst paroxysm is so violent as to destroy life in a few hours, while inothers it comes on insidiously, the first one or two paroxysms beingcomparatively 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 onlymet with in the Mississippi valley, and in other localities where theair contains a large quantity of malarial poison. 

TREATMENT. This fever is so dangerous that a physician should besummoned as soon as the disease is recognized. For the benefit of thosewho are unable to obtain medical attendance, we will say that thetreatment should be much the same as in intermittent fever, but moreenergetic. Quinine should be taken in doses of from five to fifteengrains every two or three hours. If it be not retained by the stomach, the following mixture may be administered by injection: sulphate ofquinine, 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 usuallycharacterized 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 forthese more grave disorders which should always, for the safety of thepatient, be attended by the family physician, except to recommend somesimple 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 mesentericglands. This diseased condition of the bowels distinguishes this feverfrom all others, and is readily detected by sensitiveness to pressure, especially over the lower part of the abdomen on the right side. Theearly 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 diseasebecomes fully developed. 

CAUSE. Typhoid fever is a specific form of fever developed from theaction of a specific germ upon a susceptible system. The poison oftyphoid fever is eliminated mainly through the bowels. The germs oftyphoid can maintain life for months in water, and thus it happens thatponds, lakes, rivers and streams which receive sewage can spread thegerms of typhoid fever. Well water often swarms with these poisonousgerms. In some cases it has been found that privies, though twenty orforty feet away from a well, have yet drained into it--through a claysoil covered with gravel--and carried the germs to those drinking thewater from the well. Next to water, milk is the most prominent carrierof contagion. Milk is apt to get infected with the germs if cooled intanks of water which may receive drainage from outhouses and barns. 

TREATMENT. Scientific support has been given the treatment by cold tubbaths (70° Fahrenheit) and it is advised by many physicians. Experiencehas 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 inblankets when taken out to avoid danger of chill, and then given a warmdrink or stimulant. Treatment should be directed by an experiencedphysician to suit the symptoms. The evacuations from the bowels shouldbe thoroughly disinfected with chloride of lime or carbolic acid, thatthey may not convey the disease to others. All the sewerage and drainpipes in the house should likewise be disinfected. 

SCARLET FEVER. (SCARLATINA. )

This fever takes its name from the scarlet color of the eruption on thesurface of the body. Sometimes it is comparatively mild, and is thencalled _Scarlatina Simplex_; when it is accompanied by a sore throat, itis termed _Scarlatina Anginosa_; and when the disease is of a low, putrid type, it is called _Scarlatina Maligna. _ This disease has threedistinct stages: (1), the stage of invasion; (2), the stage of eruption;and (3), the stage of desquamation. In the first stage there is pain inthe head, increased heat of the skin, redness and soreness of thethroat, and sometimes nosebleed, diarrhea, or vomiting. The averageduration of this stage is twenty-four hours. The eruptive stagegenerally begins on the second day, though sometimes it is delayedlonger, and the scarlet rash rapidly diffuses itself over the wholebody. The redness is vivid and has been compared to the appearance of aboiled lobster. The stage of eruption reaches its maximum of intensityon the third day, and it is important that it does not recede. Rednessof the tonsils and throat is one of the early symptoms which precedesany cutaneous eruption. The tongue also is finely spotted with numerousred points which mark its papillae, presenting an appearance which hasbeen compared to that of a strawberry. 

The thirst is urgent, there is no appetite, and vomiting and milddelirium are common. This stage continues from four to six days, andsometimes longer. Desquamation (scaling off of the skin) commences atthe decline of the eruption, in the form of minute, branny scales. Theduration of this stage is indefinite, and may end in five or six or maycontinue ten or twelve days. 

If the inflammation in the throat is very severe, it may terminate in anabscess, which may also occur in the glands of the neck, and sometimesthe inflammation extends to the lips, cheeks, and eyelids. Gangrenewithin the throat occurs in rare instances. The disease is easilycommunicated, and usually develops in two to five days after exposure. It occurs most frequently in the third and fourth years of life. Thereis 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 ofthe family physician. 

Domestic treatment may be given as follows, until a physician can beobtained: Catnip, pennyroyal, or pleurisy-root tea, containing oneteaspoonful of the Extract of Smart-weed, may be given, to drive therash to the surface. Cold drinks are suitable to allay the thirst, nausea, and fever. The sick-room should be kept at a temperature ofabout 65° Fahr. , and fresh air admitted freely. The patient ought not tobe overloaded with bed-clothes; and the skin should be sponged overtwice daily with tepid water, different parts being exposedsuccessively, and carefully dried with soft cloths. Soda may be added tothe water, but no soap should be used. The diet should consist of milk, extract of beef, and soups. Injections may be employed to relieveconstipation, but purgatives should be avoided. We repeat that thisdisease is one which requires the attendance of the family physician, and great care should be exercised during recovery, that no bad resultsmay follow. 

SMALL-POX. (VARIOLA. )

Small-pox is produced by a specific poison, which is reproduced andmultiplied during the progress of the disease. It is contained in thepustules, and in the excretions and exhalations of affected individuals. It is established after a period of incubation varying from nine tothirteen days after infection. 

There are two varieties of this disease, known as _confluent_ and_distinct_ variola; in the former, the vesicles run together, in thelatter, they are separate. 

This fever has three stages. The first is that of _invasion_, distinctlymarked by a chill or a series of chills, which alternate with flushes ofheat. In this stage the tongue becomes coated, there is also nausea andvomiting, pain in the limbs, back, and particularly in the loins, thelatter symptom being of diagnostic importance. This stage continuesabout two days, and if the symptoms are light, it may be expected thatthe 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 throatand mouth may be discovered round, whitish, or ashy spots, several hoursprevious to the appearance of vesicles on the surface of the body. Theseare first seen on the face and neck, then on the trunk and upperextremities, and, lastly, on the lower extremities. The eruption atfirst appears in the form of small, red or purple spots, which changethe texture of the skin by becoming more hard, pointed, and elevated. Onthe fifth day of the eruption they attain their full size, beingsoftened 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 skinbecomes hotter, and in many cases of the confluent variety, swelling ofthe face, eyelids, and extremities occurs. Frequently there is passivedelirium in this stage, and if diarrhea sets in, it is an unfavorablesign. The duration of this stage of the eruption is four or five days. 

_The stage of desication_, or of the drying of the pustules, commencesbetween the twelfth and fourteenth day of the disease. In the confluentvariety, 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 eruptionto the surface. If there is thirst, allow cold drinks, ice-water, orlemonade. Bathing the surface with cold water, breathing plenty of freshair, using disinfectants in the room, and taking antiseptic medicineinternally, are proper. Add one part of carbolic acid to six parts ofglycerine, mix from two to three drops of this with an ounce of water, and of this preparation administer teaspoonful doses frequently. A fewdrops of carbolic acid and glycerine may be rubbed up with vaseline, andthe surface anointed with it to prevent pitting. The malady is so gravethat 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 constitutionaldisturbance, and very little or no pitting of the skin. Varioloidgenerally occurs in persons who have not been fully protected byvaccination. A person suffering from this modification of the diseasemay, 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, whoascertained that when the cow was affected by this disease and it wasthen communicated to man, the affection was rendered very mild anddevoid of danger, and at the same time it proved a very completeprotection against small-pox. Like most other valuable discoveriesintroduced to the world, it encountered bitter prejudice and the mostunfair opposition. Now its inestimable value is generally known andadmitted. 

In a few cases, in which the quality of the vaccine virus wasdeteriorated, its effect is only to slightly-modify small-pox, and thenthe disease resembles that caused by inoculation. The operation ofinfecting the blood with the _kine virus_ is called _vaccination_. Allthat 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 aprotection against small-pox. In a great majority of cases thisprotection is absolute, and only in a very few does it leave the subjectsusceptible to small-pox, materially modified. The protection it affordsagainst small-pox is found to diminish after the lapse of an indefinitenumber of years, and hence it is important to be re-vaccinated once ortwice, for instance, after an interval of five years. Between the secondand third months of infancy is the best period for vaccination, and theplace usually selected is the middle of the arm above the elbow-joint. 

CHICKEN-POX. (VARICELLA. )

Chicken-pox is an eruptive disease, which affects children, andoccasionally adults. It is attended with only slight constitutionaldisturbance, and is, therefore, neither a distressing nor dangerousaffection. The eruption first appears on the body, afterwards on theneck, the scalp, and lastly on the face. It appears on the second orthird day after the attack, and is succeeded by vesicles containing atransparent fluid. These begin to dry on the fifth, sixth, or seventhday. This disease may be distinguished from variola and varioloid by theshortness of the period of invasion, the mildness of the symptoms, andthe absence of the deep, funnel-shaped depression of the vesicles, sonoticeable in variola. 

TREATMENT. Ordinarily very little treatment is required. It is best touse 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 toone teaspoonful of the Extract of Smart-weed. If the fever runs high, afew drops of aconite in water will control it. 

MEASLES. (RUBEOLA. )

This is generally a disease of less severity and importance than theother eruptive fevers, but it is sometimes followed by seriouscomplications. The stage of invasion is marked by the symptoms of acommon cold, sneezing, watery eyes, a discharge from the nostrils, a drycough, chilliness, and headache. This stage may last four days. Thenfollows an eruption of red dots or specks, which momentarily disappearon pressure. On the fourth day of the eruption the redness of the skinfades, the fever diminishes, and the vesicles dry into scales or littleflakes. The eyes may be inflamed and the bowels may be quite lax at thisstage. 

TREATMENT. The great object in the treatment is to bring out theeruption. To effect this, sweating teas are beneficial. The free use ofthe Extract of Smart-weed is recommended, and the skin should be bathedevery day with tepid water. Sometimes when warm drinks fail to bring outthe eruption, drinking freely of cold water and keeping warmly coveredin bed, will accomplish the desired result. 

FALSE MEASLES (_Rose Rash_) is an affection of very little importanceand may be treated similarly to a case of ordinary measles. 

ERYSIPELAS. 

There are few adult persons in this country who have not, by observationor experience, become somewhat familiar with this disease. Itsmanifestations are both constitutional and local, and their intensityvaries exceedingly in different cases. The constitutional symptoms areusually the first to appear, and are of a febrile character. A distinctchill, attended by nausea and general derangement of the stomach isexperienced, followed by febrile symptoms more or less severe. There arewandering pains in the body and sometimes a passive delirium exists. Simultaneously with these symptoms the local manifestations of thedisease appear. A red spot develops on the face, the ear, or other partof the person. Its boundary is clearly marked and the affected portionslightly raised above the surrounding surface. It is characterized by aburning pain and is very sensitive to the touch. It is not necessary forthe benefit of the popular reader that we should draw a distinctionbetween the different varieties of this malady. The distinctions madeare founded chiefly upon the _depth_ to which the morbid conditionattends, 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 greatprostration, the case is very serious, and energetic means must beemployed to save life. A retrocession of the inflammation from thesurface to a vital organ is an extremely dangerous symptom. The diseaseis not regarded as contagious, but has been known to become epidemic. 

TREATMENT. The treatment during the initial stage of this disease shouldcorrespond with the general principles laid down for the treatment offever. The spirit vapor-bath, with warm, diaphoretic teas, or theCompound Extract of Smart-Weed may be given to favor sweating. The wholeperson should be frequently bathed in warm water rendered alkaline bythe addition of saleratus or soda. The bowels should be moved by a fulldose of the Purgative Pellets. Fluid extract of aconite in small andfrequent doses will best control the fever. The specific treatment, which should not be omitted, consists in administering doses of tendrops of the tincture of the muriate of iron in alternation withteaspoonful doses of the Golden Medical Discovery, every three hours. Asa local application, the inflamed surface may be covered with cloths wetin the mucilage of slippery elm. Equal parts of sweet oil and spirits ofturpentine, mixed and painted over the surface, is an application ofunsurpassed efficacy. 

DIPHTHERIA. 

This is an exceedingly grave, constitutional disease characterized by arapid breaking down of the powers of life, together with a peculiaraffection of the throat, in which a disposition to the formation offalse membranes is a prominent feature. The formation of thesemembranes, however, is not limited to the throat, but may occur onmucous surfaces elsewhere. 

CAUSE. Infection with the specific germ of the disease by contagion orinoculation. It can be carried in milk or water, and the germs canattach themselves to furniture, walls, clothing, etc. A person withchronic diphtheretic sore throat can infect children or susceptiblepersons with the disease in its most acute type by kissing. All personswith sore throat should avoid kissing--as this disease is commonlyspread in this way. 

SYMPTOMS. The symptoms vary in different cases. In some the diseasecomes on gradually, while in others it is malignant from the first. Thethroat feels sore, the neck is stiff and a sense of languor, lassitude, and exhaustion pervades the system. Sometimes a chill is experienced atthe outset. Febrile disturbance, generally of a low, typhoid character, soon manifests itself. The skin is hot; there is intense thirst; thepulse is quick and feeble, ranging from 120 to 150 per minute. Thetongue is generally loaded with a dirty coat, or it may be bright red. The odor of the breath is characteristic, and peculiarly offensive, andthere is difficulty in swallowing and sometimes in breathing. Vomitingis sometimes persistent. If we examine the throat, we find more or lessswelling of the tonsils and surrounding parts, which are generallybright red, and shining, and covered with a profuse, glairy, tenacioussecretion. Sometimes the parts are of a dusky, livid hue, and, in rareinstances, pallid. The false membrane, a peculiar tough exudation, soonappears and may be seen in patches, large or small, or covering theentire surface from the gums back as far as can be seen, its colorvarying from a whitish yellow to a gray or dark ashen tint. When it isthrown off, it sometimes leaves a foul, ulcerating surface beneath. Theprostration soon becomes extreme, and small, livid spots may appear onthe surface of the body. There may be delirium, which is, in fatalcases, 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 demandsthat the services of a skillful physician be obtained at once; and thathis efforts should be aided by the most thorough hygienic precautions, good fresh air, bathing, and a supporting diet. Prior to the arrival ofthe physician, lose no time in using plenty of good brandy or whiskey tooffset the extremely weakening effect of the disease. The employment ofalcoholic stimulation in this disease is almost always used byphysicians. Control the vomiting and allay the thirst by allowing thepatient to suck small pieces of ice every five or ten minutes. Hotfomentations or spirits of turpentine should be applied to the throat. If the physician does not take charge of the patient by this time, theuse of permanganate of potash, triturated, in strength of one grain tothe ounce, in a mixture of fine sugar of milk and gum acacia, and blownover the parts with an insufflater every few hours, brings the bestresults if thoroughly carried out; or the throat can be swabbed out withthe following mixture: chlorate of potash, four drachms; tincture ofmuriate of iron, three drachms, syrup of orange, two ounces; watersufficient 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 thestrength must be supported by the most nourishing diet, as well as bytonics and stimulants. Beef tea, milk, milk punch, and brandy should befreely administered. A competent physician should be called in as earlyas possible. The general results of the treatment with antitoxin, ifgiven on the first, second or third day of the disease, are usuallyfavorable. There are rarely any immediately bad results from theinjections, and the published testimony of careful observers would tendto prove that recovery has followed its use in a larger percentage ofcases than under former methods of treatment. 

QUINSY. (TONSILLITIS. )

This is an acute inflammation of the tonsils, which generally extendsto, and involves adjacent strictures, and is attended with generalfebrile disturbance. Its duration varies from four to twenty days. Itsometimes terminates by a gradual return to health (resolution); or bythe formation of "matter" within the gland (suppuration. ) When thislatter is the case, the swelling sometimes becomes so great before itbreaks as to require lancing. 

CAUSES. It most frequently results from a cold. In some persons there isa predisposition to it, and the individual is liable to recurringattacks. Persons of a scrofulous diathesis are more liable to it thanothers. 

SYMPTOMS. Difficulty of swallowing, soreness, and stiffness of thethroat, are the first monitions of its approach. There is fever, quick, full pulse, and dryness of the skin; the tongue is furred, and thebreath offensive. The tonsils are intensely red, swollen, and painful, the pain often extending to the ear. Sometimes but one tonsil isaffected, though generally both are involved. In severe cases thepatient cannot lie down, in consequence of the difficulty of breathing. 

TREATMENT. In the early stage of the disease, the spirit vapor-bath isinvaluable. The sweating which it produces should be kept up by the useof the Compound Extract of Smart-weed in some diaphoretic infusion. Hotwet-packs to the throat, covered with dry cloths, are useful. Theinhalation of the hot vapor of water or vinegar, or peppermint andwater, is beneficial. A carthartic should be given at night. When thedisease does not show a disposition to yield to this treatment, theservices of a physician should be obtained. When pus, or "matter, " isformed in the tonsil, which may be known by the increased swelling andthe appearance of a yellowish spot, the services of a physician will berequired to lance it. 

ENLARGED TONSILS. 

[Illustration: Fig. 147. _A A. _--Enlarged Tonsils. B. --ElongatedUvula. ]

Chronic enlargement of the tonsils, as shown in Fig. 147, _A A_, is anexceedingly common affection. It is most common to those of a scrofuloushabit. It rarely makes its appearance after the thirtieth year, unlessit has existed in earlier life, and has been imperfectly cured. Bothtonsils are generally, though unequally enlarged. A person affected withthis disease is extremely liable to sore throat, and contracts it on theslightest exposure; the contraction of a cold, suppression ofperspiration, or derangement of the digestive apparatus being sufficientto provoke inflammation. 

CAUSES. Repeated attacks of quinsy, scarlet fever, diphtheria, orscrofula, and general impairment of the system, predispose theindividual to this disease. 

SYMPTOMS. The voice is often husky, nasal or guttural, and disagreeable. When the patient sleeps, a low moaning is heard, accompanied withsnoring and stentorian breathing, and the head is thrown back so as tobring the mouth on a line with the windpipe, and thus facilitate theingress of air into the lungs. When the affection becomes serious, itinterferes with breathing and swallowing. The chest is liable to becomeflattened in front and arched behind, in consequence of the difficultyof respiration, thus predisposing the patient to pulmonary disease. Onlooking into the throat, the enlarged tonsils may be seen, as in thefigure. Sometimes they are so greatly increased in size that they toucheach other. 

TREATMENT. The indications to be carried out in the cure of this maladyare:

(1. ) To remedy the constitutional derangement. 

(2. ) To remove the enlargement of the tonsil glands. 

The successful fulfillment of the first indication may be readilyaccomplished by attention to hygiene, diet, clothing, and the use of theGolden Medical Discovery, together with small daily doses of thePleasant Purgative Pellets. This treatment should be persevered in for aconsiderable length of time after the enlargement has disappeared, toprevent 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 ofpotash, four drachms; pure, soft water, two ounces. Apply thispreparation to the enlarged tonsils twice a day, with a probang, or softswab, being careful to paint them each time. A persevering use of theseremedies, both internal and local, is necessary to reduce and restorethe parts to a healthy condition. 

Sometimes the enlarged tonsils undergo calcareous degeneration; in thiscase, nothing but their removal by a surgical operation is effectual. This can be readily accomplished by any competent surgeon. We haveoperated in a large number of cases, and have never met with anyunfavorable results. 

ELONGATION OF THE UVULA. 

Chronic enlargement or elongation of the uvula, or palate, as shown atB, Fig. 147, may arise from the same causes as enlargement of thetonsils. It subjects the individual to a great deal of annoyance bydropping into and irritating the throat. It causes tickling and frequentdesire to clear the throat, change, weakness, or entire loss of voice, and difficulty of breathing, frequently giving rise to the mostpersistent and aggravating cough. 

TREATMENT. The treatment already laid down for enlarged tonsils, withwhich affection, elongation of the uvula is so often associated, isgenerally effectual. When it has existed for a long time and does notyield 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 signof debility. A copious hemorrhage, in consequence of a cut, or otherserious injury, will lessen the quantity of blood and may produceanæmia. After sudden blood-letting, the volume of the circulation isquickly restored by absorption of fluid, but the red corpuscles cannotbe so readily replaced, so that the blood is poorer by being morewatery. This is only one way in which the blood is impoverished. 

The blood may be exhausted by a drain upon the system, in consequence ofhard and prolonged study. Severe mental employment consumes the redcorpuscles, leaving the blood thin, the skin cool and pale, and theextremities moist and cold. 

Anæmia may arise from lack of exercise, or it may be occasioned bymental depression, anxiety, disappointment, trouble, acute excitement ofthe emotions or passions, spinal irritation; in fact, there are manyspecial relations existing between the red corpuscles of the blood andthe various states of the mind and the nervous system. The latterdepends directly upon the health and quantity of these red corpusclesfor its ability to execute its functions. 

Anæmia may arise in consequence of low diet, or because the alimentaryorgans do not properly digest the food, or when there is not sufficientvariety in the diet. No matter how anæmia is occasioned, whether bylabor and expenditure, by hemorrhages, lead poisoning, prolongedexposure to miasmatic influences, deprivation of food, indigestion, imperfect assimilation, frequent child-bearing, or lactation, the numberof 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 respirationon slight exercise, swelling or puffiness of the eyes, and a murmur ofthe heart, resembling the sound of a bellows. 

This disorder of the blood tends to develop low inflammation, dropsicaleffusion, tubercular deposits, Bright's disease, derangements of theliver, diarrhea, leucorrhea, and is a precursor of low, protractedfevers. This condition of the blood predisposes to the development ofother affections, providing they are in existence, and often it is foundassociated 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, byregulating the exercise and clothing entertaining the mind, andfurnishing plenty of pure air. 

(3. ) Prescribe such a nutritious diet as will agree with the enfeebledcondition 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 ofquinine 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, manualfriction, rubbing the surface of the body lightly and briskly with thewarm, dry hand, which greatly stimulates the circulation of the blood. Anæmia occurs more frequently in the female than in the male, becauseher functions and duties are more likely to give rise to it. 

APNOEA. 

Apnoea, or short, hurried, difficult respiration, is occasioned bycertain conditions of the blood. When anything interferes with theabsorption of oxygen, or the elimination of carbonic acid, the blood isnot changed from venous to arterial, and becomes incapable of sustaininglife. This morbid condition is termed _asphyxia_. We often read ofpersons going into wells where there are noxious gases, or remaining ina close room where there are live coals generating carbonic acid gas andthus becoming asphyxiated, dying for want of oxygen. 

Deficiency of oxygen is the cause of apnoea, and sometimes the redcorpuscles themselves are so few, worn out, or destroyed, that theycannot carry sufficient oxygen, and the consequence is that the patientbecomes short of breath, and when a fatal degeneration of the corpusclesensues, he dies of asphyxia. Many a child grows thin and wan andcontinues to waste away, the parents little dreaming that the slowconsumption of the red corpuscles of the blood is the cause which isundermining the health. Sometimes this disease is the result ofstarvation, irregular feeding, improper diet, want of care, and, atother times, want of fresh air, proper exercise, and sunlight. 

TREATMENT. The first essential to success in the treatment of thisdisease, is the removal of the exciting cause. Exercise in the outdoorair and sunlight, with good, nutritious food, and well-ventilatedsleeping apartments, are of the greatest importance. The bitter tonics, as hydrastin, with pyrophosphate of iron, should be employed to enrichthe blood and build up the strength. 

LEUCOCYTHÆMIA. 

This term is used to designate a condition in which there is an excessof colorless blood-corpuscles. In health, the colorless corpusclesshould exist only in the proportion of one, to one or two hundred of thered corpuscles. These colorless corpuscles increase when there isdisease of the lymphatic glands, but whether this is the cause of theirincrease or perversion is not known. 

They have been found abundant in the blood in diseases of the spleen andof the liver. Diarrhea usually attends this complaint, together withdifficult breathing, loss of strength, gradual decline, fever, diminution of vital forces, and finally death. The recovery of awell-marked case of this disease is very doubtful. Its average durationis about one year. 

DROPSIES. 

_Transudation_ is the passage of fluid through the tissue of any part ofthe body without changing its liquid state, while _exudation_ means, medically, the passage of matter which coagulates and gives rise tosolid deposits. When transudations are unhealthy, they may accumulate inserous cavities or in cellular structures, and constitute _dropsy_. Exudation is the result of inflammation, and the product effusedcoagulates and becomes the seat of a new growth of tissue. Exosmosismeans the passage of fluid from within outward, and is a processconstantly taking place in health; while transudation takes placebecause the blood is watery and the tissues are feeble and permeable, permitting the serum and watery elements of the blood to pass intocertain cavities, where they accumulate. 

The cause of dropsies may be low diet, insufficient exercise, indigestion, hemorrhages, wasting diseases, in fact, any thing whichimpoverishes the blood and increases the relative amount of serum. Thetardy 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 bybloating or puffiness of the skin all over the body. This condition isalso called _oedema_. The skin is pale, yields under the finger withoutpain, and preserves the impression for some time. The oedema usuallyappears first in the lower extremities, next in the face, and fromthence extends over the body. 

General dropsy is commonly due to an impoverished condition of theblood, and this may be the result of _albuminuria_, a disease of thekidneys. Albuminuria is frequently the sequel of scarlatina. Hence, theutmost care should be taken against exposure of a patient recoveringfrom scarlatina, and the same caution should be exercised duringconvalescence from measles, erysipelas, and rheumatism. Dropsies may begeneral, as in anasarca, or local, as dropsy of the heart, called_cardiac_ dropsy: dropsy of the peritoneum, the serous membrane whichlines the abdominal cavity, called _ascites_; dropsy of the chest, called _hydrothorax_; dropsy of the head, called _hydrocephalus_; dropsyof the scrotum, called _hydrocele_. 

Dropsy is not, therefore, of itself a disease, but only the symptom of amorbid condition of the blood, kidneys, liver, or heart. Thus disease ofthe valves of the heart, may obstruct the free flow of blood and thusretard its circulution. In consequence the pulse grows small and weak, and the patient cannot exercise or labor as usual, and finally the lowerlimbs begin to swell, then the face and body, the skin looks dusky, theappetite is impaired, the kidneys become diseased, there is difficultyin breathing, and the patient, it is said, dies of dropsy, yet dropsywas the result of a disease of the heart, which retarded the circulationand enfeebled the system, and which was actually the primary cause ofdeath. 

TREATMENT. Dropsy being only a symptom of various morbid conditionsexisting in the system, any treatment to be radically beneficial must, therefore, have reference to the diseased conditions upon which thedropsical effusion, in each individual case, depends. These are sovarious, and frequently so obscure, as to require the best diagnosticskill possessed by the experienced specialist, to detect them. Thereare, however, a few general principles which are applicable to thetreatment of nearly all cases of dropsy. Nutritious diet, frequentalkaline baths to keep the skin in good condition and favor excretionthrough its pores, and a general hygienic regulation of the dailyhabits, are of the greatest importance. There are also a few generalremedies which may prove more or less beneficial in nearly all cases. Werefer to diuretics and hydragogue cathartics. The object sought in theadministration of these is the evacuation of the accumulated fluidsthrough the kidneys and bowels, thus giving relief. Of the diuretics, queen of the meadow, buchu, and digitalis generally operate well. As acathartic, the Purgative Pellets accompanied with a teaspoonful or twoof cream of tartar, will prove serviceable. Beyond these generalprinciples of treatment it would be useless for us to attempt to advisethe invalid suffering from any one of the many forms of dropsy. Thespecialist skilled by large experience in detecting the exact morbidcondition which causes the watery effusion and accumulation, can selecthis remedies to meet the peculiar indications presented by eachindividual case. Sometimes the removal of the watery accumulation bytapping becomes necessary, in order to afford relief and give time forremedies to act. We have found it necessary to perform this operationvery frequently in cases of _hydrocele_, and also quite often in casesof abdominal dropsy. The chest has also been tapped and considerablequantities of fluids drawn off, and this has been followed by promptimprovement 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 ormanifestations in fibrous tissues. This term has been applied toneuralgic affections and to _gout_, but it differs from each in severalessential particulars. Rheumatism may be divided into (1) _Acute_, (2)_Chronic_, (3) _Muscular_. 

ACUTE ARTICULAR RHEUMATISM. Acute articular rheumatism implies anaffection of the articulations or joints. It usually commences suddenly;sometimes pain or soreness in the joints precedes the disclosure of thedisease. The symptoms are pain in the joints, tenderness, increasedheat, swelling and redness of the skin. The pain varies in its intensityin different oases, and is increased by the movement of the affectedparts. Swelling of the joints occurs, especially those of the knee, ankle, wrist, elbow, and the smaller joints of the hands and feet. Theswelling and redness are generally in proportion to the acuteness of theattack. Acute articular rheumatism is always accompanied with more orless fever. Sweating is generally a prominent symptom, being stronglyacid and more profuse during the night. The appetite is impaired, thetongue is coated, the bowels are constipated, or there is diarrhea. 

THE DURATION OF THIS DISEASE. Unlike fevers, its course is marked byfluctuations; frequently after a few days the pain subsides, the feverdisappears, 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 asuppression of the functions of the skin, and is generally attributed tothe action of cold upon the surface of the body. But this acts only asan exciting cause. It is a disease of the blood. This form of rheumatismusually occurs between the age of fifteen and thirty, and prevails mostextensively in changeable climates. Acute articular rheumatism seldomterminates in the chronic form. 

CHRONIC ARTICULAR RHEUMATISM. Articular rheumatism, in the subacute orchronic form, is frequently observed in medical practice. The symptomsare pain and more or less swelling of the joints, although not of asgrave a character as in acute rheumatism. There is frequently an absenceof increased heat and redness. As in the acute form, the differentjoints are liable to be affected successively and irregularly, until, after a time, the disease becomes fixed in a single joint, and thefibrous tissues entering into the ligaments and tendons are liable to beaffected. The appetite, digestion, and nutrition are often good, and, inmild cases, patients are able to pursue their daily vocations. Thedisease is supposed to be the same as in the acute form, but milder, and, strange to say, more persistent. A diseased condition of the bloodis supposed to be involved in both instances, but this morbid state isless extended, and, at the same time, more obstinate in the chronic thanin the acute form. Sub-acute articular rheumatism is not always chronic, and may disappear in a shorter time than in the acute form. Chronicarticular rheumatism is not generally fatal, but there is danger ofpermanent deformities. 

MUSCULAR RHEUMATISM. This affection is closely allied to _neuralgia_, and may properly be called _myalgia_. It exists under two forms, acuteand chronic. In acute muscular rheumatism, there is at first a dull painin the muscles, which gradually increases. When the affected muscles arenot used the pain is slight, and certain positions may be assumedwithout inducing it constantly; but in movements which involvecontraction of the muscles the pain is very violent. In some cases, thedisease is movable, changing from one muscle to another, but usually itremains fixed in the muscle first attacked. The appetite and digestionare not often impaired, and there is no fever. The duration of this formof rheumatism varies from a few hours to a week or more. 

In subacute or chronic muscular rheumatism, pain is excited only whenthe affected muscles are contracted with unusual force, and then it issimilar to that experienced in the acute form. The chronic form is moreapt to change its position than the acute. The duration of this form isindefinite. In both the acute and chronic forms some particular parts ofthe body are more subject to the affection than others. 

The muscles on the posterior part of the _neck_ are subject to rheumaticaffection. It is termed _torticollis_ or _cervical_ rheumatism in suchcases, and should be distinguished from ordinary neuralgia. When themuscles of the loins are affected, it is commonly known as _lumbago_. Incase the thoracic muscles are affected, it is known as _pleurodynia_. Incoughing, sneezing, and the like, the pain produced is not unlike thatin pleuritis and intercostal neuralgia. 

One of the most marked features of muscular rheumatism, is thecramp-like pain, induced by the movements of the affected muscles, whereas the pain is slight when those muscles are uncontracted. Thisfeature is very serviceable in distinguishing muscular rheumatism, ormyalgia, from neuralgic affections. Another trait which distinguishesmuscular rheumatism from neuralgia, is that the former is characterizedby great soreness, while the latter is not. There is also a distinctionbetween inflammation of the muscles and muscular rheumatism. In the caseof the former, there is continued pain, swelling of the parts, occasional redness, and the presence of more or less fever, whichconditions do not exist in the latter. Persons subject to rheumatism ofthe muscles, are apt to suffer from an attack, after exposure of thebody to a draught of air during sleep, or when in a state ofperspiration. 

TREATMENT OF ACUTE RHEUMATISM. Administer the spirit vapor-bath toproduce free perspiration, which should be maintained by full doses ofthe Compound Extract of Smart-weed. The anodyne properties of the latteralso prove very valuable in allaying the pain. Tincture or fluid extractof aconite root may also be employed, to assist in equalizing thecirculation, and also to secure its anodyne action. Black cohosh seemsto exert a specific and salutary influence in this disease, and thetincture or fluid extract of the root of this plant may beadvantageously combined with the aconite. Take fluid extract ofaconite-root, thirty drops; fluid extract of black cohosh, one drachm;water, fifteen teaspoonfuls; mix. The dose is one teaspoonful everyhour. The whole person should be frequently bathed with warm water, rendered alkaline by the addition of saleratus or soda. The painfuljoints may be packed with wool or with cloths wrung from the hotsaleratus water, and the patient kept warm and quiet in bed. The acetateof potash taken in doses of five grains, well diluted with water, everythree or four hours, is very valuable in acute rheumatism. Its alkalinequalities tend to neutralize the acid condition of the fluids of thesystem, and it also possesses diuretic properties which act upon thekidneys, removing the offending blood-poison from the system throughthese organs. If the joints are very painful, cloths wet with theCompound Extract of Smart-weed and applied to them, and covered with hotfomentations, very frequently relieve the suffering. The majority ofcases yield quite promptly to the course of treatment already advised, if it is persevered in. The disease, however, sometimes proves obstinateand resists for many days the best treatment yet known to the medicalprofession. 

TREATMENT OF CHRONIC RHEUMATISM. The general alkaline baths recommendedin the acute affection are also valuable in the chronic. The spiritvapor-bath, the Turkish, as well as the sulphur vapor-bath, are allworthy of a trial in this obstinate and painful disease. Alternativesare a very valuable class of agents in chronic rheumatism. The followingmixture, in teaspoonful doses three times a day, in alternation with theGolden 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 withthe use of alkaline and vapor-baths, will generally prove verysuccessful. The specialist, however, dealing with chronic diseasesexclusively, will occasionally meet with a case which has been therounds of the home physicians without benefit, that will tax his skilland require the exercise of all his perceptive faculties to determinethe exact condition of the patient's system, upon which the obstinacy ofthe disease depends. When this is ascertained, the remedies willnaturally suggest themselves, and the malady will generally yield tothem. But, although the treatment of this disease has entered largelyinto our practice at the Invalid's Hotel, and has been attended by themost happy results, yet the cases have presented so great a diversity ofabnormal features, and have required so many variations in the course oftreatment, to be met successfully, that we frankly acknowledge ourinability to so instruct the unprofessional reader as to enable him todetect the various systemic faults common to this ever-varying disease, and adjust remedies to them, so as to make the treatment uniformlysuccessful. If the several plans of treatment which we have given do notconquer the disease, we can not better advise the invalid than torecommend him to employ a physician of well-known skill in the treatmentof chronic diseases. If such a one is not accessible for personalconsultation, a careful statement of all the prominent symptoms, inwriting, may be forwarded to a specialist of large experience in thisdisease, who will readily detect the real fault, in which the ailmenthas its foundation. Particularly easy will it be for him to do so, if hebe an expert in the analysis of urine. A vial of that which is firstpassed in the morning, should be sent with the history of the case, aschronic rheumatism effects characteristic changes in this excretion, which clearly and unmistakably indicate the abnormal condition of thefluids of the body upon which the disease depends. 

 * * * * *

DISEASES OF THE SKIN. 

ECZEMATOUS AFFECTIONS. 

Eczematous affections constitute a very important class of skindiseases, the prominent characteristics of which are _eruption_ and_itching_. They are progressive in character, passing through all thesuccessive stages of development, from mere redness of the skin todesquamation, or thickening of the cuticle. The affections belonging tothis group are _eczema, psoriasis, pityriasis, lichen, impetigo, guttarosacea, _ and _scabies_, or _itch_. A careful examination of each ofthese 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 skindiseases. 

In this disease, the minute blood-vessels are congested causing the skinto be more vascular and redder than in its natural state. There is anitching or smarting in the affected parts. The skin is raised in theform of little pimples or vesicles, and a watery lymph exudes. Sometimesthe skin becomes detached and is replaced by a crust of hardened lymph, or it may be partially reproduced, forming _squamæ_, or scales. Thereare three stages of this disease; the inflammatory, accompanied byswelling, and the formation of pimples or vesicles; that of exudation, which is succeeded by incrustation; and that of desquamation, in whichthe 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 theirpredominating characteristics. Thus, when pimples or vesicles areabundant, it is termed, respectively, _eczema papulosum_ and _eczemavesiculosum, _ a fine illustration of which may be seen in Colored PlateI, Fig. 1. Again, when characterized by the eruption of pustules, it istermed _eczema pustulosum_, a representation of which may be seen inPlate I, Fig. 2; and, when the prominent feature is the formation ofscales, it is termed _eczema squamosum_. 

Eczema may be general or partial; in other words, the eruption mayappear 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 maygradually 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 severestform and eventually become chronic. The muscles are soft, the eyes aredull and expressionless, and the little sufferer experiences the mostexcruciating torments. Frequently the whole body is covered with patchesof 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 toconstitutional debility, of which eczema is the result. The _signs_ ofeczema are redness, heat, an itching or smarting sensation, theformation of pimples or vesicles, exudation, incrustation, theseparation of the cuticle into scales and a gradual thickening of theskin. 

CAUSES. Three forms of constitutional derangement predispose the systemto eczema; nutritive, assimilative, and nervous debility. In the former, there is a diminution of nutritive power, so that the patient becomesweak and emaciated. Assimilative debility is indicated by an impaireddigestion and a consequent suppression, or an abnormal state of thesecretions. Eczema occasioned by nervous debility, is accompanied by allthe morbid conditions incident to irritation and exhaustion of thenervous system. Eczema may be excited by a violation of the rules ofhygiene, 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_. Thetransition of the last stage of eczema into psoriasis is indicated by atendency of the inflamed, thickened, scaly skin to become moist whenrubbed. It usually appears in patches on various portions of the body. The skin is parched and highly discolored. The hairs are harsh andscanty. The patient is constantly tormented by an unbearable itchingsensation and, if the skin is rubbed, it exudes a viscous or stickyfluid. These are the characteristic signs of psoriasis. It generallyappears on the flexures, folds and crooks of the joints, the backs andpalms of the hands, the arms, and the lower portions of the legs. 

PITYRIASIS. (_Branny Tetter_, or _Dandruff_. ) This affection is a mildform of psoriasis, from which it may be distinguished by a moresuperficial congestion or inflammation of the affected parts, theabsence of swelling, and the formation of smaller scales, having theform and appearance of _fine bran_. It generally appears on the scalp, sometimes extends over the face, and, in rare instances, affects theentire surface of the body. The signs peculiar to this disease areslight inflammation, itching, and the formation of minute scales. 

CAUSES. Pityriasis is caused by nutritive debility, and is oftenassociated with erysipelas, rheumatism, and bronchitis. 

LICHEN. (_Papular Rash_. ) Lichen is a term used to designate an eruptionof minute conical pimples, which are more or less transparent, red, andoccasion 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 quantityof blood and serum. This disease more frequently occurs between the agesof twelve and fifty, but occasionally appears during dentition, when itis called "tooth rash. " The lichen pimples are sometimes dispersedsingly over the skin and gradually subside, forming a minute scale, corresponding in position with the summit of the pimple. When thepimples appear in clusters, there is a diffused redness in the affectedpart, and, if they are irritated, minute scabs will be formed. Lichengenerally 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 indicatedby the appearance of minute pimples, which, when the distribution isgeneral, are arranged like the blotches of measles. Sometimes theeruption 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 minutescales, which are detached and thrown off; but a new crop of pimplessoon 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_, andis characterized by a circular arrangement of the pimples. Thecircumference which marks the limit of the patch is sharply defined. This form of lichen usually appears on the chest, hips, or limbs, and isnot unfrequently mistaken for ringworm. 

_Lichen strophulosus_ is a variety peculiar to infants. Dermatologistsrecognize several subdivisions of this species, but the generalcharacteristics are the same in all. The pimples are much larger than inthe other forms of lichen, of a vivid red color and the duration of theeruption is limited to two or three weeks. 

_Lichen urticatus_ is also an infantile affection and begins withinflammation, which is soon succeeded by the eruption. In a few days thepimples shrink, the redness disappears, and the skin has a peculiarbleached appearance. The eruption is attended by an intense itchingsensation and, if the skin is ruptured, a small quantity of blood isdischarged and a black scab formed. This variety of lichen is veryobstinate and of long duration. 

_Lichen tropicus_, popularly known as _prickly heat_, is an affectionwhich attacks Europeans in hot climates. It is characterized by theappearance of numerous red pimples of an irregular form, distributedover those portions of the body usually covered by the clothing. It isattended with a fierce, burning, itching sensation, which is aggravatedby warm drinks, friction of the clothing, and the heat of the bed. Theeruption indicates a healthy condition of the system; its suppression orretrocession is an unfavorable symptom, denoting some internal affectionsuch 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 aresolitary and have an angular base, and the fresh pimples formed appearon the spaces between the former eruptions. This affection usuallyattacks some particular region, such as the abdomen, hips, or chest. Instances are recorded in which it has appeared on the tongue and thelining membrane of the mouth. Sometimes it appears in patches, but eventhen, the margin of each pimple can be discerned. 

_Lichen pilaris_ and _lividus_ are modifications of lichen simplex, theformer being so named to describe the location of the pimples, _i. E. _, surrounding the minute hairs which cover the body, especially the lowerlimbs. The term _lichen lividus_ indicates the dark purplish hue causedby a torpid circulation and the consequent change of arterial intovenous blood before leaving the pimples. _Lichen circinatus_ is amodified form of _lichen circumspectus_. The pimples in the center ofthe circular patch subside and a ring is formed which graduallyincreases in size. When the rings become broken or extend in regularforms, 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 afatal disease, yet it tends to reduce the vitality of the system. 

IMPETIGO. (_Crusted Tetter_ or _Scall_. ) Impetigo is a term applied toan inflammation of the skin, more severe and energetic in its characterthan the preceding affection. We have found the predominatingcharacteristics of eczema and lichen to be the presence of exudation inthe former, and the absence of it in the latter. 

Impetigo is marked by the formation of yellow pus, which raises thecuticle into pustules. There is a slight swelling, redness, and the pusgradually dries up, forming an amber-colored crust, a representation ofwhich is given in Colored Plate I, Fig. 5. It soon falls, leaving theskin slightly inflammed, but with no scar. The pustules are sometimessurrounded by a cluster of smaller ones. 

The varieties of impetigo are designated according to the distributionof the pustules. _Impetigo figurata_, is characterized by the appearanceof large clusters upon an inflamed and swollen surface, generally uponthe face, but sometimes upon the scalp. This form is represented inColored Plate I, Fig. 4. In _impetigo sparsa_ the pustules are scatteredover the whole body. 

CAUSES. The predisposing cause of impetigo is nutritive debility, andthe exciting causes are irritation, impure air, and errors of diet. 

GUTTA ROSACEA is a _progressive_ disease, and its successive stages ofdevelopment mark the several varieties, such as _gutta rosacea, erythematosa, papulosa, tuberculosa, pustulosa_, according as they arecharacterized by redness, pimples, tubercles, or pustules. Thisaffection is attended with heat, itching, and throbbing. The pustulescontain serous lymph, which exudes if the cuticle be broken, and forms acrust at the summit of the pustule. 

This eruption often appears on the face of persons addicted tointemperate habits, and has thus received the name of "_rum blossom_. "

CAUSE. It is essentially a chronic affection, and depends uponconstitutional causes. 

SCABIES. (_Itch_. ) This disease is characterized by a profuse scalinessof the skin, by an eruption of pimples, vesicles, and, in rareinstances, of pustules. Its prominent feature is an intense itching, soaggravating that, in many instances, the skin is torn by the nails. Unlike other diseases of the skin, it is not due to inflammation, but iscaused 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 arecomparatively few in number, and contain a transparent fluid. Thepustules are only present in the severest forms or when the skin is verythin and tender. It is then termed _pustular itch_. 

The parts usually affected are the hands, flexures of the joints, andthe genital organs. Cases are recorded, in which scabies appeared uponthe face and head, but they are of rare occurrence. The activity of theanimalculæ, is modified by the vitality of the victim. In persons of avigorous constitution, they will rapidly multiply, and, in a few daysafter their first appearance, will be found in almost every part of thebody. 

Scabies is not confined to any age or sex, but chiefly affects personsof filthy habits. This disease can only be communicated by contact, orby articles of clothing worn by an infected person. There are certainindications which predispose the system to infection, such as robusthealth, a hot climate, and uncleanliness. 

TREATMENT. In all the varieties of eczematous affections, exceptscabies, the treatment of which will hereafter be separately considered, remedies employed with a view to the removal of the constitutional faultare of the greatest importance. The eruption upon the skin is but alocal manifestation of a functional fault, which must be overcome byalterative remedies. All the excretory organs should be kept active. Toopen the bowels, administer a full cathartic dose of Dr. Pierce'sPleasant Pellets. Afterwards they should be used in broken doses of oneor two daily, in order to obtain their peculiar _alterative_ effects. The use of Dr. Pierce's Golden Medical Discovery is also necessary tosecure its constitutional remedial benefits. As a local corrective torelieve the itching and disagreeable dryness of the skin, add half anounce of blood-root to half a pint of vinegar, steep moderately for twohours, strain and paint the affected parts once or twice daily with theliquid. Every night before retiring, apply glycerine freely to all theaffected parts, or dissolve one drachm of oxalic acid in four ounces ofglycerine and anoint the skin freely. The white precipitate ointment, obtainable at any drug store, is an excellent application is most formsof eczema. A tea, or infusion, of black walnut leaves, applied as alotion to the affected parts, has also proved beneficial. The surface ofthe body should be kept clean by frequent bathing, and thus stimulatingits capillary vessels to healthy activity. The eczematous surfacesshould not be bathed frequently, and never with harsh or irritatingsoaps. All varieties of eczematous affections, except scabies, are onlytemporarily relieved by external applications, while the _radical cure_depends upon a protracted use of alterative, or blood-cleansingmedicines. Therefore, we would again remind the reader of the necessityof keeping the bowels regular, and removing all morbid taints of theblood and faults of the secretory organs by the persistent use of Dr. Pierce's Golden Medical Discovery. _The successful treatment ofscabies_, or common itch, generally requires only local applications, for the object to be obtained is simply the destruction of the littleinsects which cause the eruption. Happily, we possess an _unfailingspecific_ for this purpose. Numerous agents have been employed withsuccess, 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 vaselineor lard to form an ointment. Having first divested the body of clothing, anoint it all over freely, and rub the ointment thoroughly into thepores of the skin while standing before a hot fire. The applicationshould be made at night before retiring, and the patient should wearwoolen night-clothes or lie between woolen blankets. In the morningafter the application, the patient should take a warm bath, washing theskin thoroughly and using _plenty of soap_. This treatment should berepeated two or three times to be _certain_ of a _perfect eradication_of the disease. After this course of treatment, the wearing apparel aswell as the bed-clothes should be thoroughly cleansed, as a precautionagainst a return of the disease. 

 * * * * *

ERYTHEMATOUS AFFECTIONS. 

The prominent features, eruption, and itching of _eczematous_ affectionsare purely local. _Erythematous_ affections are, however, remarkable fortheir symptoms of constitutional disorder. Each of these affections ispreceded 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 thesystem. This group includes _erythema, erysipelas_, and _urticaria_. 

ERYTHEMA. A vivid and partial flushing of the face is produced by asuperficial inflammation of the skin, termed _erythema_. There are manystages of this disease, from the instantaneous transient flush caused byemotional excitement, to the protracted inflammation and swelling of_erythema nodosum_. 

The affection is characterized by a flush which is at first a brightvivid scarlet, but which changes to a deep purplish tint. There is aslight elevation of the skin, sometimes accompanied by itching. In thesecond stage of development, the flush subsides, the skin has ayellowish or bruised appearance, and a few minute scales are formed. In_erythema papulosum_, a fine representation of which is given in ColoredPlate III, Fig. 18, there is an eruption of red pimples or pustules. Theprominent feature of _erythema nodosum_, a variety of erythema whichaffects those portions of the skin exposed to the sun, is the appearanceof a large swelling, usually lasting four or five days and attended byconstitutional symptoms, such as nausea, fever, languor, anddespondency. The disease is associated with the symptoms incident to adisordered 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, byobservation or experience, become somewhat familiar with this disease. Its manifestations are both constitutional and local, and theirintensity varies exceedingly in different cases. The constitutionalsymptoms are usually the first to appear, and are of a febrilecharacter. A distinct chill, attended by nausea and general derangementof the stomach is experienced, followed by febrile symptoms more or lesssevere. There are wandering pains in the body and sometimes a passivedelirium exists. Simultaneously with these symptoms the localmanifestations of the disease appear. A red spot develops on the facethe ear, or other part of the person. Its boundary is clearly marked andthe affected portion slightly raised above the surrounding surface. Itis characterized by a burning pain and is very sensitive to the touch. It is not necessary for the information of the general reader that weshould draw a distinction between the different varieties of thismalady. The distinctions made are founded chiefly upon the _depth_ towhich 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 greatprostration, the case is very serious, and energetic means should beemployed to save life. A retrocession of the inflammation from thesurface to a vital organ is an extremely dangerous symptom. 

The disease is not regarded as contagious, but has been known to becomeepidemic. 

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 ofpustules, or white blotches of various forms. A representation of thiseruption is given in Colored Plate III, Fig. 17. It is appropriatelynamed nettle-rash, from its resemblance to the irritation caused by thesting of a nettle. There is the same sharp, tingling sensation and asimilar white wheal or blotch, caused by the muscular spasm of thecorium, a layer of the skin. 

Urticaria may be either acute or chronic. Acute urticaria is alwayspreceded by febrile symptoms and the attack is indicated by a suddencongestion of the skin, followed by a slight swelling or elevation ofthe affected part. When the congestion subsides, the skin has a bruisedappearance. 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. Thepredisposing causes are conceded to be assimilative and nervousdebility. Hence, it frequently accompanies purpura or land scurvy andrheumatism. The skin in some persons is so susceptible to irritationthat urticaria can be kindled at any moment by excitement, as ananimated conversation, or by the simple pressure of the hand. 

TREATMENT. The proper treatment for simple erythema consists in applyingto the affected parts a little lime-water, or sweet-oil, or glycerine, with the use of warm baths and mild cathartics. This is generallysufficient to effect a cure, if followed up with the persistent use ofDr. 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 favorsweating. The whole person should be frequently bathed with warm waterrendered alkaline by the addition of saleratus or soda. The whole shouldbe moved by a full dose of the "Pleasant Pellets. " Fluid extract ofveratrum viride, in doses of a drop or two every hour will best controlthe fever. The specific treatment, that which antidotes the poison inthe blood, consists in administering fifteen-drop doses of the tinctureof the muriate of iron in one teaspoonful of the "Golden MedicalDiscovery, " every three hours. As a local application, the inflamedsurface 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 insufficient doses to move the bowels, the skin bathed with warm waterrendered alkaline by the addition of common baking soda or saleratus, and, if there be any febrile symptoms, a little tincture of aconite orveratrum may be administered in one drop doses once each hour. In thechronic form of the disease, the diet should be light, unstimulating, and easily digested, the skin kept clean by frequent bathing, and freshair and outdoor exercises freely taken. The somewhat protracted use ofDr. Pierce's Golden Medical Discovery will result in the greatestbenefit in this form of disease. 

BULLOUS AFFECTIONS. 

The distinguishing feature of this group of cutaneous affections is theformation of _bullæ_, or blebs, which are defined as "eminences of thecuticle, containing a fluid. "

HERPES is an inflammation of the skin in which the eruption appears inpatches of a circular form. On the second day, minute, transparentvesicles appear and gradually develop, becoming opalescent. On thesucceeding days, they shrink and produce reddish brown scabs, which soonbecome hard and fall off, leaving deep, purplish pits. In adults, thesevesicles sometimes terminate in painful ulcers, caused by an irritationof the eruption. By some practitioners, herpes is regarded as a purelynervous disorder, from the fact that it is frequently accompanied bysevere 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 arerecorded in which they remained many years after the disease haddisappeared. 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 encircleone-half of the body, frequently at the waist; hence, it has receivedthe name of _zona_ or _girdle_. The vesicles often develop into bullæ, and sometimes ulcerate. In _herpes phlyctoenodes_, the vesicles aresmall, round, and irregularly distributed over the face, neck, arms, andbreast. This form is accompanied by febrile symptoms and offensiveexcretions. 

In _herpes circinatus_, or _ringworm_, the vesicles appear in circularpatches, or rings. This is the mildest form of herpes, and is notattended by symptoms of constitutional disorder. The various forms ofherpes are represented in Colored Plate I, Fig. 3. 

CAUSES. Herpes is not contagious. It is caused by vicissitudes of heatand 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 largerthan those of eczema, but smaller than the bullæ of herpes. At first, the serum contained in the vesicles is perfectly transparent, andreflects the red tint of the underlying skin, hence the name _miliariarubra. _ But gradually it becomes milky and opalescent, hence, the term_miliaria alba_. The vesicles of miliaria are generally solitary, andappear on those portions of the body most liable to become heated and toperspire. The eruption is preceded by chills, languor, slight fever, intense thirst, a sharp prickling sensation of the skin, and profuseperspiration. The vesicles soon desiccate and are replaced by a newcrop. 

CAUSES. Miliaria is almost universally an accompaniment of febriledisease, 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 andabdomen. The affected part is of a bright red color, and, in a fewhours, small vesicles appear containing a transparent fluid. Thevesicles soon develop into bullæ, entirely covering the inflamedportion. The fluid becomes opaque and in a few hours escapes. The patchis then covered with a yellow scab. Pemphigus may be either acute orchronic. The acute form is subdivided according to the degree ofinflammation, as _pemphigus pompholyx_ in which it is severe, and_pemphigus benignus, _ when it is mild. The bullæ of pemphigus areillustrated 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 awatery fluid, which desiccates into a yellowish-brown crust. A finerepresentation of rupia vesicles in both stages of development, is givenin Colored Plate II, Fig. 13. 

TREATMENT. In all forms of herpes, the administration of a small dose ofDr. Pierce's Pleasant Pellets, with the use of his "Golden MedicalDiscovery" in one to two teaspoonful doses three times a day, will befollowed by the happiest results. The skin should be kept clean by theuse of the sponge-bath, rendered alkaline by the addition of commonbaking soda or saleratus. The portion of the body covered by theeruption, should be bathed with a solution of sulphate of zinc, oneounce to a pint of water. 

Miliaria is generally associated with certain febrile diseases, and itsproper treatment consists in overcoming the febrile and otherconstitutional symptoms which accompany the disease. A hot foot-bath andsmall 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 avitiated condition, as they are apt to be, a mild cathartic dose of"Pellets" should be given. 

_The treatment of pemphigus_ should consist in frequent alkalinesponge-baths, and in covering the affected parts with poultices ofslippery elm, which should be kept moist with vinegar, Theconstitutional treatment should embrace the persistent use of the"Golden Medical Discovery. " When the disease occurs in children, it ismost generally dependent upon deficient nutrition, and special attentionshould 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 forpemphigus. 

NERVOUS AFFECTIONS OF THE SKIN. 

In nervous affections of the skin, the natural sensibility may beincreased, diminished, or perverted. These morbid impressions arise fromthe nervous system. Although there are several varieties of theseaffections, yet, being of minor importance, we shall omit theirconsideration and only speak of one of them in this work. 

PRURIGO affects the entire surface of the body and imparts to the skin aparched, yellowish appearance. It is characterized by pimples, and anintense burning, itching sensation. Rubbing and scratching only irritatethe skin, which becomes covered with thin black scabs. A goodrepresentation of _prurigo_ may be seen in Colored Plate II, Fig. 6. Theitching sensations are sometimes caused by chilling the body, by violentexercise, and heat; allowing the mind to dwell upon the affectionaggravates it. Prurigo is recognized under two forms; _vulgaris, _ whichis a mild form, and _senilis_, which chiefly occurs in old age, and ismore severe. The external genital parts of females are frequentlyaffected with this disease, and it is aggravated by menstruation anduncleanliness. 

This affection may be due to a vitiated condition of the blood, and iscommon among those who are greatly debilitated. It is frequentlyoccasioned by uncleanliness, intemperance, the use of unwholesome food, or by an impure atmosphere. 

TREATMENT. To allay the itching, take glycerine, one ounce, add to itone drachm of _sulphite_ of soda, and one ounce of rose-water, and applythis to the affected parts. A solution made with borax, two drachms, andmorphine, fire grains, dissolved in six ounces of rose-water, makes anexcellent lotion to allay the itching. If the disease be severe, it willbe necessary to correct the vitiated condition of the blood by aprotracted use of Dr. Pierce's Golden Medical Discovery, and to aid itseffects, give one "Pleasant Pellet" every day, not to operate as acathartic, but only to exert an alterative influence. 

ALPHOUS AFFECTIONS. 

(SCALY SKIN DISEASES. )

Differences of opinion exist with regard to the proper classification ofthese affections. We shall briefly consider _alphos_, which is sometimesconfounded with _lepra_. 

ALPHOS, which from its Greek derivation signifies _white_, ischaracterized by circular, slightly raised white spots. These eruptionsvary in size from one line to two inches in diameter, and may bescattered over the entire surface of the body, although they mostfrequently appear upon the elbows and knees. Alphos may consist of asingle tubercle, or of large clusters constituting patches. The scalesvary in color and thickness. In Colored Plate III, Figs. 14 and 15, arefine illustrations of alphos. When a person begins to recover from thisaffection, the scales fall off, leaving a smooth red surface, whichgradually returns to its natural color. 

This disease is more liable to occur in winter than in summer, althoughin some cases the reverse holds true. It may disappear for a time, onlyto return again with renewed vigor. It is not regarded as contagious. 

TREATMENT. Thorough and protracted constitutional treatment is requiredto overcome this disease. Dr. Pierce's Golden Medical Discovery shouldbe taken internally and also applied locally to the affected parts. Toevery other bottle of the "Discovery" which is taken, one-half ounce ofthe iodide of potash may be added. One or two of the "Pellets" takendaily 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 inone ounce of glycerine, makes an excellent local application. Whateverthe 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 isindicated by the formation of small yellow crusts, having the form of aninverted cup. The eruption has a very offensive odor. When it appears inisolated cups, it is termed _favus dispersus_, but it often occurs inlarge clusters, as represented in Colored Plate II, Fig. 12, and is thentermed _favus confertus_. It generally affects the scalp, but sometimesextends to the face and neck. 

CAUSE. Favus is caused by nutritive debility, which results in aperverted cell-growth. 

SYCOSIS (_Barber's Itch_) is an inflammatory affection of the hairfollicles of the face. The prominent features of the disease are rednessand the formation of scales. It is peculiar to males. It has receivedvarious 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 generalcauses are nutritive debility, vicissitudes of heat and cold, and anexhausted state of the nervous system. It may also result from variouschronic diseases, such as syphilis and dyspepsia. 

COMEDONES, or _grubs_, are due to a retention of the sebaceous matter inthe follicles. The sebaceous substance undergoes a change, becominggranular and somewhat hardened. It gradually extends to the mouth of thefollicle, where it comes in contact with the atmosphere, and assumes adark color, as represented in Plate II, Fig. 8. This fact, together withits peculiar form when squeezed out of the skin, has caused it to betermed _grub_. They often appear in great numbers on the face of personswhose circulation is not active, or those who are of a particularlynervous temperament. Stimulating baths and friction will prove veryefficacious in removing these cylinders of sebaceous matter. If they areallowed to remain, they will produce an irritation of the skin causingan inflammatory disease known as acne, or stone-pock. 

ACNE OR STONE-POCK. In the earliest stage of congestion, acne ischaracterized by minute hardened elevations of the skin, as shown inPlate II, Fig. 9, and is termed _acne punctata_. As the affectionprogresses, a bright red pimple, Plate II, Fig. 11, appears, having aconical form, hence the name _acne coniformis_. The pimple develops intoa pustule containing yellow "matter, " and is then known as _acnepustulosa_. This is followed by a thickening of the tissues, termed_acne tuberculata_. When the thicker skin is removed, it leaves a deepscar, hence the term _acne indurata_. 

CAUSES. The remote cause of acne is nutritive debility. The immediatecauses 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 byshaving the hair off close to the scalp and washing the head thoroughlywith soap and water. In some severe cases, it may be necessary to softenthe incrustations with poultices, following these with a free use ofsoap and water. Having thus exposed the scalp and thoroughly divested itof incrustations, apply to it the ointment of iodide of sulphur, whichmay be procured at any good drug store. It should be gently rubbed overthe parts night and morning. The scalp ought to be kept perfectly cleanthroughout the treatment. Instead of the foregoing, the following may beapplied: Take oxalic acid, ten grains; creosote, twenty drops; water, two ounces; mix. Half an hour after using this lotion, anoint the headfreely with butter or lard; it will add greatly to the efficacy of thetreatment. But while local applications will relieve many skin diseasesand mitigate suffering, we cannot too strongly impress upon the minds ofour readers the importance, in this as in all other chronic diseases ofthe skin, of perseverance in the use of the best alteratives. In thisclass of agents Dr. Pierce's Golden Medical Discovery standspre-eminent. Its efficacy may be increased in this disease by adding toeach 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 beenmade to it. 

_The Treatment of Sycosis_ should be essentially the same as thatsuggested for favus, and it will result in prompt relief and a permanentcure. 

_Treatment of Acne. _ In the treatment of this, as in that of otherdiseases, we should seek to ascertain the cause, and, when possible, remove it. Outdoor exercise, a spare, unstimulating diet, and perfectcleanliness are of the first importance. The affected parts should bebathed with warm water and Castile, or, what is better, carbolic soap. Washing the face in cold water generally aggravates the disease. As alocal application to the pustules, we have used with good results thefollowing lotion: Oxide of zinc, twenty grains; morphine, five grains;glycerine, two ounces: mix. First having washed the affected partsthoroughly, apply this compound. Our chief reliance, however, as in thepreceding diseases, should be upon the persistent use of alteratives andmild 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 tissuebeneath the skin. They vary in size from a pea to a hen's egg, and mayoccur on any part of the body. The color of a boil varies from deep redto 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 ofsloughing cellular tissue which is called the _core_. In from four tofifteen days, it is all expelled and the sore rapidly heals. The causesare an impure condition of the blood, which generally arises fromimperfect action of the liver or kidneys. 

TREATMENT. Spirits of turpentine applied to a boll _in its earlieststage_ will almost always cause it to disappear; but when suppurationhas commenced it should be favored by the application of poultices. Nextpurify the blood to prevent subsequent returns to other parts of thebody. For this purpose take Dr. Pierce's Golden Medical Discovery. Oneor two "Pleasant Pellets" each day will aid in the cure. 

CARBUNCLE. (ANTHRAX. )

These are more violent, larger, and more painful than boils, which theyresemble. They may spring from several small pimples which extend deepinto the tissues, and on the surface frequently several small vesiclesappear and break. They may discharge, through one or several openings, athin acrid, bloody, or dark-colored fluid. They most frequently appearupon the back of the neck, back, back part of the limbs, and under thearms. Their presence is evidence of a depressed condition of vitality. These tumors vary in size from one-half an inch to six inches indiameter, and rapidly proceed to a gangrenous condition, a grayishslough being detached from the healthy tissue. 

TREATMENT. Invigorate the system by every possible means. The bittertonics, such as Golden Seal, Gentian, or Willow, together with quinineand 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 bornewithout acting too freely on the bowels. Anodynes may be necessary toovercome the pain. Poultices are useful to encourage the separation ofthe dead from the living tissues. Antiseptic dressings are beneficial, of which carbolic acid is to be preferred; yeast, however, may beemployed. 

Sometimes powerful caustics or free incisions are productive ofgratifying results, if followed by appropriate dressings, but theseextreme measures should only be resorted to by the direction of aphysician. 

For a considerable time after the urgent symptoms have subsided, the"Golden Medical Discovery" should be used, to purify and enrich theblood, and the bitter tonics and iron may be alternated with it, or beused conjointly to good advantage. 

 * * * * *

SCROFULA. 

It is estimated that about one fifth of the human family are afflictedwith scrofula. A disease so prevalent and so destructive to life, shouldenlist universal attention and the best efforts of medical men indevising the most successful treatment for its cure. It varies in theintensity of its manifestation, from the slightest eruption upon theskin (scrofulous eczema), to that most fatal of maladies, pulmonaryconsumption. 

THE SCROFULOUS DIATHESIS. The existence of a certain disposition orhabit of body designated as the _scrofulous_ or _strumous diathesis_, isgenerally recognized by medical practitioners and writers as aconstitutional condition predisposing many children to the developmentof this disease. Enlargement of the head and abdomen, fair, soft andtransparent or dark, sallow, greasy or wax-looking skin, and precociousintellect are supposed to indicate this diathesis. 

The characteristic feature of this disease, in all the multifariousforms that it assumes, is the formation of tubercle, which, when themalady is fully developed, is an ever-present and distinguishingelement. 

_Tuberculous_ is therefore almost synonymous with _scrofulous_, and tofacilitate 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 andsurgery, playing, as it does, a conspicuous part in an important list ofdiseases, the reader may very naturally be led to inquire:

WHAT IS TUBERCLE? As employed in pathology, the term is usually appliedto a species of degeneration, or morbid development of a pale yellowcolor, having, in its crude condition, a consistence analogous to thatof pretty firm cheese. The physical properties of tubercle are notuniform, however. They vary with age and other circumstances. Some arehard and calcareous, while others are soft and pus-like. The colorvaries from a light yellow, or almost white, to a dark gray. 

It is almost wholly composed of albumen united with a small amount ofearthy salts, as phosphate and carbonate of lime, with a trace of thesoluble salts of soda. 

The existence of tubercular deposits in the tissues of the body, whichcharacterizes scrofula, when fully developed, must not, however, beregarded as the primary affection. Its formation is the result ofdisordered nutrition. The products of digestion are not fullyelaborated, and pass into the blood imperfected, in which condition theyare unable to fulfill their normal destiny--the repair of the bodilytissues. Imperfectly formed albuminous matter oozes out from the blood, and infiltrates the tissues, but it has little tendency to take oncell-forms or undergo the vital transformation essential to becoming apart of the tissues. Instead of nutritive energy, which by assimilationproduces perfect bodily textures, this function, in the scrofulousdiathesis, is deranged by debility, and there is left in the tissues animperfectly organized particle, incapable of undergoing a complete vitalchange, around which cluster other particles of tubercular matter, forming little grains, like millet seed, or growing, by new accretionsof like particles, to masses of more extensive size. As tubercle is buta semi-organized substance, of deficient vitality, it is very prone todisintegration and suppuration. Being foreign to the tissues in which itis embedded, like a thorn in the flesh, it excites a passive form ofinflammation, and from lack of inherent vital energy it is apt todecompose and cause the formation of pus. Hence, infiltration of themuscles, glands, or other soft parts with tuberculous matter, wheninflammation is aroused by its presence, and by an exciting cause, giverise to abscesses, as in lumbar or psoas abscesses. When occurring inthe joints, tubercles may give rise to chronic suppurative inflammation, as in white swellings and hip-joint disease. Various skin diseases areregarded as local expressions of, or as being materially modified by, the scrofulous diathesis, as eczema, impetigo, and lupus. The diseasepopularly known as "_fever-sore_" is another form of scrofulousmanifestation, affecting the shafts of the bones, and causingdisorganization and decay of their structure. Discharges from the ear, bronchitis, chronic inflammation of the intestinal mucous membrane, andchronic diarrhea are frequently due to scrofula, while pulmonaryconsumption is unanimously regarded as a purely scrofulous affectation. Scrofula shows a strong disposition to manifest itself in the lymphaticglands, particularly in the superficial ones of the neck. The mostdistinguishing feature of this form of the disease is the appearance oflittle kernels or tumors about the neck. These often remain about thesame size, neither increasing nor diminishing, until finally, withouthaving caused much inconvenience, they disappear. After a time theseglands may again enlarge, with more or less pain accompanying theprocess. As the disease progresses, the pain increases, and the partsbecome hot and swollen. At length the "matter" which has been formingbeneath, finds its way to the surface and is discharged in the form ofthin pus, frequently containing little particles or flakes of tubercularmatter. During the inflammatory process there may be more or lessfebrile movement, paleness of the surface, languor, impaired appetite, night sweats, and general feebleness of the system. The resulting openulcers show little disposition to heal. 

SYMPTOMS. There is a train of symptoms characteristic of all scrofulousdisease. The appetite may be altogether lost or feeble, or in extremecases, voracious. In some instances there is an unusual disposition toeat fatty substances. The general derangement of the alimentaryfunctions is indicated by a red, glazed or furrowed appearance of thetongue, flatulent condition of the stomach, and bloated state of thebowels, 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 hasshown 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 oneof their children be free from this dire disease. It may present itselfin the form of hip disease, white swelling, "fever-sore" suppuratingglands, curvature of the spine, rickets, ulcers, pulmonary consumption, or some skin disease, in every case showing the original perversion ofthe constitution and functions. Scrofula is hereditary when the disease, or the diathesis which predisposes to its development, is transmittedfrom one or both parents who are affected by it, or who are deficient inconstitutional energy, showing feeble nutrition, lack of circulatoryforce, and a diminished vitality. All these conditions indicate that afew exposures and severe colds are often sufficient to produce a trainof symptoms, which terminate in pulmonary or other strumous affections. Whatever deranges the function of nutrition is favorable to thedevelopment of scrofula, therefore, irregularities and various excessestend to inaugurate it. Depletion of the blood by drastic and poisonousmedicines, such as antimony and mercurials, hemorrhages andblood-letting, syphilis, excessive mental or physical labor, as well asa too early use and abuse of the sexual organs, all tend to waste theblood, reduce the tone of the system, and develop scrofula. 

[Illustration: Fig. 1. A Scrofulous Tumor]

Scrofula may be the consequence of insufficient nourishment, resultingfrom 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 ismuch more prevalent in temperate latitudes, where the climate isvariable, than in tropical or frigid regions. The season of the yearalso greatly influences this disease, for it frequently commences in thewinter 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 surfaceof the body, permit the stimulating influence of the light and air andfacilitate the aeration of the blood, as well as the transpiration offluids through the innumerable pores of the skin. All exposure to a lowtemperature, especially in damp weather, and the wearing of aninsufficient amount of clothing should be avoided. Then the food shouldbe generous and of the most nourishing character. Steady habits andregular hours for eating and sleep must be observed, if we would restoretone and regularity to the functions of nutrition. Moderate exercise inthe open air is essential, in order that the blood may become welloxygenated, that the vital changes may take place. It is no doubt truethat the occasion of the prevalence of scrofula among the lower classesmay be ascribed to frequent and severe climatic exposures, irregular andpoor diet, or want of due cleanliness. Every well-regulated family canavoid such causes and live with a due regard to the conditions ofhealth. The proper treatment of scrofula is important, because we meetwith its symptoms on every side, showing its slow actions upon differentparts of the body and its influence upon all the organs. After thisdisease has been existing for an indefinite length of time, certainglands enlarge, slowly inflame, finally suppurate, and are verydifficult to heal. These sores are very liable to degenerate intoulcers. All of these symptoms point to a peculiar taste of the blood, which continually feeds and strengthens this morbid outbreak. Allauthors agree that the blood is not rich in fibrinous elements, buttends to feebleness and slow inflammation, which ends in maturation. Thus we may trace back this low and morbid condition of the blood todebility of the nutritive organs, defective digestion, which may beinduced by irregular habits, a lack of nourishing food, or by theacquirement of some venereal taint. 

The matter that is discharged from these glands is not healthy, but isthin, serous, and acrid; a whey-like fluid containing little fragmentsof tuberculous matter, which resembles curd. The affected glandsulcerate, look blue and indolent, and manifest no disposition to heal. We have thus traced this disorder back to weak, perverted and faultynutrition, to disordered and vitiated blood, the products of whichslowly inflame the glands, which strain out unhealthy, irritating, poisonous matter. The medicines to remedy this perverted condition ofthe blood and fluids must be alteratives which will act upon thedigestive organs and tone the nutritive functions, thus enriching andpurifying the blood. As this affection is frequently a complication inchronic diseases, it is eminently proper for us to refer to a fewconsiderations involved in its general treatment. 

An alterative medicine belongs to a class which is considered capable ofproducing a salutary change in a disease without exciting any sensibleevacuation. In scrofula, remedies should be employed which will improvedigestion and also prevent certain morbid operations in the blood. 

It is well known to medical men that nearly all medicines belonging tothe class of alteratives, are capable of solution in the gastric andintestinal secretions, and pass without material change, by the processof absorption, through the coats of the stomach and intestines, as doall liquids, and so gain an entrance into the general circulation; thatthese same alteratives act locally to tone and strengthen the mucoussurfaces, and thus promote and rectify the process of digestion beforebeing absorbed; that alterative medicines, when in the blood, mustpermeate the mass of the circulation, and thus reach the remote parts ofthe body and influence every function; that these medicines, while inthe blood, may combine with it, reconstruct it, and arrest its morbidtendencies to decomposition. 

We should use those alteratives which give tone to the digestive andnutritive functions, in order to curtail the constant propagation ofscrofula in the system; which alter and purify the blood through thenatural functions, thus reconstructing it; and which check the septic, _disorganizing_ changes which are evinced by the irritating andpoisonous matter discharged from the ulcers. 

These are the three ways in which medicines operate upon the nutritivefunctions and the blood. 

Thus alteratives may be specifics, in so far as they are particularlyuseful in certain disorders, and the combination which has been made inDr. Pierce's Golden Medical Discovery, excels all others with which weare acquainted, for scrofulous diseases, particularly in fulfilling theforegoing indications. It works out peculiar processes in the blood, notlike food, by supplying merely a natural want, but by strengthening thenutritive functions and counteracting morbid action, after whichoperations it passes out of the system by excretion. 

From what has been said upon the importance of blood medicines and theirmodes of action, the reader must not infer that we account for alldiseases by some fault of the humors of the body, for we do not. Butthat scrofula, in its varied forms, results from imperfect nutrition anddisorders of the blood, is now universally conceded. It is for thisreason that neither time nor pains have been spared in perfecting analterative, tonic, nutritive, restorative, and antiseptic compound, towhich Dr. Pierce has given the name of "Golden Medical Discovery. " Notonly is it an alterative and a nutritive restorative, acting upon thesecretions, but it opposes putrefaction and degenerative decay of thefluids and solids. Hence its universal indication in all scrofulousdiseases. It will intercept those thin, watery discharges which are theresult of weakness, degeneration, and putrescent decay of the blood, perpetuated by a low grade of scrofulous inflammation. By an adult itcan be taken in doses of from one to two teaspoonfuls three or fourtimes per day. 

The bowels should be properly regulated. When constipation exists one ortwo of Dr. Pierce's Pleasant Pellets taken daily, will fulfill theindication. The patient ought not to neglect to carry out all thehygienic recommendations heretofore given. The treatment of runningsores is very simple. Cleanse them every day with Castile-soap andwater, being careful not to rub or touch the surface of the sores. Use aclean sponge or a piece of clean muslin and saturating it with the warmwater, hold it a few inches above the affected part, and squeeze out thefluid, allowing the cleansing stream to fall gently upon the open sore. After thoroughly cleansing the sore, apply to it Dr. Pierce'sAll-Healing Salve. 25 cents in postage stamps sent to us will secure abox 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 scrofulousaffection of the hip-joint. It usually attacks children, but may occurat any period of life. The causes of this affection are imperfectlyunderstood, yet all the indications point to a scrofulous state of thesystem. Dampness, cold, improper diet, severe injuries from blows orfalls are all numbered among the exciting causes which are conducive tothe establishment of this disease. 

THE SYMPTOMS are usually developed gradually; at first there is severepain 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 thedisease progresses, the general health becomes impaired, there iswasting of the muscles, wakefulness, disturbed sleep, high fever, profuse and offensive perspiration, the hair falls out, and there is aninability to move the limb without producing excruciating pain. Frequently pus will be formed and discharged at different points, andthe limb will become greatly emaciated. Since pain in the knee-joint maymislead as to the location of the disease, to determine the seat of theaffection, place the patient in a chair and percuss the knee lightly, bygiving it a slight blow with the knuckle; if the hip be affected, thepain will be readily felt in that joint; if it be simply neuralgia ofthe knee-joint, it will excite no pain whatever. If the disease beallowed to progress and dislocation of the joint takes place, theaffected limb becomes shortened. 

TREATMENT. The treatment of this disease should consist in rest for thehip-joint, cleanliness of the person and plenty of fresh air and light, a nutritious diet and the use of tonics and sustaining alterative, orblood-cleansing medicines. Dr. Pierce's Golden Medical Discovery has, unaided by other medicines, cured many cases of this disease. This classof medicines should be persistently employed, in order to obtain theirfull effects. It is a disease which progresses slowly and which is noteasily turned from its course, and its fatality should warn theafflicted to employ the best treatment. 

Many poor, unfortunate victims know too well, from sad experience, thatthe course of treatment frequently recommended and employed byphysicians and surgeons is ineffectual, and cruel; they deplete thesystem, apply locally liniments, lotions, iodine, and hot applications;confine the patient in bed and strap his hips down immovably, thuspreventing all exercise; then they attach that cruel instrument oftorture, the weight and pulley, to the diseased limb. 

After many years of practical experience in the treatment of hundreds ofcases, we have developed a system of treatment for this terrible maladywhich is based upon common sense. Instead of depleting, we, by properconstitutional treatment, strengthen and fortify the system. We do notconfine the patient in bed, but permit him to go around and take allnecessary exercise. We adjust an ingeniously devised and perfectlyfitting appliance or apparatus, by which a gentle extension of the limbis maintained, thereby relieving the tension of the muscles, andpreventing the friction and wearing of the inflamed surfaces of thejoint, which, without the use of our new and improved appliance, are asource of constant irritation. The appliances required in the successfultreatment of this disease are numerous and varied in their construction, and require skill and experience on the part of the surgical mechanic aswell as on the part of the surgeon, to take accurate and propermeasurements of the diseased limb, and to construct the appliances sothat they will be adapted to the various requirements of differentcases. There are no definite rules for taking these measurements, andonly a thorough examination of the case can indicate to the eye of theexperienced surgeon what measurements are required, and what kind of anappliance is suitable for each individual case. At the Invalids' Hoteland Surgical Institute these measurements are all taken by the surgeonin person, and each appliance is constructed under his immediatesupervision. It is utterly impossible for physicians who have but alimited experience in the treatment of such cases to take correctmeasurements and send off for an apparatus which fulfills therequirements of the case. 

In the light of our vast experience at the Invalids' Hotel and SurgicalInstitute, we feel that we cannot too strongly urge the employment of asuitable apparatus for supporting the hip-joint, giving it perfect rest, and enabling the patient to exercise and get the outdoor air. As much ofthe pain in this disease is due to the pressure of the head of the_femur_, or thigh-bone, in the _acetabulum_, or socket, steadily-appliedmechanical extension, to relieve the inflamed and sensitive joint of thepressure, is of the greatest importance. By such application the patientis enabled to move about without pain, while the joint is kept perfectlyat rest--a condition favorable to the reduction of inflammation withinit. The surgeon specialist of the Invalids' Hotel and Surgical Instituteis frequently sent for to visit cases of this disease hundreds of milesaway and by the employment of suitable apparatus he has been enabled, inscores of cases, to relieve the suffering at once. In cases in which thehead of the thigh bone, or the bony socket of the joint has become sodiseased as to cause it to ulcerate and break down, all portions ofdiseased bone should be _thoroughly removed_ by a surgical operation. Ifthis be neglected or delayed, a fatal termination of the disease may beexpected. Parents should not put off the employment of a competentspecialist in this terrible, distressing, and fatal disease. As treatedby general practitioners, it very often proves fatal; or, after causingintense suffering for a series of years, if the active condition of thedisease subsides, the patient is left with a ruined and brokenconstitution, a result which more prompt and earlier relief would haveprevented. 

The records of practice at the Invalids' Hotel and Surgical Instituteabound in reports of cases, demonstrating the fact, that by careful andjudicious management, hip-joint disease in its earlier stages, may bepromptly arrested, and that cures may be effected even when the bonystructure of the joint is seriously diseased. 

WHITE SWELLING

White Swelling, otherwise known as _Hydrarthrus_, or _Synovitis_, morefrequently affects the knee-joint than any other part. The joints of theelbow, wrist, ankle, or toes, may, however, be affected with thisdisease, but we shall speak of it in this connection as affecting onlythe knee-joint. Synovitis may be acute or chronic. The latter form issometimes induced by blows, sprains, falls, etc. , or from exposure tocold; 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 firstpresents only a slight degree of swelling, which gradually increases. Pain is soon felt, mild at first, but augmenting until it becomessevere. The skin has a smooth, glistening appearance, and there is anincreased amount of heat in the parts. The affected limb becomes wasted, and is sometimes permanently flexed. There is more or less fever aboutthe body, impairment of the digestive organs, and sleeplessness. Thepulse is low but quick, and night-sweats and diarrhea often appear. Under this irritation, the patient is liable to waste away and finallydie. 

A _post-mortem_ examination reveals the effects of the disease upon theparts attacked. The cartilages of the joint are soft, the synovialmembrane is thickened, the ligaments are inflamed and often destroyed, the synovial fluid is increased in amount, sometimes normal inappearance, at others thick and viscous. If the bones be diseased, theirarticular extremities may be distended and fatty matter deposited inthem. The conditions depend upon the form, severity, and duration of thedisease. 

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 bedistinctly marked, or it may come on so gradually that the time of itscommencement cannot be noted. The pain is of a dull, steady character, and less severe in the night. This form of the disease sometimesterminates favorably, but in scrofulous systems it is liable to end inthe destruction of the joint. It is more common in early life, rarelyoccurring after the thirtieth year. 

_Scrofulous Synovitis_, or _Tuberculosis of the Knee-joint_, when of achronic character, shows a wasting of the limb, and the swelling is of apulpy consistence. This form of the disease is more liable to occur inchildren, though occasionally it is met with in adults. But little painaccompanies this form, although the limb is liable to become permanentlyaffected. In its earlier stages this disease may be checked. 

_Syphilitic Synovitis_ is the result of syphilis. The pain is moresevere 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'sGolden Medical Discovery is unequaled for this purpose. 

As local treatment, in the active stage of the disease, the knee-jointshould be steamed, and hot fomentations applied. This should be followedby applications over the joint of solid extract of stramonium orbelladonna, mixed with glycerine. The joint should be wrapped in cottonor wool to keep it uniformly warm. If there are openings about thejoint, discharging pus, syringe them out once a day with Castilesoap-suds, which may be improved by adding a little bicarbonate ofpotash (common saleratus). See that the bowels are kept regular, andthat the diet is nourishing. 

Cases of this disease which have been treated at the Invalids' Hotel andSurgical Institute with uniform success might be cited to the extent offilling a very large number of pages like these. When treated by askilled specialist, this otherwise formidable and dangerous disease isreadily amenable to treatment, and good and serviceable limbs can bepromised, even in the extreme cases in which amputation is usuallyadvised by general practitioners and surgeons, who desire the glory thatthey imagine they will receive by performing a capital operation. 

RICKETS. (RACHITIS. )

Rickets is a scrofulous disease, in which there is derangement of theentire system, and it finally manifests itself in disease of the bones. It is characterized by a softening of the bony tissue, due to adeficiency of earthy or calcareous matter in their composition. Itappears to be a disease incident to cold, damp places, ill-lighted andimperfectly ventilated rooms, and it especially attacks those who areuncleanly in their habits. 

THE SYMPTOMS of rickets are severe pains in the bones, especially duringthe night, febrile excitement and profuse perspiration, paleness of theface, a sallow and wrinkled appearance of the skin, and derangement ofthe digestive organs. After a time the body becomes emaciated, the facepale, and the head unusually large. The bones become soft and unable tosupport the body; various distortions appear; the extremities of thelong bones are enlarged, while the limbs between the joints are veryslender. Rickets is a disease peculiar to childhood, though it may notbe developed until a more advanced period of life. It rarely provesfatal, unless the lungs, heart, or other vital organs, become involved. In some instances the softening and other symptoms continue to increaseuntil every function is affected, and death ensues. 

_Post-mortem_ examinations of those who have died of rickets havedisclosed morbid changes in the brain, liver, and lymphatic glands. Thelungs are often compressed or displaced, and the muscles of the bodybecome pale and wasted. Sometimes the bones are so soft, on account ofthe deficiency of the calcareous deposit, that they can be easily cutwith a knife. 

TREATMENT. The use of Dr. Pierce's Golden Medical Discovery is indicatedin 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 isessential to obviate all known causes, and, at the same time supply thepatient with food rich in those elements which the system seems todemand. Under any plan of treatment the general directions given for thehygienic management of scrofula should be followed. We might cite manycases that have entirely recovered from this disease, under our adviceand the use of "Golden Medical Discovery. " We shall merely say, for theencouragement of the afflicted, that this form of scrofula yieldsreadily to this medicine. 

OLD SORES. (CHRONIC ULCERS. )

Under this head we may properly consider that class of affections knownas Fever-sores, Running-sores, Ulcers, etc. These sores have commoncharacteristics, yet each possesses certain peculiarities, which haveled to their division into _irritable, indolent_, and _varicose_. Thesepeculiarities are not constant, one form of ulcer often changing intoanother. One feature common to all, however, is their slowness inhealing, which has sometimes led to the belief that they are incurable. Another popular notion is that their cure is detrimental to the healthof the patient. With equal propriety we might say that it is dangerousto cure diarrhea, dysentery, consumption, or cancer. As a result ofthese erroneous impressions, many people suffer from chronic ulcers foryears, and even for a life-time, without attempting to obtain relief. Chronic ulcers usually appear upon the lower extremities. The depth andappearance of the ulcer depend upon its character and the thickness ofthe tissues where it is situated. Fig. 2 shows a chronic ulcer, orfever-sore, as it appears upon the ankle. 

[Illustration: Fig. 2. A Chronic Ulcer. ]

THE IRRITABLE ULCER is painful and tender, the slightest injury causingit to bleed. It is of a dark purplish hue, and filled with spongy, sensitive granulations. It discharges a thin, bloody matter which issometimes very fetid and acrid, and excoriates the tissues if it comesin contact with them. The edges of this species of ulcer are shelf-likeand ragged, and turn inward. The adjacent structures are red andswollen. Very often they are attended by severe constitutionaldisturbances, such as chills, fever, and great nervous prostration andirritability. 

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 itis 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 enlargedcondition of the neighboring veins, which are very much enfeebled. Italmost invariably appears below the knee, and may be either indolent orirritable. It is generally sensitive to the touch, and sometimesexcessively painful. Knots of superficial veins may often be seenbeneath the skin. 

As we have before remarked, these various species of ulcers are merelymodifications of one form of chronic sore. The patient may assert thathe enjoys excellent health, but if we question him closely, we find thatthe sore irritates him, and that there is sufficient constitutionaldisturbance to prevent the healing powers of nature from effecting acure. 

TREATMENT. The cure of these sores is necessarily slow, and who everexpects 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 thechannels by which the broken-down tissue surrounding the sore isreplaced by that of a higher grade of vitality. For this purpose, thebest alteratives or blood cleansing remedies are required. If secretionand excretion are not normally performed, the blood becomes poisoned bythe absorption of unhealthy "matter" from the sore, and variousconstitutional disturbances occur. If, at any time during treatment, constitutional disturbances are manifested by fullness or disagreeablesensations in the head, nausea, pain, cough, chills, or fever, athorough cathartic should be given. If the patient be robust, arepetition of the same once a week will be very beneficial. Dr. Pierce'sGolden Medical Discovery, and "Pellets" will be productive of the bestresults. 

The local treatment should depend upon the character of the ulcer. Ifthe sore be _irritable_ or painful, soothing applications, such as warmpoultices or steaming in a vapor of bitter herbs, as hops, boneset orsmart-weed or water pepper, will be found highly beneficial. A poulticeof powdered slippery elm is also very soothing, and hence well adaptedto this purpose. If the ulcer be _indolent_, a stimulating applicationis necessary. The hardened, callous state of the edges should be removedby alkaline applications. A strong solution of saleratus, or even acaustic, prepared by boiling the lye from hard-wood ashes to theconsistence of syrup, will prove of great utility. One or twoapplications of the latter are generally sufficient. 

The foregoing course of treatment is intended to put the open sore orulcer in what is known to surgeons as a healthy condition--a conditionmost favorable for the healing process. 

But the open surface of the sore needs something more. It needs thecleansing or antiseptic and soothing influence of such a dressing as isfound in Dr. Pierce's All-Healing Salve. If your dealer in medicinesdoes not have this Salve in stock, 25 cents in stamps sent to World'sDispensary Medical Association, Buffalo, N. Y. , will secure a box of thisunequaled dressing. It will be sent to your address by return post. Therefore, do not allow the dealer to put you off with some inferiorpreparation. If he has not the All-Healing Salve in stock you can easilyobtain it by sending to us as above directed. 

No matter how good the local dressing applied to the open sore, orulcer, do not discontinue the internal use of the "Golden MedicalDiscovery" until the affected parts are completely healed. 

FEVER-SORE. (NECROSIS. )

By the term _necrosis_ we mean mortification, or the state of a bonewhen it is deprived of life. Dunglison says: "This condition is to thebone what _gangrene_ is to the soft parts. " It is popularly known as_fever-sore_, there being no distinction made between this species ofsore 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 foreignbody. Nature makes an effort for its removal, and at the same timeattempts to replace it with new and healthy materials. In consequence ofthis process, the dead portion is often inclosed in a case of new, soundbone, termed the _involucrum_; when this is the case the dead portion istermed the _sequestrum_. If, however, it be superficial, and separatefrom the parts beneath, it is called an _exfoliation_. This healingprocess, by which the involucrum is formed, cannot be completed whilethe dead portion remains. Hence, numerous openings are made through theinvolucrum, to permit the escape of the sequestrum. When a surgicaloperation is performed for the removal of the necrosed bone it is called_sequestrotomy_. The instruments which our specialists usually employfor 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 inphosphorus, or from the inordinate and protracted use of mercury. 

SYMPTOMS. The pain frequently commences in the night, and all thedifferent stages succeed, until, finally, the result is frequentlymortification or death. The entire bone, or only a part of it, may beaffected; the parts become swollen, "matter" forms, and unless it beartificially evacuated, it will in time work its way out through afistulous opening. As the disease progresses, the adjacent tissuesbecome thickened and numerous openings are formed, which communicatewith the bone, and often with each other, so that a probe may be passedfrom one to another, as represented in Fig. 6, copied from a drawing byDr. Howe. The discharge from fever-sores varies in character, andusually has a fetid odor. The surgeon can readily distinguish betweenhealthy and unhealthy bone by the use of a probe. The pus discharged innecrosis contains minute particles of bone, which may be felt by rubbingit between the fingers. Sometimes large pieces present themselves at theopenings. The general health is seriously impaired, and the patientbecomes debilitated, anæmic, and hectic. 

[Illustration: Fig. 6. Necrosis of the tibia. A commonprobe is passed through the sinuses, or openings. ]

TREATMENT. The process of repair is necessarily tedious, and natureshould be assisted to remove the old bone and promote the formation ofthe new. An alterative course of treatment is indicated and must bepersistently followed. Give Dr. Pierce's Golden Medical Discovery andPleasant 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 withinjections of an alkaline solution, after which bandages, moistened withglycerine, may be applied. If they emit a fetid odor, add a few drops ofcarbolic acid to the glycerine. The dead bone can be but slowly removedby suppuration, therefore time, and, indeed, sometimes life itself, maybe saved by removing it with surgical instruments. In the operation ofsequestrotomy, the surgeon must exercise great judgment. Carelessnessmay prolong the disease and subsequently necessitate another operation, or, perhaps, an amputation. 

Usually the dead bone is easily removed by the skilled specialistsurgeon, and, when thoroughly taken out, the parts readily heal and thepatient rapidly recovers. The removal, therefore, of the dead bone whichis a constant source of irritation, and the cause of protractedsuffering, should not be delayed, for very rarely indeed can it beremoved at all without the assistance of the surgeon. Besides, delayoften results in the loss of the limb, and not unfrequently occasionsthe death of the patient. Under the influence of a reliable local_anæsthetic_, carefully applied, the operation of removing the decayedand offensive bone is speedily and painlessly performed, the use ofchloroform or ether not generally being required. 

 * * * * *

TESTIMONIALS. 

If the following letters had been written by your best known and mostesteemed neighbors they could be no more worthy of your confidence thanthey now are, coming, as they do, from well known, intelligent andtrustworthy citizens, who, in their several neighborhoods, enjoy thefullest confidence and respect of all who know them. 

Out of thousands of similar letters received from former patrons, wehave selected these few at random, and have to regret that we can findroom 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 strickenwith what the doctors called erysipelas. We had employed two doctors formonths without any effect, until he commenced taking your Dr. Pierce'sGolden Medical Discovery. Two bottles effected a cure. His leg was rawfrom his knee to his ankle; it has never broken since, which has beenseveral years. The same medicine also did great things for my nowdeceased husband in a case of erysipelas of long standing. Respectfullyyours, MRS. A. B. PECK, Ranger, Eastland Co. , Texas. 

My daughter Mrs. Jennie Rice, was cured of catarrh in her head by usingthe "Discovery" with Dr. Sage's Catarrh Remedy. She derived greatbenefit 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 myrecovering. My mother advised me to consult you, which I did. After onemonth's treatment I was on foot again; it was truly astonishing howspeedily I found relief after taking your preparations. I have also usedyour "Favorite Prescription" and "Golden Medical Discovery, " whichproved 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 memany doctors' bills, as I have for the past eleven years been using itfor the erysipelas and also for chronic diarrhea, and am glad to saythat it has never failed. I have also recommended it to many of myneighbors, 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 thedoctors in our country prescribe for me, but they could not say justwhat ailed me. When I wrote you giving the history and symptoms, youdiagnosed my case as disease of the blood and kidneys, and advised me totry your "Golden Medical Discovery" and "Pellets" and I feel confidentyour medicines _saved my life_, and I hope all sufferers from kidney andblood 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 ofthe skin on my legs and arms, which in a short time terminated in themost aggravated eczema. My sufferings were intense, and no relief did Iexperience, until I commenced the use of your preparations. I have takenfive bottles of the "Golden Medical Discovery, " and more than thatnumber of the "Pellets, " and believe that I am entirely cured. I neverfeel the least itching, or burning, which was at one time so unbearable. My appetite and digestion are splendid, and, although I will be seventyyears old my next birthday, I am as hearty and strong as most men offifty. 

 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 inconfirmation of his statement, which I cheerfully do. I know Mr. Delanowell 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 oftenduring the time he was afflicted, as he came to my store often aftermedicine. He purchased the "Discovery" and "Pellets" from me, and hasbeen one of the strongest champions of your medicines, and thus aided mevery much in their sale. I am quite sure that he has been the means ofmy 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 agoI was so afflicted with them that I could not walk. I bought Dr. Pierce's Pleasant Pellets, and took one "Pellet" after each meal. Theboils soon disappeared and have had none since. I have also beentroubled with sick headache. When I feel the headache coming on, I takeone 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 Igrew older the disease seemed to be taking a stronger hold upon me. Itried many advertised remedies with no benefit, until I was led to tryyour "Golden Medical Discovery. " When I began taking it my health wasvery poor; in fact, several persons have since told me that they thoughtI had the consumption. I weighed only about 125 pounds. The eruption onmy skin was accompanied by severe itching. It was first confined to myface, but afterwards spread over the neck and head, and the itchingbecame _simply unbearable_. This was my condition when I began takingthe "Discovery. " When I would rub the parts affected a kind of brannyscale would fall off. 

For a while I saw no change or benefit from taking the "Discovery, " butI persisted in its use, keeping my bowels open by taking the "Pellets, "and taking as much outdoor exercise as was possible, until I begun togain in flesh, and gradually the disease released its hold. I tookduring the year somewhere from fifteen to eighteen bottles of the"Discovery. " It has now been four years since I first used it, andthough not using scarcely any since the first year, my health continuesgood. My average weight being 155 to 160 pounds, instead of 125, as itwas when I began the use of the "Discovery. "

Many persons have reminded me of my improved appearance. Some say I lookyounger than I did six years ago when I was married. I am nowforty-eight (48) years old, and stronger, and enjoy better health than Ihave 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. Idoctored with a number of our home physicians and received no benefitwhatever. I also took treatment from physicians in Rochester, New York, Philadelphia, Jersey City, Binghamton, and received no benefit fromthem. In fact I have paid out hundreds of dollars to the doctors withoutbenefit. My brother came to visit us from the West and he told me to tryDr. Pierce's Golden Medical Discovery. He had taken it and it had curedhim. I have taken ten bottles of the "Discovery" and am entirely curedand if there should be any one wishing any information I would gladlycorrespond 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 wasaccompanied with backache and a tired and miserable feeling all over;left side hurt me very much, and could not lie on that side, and thedoctor said it came from affection of the spleen; had a great deal ofheadache; was costive, and suffered terribly from erysipelas; it nearlyset me crazy, so great was the burning and itching; sometimesexperienced severe burning in the stomach. I took twelve bottles of yourmedicines, six bottles of Dr. Pierce's Golden Medical Discovery and thesame amount of his "Favorite Prescription. " Was using them for about sixmonths, and can say that they did their work well. I have ever sincefelt like another person, and do not think I can say enough in theirpraise. I have no more weakness, and all evidence of erysipelas hasdisappeared. 

 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, wasafflicted with Eczema in a distressing form. She tried medicines toonumerous to mention, but they did no good. I told her that I would writeto Dr. Pierce, which I did, and after a few months' use of his medicinesshe was entirely cured. I believe your medicines unequaled. 

MRS. JNO. H. RICHARDSON, a widow living near Wakefield, Va. , a few yearsago, was in extremely bad health, and used your proprietary medicineswith 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 ofDr. Pierce's Golden Medical Discovery. Having suffered for three yearsfrom salt-rheum and after having been unsuccessfully treated by a goodphysician, I began the use of the "Discovery. " The humor was in myhands. I was obliged to keep a covering on them for months at a time, changing the covering morning and night. The stinging, burning anditching sensation would be so intense that at times it seemed as if Iwould go crazy. When I bent the fingers the flesh would crack open andbleed. It is impossible for me to describe the intense pain andsuffering 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 MainSt. , Buffalo, N. Y. :

[Illustration: M. Allen, Esq. ]

_Gentlemen_--I desire to state that I am perfectly well and verythankful to you for curing me. The medicines which I used for two monthsonly have effected a perfect and permanent cure of my case. My facelooks as well as ever. 

I was six weeks under treatment at the Invalids' Hotel and SurgicalInstitute, and I got first-class accommodation. 

The case was a strange one. The pimples did not break out on my chinwhere I had let my beard grow, they broke out on my cheeks, forehead andnose. A doctor in San Francisco told me it was blood poison and said itwas very hard to cure it. I think if it were blood poison it would runall through my system. When I first felt the disease coming on inwinter--my face used to be very cold. I worked under the sun fourteenyears every summer. I wore no hat--nothing but a skull cap. I thought Iwas sun-proof. The doctor in San Francisco stopped the disease for oneyear but it came back again. I had it for five years. It came on fromhard work and exposure in the sun. 

When my face would break out in the fall it got so itchy, and thenlittle pimples would break out on my face, nose and forehead. I thinkparasites were in my face. If I would drink a glass of beer, I wouldfeel the effects of it in my face, and tobacco would affect me just thesame. 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 caselike mine. The doctor said if I would get tanned with the sun I would beall 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 lastfifteen years. I cannot say what my disease was, but I was as spotted asa leopard with brown spots; I was so miserable and nervous, and couldnot sleep. I took Dr. Pierce's Golden Medical Discovery one year, andthe brown spots all disappeared and I am well. Have not taken anymedicine in two years. I think the "Golden Medical Discovery" a splendidmedicine for stomach, liver and skin disease. I got no help from theother 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 Iused Dr. Pierce's Golden Medical Discovery and it cured me. I used fivebottles and I have used it since for other troubles. It has helped mewonderfully, 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 littlesores 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 atthe early stages of the disease and tried everything he knew of for thecure of the same, but nothing did him any good. The disease baffled theskill of the doctor in every way, and I was advised by friends to trycertain remedies, which I did, with very little effect. The child bythis time was a heart-rendering sight to behold, and suffered unknownagonies with the torturing itching and burning of the sores, and sothings ran on until my brother, who resides in Buffalo, visited me. Assoon as he saw the child he advised me to have him treated at theInvalids' Hotel and Surgical Institute in Buffalo. I wrote to themstating my baby's case, asking them if they could help him, and theythought they could, so began their treatment at once by using salvesexternally and medicine internally and as soon as they began theirtreatment the child began to improve and continued so until he wasentirely cured in six months' time. He is now two years and six monthsold and is as tough as any child you ever saw; weighs thirty-five poundsand 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 everythingthat doctors and others prescribed, but only got worse. Severalabscesses formed about my neck and breast, discharging a quantity ofmatter. I got so weak I could scarcely walk about the house. I read allthe medical works I could get hold of, and, among the rest, read some ofyour works. You described my case, and recommended Dr. Pierce's GoldenMedical Discovery with his "Pleasant Pellets. " So I procured some andcommenced using them and soon began to mend. In six months my sores wereall healed up, and in twelve months _I was entirely well_. I amforty-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" withthe "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 ambound 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 afflictedwith badly crossed eyes from my birth, and my sight was impaired, and Iwas badly disfigured. By a painless operation my eyes wereinstantaneously restored to a proper position and my sight muchimproved. 

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 whitepimples and itching all the time in the mornings; when I awakened myeyes would have to be washed open; I could not see and when they werewashed open the corruption would run down my face and drop off. I havetried all of our physicians and their medicine did me no good. Aphysician attended them from Ellicott City and did them no good. He saidit was the running scrofula in the eyelids and could never be cured; ithad continued fourteen years, and I had given up all hopes of ever beingcured until I saw your advertisement of the "People's Common SenseMedical Adviser, " and I sent and got one, and I saw a great deal in itabout the eyes. I wrote to you about them and you prescribed for me. Nowmy eyes are quite well. Some advised me to wear glasses, but you saidnot. I have been a great sufferer but am glad to say you did me all thegood 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 fourweeks, at a cost of only $1. 50, I am more than pleased to announce thatmy eyes are perfectly well and strong as ever. I doctored and fussedwith quack medicines for about one year and a half and found no relief. Finally I consulted your "Medical Adviser" and found a case similar tomine so I wrote and got a speedy reply. I followed directions, whichresulted 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 withmumps, also had fever, finally I had that dreaded disease Scrofula. Themost eminent physicians in this section treated me to no avail. I hadrunning scrofulous sores on left side of neck and face. I was small andweakly when eight or nine years old, and in fact was nearly a skeleton. Six bottles of Dr. Pierce's Golden Medical Discovery wrought marvelouschanges. Although the sores were healed in eight months, I did not quittaking 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 everremind 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 havenot 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 asevere pain and swelling in her ankle, which soon caused her to havehigh fever. We employed some of the best physicians in this locality whopronounced it rheumatism, did everything for her they could do, but shekept getting worse from day to day, and in about five weeks after shewas first taken sick her ankles and legs came open and discharged a lotof yellow matter and finally slivers of bones came out of the openingsin her ankles. All the doctors we consulted said that we would have tohave an operation performed on her and have the dead bones taken out, orelse she could not get well, with the exception of one of the doctorswho said that if her health could be improved the dead bones would comeout and be replaced with new ones, for the dead pieces would brake loosefrom 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 andhad to be tended to like a mere baby and have her feet elevated, or elseshe would scream with pain. We commenced giving her Dr. Pierce's GoldenMedical Discovery. After using it for one month we could see, for thefirst time, that she was getting no worse, and after using about fivebottles her health began to improve a little; but she still sufferedwith pain and could not have her feet down until she had taken twelvebottles. When she had taken fifteen bottles--she began to walk oncrutches, and later with a cane, for about two or three months, when shecould walk without a crutch or cane. The diseased bones gradually cameout in pieces, some of them an inch to two inches long and one-fourth ofan 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 sinceI have taken your special medicine and one bottle of "FavoritePrescription. " I was as weak as any person could be without dying, and Iam as healthy as any person can be to-day, and I have gained ten poundssince, 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 "GoldenMedical Discovery. " His name is John McCoy. For near two years he neverwalked. He suffered from a running sore on his leg, and after usingtwelve bottles, he could walk all right and is well to-day The doctorswanted to have it taken off. You say in your letter you would like tohave a photograph. I have none and there is no photograph gallery inthis 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 sickwith a disease which my doctor said was eczema. He failed to do me anygood, and I fell away to 90 pounds. I had dyspepsia so bad that I couldnot eat anything. My husband got me "sarsaparillas" and "cures" and"bitters, " and nothing did me any good. Finally he got two bottles ofDr. Pierce's Golden Medical Discovery. I began using it, and, thank Godand you, I improved; now I weigh 140 pounds, and my skin is as smooth asa baby's. My husband says I look younger than I did the first time hesaw me. I have better health than ever, and I owe it all to you. It is amiracle 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 aresult of the grippe I had dropsy, and ulcers formed on my legs with amost intolerable itching at night after going to bed. My circulation wasvery poor and liver inactive. I feel perfectly well since I took themedicine. The old sores on my legs are all healed up, and I feel like anew man. I highly recommend your "Golden Medical Discovery" to anyinquiring 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 myneck, 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 usingDr. Pierce's Golden Medical Discovery. I took a few bottles and was sooncured Later my husband had a lump behind his ear; he tried yourmedicine, and one bottle cured him. I shall always recommend yourmedicines. 

 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 suffererwith 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 beenfor some time. I had THE best doctors of this country treat my case andthey 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 possiblefor a human being to suffer. My physicians told me I would have to waitpatiently, but my father procured me some of Doctor Pierce's GoldenMedical Discovery, and I found my falling health restored. 

I can cheerfully say that I believe I owe my life to the use of thatvaluable 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_, whenonly three years old, had lameness in one of her lower limbs but the useof liniment and Dr. Pierce's Pellets relieved her, and she got better. When six years old the trouble developed into hip-joint disease, sopronounced by her physician. She lost the use of the limb. Was threemonths under the doctors, but got no better. She complained of greatpain in the limb, especially in the knee and hip. The limb wasted away, becoming small and short, and her back became crooked. She had noappetite; 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. Pierceas follows: "She is growing fast, and never complains of any pain orache. She sleeps well, and eats heartily. Her leg has filled up, and isas 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 twelveyears after this treatment, at the age of eighteen. The young ladyherself, writes Dr. Pierce as follows: "Your medicines are worth theirweight in gold. I was cured of hip-joint disease by the "Golden MedicalDiscovery" and "Pellets, " and I feel sure that they can cure the worstcases 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, nothingwould relieve me, my hip being swelled seemingly ready to burst. When Ibegan to take Dr. Pierce's Golden Medical Discovery and "Pellets, " theswelling gradually decreased; when I had taken one bottle I was able tobe up. I don't know how long I will remain well, but I am satisfied thatit is the medicine that did the work: I take it right along; as long asI can keep the way I am now, I am satisfied. I have recommended yourremedies, 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 Ihave written in regard to the cure of my little son of Goitre (that asurgeon of N. Adams said could never be cured). 

I do hope that by so doing some little one may escape the misery mylittle one suffered for over a year until I began the use of the "GoldenMedical Discovery. " I followed your directions found in the little bookaround the bottles. Before the first bottle was gone, he could eat andsleep 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 wouldnever have known he ever had a tumor there. He is now hearty andhealthy. Sleeps as good as any child and is full of life. He does nottake anything to prevent a return, and has not for over a year. 

I have one of your Common Sense Medical Advisers, and found it worthfive times what I gave for it; I have helped others to get it and the"Medical Discovery" and "Favorite Prescription" have brought relief tomany through me I use the "Prescription" off and on; it has given mestrength; 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 tothe 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 ofThick Neck, Nervous Prostration, Weakness and a complication of ailmentsby Dr. Pierce's "Discovery" and "Favorite Prescription. " She says: "Myhealth 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 gratitudefor the benefit I have received from your treatment has induced me torecommend you to all whom I know to be sick. " "I have known of two orthree 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 thecase of my sister, Miss Rachel Mann. She is entirely well of Goitre andthroat trouble. I am glad to say that we can recommend your medicinesvery 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 withcarbuncles, 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 anygood. Had six or seven carbuncles at a time, as large as a hen's egg; hegot so weak and suffered so much he could not walk a step. It was in thesummer of '72 or '73 that he had his bed put in the middle of hischamber and got on it to die. No one expected him to get well. Lookingover the newspapers, he saw your "Golden Medical Discovery" advertised, and the good it had done. There was not any sold then in the country, sohe sent to Richmond--forty-five miles--and got a bottle. When he beganto take it he was nearly covered with carbuncles--little and bigtogether. 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 neverbeen bothered with them since. Every time he sees any sign of them, hegets a bottle of "Golden Medical Discovery" and it cures them. Myfather, Col. T. U. Fogg, lives in West Point, King William Co. , Va. He isnow 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 anenlargement of the thyroid gland, which lies over and on each side ofthe trachea, or windpipe, between the prominence known as "Adam's apple"and the breast bone. The tumor gradually increases in front andlaterally, until it produces great deformity, and often interferes withrespiration and the act of swallowing. From its pressure on the greatblood-vessels running to and from the head, there is a constantliability to engorgement of blood in the brain, and to apoplexy, epilepsy, etc. When the enlargement once makes its appearance, itcontinues to increase in size as long as the person lives, unlessappropriate treatment be resorted to. It never disappears spontaneously. These tumors are much larger than those not familiar with them wouldsuppose from their outward appearance, as they extend under and arebound down by the muscles on each side of the neck, so that they becomeembedded in the cellular tissues underneath, while the sides of the neckretain, to a considerable extent, their round and even appearance, whereby the real magnitude of the tumor is not apparent. Figure 7represents the appearance of the neck of a person afflicted with thisdisease. The form of protuberance varies materially with differentpersons, that shown in the engraving being the shape which it ordinarilyassumes. 

[Illustration: Fig. 7. ]

The causes of the affection are not well understood. The use ofsnow-water, or water impregnated with some particular saline orcalcareous matter, has been assigned as a cause. It has also beenattributed 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 thelarge veins of the neck, from pressure of the clothing, or from the headbeing 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 oftreatment, which consists in the employment of electrolysis inconjunction with other therapeutic means. There is scarcely a case inwhich this treatment, properly carried out, will not effect a radicalcure. It is attended with no danger whatever. 

Those who are afflicted with this disease and unable to avail themselvesof special treatment, cannot do better than to take Dr. Pierce'sAlterative Extract, or Golden Medical Discovery, and apply to the skinover and around the tumor, night and morning the following solutionwhich may be prepared at any drug store: iodine, one drachm; iodide ofpotassium, four drachms; dissolve in three ounces of soft water. Applyto the tumor twice a day, with a feather or hair pencil. 

MUMPS. (PAROTITIS. )

This is an inflammation of the parotid glands and generally occurs inchildhood. It is often epidemic, and is manifestly contagious. Itusually, though not always, appears on both sides of the neck at thesame time. 

SYMPTOMS. An external, movable swelling, just below and in front of theear, near the angle of the jaw, is the prominent symptom. Theenlargement is not circumscribed, but hard and painful, and attendedwith more or less fever, derangement of the secretions, and difficultyin swallowing. The swelling increases until the fourth and fifth day, when it gradually diminishes, and by the eighth or tenth is entirelygone. Sometimes the disease is accompanied by swelling of the breasts inthe female, or the testicles in the male. 

TREATMENT. Usually but little treatment is necessary. Exposure to coldshould be avoided. If severe or painful, with febrile symptoms, a hotfoot-bath and small doses of the "Compound Extract of Smart-Weed, " insome diaphoretic infusion, to induce sweating, together with small dosesof aconite, will produce good results. If swelling of the testiclesthreatens (which seldom happens except on taking cold), resort should behad to mild cathartics, the spirit vapor-bath, stimulating liniments tothe 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 usuallyassociated with a catarrhal condition of the mucous membrane. It mayaffect the respiratory organs or the intestinal canal. There is a markedliability to serious complications, of which pneumonia is the mostdangerous. The disease is evidently due to a specific virus of greatinfectiveness, and is more active and contagious at certain seasons andunder certain conditions of the atmosphere. By some it has been supposedthat it is due to a miasma in the air, but the character of itsinfection indicates that the true virus is of a germinal nature. 

Uncomplicated cases recover, but in the aged and in the delicate we maysee fatal results, due usually to the profound depression or the hightemperature to which the individual is subjected. There is much rednessand swelling of the mucous membranes of the nose and throat--abronchitis--and a catarrhal state of the stomach and intestines. Thesemay all be present, or the disease may center upon one particularportion of the animal economy, and manifest its ravages there alone. 

SYMPTOMS. The attack usually resembles an ordinary catarrh of cold. Insome cases the nasal catarrh is absent, or very mild, and the infectioninvades the general system, with much fever. A very strikingmanifestation of the disease is the severe nervous troubles which arepresent at the outset, consisting of headache, pain in the back andlegs, and a general soreness of the muscles and bones as if bruised orbeaten. The pulse is usually feeble and small--intermittent. The diseasemay center in the brain, producing delirium. Mental disorders are notuncommon, and there is usually following the disease more or lessinaptitude for mental work and a tendency to depression of spirits. Inmany cases there is a severe diarrhea, and the individual suffers muchfrom pain and discomfort in the abdomen. This is a gastro-intestinalirritation, and apparently favors an early recovery, and usually thereare less severe sequels in such cases. 

The most dangerous complication is pneumonia. These cases may followbronchitis, or the grip may begin with well-characterized symptoms ofthis disease, for which see the chapters upon this trouble. The sputamay not be rusty until after several days. The crisis is usually slow, and a considerable proportion recover, the disease frequently showing asudden change for the better, and the patient being up and around in afew days. Cases complicated with pneumonia are the most indefinite intheir symptoms, and require the closest attention. 

TREATMENT. In every case the disease must be regarded as a dangerousone, and the patient be confined to bed and indoors until all fever hasdisappeared, otherwise sudden and serious manifestations are liable toappear at any time. The patient must be well fed and nourished from theoutset. The bowels should be acted upon by mild laxatives, such ascastor oil or Dr. Pierce's Pleasant Pellets, using from one to three. Itis also of advantage afterward to move them twice each day, by theinjection of warm water, to which has been added a teaspoonful of tablesalt to each pint. This injected into the rectum, using the waterslightly tepid, or cool if the patient is feverish, will tend to softenthe actions from the bowels and favor the escape of poisonous matter. The cool water has also a soothing effect upon the fever and nervoussystem. If the fever is high, and there is delirium, small doses ofaconite, with water, should be used every half hour or hour, but alldepressing agents of this kind must be used with caution, as profoundprostration sometimes develops. Warm baths, repeated frequently, andfollowed by hot lemonade, are of the greatest benefit in reducing thefeverish condition and quieting the patient. The bed should be warmedafter these are administered and the patient given hot lemonade to bringon free action of the skin, kidneys, and bowels. Where the pulse isweak, the free use of stimulants, as wine, coffee, tea, and brandy orwhiskey, are required, as the great danger of the disease is adepression of the heart. In severe bronchitis, pneumonia, and othercomplications, appropriate treatment should be applied. 

 * * * * *

ACUTE NASAL CATARRH. 

Acute Nasal Catarrh, or cold in the head, is an acute inflammation ofthe mucous membrane lining the nasal passage which may confine itself tothese parts or extend to the pharynx, larynx, and air-passages below, oraffect the auxiliary sinuses or cavities communicating with the nasalpassages. 

The most frequent cause of cold in the head is exposure to suddenchanges in temperature, or draughts of cool air, without taking properprecaution to protect the body so as to prevent the rapid radiation ofanimal heat. In most cases there is an inherited tendency or acquiredweakness, which frequently may be associated with a scrofulous conditionof the whole system, that render these points less resistant, andconsequently invite the morbid changes which result from exposure andcold. Acute Catarrh also occurs during the initial stage of sucheruptive diseases as measles, typhus, typhoid, erysipelas, etc. 

Seldom do we meet with an otherwise healthy individual, who is subjectedto a frequent cold in the head. Impure blood, inherited scrofuloustaints, enfeebled circulation, debility, either general or nervous, areall advance agents, inviting catarrhal disease, and preventing rapidrecovery from an acute attack, so that a low grade of Chronic Catarrh isgenerally the sequence. 

SYMPTOMS. The attack is visually ushered in by a chill, or chillysensation, feeling of lassitude, followed by a slight fever. Thesesymptoms are not as distressing as the sense of fullness about the eyesand frontal region, and prickling dry heat, with more or lessobstruction in the nostrils. A few hours later follows a copious, acridwatery discharge, which gradually becomes thick and yellow. Often theinflammatory 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 swollenparts upon the branches of sensitive nerves. 

TREATMENT. In the mild forms of acute catarrh, or coryza, only simpletreatment is required. A hot foot-bath on retiring at night, with a fulldose of Dr. Pierce's Compound Extract of Smart-weed, to produce freeperspiration will generally break up the attack. Should the dischargefrom the nostrils continue, Dr. Sage's Catarrh Remedy should be freelyused four to six times each day, until the symptoms are controlled. Incase the bowels do not act, a full dose of Dr. Pierce's Pleasant Pelletsmay he taken at bed-time. Avoidance of exposure to cold, and lightvegetable diet, are advisable. In the more severe attacks, especiallywhen complicated by laryngeal or bronchial symptoms, the most decisivemeasures should be employed. The Compound Extract of Smart-weed shouldbe taken freely, together with hot drinks, or a hot general bath. Thepatient should be warmly covered in bed to encourage a continuedperspiration, to equalize the circulation, and subdue the inflammation. Dr. Pierce's Golden Medical Discovery should be taken in teaspoonfuldoses four times each day in all cases that are complicated orprotracted. 

Individuals suffering from frequent colds will do wisely to fortifytheir systems by taking a few bottles of the "Golden Medical Discovery"to improve nutrition, purify the blood, and thus aid nature inovercoming such inherited tendency or required weakness as may be theirmisfortune to possess. Remember frequent attacks of Acute Catarrhprepare fertile soil for the chronic form which oftentimes is soloathsome and destructive. 

 * * * * *

CHRONIC NASAL CATARRH. 

OZAENA. 

In consequence of repeated attacks of acute catarrh, or "cold in thehead, " as it is usually termed, the mucous membranes of the nose and theair-passages of the head become permanently thickened, the mucousfollicles or glands diseased, and their functions either destroyed orvery much deranged. Although chronic catarrh is most commonly brought onin the manner above stated, it sometimes makes its appearance as asequel of typhoid fever, scarlet fever, measles, or other eruptivefevers, or shows itself as a local manifestation of scrofulous orsyphilitic taints in the system. 

Injury to the nose may result in a displacement of one or more of thebony structures, setting up a chronic inflammation with catarrh at thatpoint. In the early stages of the disease, the patient may be annoyedwith "only a slight dropping into the throat, " as many express it, theamount of the discharges from the air-passages of the head at this stageof the disease being only slightly in excess of health. In some casesthe discharge is thick, ropy, and tough, requiring frequent and strongefforts in the way of blowing and spitting, to remove it from thethroat, in which it frequently lodges. In other cases, or in otherstages of the same case, the discharge is thin, watery, acrid, irritating, and profuse. The nose may be "stopped up" from the swollenand thickened condition of the lining mucous membrane, so as tonecessitate respiration through the mouth, giving to the voice adisagreeable nasal twang. From the nature of the obstruction in thiscondition, it is useless for the sufferer to endeavor to clear thepassage by blowing the nose; this only tends to render a bad matterworse, by increasing the irritation and swelling of the alreadythickened lining membrane. The swelling of the mucous membrane does notin all cases become so great as to cause obstruction to respirationthrough the affected passages. In some cases, the patient suffers fromhead ache a great portion of the time, or experiences a dull, heavy, disagreeable fullness or pressure in the head, with a confusion of hisideas, which renders him quite unfit for business, especially such asrequires deep thought and mental labor. Memory may be more or lessaffected, and the disposition of those who are otherwise amiable isoften rendered irritable or morose and despondent. The mental facultiessuffer to such an extent in some cases as to result in insanity. Thesense of smell is in many cases impaired, and sometimes entirely lost, and the senses of taste and hearing are not unfrequently more or lessaffected. 

OZÆNA. The ulcerous or more aggravated stage of the disease, from theoffensive odor that frequently attends it, is denominated _Ozæna_. 

The secretion which is thrown out in the more advanced stages of chroniccatarrh becomes so acrid, unhealthy, and poisonous, that it producessevere irritation and inflammation, which are followed by excoriationand ulceration of the delicate membrane which lines the air-passages inthe head. Although commencing in this membrane, the ulceration is notconfined to it, but gradually extends in depth, until it frequentlyinvolves all the component structures of the nose--cartilage and bone, as well as fibrous tissues. As the ulceration extends up among the smallbones, the discharge generally becomes profuse and often excessivelyfetid, requires the frequent use of the handkerchief, and renders thepoor sufferer disagreeable to both himself and those with whom heassociates. Thick, tough, brownish incrustations, or hardened lumps, aremany times formed in the head, by the evaporation of the watery portionof the discharge. These lumps are sometimes so large and tough that itis with great difficulty that they can be removed. They are usuallydischarged every second, fourth, or fifth day, but only to be succeededby another crop. Portions of cartilage and bone, or even entire bones, often die, slough away, and are discharged, either in large flakes, orblackened, half-decayed, and crumbly pieces; or, as is much morecommonly the case, in the form of numerous minute particles, that escapewith the discharge and are unobserved. It is painfully unpleasant towitness the ravages of this terrible disease, and observe the extent towhich it sometimes progresses. Holes are eaten through the roof of themouth, and great cavities excavated into the solid bones of the face; insuch cases only the best and most through treatment will check theprogress 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 hasalready been pointed out, but also by an extension of the diseasedconditions to other parts beyond the air-passages of the head. 

Occasionally deformities of the septum or other internal structures alsopolypi or tumors, are sources of constant irritation and acceleratecatarrhal disease. 

DISEASE OF THE THROAT. The acrid, irritating and poisonous discharge, which, in some stages of disease, almost constantly runs down over thedelicate lining membrane of the _pharynx_ (throat), is liable to producein this sensitive membrane a diseased condition similar to that existingin the air-passages of the head. The throat may feel dry, husky, and attimes slightly sore or raw; or, from the muco-purulent discharge that isalmost constantly dropping down over its surface, the patient may feelvery little inconvenience from the disease of the throat until it is faradvanced--the moistening and lubricating effect of the matter that dropson the surface tending to blunt the sensibility of the parts. (_Seepharyngitis for symptoms and treatment_. )

THE EXTENSION OF THE DISEASE TO THE LARYNX. The larynx, situateddirectly below the pharynx (throat), is subjected to the influence ofthe same irritation from acrid and poisonous discharges dropping intothe throat from the head. More or less of it is removed by hawking andspitting, but some remains and is drawn into the larynx, or still lowerinto the trachea (windpipe), with the inspired air. Thus the diseasecreeps along the continuous mucous surfaces of the air-passages, theacrid poisonous discharge arousing in its track the irritation, inflammation, ulceration, and thickening of the lining membrane whichcharacterize the disease in other portions of the air-passages. Thesymptoms and treatment of laryngitis will be found under its appropriateclassification. 

BRONCHITIS AND CONSUMPTION. We have already detailed the manner in whichthe throat, larynx, and trachea, in succession, become affected fromcatarrh, or ozaena. By the same process of extension, the bronchialtubes, and lastly, the _parenchyma_, or substance of the lungs, in theirturn, become diseased, and bronchitis and consumption are firmlyestablished. Tightness in the chest, with difficulty of breathing;soreness; darting, sharp, or dull, heavy pain, or a prickly, distressingsensation, accompanied with more or less cough and expectoration--areevidences that the bronchial tubes have become affected, and they shouldadmonish the sufferer _that he is now standing on the stepping-stone to_CONSUMPTION, over which thousands annually tread, in their slow journeyto 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_, anair-passage and communication between the throat and middle ear isformed. (See Fig. 8. ) This passage is lined by a continuation of themucous membrane which covers the throat and nasal passages. Thecatarrhal inflammatory process, by continuity of surface, follows themucous membrane, thickening its structure, until the eustachian tube isclosed, and the beautiful mechanism of the internal ear is rendereduseless. While the thickening of the mucous membrane is going on, andthe passage is gradually becoming closed (and the process sometimesextends through several years), the patient will occasionally, whileblowing the nose, experience a crackling in one or both ears, andhearing becomes dull, but returns suddenly, accompanied with a snappingsound. This may be repeated many times, until, finally, hearing does notreturn, but remains permanently injured. In other cases the hearing islost so gradually that a considerable degree of deafness may existbefore the person is really aware of the fact. Either condition is oftenaccompanied with noises in the head of every conceivable description, increasing the distress of the sufferer. The delicate bones of the earare sometimes detached from their articulations, the drum is ulceratedand 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 theeye into the nose, may be closed by the same inflammatory and thickeningprocess which we have already explained. This condition is usuallyattended with watery and weak eyes, the tears escaping over the cheeks, and sometimes producing irritation and excoriation. The nasal branch ofthe ophthalmic nerve sometimes participates in the ulceration going onin the head, so that the eyes are sympathetically affected. Theysometimes become congested or inflamed, and sharp pain in the eyeballsmay be experienced. 

INDIGESTION, DYSPEPSIA, ETC. A large portion of the acrid, poisonous, purulent discharge, which drops into the throat during sleep, isswallowed. This disturbs the functions of the stomach, causing weaknessof that organ, and producing indigestion, dyspepsia, nausea, and loss ofappetite. Many sufferers complain of a very distressing "gnawingsensation" in the stomach, or an "all gone, " or "faint feelings, " asthey often express it. 

SYMPTOMS. Dull, heavy headaches through the temples and above the eyes;indisposition to exercise; difficulty of thinking or reasoning, orconcentrating the mind upon any subject; lassitude; indifferencerespecting business, lack of ambition or energy; obstruction of nasalpassages; discharges voluntarily falling into the throat, sometimesprofuse, 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, orinflamed eyes; ringing in the ears, deafness, discharge from the ears, hawking and coughing to clear the throat, ulcerations, death and decayof bones, expectoration of putrid matter, _spiculæ_ of bones, scabs fromulcers leaving surface raw, constant desire to clear the nose andthroat, voice altered, nasal twang, offensive breath, impairment ortotal deprivation of the sense of smell and taste, dizziness, mentaldepression, loss of appetite, nausea, indigestion, dyspepsia, enlargedtonsils, raw throat, tickling cough, difficulty in speaking plainly, general debility, idiocy, and insanity. 

All the above symptoms, as well as some others which have beenpreviously given, and which it is not necessary here to repeat, arecommon to this disease in some of its stages or complications; yetthousands of cases annually terminate in consumption or chronicbronchitis, and end in the grave, without ever having manifestedone-half of the symptoms enumerated. 

VARIETIES. People often suppose that there are a great many varieties orspecies of catarrh. This is an error. The nature of the disease is thesame in all cases, the symptoms only varying with the different stagesof the disorder, and the various complicated conditions which are liableto arise, and which have already been pointed out. 

CAUSES. Anything which debilitates the system, or diminishes its powersof evolving animal heat and withstanding cold or sudden changes ofatmospheric temperature, and other disease-producing agencies, rendersthe individual thus enfeebled very liable to catarrh. Among the mostcommon debilitating agencies are a scrofulous condition of the system, or other impurities of the blood, exhaustive fevers, and otherprostrating acute diseases, or those badly treated; exhaustive andunnatural discharges, intemperance, excessive study, self-abuse, adversity, grief, want of sleep, syphilitic taints of the system, whichmay have been contracted unknowingly, or may have been inherited, havingperhaps been handed down even unto the third or fourth generation, to aninnocent posterity from infected progenitors; too sudden rest aftergreat and fatiguing exercise, and living in poorly-ventilatedapartments. These are among the most fruitful causes of those feeble, deranged, or impure conditions of the system to which catarrh sofrequently owes its origin. Although the immediate or exciting cause isgenerally repeated attacks of "cold in the head, " which, being neglectedor improperly treated; "go on from bad to worse, " yet the predisposingor real cause of the disease is in the majority of cases, an enfeebled, impure, or otherwise faulty condition of the system, which invites thedisease, and needs only the irritation produced in the nasal passages byan attack of cold, to kindle the flame and establish the loathsomemalady. Some people are convinced with difficulty that there exists intheir system a weakness, impurity, or derangement of any kind, whichpermitted the disease to fasten itself upon them. They may not feel anygreat weakness, may not have any pimples, blotches, eruptions, swellings, or ulcers, upon their whole person; in fact, nothing aboutthem that would, except to the skilled eye of the practical andexperienced physician, indicate that their system is weakened orderanged 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 uponthe skin, may be the only outward sign of a fault in the system, sofrequently chronic catarrh is the only sign by which a bad condition ofthe system manifests itself in a manner that is perceptible to thesufferer himself, or to the non-professional observer. Thefinely-skilled physician, whose constant practice makes his perceptivefaculties perfect in this direction, would detect the constitutionalfault, as an experienced banker detects a finely-executed and dangerousbank-note which the unpracticed eye would pronounce genuine. 

[Illustration: Fig. 9. Examination of the Nasal Passages by means of the Rhinoscopeand Head Mirror. ]

TREATMENT. If you would remove an evil _strike at its root_. As thepredisposing or real cause of catarrh is, in the majority of cases, someweakness, impurity, or otherwise faulty condition of the system, inattempting to cure the disease our chief aim must be directed to theremoval of that cause. The more we see of this odious disease, the moreso we the importance of combining; with the use of a local, soothing andhealing application, a thorough and persistent internal use ofblood-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 preparationever invented. It is mild and pleasant to use, producing no smarting orpain, and containing no strong, irritating, or caustic drug, or otherpoison. Its ingredients are simple and harmless, yet when scientificallyand skillfully combined, in just the right proportions, they form a mostwonderful and valuable healing medicine. Like gunpowder, which is formedof a combination of saltpeter, sulphur, and charcoal, the ingredientsare simple, but the product of their combination is wonderful in itseffects. The Remedy is a powerful antiseptic, and speedily destroys allbad smell which accompanies so many cases of catarrh, thus affordinggreat comfort to those who suffer from this disease. 

The reader's mind cannot be too strongly impressed with the importanceof combining thorough constitutional with the local treatment of thisdisease. Not only will the cure be thus more surely, speedily, andpermanently, effected, but you thereby guard against other forms ofdisease breaking out, as the result of humors in the blood orconstitutional derangement or weakness. 

In curing catarrh and all the various diseases with which it is sofrequently complicated, as throat, bronchial, and lung diseases, weakstomach, catarrhal deafness, weak or inflamed eyes, impure blood, scrofulous and syphilitic taints, the wonderful powers and virtues ofthe "Golden Medical Discovery" cannot be too strongly extolled. It has aspecific effect upon the lining mucous membranes of the nasal and otherair passages, promoting the natural secretion of their follicles andglands, thereby softening the diseased and thickened membrane, andrestoring it to its natural, thin, delicate, moist, healthy condition. As a blood-purifier, it is unsurpassed. As those diseases whichcomplicate catarrh are diseases of the lining mucous membranes, or ofthe blood, it will readily be seen why this medicine is so wellcalculated to cure them. 

The "Golden Medical Discovery" is the natural "helpmate" of Dr. Sage'sCatarrh Remedy. It not only cleanses, purifies, regulates, and builds upthe system to a healthy standard, and conquers throat, bronchial, andlung complications, when any such exist, but, from its specific effectsupon the lining membrane of the nasal passages, it aids materially inrestoring the diseased, thickened, or ulcerated membrane to a healthycondition, and thus eradicates the disease. When a cure is effected inthis manner it is permanent. The system is so purified, regulated, andstrengthened, as to be strongly fortified against the encroachments ofcatarrh and other diseases. The effects of the "Golden MedicalDiscovery" upon the system will be gradual, and the alterative changesof tissue and function generally somewhat slow. They are with however, less complete, radical, and lasting; and this constitutes its greatmerit. Under its influence all the secretions are aroused to carry theblood-poisons out of the system, the nutrition is promoted, and thepatient finds himself gradually improving in flesh; his strength isbuilt up, his lingering ailments dwindle away, and by and by he findshis whole person has been entirely renovated and repaired he feels likea 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 beingsufficient to produce an acute attack, which greatly aggravates thechronic affection and operates to render it permanent. To obviate thebad effects that are liable to result from this predisposition, greatattention should be paid to the clothing, that it thoroughly protectsthe person from sudden changes of temperature. For more particular andpractical suggestions in regard to this matter, the reader is referredto the article on Clothing, in Part Two, Chapter II, of "The People'sCommon Sense Medical Adviser. "

THE DIET has an important influence with this disease, as withconsumption and many other chronic ailments. It should be largelycomposed of those articles rich in the non-nitrogenized or carbonaceouselements. Fat meats, rich, sweet cream, good butter, and other similararticles of food, should comprise a large part of the diet. Theseelements, which are prolific in the production of animal heat counteractthe predisposition to take cold, and thus become most valuable remedialagents--not less essential than the medical treatment that has beenadvised. The patient, suffering from chronic catarrh, should study wellthe hygienic teachings to be found in Part Two of "The People's CommonSense Medical Adviser, " and govern himself accordingly. 

TREATMENT OF COMPLICATIONS. There are various complications of thisdisease that require modifications of the treatment to meet themsuccessfully. The rules cannot be made that would enablenon-professional readers to vary the treatment to suit peculiarities ofconstitution, or complications of the disease. When consulted, eitherthe person or by letter, we have been able to so modify the treatment asto be adopt it to peculiar individuals which rejected the ordinarytreatment, and have thus cured hundreds who had otherwise failed to findrelief. 

[Illustration: Fig. 11. Steam Atomizer, illustrating position of head during treatment. ]

TIME REQUIRED IN EFFECTING A CURE. Reader, if you suffer from chronicnasal catarrh, do not expect to be very speedily cured, especially ifyour case is one of long standing. Unprincipled quacks and charlatans, who possess no knowledge of disease, or medicine either, and whose soledesign is to palm off upon you a bottle or two of some worse thanworthless strong, caustic solution, irritating snuff, or drying"fumigator, " "dry up, " "annihilator, " "carbolated catarrh cure, ""catarrh specific, " or other strong preparation, will tell you that theworst cases can be _speedily_ cured by these unreasonable means. It istrue that such strong, irritating, and drying preparations will manytimes suddenly arrest the discharge from the nose, but the thickened orulcerated condition of the lining mucous membrane, which reallyconstitutes the disease, is not removed by such treatment, and thedischarge soon comes on again. Besides, there is danger attending theemployment of such strong, irritating, or drying preparations. Thedisease, by their use, is frequently driven to the throat, bronchialtubes, lungs, or brain, and thus a bad matter is made worse. Not lessirrational and unsuccessful is the plan of treating the disease withinhalations of "carbolized iodine, " and other drags, administeredthrough variously-devised pocket and other inhalers. Such treatment maymask or cover up catarrh for a time; but, by reason of theconstitutional nature of the disease, it cannot effect a perfect andpermanent cure. Dr. Sage's Catarrh Remedy, on the other hand, cures thedisease on common-sense, rational, and scientific principles, by itsmild, soothing, and healing properties, to which the disease graduallyyields, 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 upona large experience and a perfect familiarity with the nature andcurability of the disease. For many years our whole time and attentionhas been given to the study and cure of catarrh and other chronicdiseases treated of in "The People's Common Sense Medical Adviser. "Cases of catarrh have been treated by thousands, and our medicines forthe cure of this loathsome disease, and of other chronic diseases, havemet with an extensive sale in all parts of the United States, and havefound their way into many foreign countries. The universal satisfactionwith which their use has been attended, and the grateful manifestationsreceived from the cured, have afforded one of the greatest pleasures ofour lives. Scarcely a mail arrives that does not bring new testimony ofcures 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 powdercontained in the package, as put up for sale, into a bottle; pour intoit 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 allowit to stand six or eight hours to settle. Two of the ingredients ofwhich the remedy is composed do not entirely dissolve, but theirmedicinal properties are completely and speedily extracted and taken upby the water. These settlings have lost their medicinal properties andshould not be allowed to enter the nasal cavity. It should be kepttightly corked, not allowing it to freeze in winter, or be kept where itis very warm in summer. This we term the "Catarrh Remedy Fluid. "

Use the fluid, prepared according to the above directions, not less thanthree or four times a day, the last time just before retiring, in thefollowing manner: Without shaking the bottle to roll the fluid, pour outa teaspoonful or more into the hollow of the hand, hold it there untilwarmed; first gently, and afterwards forcibly, snuff the fluid up onenostril and then the other, until the nose is well filled and it passesback into the throat. No fears need be entertained that it will producestrangling or any unpleasant effect in thus using it, for, unlike anyother fluids (simple tepid water not excepted), it does not produce theslightest pain or disagreeable feeling, but, on the contrary, leavessuch a cooling, pleasant sensation that its use soon becomes a pleasurerather than a task. In a few minutes after thus using the remedy, itshould be blown out gently (never forcibly), to clear the nose andthroat of all hardened crusts and offensive accumulations, if any suchexist. Never blow the nose violently, as it irritates the passages andcounteracts, to some extent, the curative effects of the remedy. Thisprocess should be repeated until the remedy has been thoroughly appliedtwo or three times, not blowing it out the last time of using it, butretaining the medicine in contact with the affected parts for aconsiderable length of time. No harm can result if the fluid beswallowed, as it contains nothing poisonous or injurious. 

A BETTER WAY. The manner of using Dr. Sage's Catarrh Remedy, advisedabove, is somewhat imperfect and not nearly so thorough a mode as theone to which the reader's attention will now be directed. 

In a very large number of bad cases of catarrh, or those of longstanding, the disease has crept along and extended high up in the nasalpassages, and into the various sinuses or cavities, and tubescommunicating therewith. The act of snuffing the fluid _carries it alongthe floor of the nose and into the throat_, but does not carry it _highenough_, 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 betweenthe eyes, or even above them, but it does not. It is only a sensationtransmitted to these parts by nerves, the filaments of which aredistributed to that portion of the mucous membrane which the fluid doesnot reach, just as a sensation is transmitted to the little finger by ablow upon the elbow. 

Now, in order to be most successful in the treatment of catarrh, it isnecessary that _the remedy should reach and be thoroughly applied to allthe affected parts_. This can be accomplished in only one way, which isby _hydrostatic pressure_. The anatomy of the nasal passages, and thevarious chambers and tubes that communicate therewith, is such that theycannot be reached with fluid administered with any kind of syringe orinhaling tube, or with any instrument, except one constructed to applyit upon the principle above stated. Such an instrument is Dr. Pierce'sNasal Douche. 

By the use of this instrument, the fluid enters every portion of theair-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 Remedyfluid, take one quart of soft water, add to it two large tablespoonfulsof common salt, and shake it up occasionally until all is dissolved. Before use heat it until blood warm, or, in other words, until it givesa pleasant, mild warmth to the inserted finger. Put the reservoir on ashelf, 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 thethumb and finger so as to prevent the fluid from escaping through it;introduce the nozzle at the end of the tube into one nostril, pressingit in far enough to close the entrance of the passage so that no fluidcan escape by the side of the tube, breathe through the mouth, avoidswallowing, and allow the fluid to flow. The soft palate, by the act ofbreathing through the mouth, is elevated so as to completely close thepassage into the throat, and thus the fluid is made to flow up onenostril in a gentle stream, to pass into and thoroughly cleanse all thesinuses, or cavities, connected with the nasal passages, and to flow outof the other nostril. The douche should not be employed unless bothnostrils are open and the flow is free. If the head is "stopped up, "snuff up the warm liquid from the hand occasionally, until the passagesare 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 onusing it the first time, pass the current through in the oppositedirection; that is, so that it will flow out of the nostril into whichit flowed the first time of using it. 

After having thus thoroughly cleansed the passages, fill the instrumenthalf full or more with the "Catarrh Remedy Fluid, " prepared asheretofore directed, and warmed to a moderate temperature, and pass thisthrough the nose in the same manner as directed for the salt water. Thesalt 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 itonly a very little higher than the forehead, but after using it a fewtimes, 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 ofthis instrument, as its operation is perfectly simple and harmless, and, with the fluids which we recommend, is never attended with anystrangling, choking, pain, or other disagreeable sensations. Themedicine should be applied with the Douche at least twice a day, in themorning and at night on retiring. There is no advantage in using themedicine oftener than three times a day, when used with the instrument, but a _sufficient_ quantity should be used each time to medicate all thediseased parts. If any remains in the Douche it may be poured back intothe stock solution for subsequent use, but a liquid that has once passedthrough the nasal cavity contains the germs of the disease and must notbe used a second time. 

 * * * * *

NASAL POLYPUS. 

The term Nasal Polypus is usually given to a variety of growths whichare met with in the nasal passages far more frequently than any othertumors. They are thus designated because of their fancied resemblance tothe aquatic polypus. They occur singly, or in clusters, as illustratedin Fig. 13. In the early stages the mucous membrane is swollen andirregularly dilated, presenting a rough and mottled appearance notunlike chronic catarrh with which they are usually associated. Graduallythese mound-like tumors enlarge, usually becoming pendulant, andpresenting a grayish opaque glistening surface, similar to the pulp of agrape. Occasionally they become massive at the point of attachment, andassimilate a warty or cauliflower growth. The latter variety is bettersupplied with blood vessels and presents a red or dark pink surface andmay bleed on slight irritation. The favorite location is beneath orbehind the middle or superior turbinated bodies, oftentimes nearly orquite concealed. However, no portion of the mucous membrane lining theupper air passages is exempt. Sometimes they grow from the roof of thenostril and pharnyx in pendulous masses, assuming the shape of thecavities, filling the entire nostril and upper portion of pharnyx. Themucous membrane covering the turbinated bodies may become dilated andswollen, finally developing by catarrhal processes into a polypus atthat point. (See _H_, Fig. 13. )

[Illustration: Fig. 13. NASAL POLYPI. 

_A_. Anterior opening of the nostril. _B_. Soft Palate, _C_. Orifice of theEustachian tube. _D, D_. Superiorand inferior turbinated bodies. _E_. Large Polypus. _F_. Several smallPolypi. G. Throat. _H_. Polypoidgrowth on turbinated body. ]

CAUSES. Nothing definitely is known regarding their causation. They aregenerally supposed to originate in some constitutional derangement, impairing the nutrition of the mucous membranes. Other cases are closelyassociated with chronic nasal catarrh, and frequent attacks of cold inthe head. 

SYMPTOMS. These may vary considerably in different cases due to thecharacter and location of the polypus. In the early stages before thetumor is well developed, the symptoms may be those of nasal catarrh, andthe diagnosis of polypus be possible only after a personal examinationby a skillful specialist. Neither is the size of the polypus always inproportion to the severity of the symptoms. The nasal discharge isgenerally increased and of a variable character. As the tumors enlargethey cause a sense of fullness and weight between and below the eyes, with more or less headache and facial neuralgia. There is partial orcomplete obstruction of one or both nostrils. In some cases theobstruction changes from one nostril to the other when lying down; thestoppage generally being on the side toward the pillow. A polypuslocated at the junction of the nasal passages and throat by force ofgravity always causes obstruction to the lower nasal cavity when lyingdown. Polypi often attain considerable size and by pressure upon anddisplacement of the surrounding structures occasion hideous facialdeformity. Changes in the weather often aggravate the symptoms. Byblowing the nostril the tumor sometimes may be forced forward, so thatit may be seen a short distance from the anterior opening of thenostril. The _voice_ is often affected, being muffled or harsh in tone, similar to that which accompanies a cold in the head. _Respiration_ maybe considerably embarrassed, due to the obstruction in the nasalpassages, and the patient necessarily resorts to mouth breathing. Inadvanced cases the Larnyx is usually much congested, being constantlyirritated, not only reflexly through the nervous system, but directly bythe inspired air, and excoriating discharges dropping in the throat frombehind the palate. Thus it is plain to understand how chronicPharyngitis, Laryngitis, Bronchitis, and Asthma may result from a smallpolypus in the nasal cavity. 

TREATMENT. In mild cases correcting the constitutional derangement maycheck the morbid process in the nostrils and cause absorption of thepolypus growth. For this purpose Dr. Pierce's Golden Medical Discoveryis unequaled. The removal of the polypus may sometimes be accomplishedby snuffing powdered blood-root. When these measures fail it isnecessary to seek surgical assistance. After the removal of the polypusDr. 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 andvariety of nasal tumors at the Invalids' Hotel and Surgical Institute weare positively assured that the means and methods which we employ areneither severe or dangerous; _no pain_, consequently _no shock_;recovery rapid and permanent. Many forms of injection and localtreatment are in use for the removal of nasal polypi, none of which haveproven to be curative; recurrence of the tumor many times following suchtreatment. Many cases have presented themselves after having beentreated by the heroic method of seizing the polypus with a pair offorceps and forcibly tearing it loose, bringing with it segments ofhealthy tissue, leaving bone exposed, and a ragged, uneven surface ofdiseased membrane. It is much easier to properly treat a case from thebeginning than to undertake it in such a rendition. 

Owing to the fact that these nasal tumors grow directly from the liningmembranes it is necessary not only to thoroughly remove the tumor but totreat the diseased membrane at the point from which the polypus springs;otherwise another tumor may develop at the same point. The nasal passagehaving been thoroughly anæsthetized, or benumbed, by the use ofcocaine, the nasal speculum is introduced, and by means of reflectedlight from the head mirror worn by the operator, the interior of thenostril is brought into view. (See Fig. 9, p. 479. )

Often the attachment of the growth is entirely hidden behind theirregular bony structures of the nostril so that it requires the skillof an expert specialist, deft in the manipulation of these parts, tooperate properly. 

Many styles and shapes of delicately devised instruments are necessaryto completely remove the growth without doing injury to the adjacentstructures. 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 treatedthere is not the offensive discharge for a long time afterward and thedanger from infection and blood-poison to which the patient is subjectedin other forms of treatment. 

In conclusion we would say that we claim for our operation the followingpoints that are worthy of the careful consideration of every one who maybe so unfortunate as to require the services of a specialist for theremoval 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 causeblood-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 samesize and shape. This plate or partition is also a support to which theflexible structures which form the tip of the nose are attached. Inearly life the septum is flexible and may be bent or doubled by injuryto the nose; but owing to its elasticity usually resumes its naturalposition and shape. After maturity any dislocation or change in thisbony plate usually remains permanent unless some means are employed forits correction. In a limited number of cases supposed to be chronicnasal catarrh, we have found upon examination that one or both nasalcavities were more or less obliterated and obstructed by the deformedand thickened septum. (See _A_, Fig. 15. ) Many of these cases date froman injury to the external parts, causing only bleeding from the nose anda slight pain for a short time. Chronic inflammation develops at thepoint where the bone is bent or cracked, resulting in thickening, oftenproducing nodules or spur-like projections which not only interfere withnasal breathing, but also act as irritants to the adjacent delicatemembranes and produce many of the symptoms common to nasal catarrh. 

[Illustration: Fig. 14. Anterior view of the healthy nasal passages asseen with the projecting portion ofthe nose removed. 

_A. _ Vertical septum or bony plate separatingnostrils. _B, B. _ Turbinated bodies. _C, C. _ Nasalpassages. ]

Among other common causes are unequal or imperfect development of thenasal bones, due to an inherited strumous tendency and local ulcerativedisease, weakening or destroying the bone. 

SYMPTOMS. The location and extent of the deformity of the nasal septumnecessarily gives opportunity for a variety of symptoms. In aggravatedcases the nose appears to be bent toward one side. In the earlier stagesthere is an excess of mucous secretion, often dropping into the throatfrom behind the palate. The discharge is variable as in nasal catarrhwith more or less difficult nasal breathing, the stoppage changing fromone nostril to the other. Sneezing and frequent attacks of nose bleedare often common symptoms. The tendency of the disease is to extendbackward often causing headache, deafness, roaring in the ears andpost-nasal disease which results in a chronic sore throat, the latterdisease often being the one for which the patient seeks advice. Ifallowed to progress uninterruptedly the throat gradually becomes moreirritable, associated with an annoying cough, and the voice becomesharsh and has a nasal tone. The general health is impaired, the nervoussystem excitable; laryngitis, asthma, and lung disease becomecomplications, which render the existence of the individual miserable. 

TREATMENT. In mild cases where the deformity is slight, and theobstruction is not a constant symptom, the nasal cavities should becleansed (See treatment of nasal catarrh) after inhaling dust, andspecial attention given to the prompt treatment of cold in the head. Should there be irritability, sneezing, or a constant discharge, it isadvisable to use Dr. Sage's Catarrh Remedy as directed on p. 483 tosoothe the excitability and lessen the inflammatory action in and aboutthe thickened and deformed septum. As an auxiliary to promote theabsorption of the thickened tissues and restore them to a healthyactivity, a number of bottles of the "Golden Medical Discovery" shouldbe taken while using the local treatment. Any dormant condition of theliver or digestive tract may be corrected by taking Dr. Pierce'sPleasant Purgative Pellets. In advanced cases after the structures areso diseased and thickened that it renders local treatment hopeless, onlysurgical interference can prove curative. 

OUR PAINLESS OPERATION. 

By the application of a few drops of a solution of cocaine in thenostril, at the point to be treated, we are now able to produce suchlocal anæsthesia as to render the operation entirely painless withoutthe administration of either chloroform or ether. This is an importantconsideration as many are adverse to taking chloroform or ether, and nowthat we possess an agent that produces, locally, complete insensibilityto pain, we are very glad to dispense with their use in all such minoroperations. There is no pain caused even by the application of thecocaine to deaden the sensibility of the part. Many examinations of theupper air-passages heretofore very annoying and even painful to thepatient and sometimes unsatisfactory, are rendered entirely painless, and carried out with a thoroughness that would be impossible without theuse of this wonderful agent. Not only in surgery of the nose and throat, but alike in other departments, our surgeon-specialists employ the samelocal anæsthetic in all minor operations, none of which are attendedwith the least pain. 

Our specialists were among the first surgeons in this country to employthis newly-discovered anæsthetic. We regard it as a great boon to ourpatients, and never withhold it in any case where it can be employed toprevent suffering. Its use is attended with no danger, nor is itfollowed by bad or disagreeable results. 

OUR OPERATION. 

[Illustration: Fig. 15. Anterior view of deformed nasal passages asseem with the projecting portion of the nose removed. _A. _ Deformed and thickened septum or bonyplate separating nostrils. _B, B. _ Irregular andobstructed nasal passages. _C. _ Diseased and swollenturbinated body. _D, D. _ Turbinated bodiescrowded back by septum. ]

The nostrils being the entrance to and the beginning of the air passagesno dexterity and skill can be spared in treating and properly correctingany deformity that may exist. Mutilation of these sensitive structuresis sure to be followed by serious reflex symptoms in adjacent parts. 

Consequently cases of this nature should only be entrusted to the careof a competent and experienced specialist. Our resources and appliancesare unlimited and seldom do we use the surgeon's knife in a case of thisnature. 

As in the treatment of other pathological growths in the upper airpassages the rhinoscope is indispensable. The parts can only be broughtinto the view of the operator by means of this instrument and sets ofmirrors to reflect light on all sides of the deformed and hidden parts. 

By our operation both nasal cavities are restored to their normal sizeand contour (compare Figs. 14, 15), unhealthy and diseased tissues areremoved, and free nasal respiration established. 

All treatments are carried out under strict aseptic precautions, thusreducing the danger from absorption of poisonous secretions to theminimum. By our skillful and ingenious management of these cases wenever have had a single patient manifest any serious symptoms afteroperation. In such cases we consider this the only safe, practical, andpermanent cure. Every year hundreds pass out of existence the victims ofincurable disease of the air-passages resulting from morbid nasalconditions, 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 treatmentof Post-nasal Catarrh. 

_A_. Tongue. _B_. Epiglottis. _C_. Soft palate. _D_. Anterior opening ofthe nostril. _E, E, E. _ Turbinated bodies. _F_. Junction of the nasal passage andthroat. _G_. Diseased and roughened mucous membrane. _H_. Throat orPharynx. _I, I_. Interiorof nasal passage. ]

Simple chronic pharyngitis seldom exists alone and uncomplicated; mostcases being the result of previous existing disease of the nasal orpost-nasal passages. Many cases are associated with hypertrophy, orenlargement, of the tonsils. Usually the disease is located in the upperpart of the pharynx, or throat, behind and above the uvula and softpalate, and is thus hidden from view when looking into the throatthrough the mouth. When not associated with nasal catarrh the commonsymptoms are dropping of tenacious mucous in the throat, causing aconstant desire to hawk and spit; sense of dryness in this region; coughand expectoration on rising in the morning, which is due to theirritability of the throat, and may invade the lower air-passages. Thethroat may be studded with red and thickened patches of its mucousmembrane. Respiration may be embarrassed, the voice affected and thegeneral health gradually decline. The membrane above and behind thepalate is angry, reddened, thickened and roughened, as represented in_G_, Fig. 16. 

TREATMENT To rationally treat a disease, attack the cause. Therefore, inan uncomplicated case of post-nasal disease of the pharynx the medicineshould be applied at this point. For this purpose we recommend theregular and continuous use of Dr. Sage's Catarrh Remedy administeredpreferably 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 catarrhof mucous membranes is unequaled if the medicine be properly andthoroughly applied. The Catarrh Remedy fluid should be prepared asdirected in the pamphlet which accompanies the medicine. Warm enough ofthe medicine to fill the syringe twice. After the syringe is filled withthe warm medicine, introduce the curved tip behind the soft palate, holding the syringe as seen in Fig. 16, then incline the head forwardover a wash bowl and empty the syringe by pressing the plunger quickly. The medicine will immediately come in contact with the diseased surfacesand pass out through the nostrils, thoroughly medicating, disinfectingand cleansing the upper part of the throat and the posterior region ofthe nostrils. Two syringes of the medicine should be used for eachtreatment, and two or more applications made every day until a cure iseffected. 

At the same time the local treatment is being used, Dr. Pierce's GoldenMedical Discovery should be taken to act through the blood upon thediseased tissues. 

The Catarrh Remedy may be administered by means of the Nasal Douche, ifthe case is complicated by nasal catarrh. Should tumors or deformitiesexist, it is advisable to consult a specialist. 

 * * * * *

ENLARGED TONSILS. 

Chronic enlargement of the tonsils, as shown in Fig. 17, _A A_, is anexceedingly common affection. It is most common to those of a scrofuloushabit. It rarely makes its appearance after the thirtieth year, unlessit has been imperfectly cured. Both tonsils are generally, thoughunequally enlarged. A person affected with this disease is extremelyliable to sore throat, and contracts it on the slightest exposure; thecontraction of a cold, suppression of perspiration, or derangement ofthe digestive apparatus being sufficient to provoke inflammation. 

CAUSES. Repeated attacks of quinsy, scarlet fever, diphtheria, orscrofula, and general impairment of the system, predispose theindividual to this disease. 

SYMPTOMS. The voice is often husky, nasal or guttural, and disagreeable. When the patient sleeps, a low moaning is heard, accompanied withsnoring and stentorian breathing, and the head is thrown back so as tobring the mouth on a line with the windpipe, and thus facilitate theingress of air into the lungs. When the affection becomes serious itinterferes with breathing and swallowing. The chest is liable to becomeflattened in front and arched behind, in consequence of the difficultyof respiration, thus predisposing the patient to pulmonary disease. Onlooking into the throat, the enlarged tonsils may be seen, as in theFig. 17. Sometimes they are so greatly increased in size that they toucheach other. 

[Illustration: Fig. 17. _A. A. _ Enlarged Tonsils. _B_. ElongatedUvula. ]

TREATMENT. The indications to be carried out in the cure of this maladyare:

(1. ) To remedy the constitutional derangement. 

(2. ) To remove the enlargement of the tonsilar glands. 

The successful fulfillment of the first indication may be readilyaccomplished by attention to hygiene, diet, clothing, and the use of Dr. Pierce's Golden Medical Discovery, together with small daily doses ofhis "Pleasant Pellets. " This treatment should be persevered in for aconsiderable length of time after the enlargement has disappeared, toprevent 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 ofpotash, four drachms; pure, soft water, two ounces. Apply thispreparation to the enlarged tonsils twice a day, with a probang, or softswab, being careful to paint them each time. A persevering use of theseremedies, both internal and local, is necessary to reduce and restorethe parts to a healthy condition. 

Sometimes the enlarged tonsils undergo calcareous degeneration; in thiscase, nothing but their removal by a surgical operation is effectual. This can be readily accomplished by any competent surgeon. We haveoperated in a large number of cases, and have never met with myunfavorable results. 

The method we adopt at the Invalids' Hotel and Surgical Institute forthe removal of diseased tonsils is, like other minor operations, painless. The patient is not required to take chloroform or ether. Whenthe enlarged gland is once thoroughly removed the disease seldomreturns. 

ELONGATION OF THE UVULA. 

Chronic enlargement, or elongation of the uvula or soft palate, as shownat _B_ in Fig. 17, may arise from the same causes as enlargement of thetonsils. It subjects the individual to a great deal of annoyance bydropping into or irritating the throat. It causes tickling and frequentdesire to clear the throat, also change, weakness and loss of voice, andoften gives rise to a very persistent and aggravating cough. Constriction of the throat, cough and difficult breathing are moreprominent symptoms in complicated cases. 

TREATMENT. The treatment already laid down for enlarged tonsils, withwhich affection, elongation of the uvula is so often associated, isgenerally effectual. When it has existed for a long time, and does notyield 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 isoften associated with tubercular affections, and constitutionalsyphilis. It is characterized by an inflammatory condition, ulceration, or hardening of the mucous membrane of the larynx, most frequently thelatter. 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 thevocal organs in reading or speaking; using them too long on one pitch orkey, without regard to their modulation; improper treatment of acutediseases of the throat; neglected nasal catarrh; the inordinate use ofmercury; syphilis; repeated colds which directly cause sore throat, injuries, etc. It is also frequently due to tubercular deposits, and inthese cases it generally terminates in consumption. 

SYMPTOMS. The affection often comes on insidiously. There is soreness ofthe throat, noticeable particularly when speaking, and immediatelythereafter; a "raw" and constricted feeling, leading to frequentattempts 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 matterexpectorated is mucus, but as the disease advances, and ulcerationprogresses, it becomes muco-purulent, perhaps lumpy, bloody, or isalmost wholly pure pus. The voice becomes more and more impaired, and isfinally lost. In the latter stages, it resembles consumption, beingattended with hectic fever, night-sweats, emaciation, cough, profuseexpectoration, 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, andthe clothing. Every thing should be done that is calculated to build upand improve the general health. Dr. Pierce's Golden Medical Discovery iswell adapted to remove morbid states of the disease, in consequence ofits direct action on the mucous membranes of the air-passages, and itsefficacy in allaying irritation of the laryngeal, pharyngeal, andpneumogastric nerves. It should be perseveringly employed. Iodineinhalations, administered with the pocket inhaler, illustrated by Fig. 3, and the application of tincture of iodine to the forepart of theneck, are efficacious in many cases. Inhalations of chloride of ammonia, administered with a steam-atomizer, Fig. 11, in the form of spray, arefrequently of great benefit. _Perseverance_ is necessary, and theafflicted 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 awasting away of the body, attended by the deposition of tubercularmatter into the lung tissue. Hence the appellations, _PhthisisPulmonalis; Pulmonary Tuberculosis; Tubercular Consumption_. Tuberclesmay form in other organs and result in a breaking down of their tissues, but the employment of the term _Consumption_ in this article isrestricted to the lungs. The general prevalence, the insidious attack, and the distressing fatality of this disease, demand the specialattention and investigation of every thinking person. It preys upon allclasses of society. Rich and poor alike furnish its victims. 

Some idea of its prevalence may be formed when we consider that, of theentire population of the globe, one in every three hundred andtwenty-three persons annually dies of consumption. It may not bedefinitely known just what proportion of all the deaths in this countryand Europe occurs from this one disease. Those who have gatheredstatistics differ somewhat, some claiming one-fourth, while others putthe ratio at one-sixth, one-seventh, and even as low as one-ninth. Afair estimate, and one probably very near the truth, would be one-sixthor one-seventh of the whole number. In New York City, for fiveconsecutive years, the proportion was three in twenty. In New England, about twenty thousand annually succumb to this destroyer, and in theState of New York as many more. These figures may appear to beexaggerations, but investigations of the subject prove them to be thesimple truth. Epidemics of cholera, yellow fever, and other diseases ofsimilar character, so terrible in their results, occasion wide-spreadalarm, and receive the most careful considerations for their preventionand cure, while consumption receives scarcely a thought. Yet the numberof their victims sinks into insignificance when compared with those ofconsumption. Like the thief in the night, it steals upon its victimunawares. In a large proportion of cases, its approach is so insidiousthat the early symptoms are almost wholly disregarded; indeed, theyexcite but little, if any, attention, and perhaps for a time disappearaltogether. 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 hismalady, he is progressing rapidly towards that "bourne from which notraveler returns. "

As has already been stated, consumption is a constitutional disease, manifested by feeble vitality, loss of strength, emaciation--symptomswhich are too often classed under the name of _general debility_, untillocal symptoms develop, as _cough, difficult breathing_, or_hemorrhage_, when examination of the chest reveals the startling factthat tubercular deposits have been formed in the lungs. Invalids areseldom willing to believe that they have consumption, until it is so faradvanced that all medicine can do is to smooth the pathway to the grave. Another characteristic of this disease is _hope_, which remains activeuntil the very last, flattering the patient into expectation ofrecovery. To the influence of this emotion, the prolongation of thepatient's life may often be attributed. 

NATURE OF THE DISEASE. It is an error to suppose that the disease underconsideration is confined to the lungs. "Pulmonary Consumption, " as hasbeen 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 operationmore or less deranged; especially is the _nutritive_ function vitiatedand imperfect. The circulation is also involved in the general morbidcondition. Tubercles, which constitute a marked feature of the disease, are composed of unorganized matter, deposited from the blood in thetissue of the lungs. They are small globules of a yellow, opaque, friable substance, of about the consistency of cheese. After theirdeposition, they are increased in size by the accretion of fresh matterof the same kind. They are characteristic of all forms of scrofulousdisease. 

The most plausible theory in regard to them is, that they are the resultof imperfect nutrition. Such a substance cannot be produced in the bloodwhen this fluid is perfectly formed. It is an unorganized particle ofmatter, resulting from the imperfect elaboration of the products ofdigestion, which is not, therefore, properly fitted for assimilationwith the tissues. The system being unable to appropriate it, andpowerless to cast in off through the excretory channels, deposits it inthe lungs or other parts of the body. There it remains as a foreignsubstance, like a splinter or thorn in the flesh, until ejected bysuppuration and sloughing of the surrounding parts. It might be supposedby some that when the offending matter was thus eliminated from thelungs, they would heal and the patient recover; but, unfortunately, thedeposition of tubercular matter does no cease. Owing to the morbidaction of the vital forces, it is formed and deposited as fast orfaster than it can be thrown off by expectoration. Hence arises theremarkable fatality of pulmonary consumption. 

CAUSES. The causes of consumption are numerous and varied, but may allbe classed under two heads, viz: _Constitutional_, or _predisposing_, and _local_, or _exciting_. Of just what tubercular matter consists, isstill a subject of controversy, but that its existence depends uponcertain conditions, either _congenital_ or _acquired_, is generallyconceded; and one of these conditions is impaired vitality. Constitutional predisposition must first give rise to conditions whichwill admit of the formation of tubercular matter, before any causewhatever can occasion its local deposition. It must modify the vitalityof the whole system, when other causes may determine in the system thusimpaired, the peculiar morbid action of which tubercular matter is theproduct. The general division of causes into predisposing and exciting, must ever be more or less arbitrary. Individuals subject to predisposingcauses may live the natural term of life and finally die of otherdisease. Indeed, when predisposing causes are known to exist, theyshould 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 theresult will be the same as if the disposition had been congenital. Thecauses which in one individual are _exciting_, under other circumstancesand in other individuals, would be _predisposing_, because they act soas 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 forcesand interferes with the perfect elaboration of nutritive material. 

THE EXCITING CAUSES are those which are capable of arousing thepredisposing ones into activity, and which, in some instances, maythemselves induce predisposition; as dyspepsia, nasal catarrh, colds, suppressed menstruation, bronchitis, retrocession of cutaneousaffections, 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-continueddischarges, masturbation, excessive venery, wastes from excessive mentalactivity, insufficient diet, both as regards quantity and quality, exposure to impure air, atmospheric vicissitudes, dark dwellings, dampness, prolonged lactation, depressing mental emotions, insufficientclothing, improper treatment of other diseases, exhaustive discharges, tight lacing, fast life in fashionable society, and impurity andimpoverishment of blood from any cause. This list might be greatlyextended, but the other causes are generally in some manner allied tothose already named. 

SYMPTOMS. The symptoms of consumption vary with the progress of thedisease. Writers generally recognize three stages, which so graduallychange from one to the other that a dividing line cannot be drawn. Asthe disease progresses, new conditions develop, which are manifested bynew symptoms. Prior to the advent of pulmonary symptoms, is the latentperiod, which may extend over a variable length of time, from a fewmonths to several years; and, indeed, may never be developed anyfarther. Until sufficient tubercular matter has been deposited in thelungs to alter the sounds observed on auscultation and percussion, adefinite diagnosis of tubercular consumption cannot be made, even thoughthere may have been hemorrhage. Nevertheless, when we find _paleness, emaciation, accelerated and difficult breathing, increased frequency ofthe pulse, an increase of temperature_, and _general debility_ coming ongradually without any apparent cause, we have sufficient grounds forgrave suspicions. These are increased if tenderness under thecollar-bone, with a slight, hacking cough is present. These symptomsshould be sufficient to warn any individual who has the slightest reasonto believe that he is disposed to consumption, to lose no time ininstituting the appropriate hygienic and medical treatment, for it is atthis stage that remedies will be found most effective. Unfortunately, this period is too apt to pass unheeded, or receive but triflingattention; the patient finds some trivial excuse for his presentcondition, and believes that he will soon be well. But, alas for hisanticipations! The disease goes onward and onward, gradually gainingground, from which it will be with great difficulty dislodged. 

The cough now becomes sufficiently harassing to attract attention, andis generally worse in the morning. The expectoration is slight andfrothy; the pulse varies from ninety to one hundred and twenty beats ina minute, and sometimes even exceeds this. Flushes of heat and a burningsensation on the soles of the feet and palms of the hands areexperienced. A circumscribed redness of one or both cheeks is apparent. These symptoms increase in the afternoon, and in the evening arefollowed by a sense of chilliness more or less severe. The appetite maybe good, even voracious; but the patient remarks that his food "does notseem to do him any good, " and, to use a popular expression, "he is goinginto a decline. " As the strength wanes the cough becomes more and moresevere, as if occasioned by a fresh cold, in which way the patientvainly tries to account for it. Expectoration increases, becomes moreopaque, and, perhaps, yellow, with occasionally slight dots or streaksof blood. The fever increases, and there is more pain and oppression ofthe chest, particularly during deep respiration after exercise. Palpitation is more severe. There may now be night-sweats, tire patientwaking in the morning to find himself drenched in perspiration, exhausted, and haggard. Bleeding from the lungs occurs, and createsalarm and astonishment, often coming on suddenly without warning. Thehemorrhage usually ceases spontaneously, or on the administration ofproper remedies, and in a few days the patient feels better than he hasfelt for some time previously. The cough is less severe, and thebreathing less difficult. Indeed, a complete remission sometimes occurs, and both patient and friends deceive themselves with the belief that theafflicted one is getting well. 

After an indefinite length of time, the symptoms return with greaterseverity. These remissions and aggravations may be repeated severaltimes, each successive remission being less perfect, each recurrencemore severe, carrying the patient further down the road toward the "darkvalley. " Now the cough increases, the paroxysms become more severe, theexpectoration more copious and purulent, as the tubercular depositssoften and break down. The voice is hollow and reverberating, the chestis 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 soundor if there are large cavities, it is hollow, and auscultation elicitsthe amphoric sound, as of blowing into a bottle. Hectic fever is nowfully established; the eye is unusually bright and pearly, with dilatedpupils, which gives a peculiar expression; the paroxysms of coughingexhaust the patient, and he gasps and pants for breath. The tongue nowbecomes furred, the patient thirsty, the bowels constipated, and all thefunctions are irregularly performed. Another remission may now occur, and the patient be able to resume light employment, for an indefinitelength 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 hasnot marked the accession of pulmonary symptoms, the flow now becomesprofuse and clotted, or is scanty and colorless, sometimes ceasingaltogether. In the male, the sexual powers diminish, and copulation isfollowed by excessive and long-continued prostration. From this timeonward, the progress of the disease is more rapid. The liver and kidneysare implicated. In addition to the pallor, the complexion becomesjaundiced, giving the patient, who is now wasting to a mere skeleton, aghastly look. The urine is generally copious and limpid, thoughoccasionally scanty and yellow. The pulse increases to one hundred andthirty or one hundred and forty beats in the minute, and is feeble andthread-like. The cough harasses the patient so that he does not sleep, or his rest is fitful and unrefreshing; whenever sleep does occur, thepatient wakes to find himself drenched with a cold, clammy perspiration. The throat, mouth, and tongue now become tender, and occasionallyulcerate. Expectoration is profuse, purulent, and viscid, clingingtenaciously to the throat and mouth, and the patient no longer hasstrength to eject it. The hair now falls off, the nails become livid, and the breathing difficult and gasping; the patient has no longerstrength to move himself in bed and has to be propped up with pillows, and suffocates on assuming the recumbent position. Drinks are swallowedwith difficulty. Diarrhea takes the place of constipation. Theextremities are cold, swollen, and dropsical; the voice feeble, hollow, grating, husky, the patient gasping between each word; the respirationis short and quick. A slight remission of these symptoms occurs. Thepatient is more comfortable, lively, cheerful, and perhaps forms plansfor the future. But it is the last effort of expiring vitality, the lastflicker 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 weeksto several years, the average time being about eighteen months. 

_Cough_ is always a prominent symptom throughout the entire course ofthe disease, varying with its progress. 

_Expectoration_, at first scanty, then slightly increased, colorless, frothy, and mucous, is also a characteristic. After a time it becomesopaque, yellow, and more or less watery; then muco-purulent and finallypurulent, copious, and viscid. When tubercular matter is freelyexpectorated, with but little mucus, it sinks in water. This symptomcontinues to the very last. 

_Haemoptysis_ (bleeding from the lungs) may occur at any stage of thedisease, often being the first pulmonary symptom noticed, again beingdelayed until late; and there are cases in which it does not happen atall. It seldom occurs in any other disease. 

_Night-sweats_ may occur at any stage, though they are rarelyexperienced until the disease is pretty well established, and are veryexhausting. 

_Hectic Fever_ generally occurs soon after the pulmonary symptoms aredeveloped, and increases in intensity with the progress of the disease. There are usually two paroxysms in twenty-four hours, one of whichoccurs towards evening and is followed by night-sweats. 

_Dyspnoea_ (difficult breathing) is at first slight, except afterexertion, amounting to only a sense of oppression; but it becomes moreand more severe as the disease advances, until the very last, when it isagonizing in the extreme. 

_Aphthæ_, sometimes extending to the pharynx and larynx, generallyoccurs towards the last. The mouth and throat become so very sore andtender that nourishment and medicine are taken with difficulty. 

_Emaciation and Debility_ are characteristic of the disease. Theyfluctuate as the disease advances or is retarded, increasing to the verylast. 

_Auscultation and Percussion_ constitute valuable means of diagnosisfrom the time tubercular matter begins to be deposited to the very last, and, when correctly practiced, reveal the extent and progress of thedisease. As a knowledge of the sounds elicited can only be acquired bypractical experience with proper instruments, they will not be describedhere. The only diseases with which consumption is likely to beconfounded are general debility in the early stage, bronchitis, chronicpleurisy, chronic pneumonia, and abscess in the lungs, after the adventof pulmonary symptoms. 

CURABILITY. Notwithstanding the prevailing opinion that consumption isincurable, there exists ample, incontrovertible evidence to thecontrary. Its curability is established beyond the shadow of a doubt. Individuals have recovered in whom there was extensive destruction ofpulmonary tissue, and, indeed, entire destruction of one lung. Numerousinstances are on record in which persons have suffered from all thesymptoms of confirmed consumption, and have regained their health andsubsequently died of other diseases. The case of the late Dr. JosephParish, of Philadelphia, affords a striking example of this kind. Inearly 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, inhis Practice of Medicine, mentions another instance of a medicalgentleman in Philadelphia, who in early life suffered from consumptionwith hæmoptysis, from which he recovered, and afterwards died, at anadvanced age, of typhoid fever, when the knife revealed the presence ofcicatrices. Post-mortem examinations of individuals who have died ofother diseases, have revealed, in numerous instances, the presence ofconsumption at some period of their existence. In these cases the lungswere perfectly healed by cicatrization, or by the deposit of a chalkymaterial. A French physician made post-mortem examinations of onehundred women, all of whom were over sixty years of age, and who haddied of other diseases, and in fifty of them he found evidences of theprevious existence of consumption. 

Professor Flint says that consumption sometimes terminates in recovery, and that his observations lead him to the conclusion that the prospectof recovery is more favorable in cases characterized by frequenthemorrhages. Drs. Ware and Walshe are also led to the same conclusion. 

Professor J. Hughes Bennett, of Edinburgh, has thoroughly investigatedthe subject, and adds his testimony to that of others, citing numerouscases that have resulted in perfect recovery. If such testimony is notsufficient, we may mention the following, whose names are well known andrespected in professional circles, and all of whom declare thatconsumption 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 theConnecticut Medical Society, we find "Observations, Ante-mortem andPost-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, whilea mere youth, a victim of pulmonary consumption. During his infancy andboyhood his vitality was feeble. He entered Yale College as a student in1789, "but was soon obliged to leave the institution on account ofpulmonary difficulty, which was doubtless the incipient stage of theorganic disease of the lungs which subsequently developed itself. " Heremained in feeble health for two years, but returned to college, andgraduated in 1797. For the next six years his lung difficulties werequite severe, and he repeatedly bled in large quantities, but he had sofar recovered in 1803, as to accept a Professorship. He was afterwardschosen President of the college, which office he held for many years, inthe enjoyment of good health. He died from "old age, " as we are told, in1867, aged 94 years. 

Statistics show that under the improved methods of treating thisdisease, the mortality, as compared with previous years, has beengreatly reduced. Clinical observation proves that injuries to the lungsare not so fatal as was once supposed. 

TREATMENT. The earlier the treatment of this disease is undertaken, thegreater is the probability of success. The reason of this is obvious; atfirst the disease is general or constitutional, but as it advances, bythe deposit of _tubercular matter_, it becomes both constitutional andlocal. Hence the treatment must be both _general_ and _local_. Theoccurrence of certain prominent and distressing symptoms, either fromthe natural progress of the disease, or from complications with otheraffections, often renders it difficult, even for physicians, todetermine how far their treatment should be general and how far local. 

Treating the symptoms instead of the general disease, or treating theconstitutional disease without regard to the symptoms which arise fromit, is an error into which many physicians have fallen. Theconstitutional affection, the local manifestations and complications, and the circumstances and individual peculiarities of the patient, mustall be carefully considered; bearing in mind all the while, thattubercular matter is the product of a morbid action, which, in everycase, must exist before its deposition in the lungs, or any othertissue, can take place. 

In every case in which curative treatment is to be instituted, thehearty and persistent co-operation of both patient and friends isabsolutely necessary; and the treatment, which is both hygienic andmedical in character, should have in view the following aims:

(1. ) The avoidance of the causes concerned in the production andperpetuation of the disease. 

(2. ) The restoration of healthy nutrition, in order to stop theformation of tuberculous matter. 

(3. ) The arrest of the abnormal breaking down of the tissues, and theprevention of emaciation. 

(4. ) The relief of local symptoms, and the complications arising fromother diseases. 

The fulfillment of the first indication, the avoidance of causes, is ofthe utmost importance, for if they have been sufficient to _produce_ thedisease, their continued operation must certainly be sufficient to_perpetuate_ it. A single individual is very often subjected to theoperation of several of the causes already enumerated, some of which, inconsequence of circumstances and surroundings, are unavoidable. Ofthese, the one most difficult to overcome is climate; _i. E. _ thefrequent variations of temperature. 

Upon the subject of climate much has been written. But that which isbest adapted to the cure of consumption, is that which will enable thepatient to pass a certain number of hours every day in the pure openair, without exposure to sudden alterations of temperature. There arevery few persons who change their place of residence, except as a lastresort, when the disease is in the last stage. It is then productive oflittle or no good. This is one reason why so many people havingconsumption die in Florida, and other warm countries. If a change ofclimate is to be effected at all, it should be made early. 

The most powerful stimulant to health is well-regulated exercise. Itassists the performance of every function, and is of paramountimportance to promote good digestion and proper assimilation, conditionsessential for recovery. It should not, however, be carried beyond thepowers of endurance of the individual, so as to exhaust or fatigue. Everything that can invigorate should be adopted; everything thatexhausts should be shunned. 

To fulfill the second indication, to restore healthy nutrition, requiresnot only a proper diet, both as regards quantity and quality, butdemands that the integrity of the organs concerned in the process ofdigestion and assimilation, shall be maintained at the highest standardof perfection possible. 

That the diet be sufficient in quantity should be obvious to all. It isalso necessary that it be nutritious, and that it should containcarbonaceous elements. Food of a starchy or saccharine character is aptto increase acidity, and interfere with the assimilation of otherelements, therefore, articles, rich in fatty matters, should enterlargely into the diet. The articles of food best adapted to theconsumptive invalid are milk, rich cream, eggs, bread made from unboltedwheat-flour, and raised with yeast, cracked wheat, oatmeal, good butter, beef, game, and fowls. These contain the necessary elements forassimilation. Oily food is of great importance, and the beef eatenshould contain a good proportion of fat. Plenty of salt should always beeaten with the food, and a desire for it is often experienced. Over-eating should be avoided, lest the stomach be induced to rebelagainst 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 thenutritive transformation of the food, enriches the blood, and thusretards the deposition of tubercular matter. It is so combined that, while it meets all these indications, it relieves or prevents thedevelopment of those distressing symptoms so common in this disease. 

The "Golden Medical Discovery" is adapted to fulfill the thirdindication in the management of this disease, which is to check theabnormal breaking down and waste of tissues, which constitute such aprominent feature in this malady. The antiseptic properties of the"Discovery" are unmistakably manifested in preventing such abnormaldecomposition. The emaciation, excessive expectoration, profuseperspiration, diarrhea, and hectic fever, common to consumption, are alldue to a too rapid disintegration and waste of the tissues. It is inthis condition of the system that this medicine, by its powerfulantiseptic properties, manifests its most wonderful curative ability. When, as in this disease, the vital forces of the system have, in adegree, lost their restraining influence over the processes ofdisintegration, waste, and decay, which goes on so rapidly thatnutrition cannot compensate for the loss to the system, then it is thatthe "Golden Medical Discovery, " by its antiseptic influence, checks thisrapid waste of the tissues, and thus arrests the disease. To the lack ofemployment of such a remedy in the treatment of consumption, theunparalleled fatality of the disease is largely due. In their anxiety toimprove digestion and nutrition, and thus build up the tissues, physicians often lose sight of the no less important indication ofrestraining the destructive waste going on in the system, whichoverbalances the supplies furnished by absorption. The graduallyincreasing emaciation and loss of strength render perpetuity of theorganism impossible. 

The fulfillment of the fourth indication, to relieve local symptoms, andthe complications with other diseases, is often attended with no littledifficulty. 

_The Cough_ is a secondary symptom, arising from the irritation causedby the tubercular deposits. Medicated inhalations may give temporaryrelief, 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 veryingenious. That they modify the cough, we do not attempt to deny; but itis usually at a great expense, for they derange the stomach andinterfere with digestion and assimilation. 

Improvement of the general health is always attended with ameliorationof the cough. If the patient did not cough at all, the lungs would soonfill up with broken-down tissue, and death from suffocation wouldresult. Irritation of the nerves supplying the lungs sometimes occurs, and causes the patient to cough immoderately, when it is not necessaryfor the purpose of expectoration. This condition is readily controlledby Dr. Pierce's Golden Medical Discovery, which exerts a decidedlyquieting and tonic influence upon the pneumogastric nerve, which, withits ramifications, is the one involved. An infusion of the common redclover, in tablespoonful doses, will also be found a valuable adjunct inovercoming this condition. 

_Hoemoptysis_. Hemorrhage from the lungs is generally sudden andunexpected in its attack, though sometimes preceded by difficulty ofbreathing, and a salty taste in the mouth. Although it _very rarely_destroys life, it often occasions alarm. Common table salt, given inone-fourth to one-half teaspoonful doses, repeated every ten or fifteenminutes, is generally sufficient to control it. Ligatures applied to thethighs and arms, sufficiently tight to arrest the circulation of bloodin the veins, but not tight enough to impede it in the arteries, is auseful 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 tobe remedied by an improvement of the general health. Bathing in saltwater is sometimes attended with good results. The practice of givingacids for this symptom can only be regarded as irrational. It may arrestthe sweating, but it will do harm in other ways. Belladonna, given atbed-time, is an effectual remedy. 

_Frequency of the pulse_ is generally a prominent symptom in thisdisease. It sometimes points to a condition of sufficient importance torequire a remedy. Although the "Golden Medical Discovery" is combined tomeet this condition, its value may be greatly enhanced by addingone-half to one teaspoonful, according to the urgency of the case andthe frequency of the pulse, of the fluid extract of _Veratrum Viride_ toeach bottle. The benefit of this, when persisted in, will be apparent inthe 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 inthe latter stages of the disease. It is generally due to acidity of thealimentary canal, to which the treatment must be directed. Great careshould be taken in the selection of the diet to improve the quality andavoid everything which disagrees with the patient. Improve digestion byevery possible means. Carbonate of soda and rhubarb, in the form of asyrup, are sometimes excellent. The Compound Extract of Smart-weed, insmall 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 generalcondition of the patient. The "Golden Medical Discovery" is generallysufficient to relieve this complication. Its influence, however, may beconsiderably increased in this direction by the use of Dr. Pierce'sPleasant Pellets, according to the directions which accompany them. Theyshould only be taken in the smallest doses, one or two "Pellets "everyday, just enough to produce a natural movement of the bowels each day. 

_Uterine Derangements_. In the female, derangement of the menstrualfunction is generally an early complication of consumption, if indeed itdoes not occur at the outset. It deserves early attention, and, inaddition to the remedies already advised, Dr. Pierce's FavoritePrescription is so compounded as to meet the requirements of thiscondition, and at the same time exert a favorable influence upon theconstitutional disease. 

The numerous reports of cures of well-developed cases of Consumption tobe found in the back portion of this little treatise must be sufficient, it seems to us, to convince the most skeptical of the wonderful powerwhich Dr. Pierce's Golden Medical Discovery exercises over this terriblyfatal malady. As will be noted, many of the cases there reported hadlong been unsuccessfully treated with cod liver oil emulsion and all theother usual remedies employed by the profession and were fast runningdown. "Golden Medical Discovery" aroused the stomach and liver, andstarted all the nutritive functions into action, whereby digestion andnutrition were promoted and both the strength and flesh steadily builtup. The reader will bear in mind, that most of the cases hereinafterreported, were pronounced Consumption by their attending physicians aswell as by us. It cannot be said, therefore, that we exaggerate themalady and that the cases were merely bad, lingering coughs. Thousands, whose maladies have been pronounced genuine Tubercular PulmonaryConsumption, (Phthisis Pulmonalis) by eminent physicians have been_perfectly_ and _permanently_ cured by the use of Dr. Pierce's GoldenMedical Discovery. It can, therefore, no longer be doubted that thiswonderful compound is far superior as a remedy for Consumption to codliver oil, compound Hypophosphites, and the many other agents so highlyextolled, and so generally prescribed for this fatal malady by even themore progressive and advanced of the medical profession of our day. Readthe letters received from grateful patients who have been cured and notehow many commend the use of "Golden Medical Discovery, " as a "lastresort, " after their home physicians had exhausted all their skill andresources in vain. 

 * * * * *

CHRONIC BRONCHITIS. 

This is a subacute or chronic form of inflammation of the mucousmembrane of the bronchial tubes, of a very persistent character andvariable intensity. There are few diseases which manifest a greatervariety of modifications than this. 

SYMPTOMS. The symptoms of this disease vary greatly with its violenceand progress. Cough is always present, and is very often the firstsymptom to attract the patient's attention. It is usually increased byevery slight cold, and with each fresh accession becomes more and moresevere, and is arrested with greater difficulty. The cough is alwayspersistent, sometimes short and hacking, at other times deep, prolonged, and harsh. Sometimes it is spasmodic and irritating and particularly sowhen it is associated with affections of the larynx, or with asthma, involving irritation of the branches or the filaments of thepneumogastric nerve. 

When the chronic follows the acute form of the disease, or followsinflammation of the lungs, the expectoration may be profuse from thefirst, and of a yellowish color and tenacious character. When thedisease arises from other causes, the expectoration is generally slightat first, and the cough dry or hacking. This may continue some timebefore much expectoration occurs. The expectorated matter is at firstwhitish, opaque, and tenacious, mixed sometimes with a frothy mucus, requiring considerable coughing to loosen it and throw it off. As thedisease progresses, it becomes thicker, more sticky, of a yellowish orgreenish color, mixed with pus, and sometimes streaked with blood. Inthe latter stages, it becomes profuse and fetid, and severe hemorrhagemay occur. Sometimes the cough and expectoration disappear when theweather becomes warm, to appear again with the return of winter, whichhas gained for it the appellation of _winter cough_. The sufferers feelas if something was bound tightly round them, rendering inhalationdifficult. Soreness throughout the chest is often a persistent symptom, especially when the cough is dry and hard. Behind the breast-bone thereis 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 aredepressed, and he gradually sinks, or tubercular matter is deposited inthe lungs, and consumption is developed. 

TREATMENT. Thorough attention to hygiene, with the avoidance of thecauses concerned in the production and perpetuation of the disease, isnecessary. The patient must be protected from the vicissitudes of theweather 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 bekept warm and dry. Exercise in the open air is essential. When theweather is so cold as to excite coughing, something should be worn overthe mouth, as a thin cloth, handkerchief, muffler, or anything whichwill modify the temperature of the atmosphere before it comes intocontact with the mucous lining of the lungs. Good ventilation ofsleeping-rooms is all-important; not that the air should be cold, butthat 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 breadfrom unbolted flour, supply the appropriate alimentary substances forperfect 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 casesof this disease that Dr. Pierce's Golden Medical Discovery has achievedunparalleled success, and won the highest praise from those who haveused it. Its value will generally be enhanced in treating this complaintby adding one-half a teaspoonful of the fluid extract of _VeratrumViride_ to each bottle. This can be added by any respectable druggist. Especially should it be thus modified if the pulse be accelerated so asto beat ninety or a hundred times in a minute. The "Golden MedicalDiscovery" should be taken in teaspoonful doses, repeated every twohours. When the cough is dry and hard, with no expectoration, it arisesfrom irritation of some of the branches of the pneumogastric nerve, which this remedy will relieve. It may, however, be aided by inhalingthe 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 keepingup its use until the disease yields and is perfectly stamped out. Do notexpect a formidable disease of perhaps weeks' or months' duration to be_speedily_ cured. Chronic diseases are generally slow in their inceptionand development and can only be cured by gradual stages. Perseverance intreatment is required. Many invalids do not possess the strength ofpurpose--the will power--to continue the use of the "Golden MedicalDiscovery" long enough to receive its full benefits. It is worse thanuseless for such to commence its use, for without persistency it cannotbe expected to cure such obstinate maladies as chronic bronchitis. 

 * * * * *

ASTHMA. 

PHTHISIC. 

One of the most distressing ailments with which the human family isafflicted is asthma. Its symptoms are not to be mistaken. Suddenly andwithout apparent provocation the patient experiences the greatestdifficulty in breathing. When warning is given, there is usually a senseof fullness in the stomach, flatulence, languor, and general nervousirritability. The countenance is a picture of anxiety and horror. Thedifficulty of breathing increases and the struggle for air commences. Windows and doors are thrown open, fans used, and, utterly regardless ofconsequences, the sufferer passes the whole night in exposure andtorture, even though the temperature be below zero. Fearing suffocation, the patient dare not lie down; he rushes to the window for air, restshis head upon a table or chair, or upon his hands, with the elbows uponthe knees, jumps up suddenly and gasps and struggles for air. The eyesare prominent and the veins of the forehead distended with blood;sometimes the bowels are relaxed. The urine is colorless and is passedin copious quantities. This symptom indicates great excitement of thenervous system. The voice is hoarse, articulation difficult, breathinglimited, noisy and wheezy. The _wheezing_ is pathognomonic of thedisease. It can only be confounded with croup, and then only in theyoung. In croup there is pain and difficulty in swallowing, fever andcough, which are usually absent in asthma. A severe paroxysm of asthmais very distressing to witness, and one unused to it might well supposethe sufferer to be in his last agonies. No definite limit can beassigned to the duration of the attack or of the disease. It may lastbut a few minutes, may endure for hours, or with slight remissioncontinue for days. The condition of the patient may be for years aschangeable as the pointings of the weather-vane. In fact, the atmospherehas much to do with the disease. With every approaching storm, withevery cloud of dust, even the dust from sweeping a room, with every foulodor, and, in some more sensitive organizations, with even the perfumeof flowers, a paroxysm is provoked. Truly he is a "child ofcircumstances, " a veritable football upon the toes of every atmosphericdisturbance. 

UNPARALLELED SUCCESS. 

Persons affected with asthma or phthisic are numerous. With such anamount 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 halfcentury ago and pronounce it incurable, rather than make stupendous andlaudable efforts to discover plans of medication that will result incertain and permanent cure? Almost single handed we undertook this fieldof investigation, and we take pleasure in reporting that our labors havebeen crowned with success. The large experience furnished us has led tothe discovery of remedies for this distressing malady of more thanordinary efficacy. Through the agency of these means we have beenenabled to cure hundreds, who had suffered untold tortures for twelve, fifteen, or twenty-five years. Some whom we have been successful incuring had suffered from childhood to middle and even old age. Thetreatment of asthma, or phthisic, still continues to be a prominentspecialty 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, ofthe blood, others, of the bronchial tubes, while not a few believe it tobe dependent upon some disease of the stomach, heart, liver, kidneys, ordue to urinary affections, or "female weakness. " Respecting all thesediseases of special organs, it is evident that any complication, andparticularly one that is debilitating or causes irritation of thenervous system will increase its severity. This important fact we keepconstantly in view in our treatment, and prescribe remedies to removeall complications. 

In heart disease there is often dyspnoea, or difficult breathing, butthis is not of the nature of asthma, or phthisic. The condition of thelungs is readily understood. There being an obstruction to the freepassage of the blood through the heart, any excessive muscular exertion, or anything, in fact, which increases the action of the heart, is veryapt to produce congestion of the lungs, and then the blood becomessurcharged with carbonic acid, which causes increased efforts to takemore air into the lungs. 

A NERVOUS DISEASE. A sudden fright, unfavorable news, grief, loss ofproperty, etc. , circumstances which affect the mind and nervous system, almost invariably throw the phthisical into a paroxysm. Nervines aredemanded, particularly if the case be a chronic one, and we see thatthey are carefully and properly prepared and supplied, and in such aform 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_ ofasthma. Among them we will notice a few that are most frequentlyemployed by the profession. They can be easily and inexpensivelyprepared by any patient or druggist:

1. Equal parts of the tinctures of lobalis capsicum and skunk cabbageroot. _Dose_. --Take a half teaspoonful in a little water every ten orfifteen minutes until relieved. 

NOTE. --This is an antispasmodic and relaxant. In considerable quantitiesit will produce sickness at the stomach and perhaps vomiting. It shouldnot be used when there is disease of the heart. 

2. Chloroform. _Dose_. --A small quantity (say thirty drops), may bepoured upon a handkerchief or napkin, held about one inch from thenostrils and the vapor inhaled. It is quite unnecessary to use thisuntil insensibility follows; in fact, such an effect would be hazardousto life in the hands of the inexperienced. 

3. Sulphuric ether. _Dose_. --The same as No. 2, and with the sameprecaution. Either of them should be used promptly upon the beginning ofthe 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 ofsaltpetre, finely powdered. _Dose_. --Place a half teaspoonful upon avery hot shovel. Inhale the rising smoke. If the first few inspirationscause coughing, the smoke should not be evaded as the coughing incitesdeeper inspiration. 

5. Stramonium and saltpetre as in No. 4. Dampen with water and make intoballs or cones. These are more easily handled and are fired in the sameway as the powder and used in the same way. 

6. Take of sunflower leaves, stramonium leaves, mullein leaves, oneounce each; of lobelia leaves, half an ounce; of powdered nitre, oneounce; 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 especiallyeffective in cases arising from checked perspiration, from rheumatism, etc. 

These recipes are given to the public as being the principal agentsemployed by the medical profession throughout the world. It must bedistinctly understood that they are not _curative_ but merely_palliative_, and used to relieve paroxysms. We object to them whollyand unqualifiedly because they contain NARCOTICS. It is a fundamentalprinciple in our treatment not to use this class of remedies. Theystupefy the brain, debilitate the nervous system, and have, in not a fewinstances, formed an unfortunate appetite and habit, most difficult toovercome. We are of the opinion that one of the chief reasons why thismalady has been considered incurable is the fact that physicians havealmost universally relied upon narcotic drugs. With such medication acure is the exception. A cure can only be effected under suchcircumstances when the _powers of nature are sufficient to overcome boththe_ NARCOTIC _and the_ DISEASE. That they will _relieve_ we do notdeny, but _they will never cure_. It reminds us of an old country doctorwho advised a lady to smoke tobacco to cure acid dyspepsia. She followedthe prescription for over thirty years and at last accounts was notcured yet. In all seriousness we ask would any other remedy except anarcotic or stimulant be used with such persistency for anything likethis length of time? Is it not apparent that such agents form a habitwhich is often worse than the disease, and yet fail to effect a cure? Weappreciate the necessity for relief, and do not blame sufferers foravailing themselves of any means for this purpose. But they should notbe satisfied with relief only, but should look about for such a systemof medication as will rid them of the disease completely andpermanently. If a week's or a month's exemption is a "foretaste ofheaven, " how incomparable are the comforts and happiness to be derivedfrom 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 achange of climate that will be advantageous. It is the last expedient ofthe doctor who is annoyed by the continued complaint of his unrelievedpatient, and can only be made available by the wealthy. In someinstances the change is beneficial, but to be effectually so a permanentchange of residence is required. Most patients are unable or unwillingto do this. In some cases change only affords temporary relief, theattacks returning after a few months. Even the wealthy dislike to takesuch chances. The less opulent cannot think of such methods, and henceare compelled to bear their sufferings as best they can. In the majorityof instances the "change of climate" is only an illusion, or onlytemporarily beneficial at best. We can tell them a better way, and ifthey are wise they will follow it. 

 * * * * *

HAY ASTHMA, OR HAY FEVER. 

This affection, known also as Hay Catarrh, Hay Fever, or Rose Colddiffers but little in its manifestations, from coryza, or cold in thehead, save in its _inciting cause_, and in its element of periodicity. In this latitude there are persons who, during summer or early fall, areinvariably attacked with acute congestion or inflammation of the upperair-passages, giving rise to sneezing, watery discharges from the noseand eyes, difficult respiration, fever, and general prostration. Thesesymptoms are supposed to be induced by the inhalation of pollen or odorsfrom grasses or flowers, which at that time are supposed to give offcertain exhalations of an Irritating character. Unless arrested bymedical treatment, the disease lasts until cool weather, or theoccurrence of a hard frost rids the atmosphere of the excitinginfluence. 

Some feather beds give off an odor which excites all the aggravatedsymptoms of this disease. Thus it appears that certain emanations havethe power of inciting these inflammatory conditions in certain sensitiveconstitutions. In all individuals suffering from this disease there isan over sensitiveness of the nervous system which admits of theappearance of such sudden and severe manifestations. Many casessuffering only mild symptoms for the first few seasons, annually becomeaggravated until severe spasmodic asthma is a regular, and sometimescontinuous complication. A case or two are on record in which the odorfrom the body of a horse so induced these symptoms that the individualcould never ride or drive him. 

TREATMENT. In mild cases, or when the attack first appears, the dailyuse of Dr. Sage's Catarrh Remedy fluid will neutralize and wash away thepoisonous particles which have found lodgment in the nasal passages. TheRemedy is best applied with Dr. Pierce's Nasal Douche. When the diseasehas existed the previous season it is necessary that the patient beginboth constitutional and local treatment four or six weeks prior to anexpected return of the disease. The nervous system should bestrengthened, and the resistance of the patient to the irritatinginfluence of these pollens and odors so increased, that even though hemay be exposed, no severe symptoms will follow. 

Dr. Pierce's Golden Medical Discovery will be found invaluable as analterative, blood purifier, and nerve tonic, and should be takenregularly while Dr. Sage's Catarrh Remedy is being used locally for itsantiseptic and curative properties. The action of the "Discovery" isespecially desired in cases that are so far advanced as to be attendedwith asthmatic symptoms, such as difficult breathing, headache, and afeeling of lassitude and prostration. 

In very obstinate or distressing cases our specialists have been able toprescribe and send, by mail or express, special courses of treatmentwhich have proven so effective as to cure the disease _permanently_, sothat it has not reappeared the following season. The treatment seems tohave produced such an impression upon the system as to have fortifiedthe individual against a return of the disease. 

In rare cases morbid growths in the upper air-passages are of such anature as in themselves to be a source of sufficient excitement tounbalance the nervous equilibrium so that the individual is thusrendered more susceptible to this disease. In such, or exceedinglyobstinate 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 mostesteemed neighbors they could be no more worthy of your confidence thanthey now are, coming, as they do, from well known, intelligent, andtrustworthy citizens, who, in their several neighborhoods, enjoy thefullest confidence and respect of all who know them. 

Out of thousands of similar letters received from former patrons, wehave selected these few at random, and have to regret that we can findroom 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 MedicalDiscovery saved my life and has made me a man; my home-physician says Iam good for forty years yet. You will remember that my case was a casejust between life and death, and all of my friends were sure it was acase of death, until I commenced taking a second bottle of "GoldenMedical Discovery, " when I was able to sit up and the cough was verymuch better, and the bleeding from my lungs stopped, and before I hadtaken six bottles of the "Golden Medical Discovery" my cough ceased andI was a new man and ready for business. 

And now I feel that it is a duty that I owe to my fellow-men torecommend to them the "Golden Medical Discovery" and Dr. Sage's CatarrhRemedy, which saved my life when doctors and all kinds of medicinesfailed to do me any good. 

I will send to you with this letter two of my photographs; one was takena few weeks before I was taken down sick in bed, and the other was takenafter 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" toohighly. I had a severe chronic cough and I began to use that medicineand took only one bottle, and I have not been sick a day since. When Ibegan 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 MedicalDiscovery to all suffering from diseases for which you recommend it. Inthe summer of 1888 I took a severe cold, which settled on my lungs andchest, and I suffered intensely with it. I tried several of our bestphysicians here and they gave up all hopes of my recovery, and myfriends thought I would have to die, and I thought so myself, as thedoctors did not know what was the matter with me. In the morning, onrising, I would cough and spit blood for two hours, and I was pale andweak and not able to work any. I then ran across Dr. Pierce'sadvertisement and I came to the conclusion I would try the "GoldenMedical Discovery, " as it was so highly recommended. I was greatlydiscouraged when I began the use of the "Discovery, " but after I hadtaken four or five bottles I then noticed I was getting better, and Icould stand it to work some, and kept on taking it till I took abouttwenty or twenty-five bottles. It has been five years since I took itand have had no return of that trouble since. I gladly recommend yourmedicine 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 herlung 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; uterinedisease, leucorrhea, menstruation scanty and painful; feet and anklesswollen; was confined to house most of the time; was given up by herhome 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, andwe summoned our home physician. He checked the hemorrhage but failed tocure 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, butthis gave but little relief. I happened to get hold of one of yourlittle books that comes with each bottle of Dr. Pierce's medicines and Iread some cases about like my wife's. I went to the drug store andprocured a bottle of Dr. Pierce's Golden Medical Discovery and my wifecommenced using it according to directions. She began to get betterright away and her cough has left her. She used about ten bottles. Sheis in her fifty-fifth year and can walk ten or twelve miles without anytrouble. We are satisfied that her life and health have been saved bythe use of "Golden Medical Discovery. " As soon as she takes any cold sheinsists upon having a bottle of her medicine, as she calls it, and thatis 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 onlyweighed 130 pounds. I had been suffering with malarial fever, chills, and lung disease for four years. I took treatment from many doctors, andtried many different kinds of patent medicines and all seemed to do nogood. Since I have used four bottles of "Golden Medical Discovery" andone 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 itsuse. 

 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. Theyalmost raised me from the grave. I had three brothers and one sister dieof consumption, and I was speedily following after them. I had severecough, pain, copious expectoration, and other alarming symptoms, and myfriends all thought I had but a few months to live. At this time I waspersuaded to try your "Discovery, " and the first bottle acted likemagic. Of course I continued on with the medicine, and as a result Igained rapidly in strength. My friends were astonished. When I commencedthe use of your medicines, six years ago, I weighed but 120 and wassinking rapidly. I now weigh 135, and my health continues perfect. Ihave a copy of your "People's Common Sense Medical Adviser, " and neithermoney 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 MedicalAdviser 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 wascontinually coughing day and night, and not able to work. I bought sixbottles of Dr. Pierce's Golden Medical Discovery and it did me more goodthan 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 fullyrecommend Dr. Pierce's Golden Medical Discovery to any person that hasconsumption. 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 verypoor. I was clear "run down. " Pain in my lungs, right side and in mybowels; had been ailing for nearly two years; my feet swelled during theday so I could hardly stand it till night, as I was on my feet the mostof the time. 

I wrote you and you sent me special medicines, which brought me aroundall right. I have weak lungs, and when I get run down I usually take afew bottles of Dr. Pierce's Golden Medical Discovery, which alwaysbuilds me up. We have used your "Discovery" in our family with the bestresults. 

When living at Blue Mound I was very sick with inflammation of the lungsfrom taking cold. When I took cold I was at Clinton, Missouri. Wasconfined to my bed for a few days. I said to the doctor that I must gohome; he advised me to stay where I was, but I started for Blue Moundwith my pulse at 140. When I arrived home I was glad to get in bed, andcalled in Dr. ----. He said my lungs were in a bad condition. Well, Iwas very sick for three weeks or more, and when I got around I was notwell, and at that time Dr. ---- came to Blue Mound, stopped there twoweeks, gave free lectures and had lots of patients. He examined me andsaid 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 wroteto your Association for advice, which was to take the "Discovery, " and Itook 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 toacknowledge the benefit I received from Dr. Pierce's Golden MedicalDiscovery. About seven years ago I became troubled with mylungs--consumption in its first stage. Some of my friends in Ontario hadbeen using your medicine before I knew anything of it; and after comingto this country, I commenced taking it, and I think it has done wondersfor me. I am positive, that if any one will persist in taking it, itwill do all you say. It has done so much for me that I feel it my dutyto 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 withdyspepsia, also nasal catarrh, and got so bad and weak that I could notwork. I could hardly eat anything without vomiting; had a pain in thestomach and a burning sensation coming into the throat. I took Dr. Pierce's Golden Medical Discovery and "Pleasant Pellets, " and can trulysay these medicines have helped me wonderfully. I improved right alongfrom the very beginning. I stopped taking medicine in the latter part ofMay and then felt as well as ever in my life. I am pretty well now, fora man of sixty-three years. I can eat all kinds of food and it doesn'tcause 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 neednot hesitate in taking Dr. Pierce's Golden Medical Discovery fordyspepsia; 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 inthe lungs; had chills and night-sweats; was much reduced in strength. After trying for relief in different directions without success, I wasinduced 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 soonas I began the use of the medicines which were prescribed for me at thattime. The improvement has been continuous, until I now feel my lungs areentirely cured; have no cough, no expectoration in the last month, andmy usual weight of 183 pounds has been restored. Have been able to do afair day's work any time during the past two mouths without unusualfatigue. I can cheerfully recommend your Institution to personssimilarly affected, and will authorize you to refer any one makinginquiry 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 ableto do hardly any work at all; had pain in my left side and back, and hadheadache all the time. I tried your medicine and it helped me. Lastspring I had a bad cough; got so bad I had to be in bed all the time. Myhusband thought I had consumption. He wanted me to get a doctor, but Itold him if it was consumption they could not help me. We thought wewould try Dr. Pierce's Golden Medical Discovery and before I had takenone 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 notdo it justice by mere words. 

I was taken sick the 5th of July; I called a doctor but did not receiveany benefit from him. I was going into quick consumption. Had a terriblecough, raised a great deal of phlegm; had pain through chest, was veryweak and all run-down. " I told my husband to get a bottle of "GoldenMedical Discovery;" he did so; I commenced taking it and I began to getbetter. I was not outside of the door yard, from July 5th, until August22d. I only took two bottles, and the first of September I was able todo the work for boarders, and have had boarders ever since. It is thegrandest 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 begantaking your medicines I thought my time was short. I have not spit upblood now for about four months, and am feeling much better. Our homedoctor says my temperature and pulse are all right now; and that I donot need further medicine, and that I will get all right again. I feelthat 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 ofphysicians, and now do convey to you, my heart-felt gratitude for yourable and skillful assistance rendered me in my afflictions. I had beenfor years a sufferer, and at times nearly despondent. I had been treatedby the most able and skillful physicians that this north-western countrycould provide. I had paid them large sums of money and was finally givento understand that there was no hope for my cure. Your advertisementsfell into my hands, which treated upon my case. I read and compared mycase with the insight you so ably explained, so I was satisfied youunderstood your profession well. I started full of hope and as I reachedBuffalo, after three days' travel by rail, some 1, 500 miles, there wassomething that cheered me on. I made my way to your Invalids' Hotel. Iwas examined and pronounced curable. I was operated upon for a localaffection that caused much of my suffering, the same day I arrived, andin ten days was discharged permanently cured. I have felt perfectly wellever since. I was nicely treated by the able nurses and attendants whowere always gentle and kind. 

I can cheerfully say to the public, that they need not hesitate inthrowing themselves into your kind care in every case that is curable bythe hand of man, and you will treat them honestly. 

Hoping this may be of some benefit to some afflicted persons who mayfeel 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 medicineand advice that I am as well as I am. I might have been entirely well ifI had been able to have kept the medicine to take as directed. I havetaken only four bottles, and it would be four or five months from thetime I would take one bottle till I could get another one. I can talkbetter, and feel almost like a new person to what I did two years ago. Iweigh more and can do any kind of work. Dr. Pierce's Golden MedicalDiscovery 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 hadtried three doctors--took over one dozen bottles of patent medicines, without relief. 

I had chills with hacking cough; my friends said I had consumption; wasreduced in flesh and nerve till the least work or exercise would exhaustme completely. 

Thanks for the day I wrote you, for I sent you ten dollars, and receivedfour bottles of medicine which I took, and have been able to do hardwork. I have never had any symptoms of those dreaded chills since. Myweight got as low as 135 pounds; now I weigh 175 pounds. I would adviseany one affected with chronic disease to consult you, as your treatmentis 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 TOHELP 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 Ivisited your Institution in 1889, completely broken down in health andsuffering, as I thought, from heart disease and consumption. I had spentmoney with many of our home physicians, but they only gave me partialrelief and I would soon be worse than ever. When I spoke of coming toyou, the doctors here cried "humbug, " but I told them I had beenhumbugged at home and if I staid I would surely die, and if I went coulddo no worse. I spent thirty days at your Invalids' Hotel and SurgicalInstitute, and came away like a new man, comparatively speaking. I foundthe 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 wearyand thirsty traveler; for those were among the happiest days of my life. No pains were spared to make each patient comfortable and at home. Icannot recommend your Institution too highly, for I feel that to yourtreatment I owe my life. I have sold a great deal of your medicines, andrecommend 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 youdesire, for my only motive in writing is to benefit the afflicted, bypointing 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 theInvalids' 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 theskill of four doctors and all the patent medicines that were recommendedfor my case, which was an abscess on the lung. My physicians and friendshad given me up to die; I was reduced to a perfect skeleton; my strengthwas gone; my eyesight was so dim I could scarcely see at all, and I hadno appetite--could not eat anything at all when I commenced using DoctorPierce's Family Medicines. I have taken sixteen bottles of the "GoldenMedical Discovery, " twelve bottles of "Pellets" and three bottles of"Favorite Prescription, " and to-day I am well and strong and weigh 128pounds--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 horriblecough and one lung was almost gone; our doctor seemed to think therecould be nothing more done, and said to go South; but not having themeans at that time, I began giving her Dr. Pierce's Golden MedicalDiscovery, which she took steadily for two years. During that time shegained rapidly in strength; the lungs became normal, the cough leavingher entirely. We are never without this medicine in the house, and haverecommended it to all our friends, and I am positively certain that ifDr. Pierce's medicine is used in time, it will cure in other cases aswell 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 bytaking your medicine, I now would say, that one year ago I was given upby my family physician and friends; all said I must die. My lungs werebadly affected, and body reduced to a skeleton. My people commenced togive me your "Medical Discovery" and I soon began to mend. It was notlong before I became well enough to take charge of my household dutiesagain. 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 alwaysin the house. I shall never forget those nights when I was down withpneumonia. Had it not been for Dr. Pierce's Golden Medical Discovery Iwould not be a well man to-day. One bottle stopped the cough and nightsweats. 

My wife was troubled with leucorrhea so bad that we did not know what todo until Dr. Pierce's Favorite Prescription was brought into the houseand 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 asevere cold, which settled on my lungs. Each succeeding winter my coughgrew 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 followingsummer I had congestion of the lungs and hemorrhage and a severe spellof fever. My physician advised me to go West in search of health. Myfriends thought I had consumption of the lungs, I coughed so much. InSeptember, 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), todeath; and to add to my distress I had an almost intolerable attack ofpleurisy. A doctor was summoned and after an examination said I hadEmpyemia, and said he could do me but very little good until he removedthe pus. He and his partner came and by the use of an aspirator drew offnine pints of pus; after about a week he drew off two pints. After a fewdays I told my doctor I could hear the pus gurgle as I had before hedrew it off. Strange to say, but nevertheless true, my heart was crowdedover on the opposite side for three months. I knew it was there for Icould feel the pulsations there, and I was so short of breath for a longtime I could not stoop down to tie my shoes. 

The doctor told me it would be useless again to use the aspirator, butthat he would be obliged to make an incision in my side and treat ittill I got well. On the 28th day of March. 1890, my doctor and hispartner and three other doctors undertook the operation, and, afterremoving 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 inthree months the doctors thought I was able to come home. I arrived homein June and was very poorly all summer, and did not sit up but _verylittle_, and had fever every day. In the latter part of the summer of'90 I commenced to take "Golden Medical Discovery" and although my sidehad been discharging for TWENTY-THREE MONTHS it healed up sound andwell. I am now able to do considerable hard work. I would advise all whoare afflicted as I was, to give your medicine a trial. I am glad I haveout-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 twoyears and lost strength so that I was unable to do much work. I tookfour bottles of Dr. Pierce's Golden Medical Discovery, and can say thatit did more good than any other medicine that I ever took. I am now ableto 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, coughand catarrh, with profuse expectoration; difficult breathing, lastingfrom one to eight hours. He writes:

"I took sick and went to the doctors. They gave me medicine, but it didnot 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 Igot sick again so I could not do anything, and I wrote to you giving mysymptoms on one of your question blanks, and asked you about my case. You told me to take your 'Golden Medical Discovery. ' I took four bottlesand 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 badcoughing spells every day and would cough up mouthfuls of solid whitefroth, and before I took one bottle it stopped it. I could not walkacross the room with the pain in my back and sides; but soon the painwas all gone, and I could sleep well at night. My general health is muchbetter since I have taken the "Golden Medical Discovery" although I havebeen 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 spittingblood for the past six years. Menstruation was scant and caused greatprostration. Suffered from constipation; cutting pains about the stomachand rumbling in the bowels; exceedingly nervous; indigestion. She writesas follows: "I wish to inform you that I am well. I never can praise youor your ways of treatment enough. I shall bring you all the patientsthat I can. I feel so rich to get my health back. I can eat well andsleep well, and work all day. I suppose you will think it took a longtime to pull me up, but I was very low, much worse than I ever told youof at the time. I was not able even to feed myself any more. My husbandhad to undress me. I could not wash my own face, or stand alone. I didnot lie down to sleep for eleven months; I always had to sit up, becauseI would choke if I laid my head down. _I have not raised a drop of bloodsince your treatment_, and I did it always for five years before. Ourminister said this spring that he had never thought I could live, andsays that he advises every one that is sick to go to you. He was sosurprised to see how strong and well I was. My relatives all think thatyou ought to write my case up for the papers in Chicago. I can neverrepay you for what you have done for me. A thousand thanks is but emptywords. My husband was telling a man just last week, "do not spend allyour money in Chicago, as we did, and then write to Buffalo, but go andwrite now, and your wife will soon be well. " My father was saying thathe wished the doctors that gave me up could see me now. I think theycould not believe their own eyes. I am astonished when I think back howI was six years ago; I could not walk across the room alone for threeyears, and after taking your treatment for eighteen months, I am_completely_ well. I can hardly believe it myself when I read over thoseletters that I received from you. I work hard every day. There is nevera day that you are not remembered. I hope that you may live many yearsto do for others what you have done for me. I had this taken so that youmight have my picture as I am now; I wish you could have seen me as Iwas then, and I wish to thank you for those little notes of inquiry thatyou used to send to find out how I was getting along, which showed thatI was remembered not only while the money lasted, but that you cared forme 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 tobed for nearly six months. I had four doctors to see me, but it justseemed to me that they could relieve me for only a short while. I had abad cough and all thought I was going into consumption. After being sickfor so long, my nerves were nearly exhausted and my stomach, liver andbowels 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 ayear before and had been greatly benefited by their use, so she said Iwill try the last resort--for I had been given up to die. 

I began taking your "Golden Medical Discovery" and "Pleasant Pellets. " Iimproved 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 theuse of your medicines, I could eat nothing in peace; I would almostcramp to death, even when I took a little cold water. 

But after the use of four and a half bottles of your "Golden MedicalDiscovery, " and two vials of "Pellets, " with God's help, I have almostrisen from the dead. 

I will cheerfully recommend your remedies to my afflicted friends, for Iam to-day, well and strong as ever. You can use this among yourtestimonials, 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 notwork without coughing so hard as to take all my strength away. I tookfive bottles of Dr. Pierce's Golden Medical Discovery, and give you myword 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 inthe weather, I have a slight attack of coughing. Remember, I have nottaken 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, hadsevere cough and great difficulty in breathing; appetite was poor andsuffered from indigestion, became very weak and despondent. My age (I amnow 71) was against me. I was treated by two physicians but they did meno good. I then used four bottles of your "Golden Medical Discovery" andwas 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. Iused Dr. Pierce's Golden Medical Discovery besides using Iodine andmustard paste. 

That pain in my lung entirely left me, and I have not felt it at allsince last August. The doctor who lives here and who has always treatedme 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 fourteenbottles of Dr. Pierce's Golden Medical Discovery. I had chronic sorethroat, hoarseness, sore chest, rheumatism in my arms, and was very muchrun down. The doctor here at home said one lung was affected and that Ihad 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 lowwith a cough, and at times spit up much blood. I was not able to do theleast work, but most of the time was in bed. I was all run-down, veryweak, my head was dizzy, and I was extremely despondent. The firstbottle I took did not seem to do me much good, but I had faith in it andcontinued using it until I had taken fifteen bottles, and now I do notlook nor feel like the same man I was one year ago. People areastonished, and say, "well, last year this time I would not have thoughtthat you would be living now. " I can thankfully say I am entirely curedof a disease which, but for your wonderful "Discovery, " would haveresulted 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 orwalk, for I coughed all day and night. My weight was reduced from 150 to127 pounds. The first night that I slept four hours at one time, wasafter I had taken three doses of Dr. Pierce's Golden Medical Discovery. The offensive matter expectorated grew less every day and when I hadtaken 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 miserableall summer; I was very bilious; sometimes my bowels would not move oncein sixty or seventy hours, and then almost impossible. I would take somebitters, which would help to move the matter, but as soon as the bitterswere gone, I had to buy more or I would be as bad as before, andsometimes worse; but none of them appeared to do me any good except tomove the bowels, until thirty years since a druggist called my attentionto Dr. Pierce's Golden Medical Discovery, and before I had taken half abottle of the "Golden Medical Discovery" I felt much better and by thetime I had taken all, I could eat three hearty meals per day and had notfelt so well for a long time. Soon after I was called to do a job somemiles from home, and one night the old lady there was speaking about herdaughter, (Mrs. Brooks) who had been under the doctor's care for fivemonths and did not get any better, and I learned by asking a fewquestions that she had no appetite, and no ambition to do anything. ThenI told her what the "Golden Medical Discovery" had done for me. The nextday the old lady drove down to her daughter's, and got Mr. Brooks tosend to Rutland--ten miles away--for two bottles of the "Golden MedicalDiscovery, " and the next day the doctor came, and when about to takeleave, Mr. Brooks told the doctor he did not want him any more atpresent and would send for him if necessary. I saw the old lady aboutten days later and her daughter was improving, and Mr. Brooks had greatfaith in the "Golden Medical Discovery, " and had not sent for thedoctor, but had gone to Rutland for more of the "G. M. D. "

When I commenced taking the "Golden Medical Discovery. " I thought I wasgoing into consumption as had a cough for three years or more and myweight 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--throatand lung and other affections, which almost resulted in consumption. Ourdoctors could do me no good. I happened to get hold of some of DoctorPierce's books, and was induced to try his treatment. To the surprise ofmyself and family, I was, in a short time, changed almost to a newperson--from pale sallow complexion to the bloom of health again. Manythanks for restoring me from an untimely grave. I will say to the publicit is not always necessary to go to the Institute; I was treated at homewith success. I cannot speak in too high praise of Dr. Pierce's GoldenMedical Discovery, "Pellets" and "Favorite Prescription. " I think theywill 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 andbronchial disease, following a severe attack of pneumonia. Was raising agreat amount of pus, had severe night-sweats and was very muchprostrated, when I was induced to visit Dr. Pierce's Invalid's Hotel andSurgical Institute for examination. After having a full statement of mycase, I paid for one month's treatment in the Sanitarium and during thattime was fully restored to health. I can not speak too highly of thephysicians, and this famous Institution. 

I take great pleasure in making my cure public and in highlyrecommending this Institution to all afflicted. The Staff of Physiciansand Surgeons is skillful and of large experience, and I feel confidentthat all the benefit that can possibly be obtained from medicaltreatment, can be obtained at the Invalids' Hotel and SurgicalInstitute. 

 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 Itried four different doctors and grew worse all the time. Then I beganon your medicine and took twelve bottles of "Golden Medical Discovery"and one of "Favorite Prescription, " and am able to do my work and feelas well as I have felt in years. Physicians called my disease Dyspepsiaand 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 skillin preparing your medicines and placing them within reach of thesuffering. 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 bestskill, and did not receive much benefit. She was first attacked withpneumonia and pleurisy in very bad form and was then taken with a verybad cough, which kept growing worse and worse, until finally it seemedas though she had consumption very bad. The physicians prescribed Codliver oil, but to no benefit. Mrs. Miller, a neighbor of ours, recommended Dr. Pierce's Golden Medical Discovery to me with very strongfaith, as she had been in the same condition and was cured by its use. Iprocured two bottles and she grew better. She hasn't felt any return oflung disease in over twelve months. She was nothing but a skeleton whenshe took the first dose, and to-day she weighs 135 pounds. I thought itmy duty to write to you in regard to her case, as so many othermedicines 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 byletter and two months' trial of Dr. Pierce's Golden Medical Discovery, Iam enjoying a better state of health than I have for some time. I havehad 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 badcough, it seemed as if my lungs were swollen; could not expectorate muchat 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 consultedyou. It seemed I was going into consumption very fast. I have as goodhealth now as could be expected. I am fifty-seven years of age and ableto work on my farm, and feel under many obligations for your kindadvice. Also my stomach was out of order, suffered with burning in mystomach and chest. I have no burning nor pains in my stomach and chestnow. 

 Yours truly, Milton Ramry

DOCTORS ENDORSE IT. 

AN EMINENT PHYSICIAN OF ARKANSAS TELLS OF SOME REMARKABLE CURES OFCONSUMPTION. 

[Illustration: Mrs. Rogers. ]

Dr. PIERCE:--I will say this to you, that Consumption is hereditary inmy wife's family; some have already died with the disease. My wife has asister, 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 hersister insisted on her using the 'Golden Medical Discovery. " I consentedto her using it, and it relieved her. She has had no symptoms ofconsumption for the past six years. People having this disease can takeno 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 invain, and expected to die with consumption. But hearing of yourInvalids' 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 tocure 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 andtried some home remedies, and it grew worse; and then I went to a doctorhere 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 grewworse for two years when I wrote you about it. You advised me to takeDr. Pierce's Golden Medical Discovery and his "Pellets, " according todirections, and they would cure me, and so they did after taking eightbottles 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 BLOODYPILES. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N. Y. :

[Illustration: Mrs. Knavel. ]

_Gentlemen_--In the winter of 1881, I became irregular in my monthlycourses. Of course at first I paid but little attention to it, hoping itwould amount to nothing and probably wear away. But I slowly but surelygrew worse, and at last resolved to apply to the doctors for help. Mywater came often, and in small quantities, and with great pain, and withred brick-dust deposit. I was attacked with severe womb trouble, bloodypiles 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 stillseemed impossible for me to get well and I began to feel exceedinglyalarmed and very uneasy, not knowing what course to pursue, or what theconsequences might be. I had heard of Dr. Pierce, and concluded to makeone more trial, so I sat down and wrote a letter to him, stating mattersas near as I could, and in due time I received a favorable reply; then Icommenced with his medicine. I commenced somewhere in February 1891 withthe "Golden Medical Discovery" and "Favorite Prescription, " in alternatedoses. 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 whatwas going to take place. I kept on till I took nine bottles. The firstrelief I felt was from sick headache, which I had been troubled with formany years; I was also cured of a very bad cough which I had beentroubled with for many years, and of dyspepsia of long standing. I wasentirely cured of a very singular and severe itching on my back, betweenmy shoulders, which our doctor's called winter itch and which theypronounced incurable. I had suffered with this for twenty years; itwould come in the winter and go away in the summer. I was also cured ofthe worst form of bloody piles and of womb disease. At present I feellike a new person. 

When I first commenced with Dr. Pierce's medicines, I could not walkhalf a mile without a pain. The other day I walked to Mercersburghpost-office, a distance of twelve miles, and the next day walked backagain, 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 moreconcerning my case and its wonderful cure, and who will enclose to me areturn self-addressed and stamped envelope for reply, I will be pleasedto 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, followedby _bronchitis_ and _pneumonia_. Her husband writes: "I feel gratifiedwith the effect of your wonderful medicine. I can recommend it toanybody, and feel I am doing them justice. My wife was not able toperform 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 thinkit 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 whotreated me with their very best skill and did not receive much benefit. I was attacked with "La Grippe" in December, 1891, and pleurisy, and wastaken with a very bad cough, which kept growing worse. The physiciansprescribed Emulsion of Cod Liver Oil, but no benefit. In June, 1892, Ibled from the lungs; everybody thought I would die. A friend told me totry Dr. Pierce's medicines. I did so, and after taking six months'home-treatment I was cured. When I commenced taking his treatment I onlyweighed 130 pounds, now I weigh 175, and can do as good a day's work asI ever could. I can cheerfully say that I believe I owe my life to hisvaluable 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. Icould do no work hardly until I used Dr. Pierce's Golden MedicalDiscovery. After using five bottles of the "Golden Medical Discovery"and three vials of the "Pleasant Pellets" I was cured, and now I amdoing the work for a family of nine. I tried other medicines and nothingwould do me any good, and if I had not gotten your medicine I would havebeen in my grave. I could not recommend it too highly for the good itdid 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 thewonderful cure that your special remedies performed in my case. In theSpring of 1891, I had a severe attack of La Grippe, which left me in badshape. I consulted as good a physician as there was in the county, andhe told me that I was suffering from enlargement of the heart and that Imust be very careful about taking: any violent exercise, and I must notallow myself to get excited, as excitement of any kind might provefatal. He gave me remedies for my trouble which made me feel somebetter; but being a farmer I was obliged to work hard and soon began torun down. I began to have spells of a terribly deathly sinking feelingat my stomach and a terrible pressure at the heart--in the region of theheart, and sometimes I would fall prostrate and although I was consciousall the time I could not speak aloud. 

The last of October, 1891, while doing my chores in the morning, I hadone of those bad spells and upset my lantern, which resulted in mylosing my buildings by fire. 

My wife was out of health at that time--she, too, was suffering from theeffects of La Grippe. Having lost everything eatable for ourselves andstock, I was forced to work very hard to get through the winter. Thenext February, 1892, we had another attack of La Grippe, which resultedin the death of my beloved wife. The next May, this terrible afflictiontogether with hard work completely broke me down and although I wasdoctoring all the time I kept steadily growing worse. I got so bad thatI could not sleep more than two or three hours any night and very oftenI would go all night without closing my eyes at all. 

The last of September, I had to give up work almost entirely. I got sothat I _could not walk one-fourth of a mile without being completelyexhausted_. One physician whom I consulted said I was suffering withnervous prostration and gave me medicine for it, but I got no better. Myfood distressed me terribly and after eating, it would sour and I wouldhave to vomit up the most that I had eaten. At last, I got so I had tolive on bread made of wheat middlings and for about three months I couldnot eat anything else, although it seemed as though I should starve todeath. I thought I would give anything if I could eat a hearty meal ofanything that I wanted, but did not dare to because every kind of fooddistressed me so. My bowels became badly constipated and for threemonths I did not have a natural operation of the bowels; and I sufferedvery much with catarrh, and there was such a pressure across my foreheadthat it seemed sometimes as though it would burst. I became verydespondent. I did not want to go anywhere, neither did I want to see anyone, everything looked dark and gloomy to me. When well, I was naturallyor a lively disposition and a great hand to joke with my friends, but noone could say anything funny enough to get a smile out of me then. I wasalways very fond of music too, but I could not bear to hear a bit ofmusic, neither vocal nor instrumental. About the first of February, 1893, some of my friends prevailed upon me to consult a physician whomade a specialty of treating chronic nervous troubles; he said I had noorganic trouble of the heart and that it was caused by my stomach beingout of order; he said that I had a bad kidney trouble and that my spinewas affected, and that unless I got help it would end in "LocomotorAtaxia. " He said he could help me but it would probably take a year tocure me. He let me have a month's treatment and gave me advice in regardto diet, etc. I thought for awhile that it was helping me but soon Ibegan to go down hill again, and as a last resort I began to take someof the cure-alls (patent) with which the country is flooded; but I soonbecame 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 myleft foot up to step over anything--had to draw it after me; I couldhardly sleep; neither could I transact any business, in fact I did nottake any interest in any of my affairs. It seemed to me as though I didnot have a friend on earth, and I longed for death to come to put me outof my misery. 

My son, with whom I was living, had been trying for a long time to getme to send to you for treatment, but I had paid out so much money andreceived no benefit from it, that I did not believe there was any helpfor me. 

At last I thought I would write you what I could of my symptoms, and getyour opinion of my case, but it took me about two days to write theletter. My head felt so bad that I could not collect myself enough todescribe my feelings. You wrote me that my trouble was caused byindigestion, dyspepsia, catarrh, and spinal affection, and that youcould cure me, and in fact, make a new man of me if I would send foryour special treatment and follow your advice. My son sent for themedicine for me. I took it and followed your directions as near as Icould; the first week I could not see much of any change--the secondweek I could see that I was improving some, the third week I could lookback and see that I had gained considerable. I could sleep better; thebloating in my bowels did not trouble me so bad; my stomach did notdistress me so much and I could eat different kinds of food and mydigestion seemed to be improving fast; and by using your Special CatarrhRemedy my nose began to run (it had been nearly six months that my nosewas perfectly dry) and one day it felt as though something gave way inmy head--it seemed to be back, in behind my eyes, and I blowed a largeamount of filth out of my head that looked like the yolk of an egg, andit was nearly as thick as jelly; after that my head began to improverapidly and I began to gain in flesh and strength, and the best of allis, I have kept right on gaining until at the present time _I feel aswell as I ever did in my life_. Sleep well, can eat three hearty mealsevery day and digest them too, and eat anything I want, and seven daysin a week. 

To look back now I don't see why I did not apply to you when I was firsttaken sick. For about ten years ago. I had treatment of you for catarrh, liver and kidney trouble, and you helped me then; also, about eightyears ago my wife had two months' treatment from you which helped her ofthe troubles from which she was suffering at that time. All the reasonsthat I can give, is, that owing to financial troubles and having to payout so much for sickness, I could not seem to get the money (that Icould spare) to pay for the treatment. 

Gentlemen, I wish I could express my thanks to you for what you havedone for me, but I cannot do it. I am a poor hand to express myself, butI consider my restoration to health almost a miracle, and I firmlybelieve that I owe my life to you, for I do not believe that I shouldhave lived till the present time had it not been for your SpecialTreatment. Now, if there is any part of this letter that you would wishto publish, you are at liberty to do so: and if it would be the means ofdirecting any suffering fellow being to a place where they can getrelief, 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, catarrhand 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, andwas advised to try a course of special treatment. After taking only twomonths' medicines from your noble institution, I feel perfectly restoredto health. I have, moreover, recovered my lost flesh, and I am pleasedto 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 withsores forming on the inside of nose; if not attended promptly the soreswould come out on bridge of nose and also in the corner of nose andupper lip. We had several physicians attending her, but they gave heronly temporary relief. We were advised by a friend who had used yourremedies to try them. After using thirteen bottles of Doctor Sage'sCatarrh Remedy, and at the same time two bottles of Doctor Pierce'sGolden Medical Discovery my daughter was completely cured of the dreadeddisease and in the past three years has had no symptoms of the diseaseever coming back. I am satisfied the above medicines will cure any kindof 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 tosuffering humanity, to make known the virtues of your medicine in curingcatarrh. About ten years ago, I first began to realize that I was thevictim of nasal catarrh; I tried every known remedy, but gradually grewworse. My ears would gather and break; nights of restlessness wouldsucceed days of agony. The disease finally attacked my left lung, and Idespaired of obtaining relief. About six years since I began the use ofDr. Sage's Catarrh Remedy, in connection with the "Golden MedicalDiscovery, " and by the persistent use of the above remedies I feel thatI am completely cured of this loathsome disease. 

For attacks of biliousness, coughs and colds, I think there is nothingequal to the "Discovery, " and I bless the day that I first began the useof 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, havingvery severe pains in the top of my head. A hunch came on the side andback of my head--my whole head and face were so sore and sensitive thata pillow of down felt hard, and I was obliged to change my positionoften. I could not breathe through my nose at all and was obliged tokeep my bed fully one half of the time, and could not collect mythoughts to think steadily on any subject--I was really afraid of losingmy reason. I got all run-down and was "out of sorts" in general; then Icommenced using Dr. Sage's Catarrh Remedy and Dr. Pierce's GoldenMedical 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 physicianswithout benefit, I went to the Invalids' Hotel and Surgical Institute, and can most highly recommend this place to all sufferers. I had asevere attack of catarrh and general debility, and after a short stay atthis Institute, my whole system was toned up and I was soon enjoyingperfect health. 

I can truthfully say that this institution fully merits all the praisethat could be given it. I never lose an opportunity to recommend all mysuffering friends to the Faculty of this Association, for I believe itis in advance of its kind in the world. The physicians and surgeons areskillful and of wide experience, the nurses kind and thoughtful, therooms large and pleasant, and everything is done to make the visit ofany one pleasant as well as beneficial in the highest degree. 

I do not hesitate to urge all invalids, no matter what their trouble, toplace themselves under the care of the eminent physicians of thisinstitution, being confident that they can give them all the relief thatpossibly 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 andliver complaint, and having become greatly reduced in health, as a lastresort I placed myself in your hands for treatment My improvement beganalmost immediately after entering your institution. I was enabled toleave at the end of one month, having experienced great benefit. Thetreatment was continued at home for a few months, after which my curewas complete. At the present time, I am able for office work, and feelthat I am completely cured of the catarrh and have but little if anytrouble with my liver. I shall lose no opportunity to recommend yourinstitution or your medicines to the afflicted. I do most unhesitatinglyrecommend chronic sufferers to visit your institution or take yourremedies 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 andremedies to see if I could not obtain relief, but I grew constantlyworse instead of better. 

I heard much concerning the Invalids' Hotel and Surgical Institute atBuffalo. I concluded to go there and try and obtain some benefit. Istaid a month in this famous Institution, and during that time made fineimprovement, and when I left felt like another man. 

I can truthfully recommend this world-renowned Institution to all theafflicted. The Institution itself, in all its appointments, is far inadvance of the age. It is more like a home than a hospital; the roomsare large and pleasant; the table the very best; the nurses kind andconsiderate, and the doctors skillful and of wide experience. Whilethere I saw and talked with a great number of people who had come tothis Institution as a last resort, and they were all unanimous in theirpraise. 

I cannot say too much in favor of the World's Dispensary MedicalAssociation and its Staff of skilled attendants, nor can I too stronglyurge all sufferers to go there, being confident that all within thepower of medical science and skill can be done for them there. Wouldsend you my photograph as requested, but there is not a photographgallery 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 friendsthought I had consumption; I got so weak I could scarcely walk acrossthe floor, and raised a good deal. I commenced taking Dr. Pierce'sGolden Medical Discovery and my cough soon got better, and I have notbeen troubled with it since. That was four years ago; I took only threebottles. I would recommend it to all having throat or lung trouble. Ihave also used Dr. Sage's Catarrh Remedy with equally good results. Ibelieve that no one need suffer long with chronic catarrh who is withinreach 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 casePulmonary Consumption. Since that time I nave taken various treatments, some of which have given relief. One treatment that was administered fornasal catarrh, from which I continued to be affected, caused erosion ofthe mucous membrane, and destruction of the bony septum which separatesthe two nostrils. Took cold quite easily, suffered from considerablenasal catarrh, with discharges passing posteriorly dropping into thethroat; occasional cough with some shortness of breath on exertion. Adeep inspiration caused a dizzy sensation in the head; eyesight wasimpaired as well as the memory. After sitting for a time, and thenquickly rising I suffered from blindness as well as a dizzy feeling inthe 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 incipientstage of consumption. I also suffered from indigestion, torpidity of theliver, and constipation of the bowels. 

Upon consulting at your Institution, was advised at once to begin thecourse of specially prepared medicines as indicated in my case. In all, I have only taken two months' special treatment, and it has now been sixmonths since I have required any medicine; all symptoms of disease haveentirely disappeared, and I desire to thank you for the interest youhave taken in my case, and the treatment prescribed. I have no objectionto your publishing my testimony, if by so doing others may be induced toplace themselves under your care for treatment at your Institution, orhave 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 GoldenMedical Discovery. I had a very bad cough, also night-sweats, and wasalmost in my grave, as we thought, with consumption, when a friend ofmine who died with consumption came to me in a dream and told me to takeDr. Pierce's Golden Medical Discovery, and, thank the Lord, I did so. Bythe time I had taken half of the first bottle I felt so much better, Ikept on till I had taken three bottles, that was all I needed. I gotwell 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 breathethrough my nose. I tried everything I was told of, and all failed tocure. I read about Dr. Pierce's remedies and thought I would try them. Iused three bottles of Dr. Pierce's Golden Medical Discovery, four of Dr. Sage's Catarrh Remedy, and I was relieved within two weeks. I continuedthese medicines for four weeks, and am perfectly cured. I would adviseany one who is troubled with catarrh to use Dr. Pierce's medicines. I amvery 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. Ihad it several years before I knew what it was, then I read Dr. Pierce'sdescription of catarrh. I felt as he described. No one else had everbeen able to tell me anything of the symptoms he described. I simplyconcluded 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 itsince. 

At the time I placed myself under his care I could not breathe with mymouth closed. My friends thought I could live only a few months more. Ihave 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 ofthat 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 leftnostril closed, I could not breathe through it; had a constant painabove my left eye night and day. I commenced using Dr. Sage's CatarrhRemedy, at the same time using the "Golden Medical Discovery"; I usedone package and one bottle of "Golden Medical Discovery" and I foundgreat relief; after using the second I thought all was right, but Ibegan to feel the effects of it again, so I got the third and fourthpackages, and I am satisfied I am rid of it. Since I commenced usingyour medicines, I have taken six bottles of Dr. Pierce's Golden MedicalDiscovery. 

 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 numberof years which greatly debilitated my system, and in consequence, havebeen in poor health for the last five years. 

Slight exposure would cause bronchial trouble, but kept up under ituntil a little more than two years ago when I was taken with "LaGrippe, " which greatly aggravated my other troubles; and for more thansix months before consulting you was scarcely able to do anything;_could not breathe through my nostrils_ only a little while at a timeeither day or night; I suffered _dreadfully_, having at times _terriblepains in my head_ being unable to sleep some nights more than two hoursand then not without dreaming, and when I awoke my head felt worse thenwhen I retired. Had indigestion, chronic constipation and stomachtrouble. 

A little more than a year ago, while reading in one of your MemorandumBooks 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 remainedabout the same until I consulted you by letter and the remedy prescribedproved effectual; after three months' treatment, I am able to do most ofmy 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'sCatarrh Remedy. I can say honestly and candidly that it is the grandestmedicine ever compounded for catarrh. I suffered terribly with thatdreadful disease and thought my case a hopeless one. I have expended onmy case about forty dollars for different remedies guaranteed to curecatarrh in its worst form, but received no benefit therefrom. I alsoreceived treatment from two physicians, but they did me no good. Havingread a great deal about Dr. Sage's Catarrh Remedy, I concluded to tryit. The first bottle gave the most pleasing results, and the secondbottle completely cured my case, which I considered hopeless. I mostheartily recommend Dr. Sage's Catarrh Remedy to all suffering fromcatarrh, with the assurance that it will surely cure. It is a great boonto suffering humanity. Hoping that this humble testimony may be themeans of leading many sufferers to try your most valuable medicine withthe same happy results as I experienced, and wishing you the best ofsuccess, 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 beentaking "Golden Medical Discovery" since I last wrote to you. I am wellpleased with the result. I feel better than I have for years. The"Golden Medical Discovery" caused a very unpleasant sensation to passthrough my body at first but I do not feel it much now. I haverecommended it to others and the only complaint I hear now is that ourdruggist cannot keep a supply on hand. 

I take pleasure in reporting my case to you, and I feel that theinterest 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 fallthey got so bad she was unable to walk. She has taken "Golden MedicalDiscovery" all winter and is now able to walk a little. She says shefeels better in body than she has for years. She has spent the most ofher 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. Iused six bottles of "Golden Medical Discovery, " and three bottles DoctorSage's Catarrh Remedy, and since using your medicines I have been ableto do more work than before. I have been teaching school since my healthgot better and last year I was able to travel and preach fifty-ninesermons, 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 Ifound to be the best blood-purifier I ever used. Had I not used yourremedies I believe that I would have been dead to-day, or at least notable to say anything. But instead of that I am able to walk one andone-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 dyspepticsymptoms have all vanished. I am no longer troubled with headache andstoppage of the nose, my stomach is in good order, and I enjoy threehearty meals daily without any bad feelings. 

I have gained in almost every respect, particularly in weight andstrength, since beginning the use of your specially prepared medicines. By continuing to follow your special hygienic rules, I believe norelapse 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 Catarrhin the Head. I can honestly recommend them to all who may suffer fromthat distressing disease. 

 Yours truly. M. D. INGRAM, Ingram, Bell Co. , Ky. 

Mr. Ingram had suffered for many years from the most distressingsymptoms, such as profuse offensive discharge from nose, stopping up ofnose, 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 myleft lung at the same time. You put so much faith in your remedies thatI concluded to try one bottle or two, and I derived much benefittherefrom. I used up three bottles of Dr. Sage's Catarrh Remedy, fivebottles of your "Golden Medical Discovery, " and in four months I wasmyself again. I could not sleep on my left side, and now I can sleep andeat heartily. So long as I have your medicines on hand I have no need ofa 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 chronicnasal catarrh. My family physician gave me up as incurable, and said Imust 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 couldbarely speak above a whisper. In the morning my coughing and clearing ofmy throat would almost strangle me. By the use of Dr. Sage's CatarrhRemedy 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 beengreatly benefited by your medicines; my trouble began with nasal catarrhand extended to my throat and ears; my bowels were inactive and mygeneral health became impaired; my worst trouble, however, was dullnessof hearing. I had an uncomfortable, bad feeling in my ears--akin toearache; I had a watery discharge from the nose; I had to hawk and spita great deal at times; my mind was greatly affected also and had a greatdeal of pain in the head. Upon advice of friends to try your medicines Iresolved to do so. Have used six bottles of your "Golden MedicalDiscovery" and two bottles of Sage's Catarrh Remedy. The pain in my headis 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 fivedifferent physicians before taking your medicines. My throat would bleedfrom three to five times a day--half a dozen mouthfuls perhaps--as freshas if you had cut your finger, and I was in a generally weakened statealthough able to be about the house, but the least exertion would makeme tremble. Finally I purchased one of Dr. Pierce's Common Sense MedicalAdvisers, and read it a good deal, and so was induced to take yourmedicines. I took in all seven bottles of the "Golden MedicalDiscovery, " one of the "Favorite Prescription, " and one bottle of Dr. Sage's Catarrh Remedy, and some of the "Pellets, " and they dideverything for me--more than anything else I ever tried. In about sixmonths' time I was well. Now, my throat does not trouble me unless Itake cold. It has been about six years since I took your medicines, andI think they cured me. 

I think there are no medicines equal to your medicines, and wouldrecommend 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; myhead was always stopped up and I had pains almost constantly. My nosewould run, and stuff would fall into my throat whenever I would liedown, and at other times it seemed dry and crusty, and then my headwould become stopped up and I would suffer again. 

I used cubebs and glycerine for a long time; they only relieved me whileI was using them. I used several other kinds of stuff, but I received nobenefit from them. I had nearly given up in despair. At last I cameacross one of your advertisements of Dr. Sage's Catarrh Remedy in one ofyour Memorandum Books, and I thought I would try it. It is the grandestthing on earth. I was thankful to God I found something at last to stopmy suffering. May God bless you, dear friends, for saving my life. 

I used your medicine about eight weeks: it only took two bottles to cureme 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'SGOLDEN MEDICAL DISCOVERY CURES PERMANENTLY A BAD CASE OF CHRONIC NASALCATARRH. 

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 ahalf-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 tosay I am permanently cured of that disease. 

Years after this letter was written Mr. Hodges informs us that his curehas 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 fivemonths since I began using your medicines. I have taken five bottles ofDr. Sage's Catarrh Remedy, and used it with Dr. Pierce's Golden MedicalDiscovery. I have no signs of catarrh now, and can say I never feltbetter 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 Ihad 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, weakstomach, catarrh, also female trouble. I took two bottles of Dr. Pierce's Golden Medical Discovery, one bottle of Dr. Sage's CatarrhRemedy. It took wonderful effect. I have recommended your medicines agreat deal, and have done a great deal of work for you. I have been thecause of selling quite a quantity of medicine in this county, and I willdo 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 diseasecalled catarrh of the head. Three years ago this fall I had catarrh inits worst form, till from three gills to one and one-half pints ofcorruption would be expectorated in twenty-four hours. 

Then I noticed your advertisement. Six months after taking yourmedicines I thought it too soon to tell you, but I can now say that mymoney was well spent in buying your medicine, for it resulted in apermanent 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 whatthe physician pronounced an abscess of the right lung. It lingered onfor three years. During that time my side discharged large quantities ofpus and I had a dreadful cough. I was so weak that I could not walkfifty yards without being completely exhausted. I had taken every kindof medicine that was recommended for similar maladies, such as cod liveroil, sarsaparillas, iron tonic and syrup of hypophosphites, without anyrelief. I was about discouraged when I commenced taking Dr. Pierce'sGolden Medical Discovery. I took six bottles and it completely restoredme to health. The discharge stopped from my side, and the cough hasceased. I am now able to follow my profession, which is a teacher ofpenmanship. I can walk ten miles any day without the least worry. If anyone doubts this statement they can write me and I will verify the abovestatement. 

Trusting that this may be the means of assisting some one else who issuffering 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 usedthree or four bottles of Dr. Pierce's Golden Medical Discovery and fourbottles of Dr. Sage's Catarrh Remedy with the Nasal Douche, in the firsttrial. Cold weather coming on I had to stop, as I could not use theInjector in freezing weather, but I was greatly benefited. Along towardsspring I found it was coming back, from taking cold, and, after severaltrials of other remedies, I again began the use of your medicines, taking two bottles of the "Golden Medical Discovery" and three bottlesof Dr. Sage's Catarrh Remedy, and I feel safe in believing I am cured asI feel no signs of its return. My health is very good for a man of 74years of age and I am satisfied that Dr. Pierce's Medicines did it. Irecommend 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 themagnificent result I obtained from your most valuable medicines. When, sometime ago, I consulted you in regard to my affliction, bronchitis, Iwas indeed fearing the worst. But I had so much confidence in yourmedicines, which I had previously used for colds and liver complaintwith good results, that I strictly followed your kind advice andcontinued taking it until I was assured of perfect health. I took fivebottles of your Dr. Pierce's Golden Medical Discovery, using the"Pellets" combined as directed, and _the effect was magical_. I am nowhealthy and hearty. Heartily thanking you for your kind advice andassistance, 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 triedmany different kinds of cough medicines, but none did me any good. I atlast became alarmed, and wrote to Dr. R. V. Pierce to know if he couldprepare 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 onlytwo bottles cured me after letting the cough run on from the winter of1889 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. Isuffered intense agony for five months, and after taking one month'smedicine I found very much relief--so much I was surprised. 

Many thanks for the good your medicines have done me, and my prayers arethat God may help you in your good work, and that you may live long andprosper. 

 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 debilityand chronic catarrh of eight years' standing and of a very aggravatednature. I was considered near my grave by many of my friends when Icommenced treatment. 

I used eight months' special treatment, after while I used some 12 or 15bottles of your Sage's Catarrh Remedy, and have had excellent healthever 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 deafnessof the right ear--the hearing becoming more and more defective until Icould scarcely hear at all. There was a constant ringing, roaring noisein my ear, and finally the disease assumed a very painful form. 

The ear became very sensitive to the touch, and the pain andinflammation extended into the eustachian tube and down into the throat. I could scarcely sleep at night, and during the day I sufferedconstantly. 

I finally decided to consult Dr. Pierce, and acting under his advice, Ibegan the use of "Golden Medical Discovery" and Sage's Catarrh Remedy bymeans of Dr. Pierce's Nasal Douche. 

I soon began to improve and after using three bottles each of the abovenamed remedies the pain and soreness left my ear, my hearing returnedand I considered myself completely cured, and indeed there has been norecurrence 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 anddryness in the throat which usually came on at night, and these symptomsgradually became aggravated until it was impossible for me to procureenough 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 yourInstitution, was examined by your specialist, who pronounced my caseasthma, complicated with nasal catarrh. After using the specialmedicines which he prepared for me for a few days I commenced to feelbetter, the shortness of breath gradually disappearing; the paroxysms ofasthma were less frequent and not so severe. 

After taking only two months' treatment I was completely restored to myprevious good health, and for five months it has not been necessary forme to use any medicine, and I feel that I am perfectly well. I give youthis testimonial in order that others who are similarly afflicted mayknow of your skill in treating cases of this nature, and seek relieffrom 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 formedical treatment for a bronchial and asthmatic difficulty; it had gotso bad that it was hard work for me to breathe if I moved around any; Ihave 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 toget my money. Can say, of a truth, that you have done mo more good thanall other doctors. One doctor said I would not live two years; that isfour years ago and I am yet alive. I am sure I am now on the safe roadto 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 fellowsufferers the benefit of my experience I wish to say, that immediatelyafter receiving your courteous reply to my letter, describing thedifficulty in breathing after any extra exertion, I began taking Dr. Pierce's Golden Medical Discovery, and before I had finished the firstbottle I was greatly relieved. 

I have taken less than one-half dozen bottles, and although the diseasewas of about three years' standing, I can now do as big a day's work asany of my neighbors and as many of them, for all of which I am indebtedto 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 skillfuloperation 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 Institutionthe two months I stayed with you. I feel sure of a permanent cure as Ido 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 shegrew older she grew worse. Her case was treated by three eminentdoctors, but all failed; they told me there was no cure for it. Discouraged as I was, I resolved to try Dr. Pierce's Golden MedicalDiscovery; she used five bottles and two vials of your "PleasantPellets, " which has made a permanent cure. She has gained twenty poundsin 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 twodistinct chronic diseases of years' standing, and having been placedunder the charge of your specialists, I was speedily relieved of myafflictions. The Invalids' Hotel is a place as much like home as it ispossible for such an institution to be. The physicians and surgeons areall expert specialists and thoroughly efficient; the nurses are verycompetent, attentive and kind; and, in fact, the whole _personnel_ ofthe Invalids' Hotel endeavor to do their best to make the patients feellike being at home. I always felt while there as if I was one of thefamily. I gladly recommend your Institution to all persons who areafflicted 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 mydiseases, and I think your Institution is worthy of the highestendorsement. 

 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 monthsago, my health was completely broken down. At times I could not evenwalk across the room, without pains in my chest. The doctor who attendedme said I had lung-trouble and that I would never be well again. At lastI concluded to try Dr. Pierce's medicines. I bought a bottle of "GoldenMedical 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 eighteenbottles of "Golden Medical Discovery, " twelve of the "FavoritePrescription" and five vials of "Pellets. " I am now almost entirely welland do all my work without any pain whatever, and can _run_ with moreease 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 fromasthma, being for weeks so I had to sit in my chair night and day; andto all people suffering with the disease, I am glad to recommend yourmedicines of which I have taken only a few bottles. I now call myselfcured, 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 Iwas well, was caught in a rain which gave me a very bad relapse, resulting in lung fever and complete prostration; was on my bed twomonths, and when I did get out, the strength to walk any more than justa few rods did not come back. My family doctor and two prominentphysicians of Sioux City, did me no good. Late in the fall I got abottle of Dr. Pierce's Golden Medical Discovery, which quieted mytrembling nerves and gave me an appetite to eat. I then concluded to trythe 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 muchI would be stupefied. I could not digest any food and my whole systemwas wasting and failing fast. I doubt if any one who saw me expected meto get well. I took the treatment sent me by the World's DispensaryMedical Association for more than a year. The medicine never gave me anydistress as other medicines had done before. I began to improve from thestart, but the change from one extreme to the other was like the growthof a child. 

To any one suffering from nervous prostration I would say, "don't beimpatient. " It takes a long time for weakened nerves to grow strong. Ihave at last become strong and well, thanks to the Giver of all good andthe grand Institution at Buffalo. I nave since married a noble-heartedyoung woman, and when I am playing with our sweet, healthy, baby girl, Igive way to the thought that at last the long, Bad chapter of my life isended; at such times her merry laugh sounds like a song of triumph oflife 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 theheart; as _increased_, or excited action, _defective_, or enfeebledaction, and _irregular_ action. 

Increased action of the heart, indicated by palpitation, or increasednumber of the beats, may be caused _mechanically_, as by distention ofthe stomach, which, by preventing the descent of the diaphragm, excitesthe action of this organ. Or it may be a _sympathetic_ disturbanceproduced through the nervous system; thus the emotions and passions maysuddenly arouse the heart to excessive action; or the presence of wormsin the intestines, improper food, and masturbation, may be the cause. The use of tea, tobacco, and alcoholic drinks excites the heart. We havefound that the excessive use of tobacco is very frequently the cause offunctional derangement of this organ. Deficiency of the blood, as inanæmia, may be the cause of palpitation of the heart. 

Functional disturbance of the heart's action is manifested bypalpitation, irregularity, intermissions, a rolling or tumblingmovement, and a feeling as if the heart were in the throat. Thesesymptoms often give rise to great apprehension, anxiety, fear, anddepression of mind. 

TREATMENT. The curative treatment of functional derangement of the heartmust have reference to the causes producing it. If it is in consequenceof indigestion, the appetite and digestion should be improved byobserving regularity in the time of taking the meals, and eating veryeasily-digested food. The use of strong tea, coffee, tobacco, andspirits, should be interdicted, and regular exercise, rest, and sleepshould be enjoined. 

In all cases, the domestic management should include daily bathing, exercise in the open air, regular habits, and the avoidance of allcauses which tend to excite the heart's irregularity. 

_The remedial treatment_ of these functional affections ought to beconfided to some experienced physician, as the remedies are not withinthe ordinary reach of all families, nor if they were, would they havesufficient experience and knowledge to select and properly administerthem. 

ORGANIC DISEASE OF THE HEART. 

By organic disease we mean disease pertaining to the structure of theheart itself, in contradistinction to _functional_ disease, which hasreference merely to the _action_ of the heart. The heart is subject tovarious organic diseases, but we have only space to consider, in thebriefest manner, those which are the most common. It is essential thatthe reader should have some knowledge of the anatomy and functions ofthe various parts of the heart in order that its diseases and theireffects may be comprehended; therefore the anatomy and physiology ofthis organ, given in Part I, Chapter VII, of this work, should becarefully studied. 

It is very evident that any disease which affects the structure andfunction of any part of the heart must, necessarily, give rise tocertain modifications of the pulse, sounds, etc. It is through theobservation and study of these modifications and changes that we arriveat a correct diagnosis as to the precise location and character of thedisease. 

[Illustration: Fig. 1. Pond's Sphygmograph. ]

Until within comparatively recent years, physicians were very much inthe dark regarding diseases of the heart. Now, however, with a thoroughknowledge of the anatomy, physiology, and pathology of the heart and theparts surrounding it, and with the aid of instruments which moderningenuity has given us, we are able to diagnosticate with precision theslightest lesions of any part of this important organ, and, knowingtheir nature, to map out an appropriate course of treatment. With theaid of the stethoscope, invented by Laennec and improved upon by Camman, we are able to distinguish the slightest deviation from the normalsounds, and, by noting the character of the sound, the time when itoccurs, the area over which It is heard most distinctly, and thedirection in which it is transmitted, to locate the lesion whichproduces it. By the aid of the sphygmograph, first invented byHerrisson, and afterward improved upon by Ludwig, Vierordt, Marey, andlastly by Pond, of our own country, the pulsations at the wrist areregistered, and thus made perceptible to the eye. 

We herewith give a cut, Fig. 1, of Pond's instrument, and two tracingsmade by it. The first is a healthy tracing, and the second indicatesenlargement, technically called hypertrophy, of the heart

PERICARDITIS, or inflammation of the membranous sac which surrounds theheart, may be either acute or chronic. The symptoms in acutepericarditis are made up from co-existing affections, and are frequentlyassociated 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 vomitingsometimes takes place. When this disease is developed in the course ofrheumatism, it is known as rheumatic pericarditis, and is almost alwaysassociated with endocarditis. In some cases acute pericarditis is verydistressing, in others it is mild. The fatality is not due so much tothe disease itself, as to co-existing affections. When it does not provefatal, it sometimes becomes chronic. 

In chronic pericarditis, pain is seldom present. The heart is generallymore or less enlarged, its sounds are feeble, the first being weakerthan the second. 

ENDOCARDITIS, or inflammation of the membrane lining the cavities of theheart, is one of the most frequent forms of heart disease. It is almostinvariably associated with acute rheumatism, or some of the eruptivefevers, as small-pox, scarlet fever, etc. , and is due to the irritationof the unhealthy blood passing through the heart. The disease isgenerally attended with little or no pain, and, consequently, if theattending physician be not on the alert, it will escape his observation. When associated with acute rheumatism, the disease is only in rareinstances directly fatal, but in the great majority of cases it leavespermanent organic changes, which sooner or later develop into valvularaffections, and these may eventually destroy life. When the diseaseoccurs, however, as the result of pyæmia (blood-poisoning produced bythe absorption of decomposing pus or "matter") or of diphtheria, or whenit is associated with any other septic conditions, it constitutes a verygrave element. Collections of matter formed on the membrane lining theheart and covering its valves, are liable to be detached and carried bythe circulation to the brain, spleen, or liver, where they plug up someartery, 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 markedsymptoms, except, perhaps, a sense of oppression and uneasiness in thechest, with palpitation. It produces a thickening and hardening of themembrane lining the heart, and generally causes a retraction, adhesion, and degeneration of some of the valves of the heart, thus bringing onvalvular disease. 

VALVULAR LESIONS are, as we have seen, very frequently the result ofendocarditis. They are of two kinds. First, those which prevent thevalves from flapping back close to the walls of the ventricles, orarteries, thus diminishing, to a greater or lesser extent, the size ofthe valvular orifices, and offering an obstruction to the free flow ofblood through them; and which consist of a thickening and retraction, oradhesion of the valves, chalky deposits, morbid growths, etc. Secondly, those which prevent complete closure of the valves, and thus permit areturn of the blood into the cavity from which it has just beenexpelled. These latter consist of retractions, perforations, and partialdetachments of the valves, chalky deposits around the base of the valvesand in them, and rupture of the chordæ tendineæ. 

These two forms of lesions are usually co-existent, one generally beingmore extensive than the other. Thus, the regurgitation may be slight, and the obstruction great, or _vice versa_. The symptoms and disturbanceof the circulation are altogether dependent upon the location and formof the lesion, or lesions. Each valvular lesion has its characteristicsound, or murmur, which is heard at a particular period in the cycle ofthe heart's action, and it is, as before stated, from these sounds, fromtracings of the pulse, and from the many other indications, that wearrive at a diagnosis. Thus, in obstruction of the orifice at thejunction of the aorta with the left ventricle, one of the most frequentof valvular lesions, a murmur, generally harsh in character, is heardwith the first sound of the heart, with greatest intensity directly overthe normal position or the aortic semilunar valves. This is conveyedalong the large arteries, and may be heard, less distinctly, over thecarotids. In the sphygmographic tracing, the line of ascent is lessabrupt than in the normal tracing (Fig. 2), and not nearly so high, andit is rounded at the top. In aortic regurgitation, the line of ascent issimilar to that of the healthy tracing, but the line of descent is verysudden. The left side of the heart is almost invariably the primary seatof these affections, but in the latter stages of their course, the rightside also is liable to become involved, and, as a consequence, therethen exists great disturbance of the venous circulation, with a dammingback 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 healthypulse as made with the Sphygmograph. ]

HYPERTROPHY OF THE HEART consists of a thickening of the muscular wallsof this organ. It may be confined to one portion of the heart, or it mayaffect the entire organ. The affection has been divided into thefollowing three forms: _Simple hypertrophy_, in which there is anincrease in the thickness of the walls of the heart, without anyaugmentation in the capacity of the cavities, and which is usually theresult of chronic Bright's disease, or great intemperance; _eccentrichypertrophy_, in which there is an increase in the thickness of thewalls of the heart, together with increase in the capacity of thecavities, and which is generally the result of some valvular lesion; and_concentric hypertrophy_, in which there is an increase in the thicknessof the walls of the heart, with a decrease in the capacity of thecavities. Valvular lesions, obstructions in the large arteries, or, infact, any thing which calls upon the heart to constantly perform anundue amount of labor must, necessarily, produce hypertrophy of itsmuscular walls, just as the undue amount of labor which the blacksmith'sarm is called upon to perform produces hypertrophy of its muscles. Withthis condition, the pulse is hard and incompressible, and the line ofascent 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 tohypertrophy of the heart, and which consists of an increase in thecapacity of the cavities of the heart, with diminished contractilepower. In simple dilatation, there is an increase in the capacities ofthe cavities, without any marked change in the walls of the organ. It isusually the result of some disease which has produced great muscularprostration, and which has interfered materially with nutrition. Morefrequently, however, dilatation is the result of valvular lesions, andis associated with hypertrophy, there being an increase in the thicknessof the walls with a diminution of the contractile power. The hypertrophyfrom valvular lesions goes on increasing until it reaches a certainstage, when dilatation commences, the two conditions then beingassociated. 

ATROPHY of the heart is the opposite to hypertrophy, and signifies awasting away of the muscular substance, and a diminution in thethickness of the walls of the heart. Its power is diminished inproportion to the degree of atrophy. 

FATTY DEGENERATION of the heart consists in the deposition of particlesof fat within the _sarcolemma_ (the sheath which invests the fibrils), which are substituted for the proper muscular tissue. If the fattydegeneration exists to any extent the muscular walls present a yellowishcolor, and the heart is soft and flabby. This may be confined to oneventricle, or it may affect the inner layer of fibres, the outer layerremaining unchanged. Degeneration of the left ventricle occasionsfeebleness of the pulse. Difficulty in breathing is one symptom of thisdisease, especially when the right ventricle is affected. There ispallor, feeble circulation, cold extremities, and frequently dropsy. Fatty degeneration is more liable to occur in corpulent persons, andbetween the ages of forty and fifty years. 

ANGINA PECTORIS, also termed _neuralgia of the heart_, might be includedamong the diseases of the nervous system, but as it is usuallyassociated with a derangement in the action of the heart, it may beproperly considered in this connection. The pain varies in intensity, sometimes being very acute, at others assuming a milder form. The actionof the heart is more or less disturbed. The beats are irregular, attimes being strong, while again they are feeble. A feeling of numbnessis experienced in those parts to which the pain penetrates. Theseparoxysms _usually_ continue but a few minutes, although they sometimeslast several hours. Persons suffering from angina pectoris are liable tosudden death. It is connected with ossification, or other organicchanges of the heart. Usually these paroxysms, if the life of thepatient continues, become more and more frequent. The danger is not tobe measured by the intensity of the pain, but by the co-existing organicdisease. Although it is not absolutely certain that organic disease ispresent in all cases of angina pectoris, yet the exceptions are so rarethat when the signs of organic disease cannot be detected, it may beinferred that angina is not the real affection, or that the existinglesions escape observation. Those who suffer from this disease are, inthe great majority of cases, of the male sex, and rarely under the ageof forty. 

TREATMENT. In the foregoing consideration of organic diseases of theheart, we have omitted to speak of their remedial management, for theobvious reason that unprofessional readers are unable to correctlydistinguish between the various diseases of this vital organ; and itwould, therefore, be useless for us to attempt to instruct them as tothe medicinal treatment of the different cardiac affections. 

In the vast majority of instances, diseases of the heart are notnecessarily speedily fatal. Persons have been known to live twenty yearsor more with very extensive organic disease of this organ. 

It is _very important_, however, that a correct diagnosis be made in theearly stages of these diseases, in order that an appropriate course ofhygiene 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 thesubject comparatively comfortable. Since we are able to diagnosticatewith the utmost precision the various affections of the heart, and sincethe discovery of certain specific medicines which exert most beneficialeffects, we are enabled to treat this class of maladies with the mostgratifying results. Thus we have seen a case in a very advanced stage ofthe disease, with the breathing so difficult that the subject had beencompelled to remain almost constantly in the sitting posture, in thegreatest agony, for so long a time that immense bed sores had formed onthe seat; in which the dropsy had become so extensive that the skin ofthe legs had burst open; and yet this patient, through the influence ofa specific course of treatment, was speedily relieved, and enabled tolive in a comparatively comfortable condition for many months. 

One afflicted with heart disease should abstain from the use of allkinds of stimulants, tobacco, and whatever tends to lower vitality. Hislife should be an even one, free from all excitement of any kindwhatsoever. He should avoid severe physical exertion, and everythingwhich causes the heart to beat with undue frequency. 

There are certain symptoms, the result of _chlorosis_ (the greensickness), a deficiency of blood, dyspepsia, uterine disease, andcertain nervous affections, which may simulate those of real organicdisease, but the physician of education and experience, with a trainedear, is able to detect the difference speedily. 

SORE MOUTH. (STOMATITIS. )

Stomatitis, or inflammation of the mucous membrane of the mouth, mayinclude the entire surface of the gums, tongue, and cheeks, or appearonly in spots. Vesicles are formed, having swollen edges and a white oryellow center, which finally ulcerate. When mild, the affection isconfined to these parts. 

If the inflammation is acute, the mouth is dry and parched, or as ismore 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 coatedwhite or red, and is glossy, and the sense of taste is considerablyimpaired. Digestion and nutrition are then disturbed, and the patientbecomes rapidly emaciated. 

THRUSH, OR CANKER, is that form of stomatitis in which white ulcerslocate on the inner side of the upper lip, the tongue, or roof of themouth; 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 painfullittle ulcers, single or in clusters, scattered over the surface of thetongue and lining of the mouth. Sometimes it is complicated with littlelumps in the tongue. These form ulcers and denote scrofulousinflammation. Fissures and cracks in the tongue indicate derangement ofthe stomach. 

THE CAUSES of stomatitis, in nursing infants, are unhealthy milk, oreffete 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 syphilitictaint, disorder the blood and induce local inflammation. 

TREATMENT. Locally, use a wash of golden seal or gold thread sweetenedwith maple-sugar, and rendered slightly alkaline with borax orsaleratus. Also use a very weak, alkaline tea, or one of slippery-elmflour, to obviate the acridity of the secretions. If the sores do notheal, constitutional treatment may be required, as the use of the GoldenMedical Discovery. The family physician should be consulted if the soremouth resists all these remedial measures. 

NURSING SORE MOUTH. (STOMATITIS MATERNA. )

During the period of nursing, and sometimes in the latter months ofpregnancy, women are liable to a peculiar variety of sore mouth. Thesoreness is sometimes so great that, although the appetite may beravenous, the patient cannot eat. When this condition extends to thestomach and bowels, symptoms of a very grave character appear, and thedisease, by interfering with the process of nutrition, causes emaciationand debility, and in extreme cases, death. It is a strange affection, nearly always disappearing upon weaning the child, though this course isnot absolutely necessary. It appears to depend upon a hepatic, orgastric derangement, in connection with a vitiated condition of theblood, but how this is brought about is unknown. 

SYMPTOMS. The disease sometimes comes on suddenly, at others moreslowly. The fact that the woman is either pregnant or nursing, is ofimportance in forming a diagnosis. At first there is a severe, scaldingsensation of the tongue, mouth, and fauces, with pain, which issometimes intense. The color of the tongue is often pink, or a lightred, while the mouth is generally of a deeper hue. This stinging, bitingsensation is accompanied by a profuse, watery discharge from the mouth, which seems extremely hot and acrid, causing excoriation whenever itcomes in contract with the face or chin. The appetite is good, sometimesravenous, but food or drinks, except of the blandest character, occasionsuch intense pain that the patient avoids their use. Ulceration occursafter a little time. The bowels are generally constipated, but when thedisease extends to the stomach or intestines, diarrhea occurs. There isgenerally anæmia, debility, and impairment of the vital powers. 

TREATMENT. The indications for treatment in this affection are toovercome the vitiated condition of the blood, and to sustain the vitalpowers. The remedies for this purpose are alteratives, antiseptics, andtonics. Give the Golden Medical Discovery, the value of which may begreatly enhanced by adding one-half ounce of the fluid extract ofbaptisia 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 andgargle, is of great value. A teaspoonful of the same may be swallowedseveral times a day. This will not interfere with other medicines. As atonic, 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, inone or two-gram doses, should be given with the iron if the debility beextreme. When there is great acidity of the stomach, which may be knownby heart burn, saleratus may be taken in water, to neutralize it, butshould not be drunk within an hour of the time for taking othermedicines. If constipation exists, use the Pleasant Pellets. This courseof treatment, thoroughly carried out, will seldom fail to effect aperfect cure, without weaning the child, yet this latter course maysometimes become advisable to promote the recovery of the patient. Should the treatment advised not produce the desired result, a skillfulphysician's services should be secured, as he may, in individual cases, distinguish other important indications which may enable him to modifythe 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 runninginto a _cholera infantum_ or a dysentery, we shall consider themtogether. 

DIARRHEA is an affection characterized by unnaturally frequentevacuations from the bowels of a liquid of morbidly soft consistency. Itmay be simple or inflammatory, and acute or chronic. 

A diarrhea is said to be bilious when the discharges are composedprincipally 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 withblood, 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 maybe an unpleasant sinking sensation in the abdomen, and, with thedischarge, exhaustion, a feeble pulse, and a cool skin. In theinflammatory variety, there is more or less fever. 

CHOLERA INFANTUM, or summer complaint, is a disease peculiar to the warmseason, and more prevalent in cities, and among those children who donot nurse at the breast. It is characterized by great irritability ofthe stomach, and persistent vomiting and purging, the discharges fromthe bowels being copious and watery, and sometimes containing specks ofcurd, yellowish-green matter, and mucus. The limbs of the littlesufferer are usually drawn up, indicating pain in the bowels, and thereis great prostration with cold extremities. The invasion may be sosudden, and the disease so violent as to destroy life in a few hours. 

DYSENTERY, also known as _bloody-flux, _ consists of an inflammation ofthe mucous membrane of the large intestine, with ulceration of theaffected surfaces. The disease is accompanied with much nervousprostration, and is distinguished by severe pains in the abdomen of agriping nature, followed by frequent scanty and bloody stools, and muchstraining. Occasionally the attack is ushered in with a chill and achingpains in various parts of the body, with copious fecal dejections. Inother cases the attack is preceded by loss of appetite, a sense ofuneasiness 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. Theymay be brought on by exposure to cold and wet, or by improper andindigestible articles of food, such as unripe fruits, salads, pastries, and, in fact, anything which interferes with the normal operations ofthe digestive apparatus. One of the most fertile sources of diarrhea ininfants, and of _cholera infantum_, is the administration of unsuitablefood, the ill effects of which are greatly increased by exposure to heator cold. Uncleanliness, and the inhalation of impure air, are prolificcauses Of these diseases. Epidemics have been supposed to be due to somepeculiarity in the condition of the atmosphere, or to some impalpablegerm of a vegetable or animal nature. 

TREATMENT. In the treatment of these diseases, one should first endeavorto ascertain the cause of the trouble, and then, if possible, effect itsremoval. Attention should be given to the hygienic surroundings of theindividual afflicted; if he reside in a miasmatic district, or in alocation in which the atmosphere is contaminated by the decomposition ofanimal or vegetable matter, or filled with noxious gases, his abodeshould be changed. A pure, dry air is most beneficial in these cases. 

Only the least irritating and most easily digestible articles of foodshould be taken. Healthy cow's milk is slightly alkaline, but that ofcows fed on slops is usually acid, and unfit for infants. It is, therefore, well to test all milk with blue litmus paper before feedingit to young children. If found to be strongly acid, that is if it turnsthe paper red, it should be rejected, but if only slightly so, sufficient lime water may be added to render it slightly alkaline. Foradults and older children, the diet should consist of such starchy foodsas arrow-root, sago, corn starch, and rice, and of ripe grapes, freedfrom the skins and seeds, peaches, and boiled milk, or milk and limewater. In some cases the animal broths are beneficial, especially muttonbroth. To quench the thirst, crust coffee, rice coffee, and lemonade, insmall quantities, may be taken. 

Rest is important in these diseases. In severe cases, the patient shouldbe kept in bed. 

At the onset of an attack of diarrhea or dysentery, if there be reasonto believe that the intestinal tract contains irritating matter, a doseof castor oil, with a few drops of anise oil added to render itpalatable, should be administered. After all irritating ingesta havebeen removed, Dr. Pierce's Compound Extract of Smart-weed should begiven in doses proportionate to the age of the patient, and the severityof the case. Being composed of the extract of smart-weed, or waterpepper, Jamaica ginger, camphor, and genuine French grape brandy, itexerts a most wonderful effect not only in those diseases but in choleramorbus and intestinal colic. It allays the irritation and inflammationof the affected mucous surfaces, and soothes the nervous system. In thegreat majority of cases, the above course of treatment will be foundsufficient, but in the more severe forms of these diseases additionalremedies may be required. 

In dysentery, accompanied with severe pain and straining, injections ofstarch water and laudanum, from two to four ounces of the former to fromtwenty to fifty drops of the latter should be used. 

Hot fomentations applied to the abdomen are beneficial. If thedischarges contain much blood, a flannel cloth moistened with thespirits 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 thesecretions, and allay irritation of the diseased mucous surface. Theabove-named preparations of soda, potash, and bismuth may be taken indoses of from five to twenty grains every few hours. 

Blackberry root and cranesbill (_Geranium Maculatum_), in the form offluid extract or infusion, are beneficial in acute cases in which thedischarges are profuse and watery, and in the chronic forms of theseaffections. 

In _cholera infantum_ subnitrate of bismuth should be given in doses offrom five to ten grains at intervals of from two to four hours. If thedischarges are very profuse, the fluid extract of cranesbill may beadministered in from two to ten-drop doses alternately with the bismuth. The camphorated tincture of opium (paregoric) is required in doses offrom two to twenty drops, depending upon the age of the child and theseverity of the case, if there is much pain, but great caution should beexercised in administering the preparations of opium to children. Asingle 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 sometimeseffectual. For this purpose a weak mustard plaster, or a cloth moistenedwith turpentine, may be laid over the stomach for a few minutes at atime. If the child is old enough to suck pellets of ice, these arebeneficial, or a piece can be wrapped in a cloth and sucked. 

COLIC. 

_Colic_ is a term applied to griping pains in the abdomen, which aresometimes accompanied with nausea and vomiting. The derangement isrecognized in several forms, some of which we shall briefly describe. 

BILIOUS COLIC. This may be the result of a morbid condition of theliver. 

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, attendedwith vomiting and general chilliness, followed by febrile symptoms. 

CAUSE. It may be induced by exposure to cold, in consequence of whichthe circulation is impeded, the pores of the skin obstructed, and all ofthe vitiated matters having to be expelled through the liver, stomach, and intestines. It may also be due to malaria in the atmosphere. It mostcommonly occurs during the autumn, after a season of hot weather. 

FLATULENT COLIC. Flatulent or "wind" colic is one of the results ofindigestion. 

SYMPTOMS. A sense of fullness in the pit of the stomach, attended withpain, which is transferred from one part of the bowels to another. Thereis fever, a quick pulse, nausea, and the presence of gas; by the latterfeature 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, arethe principle causes. 

PAINTER'S COLIC. This form is also known by various names, such as_colica pictonum, saturnine_, or _lead colic_. Those persons who areengaged in the manufacture of lead, and painters, are the most frequentvictims of this affection. 

SYMPTOMS. Impaired appetite, fetid breath, thickly coated tongue, obstinate constipation, a dry skin, scanty urine, languor, severe painin the umbilical region, and general derangement of the functions of thesystem. 

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, andskin. 

TREATMENT. The indication to be fulfilled in _bilious_ colic is torelieve the intestinal spasm. This may be done by drinking freely of adecoction of yam-root, or _dioscorea villosa_, which is an effectualremedy in this affection. If this be not at hand, the spasm may berelieved by administering freely of Dr. Pierce's Extract of Smart-Weed. If the stomach be irritable, a tablespoonful of laudanum and one oftincture of lobelia, in four ounces of starch water, administered as aninjection, is effectual. If simple means do not promptly arrest theattack, no time should be lost in summoning the family physician. 

In _flatulent_ colic, the treatment should depend upon the cause. If itbe occasioned by cold, a teaspoonful or two of the Extract ofSmart-weed, in warm water or catnip tea, repeated a few times, will besufficient. If it result from overloading the stomach, a dose of thePleasant Pellets will answer the purpose. If the pain in the abdomen issevere, apply hot fomentations. Assist the action of physic, by givingan 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 effectualremedy: sulphate of magnesia (epsom salts), twelve ounces; nitrate ofpotassa (saltpeter), half an ounce; sulphuric acid, one drachm; boilingwater, one quart. Of this remedy give a teaspoonful every thirty minutesor every hour, until the bowels move. An injection of some diaphoretictea, or of alum water, is a good remedy. Castor oil and molasses, containing a teaspoonful of spirits of turpentine, will add to theefficiency of an injection. If the colic be not promptly relieved, aphysician should be employed. To eliminate the lead from the system, andthus prevent a return of the colic, or other injurious effects, twodrachms of iodide of potassium should be added to a bottle of the GoldenMedical 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 thatorgan. When the disease imparts a greenish tinge to the skin, it istermed _green jaundice, _ and, when it imparts a blackish color, it isknown as _black jaundice. _ Jaundice is undoubtedly due to the presenceof 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_ ofjaundice, the difficulty in diagnosis may be said to begin. " Heconsiders the causes of jaundice to be (1) diseases of the liver; (2)disease or the bile ducts; (3) diseases remote from the liver, orgeneral disease leading to a disorder of that viscus; (4) certain causesacting upon the blood. 

SYMPTOMS. It is characterized by a yellowish color of the skin and ofthe white of the eyes. The skin is usually dry and harsh; if it bemoist, the linen will be tinged yellow from the perspiration. The tongueis coated yellow, the mouth is dry, and the appetite impaired; there isheadache, nausea, and sometimes vomiting; there is pain in the abdomenafter eating, and in the region of the liver, and it is also felt in theright shoulder, and between the shoulder-blades. In severe cases, thereis fever, accompanied with chills, despondency and loss of flesh. Thestools are generally of a light clay color, and very offensive; theurine is thick and yellow. When the disease terminates fatally, there isdelirium followed by stupor. 

TREATMENT. The first step should be to eliminate from the system, asspeedily as possible, all noxious materials. For this purpose, thespirit-vapor bath should be used. If the urine is scanty or voided withdifficulty, take acetate of potash or queen of the meadow. These may betaken in connection with the Golden Medical Discovery and PurgativePellets, the efficacy of which has already been described in thetreatment of chronic inflammation of the liver. They are indeed valuableagents in this disease, since they increase the action of all theexcretory 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 hydrochloricacid and the acid bath are frequently valuable agents. 

In other cases the employment, both internally and externally, ofalkalies in addition to the Golden Medical Discovery answers the purposemuch better. 

Again, there are persons who, in addition to alteratives and baths, require tonics. In the treatment or this affection, whatever may be thenature of the case, the use of _alteratives_ must not be forgotten, for_without_ them, the auxiliary treatment with acids, alkalies, andtonics, 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 intohis former condition, while if the treatment above given be adopted, therecovery will be permanent. 

GALL-STONES. (BILIARY CALCULI. )

These are concretions found in the gall-bladder or bile duct, and varyfrom the size of a pea to that of a hen's egg. There may be noindication of their existence in the gall-bladder until they begin topass through the duct. 

CAUSES. The formation of gall-stones is undoubtedly due to an unhealthycondition of the bile. Corpulent persons, and those indulging inover-stimulating diet, or in the habitual use of fermented drinks, aremost liable to be troubled by them. 

SYMPTOMS. The patient is suddenly seized with excruciating pain in theright side. After a time it subsides, but is again renewed with as greatseverity as before. There is nausea, with vomiting, which is oftenexcessive and severe. The pulse is sometimes slower than is natural, theextremities are cold, there is great exhaustion, together withperspiration and spasmodic contraction of the abdominal muscles. As soonas one stone has passed through the duct into the intestine, immediaterelief is experienced until another commences to pass, and the largerthe concretion, the greater is the pain. If the stools be washed, thegall-stones may be seen floating on top of the water. 

TREATMENT. This consists chiefly in relieving the patient of pain andvomiting during the passage of the gall-stones. Hot fomentations madewith stramonium leaves and lobelia, and applied over the painful parts, are beneficial. Small doses of lobelia may be taken, but not insufficient quantities to produce vomiting. Doses of opium should also betaken; this anodyne must, however, be used with care. Gelseminum isoften useful. Chloroform, ether, or the spirit vapor-bath generallyallays the pain. Carbonate of soda, dissolved in water, often relievesthe vomiting. 

These distressing symptoms are apt to recur until the removal of all thegall-stones is effected. To aid in removing them, take the GoldenMedical Discovery rather freely for a day or two, and continue its usewith lobelia, in doses sufficiently large to produce nausea, but notvomiting. From four to eight ounces of sweet oil may be given, and, ifthe bowels do not respond within three hours, repeat the dose, and thegall-stones will generally be evacuated. To prevent the formation ofthese concretions take the Golden Medical Discovery, together withalkaline drinks made with carbonate of soda. Tone and energy willthereby be imparted to the liver, the free flow of bile will be insuredand the subsequent formation of gall-stones prevented. 

INTESTINAL WORMS. 

We have not the space to discuss the numerous theories which have beenoffered to account for the presence of these parasites in the humanbody. We shall enumerate the principal species, describe the symptomsindicating their presence, and indicate the proper remedies. 

There are five species of intestinal worms, sufficiently common to merita description. 

(1. ) The round worm, termed by naturalists, _ascaris lumbricoides_, varies from six inches to a foot in length, and resembles the commonearth-worm. It infests the small intestines, and seldom migrates intothe stomach or large bowel. Instances are recorded, however, in which ithas crept upward in the esophagus, larynx, nostrils, and eustachiantube; but their presence in these parts is of comparatively rareoccurrence, and is generally caused by some local irritation whichcompels their migration. The fact that they have been found in theperitoneal sac, gave rise to the opinion that they perforate theintestine; but careful observations have proved that they can onlyescape through openings made by ulcers. 

This species has been found in adults, but is more common in childrenfrom three to twelve years of age. The number of this species existingin a human body is variable. Sometimes only two or three are found. Atother times a hundred, and even twice that number, are voided in a fewdays. 

(2. ) The _ascaris vermicularis_, thread, pin, or seat-worm, is round, very slender, and about half an inch in length. The habitation of thisspecies is the rectum, and they are often found matted together in theexcrement. They are very active, even after ejection, and have beenknown to cause great local irritation by entering the vagina andurethra. Their presence is an occasional cause of masturbation. It isimpossible to estimate the number of these parasites that may exist inthe human rectum. Great numbers, sometimes, are voided at a singleevacuation. 

(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. Asits name indicates, the upper portion of its body is slender, hair-like, and terminates at the lower extremity in a thick, spiral portion. It isfrom one to two inches in length, and is found attached by its head tothe mucous membrane of the cæcum, and, in rare instances, in the colonand small intestine. They are rarely numerous. 

_Tæceniæ_ or _tape-worms, _ are hermaphrodites, of a flat, ribbon-likeform, and are composed of numerous segments, each of which is providedwith a complete set of generative organs, and contains ova for theproduction of thousands of individuals. Some authors have supposed thateach segment, or joint, is a distinct individual, but the existence ofone 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 allthe countries of Europe, except France, Russia, and Switzerland. InFrance, both species are found, but the tænia lata seems to beindigenous 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 armedwith a double row of twenty or thirty hooklets. The genital organs arealternate and placed upon the outer edges of each segment. It inhabitsthe small intestine, and is usually solitary. 

(5. ) The _tænia lata_, or broad tape-worm, is distinguished by thegreater breadth of its segments, and the location of the genital organs, which are found in the centre of each segment. Its small elongated headis unarmed, and has a longitudinal fissure on each side. It usuallyattains a greater length than the _tænia solium_. 

SYMPTOMS. The symptoms which the long worms occasion, are frequentlysomewhat obscure. Thirst, irregular appetite, colicky pains, excessiveflow of saliva, enlargement of the abdomen, itching of the nose, pallorof the face, offensive breath, disturbed sleep, and grinding of theteeth, all are common symptoms. Occasionally, convulsions and othernervous affections are produced by the presence of the _ascarislumbricoides, _ but generally they produce less constitutionaldisturbance than the other varieties. The passage of this species ofworms from the bowels, or their ejection from the stomach, is the onlypositive evidence of their presence. The _ascaris vermicularis_, thread, pin, or seat-worm, gives rise to most of the symptoms produced by thelong worms, but in addition produces intense itching at the anus, and, not unfrequently, an eruption upon that part. The itching isparticularly distressing at night. When the little sufferer is wellcovered, the warmth occasioned by the bed-clothes causes these littleparasites to crawl out upon the anus, and produces such paroxysms ofitching and pain as to cause the child to kick the covering oft and lienaked. The persistent manifestations of a disposition to lie naked, should excite the parents' suspicions of seat-worms, and lead them toinvestigate all the symptoms. By examining the child's stools the wormsmay he found adhering to the feces, and they may also be seen on theanus. Thousands of children suffer untold agony from these littleseat-worms, which are left unmolested to torment them, because theparents are unfamiliar with the meaning of the symptoms manifested, andtherefore pay no heed to them. We have been thus particular indescribing the symptoms indicating the presence of these pestiferousparasites, in order that they may be readily detected. 

_The Symptoms_ produced by the tape-worm are dizziness, ringing in theears, increased secretion of saliva, indigestion, ravenous appetite, sharp abdominal pains, and emaciation. The only positive sign of thepresence of these parasites, is the passage of pieces of them in thefeces. The nervous and other symptoms produced by the ordinary longworms are also caused by the tape-worm. 

CAUSES. Careful observations have proved that there are certain causeswhich favor the generation or development of intestinal worms. Amongothers, we may mention fatty or farinaceous articles of food, gormandizing, constant exposure to a moist atmosphere, and sedentaryhabits. 

It is now generally conceded that the development of tape-worms is dueto the swallowing of an egg or germ-cell, which is contained in manykinds of animal food, and which the process of cooking has failed todestroy. People living near low marshes, lakes, or the seacoast, areliable to _tæniæ_. 

TREATMENT. The expulsion of the _ascaris lumbricoides_ may be veryeasily and pleasantly effected. Santonin is an effectual remedy for thisvariety of worms. For a child three years old, take santonin, sixgrains; podophyllin, one grain; white sugar, thirty grains; mix, triturate, and divide into twelve powders, and give one every three orfour hours, until they act upon the bowels; or take santonin, tengrains; white sugar, twenty grains; mix, triturate, and divide into tenpowders, and give one every night at bed-time, and after giving two orthree in this way, administer a mild cathartic. As santonin is almostentirely tasteless, if not combined with other medicines which areunpalatable, no difficulty will be experienced in administering it tochildren. By reference to the article on anthelmintics in this volume, other valuable vermifuges may be selected, and directions found fortheir employment. 

In the removal of thread or pin-worms, anthelmintic medicines taken intothe stomach are of little or no value. An injection of a strong solutionof salt, is a very efficient remedy. A teaspoonful of turpentine in halfa pint of milk makes a good injection. Strong coffee has beenrecommended as an injection. The anus should be well anointed withvaseline, lard, oil, or fresh butter, after each movement of the bowels. Whatever injection or remedy is used, it should be followed by theapplication of some ointment to the anus, otherwise they will continueto deposit their eggs about that orifice and multiply there. 

Various remedies have been used to destroy tape-worms. Among others wemay mention the old and time-honored remedy, which consists of two orthree ounces of the oil of turpentine, taken in castor oil or somearomatic tincture. 

A decoction made by boiling two or three ounces of freshly powderedpomegranate bark in a pint of water was used by the ancients, and is nowhighly recommended as a remedy. 

Some American physicians have used an emulsion of pumpkin seeds withmarked success. 

Twenty or thirty grains of the extract of male fern, followed by acathartic is highly recommended for the destruction and removal oftæniæ. 

TRICHINA SPIRALIS. 

In 1835, Owen discovered a peculiar parasite, which sometimes infeststhe human body, and is termed the _trichina spiralis_. The presence ofthese parasites has given rise to morbid conditions of the system, followed by the most serious results. They are developed in thealimentary canal, and then perforate its tissues and enter the muscles. Twelve trichinæ have been found in a section of human muscle onlyone-twelfth of an inch square and one-fifth of an inch in thickness. 

The early symptoms of trichinæ are very uncertain, being the same asthose of some other disease. The patient complains of severe pain in theabdomen and is troubled with diarrhea. When the trichinæ pass into themuscles, they occasion great suffering. There are sharp pains in themuscles, the perspiration is profuse, and the patient becomes exhausted. 

CAUSE. Nearly every case of trichinæ, which has been brought to thenotice of the profession, has been attributed to the eating of raw orimproperly cooked pork. The parasites can only be detected with amicroscope. 

TREATMENT. The impossibility of removing the trichinæ after they havepassed into the muscles is apparent; and, as yet, no special remedy hasbeen recommended to remove them from the alimentary canal. The onlysafety lies in prevention. Hence raw or imperfectly cooked pork shouldnever 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 thephysician to prescribe the proper remedies. It is undeniable that theclosest intimacy exists between happiness and good digestion. A healthydigestion aids materially in making a cheerful disposition, and the"feast of reason and flow of soul" is due as much to the functionalintegrity of the stomach as to a strong and generous mentalorganization. Dr. Johnson severely said: "_Every man is a rascal as soonas he is sick. _" We all know that a morbid condition irritates theindividual and excites sarcastic and disagreeable remarks. And, likewise, an irritable temper and, suddenly aroused passions may notonly turn and disturb the stomach, but even poison the secretions. Anxiety, excitability, fear, and irritability frequently cause theperversion of physiological processes. 

The slightest functional disturbance of the stomach deranges, more orless, all the succeeding operations of digestion and tends to thevitiation and impairment of the delicate processes of nutrition. Dyspepsia may commence and proceed so insidiously as not to excite thesuspicion of friends, although the patient generally desires activetreatment, such as cathartics, emetics, and medicines to act upon theliver. When the disease becomes confirmed, it presents some of thefollowing symptoms: Weight, uneasiness, and fullness in the region ofthe 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, lossof hope, courage, and energy; apathy, drowsiness, and frightful dreamsare also symptoms common in the different stages of this disease. Thereare, furthermore, the accompanying symptoms of a coated tongue, bittertaste in the mouth, unpleasant eructations, scalding of the throat fromregurgitation, offensive breath, sick headache, giddiness, disturbedsleep, 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 medicinesto act upon the liver, desire active treatment, are endlesslyexperimenting in diet, daily rehearse their symptoms, and are morbidlysensitive. 

CAUSES. Overtasking the body or mind, overloading the stomach, the useof 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 riseto indigestion. If the functions performed by the skin are embarrassedby cold, tight clothing, or lack of cleanliness, the nutritive changescannot properly take place throughout the body, and consequently thedigestive functions are embarrassed, as the revolutions of a water-wheelare impeded by the backset of the water. When food is not thoroughlymasticated, it is not properly mixed with saliva of the glands of themouth, and is not prepared for digestion by the acids of the stomach. 

Whatever diminishes the general strength, impairs the health, orencroaches upon the functions of life, also hinders the perfect solutionof food and disturbs in a measure the function of digestion. Whateverdiminishes the normal amount of the digestive secretions or pervertstheir quality, deteriorating their solvent properties, is a cause ofdyspepsia. This should be borne in mind in selecting remedies. 

TREATMENT. The hygienic treatment consists in the regulation of thedaily habits, proper selection and preparation of the food, cultivationof cheerfulness, diversion of the mind, and cleanliness of person. Wecannot give particular directions as to the kind of diet, as there areno established rules for guidance. Generally, a dyspeptic knows best, from experience, what articles of diet can be taken with the leastinjury. The directions applicable to the condition of one patient, arenot suited to those of another. In dyspepsia, animal food is, as a rule, preferable. Foods rich in starchy matter often ferment and producedistress. Sometimes alkalies may be given with beneficial effect, whenthere 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 beprepared by mixing a teaspoonful of hydrochloric acid with four ouncesof water, of which a teaspoonful may be taken after each meal, willprove beneficial to check the fermentation and aid digestion. Theaddition of one or two drops of a mixture of one part of carbolic acidand six of glycerine, to the above solution of hydrochloric acidimproves its antiseptic properties. Or, Dr. Pierce's Golden MedicalDiscovery will stop undue fermentation, and from its tonic andinvigorating effect upon the lining membranes of the stomach willgenerally overcome the indigestion. Some people are afraid to take it, when suffering from indigestion, because it has a sweet taste. But thesweet is not saccharine, or sugar sweet, but an entirely different sweetprinciple which prevents fermentation instead of promoting it. 

Acidity of the stomach and the attendant irritation may be allayed bythe following mixture: Calcined magnesia, one drachm; refined sugar, onedrachm; subnitrate of bismuth, one-half drachm; oil of cajeput, tendrops. The dose is half a teaspoonful an hour after every meal. Anydispensing druggist can put it up. 

It is frequently difficult to prevent the patient from over-distendingthe stomach, and thus impairing the tone of the muscular coats andprolonging the process of digestion. 

In consequence of debility, over-exertion, anxiety, or chronicinflammation of the stomach, there is not a proper secretion, inquantity or quality, of digestive solvents, and it matters not whetherit 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 ofwhat important agent is lacking, naturally presents itself to thephysician. Is it _pepsin_, the active principle of the gastric juice, which converts proteids into peptone, that is wanting, or is there adeficiency of _pancreatin_? Of course the principle which is lackingshould be supplied; but has the physician the remedial agents properlyprepared, and ready for prescribing? The specialist, having more casesof dyspepsia to treat than the general practitioner, is more likely tohave the latest and most approved remedies applicable to loss ofappetite, indigestion, impoverished blood, imperfect assimilation, andall diseases arising from faulty nutrition. In ordinary practice, thephysician's time is divided in his consideration of acute, chronic, surgical, and obstetrical cases; in fact, much of it is occupied inriding to reach his patients. His attention is continually diverted fromone class of cases to another, effectually preventing investigation inany particular direction. His patronage does not warrant him in theoutlay of time required for the investigation of particular diseases, and the expense necessary to obtain the latest and best remedial agentsfor their treatment. In the multiplicity of his cares and arduous dutiesby night and by day, obstinate chronic cases become an annoyance to him, and whenever he can be otherwise professionally employed, he avoidsthem, disliking to undertake their treatment. 

With plenty of time for scientific investigation, ample facilities tomeet the demands upon his skill, and each succeeding case presentingsome new phase, the treatment becomes a matter of absorbing interest tothe specialist, and each success inspires greater confidence. We notonly use in the treatment of indigestion, solvent remedies, like pepsin, which act only upon proteids, but also other remedies of recentdiscovery, which exert a remarkable curative influence in diseases ofthe 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 experiencedpractitioner who understands which of them is the _most_ and which isthe _least_ efficacious. Alkalies may dissolve lithic deposits, but who, unless he be an experienced physician, can detect the fault of nutritionwhich leads to their formation, or rightly interpret the symptomsindicating it? These simple illustrations of the complications whichattend dyspepsia, are mentioned merely to show that they must beanticipated and taken into account in the treatment. 

The number of cases of dyspeptic invalids treated by the staff of theInvalids' Hotel and Surgical Institute within file past few years, is solarge as scarcely to be credited by those unacquainted with theprevalence of this disease. For this reason we have taken unusual painsto investigate the causes of the disease, and have spared no expense toprovide the most approved digestive solvents, and stomachic tonics, which invigorate the mucous membrane of the stomach, and materiallyassist in reducing the food to a liquid condition. Some of these, without being purgative, increase the activity of the liver, andstimulate the intestinal secretions, two very important indicationswhich should be fulfilled by remedies which cause no real depression. The recent important discoveries made in obtaining the active principlesfrom indigenous plants, has opened the way to the use of a few of themost important of these remedial agents, hitherto almost wholly unknownto the medical profession, and the encouraging results attending ourpractice have amply repaid us for the investigation and originality inour treatment of this affection. 

A careful chemical and microscopical examination of the urine oftendiscloses the actual morbid conditions which perpetuate this functionaldisease. 

CHRONIC DIARRHEA. 

On account of the frequency and importance of chronic diarrhea, we deemit worthy of special consideration. It is frequently the sequel of theacute form of the affection. The urgent and severe symptoms of acutediarrhea are often abated, but the disease is not completely cured. Thebowels are left in an irritable condition, perhaps in a state of chroniculceration, which perpetuates morbid discharges. 

The most noticeable symptom is the tendency to frequent and unhealthydischarges from the intestines. The evacuated matter varies much inappearance and character in different cases. The precise location of themorbid conditions which give rise to the discharges, as well as to theirextent, modifies the color, consistency, and ingredients of the stools. Most frequently they are dark colored and of very offensive odor. Theyare of a more liquid character than is natural, except when, as issometimes the case, periods of constipation alternate with periods ofunnatural looseness. Tormina, or griping, is usually present, but not sosevere as in the acute affection. Tenesmus, or straining, oftenaccompanies it. The appetite is impaired, there is general debility, andthe patient is nervous and irritable. The complexion becomes sallow, theskin dry and rough, the tongue dark colored, and the body emaciated. 

The affection may be the sequel of neglected or badly treated acutediarrhea, may arise from the injudicious use of powerful purgativemedicines, 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 withother diseases, such as Bright's disease of the kidneys, scurvy, or someof the various forms of scrofulous disease. 

The more prominent symptoms are so apparent and so characteristic thatthe most unskilled may be able to decide whether the patient has chronicdiarrhea; but to determine in what portion of the intestinal canal theaffection is chiefly seated, to decide upon the extent of its ravages, to ascertain what peculiar shade or type the affection has taken on, toinvestigate its complications and modifications, to ferret out itsproducing or aggravating causes, and above all, to nicely and skillfullyadjust remedies to meet the depraved conditions, is by no means an easytask, even for the educated and experienced physician. It should beborne in mind that this is a dangerous malady, and one which should notbe trifled with or neglected. Its tendency is to corrode and destroy thebowels, a process which if unchecked, must sooner or latter result indeath. There is little tendency to spontaneous recovery, nor is aremoval of the exciting cause often followed by recovery. The diseasebecomes so firmly seated, and the powers of life so debilitated, thatnature 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 thesleeping-room should be warm and well ventilated. 

As will be seen from testimonials hereinafter inserted, Dr. Pierce'sGolden Medical Discovery has achieved great success in curing chronicdiarrhea. Its use should be persisted in for a considerable time tostrengthen 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, andbilious disorder_. 

Under this head may be considered all those chronic affections known ascongestion, induration, and enlargement of the liver, and which resultin deficient action, functional derangement, morbid secretion of bile, and various chronic affections. 

SYMPTOMS. Owing to the liability of other organs to become diseasedduring the progress of chronic affections of the liver, great precisionin diagnosis is required to determine, by the symptoms, the organ whichis _primarily_ diseased and those secondarily affected. This requiresnot only familiarity with the signs of a complicated disease, but alsothorough anatomical knowledge of the diseased organ, of the morbidchanges which occur in its structure, and their influence on its ownfunctions, 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 ofthe disease. The local indications are fullness of the right side, thusdenoting congestion of the liver; a dull, heavy pain, which is increasedby 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 downthe arm, and which is sometimes felt in the wrist and joints of the handNot unfrequently the complexion becomes pale and sallow, and there ispuffiness under the eye, headache, a bitter taste in the mouth, tonguecoated white or covered with a brown fur, and hardness of the gums;there is frequent sighing, a hacking cough, fever, restlessness, andloss of sleep; sometimes an unnatural, greasy appearance of the skin, atothers, it is dry and harsh, has scaly or branny eruptions, pimples, dark blotches, and troublesome itching. The urine is frequently scantyand high-colored, but variable as to quantity and appearance; it oftenproduces a scalding sensation when voided, and, if allowed to stand, deposits a sediment which sometimes contains albumen. The pulse is veryslow, particularly when the elements of the bile are not eliminated fromthe blood. The pulsations of the heart are easily quickened, andpalpitation is excited if the subject be low and anæmic. There isdepression of spirits, and a decided tendency to be discouraged anddespondent. The functional powers of the stomach are impaired; there isloss of appetite, or it becomes capricious; uneasiness is felt in theregion of the stomach, oppression, sometimes nausea and water-brash, orthere is indigestion, flatulency, and acid eructations; the bowelsbecome irregular, usually constipated, and occasionally subject toobstinate diarrhea attended with colicky pains; the stools are of alight clay color, sometimes hard and dark, again thin and veryoffensive, 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 feltin the palms of the hands and the soles of the feet. 

The foregoing symptoms are not all present in one case, nor are any twocases alike in every respect. They vary according to the organs mostimplicated in the hepatic derangement. Thus, when chronic inflammationof the liver is associated with _heart_ disease, the subject may havepalpitation, excessive or defective action of the heart, attended withmore or less pain and shortness of breath. If the _lungs_ be speciallyinfluenced, then, in addition to the ordinary hepatic symptoms, theremay be a dry cough, asthma, hurried respiration, bronchitis, hoarseness, and pain in the chest. If the _stomach_ be the sympathizing organ, thetongue 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 fermentsand gives rise to eructations and various other manifestations ofdisorder. If the _bowels_ are morbidly influenced by this affection, there is constipation or diarrhea, griping pain, distension of theabdomen, piles, and pain just within the points of the hips, thusindicating 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 thesurface 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 asensation of weight in the back, while the urine may be scanty andhigh-colored, or abundant, pale, and limpid, frequently charged withsedimentary products of disease, and voided with difficulty. If the_womb_ be implicated in this chronic affection, the menstrual functionmay 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 ofthe liver shows the necessity of clearly distinguishing between thesymptoms of this disorder and those reflected by the organs whichsympathetically respond. To discriminate more effectually, and place thecorrectness of the diagnosis beyond doubt, we make a chemical andmicroscopical examination of the urine, and thereby detect the morbidproducts which it contains, and direct our attention to the diseasedorgans furnishing them. These examinations together with a completehistory of the case, enable us to make a correct and definite diagnosisof the disease, and the extent to which it has affected the otherorgans. 

Before entering upon the consideration of treatment, let us brieflyenumerate the functions of the liver: _First_, it removes matter, which, if allowed to remain in the blood, would become noxious and unfit it forthe further support of the body. _Secondly_, by secreting bile, itfurnishes to the digestive organs a fluid which assists in convertingthe food into chyle, stimulates the intestine to action, and then isitself transformed and absorbed with the chylous products, after whichit circulates with the blood and assists in nutrition until, becominginjurious and pernicious, it is re-secreted and re-elaborated to serveagain, as described. 

For its growth and nourishment, the liver is furnished with blood by thehepatic artery; but for the purpose of secretion and depuration, it isabundantly supplied with venous blood by the portal system, which ismade up of veins from the spleen, stomach, pancreas, and intestines. This impure, venous blood, surcharged with biliary elements, which mustbe withdrawn from it, is freely poured into the minute network of thisglandular organ. In a healthy condition of the liver, the carbonaceouselements of the blood are converted into sugar, and the constituents ofthe bile are liberated by the liver, and set apart for further duties. When it fails to eliminate these noxious elements from the blood, it isitself thoroughly vitiated by them. 

TREATMENT. Food must be rich in carbon in order that it may build up thetissues and keep the body warm, but carbonic acid, the result of thecombustion, must be removed from the blood, or death will ensue. So bileis necessary to digestion, nutrition, and life; yet, if it be notseparated from the blood by the secreting action of the liver, it willas surely poison the system and destroy life as carbonic acid. Althoughthe constituents of the bile exist in the blood, they must be removed inorder that the blood may be rendered more fit to support the body, whilethe secreted bile is destined to assist in digestion, and the mysteriousprocess of nutrition. Therefore, we should induce a secretion of bile, and restore the normal activity of the liver. This should be done, notby administering stimulants, but by relieving it of all contingentembarrassments as far as possible. Would any one think of giving to aweak, debilitated man large portions of brandy to enable him to work?Does not every one know that, when the unnatural stimulus is removed, hefails? Apply this principle in the treatment of the liver. When harsh, unnatural stimulants and "bile-driving" medicines are administered for atime and then withheld, the liver relapses into a more torpid anddebilitated condition than before treatment was begun. Is not this trueof nine-tenths of all who suffer from this malady, and have recourse tothis class of remedies?

Then how can we remedially fulfill the preceding indications? We answerin the language of a distinguished author and standard medical writer, "by using a class of agents which should never be overlooked in thetreatment of long-standing liver diseases, chiefly addressed to theblood and denominated '_alteratives. _'"

_Alteratives, tonics_, and _restorative catalytics_ are required notonly in diseases of the liver, but in a large number of ailments inwhich the blood becomes charged with morbid materials. The activeremedial properties of the most efficient agents of the above classes ofmedicine now known, are scientifically combined in the "Golden MedicalDiscovery, " which acts _especially_ upon the blood, and hence influencesthe system generally. It is also powerful in eliminating those morbidhumors which are afterwards subjected to excretion through variousorgans. 

Its action is radically different from most medicines employed inchronic diseases, for the reason, that what is usually prescribed, issomething corrosive. Unless the disease be temporary, it may return withincreased violence. 

We have been very minute in the description of the remedial propertiesof the "Golden Medical Discovery, " and have relied upon the reason andintelligence of our patrons, believing that they can, in a degree, understand why we deem it so applicable to the system. It does notdebilitate the liver by over-stimulation, nor irritate the stomach andbowels by disturbing the delicate processes of digestion, neither doesit act with severity upon the blood, but it operates so gently, insensibly, and yet with so much certainty, that it excites the surpriseand admiration of the patient. 

From the careful detail of its various properties, there is abundantreason for its favorable action upon all of the excretory organs, whichco-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, " touse the "Pleasant Pellets, " which are also powerfully alterative, besides being mild and unirritating in their operation. They are thenatural assistants of the "Discovery, " working harmoniously together. They should be taken in small doses, and their use perseveringlyfollowed, until the bowels are properly regulated by the use of the"Discovery" alone. 

It has been customary to resort to powerful drastic cathartics, followedby bitters prepared in dilute alcohol. The habit is unscientific, for itis well known that alcohol deranges the functions of the digestiveorgans and depraves the blood, besides creating a morbid appetite. Ithas been repeatedly demonstrated that the use of such bitters has led toa life of drunkenness, with all the woe and untold misery which attendit. 

Medicines to be strictly remedial, should exert a tonic influence uponall the vital processes. Those organs which are contiguous to the liver, or connected by sympathy with it, should be assisted in the performanceof 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 usualrecurrence. Thus these remedies are _preventive_ as well as _curative_. 

What we have thus far recommended for the treatment of this chronicaffection is within the reach of every family. Patients laboring underthis disease, when complicated with other affections, require specialconsideration and treatment, and all such are counseled to employ onlythose physicians whose experience and success entitle them toconfidence. Health is one of the greatest of blessings, and how torestore it when lost, is a question of vital importance. 

Having successfully treated thousands of invalids who have suffered fromthis chronic affection, we possess abundant evidence of the curabilityof the disease, but we have only space to publish a few letters frompersons 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. Thereshould be proper alvine evacuations every day. There are few persons whohave not suffered at some period of their lives from constipation of thebowels. Inattentive to the calls of nature, or a neglect to regularlyattend to this important duty, sooner or later, produces disastrousresults. Furthermore, it is essential to the comfort of everyindividual, for, when this function is not performed, there isderangement of the mental as well as of the bodily organs. 

Constipation, or _costiveness_, as it is sometimes termed, is afunctional derangement of the large intestine. This intestine is aboutfive feet in length, and consists of the cæcum, colon, and rectum. Itserves as a temporary reservoir for the excrementitial residue ofalimentary matter, and for the effete materials excreted by the glandscontained 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 toFigs. 4 and 9, the reader may observe the anatomical relations which thelarge intestine sustains to the other abdominal organs. The ascendingcolon 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 acircuitous route around the abdominal cavity, comes in contact with theinferior surface of the liver, proceeds behind and below the largecurvature of the stomach, emerges on the left side, and passes downwardin front of the left kidney, where it dips into the pelvic cavity, andends in the rectum. 

If fecal matters are retained until they are decomposed, great injuryfollows, 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 thefunctions of the liver, and, frequently, the fault is attributed to thatorgan instead of the large intestine. Sometimes the blood becomes socharged with fecal matter that its odor can be detected in the breath ofthe subject. 

An overloaded condition of the large intestine may cause inflammation ofthe liver or dropsy of the abdomen. When the colon is distended, itbecomes a mechanical impediment to the free circulation of the blood inother organs, and causes congestion of the portal system, predisposingto chronic inflammation or cirrhosis of the liver. This latter is astructural affection, and may, in turn, give rise to abdominal dropsy. In a word, the accumulation of feces in the colon irritates both thelarge and small intestines, thus causing congestion of the bowels, liver, or stomach. 

The protracted presence of feculent matter deadens the sensibility ofthe intestine, so that great stimulation is required to provoke it toaction. The contents become dry, solid, knotty, and hard, and verydifficult 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 anabundant secretion of urine, as limpid as water. The direct symptomsrelate to the hardness of the feces and the great difficulty of voidingthem. The influence of constipation upon the functions of the liver, isindicated by the sympathy displayed between that organ and the mind. Thepatient manifests apprehension, mental depression, taciturnity, andmelancholy, all indicative of hypochondriac dejection, induced byconstipation. 

We have treated patients, who, from this cause, had renounced theirbright hopes, lost their buoyant spirits, and, becoming subject tosuperstitious fears, had given themselves up, night and day, todevotions and penance. It often happens that the victims of this deepdejection and morbid feeling of self-abasement, are persons not only ofgood moral character, but of high religious attainments, and theirpainful exhibitions of fear, distrust, and gloom, originate in_physical_ rather than in spiritual causes. It is interesting to witnessthis strange perversion of the imagination, this morbid debasement ofthe religious faculties, and dejection of mind, due to causes disturbingthe functions of the liver and other vital organs. 

Young girls, as they approach the age of puberty, seem possessed withthe idea that the unfrequent action of the bowels is a desirable habit. They do not associate with the duty a proper regard for health, butconsider 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 inthe system. 

How many girls illustrate the truth of this statement by theircomplaints of dizziness, throbbing pain in the forehead and temples, flushing of the face, transient flushes of heat over the body, while atthe same time the extremities are cold. At other times, they manifestthe evils of such a course by their stupor, drowsiness, and deep sleep, although upon arising in the morning, they are still tired andunrefreshed. 

The constipated condition of the bowels, often leads to congestion ofthe uterus and leucorrhea, followed by uterine debility, prolapsus, excessive menstruation, anteversion or retroversion of that organ. Theinfrequency of the habit, incorrectly supposed to be desirable by ayoung woman, becomes nearly, if not quite disastrous to all her desiresand bright prospects. Complications arise, and neither the inexperiencedgirl nor her solicitous and afflicted parents know where to look forremedial aid. If they seek an asylum from these sufferings, they findmany private institutions, where flattering expectations of speedyrecovery are aroused. At such institutions, these uterine disorders aregenerally treated merely as local diseases, while the causes areoverlooked, and, consequently, a permanent cure is not effected. Havingspent nearly all the money at her command, the patient returns homeutterly disheartened. After such failures, many of these unfortunateindividuals have applied to us and received treatment, and bypersistently following our directions, have in due time been restored tohealth, amid all the comforts of home, and among friends, who rejoicedwith them in the unexpectedly favorable turn of affairs, accomplished ata comparatively trifling expense. 

We have seen infants, and also young children, in whom constipation wasobstinate. It therefore seems that it is often hereditary. In somepersons, this affection continues from childhood, with but littlevariation, until bleeding pile tumors are developed. Habitualconstipation of the bowels for a long period of years will generate aclass of diseases, which are often very serious in their results. 

CAUSES. We have already alluded to a sense of false modesty whichprevents a response to the calls of nature, and we may mention otherreasons, equally trifling, which deter many from fulfilling its demands. Some are in the habit of temporarily postponing their visits to thewater closet, until, when they do go, they find themselves unable toevacuate the bowels. Sometimes the closet is a damp, uncomfortableout-house, situated at a distance from the dwelling, or the access istoo public, and, hence, there is an unwillingness to visit it at theproper time. Some appear to be too indolent to attend to this duty. Others are too energetic, and think they cannot take the time, untilthey have finished some self-imposed task or attended to a pressingengagement. 

Inactive life and sedentary occupations are also causes of constipation. Active exercise promotes all the bodily functions, and helps to regulatethe bowels. Those who are engaged in literary pursuits, find that mentaloccupation determines the blood to the brain, thus drawing it from theextremities; the temperature falls below the natural standard, and thereis almost invariably congestion of the bowels. The inmates ofboarding-schools, factory girls, seamstresses, milliners, employés inmanufacturing establishments, and all who sit and toil almostunremittingly twelve hours in the day, do not get sufficient exercise ofall the muscles of the body, and are often troubled with obstinateconstipation. 

Food prepared according to the modern modes of cookery, is one of thecauses which favors the developement of this derangement. People livetoo exclusively upon bolted wheat flour. The branny portion of a kernelof wheat consists of various nutritive elements, with more than fivetimes the amount of phosphate of lime contained in fine bolted flour. Those who daily use boiled cracked wheat are not troubled byconstipation. There is no dryness or hardness of the feces, and thebowels are evacuated without discomfort. 

TREATMENT. Prevention is always better than cure; hence, a few hygienicdirections may not be amiss. Do not disregard the intimations of nature, but promptly respond to her calls. If there is constipation, overcome itby establishing the habit of making daily efforts to effect a movementof the bowels. Taking regular exercise by walking, and lightlypercussing or kneading the bowels for five minutes daily, help toincrease their activity. The habit of early rising favors the naturalaction of the bowels. Drinking a glass of water on rising exerts abeneficial influence. The food should be such as will excite the mucoussecretion of the large intestines, and arouse its muscles to action. Forthis purpose, there is no one article that excels coarsely-crackedboiled wheat. Graham bread, mush, cakes, gems, and all articles of dietmade from unbolted wheat flour are valuable auxiliaries, and may beprepared to suit the taste. Take the meals at stated hours; be punctualin attendance, regular in eating, and thoroughly masticate your food. Irregularity in the intervals between eating, disturbs the functions ofthe 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, yetwere they observed, constipation, as well as most of the diseasesincident to it, would be obviated. A large proportion of the cases willyield to the foregoing hygienic treatment without the employment ofmedicines. Should it be necessary, however, to employ an aperient torelieve the constipation, Dr. Pierce's Golden Medical Discovery will actmost congenially, and will be followed by no constipating reaction, which invariably occurs when drastic cathartics are employed. Itsoperation is mild, bringing about a healthy action by promoting thebiliary and other secretions, thus aiding nature in establishing normalfunctional activity in the bowels. Recourse should be had to it beforeemploying any thing more strongly cathartic. However, should it provetoo mild in its aperient effects, small doses of Dr. Pierce's PleasantPellets may be employed daily to assist it. Unlike other cathartics, they produce a secondary tonic effect upon the bowels, which renderstheir influence more lasting than that of other purgatives. We cannottoo strongly discourage the injurious custom which many people have offrequently _scouring_ out their bowels with strong cathartics. It is abad practice, and cannot fail to do injury. The greatest benefit isderived, not from cathartic doses, but from taking only one or two ofthe "Pellets" per day, or enough to keep the bowels regular, andcontinuing their use for several weeks, in connection with Dr. Pierce'sGolden Medical Discovery, strictly carrying out the hygienic treatmentheretofore advised. 

The medical treatment of individual cases sometimes involves manyconsiderations relative to the particular circumstances andcomplications presented. The peculiar susceptibility of theconstitution, as well as the diseases incident to constipation, must betaken into account. Symptomatic derangement should not be treated asprimary, although it is by inexperienced physicians. If the patient beafflicted with uterine disease, piles, nervous affections, falling ofthe lower bowel, or fistula, they should be treated in connection withthis disease. For these reasons, we would advise our readers to submitall complicated cases, or those that do not yield to the courseheretofore advised, to a physician of large experience in the managementof chronic diseases, and not assume the great responsibility and thedire consequences which are very liable to arise from the impropertreatment of such cases. We have been called upon to treat thousands ofcases of this troublesome affection, and as a result of our vastexperience, and in consequence of our original and improved methods ofdiagnosis, it is not generally necessary that we should see and examinethe patient in person. We can almost always determine the exact natureof the patient's malady, and its stage of advancement, without seeingthe subject in person. 

PILES. (HEMORRHOIDS. )

There are few maladies more common than this, and few which are moreannoying. Piles consist of tumors formed within the rectum and about theanus, by dilatation of the hemorrhoidal veins and thickening of theirwalls. Sometimes, when attended by considerable inflammation, or whenthe attacks are very frequent, there is thickening of the adjacentcellular and mucous tissues. 

There are two general forms of this disease, the external or blindpiles, in which the tumors are outside the anus, and the internal orbleeding piles, in which the tumors are formed within the sphincters, although after their formation they may protrude. The external piles arecommonly made up of thick tissues; upon one side, the skin forms thecovering, while on the inner surface is the mucous membrane of thebowel. It is this surface which is most tender and irritable and liableto inflammation. The internal form of the disease is situated from ahalf an inch to two and a half inches above the sphincter muscle of theanus. The tumors are usually round, oval or cylindrical in form. Theymay be scattered over the surface of the bowel, or clustered together. The illustrations (Figs. 1 and 2) show the two forms of the disease. Thetwo protruding tumors in Fig. 2, illustrate the usual form of prolapsinginternal piles, whilst the one highest up in the bowel shows the formmost 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 inthe rectal region. The small venous loops, or bulb-like terminations ofthe veins H. _i_. , are the points at which the piles most frequentlyoccur. 

[Illustration: Fig. 1. Swollen ExternalPiles. ]

CAUSES. Whatever tends to favor an undue accumulation of blood in thehemorrhoidal veins predisposes to piles. For this reason the affectionis frequently a result of diseases of the heart and liver, which causean obstruction in the circulation of the blood through the portal vein. Mechanical pressure from tumors in the abdomen, pregnancy, or anenlarged or misplaced uterus, is not infrequently a cause of thedisease, by keeping the hemorrhoidal veins over-distended. Thosediseases which provoke much straining, as stricture, inflammation orenlargement of the prostate gland, and stone in the bladder are alsoactive causative agents. The most common cause of all, however, isconstipation; and persons of indolent, sedentary and luxurious habits oflife are the ones most frequently affected with this derangement. Thefollowing are also prolific causes of piles, viz. : pelvic tumors, violent horseback exercise, indigestion, pregnancy, habitual use ofdrastic cathartics, diarrhea, dysentery, sitting on heated cushions, long-continued standing posture, diseases of the liver, worms, thewearing of tight corsets, eating highly seasoned or indigestible food, and the use of alcoholic stimulants. No age is exempt from piles, nor isthe disease peculiar to either sex. Aside from the serious inconvenienceand pain which are experienced with most forms of piles, there is atendency to fistula, and to cancer in the rectal region. It isimportant, therefore, that the disease should not be allowed to run onunchecked. 

[Illustration: Fig. 2. Piles: internal and protruding. ]

SYMPTOMS. The most common symptoms at first are slight uneasiness, suchas a little soreness or itching at the verge of the anus, and at timeslancinating pains. These sensations are more severe as a rule if thebowels are constipated. If the piles are external they frequently becomeinflamed, swollen and painful, and in some instances they suppurate, which usually results in relief. When internal piles have increased toany considerable extent, or have become inflamed, they produce not onlyitching at the extremity of the bowel, pain in the back, etc. , but alsoa sensation of fullness in the rectum, as though some foreign body werepresent, and, on action of the bowels, there is a sensation as though aportion of the fæces had not been expelled. When the internal pilesbecome large, they frequently come down with fæcal matter from thebowel, as illustrated in Fig. 2, and this prolapsus becomes more andmore marked with the progress of the disease, until, in many cases, thetumors are forced down at each action of the bowels, causingexcruciating pain until they are properly replaced. Usually, in theearly stages, they recede spontaneously; however, after a time itbecomes necessary for the sufferer to press them back, but in someinstances this is impossible. Frequently during the protrusion one ofthe hemorrhoidal veins gives away, and this is followed by a free escapeof blood, and ulceration may ensue. Not infrequently with this diseasethe patient loses strength and flesh, and the face becomes pale andpuffy, assuming a waxy appearance. Many times there is nausea, withvertigo. Is consequence of the relaxation, the bowel may descend when onthe 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 bya competent physician will always determine the true character of thecomplaint at once. 

[Illustration: Fig. 3. H. _i. _ Internal hemorrhoidal veins. H. _m. _ Middlehemorrhoidal veins. H. _e. _ External hemorrhoidalveins. S. _i. _ Internal sphincter muscle, S. _e. _ Externalsphincter muscle. ]

TREATMENT. Notwithstanding the well established fact that piles arereadily cured by the appropriate treatment, hundreds of thousands ofpeople suffer untold tortures from them because of the popularimpression that they cannot be cured. All cases are not, however, amenable to the same form of treatment, for various unhealthy conditionsof the system are often concerned in their production and perpetuation, and must, of necessity, be remedied by appropriate treatment, before acure of the piles can be expected. It will, therefore, become apparentthat the avoidance of causes is of paramount importance. Some of thesecauses are external, and wholly under the control of the patient, whileothers depend upon diseases that are curable; it frequently happens thatwhile other diseases are being remedied, the piles disappear Without anyspecial 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, anddetermination of blood, which they induce; these difficulties must beremoved by appropriate treatment. 

Some years since, we ascertained that we were using in our practiceremedies which, in addition to other virtues, possessed a directspecific influence upon the vessels concerned in the formation of piles. These agents enter into the composition of Dr. Pierce's Golden MedicalDiscovery, which, consequently, will be found exceedingly efficacious inthe treatment of this disease. This remedy, therefore, in removing thedisease upon which the piles depend, as a congested or torpid liver, constipation, etc. , and in exciting a direct curative control over thepiles themselves, exerts a double influence. It may be aided, when thebowels are badly constipated, by the use of Dr. Pierce's PleasantPellets, taken in the morning, to secure a regular and easy evacuationof the bowels each day. All stimulating food and alcoholic drinks shouldbe abstained from. The cold bath is beneficial in these cases, providedthere is not great debility. The affected parts should be bathedfrequently with cold water, and, if prolapsus exists, it is well toinject a little cool water into the rectum, and allow it to remain a fewminutes. As a soothing, astringing and healing application to theaffected parts we prepare an Ointment that has acquired great fame forthe prompt relief which it affords in all ordinary cases. This we do notsell through druggists but can send by mail, on receipt of price, $1. 00per large box, postage prepaid. The persistent use of this Ointment, atthe same time keeping the bowels regular by the use of "Golden MedicalDiscovery, " with an occasional laxative dose of "Pellets, " willgenerally cure all ordinary cases of piles. 

THE RADICAL CURE OF LARGE PILE TUMORS. In cases in which the tumors havebecome indurated and very large it is impossible to effect cures by theforegoing or any other medical treatment. Various methods have been inuse by the profession for the relief of the most severe cases. The mostcommon is excision with the knife or scissors. Reference to the largevessels, shown in Fig. 3, which are affected in this disease, will atonce show the sufferer the dangers of this method. The sudden removal ofa tumor, which is connected with one or more of the large hemorrhoidalveins, is sure to be followed by severe hemorrhage, and many timespainful ulceration, and a fatal result. To avoid this it has been thepractice of many physicians to apply caustics or to burn off the base ofthe tumors with a red-hot iron. A more barbarous and painful methodcould not be devised. When it is considered that in many cases, thissevere and painful treatment is followed by ulceration, and occasionallyby the developement of cancer, the matter should be carefully weighedbefore any such dangerous procedure is attempted. Another common methodof treatment is to crush the base of the pile with a clamp, and then cutoff the tumors with scissors. After this it is also necessary to applythe hot iron to prevent hemorrhage. Formerly, applications of nitricacid were in common use by physicians as a means of cure, but it wasfound that while this treatment would give temporary relief, yet in nosevere case would it effect a cure. By what we term palliative treatmentalone more cures are effected than by the old process of treatment withnitric acid. Still another form of treatment is strangulation of thepile by means of a ligature, and this is often more painful than theapplication of hot irons, inasmuch as in cutting off the return flow ofblood from the piles, a large tumor is left for days fully distended andextremely painful. It does not slough off for a considerable time, andwe have seen the strongest men suffer intensely, to whom the use ofscissors in removing the tumors was a positive relief in comparison withthe torture of the ligature. A treatment that has been highlyrecommended by some physicians and condemned by others, is the processof injection with carbolic acid. This method of treatment is not verypainful but, unfortunately, it is dangerous. The injection of the tumorswith a fluid which causes coagulation of the blood, and which does notcompletely shut off the return current of the circulation through thetumors, has proved fatal in a small percentage of cases. The clots whichare formed by this treatment become detached and are carried into thegeneral circulation and conveyed to the liver, lungs and even to thebrain, where, by plugging up the vessels of those organs, they causeabscesses which terminate life. Serious inflammation of the veins isanother accident which often follows the injection of carbolic acid. This treatment is, therefore, now seldom resorted to except byphysicians who do not appreciate its dangers. 

A MORE SUCCESSFUL METHOD. Fortunately for suffering humanity, a methodof treatment has been perfected and thoroughly tested in ourinstitution, in which all such trouble and danger as above described areavoided. This consists in bringing down the tumors, cleansing them andmaking application, of certain chemical preparations, that cause thetumors to speedily shrivel up, and in a very short time, say ten tofourteen days, disappear entirely. These treatments and applicationscause _no pain whatever_, for by first applying a weak solution ofcocaine to the parts they are speedily rendered entirely insensible, sothat the most sensitive, nervous lady experiences not the slightestsuffering from the application of our remedies. 

Having now at our command means so positively certain in their actionupon 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 onlyhave the patient for a few days under our personal care. Considering thevery distressing character of pile tumors, it is a great boon that wehave at last found safe, painless, and positively certain means fortheir cure. The news will be hailed with joy by a large class ofsufferers. 

Probably no other discovery in modern science is destined to be themeans of conferring greater blessings on a large class of sufferers thanthat of a painless and positive method of curing the largest pile tumorsin 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 endurethe tortures inflicted by pile tumors, provided the afflicted one cancommand the little time and moderate amount of means necessary to securethe treatment indicated. Piles are not only in and of themselves verypainful and annoying, but often greatly aggravate and even cause othergrave and painful affections, and should, therefore, not be neglected. When large, they never get well without proper treatment. We have seenmany cases in which the long train of diverse and distressing symptomscaused by piles led the sufferer, and even the family physician, tosuppose that other diseases existed, but all of which annoying symptomswere speedily dispelled by the cure of the piles. We have no doubt thatneglected piles, fistulæ, and other morbid conditions of the lowerbowels, frequently degenerate into cancerous disease. We have theeminent authority of J. Hughes Bennett, of Edinburg, and many otherclose observers, for saying that benign or ordinary tumors oftendegenerate into real cancerous disease, and our own extensiveobservation convinces us that this is not infrequently a result ofneglected rectal disease, as piles, fistulæ and fissures. How important, then, to give prompt attention and skillful treatment to disease ofthese parts. When the ordinary palliative treatment, with ointments andwith laxative agents to keep the bowels soluble, does not _completelyand perfectly_ subdue the malady, lose no time in securing the mostskillful appliances, that every vestige of the affection may be promptlyremoved. We have treated many thousands of cases with uniform success, and our patients write to us expressing the greatest degree ofsatisfaction, and recommending our method most highly. 

Reports of a few cases, selected at random from the large number whichwe 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 theanus, accompanied with a little discharge; or the first symptom may be apainful abscess, like a boil, which finally breaks. The soreness then ina measure subsides, leaving a fistulous opening, with a continuousdischarge of matter. This unnatural opening, with its constant drainupon the system, sooner or later is certain to ruin the health ordevelop consumption or other maladies, and destroy life. 

Fistula in Ano may exist in three conditions: First, completefistula--when the opening is continuous from the cavity of the rectum orbowel to the surface of the skin, so that liquids, gases, etc. , escape;secondly, internal incomplete fistula, when the opening extends from theinside of the rectum into the tissues surrounding it, but not throughthe skin. A few cases of this kind exist, while the sufferers areunconscious of the nature of the difficulty, supposing it to be piles orsome trouble--they know not what. Thirdly, external, incomplete fistula, when the opening extends through the skin into the tissues around therectum, but does not enter the bowel. 

Other complications, such as pendulous tits or projections, fromone-fourth to one and a half inches in length, are attendant uponfistula. Two or more openings may appear in the skin, all communicatingwith the same sinus, or opening into the rectum. Sometimes only a smallexternal opening is seen, while a large abscess exists internally. Inany case, the discharge is not only reducing to the system, but it isdisgusting and offensive. 

CAUSES The causes are a constitutional predisposition, constipation, piles, or the presence of foreign bodies in the rectum, causing anabscess or ulcer. Some authors have contended that fistula alwaysoriginates from an ulcer in the rectum, which gradually makes its waythrough the cellular tissue to the surface. Others contend that thecause of this disease consists in an abscess, which burrows in thetissues and makes its exit into the rectum, or through the skin, orboth. No doubt it may originate in both ways. It can readily be seenthat when an internal opening is once established, the _foeces_ whichenter into it must sooner or later work their way to the surface, burrowing through those parts which offer the least resistance, until aplace of exit is reached. 

DIAGNOSIS. The disease may be suspected, if there has been an abscess inthe parts involved, or if the patient has been subject to pain in therectum, and the parts are tender, tumid, or indurated. When the fistulaopens externally, the linen will be moistened and soiled with pus, or abloody fluid, and when the tract is large, the _foeces_ may pass throughit. A careful exploration with a probe, passed into the external openingwhile the finger is in the rectum, generally reveals the direction ofthe tract; but, sometimes, in consequence of the tortuous course of thecanal, the probe cannot he made to follow it. When the fistula isincomplete, and opens internally, the probe is passed into the rectumand directed outwards, when it may be felt externally. In such cases, atumor, caused by the contents of the fistula, may generally be seenprotruding near the anus, and the pain will be considerably increasedduring defecation, by the _foeces_ passing into it and disturbing itswalls. 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 thepatient may be greatly promoted by attention to the bowels, keepingtheir contents in a soluble condition, and the liver active, so as toprevent congestion of the rectum and adjacent structures. This can bestbe done by careful attention to hygiene, and the use of "Golden MedicalDiscovery" and "Pellets, " in sufficient quantities to produce the abovenamed effects. 

A _radical cure_, however, cannot be accomplished except by surgicalmeans, for which we have the _knife, ligature, caustic, stimulatinginjections, etc. , _ which may be varied to suit the emergency, but whichshould never be employed except by a competent surgeon. Constitutionalconditions materially influence the cure, no matter what procedure isadopted; the greater the constitutional derangement and the poorer thegeneral health, the longer is the cure delayed. The great secret of oursuccess in treating this disease consists in applying appropriateconstitutional 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, othermeans will succeed in cases in which the knife fails or is for anyreason inapplicable. One great objection to the knife is not only thedread which patients entertain of it, but the great liability of its useto result in paralysis of the sphincters of the anus, the consequence ofwhich is loss of control over the bowels; and another is that itsometimes entirely fails to result in cure. By the means which weemploy, these objections are entirely overcome, and, while the generalsystem is being renovated, the fistula is healed, without anycomplications. 

Fistula is much more common than has generally been supposed. It is aptto be associated with pulmonary diseases. Heretofore, it has beensupposed that to heal the fistula, during the progress of the lungaffection, would result in fatal consequences, and the patient has beenleft to suffer and die under the combined influence, of the _two_diseases. Observation, based upon an extensive experience in themanagement of such diseases, has proved that supposition to befallacious in every respect, and we would urge all persons afflictedwith fistula to have the affliction cured, no matter what complicationsmay exist. The fact underlying this erroneous opinion is, that whengrave constitutional troubles have co-existed the use of the knife hasresulted in failure, and the fistula has refused to heal. 

Having had ample facilities for observing the relative merits of thevarious methods of treating this complaint, in hundreds of eases, in ourown practice and that of others, we feel justified in saying that theplan which we have adopted is far superior to that in general use. Thelocal treatment which we employ depends upon the nature of the fistula;in some instances the ligature is best, in others caustics, and againinjection, etc. , while still others require a combination of two or moremethods, or a modification of them. 

In cases in which it is impossible for the patient to come to our hotelfor a radical and speedy cure of the fistula, we employ constitutionaltreatment, with, the use of a medicated crayon, which is similar inshape to a small slate pencil. This crayon is made of gelatine with theremedial agents thoroughly incorporated through it, and in an easilysoluble form. They are very flexible and readily used, and where thefistulous track is sufficiently large to admit of their insertion, themost decided improvement invariable follows their application. One isoiled and gently introduced into the track every two or three days, andby its solution the unhealthy tissues which line the track are removed. They are thrown off, and a healthy action is induced. With carefulconstitutional treatment, decided improvement soon follows, and thedischarge is gradually lessened. The most satisfactory improvementoccurs in the general health and strength of the patient, and graduallythe fistula closes. Sometimes it is necessary to pursue this course oftreatment for many months, but the result obtained is sufficient rewardfor the trouble. A large percentage of cures follow this treatment, andwe recommend it when it is impossible for the patient to leave home, orwhen the general health is greatly reduced by severe constitutionaldisease. 

 * * * * *

TESTIMONIALS. 

While we have a great cloud of witnesses testifying to the efficacy ofour treatment of the diseases described in this volume, yet for lack ofspace 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 doctorscalled "liver complaint. " I tried three different doctors. They did meno good. They tried about one year; I was not able to work for twoyears. At last I thought I would try Dr. Pierce's medicines, and I wroteto Dr. Pierce, and he wrote to me to take his "Golden MedicalDiscovery, " and I bought two bottles, and when I took it, I saw it wasimproving me, and I got five more, and before I had taken all I waswell, and I haven't felt the symptoms since. I had a continued hurtingin my bowels for about two years. I feel as if the cure is worththousands 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 wasnervous and would have sour stomach and distress after eating, and whenI would rise after stooping over everything would turn dark before meand I would feel dizzy. I suffered a great deal of pain at each monthlyperiod. I took one bottle and a half of the "Favorite Prescription, " oneteaspoonful three times a day, and the "Pellets" as directions calledfor. I gained in health and strength so rapidly that I have been able towork very hard the past summer, and my back never troubles me; and whenI have my monthly periods I never feel the least bit of pain. In fact Iconsider 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 couldget no relief from the doctors of this place--Randolph, N. Y. I wasinduced to use Dr. Pierce's Golden Medical Discovery, and "PleasantPellets, " and after using five bottles of the medicine, I regained myhealth, 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 greatlyfrom headache, pain in my right shoulder, poor appetite, constipationand a sleepy feeling all the time. My health is now very good, and Iweigh 170 pounds, and I am able to do a good day's work without anytrouble 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 ofDr. Pierce's Golden Medical Discovery and several bottles of "Pellets, "I am a different person. Only weighed 119 pounds when I began takingyour medicine, now weigh 160. My symptoms were pain under the leftshoulder, distress after eating, headache, dizziness, constipation, and, in fact, my system was "out of sorts generally. " I tell every one yourmedicine 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 andliver complaint, and having become greatly reduced in health, as a lastresort I placed myself in your hands for treatment. My improvement beganalmost immediately after entering your institution. I was enabled toleave at the end of one month, having experienced great benefit. Thetreatment was continued at home for a few months, after which my curewas complete. At the present time, I am able for office work, and feelthat I am completely cured of the catarrh and have but little if anytrouble with my liver. I shall lose no opportunity to recommend yourinstitution or your medicines to the afflicted. I do most unhesitatinglyrecommend chronic sufferers to visit your institution or take yourremedies 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 wouldhave a very bad chill and then I would begin to sweat and vomit; I hadno appetite; I had the catarrh very bad; I had inward troubles ofdifferent kinds; my back ached all the time; I had sores gather andbreak inside; I had a lung trouble; I was very bad off; I could sit uponly long enough to have my bed made; my husband sent for our familydoctor; he came three times a week for three months; I was not so wellat the end of three months as when he first came, but kept growingworse; he gave me up to die, and said I had consumption. I had heard ofDr. Pierce's medicines doing a good deal of good, so I made up my mindto try them. I sent and got one bottle of "Favorite Prescription" andone bottle of "Golden Medical Discovery"; also one bottle of "Pellets, "and commenced taking them. In a few days I commenced to gain, and In twoweeks' time I could sit up most all day, and in five weeks' time I coulddo my work with the help of two small girls. After taking four bottlesof "Favorite Prescription, " six bottles of "Discovery, " and three of"Pellets, " I was well enough to get along without any medicine. I can doa good day's work, and I owe my life to Dr. Pierce. With God's will andthe 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 severalweeks with liver complaint. I became dropsical, my limbs swelled totwice their usual size and I could scarcely move them. I commenced usingDr. Pierce's Golden Medical Discovery; one bottle helped me so I couldsit up; two bottles gave me strength enough to be able to do part of myhousehold work; six bottles cured me, and to-day I am enjoying goodhealth. The "Medical Discovery" should be in every household, and ingratitude for what it has done for me I have recommended it to manyfriends. For nine years I have suffered from deafness, and while takingthe "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 Iam not entirely well, yet I have received much and lasting good fromyour treatment. My digestion was improved greatly, so that littletrouble is experienced after eating; my liver seems to act reasonablewell, and my bowels are much better. My varicocele I consider entirelycured, as I have not used the bandage for one half day for more than sixmonths, 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 movingsix or eight times a day. In addition to the diarrhea, the patient hadsuffered from indigestion and womb trouble for eight years. There wasalmost continual pain from the top of the head to the hips and throughthe shoulders. There was weakness, soreness and numbness in the arms, hands, back and hips; the bladder was irritable, urine being passedfrequently, or occasionally scanty, dark, thick, with a brick-dustdeposit. There was a dragging sensation in the region of the womb. Menstruation was irregular, and she had frequent trembling spellslasting for hours. There was difficulty in fixing the attention, evenfor a sufficient length of time to write a brief letter. In fact, shewas so weak and nervous she could scarcely write at all. Sleeplessnesswas a prominent feature of the case. The principal diet consisted oflight bread and hot milk; could not use Graham bread. A course ofspecial 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 ofthe epidemic influenza, or grip, so that, although the treatment wascarried on at intervals during a year, there were but few occasions whenour specialist had what he considered full control of the case. A yearafter 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 therewould be any return of my old disease. After suffering over eight yearswith severe chronic diarrhea, you have cured me; I have had no return ofit for over a year. It is with gratitude I write to you to tell you thegreat good you have done me, for I am sure I would have been in my gravebefore this had it not been for your treatment; My stomach troubles mevery little any more. Occasionally I use a bottle of "Golden MedicalDiscovery" and a bottle of "Pellets. " Hoping that the kind Father mayspare 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 veryweak; bowels move only in three or tour days; stomach so painful thatnothing passes through it digested; back so weak cannot sit up; had thefirst attack of dyspepsia fifteen years ago, and has spent hundreds ofdollars trying to get well; kidneys badly affected, urine highlycolored, and burns in passing; has pains around the heart and flutteringsensations at times, says: "I am not able to travel; all the doctorshave given me up as beyond medical aid. 

Reports after two months' treatment: "I am happy to say that I am almostwell; suffer with no pain in my stomach after eating; my appetite isgood; my bowels move once a day and very often twice a day, and theurine is natural; do not have that dizziness in the head any more: restwell at night and feel rested in the morning Have gained flesh all thetime; weigh 178 pounds, and work every day on the farm. Have taken nomedicine from any other physician, and give you and your medicine allthe credit for the health I now enjoy. My wife has taken your "GoldenMedical Discovery" for goitre (thick neck). She has taken it for aboutsix 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 amperfectly well, and have been since I took your last medicine. I think Iam better than I ever was, if such a thing could be. I am twenty poundsheavier than I ever was before, weighing 155 pounds. I have not had apain or an ache since, for which fact I am thankful to you for lookingafter my case as promptly as you did, as, in looking over your catalogueof diseases, I thought that I had every thing ailing me that was in thebook. I have told dozens if they were sick to call on you. With my bestwishes, and hoping that all of your patients will receive as muchbenefit 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 aftereating, sometimes pain in my bowels, headache, poor appetite and badtaste 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 allthese 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 complywith your request. Having suffered for many years with a complication ofdiseases and feeling conscious that they were rapidly making seriousinroads upon my constitution, and that I was speedily becoming unableand incapacitated to attend to my ordinary business. I resolved, afterreading a number of testimonials from your patients, to place myselfunder your treatment at the Invalids' Hotel and Surgical Institute. Withheart-felt gratitude I can truthfully say I am relieved of my trouble. Imost cheerfully and earnestly recommend this Institution to all who areafflicted 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-feltgratitude 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 theInvalids' Hotel and Surgical Institute at No. 663 Main Street, Buffalo, N. Y. , I feel warranted in its highest recommendation. While there I sawand talked with a great number of people who came there as a lastresort, to be cured of almost every chronic disease to which flesh isheir, and they were unanimous in their praise of the Institution and theskilled 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 gaveme for the relief of an affection of the spine and nervous system, disease of the digestive organs, kidneys and liver, has been entirelysuccessful. I had feared that my health was gradually being undermined, prior to entering your institution, and I can testify to the perfectappointment that you have, the excellent apparatus for theadministration of electrical and other massage treatment and baths. Myrelief 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 diseasesknown, and I have had an opportunity to satisfy myself, fromconversation with other invalids in your Institution, of the care andskillful treatment that you administer, and its excellent effects. Ibelieve that it is fully abreast of the times, and equal to anyinstitution 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 GOODHEALTH. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N. Y. :

[Illustration: Mrs. Plummer. ]

_Dear Doctors_--It is with the greatest pleasure that I add my ownexperience to that of the many that you have cured. I am nowseventy-three years of age, and enjoy very good health for my years, andas you can see by the photograph I send you, time has dealt veryconsiderately with me so far as my activity and enjoyment of life areconcerned. To this I feel that in large measure my thanks are due toyou, for eleven years ago when I was sixty-two years of age you treatedthe pile tumors so successfully. They had been the source of greatestdiscomfort. I think that they were caused first by chronic diarrhea, which had troubled me many years prior to their appearance. I was alsoafflicted with asthma, torpid liver and constipation. These conditionsproduced in time some pile tumors that were the source of muchsuffering, and seemed to continually annoy me. As is usual with suchdifficulties, I believe, I would be free from discomfort for a time, andthen 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 tolead me to fear that I would break down in health unless they wererelieved. From information obtained from others who had been relieved atyour hands, I applied to your institution, and can thankfully assertthat the tumors were permanently cured, as it has been eleven yearssince 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 nicecare at your institution that I cannot express in my testimony thethanks that I owe you. Wishing you every success in the treatment ofothers, and that you may be able to relieve the sufferings of manyhundreds 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 miserableall summer; I was very bilious; sometimes my bowels would not move oncein sixty to seventy hours, and then almost impossible. I would take somebitters, which would help to move the matter, but as soon as the bitterswere gone, I had to buy more or I would be as bad as before, andsometimes worse; but none of them appeared to do me any good except tomove the bowels, until thirty years since a druggist called my attentionto your "Golden Medical Discovery, " and before I had taken half a bottleof the "Golden Medical Discovery, " I felt much better, and by the time Ihad taken all, I could eat three hearty meals per day and had not feltso well for a long time. Soon after I was called to do a job some milesfrom home, and one night the old lady there was speaking about herdaughter (Mrs. Brooks) who had been under the doctor's care for aboutfive months and did not get any better, and I learned by asking a fewquestions that she had no appetite and no ambition to do anything. ThenI told her what the "Golden Medical Discovery" had done for me. The nextday the old lady drove down to her daughter's and got Mr. Brooks to sendto Rutland, ten miles away, for two bottles of the "Golden MedicalDiscovery, " and the next day when the doctor came and was about to takehis leave, Mr. Brooks told the doctor he did not want him any more atpresent, and would send for him, if necessary. I saw the old lady aboutten days later and her daughter was improving, and Mr. Brooks had greatfaith in the "Golden Medical Discovery, " and had not sent for thedoctor, but had gone to Rutland for more of the "Golden MedicalDiscovery. " When I commenced taking the "Golden Medical Discovery" Ithought I was going into consumption, as I had a cough for three yearsor more and my weight decreasing. My weight before taking the "GoldenMedical Discovery" was 133 pounds; last March it was 147 pounds, and Igive 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 momentduring that time had I rest from pain or weakness. I consulted six ofour best physicians, taking medicines from each for a good long time. Ibecame completely discouraged, as I had been many times before. A letterfrom the World's Dispensary Medical Association with questions to beanswered, fell into my hands; these I carefully answered. As soon as aletter could go and come I received another saying I had the LiverDisease. I could hardly believe it, for it had never entered my mindthat 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 theiradvice, strictly followed it. I found complete relief in taking the"Golden Medical Discovery. " For years I could not ride a mile nor walkto my nearest neighbor's without feeling worse for it, and most of thetime could not go at all. The day this picture was taken I rode eighteenmiles, walking up and down two long hills. To the afflicted anddiscouraged I would say consult the World's Dispensary MedicalAssociation; accept their advice, strictly follow it, and if there behelp 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 Ican cheerfully recommend your medicines, as I have tried them and foundthem just as represented. I am enjoying splendid health at the presenttime. 

 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 forthe 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. Aftertaking it for three months I began to feel better, especially the gasand sour rising off my stomach at night. Formerly it was a terribledistressed feeling, could not rest nor sleep. I am very thankful to theWorld's Dispensary Medical Association, and thankful to God who put thegreat _power_ in your medicine that cured me. I will say a good word foryour 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 twodistinct chronic diseases of years' standing, and having been placedunder the charge of your specialists, I was speedily relieved of myafflictions. The Invalids' Hotel is a place as much like home as it ispossible for such an institution to be. The physicians and surgeons areall expert specialists and thoroughly efficient; the nurses are verycompetent, attentive and kind; and, in fact, the whole _personnel_ ofthe Invalids' Hotel endeavor to do their best to make the patients feellike being at home. I always felt while there as if I was one of thefamily. I gladly recommend your Institution to all persons who areafflicted 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 mydiseases, and I think your Institution is worthy of the highestendorsement. 

 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 physicianswith little or no benefit, I resolved, as a last resort, to consult yourspecialists at the World's Dispensary. Being advised by them to use Dr. Pierce's Golden Medical Discovery, I did so, and after using severalbottles, I feel entirely restored to health. Now, I take great pleasurein 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 wassuffering badly from "Liver Complaint. " I had been out of health forthree years. I suffered terribly from "heart-burn, " had bad coat ontongue, and was often troubled with diarrhea. Three bottles of the"Discovery" cured me. Had I not commenced taking it when I did, I shouldhave 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 yourGolden Medical Discovery, " and each and every one says it is a goodmedicine. One woman in particular, told me she was getting better everyday 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 neckand in my left ear, and my tongue was so stiff at night and dry, and Ihad no taste, or appetite to eat anything. I also had such a dead achingin the small of my back; it just felt as if I would break, and suchaching between my hips. I had been having the "change of life, " and if Iworked hard I got a pain between my shoulders and a kind of aching inthe abdomen. I doctored a good deal and never got any relief. I was verynervous. I took two bottles of Dr. Pierce's Golden Medical Discovery andtwo 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 sufferedso long that I was a wreck; life was rendered undesirable and it seemeddeath was near! but I came in contact with Dr. Pierce's Golden MedicalDiscovery and "Pellets. " I took twelve bottles of the "Discovery, " andseveral bottles of the "Pellets, " and followed the hygienic advice ofDr. Pierce, and I am happy to say it was indeed a cure, for life isworth living now. A thousand thanks for your treatment. I enclose myphoto. 

 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, coughingand weak, and thought she had consumption; she had such palpitation ofthe heart and could not rest at night because of the palpitationsometimes, and then the right arm pained her so at times that she hardlyknew what to do; If we would put on hot applications, it would drive itto the heart, and the doctor did her no good; so finally, as a lastresort, we happened to get hold of some of Dr. Pierce's pamphlets andwere constrained to write to him and send a small bottle of urine forexamination. He immediately wrote back, saying it was liver trouble, andto take the "Golden Medical Discovery" according to directions. She tookit for two months, when the pain in her arm gradually left her and shecould comb her own hair, and began to be more cheerful, for she wasmelancholy before. The palpitation grew less and less, and she rested atnight, and is now doing her own work for a family of five, and issixty-one years old. 

I have taken delight in recommending to others this wonderful medicinefor heart and liver trouble; she took a dozen bottles to effect thedesired 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 meto take your "Golden Medical Discovery. " I had not had my courses forsix months; after I had taken your medicine about two months, I waswell. 

When one of my daughters with a baby two weeks old was in so much painthat she could not rest day or night, I went to her as quickly as Icould, and commenced giving her your "Favorite Prescription. " The nextmorning the pains were all gone. She said, "oh, mother, I would havedied if you had not come. I do feel so good. " Your medicine makes peoplefeel like they wanted to live. There is a woman at Verdi who had severalchildren who died with consumption of the bowels and _chronic diarrhea_. She had another one who was going the same way. The doctor said it wasbound to die. I went there and gave it five drops of Dr. Pierce'sExtract of Smart-Weed, and increased the dose every time its bowelsmoved, until I got to a half teaspoonful. The next morning the child wasalmost well. That woman says I saved her baby's life. 

I could write a week and not tell half the good your medicines have donethrough 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 quicklyas I could get some hot water, I put hot applications on his stomach andbowels, and gave him a few doses of your Extract of Smart-Weed. He gotwell 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 whenwalking; could not walk any distance, always feeling hungry but alwaysfelt bad; after eating felt as though my victuals were sticking in mythroat; could not rest well at night; I was not well all winter. In 1891took sick and quit work; in March doctored with three different doctorswith very little benefit for a good deal over a year, then began takingyour "Golden Medical Discovery. " Took ten bottles of that, and onebottle of your "Pleasant Pellets, " and steadily improved all the time Iwas taking your medicine and have worked all this summer; did not workfor two years. 

My case was liver disease and nervous dyspepsia of which your medicinehas 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 liverwith all the disorders accompanying such a condition. Doctors'prescriptions and patent medicines I have used in abundance; they onlyafforded temporary relief. I was recommended to try Dr. Pierce'sPleasant Pellets. I did so, taking three at night and two after dinnerevery day for two weeks. I then reduced the dose to one 'Pellet' everyday and continued this practice for two months. I have in six monthsincreased in solid flesh, twenty-six pounds. I am in better health thanI have been since childhood. Drowsiness and unpleasant feelings aftermeals 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, statethat I have taken your "Pellets" and "Golden Medical Discovery" forchronic "liver complaint" attended with constipation of the bowels, andafter using six bottles of "Discovery" and same of "Pellets, " I amgreatly benefited. You can use my name in advertising your medicines andI 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 torpidliver, indigestion, constipation, nervousness and general debility, andfinding no relief in my efforts to regain my health, I was induced totry your "Golden Medical Discovery" and "Pleasant Pellets. "

Under this treatment I improved very much, and in a few months was ableto attend to my professional duties. 

I now feel very grateful for the benefits I have received from the useof your valuable medicines, and recommended them to many of my friendsand 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 MedicalDiscovery, four bottles of Dr. Pierce's Favorite Prescription, and abouthalf-a-dozen packages of his "Pellets, " I am convinced that I amthoroughly cured of that dread disease, known as dyspepsia, and othertroublesome 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 expresshalf my feelings of gratefulness to you. I had despaired of ever gettingwell. 

I had been in bad health twenty years--liver and kidneys, all out oforder and aches all through me; numb hands and cold feet. Everything Iate distressed me, bowels constipated, was very nervous, depressed anddespondent; in fact I can't express half my bad feelings to you. When Ifirst wrote to you, I thought I would not live to get an answer fromyou. 

I have taken twenty bottles of "Golden Medical Discovery" and "Pellets. "My health is now very good. You have my honest recommendations to allsufferers. 

 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 fromliver and kidney trouble, six different Doctors treated me during thattime but could do me no good. I give your "Medical Discovery" the praisefor my cure. 

Then, too, my wife had a bad case of Asthma which was cured by the useof 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 MedicalDiscovery" saved my life. When I began your treatment two years ago, Ihad been given up by the Doctor, and my friends had lost all hope of myrecovery. I had suffered for years with torpid liver; I had chronicpleurisy and catarrh in a very bad form, attended with hemorrhages--wasconfined to my bed two months. In a few days after beginning yourmedicine I could perceive a slight change for the better; in threemonths 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 sincethe birth of her child, eight years before; had a headache with burningand throbbing sensations; and a hurting in her stomach; there was a deadaching and gnawing or drawing of the stomach as she described it; sharppain in the stomach extending to her right breast and shoulder. Weighedin health 125 pounds, but was reduced to 95 pounds; was weak; couldscarcely walk at all, was sick at stomach a great deal; when her monthlysickness came on had much pain and the sickness of the stomach remaineduntil menstruation stopped. She writes:

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N. Y. :

_Gentlemen_--"I have taken about six bottles of your 'Golden MedicalDiscovery' and 'Favorite Prescription, ' and am glad to say that I feelbetter and stouter than I have felt in a long time. I can work all daynow and not be tired at night. My head don't trouble me now. When Icommenced the use of the medicine I weighed 89 pounds, and to-day Iweigh 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 Itried four different doctors and grew worse all the time. Then I beganon your medicine and took twelve bottles of "Golden Medical Discovery"and one of "Favorite Prescription, " and am able to do my work and feelas well as I have felt in years. Physicians called my disease Dyspepsiaand 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 myhead and costiveness. My food would sour on my stomach and I would spitit up. I also suffered with my back a great deal; in fact, I wasentirely broken down. Had different doctors but none seemed to do me anygood and I began to take your medicine--the "Golden Medical Discovery. "

I have been enjoying better health since I have taken your medicine thanI had for years before. I have recommended it to my friends; I believeit to be the best medicine in the world. My sister has taken more ofyour medicine than I have; her husband has also taken it; she thinksthere 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 "FavoritePrescription" cured me of dyspepsia after fifteen years' suffering. Idoctored a great deal without receiving any benefit. About four yearsago my attention was called to Dr. Pierce's Favorite Prescription, whichwas highly recommended for dyspepsia and I used three bottles of"Prescription" and eight bottles of "Golden Medical Discovery, " and theyhave 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 wastroubled with my stomach, and with shortness of breath. Everything I atedistressed me. I lost flesh and strength and became very nervous anddespondent. I took eight bottles of "Golden Medical Discovery, " and sixbottles 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 knowwhat it really can be. What such a case needs I have found in yourkindly encouragement, and your "Golden Medical Discovery. "

Although I can now claim, if any one can, that I have a cast ironstomach, I always keep your "Golden Medical Discovery" and the "Pellets"on hand when settling down from an active summer's vacation, to quietstudent life. 

I heartily recommend these medicines to every one whose suffering is ofthe 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 walkacross the room without great suffering, but now I am able to do my ownwork, thanks to your wonderful medicines, I am a well woman. I sufferedall the time with a weight in the bottom of my stomach, and the mostsevere bearing-down pains, low down, across me, with every step Iattempted to take. I also suffered intense pain in my back and righthip. 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 sufferedgreatly from headaches, and the thought of food would sicken me. Now Ican eat anything, and at anytime. My friends are all surprised at thegreat change in me. Every one thought I would not live through the monthof August. Two of my neighbors are using your medicines, and say theyfeel 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 troubledwith Indigestion for three years, which, I think, resulted from "changeof life" and overwork. An eminent physician informed me I had no organicdisease. But I had distress after eating and was troubled with gas inparts affected, an unpleasant taste in my mouth in the morning. I wasweak and nervous and had to live on a very light diet. After taking your"Golden Medical Discovery" I was relieved of these symptoms. I believethe 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" toany one who is troubled with indigestion and torpid liver; I was thatbad it was about chronic with me. All the other medicines could give meno relief; but at last, what came to my relief was that wonderfulmedicine, the "Golden Medical Discovery. " I could scarcely eatanything--it would put me in terrible distress in my stomach; I had adull aching and grinding pain in my stomach with pain in my right sideand back, and headache, bad taste in my mouth; at night I was feverishand the soles of my feet burned. 

I took four bottles of the "Discovery" and two vials of the "Pellets. " Iam 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 greatpleasure in recommending to the public your system of home-treatment forchronic diseases. I am thankful to say I am in perfect health and haveworked every day since I last wrote to you and have not taken a particleof medicine of any kind and am weighing about one hundred and eightypounds. I have taken your "Golden Medical Discovery" with verysatisfactory 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 myleft shoulder and elbow. I tried a great many remedies, recommended tome by friends, but they all failed to afford relief. From that time Ibegan Dr. Pierce's Golden Medical Discovery, until I felt that I wascured, was a period covering four or five months. While the attacklasted, 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 hadspent a great deal of money previously, in various kinds of medicine, but the "Discovery, " from the day I commenced until I was well, costonly 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 veryfrequently; also nose bleed. My health was so poor that I was not ableto go to school for two years. I took Doctor Pierce's Pleasant Pelletsand "Golden Medical Discovery, " and in a short time I was strong andwell. Many friends are taking your medicines seeing what they have donefor 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, asLiver Pills, They have done me more good than any other medicine I haveever 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 hadulceration of the bowels. By the time I had taken a bottle and a half ofDr. Pierce's Golden Medical Discovery, the bleeding had almost stopped. My appetite was good, nothing seemed to hurt me that I ate. Myimprovement was wonderful. Several years have passed and my cure ispermanent. 

 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 stomachand bowels which the usual home remedies failed to relieve; afterseveral days it passed off, leaving me very sore and weak but in thecourse of a few weeks it came on again. I called in a doctor--he treatedme for biliousness; I occasionally went several months without anyattack and then it would come more severe than ever; I could scarcelybear the weight of my clothes on my stomach and bowels. I grew thin, weak and despondent, --could do no work without bringing on terriblepain. Doctors treated me for catarrh of the head and stomach, indigestion, dyspepsia, but all was of no avail; the suffering graduallyincreased 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 aboutfive weeks in bed I could again sit up, but the pain had settled in myright groin and limb. Relatives persuaded me to try "Golden MedicalDiscovery. " Two thirds of the bottle was gone when I felt a change forthe better; I had one very light attack after the first bottle; that hasbeen seventeen months ago and I have had no more trouble. I have takenten bottles of Dr. Pierce's Golden Medical Discovery and I am now welland able to support my family. 

To any one with stomach and bowel trouble I will recommend Dr. Pierce'sMedicine. 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, distressin the stomach, bowels, feet and ankles bloated, kidney and hearttrouble, loss of appetite, bad taste in the mouth, sour risings in thestomach, and indigestion. I was under the treatment of three physiciansseven months. One gave me up to die. This was my condition when I wasprevailed 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 goodqualities of your medicines, I would most gladly do so, as they havesaved 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, alsowell known as one of the accomplished singers at the ChautauquaAssembly, 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 theunder side of my tongue, and which proved very sore and troublesome. Becoming alarmed at the frequency of their appearance, and having muchfaith in Dr. Pierce and his associates, I wrote to them for advice. Theyrecommended me to take Dr. Pierce's Golden Medical Discovery, which Idid, 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 inmy stomach. A physician pronounced my case "Catarrh of the Stomach, " buthe could not help me. I lived a month without solid food and when Itried to eat I would vomit. At this time I began taking Dr. Pierce'sPleasant Pellets, and in two weeks I was decidedly better. I am now ingood health, and never felt better in my life. I have a better color, eat more, and have no distress after eating--having gained thirteenpounds 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 chronicdiarrhea, which his physician called dysentery. He had been troubledmore or less for five years; had very severe attack fifteen monthsbefore 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 uponrising in the morning; pain about the heart; itching all over body andlimbs. He had three months' treatment at home--the special medicinesbeing sent him by express. He writes that he "was greatly benefited byfirst week's treatment, " but continued and "in three months was entirelywell. "

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 GoldenMedical Discovery; I weighed 140 pounds, and now I weigh 175 pounds, soyou see how I have gained in health and weight. Dr. Pierce's Pellets arethe best pills I ever took for the liver. All my friends say they dothem 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 andbowels; could eat nothing but stale bread and tea or coffee. Meat andvegetables passed through the bowels undigested in about two hours, causing great pain. I was all "run-down. " Tongue looked like a piece ofraw meat. One doctor pronounced my case cancer of the stomach. I tooktreatment from five different physicians with but very littlebenefit--only temporary relief. I got so weak I could scarcely walkaround, 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 nowsixty-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, catarrhand 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, andwas advised to try a course of special treatment. After taking only twomonths' medicines from your noble institution, I feel perfectly restoredto health. I have, moreover, recovered my lost flesh, and I am pleasedto 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 agreat benefit to me. I was suffering from general debility, malaria andnervous sick headaches, and after my third child was born (a beautifulbaby boy of ten pounds) I only recovered after a long illness; I barelygained strength enough in two years' time so that I was able to crawlabout to accomplish the little housework that I had, by lying down toread many times each day; had sick headaches very often; and many painsand aches, all the time complaining of getting no better. I finallyasked 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 greatchange in my strength, and fewer sick headaches. 

I continued taking the medicine until I had taken eight bottles--sevenof the "Favorite Prescription" and one of the "Golden MedicalDiscovery. " For some time past I have not used it, but I am now able todo the housework for myself, husband and two children (aged nine andfive years). I also take in dressmaking, and enjoy walking a mile at atime, and I think it is all due to the medicine, for I know I was onlyfailing fast before I commenced to take it. I take great pleasure inrecommending the "Favorite Prescription" to all women who suffer fromdebility 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 andlay 22 days in fever. Our family doctor was tending her twice a day; shegot 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, " andcommenced to give them to her as directed; after taking the medicinethree 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 saya 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 worstdropsy that ever came within my knowledge, it having afflicted metwenty-two years. After I had suffered much from other surgeons withoutany cure being effected, and with only relief for a short time, youperformed a not only painless but very scientific operation, and withmedicine completed the cure. It is now five years since you treated meand no symptoms of the disease have shown themselves. I will also addthat while with you at the Invalids' Hotel I received the best of careand attention from the well trained nurses in your employ, for all ofwhich 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 Isuffered for six years, and was under fourteen different doctors in cityand country. They could not reach my case; I was given up to die; mysufferings were _indescribable_; I could not retain food on my stomach;could not control my bowels at times; suffered great pain; could notsleep 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 amsixty years old, but feel young and active; I owe it to the medicinesyou sent to me. After taking it two months I was out of bed attending tomy work; my friends could hardly believe it was I when they would meetme 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 abovedisease, which reduced me to a mere skeleton, and my friends had verylittle hope of my recovery. After trying different doctors, and manyother remedies for a year, from which I received little or no benefit, Iwas advised to try Dr. Pierce's special treatment, which I did, andafter two months I was a well, strong, healthy man, and have been eversince. 

 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 theKingsley House at Ashuelot, N. H. : "It may seem useless to add testimonyto the overwhelming mass already given of the many remarkable curesperformed at your Institution, but I deem it a pleasure and a duty toadd mine to your long list as _very remarkable_. I had a rupture oftwenty-seven years' standing, with hemorrhage of the kidney for sixmonths, preceding my visit to your Institute, and was also troubledbadly with indigestion, all of which ailments had reduced me in strengthand 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 distancewhen I left my home on the 8th of July, 1892, for treatment at yourInstitution, with but little faith or hope of ever being any better. Butthrough your skillful treatment I was able to return to my home on the9th of August, 1892, and consider myself permanently cured, having hadto take no medicine since. Considering my case _almost a miracle_, Icannot speak too highly of your Institute and skillful treatment, towhich I feel that I am indebted for my continued existence. You are atliberty 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 byletter. He was suffering from great nervous prostration; could not walkwithout tottering; was troubled greatly with inability to sleep; poorappetite; did not relish food; suffered much pain and stiffness in thejoints; was overcome with neat working on a thresher, followed bypersistent nausea, confusion of ideas, his memory being very defective. 

After taking a single course of treatment, the medicines being sent byexpress, he writes as follows: "The medicine you sent me lasted me fiveweeks, and proved very beneficial indeed. I believe it, under God, wasthe means of saving me from a premature grave. When I received themedicine, I had just gotten rid of an attack of bilious fever, whichleft me in a deplorable condition. I was very week and nervous, but myimprovement commenced with the first dose of your medicine, so by thetime my medicine was out I felt better than I had for years, and nowhave 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 lifeworth living. I have gained twenty-one pounds since I have been able toattend to business. Please accept my profound thanks for your promptnessin 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, eyesbright, circles nearly all gone from under eyes; am fleshier, stronger, more active, and an entirely different man. No piles, catarrh, hearttrouble; 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 dyspepticsymptoms have all vanished. I am no longer troubled with headache andstoppage of the nose, my stomach is in good order, and I enjoy threehearty meals daily without any bad feelings. 

I have gained in almost every respect, particularly in weight andstrength, since beginning the use of your specially prepared medicines. By continuing to follow your special hygienic rules, I believe norelapse 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 myhealth, which had at that time become very much impaired from theeffects of uterine disease, indigestion and chronic constipation. I wasalso troubled with frequent attacks of nervous headache which renderedme very miserable. 

A line of treatment was outlined by your specialist, which I followedclosely, and I immediately began to improve under the use of themedicine advised. The benefits wore so marked that within two or threemonths I was able to discontinue the use of the medicine, and have sincethat time been enjoying good health. I attribute my cure to the use ofyour medicines, and I heartily thank you for the benefits received, aswell 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 invain, and expected to die with consumption. But hearing of yourInvalids' 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 tocure 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 diseasedstomach. It was very light at first, but as time went on it graduallygrew worse. I did not suffer much at first--say for the first fiveyears; but after that it was continual suffering all the time (andgrowing worse all the time), until just two years ago, when I completelycollapsed, and had to give up all thoughts of work. I have not done aday's work since, but am now ready to go to work again. During the lastfive years I have been doctoring with as many as six different doctorshere and in San Francisco. I was with one specialist here in my cityfive months, but none of the doctors gave me even temporary relief. Themain symptoms of my disease were that my food would sour on my stomachand 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 lookingover the ads. In the San Francisco Examiner, I ran across yours--statingthat any one who would send twenty-one one-cent stamps to the addressgiven would receive The People's Common Sense Medical Adviser I did asrequested, and read a copy, and I now owe my life and present goodhealth to Dr. Pierce and his noble staff of physicians. I have now takenfourteen bottles of the "Golden Medical Discovery" and four bottles ofthe "Pleasant Pellets, " and will say that I am entirely well of all mystomach troubles. Can sleep nine hours every night. 

A word to those who are taking or contemplating taking this grandremedy. Do not give up with one or two bottles, but continue on, and itwill 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 nervousindigestion and acidity of the stomach. I tried some of the bestdoctors, both in England and this country, but did not find permanentrelief until I went to the Invalids' Hotel and Surgical Institute. Themedicine prepared for me by the specialist at this famous institutionwas so effectual that I feel that I am perfectly cured. 

I cannot speak in too high praise of the Invalids' Hotel and SurgicalInstitute. The Staff of Physicians is skillful and of large experience, and the institution itself, in all its appointments, excellent and inadvance of the age. I highly recommend it to all the afflicted, feelingconfident that all the benefit to be derived from medical or surgicaltreatment 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-sixyears old. A pain began in the stomach, a sort of cramp; extended to thechest, shoulders and arms, also affecting the spinal column opposite thelocation of pain; had a hard lump that felt like lead in the pit of herstomach. Pain was brought on sometimes by eating something that at othertimes she could eat with impunity. Attacks of pain lasted usually aboutthree days. After the pain would leave, she was weak and sore. Sometimesattacks 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 thelast set of medicines, and think I will not need to continue. A ladysimilarly afflicted is trying some of my medicine, and will order fromyou direct. I am glad to know where to direct the sick, and where themost good can be had for one's money. I am feeling well, and can work asformerly. "

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 resortto hot water injections regularly to move my bowels. This got to be agreat drudge to me. I took treatment from the leading physicians of thispart of the country for my stomach and bowel troubles, and spent overone hundred dollars in this way, but they did me no good whatever. I gotso bad that I began to think my time on earth was short, and did notcare if I lived or died. I had to stop work; everything was a burden tome, until at last I tried your Institution. I went there, and you saidyou could help me, and those words sounded so good to me, as I thought Inever could get well again. After taking your special home-treatment forfive months, I was in the enjoyment of perfect health. This was twoyears ago, and ever since my bowels have moved regularly, and I have nottaken any medicine to make them move. I cannot find words in which toexpress my sincere thanks for the almost immediate relief. I receivedfrom your specialists, and will say I am now enjoying the very best ofhealth. 

 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 acomplication of rectal troubles; pile tumors, prolapsus and fistula inAno. I have been under the treatment of our most skilled practitioners, by ligature, carbolic acid, constitutional treatment, change of climateand the celebrated Brinkerhoff treatment, and also tried all of thelocal guaranteed nostrums, from all of which I have been onlytemporarily relieved. The old troubles would in a short time return, andwith seemingly renewed vigor. With fast failing health and terriblenerve prostration, I left home the 1st day of October last, to take atwo weeks' trip, hoping for some temporary relief. On the trip I stoppedover at Buffalo, and having several years before been in correspondencewith the Infirmary, concluded to consult you. I did so with little hopeof a beneficial result. From the manner in which I was received and thesatisfactory diagnosis of my case, I placed myself under your treatment. On the 16th day of October you operated upon me with such complete andsatisfactory success, that I am now a sound and happy man, and amconfident that had I been treated by you ten years ago that I would nowbe twenty years younger in feeling and thousands of dollars better off. It affords me pleasure, doctors, to recommend the Invalids' Hotel andSurgical Institute to all of the afflicted, and to assure them of themost skillful treatment, honest and polite attention, and with theassurance 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 littleor no benefit from other physicians, I determined to try yourInstitution, 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 noother means. And my troubles are yielding slowly but surely; my generalhealth 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 aninmate by all connected with the Invalids' Hotel. I shall heartilyrecommend 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 andRectal disease. My disease was of very long standing and had baffled theskill of our home physicians. I went to the Invalids' Hotel and SurgicalInstitute, and received treatment of their specialist. Under hisskillful care and kind attention I soon regained my strength and feltthat my former life and ambition were again restored to me. I cannotspeak in too high praise of this famous Institution; the rooms are largeand cheerful, the food of the very best, the nurses kind and attentive, and the staff of physicians and surgeons skillful and of largeexperience. 

 Yours respectfully, MRS. CHAS. CLAWSON, Middlesex, Yates Co, N. Y. 

RECTAL FISTULA

WITH BLOOD-POISONING, CURED BY A SAFE AND PAINLESS METHOD. A PROMINENTMERCHANT 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 whichyou treated me. I had suffered from it for a long time, and felt that itwas likely to seriously undermine my health and poison my system. I haddeterred having it treated from the fears of the cutting operation incommon use by physicians in the large hospitals and by surgeons ingeneral practice. My fears were grounded on the fatal results that hadfollowed in cases in my knowledge. I am thankful that I placed my casein the hands of your experienced specialists for treatment. The resulthas been a perfect cure. The treatment of the blood-poison that you gaveme was successful in eliminating it all from my system, and I have sinceenjoyed perfect health, and no recurrence whatever of the fistula. Ithas been now many years since I was cured, and I thank you mostsincerely for the good results that were brought about in my case. 

I can recommend your institution as one in which all the requirements ofan 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 casesand chronic ailments of every description. It is with especial pleasurethat I recommend the surgeon-in-chief of the Hotel, who is a skilledsurgeon, one who stands at the head of the profession. The appointmentsof the Hotel are excellent. I was afflicted with an Anal Fistula (a verybad 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 suchskill, that the parts are healed soundly. I recommended a friend ofmine, who had a rupture, to go to you for treatment. He did so and wassoundly healed of his trouble. I will cheerfully answer allcommunications relative to my stay at the Invalids' Hotel, provided astamp 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 themknow of your great success with me. I had a chronic disease that I hadsuffered with for sixteen years, and last November, owing to a fall, thedisease doubled on me. I was confined to my bed for months, and the bestsurgeons of our city attended me daily. I continually grew worse. Afterconsultation they decided that the knife must be used, which is attendedwith great pain and danger. I wrote you and stated my case; you said youcould 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 onthe 20th of April I was at home entirely cured, and have enjoyed betterhealth than for years. You also treated my wife for heart trouble, andgreatly benefited her. The thoroughness of your methods, preparing thesystem, etc. , greatly adds to your success, as well as your skillfultreatment. I shall ever hold the surgeons at the Invalids' Hotel andSurgical 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 forpiles and also rupture of the left side. 

Your institution is all it claims to be, and the treatment of my casewas accomplished without pain and apparently any risk. Your method ofusing locally cocaine as an anæsthetic is such a decided improvement. Idid not have to take any dangerous ether or chloroform, but had a smallquantity of medicine injected that made the operation as painless asthough it was being done on some one else. At the same time I kneweverything and could see what was being done. 

You have my kindest thanks for the good care and many attentions givenme. 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 byheavy lifting during the war. My suffering was extreme, and the piletumors gradually increased in size, notwithstanding the fact that Itried many different kinds of treatment. After becoming physicallyincapacitated and unable to do any work at all, and after muchhesitation, I visited your institution as the last resort. I am happy tostate 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 ofyour specialist, and I wish to thank you most heartily, for theattention which I received while there, and for the cure which has beenaccomplished in my case. I cannot say enough in favor of you and yourstaff of physicians who gave every attention, and whose treatment hasbeen so successful. All suffering has entirely vanished, and I havegained 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 atfirst but gradually increased in severity, and I was unable to getanything which would relieve them. They gradually increased in size, andfor a good many years past have caused me a great amount of pain. Thetumors became of large size and protruded whenever I lifted anythingheavy or strained in the least; also bled copiously at times. This, together with chronic inflammation of the bladder, with which I havealso suffered for some years, rendered my life miserable. Physicians athome gave up my case as hopeless, and said that they did not think Icould be benefited, and certainly not cured. I visited your Institution, hoping to obtain relief, but with very little faith, and am happy to saythat the treatment which I obtained there has resulted in a permanentcure of the piles, and the inflammation of the bladder has been sogreatly relieved that at present I have no suffering of any kind. Thecure is complete and I feel like a new person. In fact I have notexperienced such comfort in many years. I shall always appreciate thekindness and attention shown me by your staff of physicians, and also bythe nurses in your Institution, and shall advise my afflicted friends tomake 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, theresult of sun-stroke while in the U. S. Army, and pile tumor growth. Forthe last named disease I was treated at the Invalids' Hotel and SurgicalInstitute, in June of 1887, and the growth, as I believe, is killed, andthe result has been a great benefit to my general health. I am quitecomfortable and with strength to look after my little work andsuperintend the same, much better than before treatment, for whichbenefit 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 yourequesting a photo, of myself. I will say that I am sorry, but I havehad no photograph of myself taken since I was a child, but will gladlygive you a testimonial and I will answer by letter any skeptical onesthat you refer to me, provided they send a return addressed and stampedenvelope for reply. 

Just one year ago, I was suffering untold agonies from internal pilesand prolapsus of the rectum: my bodily pain was so great that the mentalstrain was almost more than I could stand. I was useless to myself andfamily and had about persuaded myself it would be better to take mylife, and I think I should have done so had not a copy of the CommonSense Medical Adviser happened to fall into my hands. I was not certainjust what my trouble was, at least what to call it. I began the Chaptertreating on Pile Tumors, and then I realized just what my trouble was. Iwrote you and received encouragement. I sent for a month's treatment andit was certainly the best investment I ever made. I received themedicines at noon--read the directions carefully and commenced at onceto carry them out. I seemed better the next day. I suffered less, and ina few days there was a decided change for the better. I continued themedicine until I had taken all of it; I have not taken any since, exceptoccasionally a few of Dr. Pierce's Pellets, just enough to act as a mildlaxative. I am perfectly well. I was always more or less constipated allmy life. I now understand that by keeping the bowels open and in goodorder, I could have avoided all of the suffering that I have gonethrough; 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 tosuffering 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 takegreat pleasure in bearing testimony to the fact, that since you treatedme, seven years since, I _have not had a symptom of piles_. 

At the above stated period I had also been a sufferer from diarrhea, inits most aggravating form, for three and a half years, and I wascompletely 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 greatskill in treating me, I should have been in my grave. I state for thebenefit of all those who may be similarly afflicted that if they willplace 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 skillfultreatment 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 knowthat they do for me all that is claimed for them. I am employed mostlyat my desk, and not infrequently have an attack of the headache. Itusually comes on in the forenoon. At my dinner I eat my regular meal, and take one or two of Doctor Pierce's Pleasant Pellets immediatelyafter, and in the course of an hour my headache is cured and no badeffects. I feel better every way for having taken them--not worse, as isusual after taking other kinds of pills. Your "Pleasant Pellets" areworth more than their weight in gold, if for nothing else than to cureheadache. 

 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; thenneuralgia set in, and I suffered severe pain through my sides, shoulders, breast and stomach. Bilious attacks were frequent; then myflesh began stinging and my heart began beating badly and making me sothat I could not lift a chair, and all together threw me into a crampand a numbness, and the family thought I was dying, and sent for anotherdoctor who said it was hard to do anything for me; he visited me almostsix years and did not help me; the pain was so great I had to scream; Isaid to my doctor, "can you give me something" and he said, "yes, but itwill not do you any good. " I told him he had not done me any good in sixyears, and I would quit him. I saw I was almost gone, very pale and weakand did not eat anything. 

I began your "Golden Medical Discovery, " and one-half bottle helped meso much I began work and improved fast; it helped me so I got 10bottles. While using them my friends said when I quit I would be just asbad as ever. It has been five years and no need of a doctor yet, and Iwill 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 havebeen in my grave. Your medicines have helped my brother, and father isusing 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 theabdomen; this would go down leaving the parts so sore he could scarcelystand. We had three different doctors to treat him, but he grew steadilyworse. We then commenced giving him Dr. Pierre's Golden MedicalDiscovery, and after using it three days he commenced to improve. Lastsummer he had so fully recovered his health as to make a full hand inthe harvest field. He took, in all, only six bottles of the "GoldenMedical 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 byuterine and spinal weakness with irritation of the same. In the Springof 1890 I became so exhausted that I was compelled to keep to my bedwith symptoms of paralysis in the lower limbs, and many otherdistressing symptoms. I accidentally obtained one of Dr. Pierce'sMedical Advisers from a friend, and finding my ailments so welldescribed therein, I wrote to Dr. Pierce for his advice, which he sentby return mail. For my recovery he requested me to use his "GoldenMedical Discovery, " his "Favorite Prescription, " and his "PleasantPellets. " He also gave me some directions for every-day living. Thesemeans accomplished my complete cure. I am thankful that we can have suchreliable 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, hadheadache all the time, indigestion, pain in my back and loins, sorenessand stiffness in my joints, my limbs ached so I could not sleep atnight: 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 immediatelyto get breath, sit up and walk the floor very near all night. I couldnot eat anything that would digest; I would do the cooking for thefamily, but I was in so much pain the tears were in my eyes all the timeI would get a meal ready. I would take one mouthful of bread and then gooff and sit down and cry with hunger, but dare not eat any more, andthen would have to vomit from that one mouthful of bread--I would havesuch weak spells I could not stand on my feet. 

I had tried five doctors, they had done me no good; I had givenup--never to take anything more, only to lull the pain. I had given upto die when I received a pamphlet and some papers from you. I decided totry once more and I have been improving ever since I commenced yourtreatment; my health is better than it has been for fifteen years; Iweighed one hundred pounds when I began taking your medicines; now Iweigh one hundred and thirty, as much as I ever weighed. I have takenten bottles of "Favorite Prescription" and still more of "Golden MedicalDiscovery, " 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 ofthis continent. 

The millions of nerve filaments are similar to the network of wires thatkeep all the cities in close sympathy and communion. The nerves have todeal with organs instead of villages, and with cells in place ofindividuals. 

Commerce is regulated and train loads of food supplies dispatched hereand there by telegraph, while in the body the nerves send theiranalogue, 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 conditionsto be met, food required and dangers to be avoided and the nervestransmit these impressions telegraphically to the brain. 

The structure of the brain, spinal cord and sympathetic nerves, is notunlike a gigantic and complicated galvanic battery. The number of cellsin the brain and spine are more numerous, by many millions, than thosesupplying any telegraph system. 

As the blood supplies each cell with its necessary nourishment andremoves its used up or waste materials, so does the workman give eachcell of his battery fresh chemicals from time to time, and removes theused up waste. 

The wires that lead from this battery to every part of the country arelike the nerve filaments that go to each part of the human body and makethem all--no matter how minute--perform their functions in a propermanner, and, when done, permit them to retire to rest. 

With the complicated human structure, when disease takes hold, we havethe same troubles that would be presented were the telegraph operatorssuddenly to become ill. What confusion and discord would prevail! If thesickness is severe enough to cause delirium, it would be as thoughmadmen were at the telegraph keys dispatching trains of passenger carswhich could hardly fail to bring injury and destruction to unwarytravelers. 

In health, we are unaware of the work of the nerves. The wheels of lifemove without noise. Few realize that the cavities of the heart (auriclesand ventricles) are contracting steadily and alternately under theguidance of nerve cells. By this means the stream of blood, laden withnourishment, is sent to every part of the body. 

Silently the stomach pours out, under nerve influence, its juices thatdissolve and change parts of the food, that it may pass into the bloodin condition to nourish. In a similar way, the pancreas pours out afluid that digests the fats. 

The muscular fibres of the intestines are caused to contractrhythmically and force along the bolus of digested food, so that itssoluble parts may be taken up by the minute absorbent vessels to enrichthe blood. 

All these things of most vital importance we know least about. They goon, from day to day, without our being aware of the work done. 

Let something interfere with the process, and how quickly is thesensation changed. Few there are who have not felt the agony of colicpain, due to stoppage of digestion. What suffering is greater than thesense of awful suffocation from a heart that is not acting well?

These are only familiar illustrations of a thousand and one distressingderangements and symptoms that come from exhaustion and prostration ofthe nervous system. 

 * * * * *

NERVOUS DEBILITY OR EXHAUSTION. 

This affection, also popularly known as Nervous Prostration, or NervousWeakness, and, to the medical profession, as Neurasthenia, or NervousAsthenia, is becoming alarmingly prevalent. 

The wear, tear and strain of modern life are concentrated upon thenervous system. The care and consequent fret, worry and labor of thisage 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 thereserve capital of nerve force. 

We extract the following from an article which recently appeared In theNew 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 NewYork for 1894, shows that while the increase in the State's populationfrom 1880 to 1892 was 28 per cent. , the increase of the insane in Stateinstitutions for the same period was 83 per cent. !

The enjoyment of the fruits of fortune, earned at the expense of thenerve cells, is an impossibility. The quiet and harmony of the nervecentres and nervous system are gone. Rest is impossible, continuance ofwork only causes increased jarring and discord of that many stringed andwonderful mechanism. 

SYMPTOMS. It is well nigh impossible to give the symptoms of thisdisease in an orderly manner, as the affection gives rise to a thousandand one varying and ofttimes vague symptoms. The particular part of thenervous system affected, and also the cause and character of the attacksmodify the symptoms. The eminent Dr. Wood says: "Nervous exhaustion may, in the beginning, affect the whole of the nervous system, or it may beat first purely local, and co-exist with lack of general nervousstrength. "

SPERMATORRHEA furnishes many examples of the local form of neurasthenia, or exhaustion, the sexual centres being primarily affected. In thesecases, however, sooner or later, the whole nervous system becomesInvolved. So in other forms of the disorder, the exhaustion at firstlocal, finally, if neglected, implicates the whole organism. Often, inbrain exhaustion, the symptoms are at first purely local. Almost alwaysthe cause of a local neurasthenia, or exhaustion, is excessive use ofthe part. Thus, cerebral or brain exhaustion, or debility, is usuallythe result of mental overwork, while sexual asthenia, or weakness isgenerally due to abuse of the sexual organs or to sexual excesses. Whento the brain fatigue, or exhaustion, are added the depressing effects ofexcessive anxiety, or allied emotions, the symptoms from the first aremore general, and the exhaustion may effect chiefly a single function ofthe brain. In pure brain exhaustion, the loss of a disposition to work, is usually the first symptom, the sufferer finding that it constantlyrequires a more and more painful effort of the will to perform theallotted task. At first, there is loss of the power of fixing theattention, and this, by and by, is accompanied by a weakness of thememory; disturbances of sleep are frequent; various abnormal sensationsin the head are complained of. In most cases there is not absoluteheadache, but a feeling of weight or fullness, or an indescribabledistress, usually aggravated by mental effort. It is true that in somecases of very dangerous brain tire, mental labor is performed withextraordinary 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 ofmental power, with an almost uncontrollable brain activity. It isprobable, however, that these cases are not instances of pureneurasthenia, or brain exhaustion, but that there is active congestionof the gray matter of the brain. In these cases the disease is veryprone to end in serious organic affection of the brain. 

[Illustration: Melancholy. ]

Severe brain exhaustion may be associated with good spirits, but usuallythere is marked depression, and this perversion of function generallygoes on, if the disease be not checked, to decided melancholy. The willpower, like all the other functional activities of the brain, is proneto be weakened, morbid fears may finally develop, and at last, thatwhich was at the beginning a single brain exhaustion, may end inpersistent hypochondria, followed by insanity. 

Peculiar sensations are common in neurasthenia, such as chilliness, unnatural itching, a feeling as though ants or other insects werecrawling on the skin. Eruptions are common. Attacks of neuralgia areoften frequent and sometimes severe, being usually worse in thosepersons of nervous ancestry. In some cases there is a lack of propersensation, in others an unnatural sensitiveness. There is also in manycases a peculiar tenderness over some portion of the spinal column, especially in women. 

IN WOMEN, with nervous disturbance of the sexual organs, there isfrequently great pain felt during menstruation; in others, ovarianirritation and a so-called "irritable, " or sensitive uterus, giving riseto manifold nervous and hysterical symptoms, sometimes culminating inconvulsions or "fits. " In not a small proportion of the uterine diseaseswhich are generally only locally treated by physicians, the localdisease is largely and sometimes solely the expression of a generalweakness of nervous origin. 

SELF-ABUSE AND EXCESSES. 

It is well known that Onanism, or masturbation, as well as sexualexcesses, produce an exhaustion of the nerve centres presiding over thesexual functions. This is the common history of spermatorrhea or loss ofthe virile fluid by nightly emissions, accompanied by lascivious dreams. 

GENERAL NEURASTHENIA, or nervous exhaustion, may also produce a localweakness of the sexual centres of the brain and spinal cord, withsymptoms at least resembling those of partial impotency and greatirritability of the sexual organs, or a complete impotence, withpremature seminal discharge whenever coition is attempted. Many timesthis condition results from excessive intellectual labor, even with nosexual excesses or abuses. Nocturnal, or nightly emissions, are notalways experienced in these cases. When they do occur, the debilitatinglosses of vital fluid react upon the brain, robbing the victim ofcourage and manliness and exciting various phases of morbid fear andsensitiveness. 

Many cases of nervous debility, or exhaustion, are the result of longcontinued malarial poisoning, diarrhea, Bright's disease, exhaustingfevers or other debilitating affections. Numerous are the cases in whichthe patient is able to trace the origin of the malady back to an attackof influenza, or grip. An epidemic of the latter disease is sure to befollowed by numerous cases of nervous prostration, or exhaustion. 

CARE SHOULD BE EXERCISED. 

In all cases, it is necessary to make careful examinations in order todetect any obscure chronic disease which may exist. In women, nervousprostration often develops without perceptible cause at the age ofpuberty or at the "change of life. " Overwork, especially overworkcombined with worry, are fruitful causes of nervous exhaustion in bothsexes. 

AN OVERWORKED NERVOUS SYSTEM

is always an exhausted nervous system. The nerve cells have been robbedof their vital forces. All the nutritive organs of the body suffer fromthe lack of nerve control, and the blood-vessels that supply the nervecentres are not in proper tone. Hence the supply of blood and the actionof the heart are greatly interfered with. Many times, the mosttroublesome symptom, early in the disease, is an excessive perspirationof the hands and feet. 

IMPOVERISHED OR POOR BLOOD. 

A badly nourished nervous system is irritable. Many of the symptoms ofweakness and lack of nutrition resemble those found in congestion, orstimulation from excess of blood. Then, too, we find sometimes thatpoor, thin, watery blood, not suitable for nourishment although sent inlarge amount to the brain, does not properly nourish that organ. Therewill still be brain exhaustion, as the nervous structures have losttheir power of absorbing the nutrient materials from the blood which, being poor in quality, does not vitalize and strengthen the nervecentres as it should. In such cases thought is an effort and sustainedmental exertion is impossible; the memory is uncertain, and the patientdrowsy. 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 atemporary aid, and sometimes its habitual use is begun in this way. Stimulants only make a bad matter worse when their use is continued forany considerable length of time. The sufferer becomes more and moredependent upon them and the nervous exhaustion is much aggravated aslarge quantities are taken to satisfy the morbid craving that has beenacquired. 

WAKEFULNESS, OR INSOMNIA, is present in many cases; in others, there isunusual drowsiness but sleep gives neither rest nor strength; often itis disturbed by dreams that exhaust the vitality and leave the patientmore tired than when rest was sought. 

HEADACHE is one of the most annoying symptoms and sometimes is verypersistent. It may incapacitate the patient for the ordinary duties oflife. After laying down awhile and being quiet, the headache may berelieved, but recurs on attempting to go about. 

FRETFULNESS. Sometimes, owing to the discomfort experienced, there islikely to be a change of disposition, irritability of temper, fretfulness and peevishness; a tendency to an irascibility all out ofproportion to the real provocation. In many cases there is dizziness, and frequently noises in the head, ringing in the ears, spots before theeyes, twitching of the muscles, eyelids or eye muscles, and at timesdimness of vision, or sudden spells when the sight is not satisfactory. At times there is a feeling of discomfort, as if the quantity of goodair were not sufficient to aerate the blood, and there is sighing or adesire to sit in an open window, or a strong desire to be fanned. Thepulse and temperature are usually normal, or a little below, but mayrise if any local irritation exists. At times the face is flushed and atothers pale. The skin may be dry, or in other cases bathed inperspiration on slight exertion or mental worry. When there is weaknessof the nervous system, the disease manifests itself through variousorgans. Hence, the palpitation of the heart, dyspepsia or acute attacksof indigestion, with colicky pains and heaviness after meals, witheructations or belchings of gas, or local discomfort and unnaturalaction affecting, at different times, almost every organ of the body. Itis well known that insanity may result from the loss of sleep andconstant brooding over the symptoms that the patient fails to properlyunderstand. 

TREATMENT. 

In no class of diseases is greater care, scientific knowledge and skillmore necessary than in the treatment of nervous affections. Almost everycase is a law unto itself, and must receive careful consideration, pains-taking advice and specially prescribed treatment suited to thepeculiarities of the individual. Hereditary influences, causes of thedisease and constitutional peculiarities of the patient must all betaken into account. 

VALUE OF EXPERIENCE. 

Only through extensive experience can the medical practitioner becomeexpert at detecting and successfully meeting, by rational scientific andcarefully adapted treatment, the many phases and complications incidentto the different forms and stages of this very prevalent malady. 

For more than a quarter of a century, the Specialists of the InvalidsHotel and Surgical Institute having charge of this department ofpractice, have been actively engaged battling with diseases of thenervous system. As a result of this long time and vast experience, theyhave naturally developed and thoroughly tested many valuable remedialagencies for the relief and cure of this class of sufferers. Many ofthese can be successfully prescribed and used at the patients' homeswithout a personal consultation; while others can only be brought intouse at our Institution. 

TREATMENT AT HOME. 

Many cases, especially when the exciting cause of the malady can beeasily ascertained, as in spermatorrhea from self-abuse, or sexualexcesses, or in women when arising from uterine affections, can be verysuccessfully managed and cured at home. This is also true when thedisease is due to the excessive use of tobacco, opium and othernarcotics. 

CONSULTATION BY LETTER. 

The patient has thought over his symptoms hundreds of times. Thelocation of every discomfort has been carefully noted. These matters arestated with accuracy, common sense and good judgment when writing to us. The people are far more intelligent in these matters than physicians aregenerally willing to admit. A patient is often confused while beingpersonally examined by a physician and gives imperfect or incorrectanswers. After he has left the presence of the physician, he finds thathe has failed to enumerate many of the most important symptoms. Inconsulting by letter, the patient is not embarrassed, states the exactsymptoms and carefully reads over the letter, to see if it is a completeand accurate description of his sufferings. In this way he often conveysa much better idea of the case than if present in person, and subject tothe most thorough questioning and "cross-examination. " The timid ladyand nervous young man write just as they feel and one reason why we havehad such success in treating intricate and delicate diseases, is becausewe have obtained such true and natural statements of the cases fromthese letters, many of which are perfect pen pictures of disease. Asbank tellers and cashiers, who daily handle large quantities ofcurrency, can unmistakably detect spurious money by a glance at theengraving or touch of the paper, so the experienced physician, by hisgreat familiarity with disease, becomes equally skilled in detecting thenature and extent of a chronic malady, from a written description of itssymptoms. To aid the patient in giving a clear and intelligible historyof his case we send, when requested, a very complete question blank. 

EXAMINATION OF THE URINE. 

A careful, microscopical examination and chemical analysis of the urineis a valuable aid in determining the nature of these diseases of thenervous system. This important fact is not overlooked at the Invalids'Hotel and Surgical Institute, where experienced chemists are employed tomake such examinations and report the result to the attendingphysicians. Persons consulting us and desiring to avail themselves ofthe advantages afforded by these examinations, can send a sample oftheir urine by express. The bottle should be thoroughly cleansed andshould contain from two to four ounces of that first passed afterarising in the morning. It should be carefully packed in saw-dust orpaper and inclosed in a light wooden box. All express charges must beprepaid through and a complete history of the case, including the ageand sex of the patient, should accompany every package, or it willreceive no attention. This saves valuable time by directing theexamination into the channels indicated and thus avoiding a lengthyseries of experiments. As we are daily receiving numerous bottles ofurine, every sample, to prevent confusion, should be labeled with thepatient's name. By the postal regulations, all liquids are excluded fromthe 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 dealingwith these distressing maladies. We do not prescribe coca mixtures, whiskey, malt extracts, so-called celery compounds or other nervestimulants, which only spur the already weakened nervous system on as aman would urge his jaded horse to renewed efforts when the animal shouldbe refreshed by proper food and rest. Neither have we any faith, inlasting good resulting from prescribing such nerve sedatives as put thenerves to sleep and so, by simply blunting sensibility, delude thepatient into the false belief that he is being benefited. 

To effect a radical cure of the weakness, the nerve centres must berestored to a normal condition by improving the nutrition of the nervecells. To do this the causes of the difficulty must be understood andany local weakness or disease of any organ, be it the liver, kidneys, lungs, stomach, rectum, bladder, or generative organs, must beunderstood, properly treated and overcome. The desire for alcoholicstimulants is a most common and dangerous tendency of the disease. Togratify the morbid appetite for stimulants is to do the patient lastinginjury. 

IMPOVERISHED BLOOD. 

In some cases the nervous affection is the result of an impure, orimpoverished, 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 permanentrestoration 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 combinedaction tends to remove from the blood the poisons which it is thefunction of the liver to take from that fluid. The cells of the brain, after performing their function, throw into the blood certain poisonousmaterials which it is the function of the liver to remove. If this isnot done, the cells become clogged, and can only be restored to anatural and healthful condition by increasing the activity of the liver. This treatment gives rise to an immediate improvement, and a continuanceof the remedies results in a gradual toning up of the nervous system andrelief from the unpleasant symptoms. 

"FEMALE WEAKNESS. "

Many women suffer from nervous prostration, or exhaustion, owing tocongestion of the uterus and ovaries, caused by over-indulgence; againby overwork, the strain of too many household cares, or too frequentchildbirths. In these cases, the use of Dr. Pierce's FavoritePrescription is of the greatest benefit, tending to restore the uterusand ovaries to a normal condition. Its wonderful restorative effects, tonic and nerve invigorating properties, especially adapt it to the cureof these cases. Digestion and assimilation of food are promoted by itsuse. When the liver or blood is not in healthful condition, aspreviously referred to, the "Golden Medical Discovery" should be used inconjunction with the "Prescription. " If menstruation be scanty, Dr. Pierce's Pellets will have a beneficial influence in increasing theflow, and overcoming the headache and congestion of internal organs thatis the result of scanty menstruation, especially if their use beaccompanied with full doses of Dr. Pierce's Compound Extract ofSmart-Weed. 

LOCAL CAUSES. 

In the great majority of cases, when nervous prostration has made itsappearance at intervals, with periods of prolonged good healthintervening, but in which, as a rule, slight excesses, over-exertion orthe attacks of some acute disease, produces a nervous exhaustion, wehave found that local derangement is the cause of the whole trouble. This cause may often be readily removed and a perfect and permanentrestoration of the health will follow. 

IN MEN, we have often found a varicocele to be the cause of nervousprostration. In others rupture, or urethral stricture, sometimes of acharacter so mild as hardly to give serious inconvenience, has been thecause. 

IN WOMEN, , ulceration of the uterus, stricture of the cervix, congestionor other diseases of the ovaries, such as cysts, abscesses, etc. , inflammation of the Fallopian tubes, characterized with more or lessperiodical discomfort and attacks of leucorrhea, or "whites, " are commoncauses. 

In all cases in which the nervous disease depends upon local causes, wefind that the relief of the local source of irritation, which tends toreduce the general health and interfere with perfect nervous tone, isall that is necessary to give the invalid a perfect restoration tohealth, vigor and activity. It is like removing the burden from a tiredhorse who has fallen prostrate under an excessive load. The removal ofthe burden puts the individual under a favorable condition for theimmediate restoration to health and strength, and permanent relief isonly a matter of a few days' or weeks' time, with appropriatenourishment and restorative nerve tonics. 

ALCOHOL, OPIUM AND TOBACCO

affect different individuals according to their severalsusceptibilities. Some are able to withstand, with apparent impunity, anamount of these that can not be tolerated by others without greatinjury. No one, however, is wholly proof against these unwholesomeagents which are in such common use. The sad results of their excessiveuse 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 nervousaffections. 

Happily, we have now at our command remedies which exercise a mostpotent controlling influence over the acquired, morbid appetite forthese narcotics and stimulants. Of course we have to depend, to someextent, upon the will power of the patient, but where this is not whollylost, we have in all our later experience, been able to realize a degreeof success which has been alike gratifying to both physician andpatient. 

THE INVALIDS' HOTEL AND SURGICAL INSTITUTE SPECIALLY EQUIPPED FOR THECURE OF NERVOUS AFFECTIONS. 

Private institutions, well supplied with the numerous and costly aids tothe work of the specialist treating nervous diseases, are now arecognized necessity. Physicians and sufferers alike appreciate thisfact. 

Public hospitals do not answer this purpose, owing to the fact that theyare more especially intended for the alleviation of the sufferings ofthe poor, and the greater part of the work done is in affording relieffrom acute diseases and emergencies requiring surgical aid. Attention isthus detracted from delicate nervous affections and is almost whollyengrossed in caring for sufferers from other diseases and injuries. Besides, association with the charity cases that abound in such placesand the evidences of suffering present on every hand, are enough toprevent all improvement in sensitive and sympathetic invalids. 

Perfect equipment is an important part of the battle in the cure ofnervous 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 theattendant, a technical knowledge of the highest character with costlyapparatus and special appliances. There can be little doubt thatelectricity 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. Theseconsist of cell batteries, such as is illustrated by Fig. 4, dynamos, operated by power, Franklin, or static electrical machines illustratedin Fig. 5, and other electrical apparatus, the choice of the particularmachine or battery being determined by the nature of the case. 

CARE AND SKILL REQUIRED. 

Electricity, like other powerful agencies, in order to prove remedialmust be used of proper strength and in proper quantity. The potential, or strength, as well as the volume, or amount, of current has to becarefully measured for that purpose. To accomplish this, we employ aninstrument called a galvanometer, or amperemeter, illustrated in Fig. 6, which indicates the exact amount of current being applied. For the wantof such instruments to measure the current, physicians often fail to getbeneficial results, as they are not able to administer either the properquantity or quality of current. Ofttimes, for like reasons, theirhap-hazard way of employing this powerful agent does positive injury tothe patient. 

[Illustration: Fig. 6. The Galvanometer, or Amperemeter. ]

Of course, in treating cases at a distance, we cannot avail ourselves ofall the great variety of apparatus brought into use at our InvalidsHotel, yet we have some forms of machines well adapted for home use, andso simple that, by sending plain printed directions with the machines, our patients are able to use them effectively without the aid of thephysician. Especially is this true in the milder forms of nervousdisease, and when great exactness and nicety of application is not soimportant. We show in Fig. 7 and Fig. 8, two forms of such batterieswhich are often furnished our patients for use at their homes. Manytimes, after cases are under treatment here for a while, we are able toeducate them in the use of the battery so that by taking one of thesehome with them they can continue the treatment with good results afterleaving the Institution. 

ORGANIC, OR ANIMAL, EXTRACTS AS REMEDIES. 

The experience of Pasteur, Brown-Sequard, and our own specialists, inthe use of extracts of nerve substance and of certain glands and organsby hypodermic or subcutaneous injection of these fluids, has, in a vastnumber of cases, been most gratifying to both physicians and patients. Many wonderful cures have thus been obtained. Injected subcutaneouslythese animal extracts are immediately assimilated and we are often ableto stop, at once, the progress of disease and turn the tide towardsrecovery. Thus the cells receive the special stimulants upon which theirlife and activity depend. 

[Illustration: Fig. 7. A small Battery for home use. ]

The animal extracts employed in our Institution are all scientificallyand carefully produced in our chemical laboratory under the directsupervision of an experienced chemist, and are believed to be superiorin quality. They are turned out fresh, as wanted, which is important, asall 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 otherorgans and parts of bullocks, rabbits, guinea pigs and other animals. That they possess properties which exert most potent tonic, orinvigorating, influences upon those organs and parts of the human systemcorresponding to the organs and parts of the lower animals from whichthey have been extracted, no longer admits of doubt. In cases of partialand even complete impotency, especially in elderly men, attended withnervous exhaustion, most astonishingly favorable results are obtained byour specialists through the administration of our extracts obtained fromthe nerve tissue of the spinal cord, associated with the use of theexpressed juices from animal testes. We do not, however, prescribe theseextracts to the exclusion of other well tested remedial agents, but doregard them, especially in the more confirmed and obstinate cases, asamong 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 Valuableremedial agents, we regarded the use of these extracts with good deal ofskepticism, but experience is, after all, the best teacher and we wereforced, after numerous successful tests, to admit their great efficacy. We have always endeavored to keep up with the vanguard of the army ofmedical reform, and so took early occasion to introduce these agentsinto our practice and made preparations to produce them in ourlaboratory. 

From an article written by an eminent specialist in nervous diseases, and recently published in the New York _Medical Journal_, we extract thefollowing:

 "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 hisopinion that the plan of treatment will prove efficacious in all organicdiseases, but certainly, from our experience, we can endorse his beliefas to its great efficacy in many forms of organic weakness, especiallythose of the generative organs, nervous system, heart and some otherparts of the body. We believe that we are placing a conservativeestimate upon the remedial value of these animal juices, or extracts, when we say that they are destined to fill an important place in thecurative resources of the specialist in chronic diseases. 

Under the head of epilepsy, also in connection with our consideration oflocomotor ataxia, we shall have occasion to refer to the use of theseextracts as applicable to the cure of those maladies. 

Most cases of nervous diseases that come to us, for examination andtreatment, do so after having tried, without success, treatment bybaths, enforced seclusion, as well as unskillfully applied electricaltreatment and massage. Prolonged medication has frequently arouseddigestive disorders and made the patient hate the sight of the medicinebottle. In such cases our improved methods, as applied in theInstitution and also prescribed for patients at a distance, enable ourspecialists to give relief and effect cures with a minimum of medicine. They also enable us to treat many cases of nervous diseases heretoforeregarded as almost hopeless, such as locomotor ataxia, paralysis, epilepsy and spinal affections, with a degree of success which has beenvery gratifying alike to physicians and patients. 

 * * * * *

HEADACHE AND NEURALGIA. 

There is no ill to which flesh is heir that is the source of a greaterdegree of discomfort to the human race than headache. The farmer, housewife, banker, merchant and laborer seem to be equally prone to theaffliction and all who suffer have a great number of days rendereduncomfortable and unhappy by the presence of this most unpleasantaffection. Pain is the warning finger of disease--the threateningindication of coming trouble. In headache, we have an indication thatthe system is subjected to some strain or injurious impression. It maybe that the eyes have been overworked or the brain unnaturally taxed; orthat the nervous and physical systems have not been properly refreshedby sufficient sleep, and have used up the residue of reserve power. Manysuffer from headache only after they have been subjected to suddenchanges of temperature and have taken cold; others only when the bowelshave become inactive, the liver torpid and the blood vitiated withretained poisons. 

All appreciate the discomfort that results from this malady andearnestly seek for permanent relief. 

Headaches may be divided in two classes: (1) those due to the presenceof poisons in the blood, and (2) those due to irritation of variousorgans, as of the eyes, stomach, liver, and intestines. 

Of the first form, or variety, of headache, influenza, or grip, andacute "cold in the head, " are the most common causes. These give rise tomost excruciating pain. There is congestion, followed by inflammation inthe nasal passages and cavities communicating therewith. The membranesof these passages throw out a thin, watery, irritating discharge, whichgradually thickens and becomes pus-like and offensive in character, ifthe disease continues. 

Poisonous matters are absorbed from the affected surfaces into theblood. These poisons, circulating in the blood, produce great irritationof the nerve cells, so much so, that the severity of the attack is feltin the nervous centres, the brain and spinal cord, with pain varyingfrom 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 ofgreatest pain. Such attacks vary in frequency and severity. One attackis usually followed by an early recurrence, which may be more or lesssevere, while the period of active pain varies from a few hours toseveral days. Such attacks leave an exhausted state of the nerve centresand general weakness of the system that often lasts for weeks and maypermanently impair the system, except such results be prevented byappropriate treatment. Every recurrence of the attack leaves the systemin a worse condition, until profound nervous prostration; ensues. 

Malarial headache, sometimes termed "brow ague, " is a common form of themalady with those residing in malarial regions. The pain rapidlydevelops, usually over one eye. It lasts from five to ten hours, and isoften of frightful intensity. 

Other forms are rheumatic and gouty headache; usually a heavy achingpain appearing on the approach of storms, but at times almostcontinuous, made worse by improper diet. 

Uræmic headache is due to kidney disease, and alcoholic to directirritation of the brain membranes from the use of alcoholic beverages. The latter is accompanied with much irritation of the stomach andintestines. 

Headaches of a similar character result from the presence in the bloodof an excess of the active principles of coffee and tea. 

Overindulgence in these agents, as with alcohol, affects the nerve cellsand membranes, often causing severe attacks of headache. 

Nervous headache is another common affliction. This seems to arise fromseveral causes, such as impoverished blood and exhaustion from overworkof the brain. Hysterical headache is not uncommon. There is a severekind of headache, the attacks of which appear first at early puberty andcontinue at intervals more or less frequent in women up to the change oflife 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 mentalactivity. This is followed by unusual drowsiness, in which the night'srest is broken by dreams, and from which the patient awakes tired. Gradually, during the day, the headache develops, beginning in the eyesor bones over them. It gets more and more severe, shooting into the jawsand neck or extending to the back of the head and spine. As the painsget most severe, nausea or vomiting, often repeated, follow, in whichthe contents of the stomach, with mucus and bile, is ejected. The wholeparoxysm lasts from five hours to two or even three days. 

NEURALGIC HEADACHE is a common variety; often the pain is not confinedto 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 ispain. This is of variable intensity and character. It follows the courseof the affected nerve and its branches, and occurs in paroxysms, ofagonizing pain with periods of intermission during which the pain may bevery 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 theattacks, and there is probably a difference in the character of thepain, though in a severe paroxysm one is scarcely able to make a verynice distinction. We have known cases in which the pain occurredsuddenly and overwhelmed the patient's fortitude by its severity andunexpected onset. Between the paroxysms there may be less severe pain, which is then more frequently of an aching, burning or prickingcharacter. In some, paroxysm after paroxysm succeed each other withalmost lightening-like rapidity, and even in the intervals the pain isvery 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 fordays or months. An extended freedom from all pain is rare in a patientvery much affected. The first attacks in all forms of neuralgia areoften comparatively light, and the severity of the pain graduallyincreases as the attacks multiply. We have frequently had patientsunacquainted with anatomy, map out the distribution of a nerve veryperfectly, simply describing the portion of the body in which the painwas experienced. For convenience, the neuralgia has been named withreference to the nerve most seriously attacked; lumbago to the spasms ofpain affecting the small of the back; tic-douloureux is a term appliedto 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 thelarge nerve supplying the thigh and leg is termed sciatica. These nerveaffections often prove a most grave disorder, rendering the life of thesufferer a burden. 

TREATMENT. Contrary to opinions frequently expressed by members of themedical profession, we find that most cases present some removable, orremediable, cause for attacks of headache and neuralgia. The temporaryrelief that is obtained by the use of "headache powders, " variousbromide combinations, caffeine and other anodyne and narcotic medicines, is sometimes necessary in order that the excruciating sufferings may beborne for the time, but as a rule such remedies only react unfavorablyby interfering still further with the natural restoration of theaffected organs, or protract the removal of the cause of the disease. Hence, the next attack is usually earlier in its appearance and moresevere and lasting when such agents are employed. 

The great majority of headaches and neuralgias are due to the presenceof poisons in the blood. This may be due to affections of theblood-making, or blood-purifying organs. 

For the correction of inactive blood-making glands, or a lack ofpurification of the blood, due to such cause, the use of Dr. Pierce'sGolden Medical Discovery is particularly beneficial. It has no equal inits direct effect upon the liver, the great purifying organ of the body. Through this natural gateway, it removes from the system poisonousmaterials which are the waste from the nerve cells. The accumulation ofthese waste materials irritates the cells and causes them to cry outwith pain. The blood, being properly purified by the use of "GoldenMedical Discovery" supplies to the nerves, and to the nerve cells, whatthey 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 overloadedwith fecal matters that putrefy and give rise to gases and consequentdistention. Deleterious poisons are formed and absorbed by the bloodfrom such hardened and irritating lumps in the intestines. When thebowels are thus constipated, Dr. Pierce's Pleasant Pellets are necessaryas an adjunct to the "Golden Medical Discovery. " The "Pellets" removefrom the intestinal canal all irritating materials and thus enhance thealterative, or blood-cleansing, action of the "Golden MedicalDiscovery. "

In women, when there is a nervous affection, dependent upon someunnatural state of the ovaries or uterus, and complicated with animperfect or unnatural circulation in those parts, we have noted thatmost satisfactory results invariably follow the use of Dr. Pierce'sFavorite Prescription. This agent improves the tone of the nervoussystem, and by its direct restorative tonic effects, lessens, orovercomes, any congestion of the womb or its appendages, regulatesmenstruation and promotes a condition of health and vigor. 

In a vast experience, our specialists have thoroughly tested a greatmany specific remedies which we prescribe for home-treatment, sendingthe necessary remedies to our patients by express or mail, carefullyadapting them to each individual case. Many sufferers have been, by abrief course of our home-treatment, relieved permanently fromexcruciating sufferings that had been a source of annoyance and loss oftime for many years prior to the use of our remedies. 

Our treatment is intended to effect permanent cures. We do not use thosenarcotics and compounds of antipyrine and other similar agents which arevery depressing in their effects, and, like morphine and otherpreparations of opium, give only temporary relief, and interfere withthe action of the heart, but we use treatment that builds up the system, removes the cause of the difficulty and restores the nervous system andall the organs of the body to a normal and healthful condition. 

In some cases we advise treatment in our Institution, where we haveevery facility in the way of electrical appliances and many other aidsthat can only be employed by the personal attention of a skillfulphysician. These aids are more fully described under the head of nervousexhaustion and a reference is also suggested to what we have to sayunder the heads of paralysis and locomotor ataxia. 

Headaches or neuralgic pains, due to local irritations, as uterinedisease, stricture, neurotic or nerve tumors, pressure of trusses, eyestrain from weakened eye muscles, or lenses that need the help of properspectacles, require for a permanent cure the removal of the cause. Sciatic neuralgia, one of the most common and painful forms of nerveirritation, is particularly amenable to treatment by the modern means ofcure used in our practice at the Invalids' Hotel. 

We find, as a rule, that severe headaches and neuralgias are but theforerunners of more serious conditions, and are therefore deserving ofspecial attention. They should be corrected as early as possible, beforeany organic changes have occurred. 

 * * * * *

PARALYSIS OR PALSY;

LOCOMOTOR ATAXIA AND KINDRED AFFECTIONS. 

Paralysis is an affection characterized by loss of muscular power or bythe sense of touch, taste, sight or smell becoming impaired from injuryto 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 nervecentres, as in hysterical palsy and reflex paralysis. Frequently thepower of speech is affected in this way, ability to remember anddifficulty in pronunciation of certain words being the most common. Certain affections of the womb and its appendages, in women, and, inmen, stricture of the urethra, adherent prepuce, or foreskin, withwounds and injuries, many times of nerves and organs remote from theparalyzed points, cause the loss of power. 

THE CAUSES OF PARALYSIS are very numerous. Whatever destroys, or impairsthe natural structure of nervous matter, or whatever interferesmaterially with the conducting power of nerve-fibre, or the generatingpower of the nerve-centres, will produce a paralysis, the extent ofwhich will depend upon the amount of nervous matter affected. Thusparalysis may be due to disease of the brain arising from apoplexy; toabscess, softening, syphilitic or other tumors, or epilepsy; to diseaseof the spinal cord, or marrow; to disease of the structures whichsurround the spinal cord, producing pressure upon it; to injury orcompression of a nerve, by which its conducting power it impaired; tothe effects of diphtheria, hysteria, or rheumatism. It may also be dueto poisoning of nervous matter with opium, lead, arsenic, or mercury; orto the retention of poisonous substances which are generated in theliving body and which should pass off through the excretory organs, asthe 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 nervousstrain, or over excitement The over indulgence of the passions isparticularly a fruitful source of injury to the brain and spinalcentres. An angry man or woman uses up more nerve energy in a fewminutes than would be sufficient to serve the muscles with stimulusthrough hours of toil. 

The young, in unnatural indulgence of the sexual passions, waste thevigor and energy of maturity. Sexual excesses must be put down as amongthe most prolific causes of this terrible malady. Ignorance shields noone from the consequences of violations of the laws of health. 

The passion for wealth with its ceaseless toil, continuous strain, andrapid exhaustion of the nerve forces, usually brings its devotee intothe same condition of discord as does the abuse of a stimulant. For atime the system will repair and bolster up the weakness, but the longerthe day of reckoning is postponed, the more serious and terrible is thecollapse. 

Such individuals need only an exposure to cold, or an over indulgence ofsome kind, to suddenly precipitate a paralysis. 

GENERAL PARALYSIS. This term is applied to paralysis affecting the armsand legs. In this form of paralysis there is generally more loss ofmotion than of sensation, and the mind is usually more or less affected. 

HEMIPLEGIA, or paralysis of one side of the body, is generally spoken ofas a "stroke of palsy. " Sometimes only one extremity, the arm, isaffected. Only occasionally is the face involved. In the majority ofcases the mind is affected, the memory being poor, the sufferer becomingmelancholy, peevish, and fretful. 

In paralysis of the right side, there is sometimes a curiousforgetfulness or misplacement of language, the patient being unable tothink of words to express his thoughts. This condition is called_aphasia_. It is usually the result of some injury or disease of thebrain, almost invariably the side of the brain opposite the affectedhalf of the body. In some cases it is due to a wasting, or softening, ofthe brain substance, on account of insufficient nourishment, a deficientsupply of blood; whilst in others, it is due to just the oppositecondition, 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 ofdisease of the spinal marrow. The paralysis may occur suddenly, but, inthe majority of cases, it comes on slowly and insidiously, with weaknessand numbness of the feet and legs, or with tingling and a sensationresembling that produced by ants creeping on the surface of the skin. Bydegrees the weakness increases, until there is complete loss of bothmotion and sensation in the feet and legs. The lower bowel and bladderare generally involved, and as a result, the patient suffers fromconstipation, and retention and dribbling of urine. Although completelyparalyzed, the patient is often tormented with involuntary movements andcramps in the affected muscles. 

Paraplegia may be caused by various injuries of the spinal cord; bycongestion, degeneration, or hemorrhage; by pressure from thickening ofthe sheath of the cord, or from tumors, or from disease of the bones andcartilages of the spinal column. Paraplegia may also be produced throughreflex action, by an irritation, or injury to some organ or part of thebody distant from the spinal cord; thus, irritation of the skin, or ofthe bowels from the presence of worms, or disease of the bladder or ofthe womb, may produce paraplegia. 

LOCOMOTOR ATAXIA. 

Locomotor ataxia, or creeping palsy, is also called progressiveparalysis. This affection consists of a disease of the nervous matter inthe posterior columns of the spinal cord. It usually affects first thelower part of the cord, and those portions of the nerve matter thatsupply the muscles of the legs. In other cases it first affects theportions of the spinal cord that supply the arms. In most cases of thisdisease 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 asto have induced suicide. These paroxysms, in the milder form of thedisease, are not so severe, and are readily controlled by anodynes. Theymay 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 caseswe find the patient has been treated for a long period of years forrheumatism, sciatica, or neuralgia, when the real disease has been thisprogressive paralysis in its earlier stage. Sometimes the disease takesthe form of spermatorrhea or impotency; in other cases it is manifestedin weak eyes, disturbances of vision, or cross-eyes. Sooner or later, there appears the peculiar paralysis of the disease, which consists ofmore or less numbness of the feet and legs, and, in the later stages, ofthe hands and arms, sometimes of the face. As a rule, however, thepatient finds difficulty in properly maintaining his balance, and inwalking his movements are tottering, like a man partially intoxicated. It is difficult for him to maintain his balance and walk with his eyesclosed. If the arms are affected, their movements are uncertain. Inguiding a needle or in buttoning or unbuttoning the clothing, there isan inability to move the hand with rapidity and certainty, or to anyportion of the face or body if the eyes be closed. The eyes andattention must be constantly directed to the motion that is about to beperformed, or it is imperfectly done. The brain centres in this casesupply the weakened action of the spinal cord, and the stimulus to themuscles is directed by the intelligence instead of being automatic, asin health, and due to spinal action. Still later, the voluntarymovements become spasmodic or jerking. The neuralgic pains often becomevery distressing; there is often a sense of constriction around thelimbs or body, as if they were encircled with tight cords. In extremecases locomotion becomes impossible, the patient is unable to bring thehand to the mouth, and the speech may become impaired, articulationbeing difficult and imperfect. In all cases there is more or less lossof sensation in the lower limbs, the patient generally being usable todistinguish between two points and one, even when the two, are aconsiderable distance apart. The inability to feel the contact of theground or floor with the feet occasions the difficulty in walking. THECAUSES of this disease are somewhat obscure, but unquestionably exposureto cold and dampness, and over-mental work, are largely instrumental inits production. Scrofula and syphilis favor its development, while abuseof the nervous system, such as results from over-indulgence of theanimal and reproductive instincts, are frequent sources of the nervouschanges that lead to ataxia. 

SHAKING PALSY. 

_Shaking Palsy, or Paralysis Agitans_, is an affection dependent upondegenerative changes in the nervous centres. It is characterized by atremulous agitation, or continual shaking, beginning in the hands, armsor head, and gradually extending itself over the entire body. Thedisease progresses slowly, but when far advanced the agitation isviolent, and the patient swallows and masticates his food with greatdifficulty. In an advanced stage of the disease, the body becomes bentforward, and the chin almost touches the breast-bone. The tremor, whichearly in the disease only occurred during the time the patient wasawake, now continues during sleep, and not infrequently the agitationbecomes so violent as to waken the sufferer. 

GENERAL TREATMENT OF PARALYSIS. 

The indications of treatment for the various forms of paralysis are toremove the causes, if these can be determined, and rouse the functionsof the paralyzed parts. Measures should be adopted to remedy the morbidconditions upon which this affection depends. Keep the skin clean andhealthy, promote the circulation of the blood, especially in theparalyzed limbs, and encourage healthy nutrition. These ends may be bestattained by the daily employment of stimulating baths and frictions uponthe surface. As much regular exercise as the patient can bear withoutfatigue should be taken in order to favor the preservation of theappetite and strength. Care should also be taken that the bowels areevacuated regularly every day. The circulation through, and consequentlythe nutrition of, the palsied muscles may be aided by having a stronghealthy person knead and manipulate them. These manual movements uponthe surface of the body will often excite muscular sensibility, similarto that awakened by a weak Faradic current. The internal medicinesshould be such as to regulate the general functions of the system. Theuse of these remedies must be directed by the skill and experience ofthose who are professionally qualified to administer hem. 

When the patient has been able to be under our personal care at theInvalids' Hotel, we have found the employment of mechanical movementsand manipulations, applied by means of a variety of machinery, employedin this Institution, together with the use of the equalizer, or largedry cupping, or vacuum apparatus, to be of the greatest benefit. Theseseveral machines and apparatus furnish a perfect system of physicaltraining, thus rendering valuable aid in the cure of many forms ofobstinate 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 thenerve-centers and nerves by means of specific irritants, with the viewof exciting the power-producing function, of compelling the weakened anddisabled centers to evolve more power. By such stimulation and forcing, he places a burden on the weakest parts. The compulsory and ineffectualendeavor of the weak parts to act in response to such stimulation isvery liable to make undue drafts upon the capacity to act, which onlyend in exhaustion of the little remaining power instead of itsre-enforcement. Cases which were previously curable by direct andappropriate means, are thus forever placed beyond the reach of remedies. No powerful stimulating or depressing medicines are indicated in any ofthe various forms of the affection. In paralysis it should be our aim toimprove local and general nutrition, to relieve local congestions andinflammations, to produce absorption of deposited matters, and to forcean abundance of blood through palsied muscles, from which they mayderive a proper supply of nutriment, and to which they may give up theproducts of waste. All this can be accomplished by massage, mechanicalmovements, regulation of the atmospheric pressure on the body, baths, and proper physical culture. 

In paralysis, there is a diminution or total loss of the contractileproperty of the muscles to which the affected nerve fibers aredistributed; consequently the capillaries and small veins are notcompressed, as in health, and the blood is not forced on through themtowards 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 partsof the body, accomplish the same results as contraction of the muscles. They compress the capillaries and veins and thus force the blood onthrough these vessels towards the heart. There is a constant pressure inthe arteries, hence the flow of blood in the capillaries is alwaystowards the veins, and, when it gets into the veins, it is preventedfrom flowing back by the valves in those vessels. 

A proper circulation of the blood through the disordered parts is thuseffected, and, as the result, they receive an abundance of nutriment, and their waste products are promptly carried away to the excretoryorgans, by which they are separated from the body; the deposits of fattymatter between the muscular fibers are absorbed, and the agglutinatedfibers are separated. 

[Illustration: Fig. 12. Rubbing the Legs. ]

As proof of these statements, it has been found by experiment andobservation that there is an increase of temperature in the partssubjected to this action, which _must_ be due mainly to an increase inthe chemico-vital changes that are superinduced by the nutritiouselements of the arterial blood, particularly that element which issupplied to it by the inspired air, oxygen. All the products of wasteare increased. The skin becomes more soft and moist, showing that theamount of matter eliminated by it is increased. The urine becomes moreabundant, and the relative amount of urea, its most importantconstituent, becomes greatly increased. The amount of carbonic acid gasexhaled is increased, and further evidence in the same direction isfurnished 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 appliedmechanical movements, must produce a corresponding diminution of bloodin other, even in remote, regions of the body. Thus this treatment, byits revulsive effects, is capable of relieving various disorders of thehead, chest, digestive organs, and pelvis. Nowhere, however, is theeffect more satisfactory than in affections of the brain and spinalcord, whether characterized by loss of power, of sensation, or byneuralgic pain. Any portion of these nerve centres suffering fromcongestion, 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 bycomplex structures, which combine a variety of mechanical powers. Theinventions 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 greatvelocity, we are able to apply _soft, pleasant, rapid vibratingmovements_ over the surface of the body, and thereby increase thecirculation of blood through the parts, raise the temperature, andexcite pleasant sensations. The movements can be applied by ouringeniously-devised machinery to any part of the body through theclothing and _without the least exposure of the person. _ They can beadministered in a great variety of ways, by light, quiet persuasions, bygentle frictions, by rubbing, by oscillations, by kneadings, by circularmovements, in fact, by an almost _endless variety_ of reciprocating andalternating motions, which, if described, would convey to the mind ofthe reader but a faint conception of their remedial value. 

VIBRATORY MOTION not only establishes activity of the circulationthrough the skin and muscles, but it also affects profoundly thecirculation in the important and vital organs of the body; it is thuscapable of overcoming torpidity or congestion of the liver, spleen, andother deep-seated organs, without the depressing effects which sometimesfollow the administration of powerful medicines. 

It has not been our purpose to literally explain, in detail, the methodsof applying vibratory motion in the treatment of paralysis for popularexperiment, since to be successful one should become an expert, not onlyin this mechanical treatment, but also in the diagnosis of the variousforms of paralysis, as well as familiar with their causes, pathology, and remedial requirements. Thus, to be successful in the treatment ofparalysis and other nervous diseases, by the application of motor forceswith our ingeniously-contrived machinery, the cost of which is beyondthe means of most invalids, one must exercise great discretion. 

GRATIFYING SUCCESS. Not only is vibratory motion as a remedial agentrational and philosophical, but our experience has fully demonstratedits marvelous effects in the treatment of paralysis in its variousforms, and also in the cure of other chronic diseases. We have curedcases of infantile paralysis which had resisted the skill of the mostrenowned physicians in our country. We have treated those who could notstand or bear the weight of the body, but who have been so far restoredas to be able to walk and run without assistance. Writer's and telegraphoperator's paralysis, or cramp, we have cured in a few weeks' time. Club-feet, spinal curvature, and other deformities resulting fromparalysis, 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 tothose who are afflicted with paralysis and other nervous affections. 

Vibratory motion is a desideratum of priceless value to those who areafflicted with diseases of the nervous system, as well as to all otherswho need a gentle stimulus to call forth their latent energies andimprove their physical condition. 

RECAPITULATION. 

Motion, properly transmitted to the human system by mechanicalapparatus, is transformed into other forms of force identical with vitalenergy, by which the ordinary processes of the system are greatlypromoted. 

It increases animal heat and nervous and muscular power to the normalstandard. 

It removes engorgement or local impediments to the circulation. 

The electrical induction produced, renders it a most efficacious remedyfor paralysis of all kinds. 

It removes interstitial fluids and causes rapid absorption anddisappearance of solid and fluid accumulations. 

It is a powerful alterative, or blood-purifier, increasing oxidation andstimulating excretion. 

It diminishes chronic nervous irritability and promotes sleep. 

It hardens the flesh by increasing muscular development and improvesdigestion and nutrition. 

ANIMAL JUICES, OR EXTRACTS. 

The use of animal, nerve and gland extracts has proven of surprisingefficiency in the treatment of paralysis and locomotor ataxia. Theyfurnish a pabulum in concentrated form for the nourishment andrestoration of the weakened nerve cells and fibres. 

In the vast majority of cases, we have been able, by the use of theserecently discovered curative agents, when assisted by other means at ourcommand at the Invalids' Hotel and Surgical Institute, to arrest theprogress of these nervous affections, hitherto so generally consideredincurable, and bring about restoration of the paralysed functions and arenewal of lost power. 

These comparatively new remedial agents have been very thoroughly testedby us. Their merits are more fully considered in a preceding chapter ofthis treatise, under the head of treatment for Nervous Exhaustion, orDebility. 

 * * * * *

EPILEPSY ("FITS"). 

Epilepsy, or falling sickness, is a disease which is characterized byattacks of sudden loss of consciousness, together with convulsivemovements of the muscles. The paroxysms occur at irregular intervals, the periods between them, in some cases, being only a few minutes orhours, while in others, several months elapse. 

There are two classes of Epilepsy: 1st. The general form, with aconvulsion that usually involves all the muscles of the bodysimultaneously. It begins suddenly with little or no warning, commonlywith a cry or scream. The convulsion may last several minutes and isfollowed by a deep sleep for some hours. 

2nd. The local or Jacksonian form in which the attack begins with apeculiar sensation in some particular region of the body, either in oneextremity or one half of the face. This sensation is followed by atwitching of the muscles of the part. The sensation and spasm extend oradvance 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, graduallypassing away. When the attack begins on the right side of the face it isassociated with an immediate inability to speak. 

SYMPTOMS. In the severe forms of the disease, the subject suddenly losesconsciousness and falls; there is rigidity of the muscles, which causesa twitching of the face and limbs; the eyes are turned up, and there isfoaming at the mouth. In the severe form of the disease, the respirationis arrested, while in the milder attacks, the breathing is difficult, slow, deep, and snoring. With the commencement of the spasm, the tongueis sometimes caught between the teeth and severely bitten. During theparoxysm, the countenance changes from a livid hue to dark purple. Theconvulsion continues from one to three minutes, and is followed by adeep, sighing inspiration; the subject then sinks into a deep sleep, which continues for half an hour or longer. When consciousness is firstregained, the subject appears confused, stupid, and usually complains ofheadache. He has no recollection of what has occurred during the attack, he pronounces words indistinctly, and if he attempts to walk, hestaggers like a drunken man. Sometimes, several attacks occur so closelytogether 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 subjectof an approaching paroxysm. Occasionally, a wave of cold commencing atthe 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 toproceed unchecked, it almost invariably leads to great impairment ofmind, insanity, or paralysis. 

CAUSES. The _predisposing causes_ are an hereditary tendency to thedisease, and everything which impairs the constitution and producesnervous prostration and irritability. Syphilis, phimosis, sexual abuses, uterine disease, and the use of alcoholic liquors are prominentpredisposing causes. Many of the causes treated by us have been broughton by masturbation. Others are the results of injury to the head. Oftenfracture of the skull is followed by epileptic attacks. 

_The exciting causes_ include everything which disturbs the equilibriumof the nervous system. Indigestible articles of food, intestinal worms, loss of sleep, great exhaustion, grief, anger, constipation of thebowels, piles, and uterine irritation may be enumerated among suchcauses. Convulsions of an epileptic character may also be induced by apoisoned condition of the blood, from malaria and disease of the kidneysor liver. 

TREATMENT. When the time of an expected paroxysm approaches, great careshould be exercised that the patient be not suddenly attacked whilecarrying a lighted lamp, or that he does not fall in some dangerousplace, strike upon a heated stove, or in some similar way inflict greatinjury. If there be warning symptoms before the attack, the subjectshould carry a vial of the _nitrite of amyl_ in the pocket, and, whenthe premonitory symptoms are felt, two or three drops should be pouredon 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 thehead slightly elevated, and the clothing about the neck and waist, iftight, should be loosened. If there be sufficient warning, a foldednapkin, or a soft pine stick covered with a handkerchief or cloth, should be placed between the double teeth, to prevent the tongue frombeing bitten. During the fit, the head may be bathed with cold water. 

A person who suffers from this disease should avoid everything whichtends to excite the nervous system, or increase to any great extent theaction of the heart. The sufferer should go to bed at regular hours, andtake at least eight hours sleep. The sleeping-room should be large andwell ventilated, and the patient should lie with the head elevated. Allindigestible articles of food should be avoided and the diet shouldconsist principally of bread, vegetables, milk, and fruits. Meat shouldbe taken but once a day, and then in very small quantities. The use ofalcoholic liquors and coffee should be avoided, and tea only taken insmall quantities. The bowels should be regulated with Dr. Pierce'sPleasant Pellets and injections, if necessary. A thorough bath should betaken once or twice a week. If the attacks occur at night, the bodyshould be sponged before going to bed with tepid water, to which shouldbe added sufficient tincture or infusion of capsicum, or red-pepper, torender it stimulating to the skin. 

The causes, if they can be determined, should be removed, and thoseremedies administered which relieve nervous irritability and cerebralcongestion. If due to worms, the proper remedies should be given; if tophimosis, the subject should be circumcised; if to pressure on thebrain, from fracture of the skull, trephining should be practiced, andthe depressed bone raised. There are no _specifics_ for this disease;each individual case must be treated according to the conditionpresented. The nostrums advertised extensively over the country asspecifics for this disease, while they may, in some instances, preventthe attacks for a short time, irritate the stomach, impair digestion, lower vitality, and permanently injure the system, often rendering thedisease incurable. They deceive the sufferer, leading him to think thathis disease is being cured, until it progresses so far that he is beyondthe reach of any treatment. As a rule, the longer the diseaseprogresses, the more difficult it is to cure. 

Epilepsy has by many physicians been regarded as incurable, but ourextensive experience has convinced us that by an appropriate course oftreatment, the _vast majority_ of cases can be cured. The animalextracts, or juices, herein more fully described under the head oftreatment for Nervous Exhaustion, have proven curative in some casesthat have resisted other remedies. This treatment requires the personalattention of a physician skilled in its employment. It is also of firstimportance that the extracts be properly made. We have discoveredseveral new remedies, which undoubtedly exert a powerful curativeinfluence over this disease, but it is necessary to vary the treatmentso much in different cases, that it would be useless to enter furtherinto details in this treatise. 

SURGICAL TREATMENT. A considerable proportion of those cases ofepilepsy, termed Jacksonian, have been found to be caused by new growthupon, or in, the substance of the brain. Sometimes cysts form as aresult of small hemorrhages, or of spots of softening from clots in thecerebral arteries. Other cases are due to a small spot of hardenedtissue or an inflamed centre of irritation in the outer gray matter ofthe brain. 

The majority of these forms of disease can be exactly localized in asmall area of the brain, and may usually be traced to a blow or fall onthe head, or to fracture of the skull without depression. The discoveryof the fact that such results of injury will produce localized spasm hasnaturally lead to the conclusion that similar products anywhere in thebrain may give rise to epilepsy. In these cases trephining of the skulland the removal of irritation from the brain has been followed by themost successful results. It is seldom a serious or dangerous operation, but very few deaths having resulted in the practice of good surgeons inmany hundreds of cases, and these were individuals who were notfavorable 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 solong as to bring upon the brain a general epileptic tendency, theresults of operation are good and the procedure warrantable. 

SEE TESTIMONIALS FROM A FEW OF THE MANY CURES EFFECTED BY OURSPECIALISTS. 

 * * * * *

CHOREA (ST. VITUS'S DANCE). 

This disease is an affection of the nervous system, which ischaracterized by spasmodic contractions of certain muscles. It mayaffect the entire body, although it is usually confined to the leftside, or to a special group of muscles. 

SYMPTOMS. Twitchings of the muscles of the face are the most conspicuoussymptoms. They are at first comparatively slight, but as the diseaseprogresses, these spasms become more decided, and the face is twistedinto various shapes and forms. The head, in some cases, is constantlyjerking. It is with great difficulty that the tongue is thrust out ofthe mouth, and then, with a sudden jerk, it is quickly withdrawn. 

These spasms or contortions, may affect the extremities in a similarmanner, the hands and arms cannot be kept quiet, the gait may beunsteady, and one foot is merely dragged after the other. If one limb beforcibly held, to keep it quiet, some other limb will involuntarilymove. Strange as it may appear, these contractions, which cannot becontrolled by the will during wakefulness, are very much lessened orarrested by sleep. 

Prior to the development of the spasmodic affection, there is usually aperiod in which the sufferer notes a want of appetite, languidness, withdisinclination towards mental or bodily pursuits, headache, restlessness, pains in the limbs and joints, with irritable temper andweakness of memory. There are many other symptoms in special cases. Asthe disease develops, the patient gradually begins to exhibit anawkwardness of movement in the extremities, and objects frequently fallfrom 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 oftenpunished for supposed ill-behavior or careless habits. Later on thesymptoms become more unmistakable, and the presence of the disease isreadily recognized. The patient may become incapable of dressing, andthe limbs and face are no longer under the control of the will. Uncontrollable movements of the fingers, hands, shrugging of theshoulders, dancing of the legs, grimaces of the face, and distortions ofthe body, become more or less constant. Speech and swallowing may beseriously embarrassed. Any unusual excitement of the mind or body is aptto intensify the muscular twitchings. Severe mental application, thereading of exciting books, the witnessing of entertainments, andexcessive indulgence in sports, have to be discontinued. 

THE MOST COMMON CAUSES seem to be exhaustion of the nerve centres, dueto the appearance of the second teeth in children and the developmentcommon to the age of puberty. Other causes may be briefly mentioned asfollows: rheumatic affections, constipation, a morbid state of theblood, suppression of the menstrual function, uterine difficulties, masturbation, or self-abuse, blows, injuries, or any cause which wouldgive rise to nervous debility. Sometimes it is caused by obstruction inthe alimentary canal, or by intestinal worms. 

TREATMENT. The disease is one in which there is a debility of the nervecentres, complicated with a lack of assimilation and digestion. There isno affection more amenable to treatment in its early stages than this. We are daily in receipt of correspondence from sufferers, or theirparents, or friends, in which the most gratifying relief and a cure hasresulted from the use of Dr. Pierce's Favorite Prescription used inconjunction with Dr. Pierce's Golden Medical Discovery. These tworemedies should be used alternately, the dose being suited to the age ofthe patient. 

A large majority of the cases of chorea occur in females and at theperiod of life when the nervous system is subjected to unusualrequirements. In these cases the "Favorite Prescription" effects agradual restoration of nervous energy, and improvement in the tone ofthe nerve centres, and by its direct effect upon the circulation in theovarian region, eliminates the most potent causes of debility. In youngpeople, we usually advise a dose of three drops for each year of theage. For instance, children of eight years of age should taketwenty-four drops; those of twelve, thirty-six drops; those of fifteen, forty-five drops, which is about two-thirds of a teaspoonful. A similardose of Dr. Pierce's Golden Medical Discovery should be administered, taking it before meals, and the "Prescription" after meals. Under theiradministration 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, ofthe impurities that represent nerve waste, and as a consequence thenerve cells are properly nourished. The disease is gradually controlled, and when the favorable influences of quiet, nourishing food, with plentyof outdoor air, and not too active exercise is added, the progress ismost gratifying. The patients, in a few weeks, are able to control muchof the spasmodic movements, and gradually their restoration to a normalcondition is accomplished. 

In occasional cases, where there is some complication, as rheumatism orother severe affection, complicating and preventing their recovery, special treatment is required. We are always ready to advise in regardto such cases when consulted either by mail or in person. 

 * * * * *

TESTIMONIALS. 

If the following letters had been written by your best known and mostesteemed neighbors they could be no more worthy of your confidence thanthey are now, coming, as they do, from well known, intelligent andtrustworthy citizens, who, in their several neighborhoods, enjoy thefullest confidence and respect of all who know them. 

Out of thousands of similar letters received from former patrons, wehave selected these few at random, and have to regret that we can findroom 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 aresult of your few weeks' treatment, I feel better now in both body andmind than I have for fifteen years. Before I consulted you I felt morelike taking my own life to end my miserable feelings than I felt likeliving; I had given up all hopes of ever being any good to myself oranybody else, but, thank God, your encouragement, and kind words, andskillful treatment have made a different man of me. 

Before I consulted you, I took no interest in business nor any thingelse in the world, which the wise Creator has placed in this world forall mankind to enjoy; but now my mind is clear, and I take an interestin 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 sufferingfrom the same complaint to at once consult you, as I can assure themthat they will receive full benefit of your kind attention, for moderatecharges. 

 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 receivedfrom your treatment. For some time I had been suffering from nervousdebility, and before placing myself under your treatment my trouble wasvery severe; and not understanding the nature of my disease, I did notknow 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 tothen 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 nolonger with the old symptoms, and I thank God, and also the kindgentlemen that have been conducting my case, for the treatment andadvice which I have received. I also think the "Golden MedicalDiscovery" is a most wonderful medicine, and I shall feel it my duty tospeak well of your medicines and treatment to all fellow sufferers I maymeet. 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 healthat the hands of local doctors, I began treatment with you for "NervousDebility of a complicated nature. Ag a result thereof I now give thistestimonial, having been changed from a person of rapidly declininghealth--often despondent and with no inclination to work of any kind, toone of sound constitution who enjoys life and is once more able tobattle his way to success in life; and it is now about two years sincethe change occurred, showing it to be permanent. 

I cannot say too much in praise of your methods, and careful, courteousattention which myself and others have enjoyed at your hands; and thatthe 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 Creatorfor restoring my health. When I first wrote to you I was a miserablesufferer with nervous debility, dyspepsia, heart disease, also femaleweakness. I was so nervous and low-spirited I could not sleep, in fact Iwas just about as weak and low as I could be, and could scarcely dragaround; but, after persevering for about twelve months, occasionallywith the help of your kind treatment and advice, I once more begin tofeel like myself again. Words cannot tell how I do appreciate my health. 

Thank you, gentlemen! I shall never forget the kind business-like mannerin which you have treated me. May God bless you, inasmuch as yourheart'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 NervousDebility. I tried some medicine that I bought from the druggist, whichdid me little or no good; so, hearing of the World's Dispensary MedicalAssociation, of Buffalo, I wrote them about my case, and in reply, theysaid they were sure they could cure me. At that time I was weak in myarms and legs, had poor sight and, worst of all, I was very nervous andbashful. I could not sleep at night and feel refreshed in the morning. Icould not look any one in the eye without feeling ashamed. 

I have now taken two months' treatment and I feel sound in mind andbody; but to be sure I am going to take another month's treatment fromthese same doctors in Buffalo. 

I recommend all men who are afflicted with any disease similar to theone of which I have just been cured to apply to the World's DispensaryMedical Association, and if they take treatment from these doctors theywill surely be cured. I cannot praise them too much for what they havedone 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 obtainrelief, but received little, if any good. I was scarcely able to work, when in July, 1887, I wrote to your Association, describing my case. Youreplied, advising me, and prescribing a course of treatment, which yousent to me. After taking but a part of these medicines I began to feel agreat deal better; could sleep very much better and was able to resumework as usual, but still suffered some pain in head, and my buck waslame 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 thatyou 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 andhead, and at times would have such a weak tired feeling when I first gotup in the morning, and at times nervous chills. At other times, I wouldfeel as if there were a tight bandage around my forehead. 

The first physician I went to said I had nervous dyspepsia; the next onedid 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 wellnights, and that bad nervous feeling and the pain in my back soon leftme. I can walk several miles without getting tired. I took in all, threebottles of the "Favorite Prescription" and two of Dr. Pierce's GoldenMedical 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 verybad state. Your suggestion that I use Dr. Pierce's Golden MedicalDiscovery was followed with good results, and I can say I felt theeffects of it before the first bottle was finished. The dull pains in myback were leaving me very fast. I used three bottles of the "GoldenMedical Discovery. " I had a dull pain in the back, restless sleepfollowed by very trying dreams, appetite poor, weakness, consequentlyvery easily tired. Now I can go about my work, walk twelve or fifteenmiles a day and not feel tired. When I commenced to use your "GoldenMedical 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 thematter. I had a heavy and languid feeling; dimness of sight, spots andflashes before my eyes; an "all gone" feeling in my stomach as if thebottom had fallen out; was nervous and irritable and felt like sinkingdown when at work. I could hardly get up in the morning; it seemed as ifI were more tired then I was when I went to bed. My appetite at timeswas ravenous, and at other times the smell of food made me sick; I wouldoften go from the dinner table and vomit. I would have spells when itseemed that every man was my foe and would be melancholy, and think thatsomething was going to happen to me; was easily upset, could not get mymind to stay on anything long at a time. When I read about yourremedies, I made up my mind to try them. After taking one month'streatment 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 badhealth to do the same, and will assure them that Dr. Pierce is agentleman, 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 generalbreak-down, lasting three years. I placed myself under the treatment offour different physicians. At last, giving up all hope of recovery athome, I was making arrangements to go to a Sanitarium in Michigan forspecial treatment. One of your small books with blank enclosed washanded to me; I filled out the blank, and thought I would try ratherthan leave home and little ones, --"Happy decision;" two months' specialtreatment and I was well and happy, and to-day, I have the very best ofhealth. 

 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. Vomitingsometimes, severe pains in arms, from elbows to shoulders, pain in leftside. Numbness of the fingers. His home physician said "will run intoparalysis. " Analysis of the urine shows phosphatic deposits. Begantreatment with specialists of Invalids' Hotel and Surgical Institute, inAugust, '87; used the remedies interruptedly for about six months. Writes May 11th, '89, "have not had a dizzy spell for a year. " InOctober, '90, writes, "the dizzy spells have gone for good, I hope. "November 9th, '93, reports, "I most willingly recommend your medicinesfor they cured me of those dizzy spells of long standing, after fourdoctors in this county had treated my case for three years, withoutbenefit. "

 Respectfully yours, JASPER THOMAS, Alamosa, Conejos Co. , Col. 

IRRITABILITY AND EXHAUSTION OF THE NERVOUS SYSTEM, RHEUMATISM AND HEARTDISEASE. 

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 greatdeal from rheumatism, he says: "Legs ached more like toothache thananything I can think of, the thigh bones throbbing and paining; hadpains in hips, back, arms and shoulders. " His symptoms also showed thatthe heart was affected. Had chills, headache often and sometimes sickheadache. Bowels were costive and irregular. Food distressed and couldnot eat meat; urine milky; coughed in early part of night, and feet andlegs would become numb. Had difficulty in getting to sleep beforemidnight, and was restless through the night and dreamed much. Hadsinking spells which lasted for thirty minutes. Turned pale, becametrembly and sometimes vomited his food. 

Almost immediately after beginning the use of the "Golden MedicalDiscovery" the headache ceased. After using four bottles, reported thathe had been benefited by the remedy. Later he reported: "I have been inreasonable health for some time. I took six bottles of the 'GoldenMedical Discovery' and it cured the rheumatism entirely. I had sufferedwith it for several years and found no relief until I used yourmedicine. Have no weak nor nervous symptoms now, and no spells ofturning 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 aglorious change came, due solely to Dr. Pierce's Favorite Prescriptionand Dr. Sage's Catarrh Remedy. I have suffered more than tongue can evertell. I have been treated by good physicians but they only help metemporarily. I have taken a great many patent medicines with the sameresult. In 1890, I began taking Dr. Pierce's Favorite Prescription andDr. Sage's Catarrh Remedy, which gave me immediate relief and apermanent 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 yourtreatment, and as I have had no return of the old symptoms, I considerit unnecessary to take more medicine. When I visited your Institutionsome two years ago, I had but faint hopes of ever being restored tohealth, as I was suffering from a complication of diseases. My case wasan unusually obstinate one, yet I am satisfied that a cure could havebeen accomplished in half the time, had I been able to follow yourdirections in regard to diet more closely. I hereby tender you mysincerest thanks for the kind treatment received while at yourInstitution. Those days will always be the happiest in my memory. I willclose by giving your faculty my sincere thanks, and hope success willcrown 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 amonly too glad to say that I am better than I ever was. Before takingyour 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 yourspecial treatment for about two months, and received great benefit fromtaking it, but still go on taking your "Pellets" when required. I amsorry to say that I have not got a photograph before taking yourmedicines, or I should have been glad to send it to let you have seenthem 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 terribledisease, nervous prostration. I suffered untold agony and thought Iwould 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 earto the other and all sounds passed right through. I could not see, norsleep, nor scarcely eat, and was that nervous the least thing made meangry. I was treated by our home physician and given up as incurable. Atthat time I saw your Memorandum Book and thought I would write you, andthe result of it was you took my case. 

After one month of your valuable remedies I felt like a new person, andafter six months was restored to good health again after sufferingnearly one year of untold agony. 

I would heartily recommend all and every one suffering from any chronicdisease to place their case in the hands of the World's DispensaryMedical Association, of Buffalo, N. Y. , as I cannot praise your treatmenttoo highly. Words are inadequate to express the gratitude I owe you inso 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 youhave been treating me for. The pain in my back is gone--my digestion isgood. 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 mayyou reap a rich reward for the good you have done for sufferinghumanity, 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 fifteenyears' standing. 

I tried home doctors but found they were only aggravating my case. Ialso tried the Remedy Company, then of St. Louis, who claimed to performwonderful cures with their "Pastiles, " but they proved utterlyworthless. Having come in possession of Dr. Pierce's little book andcirculars, a perusal of the same convinced me that my health would notbe trifled with at his Institution. 

I was a poor man and could not afford much experimenting. I ordered onemonth's treatment, and at the end of this first month, I found, to mysurprise, that I was feeling different. The second month, still moresurprised at my returning health. Third month thought I was cured, andengaged myself to a young lady, and wrote you to that effect, and youadvised me with your congratulations to marry, and to order anothermonth'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 boyand a girl. I would never have dared to marry had it not been for yourmedicines. I must add that during this treatment I was troubled withvaricocele on left side. I wrote you this at third month of treatment, and you sent without extra charge, a Suspensory and Lotion, and twomonths' treatment cured me sound and well of this distressing malady; Ihave not felt the least symptoms of its return. 

I want the world to know what a competent and honorable firm the World'sDispensary Medical Association is. I would love to shake you by thehand. 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, forwhich you treated me. I had been in the habit of getting out with theboys and trying to see which could kick the highest with one foot on theground, and it caused me to have varicocele. I went to my home doctorand he treated me with no success. It was getting worse all the time andI got out of shape all over. My health got bad and I thought my casehopeless. 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 andreceived word in a few days that you would treat me, so I sent off forone 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 hasbeen good ever since. 

You are at liberty to use my testimony in whatever way it may be of mostbenefit to you. 

I also enclose a photograph of myself that was taken soon after yourtreatment. 

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 yourtreatment, and I have no return of the old symptoms, I consider itunnecessary to continue treatment. When I commenced taking your medicineI was suffering from nervous debility, indigestion, dyspepsia, etc. After using your medicine one month I am perfectly healthy, andcheerfully 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, Iconsider it unnecessary to take more medicines because I am gainingstrength 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 Iwish 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 "PleasantPellets" made a perfect cure of me. I increased in weight from 120pounds to 150 pounds and my strength increased in proportion. Itimproved me so rapidly that my friends inquired what produced such achange in my general appearance and health. Some accused me ofdissipation. When I told them it was your medicine, the drug storesfound a ready market for it, and continue to sell it with increasedsales. 

 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. Iapplied to you by letter for advice and received from you medicaltreatment for three months, which completely restored me to health; thecourse of treatment did not interfere with my usual vocation and was notdifficult to follow. I am a well man to-day and take pleasure inadvising all the afflicted to consult you at once, and feel sure theywill, 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 bymail 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 entirelydisappeared that I do not consider it necessary to continue thetreatment longer. I would say further that I am satisfied that youunderstand your business, and would advise anybody suffering from anychronic disease to avail themselves of your skill in preference toresorting 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. Thetreatment which you furnished me a year ago gave me great relief. I hadbeen suffering for many months with general and nervous debility, withheadache, languor, sleeplessness, indigestion, constipation, etc. , whichwere 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 mento 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 debilityand chronic catarrh of eight years' standing and of a very aggravatednature. I was considered near my grave by many of my friends when Icommenced treatment. 

I used eight months' special treatment, after which I used some 13 or 15bottles of your Sage's Catarrh Remedy, and have had excellent healthever 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 advertisementin a newspaper and concluded to write to you. I took your medicine fornine 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 andstrong. 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 thankingyou for your treatment. 

I had suffered several years from Nervous Debility, and had triedvarious remedies, and been treated by different physicians, but receivedno benefit from them. I ventured to write to you, and after taking amonth's treatment and following your Hygienic rules, I am now fullyrecovered and never felt better in my life. 

May God spare you for many more years, for the sake of sufferinghumanity. 

 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 andSurgical Institute for a course of treatment. I am happy to state thatmy case was cured to my entire satisfaction, and that I always thinkwith gratitude of the kind treatment received from the hands of doctorsand nurses. While there I became acquainted with many undergoingtreatment for various chronic and surgical diseases, and all wereunanimous 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 greatbenefit you have done me. About ten years ago I contracted rheumatism, from which I suffered dreadfully at times. Was also troubled withchronic constipation; had been from boyhood. Had doctored more or lessfor years without any great benefit until I consulted you and commencedtaking your Special Remedies. After taking three courses of yourmedicines I was so far improved in health and strength that I consideredit 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 treatmentI received from the Invalids' Hotel and Surgical Institute, that I takethe greatest pleasure in recommending all the afflicted to this famousInstitution. 

I was run down and a great sufferer from nervous debility. The remediesput up by the specialist of this Institute so suited my case, and soimproved my health, that I soon felt like a new man. My gratitude is soheartfelt that I cannot speak to my friends and to all the afflicted intoo high praise of the skill of the physicians of the World's DispensaryMedical Association and of the great benefit to be derived from theirtreatment. 

 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 andgeneral weakness, and after using your splendid treatment for fourmonths, 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 GoldenMedical Discovery and "Pellets, " and I can truly say they have done memore good than anything I have ever taken. I keep the "Pellets" in thehouse 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 notsleep nights and was very nervous, and I was depressed in spirits andwas entirely unfit for business. The principal cause was over-work. Through the influence of friends I began your treatment and continued itthree months, and at the end of that time I felt so much better that Idid 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 Isuffered intense agony for five months, and after taking one month'smedicine I found very much relief--so much I was surprised. 

Many thanks for the good your medicines have done me, and my prayers arethat God may help you in your good work, and that you may live long andprosper. 

 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 partof the country with no satisfactory benefit. They did not understand mycase. 

I was a nervous wreck--unable to sleep--could not eat, and underwent theusual horrors that one endures where there is loss of control of thenerves. A few months more would have made me insane. 

My cure has remained permanent. The relief was something that I cannotdescribe. It has enabled me to pursue my work steadily ever since, and Iam more than happy to testify to the excellent skill and honorabledealings 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 MOREYEARS 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 benefitof your special treatment. I had no hope of ever being restored tohealth again, having tried several home physicians, and having found norelief. I had little faith of ever being relieved of the dizzy spellsand black spots before my eyes. Some of my friends told me it wasnothing but a fake and a humbug. Thank God I did not listen to them. Thefirst month's special treatment gave me such relief that I continuedfive months, and to-day can do heavy work without that troublesome painin my back, and can stoop down without dizziness in my head. I wouldadvise any one that is afflicted with any of these diseases to at onceconsult the practical and skillful physicians at the World's DispensaryMedical Association, at Buffalo, N. Y. I cannot think of words that willhalf express my gratitude. Thanks to God that he has granted you suchskill. 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 weaknessfor fifteen years, I found a radical cure in the treatment I receivedfrom you at my own home. The first supply of medicine seemed to start meon the road, and the wheel was kept turning till I reached the happycondition of health. 

I hope this will meet the eyes of some of my old comrades, who have beento the eastern countries, and there lost their health, as I did, and asmany others do. 

Gentlemen, I wish again to thank you most kindly for your good treatmentand 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 NervousDebility. For some time I hardly knew what course to pursue, nearlyevery paper I might pick up contained some advertisement that would cureme. But believing in the old adage, "never expect to get something fornothing, " I decided to write to an Association that _I knew_ wasreliable. 

Acting accordingly, I took a course of four months' treatment, which Iam pleased to state has given me in return a perfect cure. Thanks to themedical 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 thoughI am entirely cured. The trouble with my back is entirely removed; havegained in strength right along and have been working hard for the lasttwo months. I cannot fully express my appreciation of your kindness andbeneficial 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 afew days ago. In answer permit me to say that the three months' courseof treatment effected a cure. Now my general health is good, bodystrengthened, mind clear, memory revived, and energy to work restored;cheerfulness and bright hopes, once lost, are now fully regained. Mycase was a complicated one of Liver disease and general effects of badhabits and usage, yet I was not too far gone to be restored by yourwonderful treatment. My prayer is that you will ever prove a blessing tomankind. 

 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, eyesbright, circles nearly all gone from under eyes; am fleshier, stronger, more active, and an entirely different man. No piles, catarrh, hearttrouble; 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 thebest institution in the world for the cure and treatment of all kinds ofchronic diseases. I was afflicted for a long time before I went to yourInstitution 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 ithas been permanently and perfectly cured. With many good wishes andhighest 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 havetaken in all three months' treatment. When I first wrote to you Ithought I was gone beyond the reach of recovery, but, thanks to God, Iam to-day a sound man, heartier than I have been for years, and yourInstitution deserves the credit of it. I will forever remember you, andwant you to publish this testimonial for the benefit of others, as thereare 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 Iconsider them good. Three years ago, I was much run-down withindigestion and nervous prostration. I purchased about four bottles of"Golden Medical Discovery" and "Favorite Prescription, " and after takingthem along with the "Pellets", I felt much improved. Indeed, my friendstold 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 theperfect 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, overstudyand anxiety, indigestion, dyspepsia, constipation, headache, inabilityto concentrate the mind, general lassitude, melancholia, backache andpains from the top of my head to the sole of my feet. You treated meabout 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 mostwonderful cure I received at the Invalids' Hotel and Surgical Instituteof Buffalo. 

I had suffered severely for eight years with a left inguinal hernia; hadtried many physicians and medicines, but found only temporary relief. Iwas greatly run-down, and my nervous system considerably shattered. Myfriends persuaded me to go to the Invalids' Hotel and SurgicalInstitute. While there I was operated on by their specialist, and in afew 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 invalidsto go there, feeling confident that they could no where receive moreskillful 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 ofThick Neck, Nervous Prostration, Weakness and a complication of ailmentsby Dr. Pierce's '"Discovery" and "Favorite Prescription. " She says: "Myhealth 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 gratitudefor the benefit I have received from your treatment has induced me torecommend you to all whom I know to be sick. " "I have known of two orthree 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 feelsomething the matter with me. I gradually got worse, with a nervous anddespondent feeling. I went to a doctor, who said I was suffering fromdebility and ordered me away. I got a little better and returned towork, but only to get worse again. I then had very restless nights withterrible dreams, and would wake up all in a perspiration. I often wishedI was dead. At last, I had to give up work again, and thought that Ishould never return to it. I was then under several doctors, but theydid 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 seeyou. I was then under your treatment for three months at my home, takingyour medicines and adhering to your rules. I felt a change the firstweek, and after three months' treatment I was restored to health. It isnow four months since I took any of your medicine, and have not had anysymptoms return. I am now at work again, and enjoying life the same asanyone 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 constitutionaldisease, or combination of diseases, which rendered life miserable attimes. Dyspepsia, headache, dizziness, irritability and gloomyforebodings were among the symptoms I suffered. By chance, one of thepamphlets you publish fell into my hands, and I was induced to writeyou, describing my condition as best I could, and consequently I wastreated by your Specialists. 

When I had been treated for two months I felt so well and the symptomswere so far gone that I felt I was cured and quit taking medicine. Asthis was more than two years ago time has proved that I was correct, forI am a healthy, robust man to-day--thanks to you and to your associatesin the noble Institution which you have established for sufferinghumanity. 

 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 availthemselves of the benefit of your invaluable medicines. In June, 1890, Itook typhoid fever of malignant type; for two months I hovered betweenlife 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 nervousprostration; could not move myself in bed nor bear to be moved by themost careful nurses without experiencing excruciating pain. I had thebest medical attention in the community, but they failed to give relief. My friends wrote to Dr. Pierce, stating my condition and requestingtreatment for me. He treated me for two months; by that time I had somuch improved that I did not think it worth while to continue thetreatment longer, and my health has been such that I have not hadoccasion to lie in bed two days together since. I feel under lastingobligations to Dr. Pierce, and thank God for blessing the world with soable 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, catarrhand 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, andwas advised to try a course of special treatment. After taking only twomonths' medicines from your noble institution, I feel perfectly restoredto health. I have, moreover, recovered my lost flesh, and I am pleasedto 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 weakand nervous, and had hard work to draw a long breath; could hardlybreathe at all, and came nearly dying once or twice. Had tried manykinds of patent medicines--many doctors, all in vain. 

One day I saw an advertisement in a newspaper, about "If you are rundown and losing flesh, use 'Golden Medical Discovery. '" I, like adrowning man, would grab at anything on sight. So I went to my druggistand asked him for "Golden Medical Discovery, " and he had it and I boughtone bottle and followed the directions and it did me good at firststart; so I bought two bottles every month until I had used about sixbottles, then I had my strength back and could draw my breath and feltlike 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 asuffering 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 mountil I began taking treatment for nervous exhaustion from Dr. Pierce ofthe Invalids' Hotel and Surgical Institute, at Buffalo, N. Y. , and canconscientiously say at the end of six weeks, I feel like another being. 

I have also consulted Dr. Pierce on numerous occasions during the pasteight years, and at no time whatever have I known his remedies to fail, more especially, his "Favorite Prescription, " (which I have used in mypractice), and the "Golden Medical Discovery, " when taken according todirections. 

These remedies will in no event disappoint. I am now In the enjoyment ofperfect health--a blessing which I attribute to the kind Providencewhich 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 andit is more than six months since I reported myself as well. I haveworked 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. Iwas subject to severe headaches; was troubled with a tired, an almostlifeless feeling, and although I slept, _I could not get rest_. I wasnervous and fretful, and could not do as much work as I wanted to do. Totell it all in a few words _I was all run down_. I had never whollyrecovered from the grip, which left me in a very poor condition; andthat, together with over-work and insufficient physical exercise, hadput me in such a condition that I was almost unfit to teach my school. 

After five months' treatment (one month intervening in which I receivednone) I considered myself well, and I think that I was right. I feelvery grateful to you for your treatment of me, and shall ever be willingto 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 takingtreatment with ten different doctors and getting no help, I started foryour city, but allowed myself to be talked out of seeing you by a man onthe train; stopped off at Lancaster and saw Dr. ----, took one month'streatment with no benefit--grew worse. 

After that, started once more, did not tell where I was going. I was acomplete wreck--had to be helped on board of the cars. You looked meover carefully--you seemed to know just what the trouble was. Gave memedicine for a month's treatment. I came back homo and took themedicine. Well, I was surprised the first week and have been eversince--gained right along. Have been well ever since and all for onemonth'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 theuse of your medicines. I can truly say I feel like a new man. I havenone of that wakefulness at night, or the tired feeling when I get up ofa morning. Now, I can work hard all day, go to bed at night tired, wakeup 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 duringtreatment I weighed about 160 pounds, and now I weigh 185 pounds. Withmany 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 mychildren I was left in a weak, run-down condition; it seemed to me thatmy nerves were unstrung very bad: I did not suffer much pain, but Ithink I suffered everything any one could suffer with nervousness; mylife was a misery to me. I doctored with seven different doctors and gotno relief; then I took almost all kinds of patent medicines and got norelief from them, but got worse all the time, when I chanced to get oneof your little pamphlets. 

I thought I would write to you, and waited as I thought to hear thatthere was no help for me; when my answer came and you said you couldcure me great was my joy. I had taken your medicine about a month when Ibegan to improve and in a few months was entirely cured. 

My recovery was like coming out of the dark into the light, so great wasthe change. I will advise all sufferers to go to you for relief--I don'tthink they will be disappointed. When I commenced taking your medicine Iweighed 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 FavoritePrescription now, and last summer every one thought she was going withconsumption; four of her father's family had died with it in five years:she has taken one bottle of "Favorite Prescription, " and now she isbetter 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 doctorsin this country but without avail. I gave up every hope. Youradvertisement fell into my hands; at the time I did not know what to dobecause all my money had gone for medicine, but money was no object tome. I could not rest till I was cured. 

Your treatment, which I received, cured me in a short time, and I amjust as good as ever. I come before the public to advise anyone in needof treatment to give you the first chance, and he will find relief for Ibelieve that nowhere can one obtain more skillful care or more kindlyattention. 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 byletter. He was suffering from great nervous prostration; could not walkwithout tottering: was troubled greatly with inability to sleep; poorappetite; did not relish food; suffered much pain and stiffness in thejoints; was overcome with heat working on a thresher, followed bypersistent nausea, confusion of ideas, his memory being very defective. 

After taking a single course of treatment, the medicines being sent byexpress, he writes as follows: "The medicine you sent me lasted me fiveweeks, and proved very beneficial indeed. I believe it, under God, wasthe means of saving me from a premature grave. When I received themedicine, I had just gotten rid of an attack of bilious fever, whichleft me in a deplorable condition. I was very week and nervous, but myimprovement commenced with the first dose of your medicine, so by thetime my medicine was out felt better than I had for years, and now haveno indication of a return of my trouble. " A month later he writes: "Icontinue to enjoy the most perfect health. Every organ of my body, andevery faculty of my mind, is in splendid condition, which makes lifeworth living. I have gained twenty-one pounds since I have been able toattend to business. Please accept my profound thanks for your promptnessin 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 thetreatment of my case. When I applied to you last June, I was sufferingall the horrors of nervous prostration, which was brought on byover-work and constant anxiety. I had no energy and no interest inbusiness; rather an aversion to anything like work. My appetite waspoor, indeed food seemed to distress rather than nourish. I felt tiredand drowsy mornings; irritable and despondent; suspicious of every bodyand everything. After two months' treatment these unpleasant symptomsdisappeared, and my health is better than it has been for twenty years. 

I can never express to you my gratitude for your kindness, and wouldcheerfully 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 greatbenefit I have received from your medicines and self-treatment at home, which you kindly sent me, advising me to take your Dr. Pierce's FavoritePrescription and "Pleasant Pellets" and "Golden Medical Discovery" formy troubles. I did take your advice as near as I could; when I wrote myfirst letter to you, I had been treated by different doctors for twelvemonths and received but very little or no benefit, but had spent onehundred dollars for treatment and medicines. 

My husband, and little boy twelve years old, did all the family sewingand washing and work in general, and I could not walk across the roomwithout help or stand on my feet one minute at a time; at night I couldnot sleep, nor day time either; nothing I ate tasted well--I had nodesire to eat anything; my bowels were costive all the time, and afterfollowing your advice and using about fourteen dollars worth of yourmedicines altogether, I now feel like a new person. I am not botheredwith that nervousness, where it used to be that I could not stand asudden rush of horses feet, or a quick halloo from one's boys, or asudden sound of anything would cause me to take sudden nervous spells ofsome kind, as if I were smothering or dying, or something of the kind--Ican't tell just how I did feel. Now I do all my washing, sewing andhouse work in general for a family of seven--five children, my husbandand self, and help my husband in the field some besides. I cantruthfully say, ii it had not been for Dr. Pierce's medicines and thekind advice to me, with self-treatment at home, I would have been deadlong ago, and I never can feel that I can say enough for his skill andmedicine 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 theydo 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. MayGod 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 beforeI 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 twomonths, and when I did get out, the strength to walk any more than justa few rods did not come back. My family doctor and two prominentphysicians of Sioux City, did me no good. Late in the fall I got abottle of Dr. Pierce's Golden Medical Discovery, which quieted mytrembling nerves and gave me an appetite to eat. I then concluded to trythe 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 muchI would be stupefied. I could not digest any food and my whole systemwas wasting and failing fast. I doubt if any one who saw me expected meto get well. I took the treatment sent me by the World's DispensaryMedical Association for more than a year. The medicine never gave me anydistress as other medicines had done before. I began to improve from thestart, but the change from one extreme to the other was like the growthof a child. 

To any one suffering from nervous prostration I would say, "don't beimpatient. " It takes a long time for weakened nerves to grow strong. Ihave at last become strong and well, thanks to the Giver of all good andthe grand Institution at Buffalo. I have since married a noble-heartedyoung woman, and when I am playing with our sweet, healthy, baby girl, Igive way to the thought that at last the long, sad chapter of my life isended; at such times her merry laugh sounds like a song of triumph oflife 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 severalweeks, I take great pleasure in telling other sufferers of my treatmentwhich I received under your efficient staff of physicians, surgeons andnurses, and I will say with clear conscience that every care and comfortwas given me that I wished for. I am sure that your Institution is farin advance of the age, and would wish that every invalid could availhimself of the treatment that I received in your most, excellently keptInvalids' Hotel. I cheerfully give this as my testimonial toindividuals, friends and sufferers. My health is so fully restored thatI look upon life with pleasure and comfort, whereas before I was asuffering nervous invalid, unable to sleep and much of the time intorment. 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 backached, and I could not sleep hardly any, and could not rest at night forabout three months, and, reading in one of your Memorandum Books a casethat suited mine and having taken medicines without any good results, Iconcluded to try your medicines. I explained my case carefully and gotone month's medicines, of which I did not take all as I thought I didnot need it, as I felt like another man--could sleep well and workwithout 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 myhealth in a precarious condition. I was placed under the treatment of agood physician who did all in his power to restore my health, but all invain. I had dyspepsia and could not eat meat, vegetables nor fruit ofany kind. I suffered alternately from cold and heat. At times my feetand knees would feel like ice to the touch, and at other times I wouldsuffer the most excruciating torture, seeming as though every nerve inmy body was being seared with a hot iron. My left hip and knee wouldbecome so affected that I could scarcely walk across the room. I sleptvery little. On one occasion I remained awake four days and four nights, and then was put to sleep by repeated doses of morphine. My nervoussystem became so shattered that words spoken by any person in my roomfell like pebbles on my brain; and nights I would often have to beraised in bed to prevent smothering to death. It is impossible for me todescribe my sufferings at that time but I know that if it had not beenfor Dr. Pierce's Favorite Prescription I would to-day have been in mygrave. 

I began the use of the "Favorite Prescription" in March--three yearsago, as well as I can remember. Continued till summer when I wrote toyou--received your advice and a few simple prescriptions which I hadfilled at the drug store. I also began the use of the "Golden MedicalDiscovery. " My nerves became quiet: I slept well; my stomach began toheal; 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 ofwork that other women do, and each season I can say I am stronger than Iwas the last. I used thirty bottles of your medicines. Some may say thatwas a great deal, but I will never regret the money and patience it tookto cure me. It has enabled me to once more enter school where I amtrying to make up for those lost years of my life, and as I join thegirls 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 littlehope myself, but at the urgent entreaty of my wife I let her write toyou for me and began taking special treatment from you. I could eat butvery little and could keep nothing on my stomach, and was vomiting upbile once or twice every day; muscles all gone and too weak to getabout. But to-day I think I am a sound healthy man. I owe it all to yourtreatment, and a loving Saviour who blessed the means in your hands tothe healing of this body of mine. And I gladly recommend the sick andsuffering 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 ofmany others in behalf of the great success of your Institution. I hadbeen breaking in general health for years and had got so that I couldnot properly attend to my business. Was very forgetful and easilyirritated and excited, and was unable to attend to my business a goodpart of my time. I doctored with country and city M. D. 's. , and tookpatent medicine, but without any permanent good. I was induced to writeto you, which resulted in my taking about one and one-half months'treatment from you, when I felt so much better that I discontinued thetreatment. For the last six months I have felt like my old natural selfagain, and am able to attend strictly to business all the time for whichI 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 megreat pleasure to state that during that time I received the mostcourteous and faithful care and treatment, and I bear willing testimonyto the skill and ability of the surgeons and the faithful care of thenurses. 

Wishing you continued success, I recommend all persons suffering fromchronic 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 agreat benefit to me. I was suffering from general debility, malaria andnervous sick headaches, and after my third child was born (a beautifulbaby boy of ten pounds) I only recovered after a long illness; I barelygained strength enough in two years time so that I was able to crawlabout to accomplish the little housework that I had, by lying down toread many times each day; had sick headaches very often; and many painsand aches, all the time complaining of getting no better. I finallyasked 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 greatchange in my strength, and fewer sick headaches. 

I continued taking the medicine until I had taken eight bottles--sevenof the "Favorite Prescription" and one of the "Golden MedicalDiscovery. " For some time past I have not used it, but I am now able todo the housework for myself, husband and two children (aged nine andfive years). I also take in dressmaking, and enjoy walking a mile at atime, and I think it Is all due to the medicine, for I know I was onlyfailing fast before I commenced to take it. I take great pleasure inrecommending the "Favorite Prescription" to all women who suffer fromdebility 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 knowthat they do for me all that is claimed for them. I am employed mostlyat my desk, and not infrequently have an attack of the headache. Itusually comes on in the forenoon. At my dinner I eat my regular meal, and take one or two of Doctor Pierce's Pleasant Pellets immediatelyafter, and in the course of an hour my headache is cured and no badeffects. I feel better every way for having taken them--not worse, as isusual after taking other kinds of pills. Your "Pleasant Pellets" areworth more than their weight in gold, if for nothing else than to cureheadache. 

 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 veryfrequently; also nose bleed. My health was so poor that I was not ableto 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 forme. 

 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. Ihad frequent spells of fainting, terrible pain in my head, and life wasa burden to me. I was attended by one of the best physicians in ourtown, 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 bottleI felt greatly benefited. I would advise all ladies similarly afflictedto 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 agoI was so afflicted with them that I could not walk. I bought Dr. Pierce's Pleasant Pellets, and took one "Pellet" after each meal. Theboils soon disappeared and have had none since. I have also beentroubled with sick headache. When I feel the headache coming on, I takeone 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 attacksand all kinds of headaches, I tried different kinds of medicines butfound nothing to cure me. Having read about Dr. Pierce's PleasantPellets, I commenced taking them. Before I had finished one phial Ifound benefit; they have done me great good. I have recommended them toall 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 inducedto 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 weighone hundred and eighty pounds, --and thanks to you for it. I used yourmedicines 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 forit, and more too. The Doctors are courteous gentlemen and the bestPhysicians I have ever met with in my life. My treatment while at theInstitute did me more good in one month than all the doctors everywhereelse combined. My ailment was Paralysis and Female Weakness. Yourtreatment did me good while at the Institute, and I have also beengreatly 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. WhenI 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 wouldadvise all people who have chronic diseases to go to the Invalids' Hoteland Surgical Institute for help, for it is a grand place and prices arereasonable. We use your Family Medicines--your "Pellets" and GoldenMedical 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'sGolden Medical Discovery and his "Favorite Prescription" very highly andoften recommend them to others. I do not think I would ever have gotwell if it had not been for your medicines. I was in a sad condition. Mybowels and half of my body (the left side), was nearly paralyzed, besides nearly my whole system was out of order. I suffered all thetime; but after taking six bottles of "Golden Medical Discovery" and thesame of "Favorite Prescription, " and using two bottles of Sage's CatarrhRemedy as an injection, I felt like a new person. I have never seenanyone suffering in the same way as I did. If anyone with female troubleof 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 thatterrible--and by many members of the medical profession pronounced tobe, incurable disease, locomotor ataxia. My family doctor declared thatnothing could be done for me, but for the sake of satisfaction advisedme to go to London, and see an expert, whom he named. I did so, with theresult of being told as above. This was in November, 1890. The symptomswere first numbness in hands and feet, which soon extended as far as thethighs, joined with the most intense feeling of cold that it can bepossible to imagine. For six months I felt as though I had stood in iceup to my thighs. I soon became unable to walk or to stand, and crawledup stairs on my hands and knees, I thought for the last time, as I thenthought I should die. Stomach troubles then set in, and for more thanthree months, I endured the utmost agony. Night and day sweats absorbedmy little remaining strength, and I became helpless. I had taken leaveof my family, not expecting to last the day out, when I was seen by ayoung doctor, who is fast becoming an eminent man, who said he thoughthe 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 ofthe 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 onsending to you for a bottle in reply to your inquiry, I began yourspecial treatment, with the happy result that I gradually improved inhealth and strength; and on the 26th of October, 1892, I was able tocall 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 couldwalk about quite nicely, and I now enjoy better health than for the pasteight years. I am thankful too, that my eldest daughter has derived thegreatest benefit from Dr. Pierce's Favorite Prescription. She took itfor 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 healthgradually declined until June, at which time he was taken very muchworse. Had nervous shocks three or four times a day. Slight paralysis oflower limbs. Respiration and pulse slow and irregular. Bowelsconstipated and tongue coated. Indigestion. Ringing in the ears. Legswasting. Dimness of vision. Lost flesh rapidly and reduced to "skin Iand bones. " Chills and sweats; dizzy. Had great distress in bowels. Painabout the heart. Had been confined to his bed 46 days, at the time thecase was submitted to us. We sent only one month's course of specialmedicines. He writes us afterwards:

"I am at regular farm work, after my doctor here having told me that Imust 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 beenafflicted with that dreaded disease, Epilepsy, for fourteen years. Shereceived treatment from seven different doctors without any materialbenefit. She has only had one spasm after commencing with yourtreatment, now almost two years. Three boxes of epilepsy medicine, followed up with your "Favorite Prescription" cured her. She took aboutsix months' treatment in all. 

This places us under a world of obligation to you as the instrument ofour great relief under a kind Providence. Should there be any signs ofit returning we would with unshaken faith send for more medicine. Youcan 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 heartfeltthanks for the benefit derived from your treatment, having suffered fromepileptic fits for six years. I have experienced as many as five andseven fits a day, some lasting two hours at a time. I am glad to saysince 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 resultsof your treatment with my little son John. He was very bad, as wethought, for the physician could do nothing for him any more, and I gotdiscouraged and went to my daughter, Mrs. D. T. Knappenberger, ofJeannette, Pa. , (who has been a terrible invalid and was cured at yourInstitute), for advice. 'Oh, father, ' she said, 'don't doctor here, butgo to Dr. Pierce. So the result was I gave her money and she sent formedicines. You sent two bottles of medicine and he never has taken adrop since and is perfectly well and never had a spell since. I do notknow what you call the disease, but we called it spasms or fits. With myexperience I can heartily recommend the Invalids' Hotel, and think if acase can be cured at all, you can cure it. And unless they can cure orgreatly benefit the patient, they will not undertake it; this is myexperience with the World's Dispensary. My daughter, Mrs. D. T. Knappenberger, and my son Johnnie, feel very grateful toward theDispensary 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 andirritable. When three and one-half years old we discovered she had thatterrible disease "epilepsy, " inherited from her father's family; she hadspasms or fits once in two or three days, and grew worse so rapidly thatin 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 pamphletscame to me as they had come often before. As my need was great I wrote adescription of her case, and though your answer did not seem veryencouraging, I did not dare to lose any chance of saving my child, so Icommenced the treatment. On November 6, 1891, she had seven fits;November 7th gave her your medicines; she had four fits that day, andnever one since. She took your medicines less than four months. She isnearly six years old, a strong, hearty, bright child, attending schoolevery day. 

What more can I say than that I thank Dr. Pierce and the Faculty of theWorld's Dispensary Medical Association for having saved the life of mychild, and I thank God that he gave them the knowledge and skill to doso. 

 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 calledour home doctor, but he got no better. Finally he had the St. Vitus'sDance, and our doctor did not know what to do. So I wrote to you and didas you told me; I got two bottles of your "Favorite Prescription, " andone bottle and a half did the work all right. At that time, eighteenmonths ago, his weight was 85 pounds, now it is 135 to 140; he isfourteen 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 halfyears old. She had been afflicted with epilepsy for three and a halfyears, and received treatment from three different doctors, and from oneespecially, for the space of two years steady, without any benefit. Before taking your treatment she had as many as six or seven spells aday. The child could not have stood it much longer. After taking yourtreatment one month the spells stopped. With four months' specialtreatment from you, and two months' use of Dr. Pierce's FavoritePrescription she was entirely cured. In one year and three months shehas not had a drop of medicine, and she is in the best of health andvigor. 

I would say to any sufferer from obstinate or chronic disease, andespecially epilepsy, that we have a living witness. You can come and seefor yourself that the doctors connected with the World's DispensaryMedical 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 andSurgical Institute, Buffalo, N. Y. , and I was cured of a chronic troublethat had been maltreated by other physicians. While there I saw a manwho had been cured by the specialists, who had before been given up todie by the best doctors in Troy, N. Y. Of course, the case must have beena 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 andcare of his skilled doctors and nurses, I know would have most assuredlygot well. Why? Because it was only a case of _stone in the bladder_, andthey are easily cured at Dr. Pierce's Surgical Institute. I think almostany chronic disease can be cured there, if taken in time, judging frommy 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-feltgratitude 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 theInvalids' Hotel and Surgical Institute at No. 663 Main Street, Buffalo, N. Y. , I feel warranted in its highest recommendation. While there I sawand talked with a groat number of people who came there as a lastresort, to be cured of almost every chronic disease to which flesh isheir, and they were unanimous in their praise of the Institution and theskilled 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 ideaof the Urinary and Generative Organs of Woman, their form and relativepositions, together with the bones, muscles and other tissues formingthe cavity of the pelvis in which the organs rest, and by which theyare protected. By dividing that portion of the body directly throughthe middle from before backward, we first cut through the cushion offat (mons veneris) covering the pubic bone, then in succession thebone, bladder, womb, vagina, rectum, front half of spine, spinalmarrow, rear half of spine, and lastly the muscles and skin. Justunderneath the bone in front is revealed that sensitive organ, theclitoris, a facsimile of the male organ in miniature, the head ofwhich protrudes, while the body is covered with tissue, but is readilytraced 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 inorder to be cleansed and to apply remedies. On the vagina rests thehollow, pear-shaped womb, the small end of which protrudes into thevagina, and in which is a small opening, leading through the neck intothe cavity of the organ. On either side of the womb, near its top, arethe Fallopian tubes leading to the ovaries, situated between the womband hip bones. At every menstruation these organs throw off agerm-cell, which passes through the Fallopian tubes into the uterinecavity. ]

THE DOOR OF LIFE. 

[Illustration]

The fear of pain and the dangers of childbirth fill many a woman'sbreast with dismay. In the olden days of leeches and witchcraft, it wasconsidered sacrilegious to lessen the pains of labor. Latterly, anæsthetics have been used at the time of parturition, and now peopleare beginning to find out that pain and danger can be almost whollyavoided. 

Proper preparation during gestation will make both as rare as they usedto be common. There is no reason why childbirth should be fraught withdanger and distress. It is a perfectly natural function, and should beperformed in a natural way without undue suffering. Nature neverintended that women should be tortured when doing the one thing whichmakes them wholly womanly. The perversion of nature's laws has broughtthis suffering about, and a return to right living will stop it. 

Nine out of ten women are troubled more or less by weakness and diseasespeculiar to their sex. It is so because they do not take proper care ofthemselves--because they neglect little ills and little precautions. Awoman in perfectly hearty health goes through her time of trial withcomparative ease. The thing to do then, is to make all pregnant womenhealthy--to strengthen them generally and locally. The medicine andtonic to do it with is Dr. Pierce's Favorite Prescription. 

It is a powerful invigorant and nervine. It soothes and strengthens thenerves and acts directly on the feminine organism in a way which fits itfor the proper and regular performance of all its functions at illtimes. 

Taken during gestation it robs childbirth of its dangers to both motherand child, by preparing the system for delivery, thereby shorteninglabor, lessening pain and abbreviating the period of confinement. TheFavorite Prescription also promotes the secretion of an abundance ofnourishment for the child, if taken after confinement, besides buildingup the mother's strength and making her recovery more perfect. 

ABORTION. (MISCARRIAGE. )

The term _abortion_ is used to denote the premature expulsion of thefoetus. If the expulsion takes place within four months afterimpregnation, it is termed _abortion_; if between the fourth and seventhmonth, _miscarriage_; if after the seventh month, but before thecompletion of the full period of gestation, _premature labor_. 

Abortion may be due to those agents which act directly upon the uterusand cause the expulsion of the foetus; to those which occasion the deathof the foetus, thereby effecting its ejection; and it may be _criminal_, that is, produced intentionally by direct agencies intended for thatpurpose. 

SYMPTOMS. The premonitory symptoms are pain in the loins and lower partof the back, a dull pain in the abdomen and thighs, nausea, chills, andpalpitation. The membranes and blood-vessels of the uterus becomelacerated, causing profuse hemorrhage. The discharge of blood from thevagina is sometimes attended with excessive pain. 

THE CAUSES which act directly upon the uterus to produce abortion may beviolent 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 ormuscular irritability, which is sometimes so great as to producecontractility of the uterus before the term of pregnancy is completed, inflammation of the cervix, ulcerations of the uterus, or any previouslyexisting disease may produce abortion. When it has once taken place, itis apt to recur at about the same time in subsequent pregnancies. 

The death of the foetus may be occasioned by a diseased condition of theembryo, amnion, or placenta, and also by convulsions or peritonealinflammation. 

CRIMINAL ABORTION is secretly practiced by women who desire to ridthemselves of the evidence of immorality, and by those in wedlock whowish to avoid the care and responsibility of rearing offspring. Statistics show that it is very prevalent, undermining the health ofwomen and corrupting the morals of society. We cannot pass over thissubject in silence. Those who frustrate the processes of nature byviolating the laws of life incur just penalties. All the functions oflife and body are vitally concerned in reproduction. Any infraction ofthe Divine law, "Thou shalt not kill, " is inevitably followed bypunishment. The obligations to nature cannot be evaded withoutinevitable penal effects. Furthermore, all such transgressors carry withthem 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 willingto engage in the murder of innocents for pay? True, there may becircumstances in which it is not right to continue in the pregnantcondition, such as when the children of an unfortunate marriage areidiots, or the pelvis of the woman is so deformed that she cannot bear aliving child. All such cases should be submitted to the _family_physician, who ought to be made acquainted with all the circumstancesand facts relating to the case, when he can summon other physicians forcounsel, and their deliberations may determine the propriety ornecessity of bringing on an abortion. 

Parties have written to us and others have made personal applicationunder circumstances when it might have been right for their _familyphysician_ to have induced abortion. We wish to have it distinctlyunderstood that we will not under any circumstances prescribe medicinesor perform any operation to relieve women of pregnancy. 

Mechanical means are resorted to by abortionists, and many women produceabortion upon themselves. It always terminates in lasting injury andsometimes in speedy death. Certain medicines will sometimes produceabortion but they are very unsafe. An opinion is very prevalent that ifabortion be produced before the movements of the foetus are felt, thereis no crime committed. It should be remembered that _life begins withconception_, and, at whatever period of pregnancy abortion is committed, _life is destroyed_. Whoever disobeys the Divine injunction cannotescape his own consciousness of the deed, and the anguish and bitterremorse which ever after disturb the soul. 

TREATMENT. In threatened abortion, there is pain in the back or lowerpart of the abdomen, and later some flow of blood. The first object isto obtain perfect rest and quiet, and assume the recumbent position. Bylying down, the blood will be more easily diverted to the surface of thebody. Gallic acid, in doses of five grains every two or three hours, isoften a valuable agent to arrest the hemorrhage, but opium in some formshould be relied upon principally. A Dover's powder, ten grains, may beadministered, to assist in determining the blood to the surface andextremities of the body and to allay irritation. The room should becool, the patient should lie on a hard bed, and all company should beavoided, for excitement favors abortion. If the flow of blood equals agill in amount, there is little hope of preventing abortion, and thetreatment of the case should be entrusted to the family physician. 

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WOMAN AND HER DISEASES. 

An imaginative poet avers that woman is the link connecting Heaven andearth. True it is, we see in her the embodiment of purity and heavenlygraces, the most perfect combination of modesty, devotion, patience, affection, gratitude and loveliness, and the perfection of physicalbeauty. We watch with deep interest the steady and gradual developmentfrom girlhood to womanhood, when the whole person improves in grace andelegance, the voice becomes more sonorous and melodious, and the anglesand 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 inintimate sympathy, render her doubly susceptible to injurious influencesand a resulting series of diseases, from which the other sex is entirelyexempt. By their sympathetic connections they wield a modifyinginfluence over all the other functions of the system. Physically andmentally, woman is man modified, perfected, --the last and crowninghandiwork of God. When, therefore, this structure so wonderfullyendowed, so exquisitely wrought, and performing the most delicate andsacred functions which God has ever entrusted to a created being, isdisturbed by disease, when the nicely-adjusted balance of her complexnature deviates from its true and intended poise, the most efficient aidshould be extended, in order that the normal equilibrium may beregained, her health restored, and her divine mission, on which humanwelfare so largely depends, be fulfilled. Its importance should elicitthe best efforts of the highest type of mind, the ripe development ofgenius, 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 havebeen afforded great experience in perfecting and adapting remedies fortheir cure, enabling us to meet their requirements with increased_certainty_ and _exactness_. 

TREATING THE WRONG DISEASE. Our improved and perfected system ofdiagnosing, or determining, the _exact_ nature and extent of chronicaffections, which, in most cases, we are able to do at a distance, andwithout a personal examination of the patient, as will be moreparticularly explained in the appendix, or latter part of this littlebook, has enabled us to avoid the blunders so often committed by thegeneral practitioner, who not infrequently treats those afflicted withchronic 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 fordyspepsia, heart disease, liver or kidney affections, sick headaches, and various aches and pains, as if they were _primary_ diseases, when inreality, they are only so many local manifestations, or _symptoms_, ofsome overlooked derangement, or disease, of the womb. For, as we havealready intimated, every organ of the system is in _intimate_ sympathywith the uterus, or womb. Any disease, either functional or organic, ofthis organ, is at once manifest through several, if not all, thesympathizing organs of the system. When we receive a sharp blow upon theelbow, the pain is felt most keenly in our little finger. Just so indiseases of the womb; often the most distress is felt in organs or partsof the system quite distant from the real seat of disease. On thisaccount, thoughtless, easy-going and ignorant physicians are misled, andvery commonly mistake the invalid's disease for some affection of thestomach, heart, liver, kidneys, or other organ, when really it islocated in the uterus. Cure the disease of the womb, and all thesedisagreeable manifestations, or symptoms, vanish. Their cause beingremoved, the various dependent derangements, and disagreeable nervoussensations and sufferings rapidly give way, and vigorous health isfirmly re-established. 

TIME AND PERSEVERANCE IN TREATMENT REQUIRED TO CURE. Most chronicdiseases of women are slow in their inception, or development, and theirremoval or cure must necessarily be gradual. Disease that has beenprogressing and becoming more firmly established for months, or perhapsyears, cannot, except in rare cases, be hastily dislodged, and thesystem restored to perfect health. The process of cure, like thedevelopment 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 aconsiderable time, arouse in the system very disagreeable sensations, and many times this leads unthinking persons to become frightened ordiscouraged, and to quit the treatment best adapted to their cases ifonly faithfully carried out. In many forms of womb disease, their areorganic lesions or changes, that can be repaired only by a gradualprocess, just as an external wound would heal, --not suddenly, but by aconstant, slow filling in and building up, or by the gradual developmentor growth of one cell upon another. Just as a great breach in a wallwould be repaired by filling in brick upon brick, until the defect iseffaced, so must these lesion's be removed by gradual processes. Whenfully repaired, the dependent, sympathetic derangements, disagreeablesensations, and all the long train of consequential symptoms are, one byone, abolished. 

NOT LIMITED IN OUR REMEDIAL RESOURCES. It should be borne in mind that, while we recommend, in this little volume, certain courses of treatmentfor ordinary cases, the remedies mentioned do not by any means embraceall our resources in the way of medicines and other curative agencies, especially for complicated, difficult, or very obstinate cases. In manyof the latter class we can send medicines that are exactly adapted tothe case, if the invalid will fill out one of our "Applications forTreatment, " 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 mostwomb diseases, the chemical and microscopical examination of the urinealso furnishes valuable aid in determining the exact condition of thepatient, as well as the precise stage of the local organic disease. Fulldirections for putting up and sending such samples may be found in the"Appendix" of this little volume. Every case submitted to us, either byletter or in person, receives the careful and deliberate considerationof a full Council of specialists before a decision as to the nature ofthe malady, or the proper course of treatment to be employed, isdetermined upon. The great advantage of this system of practice must beobvious to every intelligent, thoughtful person. No experimenting isever resorted to. The treatment is _specially_ and _exactly_ adapted toeach individual case, which requires such judgment, skill, and nicety ofdiscrimination, as has only been acquired by our specialists throughlong and diligent study, and an experience embracing the treatmentannually of many thousands of cases of those chronic diseases which arepeculiar to women. 

 WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main Street, Buffalo, N. Y. 

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MENSTRUATION AND ITS DISORDERS. 

The function of the ovaries is to furnish ova or germs, and thefunctions of the uterus or womb are to secrete mucus; to exude themenses; to secrete the decidua; to contain and nourish the foetus and toeffect its expulsion. 

Menstruation, or the menses, monthly visitation, catamenia, menstrualflow, courses, or periods, usually makes its appearance in the femalebetween the twelfth and fifteenth years, at which time the reproductivesystem undergoes remarkable changes. A marked characteristic ofmenstruation is its regular return about every twenty-eight days. Themenstrual flow usually continues from three to six days, and thedischarge seems to be ordinary blood, which, during its vaginal passage, becomes mixed with mucus, and is thereby deprived of the power ofcoagulation. The quantity exuded varies from two to eight ounces, butthe amount consistent with the health of one person, may be excessiveand weakening in another. This function is regarded as "being regularwhen its effect upon the system is favorable, for whatever organicprocess directly contributes to the health should be considered asnormal. It occurs at regular intervals for about thirty years, whenmenstruation and the aptitude for conception simultaneously cease. 

The departures from healthy menstruation are numerous. The mostimportant of these are _amenorrhea, dysmenorrhea_, and _menorrhagia_. 

AMENORRHEA. 

The term _amenorrhea_ signifies the absence of menstruation when itshould occur. It may be considered under two general heads: when itfails to be established at the proper age, and when, after having madeits appearance, it ceases to return at the usual periods. The term_retention_ has been applied to the first, and that of _suppression_ tothe latter. Menstruation may fail to be established in consequence oforganic defects, or from some abnormal condition of the blood andnervous system. 

MALFORMATION OF THE VAGINA. Retention of the menses may result frommalformation of the vaginal canal, which sometimes terminates before itreaches the womb, being simply a short, closed sac. If the uterus andovaries are perfect, all the feminine characteristics are manifest, anda vaginal exploration discloses the nature of the difficulty. If, however, the sides of this passage adhere in consequence of previousinflammation, they may be carefully separated by a surgical operation, and this function restored. 

ABSENCE OR MALFORMATION OF THE WOMB. The uterus may be deformed orentirely absent, and yet there be an inclination, or symptoms indicativeof an effort, to establish this function. The individual may be delicatein organization, graceful in bearing, refined and attractive in allfeminine ways, and yet this organ may be so defective as to preclude theestablishment of the menstrual function. Sometimes there is merely anocclusion of the _mouth_ of the uterus, the perforation of which removesall difficulty. In others, the _neck_ of the womb is filled with amorbid growth, or the walls of its canal are adherent, as the result ofinflammation, and may be separated by a small silver or ivory probe, andthe menses be thus liberated. 

IMPERFORATE HYMEN. The hymen is a circular, or semilunar membrane, whichimperfectly closes the outer orifice of the vagina in the virgin. Whenof a semilunar shape, it usually occupies the lower or posterior portionof 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 themenstrual fluid exudes. This membrane is usually ruptured and destroyedby the first sexual intercourse, and, hence, its presence has beenconsidered evidence of virginity. Its absence, however, must not beconsidered a conclusive evidence of sexual intercourse, for, as Dr. Dunglison says, "many circumstances of an innocent character mayoccasion a rupture or destruction of this membrane. It is often absentin children soon after birth; while it may remain entire aftercopulation. Hence, the presence of the hymen does not _absolutely_ provevirginity; nor does its absence prove incontinence, although itspresence would be _prima facie_ evidence of continence. "

Sometimes this membrane, when not imperforate, is so thick and strong asto render sexual intercourse impossible, and requires a cuttingoperation to open the vagina. Several such cases have been operated uponat the Invalids' Hotel and Surgical Institute. 

It occasionally happens that the hymen is entire, or imperforate, atbirth. This may not be discovered before puberty. But when this periodarrives and the menstrual discharge takes place into the vagina, thefemale will suffer from the retention and accumulation of thissecretion, and ultimately a tumor or a protrusion of the membrane whichcloses the vagina will occur, giving rise to severe pain and otherserious symptoms. The retained menstrual fluid, increasing in quantityat every monthly period, dilates the womb as well as the vagina, andeven the Fallopian tubes become distended, presenting at length anurgent necessity for relief. 

TREATMENT. This condition admits of relief only by operative surgery. The operation consists in dividing the hymen by a crucial incision, thusallowing the accumulated fluid to be discharged, after which the vaginais cleansed by syringing it with warm water. 

ABSENCE OF THE OVARIES. Let us suppose the case of a young woman who hasfully reached the period of puberty without having menstruated. All theorgans which we have described, are manifestly developed, she ishealthy, vigorous, robust, and able to exercise freely or to engage inlaborious occupations. But we notice that her voice is not sweetlyfeminine, nor is her presence timid, tender, and winning; there iswanting that diffident sexual consciousness, which gently woos, and, atthe same time, modestly repels, and tends to awaken interest, curiosity, and desire. Considering also that she has never manifested anyinclination to menstruate, we are irresistibly led to the conclusionthat the ovaries are wanting; the delicate mustache upon the upper lip, the undeveloped breasts, the coarse features, and her taste formasculine pursuits, all concur in this diagnosis. Thus we account forthe harshness of the voice, fitted for command rather than to expressthe mellow, persuasive cadences of love. Such a malformation cannot beremedied. 

RETENTION AND SUPPRESSION FROM MORBID CONDITIONS OF THE BLOOD. Non-appearance, as well as suppression of the menses, may result from anabnormal state of the blood. The first condition which demands ourattention under this head is _plethora_. In robust, plethoric femalesthe menses are sometimes very tardy in their appearance, and every monththe attempt to establish this function is attended with pain in thehead, loins, and back, chilliness, nausea, and bloating of the abdomen. Sometimes there is intolerance of light or sound, and cerebralcongestion, amounting almost to apoplectic symptoms. The pulse is fulland strong, the blood abundant and surcharged with red corpuscles. Suchpersons may be accustomed to luxurious living, and there is evidently apredisposition to abnormal activity of the alimentary functions. 

TREATMENT. We may briefly suggest that such subjects should engage inlaborious physical exercise in order to expend the surplus of vitality, and should lessen the daily amount of food taken, and use that which islight and unstimulating. We should also prevent the determination ofblood to the head, by keeping it cool and the feet warm, and byincreasing the flow of blood to the extremities. The volume of thecirculation may be diminished by acting upon the natural outlets, suchas the skin, kidneys, and bowels. The proper means and appliances forquickening the circulation of the blood are indicated, and friction uponthe surface, bathing, the daily use of such cathartics as Dr. Pierce'sPleasant Pellets, and, finally, the use of some general uterinestimulant, such as Dr. Pierce's Favorite Prescription, will generallyprove successful in cases of amenorrhea resulting from plethora. 

RETENTION AND SUPPRESSION FROM ANÆMIA. To describe the condition of thepatient whose blood is low and deprived of the richness, warmth, andbloom, it once possessed when it kindled admiration and enthusiasm inothers, 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 orconsumption slowly wasting the blood and consuming the vital cells, until the spirit can no longer dwell in its earthly abode and deathclaims the skeleton for dust. 

CHRONIC DECLINE, with its attendant anæmia, may be induced by badhabits, destitution, or constitutional depravity. Sickly forms, wrecksof health, address our senses on every side. All these subjectsevidently once had a capital in life, sufficient, if properly andcarefully husbanded, to comfortably afford them vital stamina and lengthof days. Alas! they have squandered their estate, perchance in idlenessand luxurious living, or have wasted it in vanities or misdirectedambition. Having become bankrupts in health, there is necessarily afailure of the menstrual function, and then follows a _panic_. All theblame of the insolvency and general derangement, is unjustly attributedto the non-performance of the duties of the uterus. Thus, this organ isaltogether _dependent_ Upon the general health for its functionalability, yet frequently treatment is instituted to compel menstruation, regardless of the condition of the system. Thus the enfeebled uterus iswrongfully held responsible for general disorder, because it ceases toact, when _by acting_ it would further deplete the blood and thusmaterially contribute to the already existing chronic decline. 

No matter what are the causes of this decline, whether they are thefollies of fashion, the effect of indolence, debility in consequence ofinsufficient food, perversion of nutrition by irregular habits, lack ofexercise, or the taking of drastic medicines, the result is anæmia andamenorrhea. 

TREATMENT. We would suggest in such cases a nutritious diet, increasedexercise, 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, andpermit freedom of motion. The patient should indulge in amusingexercises, walking, swinging, riding, games of croquet, traveling, singing, percussing the expanded chest, or engage in healthfulcalisthenic exercises. The hygienic treatment of this form ofamenorrhea, then, consists in physical culture, regular bathing, and theregulation of the bowels, if constipated, as suggested in this volumeunder the head of constipation. 

The _medical treatment_ should be directed to enriching the blood, improving nutrition, toning up the generative organs, and the health ofthe whole system. This requires the employment of uterine and generaltonics, and Dr. Pierce's Favorite Prescription, which is sold bydruggists, happily combines the properties required. It improvesdigestion, enriches the blood, exercises a tonic and gently stimulatingeffect upon the uterus and ovaries, and thus promotes the function ofmenstruation. It is not a strong emmenagogue, but operates slowly, yetsurely, and in accordance with physiological laws, being eminentlycongenial in its effects upon the female system, and, hence, not liableto do harm. There is danger in employing active driving medicines, besides, no emmenagogue, however powerful, can establish the menstrualfunction so long as the system is in a debilitated condition and theblood reduced. The restorative effects of the "Favorite Prescription"should be secured by administering it regularly, in from one to twoteaspoonful doses, three or four times a day, for several weeks, and asthe system is built up and those symptoms appear which indicate a returnof the menses, their visitation may be encouraged by the use of hot footand sitz-baths, and free doses of Dr. Pierce's Compound Extract ofSmart-weed. But the latter should only be used when symptoms ofapproaching menstruation are manifested. By following out this course oftreatment, a soft flush will gradually take the place of the pallor ofthe cheeks, the appetite will return and the health will be restored. 

ACUTE SUPPRESSION OF THE MENSES may be caused by _strong emotions, _ asexcessive joy, or by violent _excitement_ of the _propensities_, asintense anger, sudden fright, fear, or anxiety. Suppression may resultfrom sudden exposure to cold, immersion of the hands or feet in coldwater, drinking cold water when the body is heated, sitting on the coldground or damp grass, or from a burn or wound. It is not uncommon forwomen to labor in the heated wash-room, pounding, rubbing, and wringingsoiled linen, thereby overtaxing the delicate physical system. Whilefeeling tired and jaded, all reeking in perspiration, they rinse andwring the clothes out of cold water and hang them upon the line witharms bare, when the atmosphere is so freezing that the garments stiffenbefore they finish this part of the task. Is it any wonder that acutesuppressions 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 theovaries, uterus, lungs, bowels, brain, or other parts. No matter whatorgans are attacked the menses are suppressed. The suppression cangenerally be attributed to an adequate cause, resulting inconstitutional disturbance. The severity and duration of the attack andthe power of the constitution to resist it, must determine the gravityof the consequences. 

TREATMENT. As acute suppression of the menses is due to derangement ofthe circulation of the blood, caused by taking cold, by violentexcitement of the propensities or excessively strong emotionalexperience, the prominent indication is to secure its speedyequalization. Give a hot foot, a warm sitz, or the spirit vapor-bath andadminister full doses of Dr. Pierce's Compound Extract of Smart-weed, toproduce free perspiration. Dr. Eberle, a very celebrated medical author, says that he used the Extract of Smart-weed in twenty cases ofamenorrhea, and affirms, "with no other remedy or mode of treatment haveI been so successful as with this. " Our experience in the use of theExtract has been equally satisfactory. Should this treatment notestablish the function, Dr. Pierce's Favorite Prescription should begiven three times a day until the system is invigorated, say fortwenty-eight days, when the above course may be repeated, and generallywith success. Should the case be complicated with inflammation of thelungs, brain, or other vital organs, manifesting alarming symptoms, thefamily physician should be called. The treatment should be active andsuited to the indications of each particular case. When the diseasebecomes chronic, the active stage of symptoms having passed, and itcontinues to linger without making the desired improvement, all themeans suggested for the treatment of suppression from anæmia should beemployed. Their use will be followed by the most gratifying results. Itshould be borne in mind, however, that when we have suggested anytreatment in this volume, it is generally such as the family mayinstitute and apply, and does not, by any means, represent the varietyor extent of the remedial resources which we employ when consulted inperson or by letter. We refer our readers to only a few of the safe andreliable remedies which we have prepared and placed within their reach, and give them just such hygienic advice as we think will best servetheir interests. 

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DYSMENORRHEA. 

(PAINFUL MENSTRUATION. )

_Dysmenorrhea_, from its Greek derivation, signifies a _difficultmonthly flow, _ and is applied to menstruation when that function becomespainful and difficult. Menstruation, like other healthy operations ofthe body, should be painless, but too frequently it is the case, thatdiscomfort and distress commence twenty-four hours before the flowappears, and continue with increasing pain, sickness at the stomach, andvomiting, until the patient has to take to the bed. When the dischargedoes occur, speedy relief is sometimes obtained, and the patient suffersno more during that menstrual period. With others, the commencement ofthe function is painless, but from six to twenty-four hours after, theflow is arrested and the patient then experiences acute suffering. Painmay be felt in the back, loins, and down the thighs. Sometimes it is ofa lancinating, neuralgic kind, at others, it is more like colic. Frequently the distress causes lassitude, fever, general uneasiness, anda sense of lethargy. There are those who suffer more or less during theentire period of the flow, while the distress of others terminates atthe time when a membranous cast is expelled. For convenience ofdescription, 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 ovariesand uterine nerves, which sympathetically _respond_, especially tocutaneous, biliary, and sexual irritation, and when ovarian or uterineirritation is communicated to distant nerve-centres. In the first class, usually comprising lean persons of an encephalic temperament, whateverdisorders the functions of the general system, instantaneously reflectsupon the ovaries and uterine nerves, and the menstrual function Iscorrespondingly disturbed, and, instead of being painless, the flowbecomes spasmodic, with paroxysms of distress. In the second class, which includes those persons who are plethoric, the ovarian and uterinenerves seem to be the origin and centre of irritation, which issometimes so severe as to cause indescribable pain. We have known womenwho affirmed that the severity of labor pains was not so great as thatfrom this cause. In one instance, the subject suffered thus for elevenyears, and then became a mother, and has ever asserted that her periodicsuffering was far more intense than the pain experienced during herconfinement. These neuralgic pains fly along the tracks of nerves todifferent organs, and capriciously dart from point to point withmarvelous celerity, producing nausea, headache, and sometimes delirium. 

IN THE CONGESTIVE VARIETY of dysmenorrhea, the menstrual period may beushered in without pain; after a few hours, the pulse becomes strongerand more rapid, the skin grows hot and dry, the menses stop, there isuneasiness, restlessness, and severe pelvic pains. Evidently, the mucousmembranes of the Fallopian tubes and uterus have become congested, andthe pain results from the arrest of the functional process, theexudation of blood. 

THE CAUSES are plethora, exposure to cold, excitement of the emotions orpassions, and a morbid condition of the blood. Sometimes congestionarises in consequence of a displacement of the uterus. 

IN THE INFLAMMATORY VARIETY, the mucous membrane of the uterus is theseat of irritation. The blood flows into the capillary vessels ingreater abundance than is natural, and those vessels become over-dilatedand enfeebled and so altered in their sensibility as to produce localexcitement and pain. It may be associated with inflammation of theovaries, peritoneum, or bladder. Upon the return of the menses, there isa dull, heavy, fixed pain in the pelvis, which continues until theperiod is completed. There is generally tenderness of the uterus, andalso leucorrhea during the intervals between each monthly flow. 

IN THE MEMBRANOUS VARIETY of dysmenorrhea, the entire mucous membranewhich lines the cavity of the uterus, in consequence of some morbidprocess, is gradually detached and expelled at the menstrual period. 

SYMPTOMS. There are steady pains at the commencement of the menstrualflow, and they increase in violence and become decidedly expulsive. Themouth of the uterus gradually dilates, and finally, the membrane isforced out of the uterus, attended with a slight flow of blood and anentire subsidence of the pain. 

THE TREATMENT, in all the preceding varieties of dysmenorrhea, shouldconsist of measures to determine the circulation of the blood to thesurface, and increase the perspiratory functions. Congestion andinflammation of the internal organs are generally induced by exposure tocold or from insufficient clothing. Sometimes they follow from neglectof the skin, which is not kept clean and its excretory functionencouraged by warm clothing. The domestic treatment at the monthlycrisis should be commenced by the administration of hot foot, andsitz-baths, after which the patient should be warmly covered in bed, andbottles 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 anodyneeffects, which, for this painful affection, is unsurpassed. For theradical cure of this disease, whether of a congestive, inflammatory, orneuralgic character, Dr. Pierce's Favorite Prescription, which is soldby druggists, is a pleasant and specific remedy, which will mostspeedily correct the abnormal condition that produces the trouble, andthereby obviate the necessity of passing this terrible ordeal at everymonthly period. The patient should take two teaspoonfuls of the medicinethree 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 longerseason is required. In the end, the suffering patient will not bedisappointed, but will become a new being, ready for the enjoyment andduties of life. The bowels should be kept regular throughout thetreatment by the use of Dr. Pierce's Pleasant Pellets, if necessary. Ahand or sponge-bath should be used daily to keep the skin active, and befollowed by a brisk rubbing of the surface with a rough towel orflesh-brush. A wet sheet pack will cleanse the pores of the skin andinvite the blood into the minute capillaries of the surface, and thusprove of great benefit. It should be repeated after an interval of sevendays, but ought to be omitted if near the approach of a menstrualperiod. The clothing should be warm, to protect the system againstchanges of temperature; especially should every precaution be taken tokeep the feet dry and warm. The patient should walk in the open air, andthe distance should be regularly lengthened at each succeeding walk. Ifthe course of treatment which we have suggested be faithfully pursued, apermanent cure will be effected. 

IN THE OBSTRUCTIVE VARIETY of dysmenorrhea, some organic impedimenthinders 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 dischargethe menstrual blood. If these efforts prove successful, there is aninterval of relief. Flexion or version of the womb may produce partialocclusion of the canal of the neck of the uterus, thus preventing thefree flow of the menstrual fluid through it. Tumors located in the bodyor neck of the uterus often cause obstruction to the free discharge ofthe menses. Imperforate hymen and vaginal stricture also sometimes causeobstruction and give rise to painful menstruation. As these severalabnormal conditions and diseases will be treated of elsewhere in thisvolume, we omit their further consideration here. 

Partial adhesion of the walls of the neck of the womb may result frominflammation of the mucous lining, and prevent a free and easy exit ofthe menstrual fluid. In many cases, the contracted and narrowedcondition 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 thatcontraction and partial, or even complete, stricture of the cervix, orneck of the womb, often results from the improper application of strongcaustics to this passage by incompetent and ignorant surgeons. Everyperson has observed the contraction of tissue caused by a severe burn, which often produces such a distortion of the injured part as todisfigure the body for life. A similar result is produced when the neckof 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 thewomb, through which the menses pass into the vagina. 

[Illustration: Fig. 3. 

THE UTERINE DILATOR. 

This instrument isintroduced into thecanal of the uterineneck with its bladesclosed. By meansof the thumb-screwthe blades are thenseparated as shownin this illustration, the cervical canalbeing thereby dilatedto the requiredextent. ]

TREATMENT. From the nature of this malady, it will readily be seen thatno medical treatment can effect a radical cure. We must therefore resortto surgery. In a small proportion of cases, the stricture may be curedby repeated dilations of the constricted part of the cervical canal. This may be accomplished by using a very smooth probe which is fine atthe point, but increases in size, so that its introduction will widenand expand the orifice and canal. The stricture may be overcome in manycases by using different sized probes. In some instances, we haveemployed the uterine dilator, represented by Fig. 3. We have alsointroduced sea-tangle and sponge tents into the neck of the womb, andallowed them to remain until they expanded by absorbing moisture fromthe surrounding tissues. The latter process is simple, and in many casespreferable. By means of a speculum (see Figs. 15 and 16), the mouth ofthe womb is brought into view, and the surgeon seizes a small tent witha pair of forceps and gently presses it into the neck of the womb, whereit is left to expand and thus dilate the passage. If there seems to be apersistent disposition of the circular fibers of the cervix to contract, and thus close the canal, a surgical operation will be necessary toinsure permanent relief. In performing this operation, we use a cuttinginstrument called the hysterotome (see Figs. 4 and 5). By the use ofthis instrument, the cervical canal is enlarged by an incision on eitherside. The operation is but slightly painful, and, in the hands of acompetent surgeon, is perfectly safe. We have operated in a very largenumber of cases and have never known any alarming or dangerous symptomsto result. After the incision, a small roll of cotton, thoroughlysaturated with glycerine, is applied to the incised parts, and a largerroll is introduced into the vagina. The second day after the operation, the cotton is removed, the edges of the wound separated by a uterinesound or probe, and a cotton tent introduced into the cervix, andallowed to remain, so that it will expand and thus open the wound to itsfull extent. This treatment must be thoroughly applied, and repeatedevery 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 thewomb, when a thumb screw in the end of the handle is turned, by which a smallblade is thrown out from each side, and as the instrument is withdrawn from thecanal an incision is made on each side, thus enlarging the passage. The upperfigure 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 ofcutting the constricted cervix causes no pain; they often being entirelyunconscious of the making of the incision. The explanation is easy. Thecervix uteri, or neck of the womb, is supplied with but few nerves ofsensation, and is almost as destitute of sensation as the finger or toenails, the paring of which causes not the slightest pain. On thisaccount we never find it necessary to administer chloroform or any otheranæsthetic when undertaking this operation. If the patient be extremelysensitive the application to the cervix of a weak solution of cocaine isquite sufficient to completely benumb or anesthetize the parts so as toentirely avoid all pain from the operation. 

[Illustration: Fig. 5. 

STOHLMAN'S HYSTEROTOME. 

This instrument has two cutting blades which shut past each other, asseen in the lower figure, so as not to cut when introduced into thecanal of the uterine neck. After introduction, the cutting blades areseparated, as shown in the upper figure, the extent of the incisionbeing regulated by the thumb-screw attached to the handles, asrepresented 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 profusemenstruation. This disorder must not be confounded with thosehemorrhages which are not periodical, and which are due to other causes. The term _menhorrhagia_ is restricted to an immoderate monthly flow. Themenstrual flow may occur too often, continue too long, or be tooprofuse. 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 offlaccid muscles and bloodless features. When the menstrual discharge isnatural, it is so gradual that by mixing with the vaginal secretions itis prevented from coagulating, while in this disease, clots are oftenformed. 

SYMPTOMS. In women of a _plethoric_ habit, it is ushered in by itchingand heat in the vagina, pain and a feeling of weight in the loins andlower part of the abdomen, and, at times, the breasts become hot andpainful. There is considerable thirst, headache, and giddiness. At last, the blood appears and flows profusely, and all the violent symptoms atonce 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 casethe periods are more frequent and continue longer, and after a time theyare renewed by any bodily exertion or mental emotion, so that a constantdrain exists. If the flow of blood is not continuous, leucorrheaintervenes. The patient gradually loses strength and becomes languid, her face is pale and usually bloated, livid circles appear around theeyes, the appetite is impaired, the bowels are constipated, and the feetand ankles swollen. Lack of blood in the brain is indicated by headache, ringing in the ears, and dizziness. The patient is nervous andirritable, being disturbed by the slightest noise, and the heartpalpitates after the least exertion. 

CAUSES. The _first_ form is caused by eating too much rich andhighly-seasoned food, drinking wine, porter, ale, or beer, want ofexercise, in brief, whatever induces plethora; the _second_ results froman insufficient or poor diet, leucorrhea, frequent abortions, want ofventilation, inherent feebleness, and whatever depresses the vitalpowers. Either form may be due to syphilitic taints, excessive sexualindulgence, accidents of pregnancy, or organic diseases of the womb. Themorbid affections of the womb most likely to induce menorrhagia, aregranular ulceration of its mouth and neck, fungous degeneration of itslining membrane, and tumors within that organ. As these subjects will beseverally considered hereafter, we shall here dismiss them with thisbrief notice. 

Profuse menstruation is very prone to occur in young women of alymphatic temperament, whose organs are sleazy in texture. 

TREATMENT. To control the excessive flow, the patient should remain inher bed, and assume the recumbent position until the period is passed. If circumstances prevent strict compliance with this rule, it should beobserved as nearly as possible. Warmth should be applied to the feet, and cold cloths, which ought to be removed as soon as they become warmby the heat of the body, should be repeatedly placed upon the back andabdomen. A strong tea made from cinnamon bark, or witch-hazel leaves orbark, taken freely, will prove very efficacious in checking the flow. The fluid extract of ergot, in doses of from half a teaspoonful to ateaspoonful, in a little water or cinnamon tea, is one of the mosteffectual remedies in this affection. Another valuable remedy forarresting menorrhagia is an infusion of Canada fleabane; or the oil ofthis plant may be administered in doses of from five to ten drops onsugar. Gallic acid is also a good styptic to employ in these cases. Ifthere is febrile excitement, a hard pulse, frequent and throbbing, andif there is headache, thirst, parched lips, hot and dry skin, as issometimes the case, then menorrhagia is due to an augmented action ofthe heart and arteries, and the indication of treatment is to diminishvascular action. This may be temporarily accomplished by the use ofveratrum viride, which should be continued until the flow issufficiently diminished. 

The means already suggested will generally prove effective incontrolling the inordinate flow at the time. Treatment that will producepermanent relief should then be adopted. The condition of the skin, kidneys, and bowels, requires attention for noxious elements should notbe retained in the system. To give tone to weakened pelvic organs weknow of nothing more specific in its effects than Dr. Pierce's FavoritePrescription, which is sold by druggists. It should be takencontinuously for weeks, in order to fully correct the extremely weakenedcondition of that organ. It also aids nutrition, and thus tones up thegeneral system, so that in the form of profuse menstruation, resultingfrom debility, the patient is strengthened, her blood enriched, and hernervousness quieted, which constitutes the necessary treatment to makethe cure permanent. 

As women approach the critical age, and menstruation ceases, if they areanæmic, their condition is pitiable. This period is popularlydenominated the _turn of life_. Under favorable circumstances, thevitality is decidedly enhanced, and the decline of this function isattended with a revival of the bodily powers. But when this crisis hasbeen preceded by excessive labor, when intemperance or excesses of anykind have deranged the bodily functions and perverted nutrition, whenthe mind has been long and deeply depressed, or when the insidiousprogress of disease of the heart, liver, or other Important organs, occurs in consequence of irregularities of living, then there is dangerof 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 thatalready suggested. The diet should be light and nourishing, and dailyexercise, such as walking, riding, change of air and scenery, all willcontribute to restoration. Especial attention should be directed to thecondition 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 impairednutrition and disorders of blood, an alterative is required which willinsensibly and gradually restore activity by removing the causes ofderangement. Impairment of nutrition is very frequently associated withfunctional or organic disease of the liver, and curative measuresconsist of the use of alteratives, friction baths, exercise, nutritivediet, and diversion of the mind. Whenever innutrition depends upondeprivation of the blood or torpor of any of the secretory organs, the"Golden Medical Discovery" will prove to be an invaluable remedialagent, 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 PleasantPellets should be employed. The "Favorite Prescription" regulates themenstrual function by toning up the tissues of the uterus andrestraining the escape of the menses from the orifices of theblood-vessels. While the diet should be nourishing, consisting of wildgame, mutton, chicken, and wine, the patient ought not to debilitate thestomach by the use of strong tea or coffee. The circulation of the bloodshould be quickened by riding, walking, exposure to sunlight, and freshair. The patient ought to engage in some light occupation, in which themind will be constantly as well as agreeably employed, but notovertaxed. By pursuing the course of treatment, invalids suffering frommenorrhagia may be permanently restored to health. 

 * * * * *

THE TURN OF LIFE. 

(CESSATION OF THE MENSES. )

Menstruation commonly occurs at regular monthly intervals, during aperiod of about thirty years. The time for its cessation dependssomewhat upon the date of its first appearance. In the temperate zonesit commences at about the fifteenth year, and, consequently shouldterminate at the forty-fifth year. Instances are common, however, inwhich it has been prolonged until the fiftieth and even to thefifty-fifth year. In warm climates it commences and terminates at anearlier age. 

As women approach the critical period of life, if the general health andhabits be good, the discharge may gradually diminish, and, at length, totally disappear, without producing any particular inconvenience, butthis seldom happens. More frequently, the discharge is entirely absentfor six or seven weeks, and when it does return, it is more copious thanusual. In some cases, the flow is not only too profuse, but toofrequent. Many months may elapse before the menses return, and, eventhen, they are apt to be very pale and deficient in quantity. 

The fluctuations of this function occasion irregularities anddisturbances of the general health. When the flow of blood is divertedfrom the uterus, it is liable to be directed to the head or some otherpart of the body. In fact, there appears to be constitutional agitation, and disorders of all the organs. Perhaps one reason for calling this acritical period is, that if there is a morbid tendency in the system, adisposition to develop tumors of the breast or uterus, these are veryliable to make rapid progress at this time, since they are not relievedby the customary, local exudation of blood. It is a time favorable tothe awakening of latent disorder and morbid growths, for, at the declineof the menstrual function, the uterus is not so capable of resistingvitiating influences. 

There is greater liability to irritation of the bladder and rectum, andthe menstrual flow may be superseded by a white, acrid discharge, causedby an inflammation of the mucous membrane of the vagina. Even if thesystem be not enfeebled by excessive losses of blood, debility mayresult from a continued irritation of the uterine organs, and cause themorbid discharge. The nervous system sympathetically responds, becomingexceedingly irritable, and thus implicating in this derangement everybodily organ. In some constitutions, the change of any habit is almostimpossible, particularly if it is improperly acquired, or detrimental tohealth; and so we have sometimes thought respecting this function, thatthe more it has been abused and perverted during the time of Its naturalactivity, the greater is the disturbance occasioned when it ceases. 

TREATMENT. There should be regularity in all the habits of life. Womenare too apt to approach this important period without due care andconsideration. When the physical system is about to suspend a function, it is folly to endeavor to perform the labor or assume theresponsibilities which were permissible when the constitution was morerobust. 

How the duties of each day and hour weigh upon the energies of themother! What intense solicitude and yearning she experiences! Howunselfish is that mother who each day works steadily and faithfully forothers, and who is conscious of the hidden dangers that lurk around herpathway! With confiding faith and love, she commends the interests ofher children to Him who doeth all things well. She anticipates the wantsof her family and strives to supply the desired comforts, thus wastingher strength in the labors prompted by her loving nature. Would it notbe a greater comfort to those children to have the counsel of their dearmother in later years, than to have the bitter reflection that shesacrificed her health and life for their gratification?

Unconsciously, perhaps, but none the less certainly, do women enter uponthis period regardless of the care they ought to bestow upon themselves. Without sufficient forethought or an understanding of the functionalchanges taking place, they over-tax their strength, until, by continuousexertion, they break down under those labors which, to persons of theirage, are excessive and injurious. Is it strange, when woman has thusexhausted her energies, when her body trembles with fatigue and her mindis agitated with responsibilities, that the menses capriciously return, or the uterus is unable to withstand congestion, and capillaryhemorrhage becomes excessive? If the physical system had not been thusexhausted, it would have exercised its powers for the conservation ofhealth and strength. It is better to be forewarned of the ills to whichwe are liable, and fortify ourselves against them, rather than squanderthe strength intended for personal preservation. Let every woman, andespecially every _mother_, consider her situation and properly preparefor that grand climacteric, which so materially influences her futurehealth and life. 

The general health should be carefully preserved by those exerciseswhich will equalize the circulation of the blood, and the regular actionof the bowels should be promoted by the use of those articles of dietwhich contribute to this end. Relieve the mind of responsibility, keepthe skin clean, and enrich the blood with tonics and alteratives. Forthe latter purpose, use Dr. Pierce's Favorite Prescription and "GoldenMedical Discovery. " If these remedies fail, seek professional advice. Acareful regulation of the habits, strict attention to the requirementsof the system, and the use of tonic medicines, will very frequentlyrender the employment of a physician unnecessary

 * * * * *

LEUCORRHEA. 

("WHITES. ")

Leucorrhea is the symptomatic manifestation of some uterine or vaginalaffection, vulgarly called "whites. " We say _symptomatic_, for the whiteor yellowish discharge, which we term leucorrhea, is not a disease, buta symptom of some uterine or vaginal disorder. We call it a _white_discharge to distinguish it from the menses and uterine hemorrhages. Itvaries, however, in color and consistency from a white, glairy mucus toa yellow or greenish, purulent, fetid matter. Sometimes it has a curdledappearance, at others, it is of the consistency of cream. Leucorrhea isthe most common symptom of uterine derangement, and there are fewfemales who are not affected by it at some period of life. It mayoriginate either in the vagina or uterus, and it is accordingly termedeither vaginal or uterine leucorrhea. The nature of leucorrhea isanalogous to that of nasal catarrh. In a healthy state, the liningmembrane of the genital organs secretes sufficient mucus to moistenthem; but, if the mucous membrane is temporarily congested or inflamed, the secretion becomes profuse, irritating, and offensive. Vaginal anduterine leucorrhea are essentially different in character, the formerbeing an acid, and the latter an alkaline secretion, and, while thefirst is a creamy, purulent fluid, the latter is thick and ropy, likethe white of an egg. In fact, the latter discharge is rich in albuminousmatter and blood-corpuscles, hence, its great debilitating effect uponthe 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 ofthe vagina. When this affection is present the patient experiences asense of burning heat, aching and weight in the region of the vagina, violent and throbbing pains in the pelvis, and the discharge is profuseand very offensive. There is also a frequent desire to urinate, and thepassage of the urine causes a sensation of scalding. 

PRURITUS VULVAE. The discharge irritates the nerves of the externalgenital parts, thus producing an almost unendurable itching. Scratchingor rubbing the parts only aggravates the affection. The patient istormented night and day, is deprived of sleep, and naturally becomesdespondent. Pruritus vulvae, in its severest forms, is often developedwhen the discharge is scarcely noticeable. It is the most common resultor accompaniment of leucorrhea. 

VULVITIS. This term indicates an inflammation of the lining membrane ofthe external genital parts. Sometimes the inflammation extends to thedeeper tissues, causing great pain, and even suppuration, resulting inthe formation of an abscess. The attack is indicated by redness, swelling, and a feverish state of the affected parts, which is quicklyfollowed by a profuse flow of yellow pus, and, in some instances, smallulcers are formed on the affected parts. 

SYMPTOMS. The sufferer from leucorrhea becomes pale and emaciated, theeyes dull and heavy, the functions of the skin, stomach and bowelsbecome deranged, more or less pain in the head is experienced, sometimesaccompanied with dizziness, palpitation is common, and, as the diseaseprogresses, the blood becomes impoverished, the feet and ankles areswollen, the mind is apprehensive and melancholy, and very frequentlythe function of generation is injured, resulting in complete sterility. Exercise produces pain in the small of the back and the lower portion ofthe spine, and, owing to a relation of the vaginal walls, the womb fallsfar below its natural position, or turns in various directions, according to the manner in which the weight above rests upon it. Ulcersare apt to appear upon the mouth of the womb, the matter from whichtinges the discharge and stains the linen. Hysteria is often anattendant of this disease. 

CAUSES. The immediate cause of leucorrhea is either congestion, orinflammation of the mucous membrane of the vagina or womb, or both. Theexciting causes are numerous. Among others, deranged menstruation, prolonged nursing of children, pregnancy, abortions, excessiveindulgence in sexual intercourse, uncleanliness, piles, uterine ulcers, and displacement of the womb, are the most common. In brief, it usuallyaccompanies every uterine disorder which vitiates and reduces thesystem. During childhood, particularly in scrofulous children, discharges from the vagina are not unfrequent, owing to worms or otherintestinal irritation. 

Among the organic causes of leucorrhea, are ulceration of the mouth orneck of the womb and tumors. These will be considered hereafter. 

TREATMENT. We have dwelt upon leucorrhea because of its prevalence andin order to exhibit the various forms it may assume. These reasons longago prompted us to investigate it; and, ascertaining the derangement toconsist in a relaxation of the walls of the vagina, attendant upondepressed vitality, for many years we experimented with variousmedicines to find those that would exercise specific properties inrestoring the tissues involved to a natural condition, thereby arrestingthe abnormal discharge. Our efforts in that direction have been verysuccessful, and our expectations more than realized. The treatment whichwe shall recommend is rational, based upon the pathological conditionsof the disease, and has been attended with the greatest success. 

It embraces the use of those general restoratives and specific uterinetonics, so harmoniously combined in Dr. Pierce's Favorite Prescription, a remedy which has achieved unparalleled success in the cure of thisaffection and won the highest praise from thousands of grateful women. It many cases, it is well to accompany its use with alterativetreatment, for which the "Golden Medical Discovery" will be foundespecially effective. It is an absurd practice to arrest the dischargewith astringent injections _alone_. The weak and lax walls of thevagina, 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 theaffected parts, and the "Golden Medical Discovery" is the best generalalterative of which we have any knowledge. They may be taken inalternate doses every day. If the patient is very pale and anæmic, onedrachm of the carbonate, or two drachms of the citrate or pyrophosphateof iron, may be advantageously added to each bottle of the "FavoritePrescription. " If the carbonate be employed, as it is insoluble, thebottle should be well shaken every time before using. The functions ofthe skin should be kept active by frequent baths, and the patient, ifable, should walk or ride in the open air, and freely expose herself tothe sunshine. If the invalid be too weak to exercise much, she should goout in warm weather and sit in the open air. Sunshine is no lessimportant in maintaining animal, than in supporting vegetable growth andhealth. The human being, like the plant, sickens and grows pale, weakand tender, if secluded from the sunlight. The apartments occupiedshould be thoroughly ventilated. Many women are sickly and feeblebecause they live in badly ventilated rooms. 

We cannot too strongly urge in this, as in all other chronic diseasespeculiar to women, that the bowels be kept regular. Frequent, but smalldoses of Dr. Pierce's Pleasant Pellets will prove most beneficial. Ifthe vaginal passage is tender and irritable, an infusion, or tea ofslippery-elm bark is very soothing, and may be used freely with avaginal syringe. Whatever injection is employed, should be preceded bythe free use of Castile soap and warm water, to thoroughly cleanse theparts. One part of glycerine to six parts of water is a soothing lotionwhen there is much tenderness, heat, and pain in the vagina. If there beno great tenderness in the vagina, or if the acute, inflammatorysymptoms have yielded to the lotions already suggested, then a tonic andastringent injection should be employed. 

For this purpose a wash made by dissolving one of DR. PIERCE'S PURIFYINGAND STRENGTHENING LOTION TABLETS, in one pint of hot water is a superiorapplication and will not fail to be of great benefit in controlling thedisagreeable 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 theLotion Tablets by return post. 

These Lotion Tablets have for many years been used in the treatment ofobstinate cases of leucorrhea at the Invalids' Hotel and SurgicalInstitute, and their efficiency has been alike gratifying to bothpatient and physician. 

If _pruritus_ or severe itching, be also a symptom, the itching willreadily yield if the parts be cleansed with Castile or other fine soapand warm water, followed by the application of a compound composed oftwo ounces of glycerine, one ounce of rose-water, and one drachm ofsulphite of soda; or, for the sulphite of soda, two drachms of borax maybe substituted. The following lotion is a good one to relieve pruritus:sugar of lead, two drachms; carbolic acid, half a drachm; laudanum, fourounces; glycerine, four ounces; water, four pints; mix. This may beapplied 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 Syringeillustrated in Fig. 6, as the most convenient instrument foradministering vaginal injections. The fountains supplied by us are ofsoft rubber, and have extra nozzles, with which to make rectal, nasal orear irrigations. There is also a large, long nozzle for vaginalinjections. 

[Illustration: Fig. 7. SOFT RUBBER-BULB SYRINGE]

It is channeled so is to permit the free clearing away of the secretionsas the Douche is employed. The Fountain Syringe can he used withoutassistance, the flow of fluid is gradual, and with a force that can bevaried, by raising or lowering the reservoir, yet is never so great asto be liable to produce injurious effects. 

The syringes usually sold with small nozzles or pipes are of little orno value for vaginal injections. In many instances so small a tube willpass readily into the canal of the uterus, and hence there hasfrequently resulted an injection of a portion of the fluid into theuterus itself, producing severe pain. It is important, therefore, inusing the Vaginal Douche to employ only a large tube that has grooves inits surface for the free clearing away of the fluid as it runs from thefountain. 

Where it is desired to obtain relief from a congested, inflamed orsensitive and irritable state of the mucous surface, the employment of alarge quantity of water as hot as it can be borne, is of the greatestremedial value. It rapidly diminishes the size of the blood vessels, andaids in bringing about a normal circulation in the parts. 

As a rule, in taking the Douche with the Fountain Syringe the rubber bagis filled, and suspended from a nail or hook at a height of from two tofive feet above the patient, and the fluid passes through the tube byforce of gravity, thus requiring no muscular exercise. The force of thestream depends upon the height of the fountain above the outlet nozzle. It is only necessary that the patient should assume a comfortableposition where the fluid which comes from the vaginal canal can flowinto a water closet, or any convenient vessel. 

After a thorough cleansing of the vaginal surfaces of mucus, by means ofthe warm or hot water, it is sometimes advisable to inject remedialfluids. These injections may readily be made with the fountain or bulbsyringe, introducing not less than from two to four ounces. This may beretained sufficiently long to exert its remedial effects upon the mucoussurface, which usually takes from five to eight minutes. The hips shouldbe elevated, and the nozzle of the syringe surrounded by a napkin orother similar material, upon which moderate compression can be made soas to retain the fluid in the vagina for the necessary period. 

When suffering from any uterine trouble, it is necessary to avoid severefatigue. The amount and character of exercise should be suited to thecondition of the patient; while, most important of all, the strictestabstinence from sexual intercourse should be observed. 

To those who are unable readily to obtain the Fountain Syringe aboverecommended we can send by mail, post-paid, one of these instruments onreceipt of $2. 00. 

A Soft Rubber-bulb, or Pump Syringe (illustrated in Fig. 7), not so goodfor making vaginal injections, can be sent by us, post-paid, for from75cts. To $1. 50, the price varying with the quality and size. 

 * * * * *

STERILITY. 

(BARRENNESS. )

Real sentiment and interest center in fecundity, since the desires andhappiness of mankind are consummated in marriage and procreation. Howdreary would life be without love, companionship, and the family! Howprecious 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 manand woman. Each child born supplements the lives of its parents with newinterest, awakens tender concern, and unites their sympathies with itsyoung life. 

How dreary is the thought that one may attain a ripe old age withneither son nor daughter to smooth the decline of life, or sorrow forhis or her departure! How many women desire a _first-born_ of love, theidol of their waiting hearts, a soul, which shall be begotten within, clothed with their own nature, and yet immortal! It is a naturalinstinct, this yearning of the heart for offspring; and yet little issaid upon this subject, in which so much is experienced. All that isbeautiful and lovely in woman, finds its climax in motherhood. Whatearthly 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 ownreproductive powers. If, however, these appear to be deficient, then fewtopics are more deeply interesting or investigated with greater personalsolicitude. Such persons will seldom submit their condition to thefamily physician, for it is a delicate subject, involving personalconsiderations, and, therefor, they prefer to consult with one whocannot connect their unfortunate situation with any of the incidentswhich enter into the history of their lives. This is very natural, andsometimes is the only way to keep private matters profoundly secret. Being widely known as specialists, devoting our undivided attention tochronic affections, and having unusual facilities for the investigationand management of such cases, we have been applied to in innumerableinstances, to ascertain the causes of barrenness and effect its removal. 

It is admitted that the question of a woman's sterility is practicallydecided in the first three years of married life, for statistics showthat less than ten out of a hundred women who do not indicate theirfertility in the first three years of wedlock ever bear children. Wehave treated many who gave no evidence of fertility for a much longerperiod of married life, and who afterwards gave birth to children. Weare unable to state the proper ratio of the number of the married whoare childless; much less have we the right to assume that all whodecline the responsibilities of motherhood are necessarily barren. 

CAUSES. The causes of barrenness may be obliteration of the canal of theneck of the womb, sealing up of its mouth, or inflammation resulting inadhesion of the walls of the vagina, thus obstructing the passage to theuterus. In the latter case, the vagina forms a short, closed sac. Insome instances, the vaginal passage cannot be entered in consequence ofan imperforate hymen. Again, the cause of barrenness may either be adiseased condition of the ovaries, preventing them from maturing healthygerms, or chronic inflammation of the mucous membrane of the neck of theuterus, which does not render conception impossible, but improbable. Itis one of the most common causes of unfruitfulness, because the femaleseldom, if ever, recovers from it spontaneously. It has been known toexist 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 themenses, or any disorder of the uterine functions, may disqualify thefemale for reproduction. Flexions of the uterus, displacements, congestions, and local debility, may likewise prevent fertility. Sterility may result from impaired ovarian innervation or undueexcitement of the nerves, either of which deranges the process ofovulation. Even too frequent indulgence in marital pleasures sometimesdefeats conception. Prostitutes who indulge in excessive and promiscuoussexual intercourse, seldom become pregnant. Any thing that enfeebles thefunctional powers of the system is liable to disqualify the female forreproduction. 

TREATMENT. An extensive observation and experience in the treatment ofsterility, convinces us that, in the majority of cases, barrenness isdue to some form of disease which can be easily remedied. If thepassages through the neck of the uterus be closed or contracted, andthis is the most frequent cause of sterility, a very delicate surgicaloperation, which causes little if any pain or inconvenience to thepatient, will remove the impediment to fertility. In many of thesecases, we have succeeded in removing the contraction and stricture ofthe neck of the womb by dilatation. When the vaginal walls are so firmlyunited as to prevent copulation, a surgical operation may be necessaryto overcome their adhesion. When the hymen obstructs the vaginalorifice, 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 sexualintercourse be indulged in only very abstemiously, conception will bemore likely to occur than if moderation be not exercised. We may alsovery properly allude to the fact that there is greater aptitude tofecundation immediately before and soon after the menstrual periods thanat other times. In fact, many medical men believe that it is impossiblefor conception to occur from the twelfth day following menstruation upto within two or three days of the return of the menses. 

ELONGATION OF THE NECK OF THE WOMB. An elongated condition of the neckof the womb, illustrated by Fig. 9, is frequently a cause of sterility. If this part is elongated, slim and pointed, as shown in theillustration, it is apt to curve or bend upon itself, thus constrictingthe passage through it and preventing the transit of seminal fluid intothe womb. An eminent author says, "Even a slight degree of elongation, in which the cervix, or neck, has a conical shape, has been observed tobe frequently followed by that condition [sterility]. " Our ownobservations, embracing the examination of hundreds of sterile womenannually, lead us to believe that this condition is among the commoncauses of barrenness. But, fortunately, it is one of those most easilyovercome. 

[Illustration: Fig. 9. Conoid Neck. ]

TREATMENT. If the neck is only slightly elongated, this consists individing the slim projecting part, by the use of the _hysterotome_, Ifit 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 seemto those who are not familiar with operations upon the womb, is notpainful. We have never seen any bad results follow it, but have known itto 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 isbent upon itself, as illustrated in Fig. 10, produces a bending of thecervical canal, constricting or obliterating it, and thus preventing thepassage of spermatozoa through it. Version of the uterus in which itstop, 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 itagainst the wall of the vaginal canal, and thus prevent the passage ofspermatozoa into the womb. 'The treatment of these several displacementswill be considered hereafter. We may here remark, however, that they canbe remedied by proper treatment. Our mechanical movements, manipulations, and kneadings are invaluable aids in correcting thesedisplacements. 

DISEASE OF THE OVARIES. Sterility may be due to disease of the ovaries. Chronic inflammation of the ovaries may result from uterine disorders orperitonitis, and is commonly attended with a sense of fullness andtenderness, and pain in the ovarian region. These symptoms are moreapparent upon slight pressure, or during menstruation. This disease iscurable, although it may require considerable time to perfectly restorethe health. When this chronic affection is the result of otherderangements, the indications are to restore health in the contiguousorgans, and to relieve excessive congestion and nervous excitement inthe ovaries. The patient should be very quiet during the menstrualperiod and avoid severe exercise or fatiguing occupations, not only atthose periods, but during the intervals. All measures calculated toimprove the general health should be adopted. Use injections of warmwater, medicated with borax, soda, and glycerine, in the vagina everynight and morning. The surface of the body should be kept clean by thedaily employment of hand-baths, followed by brisk friction. The bowels, if constipated, should be regulated as suggested for constipation. Thesystem should be strengthened by Dr. Pierce's Favorite Prescription, and, if the blood be disordered, no better alterative can be found fordomestic use than Dr. Pierce's Golden Medical Discovery. If the patientdoes not in a few months improve under this treatment, the case shouldbe placed under the immediate care of some physician well qualified byeducation and experience to critically examine and successfully treatthis affection. 

CHRONIC INFLAMMATION AND ULCERATION OF THE UTERUS, A CAUSE OF STERILITY. When enumerating the causes of barrenness we mentioned that chronicinflammation of the mucous membrane of the mouth and neck of the wombwas the most common affection that defeats conception. Of all diseasesof female organs, this is, without doubt, the most common, and, since itdoes not at first produce great inconvenience or immediately endangerlife, it does not excite the attention which its importance demands. Itis overlooked, and, when the attention is directed to the existence ofthis long-neglected disease it appears so trivial that it is notregarded as being the real cause of infertility in the patient. 

When this disease has existed for a long time, the very structure of theparts involved becomes changed. The glands of the cervical membranesecrete a glairy mucus, resembling the white, or albuminous part of anegg. The secretion is thick and ropy, and fills the entire mouth andneck of the uterus, thus preventing the entrance of the spermatozoa. Themucous membrane becomes thickened, the inflammation extends to thedeeper structures, and, on examination through the speculum, we find themouth of the uterus inflamed, hardened, and enlarged, as represented inFig. 22, Colored Plate IV, or in Fig. 23 of same plate. Fig. 25, PlateIV, shows the mucous follicles just as they are found all along the neckof the womb, in a state of inflammation and enlargement, and filled witha fluid resembling honey, giving rise to ulceration and a thickdischarge, as illustrated in Fig. 23, Colored Plate IV. 

Feebleness of the constitution, impoverishment of the blood, ascrofulous diathesis, want of exercise, uncleanliness, tight lacing, disappointment, excessive excitement of the passions, the use ofpessaries for displacement of the uterus, overwork, and taking cold, allpredispose the cervical membrane to chronic ulceration. 

The inflammation may be so mild, and the discharge so trifling inquantity, as scarcely to attract attention. But after it obtains afirmer hold, and, in most cases, it is aggravated by exposure orneglect, the patient experiences dragging sensations about the pelvis, and pain in back and loins, accompanied with a bearing-down sensationand numbness or pain extending to the thighs. 

The discharge is thick, starch-like, and generally irritating. Thepatient becomes irascible, capricious, querulous, and sometimes moodyand hysterical. She is easily discouraged, her appetite and digestionbecome impaired, and she grows thin and does not look or act as when inhealth. 

TREATMENT. In offering a few hints for the domestic management of theseabnormal conditions, we would at the same time remark, that, whilehealth may be regained by skillful treatment, recovery will be gradual. We especially wish to guard the patient against entertaining too strongexpectations of a speedy recovery. Although she may employ the besttreatment known, yet from three to five months may elapse before aperfect cure can be effected. In persons of scrofulous diathesis, inwhom the recuperative forces are weakened, it is very difficult toeffect a radical cure. It is equally true, however, that under domesticmanagement alone, thousands have been restored to perfect health andfruitfulness. 

Hygienic management consists in toning the functions of the skin bydaily bathing the surface of the body, and quickening the circulation bybrisk friction. The patient should rise early in the morning, andexercise in the fresh and invigorating air. Those who sleep in warmrooms, or spend much of their time in bed, will continue to havecongestion of the uterus, and habitual discharges from this enfeebledorgan. The patient should take daily walks, increasing the length of theexcursion from time to time, but not to the extent of producing fatigue. The bowels, if constipated, should be regulated. Strengthen the systemby using Dr. Pierce's Favorite Prescription, to each bottle of which addtwo drachms of citrate or pyrophosphate of iron. The mouth and neck ofthe uterus should be thoroughly cleansed by the use of the syringe, assuggested for the treatment of leucorrhea. The use of the solution ofDr. Pierce's Purifying and Strengthening Lotion Tablets there advisedwill also be beneficial, if thoroughly applied. 

A most valuable course of local treatment, which may be adopted by anyintelligent lady without the aid of a physician, and one that willresult in the greatest benefit when there is morbid sensibility, congestion, inflammation, or ulceration about the mouth or neck of thewomb, consists in applying to those parts a roll of medicated cotton orsoft sponge, allowing it to remain there for twelve hours at a time. Apiece of fine, soft, compressible sponge, as large as a hen's egg, or aroll of cotton batting of two-thirds that size, is thoroughly saturatedwith pure glycerine. Securely fasten to it a stout cord a few incheslong. The vagina and affected parts having been thoroughly cleansed withwarm water and Castile soap, as advised in the treatment of leucorrhea, the sponge or cotton should be passed up the vagina with the finger, andpressed 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 beunmistakably distinguished from the surrounding parts by the sense oftouch. The glycerine, having a very strong affinity for water, willabsorb large quantities of the _serum_, which has been effused into theaffected tissues in consequence of their congestion and inflammation, and thus reduce the inflammation and enlargement. This is the cause ofthe profuse, watery discharge which follows the application. In twelvehours after the sponge or cotton has been applied, it should be removedby means of the attached thread, one end of which has been purposelyleft hanging out of the vagina. Then thoroughly cleanse the vagina withwarm water, use the solution of Dr. Pierce's Lotion Tablets as suggestedfor the treatment of leucorrhea, and repeat the glycerine applicationthe following day or every other day. 

If there is no irritation or tenderness of the vagina, add one drachm oftincture of iodine to each ounce of the glycerine, alternating the useof this with that of pure glycerine; or, the iodine and glycerine may beused every third day, and the glycerine alone on the two interveningdays. As the iodine will color the finger somewhat, it is well to knowthat this unpleasant effect may be almost or entirely avoided by coatingthat member with lard, sweet oil, or vaseline. The stain may be readilyremoved with a solution of iodide of potassium. The use of Dr. Pierce'sAntiseptic and Healing Suppositories as advised on an other page underthe head of Ulceration of the Uterus will aid greatly in effecting acure. 

If your medicine dealer does not have these Suppositories in stock, mail25 cents in stamps to Dr. R. V. Pierce, Buffalo, N. Y. , and a box will besent 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. Bypersevering in this course of treatment, nine-tenths of those who arethus afflicted will improve and be fully restored to health, fruitfulness and happiness. If barrenness continue, the case should beunreservedly submitted, either in person or by letter, to a physicianskilled in the diagnosis and treatment of these affections. 

From the foregoing remarks, the reader will perceive that there are avariety of diseased conditions, any one of which may produce sterility. It is equally true that nearly all these conditions may be easily curedby proper medical or surgical treatment. A frequent cause of barrennessis stricture of the neck of the uterus. No medicine that a woman cantake or have applied will remove this unnatural condition. Fortunately, however, the means to be employed cause no pain, are perfectly safe, andthe time required to effect a cure is short, rarely over twenty orthirty days. 

 * * * * *

DISPLACEMENTS OF THE WOMB. 

The relative positions of the womb and surrounding organs, when in astate of health, are well illustrated by Fig. 1, page 680. The womb issupported in its place by resting upon the vaginal walls, and by a broadligament on either side, as well as by other connective tissues. Bygeneral debility of the system, the supports of the womb, like the othertissues of the body, become weakened and inadequate to perfectly performtheir 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, requiringonly local treatment instead of being considered as a symptom of generalderangement, and, therefore, requiring constitutional treatment. Hence, variously devised supporters have been invented to retain the womb inposition after its replacement. It is a law of physiology, that themuscular system is strengthened by use, and that want of exerciseweakens it. The blacksmith's arm is strengthened and developed by dailyexercise. Support his arm in a sling, and the muscles will be greatlyweakened and wasted. So when artificial supports are used to retain thewomb in position, thereby relieving the supporting ligaments and tissuesof their normal function, the _natural_ supports of the uterus are stillfurther weakened, and the prolapsus will be worse than before when theartificial support is removed. Besides, all these mechanicalcontrivances are irritating to the tissues of the womb and vagina, andfrequently produce congestion, inflammation, and even ulceration, thusrendering the patient's condition much worse than before theiremployment. These worse than useless appliances should never be resortedto for the temporary relief which they sometimes afford. Constitutionaltreatment together with appropriate applications is the only effectualmethod of remedying this morbid condition. 

SYMPTOMS. When the displacement is sufficient to cause any seriousdisturbance, the prominent symptoms are a sensation of dragging andweight in the region of the womb, pain in the back and loins, inabilityto lift weights, great fatigue from walking, leucorrhea, a frequentdesire to urinate, irritation of the lower bowel, and derangement of thestomach. The womb may protrude from the vaginal orifice; in very rarecases, wholly protrudes, and may be inverted. 

CAUSES. As we have already stated, general debility favors prolapsus ofthe womb, but various general and local circumstances and conditionsalso favor its occurrence. Wearing heavy garments supported only by thehips, compressing the waist and abdomen with tight clothing, thusforcing the abdominal organs down upon the womb, are fruitful causes ofthis 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 theuterus from congestion, and inflammation or tumors also favor prolapsus. Abortion may leave the womb enlarged, its supports weakened, and resultin this displacement. 

[Illustration: Fig. 12. Retroflexion, U, Uterus (Womb), B, Bladder. ]

FLEXIONS AND VERSIONS. Instead of sliding down into the vagina, as inprolapsus, the uterus is liable to fall or be forced into otherunnatural positions. When the uterus is bent upon itself, it is called_flexion_. If the bending is backward, it is called _retroflexion_; ifforward, _anteflexion. _ Fig. 12, represents the former condition, theuterus being flexed backward so that the fundus, or upper part of thewomb, is pressed against the rectum, while the neck of the uterusremains 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 asense of weight in the region of the rectum, difficulty in evacuatingthe bowels, and, sometimes a retention of the feces. There may besuppression of the urine and the menses may be diminished in quantity. If retroflexion is due to a chronic enlargement of the uterus, caused byabortion or parturition, the patient suffers from an immoderatemenstrual flow. 

CAUSES. The principal causes of retroflexion are congestion, enlargementand tumors of the uterus. Congestion is liable to occur in womenpossessing an extremely active temperament, as well as in those ofsedentary and indolent habits. Retroflexion is a common displacement inboth married and unmarried women; it is a secondary affection, and, whenit is caused by congestion, the menses are painful and reduced inquantity, and there is pain in the back and a sense of weight in theregion of the rectum. In some instances, there is a reflex irritation ofthe mammary glands, and a consequent secretion of milk. There may alsobe nausea and vomiting, which often lead to the erroneous opinion thatthe patient is pregnant. 

_Anteflexion_ of the uterus denotes a bending forward of the body andfundus 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 isbent upon itself, but the whole organ is completely turned backward orforward. 

[Illustration: Fig. 13. Retroversion. B, Bladder. U, Uterus (Womb). ]

_Retroversion_ of the uterus, illustrated by Fig. 13, signifies a changein the position of the womb, so that the upper, or fundal portion of theorgan drops back toward the concavity of the sacrum, while the neckpreserves a straight line in the opposite direction. The fundus pressesforcibly against the rectum, while the upper part of the vagina bendsabruptly and forms an acute angle near the mouth of the uterus. 

SYMPTOMS. Retroversion is indicated by bearing-down pains in the loinsand difficulty in evacuating the bowels. The feces may accumulate in therectum, because they cannot pass this obstruction. 

CAUSES. Jumping, falling, or undue pressure from the contents of theabdomen, may suddenly cause retroversion of the uterus. Sometimesretroversion results from obstinate constipation. 

_Anteversion_. This term designates another unnatural position of theuterus, in which the fundus, or upper part of the organ, falls forward, as illustrated by Fig. 14, while the neck points towards the hollow ofthe sacrum. This position of the womb is the reverse of that ofretroversion. In its natural position, the fundus of the uterus isslightly inclined forward, and any pressure, or forward traction, isliable 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 frequentdesire to urinate, in consequence of the pressure of the uterus upon thebladder. 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, theprominent indication is to tone up the general system, for by so doingwe also strengthen the uterine supports. 

Digestion should be improved, the blood enriched, and nutritionincreased, so that the muscles and ligaments which retain the womb inposition may become firm and strong. The womb will thus be graduallydrawn into position by their normal action and firmly supported. It is agreat mistake, made by physicians as well as patients, to consider adisplacement of the uterus a _local_ disease, requiring only localtreatment. A restoration of the general health will result in the cureof these displacements, the uterus will regain its tone and muscularpower, and the local derangement, with its attendant pain and morbidsymptoms, will disappear. 

It is true that displacements of the womb may be associated withinflammation and ulcers, which require local treatment, as elsewheresuggested; but simple displacement of the uterus may be remedied bypursuing the following course of sanitary and medical treatment. Sleepon a hard bed, rise early, bathe, and take a short walk beforebreakfast. Dress the body warmly and allow sufficient space for the easyand full expansion of the lungs. Eat moderately three meals a day, ofthose articles which are nutritious and readily digested. Keep thebowels regular by the use of proper food. If they are constipated, useDr. Pierce's Pellets to keep them open and regular. Avoid retaining thestanding position too long at a time, especially when the symptoms areaggravated by it. Many energetic women disregard their increasing pains, and keep upon their feet as long as possible. Such a course is extremelyinjurious and should be avoided. 

As a general restorative and uterine tonic, nothing surpasses Dr. Pierce's Favorite Prescription, which is sold by druggists andaccompanied with full directions for use. If leucorrhea is an attendantsymptom, the treatment suggested for that condition should be employed. The use of Dr. Pierce's Antiseptic and Healing Suppositories, applyingone every third night After having first cleansed the vagina and neck ofthe 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 thewomb 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 thevarious displacements of the womb, nearly all who suffer from suchderangements may be fully restored to health. The patient should notexpect _speedy_ relief. Considerable time will be necessary to bring thegeneral system up to a perfect standard of health, and, until this isaccomplished, no great improvement in the distressing symptoms can beexpected. Mechanical movements are especially effective in this class ofcases. We have successfully treated many obstinate cases in which thedisplacements were very serious. 

 * * * * *

ULCERATION OF THE UTERUS. 

Ulceration is the process by which ulcers, or sores, are produced. It ischaracterized by the secretion of pus or some fetid discharge, and iscontinued as a local disease through the operation of constitutionalcauses. Ulcers are generally symptoms of other morbid conditions. 

Ulcers may form in the _mouth_ or _neck_ of the uterus, and, omittingcancerous ulcers and those of a syphilitic character, which areconsidered elsewhere, may be classified as _Granular_ and _Follicular_. 

[Illustration: Fig. 15. The Ferguson Speculum. ]

GRANULAR ULCER. This variety of ulcerative degeneration is the mostfrequent, and may exist for some time without exciting any suspicion inthe mind of the patient that she is afflicted with any such morbidcondition. There is local inflammation, and the mouth of the uterus isuneven, rough, and granular. If an examination be made with thespeculum, the mouth of the uterus is often found in the conditionrepresented in Fig. 22, Colored Plate IV. 

Figs 15 and 16 represent two different forms of specula. The onerepresented by Fig. 15 consists of a tube of glass coated withquicksilver and covered with India rubber, which is thoroughlyvarnished. That represented by Fig. 18 is made of metal and plated. Byusing one of these instruments, the condition of the mouth of the wombcan be distinctly seen. 

[Illustration: Fig. 16. An Expanding Uterine Speculum. ]

FOLLICULAR ULCER. When the mucous follicles of the neck of the uterusare inflamed they enlarge and become filled with a fluid having thecolor and consistency of honey, presenting the appearance illustrated byFig. 25, Colored Plato IV. This secretion, because of the presence ofthe Inflammation, is not discharged. The follicles, therefore, continueto 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 theulceration. It may be simple or associated with purulent leucorrhea andhemorrhage. If ulceration be slight and local, few symptoms will bepresent; but if it be associated with uterine debility, congestion andinflammation of the mucous membrane of the uterus, the discharge will beprofuse, and there will be fixed pain in the back and loins, abearing-down sensation, and great difficulty in walking. The dischargeis weakening, as it impoverishes the blood, and thus reduces thestrength. 

CAUSES. Ulceration may be induced by any thing that excites inflammationof the lining membrane of the mouth and neck of the uterus. The use ofpessaries, excessive sexual indulgence, injuries occasioned by givingbirth to children, congestions, enlargements and displacements, may alloperate as causes. 

TREATMENT. We cannot too strongly condemn the practice so popular at thepresent time with physicians generally, of indiscriminately burning alluterine ulcers with strong caustics, such as nitrate of silver, chromateof potassium, and other similar escharotics, regardless of the conditionof the general system. Ulcers of the womb must be healed in the samemanner as those upon any other part of the body. It is an irrationalpractice to repeatedly cauterize them, expecting thereby to promotehealing, while the system is vitiated and the vitality far below thestandard of health. Enrich the blood, tone up the system, keep theulcers cleansed by the frequent use of lotions, and they will generallyheal. Caustics often aggravate the irritability and interfere with thehealing processes of nature. Ladies should not unnecessarily submit tothe exposure of their persons. If they perseveringly employ thetreatment which we shall suggest, other local treatment will _veryrarely_ be found necessary. This modern warfare which physicians arewaging upon the unoffending womb is a most irrational practice. Ourgrandmothers got along very well without exposing themselves to thehumiliation and tortures of this new-born empiricism. We do not wish tobe understood as undervaluing or denying the necessity, in rare cases, of examinations of the uterus, or as being unappreciative of the aidafforded in such investigations by the speculum, and the beneficialeffects of local applications made directly to the womb through thatinstrument. What we affirm is, that such examinations and applicationsare, in the practice of most modern physicians, made unnecessarilyfrequent, resulting many times in lasting injury to the patient. 

GENERAL MEANS. As has already been indicated, constitutional treatmentshould be principally relied upon to cure ulceration of the neck of thewomb. Put the system in perfect order and the local ulceration cannotfail to heal. If you have a sore or ulcer upon the leg you verynaturally reason that there is a fault in the system at large or in theblood. You do not apply caustics to the sore, but you go to work torestore the blood and system to a normal or healthy condition and assoon as this is accomplished the open and rebellious sore, or ulcer, heals of its own accord. All you have to do locally, to stimulate theulcer to heal, is to keep it well cleansed by the use of Castile soapand warm water. Just so with ulceration of the womb. Thoroughly cleansethe vagina and neck of the womb once a day by the use of warm water anda 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 softsponge as large as a hen's egg, to which a bit of cord or strong threadis attached to facilitate removing it, may be thoroughly wet in pureglycerine and introduced into the vagina, pressed against the mouth ofthe womb, and allowed to remain there for twelve hours, when it shouldbe gently removed by pulling on the attached string. The cleansinglotion of soap and warm water should be used daily and followed by theglycerine application. 

Every third night instead of the glycerine tampon apply one of Dr. Pierce's Antiseptic and Healing Suppositories, pressing it well upagainst the mouth of the womb, and letting it remain there to slowlydissolve. This will give far better curative results than theapplication of nitrate of silver or other caustics so generally used byphysicians. Besides it has the great advantage of being entirelyharmless in any condition of the parts to which it is applied. TheseSuppositories are powerfully antiseptic, destroying all offensive odorsand have a soothing and at the same time tonic or strengthening effectupon the neck of the womb and the vagina. 

In cases where there is prolapsus or falling of the womb, or Anteversionor Retroversion, or other displacements the use of the Antiseptic andHealing Suppositories will be found to be of great benefit in givingstrength to the supports of the womb and its appendages. 

If your dealer is not supplied with the Suppositories, inclose 25 centsin one-cent stamps to us at Buffalo, N. Y. , and a package will be sentyou, post-paid. 

We are fully aware that this thorough and _systematic_ course oftreatment is slightly troublesome in its application, but what system oftreatment that can promise similar success is not?

This course of treatment must be _rigidly_ adhered to for several weeksbefore we can expect a complete cure of the ulcers and the arrest of theconsequent leucorrheal discharge. 

THE SHEET ANCHOR OF HOPE. Do not fail to bear in mind that no differencehow 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 ofsimple leucorrhea, must be upon _thorough constitutional_ treatment. Tothis end Dr. Pierce's Golden Medical Discovery should be taken threetimes a day in doses of from one to one-and-a-half teaspoonfuls one hourbefore each meal, and in the middle of the forenoon, in the middle ofthe afternoon, and just before retiring for the night, a like amount ofDr. Pierce's Favorite Prescription should be taken. The use of theseblood cleansing and invigorating tonic medicines should be kept up_persistently_ for several weeks; for you must not expect a perfect curetoo soon in a malady that has become chronic and seated. The diseasedoes not become established hastily, but is slow in its inception andprogress, and will only gradually and slowly yield to the best oftreatment, which we believe we have already pointed out. Followed_earnestly, faithfully_ and _persistently_, the use of the means whichwe have suggested will rarely, if ever, fail. 

 * * * * *

URINARY FISTULA. 

A fistula, or false passage, is sometimes formed between the bladder andthe vagina, between the bladder and the uterus, or between the urethraand the vagina. This passage allows the urine to escape through it intothe vagina, and is a source of great annoyance and suffering. Thisaffection is most commonly due to sloughing, caused by severe andlong-continued pressure upon the parts during child-labor. It is alsosometimes produced by the unskillful use of forceps and otherinstruments employed by midwives. Syphilitic and other ulcerations mayso destroy the tissues as to form a urinary fistula. 

TREATMENT. The treatment is purely surgical, and consists in paring theedges of the opening so as to make them raw, bringing them together andholding the parts thus by means of stitches until they heal. By the aidof a speculum, properly curved scissors, needles with long handles, finesilver wire, and a few other instruments and appliances, the skillfulsurgeon can close a urinary fistula with almost as much ease as he canclose a wound on the surface of the body. 

 * * * * *

DISORDERS INCIDENT TO PREGNANCY. 

While some women pass through the whole period of pregnancy withoutinconvenience, others suffer from various sympathetic disturbances, as"morning sickness, " impaired appetite, constipation, diarrhea, headache, "heart-burn, " fainting fits, difficult breathing, and sometimesconvulsions. A strong nervous sympathy exists between the uterus andevery part of the system and this sympathy is greatly intensified bypregnancy, causing the distressing symptoms above mentioned. 

TREATMENT. By proper treatment, most of these evils can be obviated andthe patient made comfortable. By the moderate use of such a nervine anduterine tonic as Dr. Pierce's Favorite Prescription, this nervousirritability may be controlled or subdued, and the disagreeable symptomsthus avoided. 

While the female is pregnant, she should avoid all compression of thewaist and abdomen. For this reason tight clothing, stays, or corsetsmust 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 bypartaking of a little light food and a cup of tea or coffee beforeleaving the bed. If vomiting occurs, and the ejected matter be veryacid, carbonate of magnesia, taken in tablespoonful doses, or somealkali with aromatics, or pulverized charcoal, which can be obtained atany drug store, will afford relief. If constipation or diarrhea beexperienced, small doses of Dr. Pierce's Pellets should be employed--oneor two only at a time. Want of appetite, headache, or a tendency toconvulsions, can be generally overcome by a persistent use of Dr. Pierce's Favorite Prescription, which should be taken in teaspoonfuldoses three or four times each day. Indeed, this valuable medicine notonly relieves the distressing symptoms which frequently attend thepregnant state, but also prepares the system for the ordeal ofparturition (delivery). One or two bottles of this nervine and tonicused previous to confinement, will, in many cases, save hours ofterrible suffering, besides regulating the system, and thus insuring aspeedy recovery. We have received the heartfelt thanks of hundreds ofgrateful mothers for the inestimable benefit thus conferred. TheFavorite Prescription is perfectly safe and harmless to use _at alltimes_ 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 andtreatment of the most frequent classes of tumors which affect theovaries and uterus. 

OVARIAN TUMORS generally consist of one or more cysts or sacs, developedwithin the ovary, and filled with a fluid, or semi-fluid matter, whichis formed in their interior. The cysts vary in size, in some instancesbeing not larger than a pea, while in others they are capable ofcontaining many quarts of fluid. In one case operated upon at theInvalids' Hotel and Surgical Institute, thirty-five pints of fluid weretaken from three cysts. 

The effect of ovarian tumors on the duration of life is shown by thestatistics of Stafford Lee. Of 123 cases, nearly a third died within ayear, more than one-half within two years from the first development ofreliable symptoms, while only seventeen lived for nine years or upwards. 

FIBROID TUMORS of the uterus are composed of fibrous tissue, identicalin structure with that of the uterine walls. They are met with in allsizes, from that of a small shot to that of a mass capable of fillingthe entire cavity of the abdomen. Cases are on record in which thesetumors have attained the weight of seventy pounds. 

The manner in which fibroid tumors terminate life is generally byprostration and debility produced by pressure on, and consequently, interference with, the function of some one or more of the organsessential to life; or by anæmia and debility, produced by the severehemorrhages, which the intra-uterine or sub-mucous form not infrequentlyinduces. 

POLYPI OR POLYPOID TUMORS of the uterus are of three kinds, cystic, mucous and fibrous. They vary greatly in size, sometimes being as largeas a tea-cup; and their point of attachment may be extensive or consistonly of a small pedicle. The cystic and mucous varieties may spring fromany portion of the mucous surface of the uterus, but they are morefrequently met with growing from the mucous membrane lining the cervicalcanal, and pendent from the mouth of the womb, as represented in Fig. 21and in Fig. 26, Colored Plate IV; while the fibrous variety generallygrows from the sub-mucous tissue at or near the fundus, or upperportion, of the uterus. 

The most prominent symptoms of polypoid growths are hemorrhage, which isalmost invariably present, leucorrhea, pain, backache, and a sense ofweight and dragging in the pelvis. 

The best method of treatment, and, in fact, the only effectual one, isremoval with the _écraseur_, polypus forceps, or galvano-cautery. Theoperation is usually attended with little or no pain. 

FOR MORE THAN TWENTY-FIVE YEARS the physicians of the Invalids' Hoteland Surgical Institute, have been successfully treating tumors by meansof electricity. More recently, the medical profession has quitegenerally adopted electrical applications in response to the advice ofApostoli, of Paris. The plan used however is crude. It does not comparein results with the successful and safe procedure that our surgeons haveinvented and pursued. 

Electrical treatment will destroy the life of ovarian and fibroid tumorsif applied early and after the improved methods so long used at ourInstitution. The destructive effect of electricity is modified by theintroduction of certain electro-chemical applications so that it attacksand kills only the cells of the tumor. 

THE VERY LARGE OVARIAN TUMORS, however, are not amenable to treatment bythis process. The walls of their cysts become so thin and weak, whilethe pressure of the fluid from within is so great, that sudden andspontaneous rupture is liable to occur at any time and produce death. Removal by a cutting operation is necessary in such cases. Fortunatelythis procedure, as skillfully modified and perfected by experience, has, in the hands of our surgeons, proven free from the dangers and hazardcommon to Ovariotomy. This is due to skillful operation and to the factthat in our Institution the sanitary arrangements are as perfect as itis possible to make them. Everything is at hand in the way ofinstruments and appliances likely to be required, and the entireprocedure is conducted upon the principles of perfect cleanliness andantisepsis, which obviate the risk of inflammation and blood-poisoning. 

Furthermore, our nurses have had such fine training and such a vastexperience in their attendance upon such cases, that wants areanticipated, and details, that would escape those not so well qualified, are looked after so thoughtfully and vigilantly that the convalescenceis rapid, as well as being in every way comfortable and safe. Under suchconditions

OUR SURGEONS HAVE COMPLETED A LONG LIST OF REMOVALS OF OVARIAN TUMORSWITHOUT A SINGLE DEATH!

We are, therefore, _warranted_ in stating that

THE DANGERS DUE TO THE PRESENCE OF THESE TUMORS ARE FAR GREATER THAN THESLIGHT RISKS OF REMOVAL BY THE SKILLFUL METHODS EMPLOYED BY OURSURGEONS. 

Owing to a change made in the anæsthetic used, the painful andpersistent vomiting that often follows abdominal operations isprevented. This does away with the greatest of all the dangers attendantupon the operation of Ovariotomy, and favors speedy recovery. Food, asadministered in the form of artificially digested and concentratednourishment, 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 theabdominal walls is large, proportionate to the size of these tumors. This is an error. Even in the largest cystic tumors where thedevelopment is immense, a small incision only, is made--simplysufficient to bring the walls of the tumor in view and admit, perhaps, two or three fingers. The tumor is then rapidly emptied of its contentsby means of a powerful suction apparatus. Adhesions, if any exist, arethen carefully removed, and hemorrhage therefrom prevented; after whichthe large sac of the tumor, which when collapsed is like a thin bag, isreadily 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 sametime, does not leave any irritating substance, such as burned andcharred flesh, rubber, silk, or any other unabsorbable material, withinthe abdomen. The parts are left unbruised and without any poisonousgerms in contact. 

Our surgeons have met with phenomenal success in removing OvarianTumors, by the operation of Ovariotomy. Thus far, in a career extendingover a long period of time and embracing the removal of a long list ofthese morbid growths, they have not had a single fatal case. 

The following cases illustrate our method of treatment in a few of themany cases that have been under our care. Each case is typical of aclass:

[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. Aboutfour years before coming under our observation, she discovered a smallbunch, as she expressed it, in the left ovarian region, which graduallyincreased in size until, when she consulted us, it caused considerablepain in the region of the liver from pressure, and interfered withrespiration. Her general health was becoming much impaired. She statedthat she had consulted a prominent gynecologist in this city, who hadtold her that the attachments of the tumor were so extensive thatovariotomy (removal with the knife) was out of the question, and that, therefore, he could only give her palliative treatment. This unfavorableprognosis only added mental anguish and despair to her physicalsuffering. On examination, we found a large multilocular cystic tumor, represented by Fig. 17, with very thick walls, extending from the leftovarian region obliquely upwards and to the right, so that it pressedmore 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, asthe doctor whom she had previously consulted had stated, were soextensive that its removal with the knife could not be thought of. Wewere not disposed, however, to give the case up as hopeless. We told herthat we would do what we could for her, but as to what the result of ourtreatment would be, we could not definitely say. She placed her case inour hands, and we resorted to the above described treatment. She wastreated two and three times per week for more than two months, at theend of which time, the tumor had decreased in size fully two-thirds. Ithas ever since remained stationary, and has given her no trouble orinconvenience 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 toconsulting 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 insize. On examination, we found the morbid growth to be about the size ofa 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 hermother had died a few years previously from the shock and hemorrhageresulting from an operation for the removal of a large ovarian tumor, performed by the late lamented Dr. Peaslee, of New York. The same coursewas pursued in this case, and at the end of six weeks' treatment, thetumor 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. Shehad suffered for eight years from profuse menstruation and dysmenorrhea, with a membranous discharge, and, for several months before consultingus, she had experienced severe pain and a soreness in the pelvic organs. Her bowels were obstinately constipated, it being next to impossible forher to have an evacuation, and she possessed a pale and careworncountenance. Upon examination, we discovered a hard, incompressibletumor, represented in Fig. 18, attached to the posterior wall of theuterus, which caused anteversion of the womb, and which pressed upon therectum so as to produce great obstruction. She was treated by means ofelectrolysis, with injections into the substance of the growth, for onemonth, at the end of which she resumed home, with the tumor reduced fromthe size of a pint bowl to the size of an egg, and her health greatlyimproved. After going home the tumor continued to grow less until, atthe end of a few months, her home physicians could detect no trace ofit, 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 complainedof severe pain in the back and a frequent desire to urinate. Menstruation was profuse, and the bowels were constipated. Onexamination, we found an inter-mural fibroid tumor, represented in Figs. 19, developed in the anterior wall of the uterus, and pressing upon thebladder. The womb was enlarged, measuring three inches in depth, and wasslightly anteflected. A month's treatment, with electrolysis andinjections into the tumor, arrested the growth and diminished the sizemore 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 hadhad several abortions, brought about intentionally. Six months beforeconsulting us, a tumor, about the size of an egg, was discovered by herhome 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 anordinary tea-cup. It was developed in the posterior wall of the womb, asrepresented in Fig. 20. Three weeks' treatment reduced the tumor twothirds. 

[Illustration: Fig. 21. U, Uterus. P, Polypus. ]

CASE VI. A widow lady, aged 52. She was examined ten years ago by two ofthe most distinguished physicians of New Haven, Conn. , who pronouncedher sufferings due to cancer of the uterus. She was then suffering fromrepeated hemorrhages, and other symptoms. They gave her palliativetreatment, and told her that to interfere with the morbid growth wouldonly shorten her life, and that by leaving it alone she might liveseveral years. By and by the hemorrhages ceased and she passed thechange of life, but she continued to be troubled with a sensation offullness in the pelvis, pains in the back, and frequent headaches. Onexamination we found not a cancer, but a large polypus, as representedin Fig. 21, which had caused all the trouble. It was quickly removed, without pain, and her health restored. Thus, through an error ofdiagnosis, she was made to suffer physically and mentally for ten, longyears of her life, in constant dread of a horrible death. 

 * * * * *

TESTIMONIALS. 

While we have a great cloud of witnesses testifying to the efficacy ofour treatment of the diseases described in this volume, yet for lack ofspace we can here introduce only the following:

LARGE FIBRO-CYSTIC TUMOR. 

[Illustration: Miss Duke. ]

PRONOUNCED INCURABLE BY MANY EMINENT SURGEONS. HEALTH RESTORED AND TUMORREMOVED WITHOUT CUTTING. 

WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N. Y. :

_Gentlemen_--I cheerfully send you the following testimonial, and hopeit may induce some sick person to seek relief where it is sure to befound. 

We never truly appreciate health until it forsakes us. 

For six years, I suffered all the tortures and fears attendant on thegrowth and development of a fibro-cystic tumor. I tried to have thetumor removed, but found it impossible. I had the very best medicaladvice the South affords, but every physician rendered the same verdict, 'incurable. ' How that word, for months, rang in my ears--'INCURABLE. ' Itseemed stamped on my mind in letters of fire. What I suffered, both inmind and body, cannot be imagined. But for my unbounded faith in God'sgoodness and mercy, I doubt not, I would have given up and died. But Itrusted in Him to direct me in the way to find relief. One hope stoodout before me like a beacon light; and that was to find the means to goto Buffalo, N. Y. , to Dr. Pierce's famous Invalids' Hotel and SurgicalInstitute. At last the opportunity came, and I bid my loved ones a sadfarewell, (not one of them ever expected to see me again, alive) andwith a sister to relieve me of every care on the journey, we started forthe Institute. 

On arriving at the Invalids' Hotel, I was too sick and fatigued to treatwith civility the sweet-faced, lady-like housekeeper who received me, orthe gentle nurses who tried so patiently and kindly to minister to mywants. 

I had read a good deal about the Invalids' Hotel, and expected to seewonderful things; but like Sheba's Queen, I could truthfully say, 'thehalf had never been told. ' The many ways, means, and appliances, for therelief of poor sufferers surpassed a thousand fold anything I had everimagined could come within the scope of human skill. The skilledphysicians were not only able and attentive, but on meeting one, if itwere every day, they always had a ready smile, a warm hand clasp, and anencouraging 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 eventemperature, even to the halls, that during my four months' stay, Inever had the slightest cold. Not only the comforts of life, but everyluxury that the most exacting could demand, were fully supplied. I sawmany poor sufferers, from various diseases, made well and happy, and Itoo, with the other happy ones, found relief, and that without the useof the knife or an anæsthetic of any kind. I would urge all poor chronicsufferers, it matters not what the trouble may be, to go to Dr. Pierce'sInstitute and be cured. If any one similarly afflicted cares to knowmore of my case, I will gladly answer any questions, if she will onlywrite me, and enclose addressed and stamped envelope in which to reply. During my stay at the Invalids' Hotel I never lacked for anything thatwilling hands and warm hearts could supply, and I came away feeling thatI was leaving a sweet, luxurious home and many warm friends, but with anew lease of life and perfect confidence in the ability of thephysicians, for I know I could not possibly have lived two monthslonger, had I not found relief. To-day I am well, rosy and happy, with aheart full of lasting gratitude for the kind treatment and cure which Ireceived 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 effortsto cure me. A tumor that had existed almost from my childhood wasgradually killing me. From frequent hemorrhages, I had become as paleand bloodless as a ghost, and so weak as to be scarcely able to stand orwalk. Frequently the loss of blood was so great as to cause such longfainting spells that my family thought me past mortal help. How I livedto get to your place is yet a matter of wonder. 

We appreciated the fact that in the skill of your surgeon lay my lastand only hope. The result proved his abilities. The restoration of myhealth, when it was so generally and for so long despaired of, wasmiraculous, and I cannot sufficiently express my gratitude and thanks. 

The comfort that was given by the kindly attention of your nurses is oneof the very agreeable memories of your home-like and pleasantInstitution. With much gratitude, I am, Respectfully yours, Miss ANNIE BOLIN, Leon, Kan. 

NOTE--The above case had been pronounced cancer of the womb by homephysicians. 

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 yourInstitution, hoping it may induce others to avail themselves of yourskill. In December, 1890, I went to you, after suffering five years withtwo fibroid tumors of the uterus. The tumors had grown rapidly for sixmonths prior to my going to you for treatment, and had become quitepainful. Under your treatment they entirely disappeared and my healthwas entirely restored. The treatment I received from your able corps ofphysicians and nurses was all that could be desired, and I would furtherstate that your Hotel and Surgical Institute possess all therequirements 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, withoutrealizing any pain, a large cyst, or Multilocular Tumor (ovarian)weighing 62 pounds, by your surgeons. Then, with kind and watchfultreatment, the care of good and faithful nurses, and by the blessing ofan all-wise Providence, I was sitting up in twelve days from that time;had no inflammation or fever, kept gaining, and in five weeks returnedhome. I am feeling better than I have for two or three years. Icheerfully and truthfully recommend the Invalids' Hotel and SurgicalInstitute to all afflicted as I was--with tumors, or any chronicdisease. The rooms are large and pleasant, the best of food is served, and everything possible is done by the physicians, nurses, andattendants connected with the Institution, to render the visits of theafflicted pleasant and desirable. 

Accept the grateful thanks of my husband and myself for your good careand great kindness to me during my stay at your Hotel, and I wish youall 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 invaluableservice, the saving of a life, is an acknowledgment of the same. Minewas a long-standing, stubborn, constitutional difficulty; chronic, anddefying _all_ previous treatment. Under the care of the doctors of theelegantly appointed Invalids' Hotel and Surgical Institute the diseaseyielded. Could I persuade some of my fashionable friends to spend asummer or winter at Dr. Pierce's rather than at "resorts" more or lessunsuited to weary or sick people, there might rise up an improvedgeneration. The electrical appliances at the Invalids' Hotel areprobably the finest in the world. With them the administration ofelectricity for the absorption and removal of all abnormal growths, especially in my sex, is an _assured science_, and no experiment. Icordially commend all my fellow sufferers to the tender care of theInvalids' 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 skillfultreatment received at the hands of your surgeon specialists. I had beengiven up to die, with an abdominal tumor and abscess. My case was notunderstood, before coming to you. Although operated upon twiceunsuccessfully by others, my life was despaired of. I am happy to statethat after a few weeks' stay in your Institution, with a skillfuloperation which owing to my extreme feebleness, was performed withoutany Chloroform or Ether (local anæsthesia only being employed), andwhich resulted in the removal of the tumor and abscess, I was perfectlycured, and have since enjoyed excellent health. I am now restored to mychildren and family, and have much to thank you for. The kindness andattention received from your physicians and nurses while in the hotelcould 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 NERVOUSPROSTRATION. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N. Y. :

[Illustration: Mrs. Gibbons. ]

_Gentlemen_--I most gladly express my appreciation of the treatment Ireceived at the Invalids' Hotel and Surgical Institute at Buffalo. WhenI first applied to you for treatment I could sit up but a few minuteseach day, and my physician had told me I never could be any better. Ibegan to improve very soon after receiving and commencing to use yourmedicines. I continued to use them for some months, following thespecial instructions faithfully as I could, and steadily improved inhealth. My trouble was of such a nature that it was necessary for me toreceive personal treatment, and I spent six weeks at your Institute. Thekindness 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 havetaken no others since, and my health is very good indeed. I can hardlyrealize that I am the same person that used to suffer so much for twentyyears 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 theInvalids' Hotel and Surgical Institute, Buffalo. The operation wasperformed with consummate skill. The Hotel is first-class in everyrespect, 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 firstclass 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 Institutecould ask that I would not willingly give. I fully realize that I owenot only my good health, but my life to the wonderful treatment receivedat the Invalids' Hotel and Surgical Institute, and would earnestlyrecommend any person needing the best medical or surgical attention togo for relief and cure to your Institution at Buffalo, N. Y. Words areinadequate to express the gratitude I owe you in so successfullytreating 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 youngunmarried woman, left home expecting to die. She had several physicians. None of them could give her any definite information as to the nature ofthe growth or other than unfavorable expectations as to its probableeffects. 

It was successfully removed. The patient being able to be up and aroundin about two weeks with no unfavorable symptoms. Cure perfect. WORLD'SDISPENSARY MEDICAL ASSOCIATION, Buffalo, N. Y. :

_My Dear Doctors_--Many months have passed since I have written youconcerning my health. I have remained perfectly well, and, in fact, myhealth 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 familythought that I would not return alive from your Institution. Yourskillful operation and removal of the tumor, which weighed over thirtypounds, 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 MedicalAssociation. You saved my life after I had given up all hope. The kindcare that all gave me was something that could not be paid for withmoney. It was like being at home. I send you my picture, which will giveyou some idea of the change for the better in my looks. I am now marriedand 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 sincethe removal of the tumor five years ago--that my general health isperfectly restored, and I grow stronger and stronger. And since thattime I have two boys, healthy, and growing as strong as can be, and Ifeel very well satisfied with the care of the good and faithful nursesand physicians. 

I cheerfully and truthfully recommend the Invalids' Hotel and SurgicalInstitute 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 forthe better in my looks. 

Accept the grateful thanks of my husband and myself for your good careand great kindness to me during my stay at your hotel and our wishes foryour 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 inthirty days I walked out of the Invalids' Hotel sound and well. Thetumor that caused my sufferings had gradually developed during a periodof several years. The trouble induced an inflammation of the bladder andI had to endure that torment in addition. There were times when I couldnot touch my feet to the floor. Walking was an agony that I could hardlybear. I faithfully tried good physicians and the various remedies andtreatments 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 theyare also the kindest and most agreeable that I have ever met. Your hotelis comfortable, home-like and perfectly clean. 

The treatment was wonderfully successful in my case. The removal of thetumor was accomplished without pain. I can highly endorse localanesthesia instead of using chloroform or ether. My recovery was rapidand I continue in good health and think of you all with thanks and goodwishes. 

 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 monthstill it was about the size of a child's head. 

From anxiety and worry, the patient had grown nervous and generallymiserable. It was successfully removed by electrolysis, no knife norother cutting instrument being employed. In ten days the patient wasable 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 eversince I left your Institution. I am perfectly well and enjoying as goodhealth as ever I did. The treatment you so skillfully applied hascompletely restored my health, and I feel that I owe you a debt ofgratitude that I can never repay. I am constantly sounding your praiseamong my friends, and know that I can never speak of you in too highterms. I once despaired of ever feeling well, --to-day, I am jolly andlike another being. May you long be spared to minster to the afflicted. 

 Very respectfully, MRS. HANNAH JOHNSON. 

NERVOUS PROSTRATION; DEBILITY; DYSPEPSIA; "FEMALE WEAKNESSES, " CURED BYSPECIAL HOME-TREATMENT. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N. Y. :

[Illustration: Mrs. Nicholson. ]

_Gentlemen_--For a number of years I suffered with a complication offemale troubles; I tried various remedies from physicians but nothingseemed 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 mynervous system, resulting in a complication of other troubles amongwhich was nervous dyspepsia. Words fail to express what I endured atthis time. Only those who have passed through a similar experience canimagine the distressing symptoms accompanying this disease; I couldneither eat nor sleep, was growing very thin in flesh and life seemed aburden to me. 

This was my condition when I wrote to your Institution for help. Ireceived a very encouraging letter and commenced treatment at once. Ihad not used their remedies a week before I began to feel better, and asI continued the treatment my health gradually improved. All thedistressing symptoms have disappeared and my general health is restored. Accept my sincere thanks for the interest manifested in my case and thehappy results obtained. I am now the mother of a fine baby girl, and Ishall 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 atall, being troubled with womb and urinary diseases; but I can gladly saythat had it not been for your medicine I could not have lived a greatwhile longer. 

I hereby give your medicine a high recommendation for the marvelous workit 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 andRectal disease. My disease was of very long standing and had baffled theskill of our home physicians. I went to the Invalids' Hotel and SurgicalInstitute, and received treatment of their specialist. Under hisskillful care and kind attention I soon regained my strength and feltthat my former life and ambition were again restored to me. I cannotspeak in too high praise of this famous Institution; the rooms are largeand cheerful, the food of the very best, the nurses kind and attentive, and the staff of physicians and surgeons skillful and of largeexperience. 

 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" andleucorrhoea or whites, previous to taking your medicines. I took sixbottles of your "Favorite Prescription, " and was entirely cured of bothin six months; it is four years this month, since I was entirely well ofboth those diseases and have never had any signs of their appearancesince, and I am satisfied the "Favorite Prescription" saved my life, forI could hardly walk around, when I commenced taking your medicine, and Ithink it is a God's blessing to me, and a great credit to you that Iever took your medicine, for had I not taken it, I think I would havebeen in the grave now, and I can highly recommend it to all who sufferfrom these two complaints. 

I was pronounced incurable by the best doctors here in the West. I gaveup all hopes and made up my mind that I was to be taken away from myhusband and baby of two years old. I was sick all of the time--could noteat anything at all. In one week, after beginning the use of yourmedicine, my stomach was so much better that I could eat anything; Icould see that I was gaining all over, and my husband then went and gotme six bottles: I took three of them and my stomach did not bother meany more. 

We sent to you and got the People's Common Sense Medical Adviser, andfound my case described just as I was; we did what the book told us, inevery way; in one month's time I could see I was much better than I hadbeen; we still kept on just as the book told us, and in three months Istopped taking medicine, only three times a day, and continued for sometime 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 lookeddead. I could not enjoy myself any where, I was tired and sick all thetime. I could hardly do my housework, but now I do that and tend a biggarden, 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 mychildren I was left in a weak, run-down condition; it seemed to me thatmy nerves were unstrung very bad: I did not suffer much pain, but Ithink I suffered everything any one could suffer with nervousness; mylife was a misery to me. I doctored with seven different doctors and gotno relief; then I took almost all kinds of patent medicines and got norelief from them, but got worse all the time, when I chanced to get oneof your little pamphlets. 

I thought I would write to you, and waited as I thought to hear thatthere was no help for me; when my answer came and you said you couldcure me great was my joy. I had taken your medicine about a month when Ibegan to improve and in a few months was entirely cured. 

My recovery was like coming out of the dark into the light, so great wasthe change. I will advise all sufferers to go to you for relief--I don'tthink they will be disappointed. When I commenced taking your medicine Iweighed 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 FavoritePrescription now, and last summer every one thought she was going withconsumption; four of her father's family had died with it in five years:she has taken one bottle of "Favorite Prescription, " and now she isbetter 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 skillprompts me to make a statement of my case. 

At the birth of my last baby (a boy weighing 14 pounds at his birth), Icontracted womb disease. And for three years previous to treatment, Ihad been a great sufferer from prolapsus. Owing to a more serious injurythan prolapsus, received at childbirth, my physicians told me that "Icould never hope for recovery. "

After delivery, I kept my bed for seven weeks. At the expiration of thattime 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 sideextending down into my groin, accompanied by great soreness. 

After repeated attempts, with my body inclined to that side and yieldingto the drawing, I finally succeeded in walking--a violent trembling allthe while in the parts affected. 

Three months after the birth of my baby, I tried to take hold of myhousehold duties--then my troubles increased, and with them came aseries of "Doctors' bills. "

I consulted two of the best physicians, besides trying all the medicinesI heard tell of, that were recommended for such diseases; but failed inobtaining a cure from any of them; my relief was only temporary. Mycondition 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 atall. I was irritable and nervous with a dull headache and constipation;hands and feet cold and clammy, except the palms and soles; a burning ontop of my head. At this stage of my disease my bladder was badlyaffected--the "neck" becoming enlarged and the water collecting therecaused a protrusion to over half the size of a tea cup, leaving it sodry and harsh, that it was with the greatest difficulty I could walk atall; a sudden jar, sneeze, or even the slightest pressure, would forcethe water out, leaving me in a spasm of pain. At this stage (22 monthsafter confinement) menstruation returned for the first time since thebirth of my baby. I had already suffered as much as I thought itpossible to bear, and live, but my sufferings were even greater afterthis; my womb was ulcerated and inflamed; nervousness increased toviolent shaking, over which I had no control; circulation so feeble thatthe extremities were scarcely supplied with blood, they were constantlycold and clammy. My sleep broken and disturbed, life was fast becoming aburden to me, For months, however, I endured this torture; I hadabandoned work altogether; I could be up but a few moments at a time andcould not walk across the floor without excruciating pain. There was nosleep, no rest, and after a week and even more, would pass during whichI would never close my eyes in sleep, even when morphine, opium andchloral, were administered. My body seemed a dead weight, while my mindwas alive to all my sufferings. There seemed to be a burning pressureabout 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, faintingfeeling over me, making it difficult to breathe at all. During mymenstrual periods I suffered a "thousand deaths. " My appetite was gone, mind and sight impaired, strength and flesh all gone. I was a pitiableobject to look at, divested of all that made life endurable for me. Ihad baffled the skill of two physicians, and was left, after three yearsof agony, to die, a "hopeless wreck, " worse than death. 

Such was my condition when I applied to you for treatment. After usingmedicines only six days I began to improve; my nerves were steadier;circulation better, hands and feet warm. Nine days after taking yourmedicines they restored the function again. I will confess I expected tosuffer death again--I did not think the medicines had had time to effecta change within so short a time. Imagine my joy and surprise upon wakingnext 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, myimprovement was so remarkable, that it seemed almost a delusion. Myappetite had returned, and I was hungry for the first time in over ayear. I slept well--awoke refreshed and feeling stronger. After twoweeks, I was able to walk around the house and yard without support; aday or two after that I walked a hundred yards, visiting and spent theday. In three weeks time I went home (I had gone to my mother's beforetreatment, as I and many others thought, to die). 

At the end of one month there was no symptom, nor sign, of the olddisease. I was able to be up all day, resting a short time at noon. Tobe 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 increasedfourteen pounds in five months after treatment. I have taken no medicinesince except one bottle of Dr. Pierce's Favorite Prescription, fouryears ago. At this time (nine years after treatment), I find my healthstill 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 housework and everything; can do a day's work with less fatigue than I havefor years before treatment. I feel sure that I would have been in thegrave years ago if it had not been for your medicines. I advise allother ladies who are troubled with the same disease to apply to you fortreatment. 

Be assured, that whenever I have it in my power I shall recommend yourinvaluable remedies. I thank you a thousand times for what you have donefor 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 avery critical condition. I could scarcely walk for inward troubles--butI cannot stop to speak of one disease, for I had such a complication ofdiseases. Now I am doing my own housework and in the past four weeks Ihave entertained forty-seven people, and I think I certainly am doingwell. It is with the greatest pleasure that I recommend all who areafflicted to go to the Invalids' Hotel and Surgical Institute. TheSurgeons are honorable, trustworthy gentlemen, who will do all theypromise; and, being men of large experience, they know just what courseof treatment to pursue from first to last, so that an invalid can restassured that no experimenting will be done. 

For seventeen years I was an invalid and never had better health than atthe 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 thirtydays' treatment. I am happy to say there is no return of the oldtrouble, and all my friends were so surprised to see me so well afterbeing an invalid so long. I shall never regret the day I went to theInvalids' Hotel. You ought to see me now--I am so healthy, I shall neverforget your kind treatment of me, and the nurses too were so kind andattentive--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 forexamination and treatment. I was at that time suffering from profuse andpainful menstruation, complicated with obstinate constipation, fromwhich I had suffered many years. I cannot speak too highly of yourtreatment of my case, as it was both prompt and thorough and resulted ina radical cure of the above named diseases, and I desire to recommendall who are thus afflicted to apply to your eminent staff of physiciansfor relief, as they cure when others fail. My advice to all who areafflicted is, if you wish to get well, go where they make such diseasesa specialty. I hope that many others may be as thoroughly cured as Ihave 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 andnerves were also affected. My physician told me I had Bright's Diseaseof the Kidneys. I suffered a great deal in various ways, at times. Ifelt as if life were a burden to me; about that time Dr. Pierce's CommonSense Medical Adviser came into my possession. I read it carefully, andI thought if Dr. Pierce can not cure me perhaps he can give me somerelief. I wrote to him, describing my symptoms and feelings as well as Icould, 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 mea box of medicines enough to last one month, especially prepared for mycase. 

I continued taking his medicines for about thirteen months, and at theend of that time I felt like a new woman; that has been almost sevenyears now and my health is still good. 

The benefits derived from Dr. Pierce's Medicines are lasting, and Iadvise 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 forit, and more to. The Doctors are courteous gentlemen and the bestPhysicians I have ever met with in my life. My treatment while at theInstitute did me more good in one month than all the doctors everywhereelse combined. My ailment was Paralysis and Female Weakness. Yourtreatment did me good while at the Institute, and I have also beengreatly 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. WhenI 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 wouldadvise all people who have chronic diseases to go to the Invalids' Hoteland Surgical Institute for help, for it is a grand place and prices arereasonable. We use your Family Medicines--your "Pellets" and "GoldenMedical 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 everhaving any children until after the time of your treatment. 

We now have two little boys, and we are happy. This picture shows myhusband, 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 myhealth, which had at that time become very much impaired from theeffects of uterine disease, indigestion and chronic constipation. I wasalso troubled with frequent attacks of nervous headache which renderedme very miserable. 

A line of treatment was outlined by your specialist, which I followedclosely, and I immediately began to improve under the use of themedicine advised. The benefits were so marked that within two or threemonths I was able to discontinue the use of the medicine, and have sincethat time been enjoying good health. I attribute my cure to the use ofyour medicines, and I heartily thank you for the benefits received, aswell 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 availthemselves of the benefit of your invaluable medicines. In June, 1890, Itook typhoid fever of malignant type; for two months I hovered betweenlife 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 nervousprostration; could not move myself in bed nor bear to be moved by themost careful nurses without experiencing excruciating pain. I had thebest medical attention in the community, but they failed to give relief. My friends wrote to Dr. Pierce, stating my condition and requestingtreatment for me. He treated me for two months; by that time I had somuch improved that I did not think it worth while to continue thetreatment longer, and my health has been such that I have not hadoccasion to lie in bed two days together since. I feel under lastingobligations to Dr. Pierce, and thank God for blessing the world with soable 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 generaldeclining health--female weakness, heart disease and rheumatism--anddespaired of ever getting well. Physicians afforded me only temporaryrelief. It was not until I commenced doctoring with Dr. R. V. Pierce thatI experienced any decided benefit. My health has gradually improveduntil now I feel like a new being. Language fails to express mygratitude for this cure, which is due wholly to your life-saving andlife-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 generalbreak-down, lasting three years. I placed myself under the treatment offour different physicians. At last, giving up all hope of recovery athome, I was making arrangements to go to a Sanitarium in Michigan forspecial treatment. One of your small books with blank enclosed washanded to me; I filled out the blank, and thought I would try ratherthan leave home and little ones, --"Happy decision;" two months' specialtreatment and I was well and happy, and to-day, I have the very best ofhealth. 

 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 forthree years before I applied to you. I had tried several doctors butthey did me no good, and I grew worse all the time. Finally I wrote toyou for special treatment, and thanks to Dr. Pierce for being the meansof 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, atthe Invalids' Hotel and Surgical Institute, and greatly benefited, I donot hesitate to recommend you and your Faculty to all who may need theservices 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 FavoritePrescription--three bottles of it and am getting well fast; I can do myown work, which I have not done for almost two years; I do my ownwashing and all of my house work; I have gained about six pounds takingyour remedy. You cannot know how glad I am that I tried your "FavoritePrescription. "

 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 FavoritePrescription and "Golden Medical Discovery. " I was under doctors' carefor two years with womb disease, and gradually wasting in strength allthe 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 andhis "Golden Medical Discovery, " and by the time I had taken one-halfdozen bottles I was up and going wherever I pleased, and have had goodhealth and been very strong ever since--that was two years and a halfago. 

 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 hisfarm--I had them to cook for--to wait upon, and my family to care for. Iworked 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 knewnot; I had a severe misery in my back, pain in my head; the monthly flowbecame so excessive--came on too often; lasted eleven days. When theflow would stop then there would be yellow discharge of thick matteryappearance. I had bearing down in the lower portion of the womb--greatpain 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, lightchills, hay fever; had pain in my stomach like colic. My womb was verylow down; the mouth was a large hard knot--was so sore I was compelledto have a soft seat to sit on; severe pains in my thighs; pain down thesides of the abdomen; pain in my breast, pain between my shoulders; mybowels costive; my nervous system prostrated; my digestion impaired; Ihad a desire to urinate all the time, could not pass only a few drops ata time; on standing a few hours, it would form a crust on thechamber--red, grainy substance; I was bloated all over my body. My feetand legs were swelled tight, and I was in so much pain day and night Icould not sleep; I could not eat any food only a little sweet milk and alittle corn-bread; I lived in this way for four years; I could not walkacross 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 someextent; none of them could cure me--none of the four could regulate themenstrual flow, they could not cure those offensive discharges. I wasgiven up to die by all four of them; my family and friends expectedevery day I would die. 

I got one of your Memorandum Books; I read it carefully, and I washoping 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 couldgive me relief; though I felt ashamed to tell a gentleman, a doctor Inever saw, those things concerning my afflictions; but I was sufferingterribly. I hoped for relief and I found it. I am happy to tell you I amwell. I was spared to be cured by your good advice and good medicine andto spread your fame. 

When I received the book you sent me and a letter telling me what totake, and what it would do for me, I was very feeble; I had just got upfrom one of those bad spells--so weak that I could not sit up for morethan an hour at a time. My husband went and got the medicine and asyringe. I began its use, as you advised, and took the medicine as youdirected; I have taken your medicine seven months; the first month myimprovement was slow; I began to have strength; my pain began to banish;my appetite began to come; I commenced to sleep sound and the bloatingbegan to go down; the pain in my head was gone; palpitation of theheart, also the misery in my back disappeared; the pain in my womb beganto banish; the first time the monthly flow appeared, it wascontrolled--it was regulated--it went so light with me that I could goall the time without a cane. I have not had one spell to confine me tobed in seven months; I have done all the cooking for my family all theyear; the pain in my stomach disappeared; the yellow discharge also--thebearing down banished. I have no pain, no aches, no bad feelings. I feelbetter to day, than I have in ten years. I now enjoy life, enjoy myfamily, enjoy my friends. I enjoy the pleasure of telling my friends whocured me, and what medicine it was that cured me; he should have thehonor. It is Dr. Pierce!

I was at death's door when I began to take his medicine, and followedhis advice. It was his "Favorite Prescription, " "Golden MedicalDiscovery" and the "Pleasant Pellets" that cured me. I also used thelotion, or wash advised, with a syringe. 

Now, I wish you to accept my best wishes, and hearty thanks for what youhave done for me. 

Last winter I gave my sick friends the pamphlets which were around thebottles of medicine; some of them are going to take it; it gives greatsatisfaction here; I will take no other myself; it will come the nearestto raising the dead of any medicine I ever saw in my life; it saved mylife, when four doctors gave me up to die. My God bless you in yourwork, 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 wouldnearly always send me to bed; I would lose from two to four quarts ofblood. I had womb trouble pretty bad and my bladder would trouble menearly all the time, by continually wanting to urinate, with smarting, burning pains. My husband got me a bottle of Dr. Pierce's FavoritePrescription. 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 withleucorrhea and female weakness, and ulcers of the womb. She has beendoctoring with every doctor of any good reputation, and has spent lotsof money in hospitals, but to no purpose. She continued to get worse. She was greatly prejudiced against patent medicines, but as a lastresort we tried a bottle of Dr. Pierce's Favorite Prescription. We hadseen some of your advertisements, and Mr. Cummings, a west-sidedruggist, advised us to try a bottle. We tried it with the followingresults: 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 gratitudeto you for having been the means, under Providence, of restoring me tohealth, for I have been by spells unable to walk. My troubles were ofthe womb--inflammatory and bearing down sensations and the doctors allsaid they could not cure me. 

Twelve bottles of Dr. Pierce's wonderful Favorite Prescription has curedme. 

 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 orseven years ago, my health began to gradually fail; some of my friendsas well as myself thought I was going into consumption. I began takingDr. Pierce's Favorite Prescription, "Golden Medical Discovery" and his"Pellets, " and was greatly benefited; took half a dozen bottles at thattime, did not take any more for several years, when I began to go downagain. I was married November, 1889. The next September had amiscarriage. The summer following my health was very bad; I then got onedozen bottles and took as directed. My health was much improved and amnow the proud mother of a healthy boy 22 months old. My health is nowmuch 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 wasaccompanied with backache and a tired and miserable feeling all over;left side hurt me very much, and could not lie on that side, and thedoctor said it came from affection of the spleen; had a great deal ofheadache; was costive, and suffered terribly from erysipelas; it nearlyset me crazy, so great was the burning and itching; sometimesexperienced severe burning in the stomach. I took twelve bottles of yourmedicines, six bottles of Dr. Pierce's Golden Medical Discovery and thesame amount of his "Favorite Prescription. " was using them for about sixmonths, and can say that they did their work well. I have ever sincefelt like another person, and do not think I can say enough in theirpraise. I have no more weakness, and all evidence or erysipelas hasdisappeared. 

 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 FavoritePrescription. The effect has been simply marvelous; a single bottlerelieved me of all pain and enabled me to sleep at night, which I hadnot been able to do for a long time. For three months I have not had anyreturn of the complaint above named. I feel as well as I ever did. Ishall heartily recommend "Favorite Prescription" to all afflicted as Iwas. 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 thebirth of her child, eight years before; had a headache with burning andthrobbing sensations; and a hurting in her stomach; there was a deadaching and gnawing or drawing of the stomach as she described it; sharppain in the stomach extending to her right breast and shoulder. Weighedin health 135 pounds, but was reduced to 95 pounds; was weak; couldscarcely walk at all, was sick at stomach a great deal; when her monthlysickness came on had much pain and the sickness of the stomach remaineduntil menstruation stopped. She writes:

WORLD'S DISPENSARY MEDICAL ASSOCIATION Buffalo, N. Y. :

_Gentlemen_--"I have taken about six bottles of your 'Golden MedicalDiscovery' and 'Favorite Prescription, ' and am glad to say that I feelbetter and stouter than I have felt in a long time. I can work all daynow and not be tired at night. My head don't trouble me now. When Icommenced the use of the medicine I weighed 89 pounds, and to-day Iweigh 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 alwaysin the house. I shall never forget those nights when I was down withpneumonia. Had it not been for Dr. Pierce's Golden Medical Discovery Iwould not be a well man to-day. One bottle stopped the cough and nightsweats. 

My wife was troubled with leucorrhea so bad that we did not know what todo until Dr. Pierce's Favorite Prescription was brought into the houseand 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 wasnearly bed-fast; my life was a misery to me. I have taken eight bottlesof your medicine and it has cured me. If I could tell the whole world ofyour medicine I would do it. If any woman undergoing the "change oflife" will take Dr. Pierce's Golden Medical Discovery and his "FavoritePrescription, " according to directions, they will cure her. When I begantaking them I could scarcely do anything and now I can do all myhousework 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 ofthe time I was in constant pain which rendered life a great burden. Icannot express what I suffered. I had eight doctors and all the medicineI 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. Igot so weak I could not walk around. I had to keep my bed, thinking Iwould never get any better. 

One day my husband got one of your little books and read it to me. Hesaid 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 weeksmy appetite was better; I was able to sit up in bed. I wrote to theWorld's Dispensary Medical Association, at Buffalo, N. Y. , and describedmy case; they sent me a book on woman's diseases. I read carefully andfollowed the directions as near as I could, and took the medicine fortwo years, With the blessing of God and your medicines I am entirelycured. 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 thatI was a sufferer from a very painful condition of the vagina and fromirregular menstruation. In fact the latter was true from its firstappearance. 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 bottlesof it and one of the "Golden Medical Discovery. " After I had taken twobottles of the "Favorite Prescription, " my menses began to be moreregular and I was also relieved of the other diseases. Before I begantaking the medicine, I felt great lassitude and weakness at times, but Inow feel quite strong. 

I can confidently recommend Dr. Pierce's Favorite Prescription to anyone 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 lowwith it that I could not sit up long at a time. We called our familyphysician, and he said I had consumption. All our neighbors thought sotoo. I had pains through my chest and spit up blood. I commenced withyour "Golden Medical Discovery" and had only taken it two or three dayswhen I felt like a different person. I took four bottles of the medicineand it cured my cough. Have not been bothered since, until a short timeago 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 medicinein the world. It saved my life. I don't think any one would die ofconsumption if they would take Dr. Pierce's Golden Medical Discovery. Irecommend it to all my friends, and tell them what it did for me. Yoursrespectfully, Mittie Gray

LEUCORRHEA, "FEMALE WEAKNESS. "

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N. Y. :

[Illustration: Mrs. Jones. ]

_Gentlemen_--I have used your "Favorite Prescription" and mustacknowledge to you and the public also, the benefits I received from theuse of a half dozen bottles of it. My condition was pitiful before I waspersuaded to use it. I had leucorrhea, no appetite, cold feet, weakness, fainting spells, melancholy. I felt that I would soon leave my childrenmotherless. I fell off in flesh to a pitiful looking object. My friendsaround said I must be consumptive. My family doctor gave me nearly allkinds of blood medicine for over a year--all kinds of tonics to build upflesh, but nothing seemed to benefit me. 

Last September--one year ago, I began using Dr. Pierce's FavoritePrescription, being convinced that my disease was female weakness. I hadonly used it three days when I began to feel better and, after usingthree bottles accompanied by the "Discovery, " I felt as though I waswell, and continued its use until I had used half a dozen bottles forfear of a relapse. 

Was a living picture of surprise to my friends. They had all expected mydeath. I have given birth two months ago to a baby and no return of myold disease. I hope that all females, dragging about with pain andweakness, dyspepsia, melancholy feelings, restlessness at night, and notfeeling 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 whichsettled on my lungs, and I had a very severe attack of asthma, which wasso bad that for three weeks I could not lie down in bed at all. I had aterrible cough, in fact, every one thought I had consumption and nothinggave me relief until I took your medicines, using two bottles of"Favorite Prescription" and two of "Golden Medical Discovery. " Theycured me and I have had no return of the dreadful cough since, and thathas 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, whichI 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 ovariantumors and leucorrhea; the treatment they gave me only producedtemporary relief. I grew worse with leucorrhea all the time until Ichanced 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 havefilled here, which I used with great success. I am entirely free from myold trouble--leucorrhea. I only used three bottles of "FavoritePrescription. "

I could not thank you enough for the cure. When I commenced with yourremedies I weighed one hundred and nine pounds; I now weigh one hundredand 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 notdo any work. The Grip left me with a weakness, my head felt very badlyand 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 distressby beating so fast and loud at times. 

In May I commenced using Dr. Pierce's Favorite Prescription; took sevenbottles of that, and then, by your advice, began taking Dr. Pierce'sGolden Medical Discovery. I took five bottles of that, making twelvebottles 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. Isuffered greatly for twelve years. Four years ago my health became sopoor 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 thenconsulted Dr. R. V. Pierce, of Buffalo. Through his good advice I beganusing his "Favorite Prescription, " having taken in all eight bottles of"Prescription" and two of his "Golden Medical Discovery. " I am atpresent enjoying better health than I have for twelve years. As it isnow three years since I quit using those medicines and I have no returnof 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 meto take your "Golden Medical Discovery. " I had not had my courses forsix months; after I had taken your medicine about two months, I waswell. 

When one of my daughters with a baby two weeks old was in so much painthat she could not rest day or night, I went to her as quickly as Icould, and commenced giving her your "Favorite Prescription. " The nextmorning the pains were all gone. She said, "oh, mother, I would havedied if you had not come. I do feel so good. " Your medicine makes peoplefeel like they wanted to live. There is a woman at Verdi who had severalchildren who died with consumption of the bowels and _chronic diarrhea_. She had another one who was going the same way. The doctor said it wasbound to die. I went there and gave it five drops of Dr. Pierce'sExtract of Smart-Weed, and increased the dose every time its bowelsmoved, until I got to a half teaspoonful. The next morning the child wasalmost well. That woman says I saved her baby's life. 

I could write a week and not tell half the good your medicines have donethrough 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 quicklyas I could get some hot water, I put hot applications on his stomach andbowels, and gave him a few doses of your Extract of Smart-Weed. He gotwell 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 myown work, and I know Dr. Pierce's Favorite Prescription is what helpedme. 

We never think of doing without Dr. Pierce's Pleasant Pellets in thehouse. 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 FavoritePrescription. I feel it my duty to say to all women who are sufferingfrom any disease of the womb that it is the best medicine on earth forthem to use; I cannot praise it too highly for the good it did me. Ifany 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 medicinehad done for me and others whom I know, and I think it raised her fromthe death-bed; her husband thinks it a miracle that she got better. Myhealth 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 thatafter I was married I used them in my own family. Two different times Ihave used the "Discovery" when physicians told me they could only patchme up--I was so bad and getting steadily worse. I sat down and wrote toyou; even after the letter was written I felt so worthless it seemedfoolish to try, so kept my letter for some time thinking it better notto trouble you with it, but finally mailed it little thinking youradvice and the "Discovery" could so speedily restore me to my usualhealth. 

A near neighbor used it for a cough occasioned by a sudden cold, andless than one bottle stopped the cough. We use the "Pellets" for malariaand the numberless ills and epidemics that go the rounds, always withhappy results; it saves us physicians' bills and much suffering. Weconsult your Common Sense Medical Adviser as our family physician. Itsaves much anxiety and fruitless journeyings after a physician, perhapsto find them gone or unwilling to breast the storm or heat, to saynothing of the delay and danger of being too late. 

Both my sister and myself have used your "Favorite Prescription" andknow it to be what it is represented by you to be. I can conscientiouslyrecommend those of your remedies we have used. I am willing to answerletters 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 triedthree 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 "FavoritePrescription, " and then I wrote to him and he told me just how to takethem. I commenced last Christmas and took eight bottles. I now feelentirely well. I could stand on my feet only a short time, and now I doall my work for my family of five. My little girl had a very bad coughfor a long time. She took your "Golden Medical Discovery" and is nowwell 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 suffereduntold misery. I commenced taking your medicines and found relief beforefinishing one bottle. After using your medicine eleven months, I made myhusband the present of a twelve pound boy. I think it is the bestmedicine 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 wombtrouble. I cannot find language to describe the tortures I suffered. 

Sixteen weeks ago I began to use your medicine and now feel better andstronger than I have felt for years, in fact my health is thoroughlyrestored and there are no signs of any return of my former trouble. Iowe it all to your wonderful "Favorite Prescription" which I shallalways 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 Ibegan treatment with Dr. Pierce's Favorite Prescription, for Leucorrheaand Uterine Debility than I have for sixteen years. I am cured of mytrouble and now weigh one hundred and sixty-six pounds, whereas myweight for many years stood at one hundred and twenty-five pounds. Withpleasure, 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 generalweakness. Was exceedingly nervous and very gloomy and despondent; hadpoor appetite, constipation, distress in stomach after eating, and couldnot 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 FavoritePrescription, as it has done me a world of good and undoubtedly saved mybaby'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 workto speak of. I was in such misery that many times, as I lay down for thenight, 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 inall, 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 myfamily 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. Ihave been using his "Golden Medical Discovery, " "Favorite Prescription, "and "Pellets" for several years, for troubles incident to the "turn oflife. " I have found them to be of very great benefit to me, andcheerfully 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 walkacross the room without great suffering, but now I am able to do my ownwork, thanks to your wonderful medicines, I am a well woman. I sufferedall the time with a weight in the bottom of my stomach, and the mostsevere bearing-down pains, low down, across me, with every step Iattempted to take. I also suffered intense pain in my back and righthip. 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 sufferedgreatly from headaches, and the thought of food would sicken me. Now Ican eat anything, and at any time. My friends are all surprised at thegreat change in me. Every one thought I would not live through the monthof August. Two of my neighbors are using your medicines, and say theyfeel 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. Ithink, and so do my relations, that if it had not been for yourmedicines that I could never have lived. I had many physicians beforebut got no relief until I began to take Dr. Pierce's FavoritePrescription and his "Golden Medical Discovery. " I then commenced to getbetter right away. I kept getting better and am now entirely cured. Theyare the best remedies for women and all their ailments. 

I suffered from severe pain in back and region of womb, frequentheadache, was pale and sallow, with dark circles around eyes, was verynervous, cross, fretful, had spells of crying, and was out of sortsgenerally. 

 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 nowork. I had five different physicians, who pronounced my case a poor orimpoverished condition of the blood, and uterine trouble. I suffered agreat deal with pain in both sides, and much tenderness on pressing overthe womb. I bloated at times in my bowels and limbs. Was troubled withleucorrhea. I could not sleep, and was troubled with palpitation of theheart. Suffered a great deal of pain in my head, temples, forehead andeyes. I had a troublesome cough, and raised a great deal, and at timesexperienced a good deal of pain in my chest and lungs. My voice at timeswas very weak. I suffered excruciating monthly, periodical pains. Sincetaking seven bottles of your "Favorite Prescription" some time ago, Ihave enjoyed better health than I have for more than four yearspreviously; in fact, for several months past I have been able to work atsewing. I have gained in weight thirty-nine pounds since taking yourmedicines; the soreness and pain, of which I formerly complained somuch, 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 beganthe use of your "Favorite Prescription, " coupled with "Golden MedicalDiscovery. " She has no more trouble with falling of the womb, and shenever feels any pain unless she stands too long. She has no bearing-downpains since she began the use of your remedies. She does nearly all ofher 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 doneher, 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'sFavorite Prescription, it having completely cured her of a serious wombtrouble of long standing. She took five bottles altogether, and she hasborne a large, healthy child since. There has been no return of thecomplaint. 

She only wishes every poor, suffering woman should know of theinestimable value your "Favorite Prescription" would be to them, andthanks you, gentlemen, from the bottom of her heart, for the benefit shehas 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 youmy testimonial. I can conscientiously recommend your medicines to anysuffering woman. I think they are indeed the best medicines for "femalecomplaint" that has ever been invented. Had it not been for them Isurely 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 "FavoritePrescription" 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 isthe best medicine she has ever tried for her case; she is in betterhealth 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 getany better under that treatment so I thought I would try Dr. Pierce'sFavorite Prescription and "Golden Medical Discovery. " I felt betterbefore I used one bottle of each. I continued their use until I took sixbottles of each. In three months' time I felt so well I did not think itnecessary to take any more. In childbirth it does what Dr. Piercerecommends it to do. I would like to recommend Dr. Pierce's Extract ofSmart-weed to those who have never tried it; it surely is the best thingfor cholera morbus, or pain in the stomach I ever used; it WORKS like acharm. 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 yourwonderful medicine, when I commenced your medicines I could neither eatnor sleep; my hands and feet were constantly cold. I had leucorrhea fortwenty years and my monthly periods were never regular, occurring aboutonce in three weeks. I used three bottles of Dr. Pierce's Prescriptionand two of his "Golden Medical Discovery, " and am a well, hearty womanto-day--thanks to your kind advice and excellent medicine. Our familydoctor said to-day, "I can't beat Dr. Pierce's Favorite Prescription; itis 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 tosuffering 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 yearshave been under the care of many good physicians, who, I must say, haveonly given me relief for a short time. I cannot describe the constantpain and torment to which I was subjected every moment of my life, and Iwas so reduced in flesh and strength that I could scarcely walk acrossthe floor and had little hope of ever being any better. 

I was induced, by the advice of a friend, to take your "FavoritePrescription, " 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. Youadvised me to take six bottles more of the "Favorite Prescription, "which I did, and in a reasonable length of time after taking it, I feltvery grateful for the happy relief I obtained. I do not suffer near somuch with my heart as I did before taking the "Favorite Prescription. " Ihad not been able to do any kind of work at all for two years, and I amnow 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 badhealth for twelve months or more. I gave them each several bottles ofthe "Favorite Prescription, " and it entirely cured them. 

I would send you my photo. , as you request, but have none, and there isno place nearer than Natchez, Miss. , thirty miles distant, where I couldhave one taken. 

I now thank you most kindly for the happy relief and cure which myselfand 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. Iwas In bad health; age was working upon me, and had ulceration of thewomb; I could not get about; I took Dr. Pierce's Favorite Prescriptionand it cured me; I felt ten years younger. I have not had any return ofmy trouble. I am the mother of thirteen children and I am fifty-threeyears old, have never seen a better woman's friend than your medicine. Ihave recommended it to my friends here, and it has never failed in anycase, 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 receivedfrom the use of your medicines. I must say that your "FavoritePrescription" is the best female regulator on earth; my wife has beencured by the timely use of it. I have been using the "Golden MedicalDiscovery" and "Pleasant Pellets, " and I am fully satisfied they are allyou claim them to be; so I wish you abundant success, and hope that theAlmighty 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. Ihad frequent spells of fainting, terrible pain in my head, and life wasa burden to me. I was attended by one of the best physicians in ourtown, 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 bottleI felt greatly benefited. I would advise all ladies similarly afflictedto 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, andthe older she grew, the worse she was until she was the picture ofdeath: the physicians could not do her any good. 

I heard of your "Favorite Prescription, " for women, and I gave her threebottles, 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 foundanything 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 andat last was given up by my physician to die, besides spending almost allwe had. After five months' treatment with your Doctor Pierce's FavoritePrescription, I now enjoy most excellent health. I would, to-day, havebeen in my grave, and my little children motherless, had it not been foryou 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 calledour home doctor, but he got no better. Finally he had the St. Vitus'sDance, and our doctor did not know what to do. So I wrote to you and didas you told me: I got two bottles of your "Favorite Prescription, " andone bottle and a half did the work all right. At that time, eighteenmonths ago, his weight was 85 pounds, now it is 135 to 140; he isfourteen 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'sFavorite Prescription for "Falling of the Womb. " I was troubled withbearing down pains and pains in my back whenever I would be on my feetany length of time. I was recommended to try Dr. Pierce's FavoritePrescription, which I did with happy results. I feel like a new personafter 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 mysickness four years ago. I took several bottles of "Pellets, " one of"Golden Medical Discovery, " and two of "Favorite Prescription" andgained right along after I had been taking them. I am at a loss to givemy sickness a name, as my physician called it a "Complication ofDiseases, " resulting from change of life and over-work. I take greatpleasure in recommending your remedies to suffering women. May you livemany years to administer to the suffering and afflicted is the wish ofyour 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 hasdone for me; I am stronger now than I have been for six years. When Ibegan your treatment I was not able to do anything. I could not stand onmy feet long enough to wash my dishes without suffering almost death;now I do all my housework, washing, cooking, sewing and everything formy family of eight. 

Your "Favorite Prescription" is the best medicine to take beforeconfinement that can be found; or at least it proved so with me. I neversuffered as little with any of my children as I did with my last, andshe is the healthiest we have. I recommend your medicines to all of myneighbors, and especially "Favorite Prescription" to all women who aresuffering. Have induced several to try it, and it has proved good forthem. 

 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 monthof pregnancy, and have continued taking it since confinement. I did notexperience the nausea or any of the ailments due to pregnancy, after Ibegan taking your "Prescription. " I was only in labor a short time, andthe physician said I got along unusually well. 

We think it saved me a great deal of suffering. I was troubled a greatdeal 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 shebegan using Dr. Pierce's Favorite Prescription, and by the time she hadused one bottle of it and one bottle of his "Pellets, " she could walk ahalf a mile with more ease than she could walk across the house beforeshe began to take it; she says she thinks it is just what all weaklywomen 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, butto-day, I am enjoying perfect health. 

I took four bottles of the "Prescription" and two of the "Golden MedicalDiscovery. " 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 "FavoritePrescription. " At that time, I was so miserable (and had been so formany years) that I could scarcely drag myself around. Concluded to tryyour medicine. I took half a dozen bottles and I have not had a returnof 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 hadbeen an invalid. Becoming convinced that it was her only hope, we boughtsix bottles of Dr. Pierce's Favorite Prescription and "Golden MedicalDiscovery. " To the surprise of the community and the joy of myself andfamily, in one week my wife commenced to improve, and long before shehad taken the last bottle she was able to do her own work (she had notbeen able to do it before for seven years), and when she had taken thelast 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 byuterine and spinal weakness with irritation of the same. In the Springof 1890 I became so exhausted that I was compelled to keep to my bedwith symptoms of paralysis in the lower limbs, and many otherdistressing symptoms. I accidentally obtained one of Dr. Pierce'sMedical Advisers from a friend, and finding my ailments so welldescribed therein, I wrote to Dr. Pierce for his advice, which he sentby return mail. For my recovery he requested me to use his "GoldenMedical Discovery, " his "Favorite Prescription, " and his "PleasantPellets. " He also gave me some directions for every-day living. Thesemeans accomplished my complete cure. I am thankful that we can have suchreliable 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 ofThick Neck, Nervous Prostration, Weakness and a complication of ailmentsby Dr. Pierce's "Discovery" and "Favorite Prescription. " She says: "Myhealth 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 gratitudefor the benefit I have received from your treatment has induced me torecommend you to all whom I know to be sick. " "I have known of two orthree 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 takenwith a spasm which frightened me so that my menses became suppressed. Isuffered severely with pressure on the brain so that I often thought Ishould go insane. I also had severe pain in the ovaries, and bearingdown pain. I consulted a physician, who treated me for awhile till Ibegan to feel worse, and consulted another physician whom I knew hadtreated several women for like ailments. He gave me medicine which didme no more good than that prescribed by the first physician. 

Finally, after an examination, the doctor said that he should have tooperate on me in order to have my health restored. 

As my husband and I had heard and read so much about Dr. Pierce'smedicines we decided to try them. We had Dr. Pierce's Common SenseMedical Adviser. I took three or four bottles of Dr. Pierce's FavoritePrescription and one bottle of "Golden Medical Discovery" and one vialof "Pellets. " After using these I felt perfectly cured. As I am alwaystroubled more or less with biliousness, I keep your little "Pellets" onhand and find relief by using them. One of them taken after meals actssplendidly 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 Ihave written in regard to the cure of my little son of Goitre (that asurgeon of N. Adams said could never be cured). 

I do hope that by so doing some little one may escape the misery mylittle one suffered for over a year until I began the use of the "GoldenMedical Discovery. " I followed your directions found in the little bookaround the bottles. Before the first bottle was gone, he could eat andsleep 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 wouldnever have known he ever had a tumor there. He is now hearty andhealthy. Sleeps as good as any child and is full of life. He does nottake anything to prevent a return, and has not for over a year. 

I have one of your Common Sense Medical Advisers, and found it worthfive times what I gave for it; I have helped others to get it and the"Medical Discovery" and "Favorite Prescription" have brought relief tomany through me. I use the "Prescription" off and on; it has given mestrength; 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 tothe 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 monthlycourses. Of course at first I paid but little attention to it, hoping itwould amount to nothing and probably wear away. But I slowly but surelygrew worse, and at last resolved to apply to the doctors for help. Mywater came often, and in small quantities, and with great pain, and withred brick-dust deposit. I was attacked with severe womb trouble, bloodypiles 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 stillseemed impossible for me to get well and I began to feel exceedinglyalarmed and very uneasy, not knowing what course to pursue, or what theconsequences might be. I had heard of Dr. Pierce, and concluded to makeone more trial, so I sat down and wrote a letter to him, stating mattersas near as I could, and in due time I received a favorable reply; then Icommenced with his medicine. I commenced somewhere in February 1891 withthe "Golden Medical Discovery" and "Favorite Prescription, " in alternatedoses. 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 whatwas going to take place. I kept on till I took nine bottles. The firstrelief I felt was from sick headache, which I had been troubled with formany years; I was also cured of a very bad cough which I had beentroubled with for many years, and of dyspepsia of long standing. I wasentirely cured of a very singular and severe itching on my back, betweenmy shoulders, which our doctors called winter itch and which theypronounced incurable. I had suffered with this for twenty years; itwould come in the winter and go away in the summer. I was also cured ofthe worst form of bloody piles and of womb disease. At present I feellike a new person. 

When I first commenced with Dr. Pierce's medicines, I could not walkhalf a mile without a pain. The other day I walked to Mercersburghpost-office, a distance of twelve miles, and the next day walked backagain, 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 moreconcerning my case and its wonderful cure, and who will enclose to me areturn self-addressed and stamped envelope for reply, I will be pleasedto 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 onlytemporary relief from medicines prescribed by them. I was advised by afriend to take the "Favorite Prescription, " which I did, and found, intaking six bottles of the "Prescription" and two of the "Discovery, "that it has effected a positive cure, for which words cannot express mygratitude for the relief from the great suffering that I so longendured. 

 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 "FavoritePrescription" I was so weak that I could hardly do my housework. I tookseven 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 yourmedicines. 

I would send you my photograph, but I have none, and live sixty milesfrom 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 SurgicalInstitute at Buffalo, N. Y. , as follows: "It is my heart's desire towrite to you of what your medicines have done for me. I was in a verybad state when I wrote to you, and you prescribed for me and I took yourmedicines according to directions and am a well woman again. I haduterine disease and tumor in the breast. The doctors said they could donothing for me any more and must resort to the knife. I would notconsent and so wrote to you, and followed your advice. I took two dozenbottles of your 'Favorite Prescription, ' seven bottles of your 'GoldenMedical Discovery' and my health is now better than it had been intwenty years; my neighbors said I could not live three months, and Iknow 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, whichI have every reason to believe have cured me. I was afflicted for morethan five years with falling of the womb and ulceration of the same, connected with very painful and irregular menstruation with chillsduring the same. Rush of blood to the head, sometimes falling down ininsensibility and remaining so for several hours; and part of the timecould not bear my weight on my limbs to stand up or walk at all forseveral days at a time. I was a burden to myself when I commenced takingDr. Pierce's Favorite Prescription and "Golden Medical Discovery, " andhis "Pleasant Pellets" and "Smart-weed;" I used the glycerine and iodineas you prescribed for me also. I think I used one dozen bottles of"Prescription, " half a dozen "Discovery" one dozen "Pills, " one-halfdozen "Smart-weed, " at first and some more afterwards, only a fewbottles, I don't remember how many. 

I am now well, doing my own work, and do not suffer any more pain, anddon'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 arevery much obliged for the same. We know they are just what you recommendthem to be. We have used your medicines for about seven years and havedepended almost entirely on them for five years. Before we began the useof your medicines, we used to have to employ a doctor every littlewhile; 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 isfar better than most cough medicines, for the "Discovery" helps theappetite and the cough medicines make one sick. I like your idea ofkeeping the blood pure and the "Discovery" is the medicine for that. Itake a bottle twice a year, in the spring and fall, and I haverecommended it to several other ladies who have tried it and they allthink highly of it. I have bought thirteen bottles of the "Discovery"and three bottles of Dr. Pierce's Favorite Prescription and nine bottlesof the "Pellets" in five years, so you see our doctor-bill has not beenvery large. Our oldest boy hurt himself, lifting, and I depended uponDr. 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 wasrun-down and through the warm weather. It worked like a charm on mysystem and I am a good deal heavier in flesh now. It is the bestmedicine in the world for "female troubles, " for I took almost all kindsof Patent Medicines, and doctors' prescriptions without benefit. Thereis hardly a day passes but that I recommend it to some of my ladyfriends. 

 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 agreat deal of good. I was sick for nearly three years. Sometimes Ithought I would go crazy I was so weak, nervous, and down hearted, andsour in spirits, that I was afraid I would die every day, and such meanfeelings I could not describe to any one. I remained in this stage fornearly three years, doctoring with every home doctor and trying everymedicine that I thought would help me, and I could get no relief. Icould not sleep at times and had palpitation of the heart so that Iwould have to get up, for my heart would beat so fast I thought everyminute 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 Iwrote to you about myself, and you told me to take "FavoritePrescription" and "Golden Medical Discovery. " I commenced in the springand took three bottles of each of your medicines, and I felt so muchbetter I thought that was enough, and ever since I have had my health. Igrew stronger, and could run and skip about like a child, and was happyall day long. I felt so well I could hardly believe it was myself. Ijust used the two kinds of medicines--"Golden Medical Discovery" and"Favorite Prescription, " and followed the "Common Sense MedicalAdviser, " took regular baths, and dieted for about a year, and theresult was a bright baby boy which brightens our home. I took the"Favorite Prescription" before, and the result was a few hours' laborand got along splendidly; my baby weighed twenty-four pounds at sevenmonths--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'sGolden Medical Discovery and his "Favorite Prescription" very highly andoften recommend them to others. I do not think I would ever have gotwell if it had not been for your medicines. I was in a sad condition. Mybowels and half of my body (the left side), was nearly paralyzed, besides nearly my whole system was out of order. I suffered all thetime; but after taking six bottles of "Golden Medical Discovery" and thesame of "Favorite Prescription, " and using two bottles of Sage's CatarrhRemedy as an injection, I felt like a new person. I have never seenanyone suffering in the same way as I did. If anyone with female troubleof 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 FavoritePrescription. For years I suffered from irregularity and uterinedebility, but now I feel as well as I ever did in my life. Thanks to youfor your "Favorite Prescription, " for it has performed a permanent cureof 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 ofmy life. I was under the doctor's care for three months with wombdisease and a gradual wasting all the time. I was so weak that I couldnot be raised in bed when I commenced taking the "Prescription, " and bythe time I had taken three bottles I was up and going wherever Ipleased, and have had good health and been very strong ever since. Thatwas 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 ofthe womb. I began the use of Dr. Pierce's Favorite Prescription and his"Golden Medical Discovery, " and other remedies that are prescribed inhis treatise on womb diseases. After three months' use of same I wascured. I have implicit faith in their medicines and can recommend themto 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 bestmedicine in the world for females; I consider myself entirely well. Ican do as much work as any woman. I gave birth to a healthy girl; yourmedicine is the best in the world for pregnant ladies--_it lessens themisery of that critical period_. I cannot praise it too much. I havegained 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 wellpleased with it. I return many thanks to you for your kindness. Mycomplaint was pain in my back, and in my side, that moved from the rightside to the left; shortness of breath and pain in the lower part of thestomach, and my doctor said I had ovaritis and I took two bottles of the"Favorite Prescription" and one bottle of the "Golden MedicalDiscovery, " and I am relieved of all pains in the back and sides, and ofwomb complaint. I shall always speak good words for you. I suffered withthose 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 medicinehas cured me of a very disagreeable complaint, leucorrhea. I sufferedfor years with pain in my back, never a night was I free. At yourrequest I commenced a course of Dr. Pierce's Favorite Prescription and"Golden Medical Discovery. " I could not sleep on a mattress; it seemedas though it would kill me. Since taking the medicine I can sleepanywhere; I am perfectly well. I would not be placed in my formercondition for any money. I bought six bottles, or $5. 00 worth. I tookbut four, my husband took the "Golden Medical Discovery. " At this time Ihad a servant girl who suffered badly from pain at the time of hermonthly 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-fastsix 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. Mynerves were prostrated and I had female weakness and ulceration of thewomb, which caused such excessive flowing that they thought I would die;then I would take sinking spells. My stomach was too weak, the medicinecould not do its part as it should have done. I had torpid liver andright side of lungs affected; catarrh of the throat and piles;palpitation of the heart, and kidneys were somewhat affected. My doctorgot me up and able to walk through the house, but the flowing wouldstill be so bad that I would have to take the bed; then would be able tobe up again and learn to walk a little again till the time would comeagain. 

My doctor treated me for the ulcers. A lady came to see me. She told meto try Dr. Pierce's Favorite Prescription. I got it but did not tell mydoctor. He soon remarked the improvement and I then told him what I wasusing; he told me to use it, that it would be good for me. I used elevenbottles of the "Favorite Prescription, " and two of the "Golden MedicalDiscovery. " The flowing was not so bad. I got so I could sit up and beabout 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 everySunday. 

 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 withfemale disease in its worst form having been afflicted about fifteenyears. I was also troubled with constipation, loss of appetite, dizziness and ringing in my head, nervous prostration, hysteria, loss ofmemory, palpitation of the heart together with "that tired feeling" allthe time. I consulted several physicians--no one could clearly diagnosemy case and their medicine failed to give relief. After much persuasionI commenced taking Dr. Pierce's Favorite Prescription--have taken fivebottles and am a well woman doing all my housework; from a run downcondition I have been restored to health. I feel it my duty to recommendyour "Favorite Prescription" for ladies afflicted with female diseasesas 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 lowcondition of the blood I was advised to try Dr. Pierce's FavoritePrescription. I had hardly finished the first bottle when I felt a greatchange, so I continued on until I had taken three bottles, and at theend of that time I was completely cured. My health was so much impairedthat I feel I owe a great deal to your wonderful medicine. Thanking youfor the advice which you so kindly gave me while taking your medicine, Iam, 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 "FavoritePrescription" is wonderful. I brought forth a fine son the first day ofDecember--the fattest baby I ever saw, and that is why I think yourmedicine is such a fine one for poor sickly females. I know I neverwould have become pregnant, if I had not got in better health. I feel itmy duty to do all that I can to praise you and your wonderful "FavoritePrescription. " I can highly recommend it to all females who aresuffering with leucorrhea, for I don't think any one suffered any worsethan I did when I made my case known to you. May God bless you, and yourgreat 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 thewomb, and falling of the womb, for several years or since the birth ofmy youngest child. I consulted all the physicians around here and theygave me up and said there was no help for me. 

At last, almost discouraged, I found in a little book your medicinesadvertised. I did not have any faith in them--I had tried so much andfailed to get relief. But I began taking Dr. Pierce's Golden MedicalDiscovery and his "Favorite Prescription, " and took five bottles ofeach, and used two bottles of your Sage's Catarrh Remedy for vaginalinjections. It is three years since and I have not had any return of thetrouble. I feel very grateful, and in fact, owe you my life, for I donot 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 alsohad painful menstruation, and took about eight bottles of Dr. Pierce'sFavorite Prescription and two bottles of his Compound Extract ofSmart-weed, which cured me. The symptoms of this disease were verysevere, pain in the region of the womb, back and thighs, Chilliness andnausea; this disease was so severe that I was barren for two years ofmarried life, and after taking the "Favorite Prescription, " I became themother 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 agreat benefit to me. I was suffering from general debility, malaria andnervous sick headaches, and after my third child was born (a beautifulbaby boy of ten pounds) I only recovered after a long illness; I barelygained strength enough in two years' time so that I was able to crawlabout to accomplish the little housework that I had, by lying down toread many times each day; had sick headaches very often; and many painsand aches, all the time complaining of getting no better. I finallyasked 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 greatchange in my strength, and fewer sick headaches. 

I continued taking the medicine until I had taken eight bottles--sevenof the "Favorite Prescription" and one of the "Golden MedicalDiscovery. " For some time past I have not used it but I am now able todo the housework for myself, husband and two children (aged nine andfive years). I also take in dressmaking, and enjoy walking a mile at atime, and I think it is all due to the medicine, for I know I was onlyfailing fast before I commenced to take it. I take great pleasure inrecommending the "Favorite Prescription" to all women who suffer fromdebility 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 thatone doctor said it was severe pain in the ovaries. His medicine did meno good; but whatever ailed me I was in such misery I could not describewhat I suffered. The first thing that gave me any relief was Dr. Pierce's Favorite Prescription. The first half bottle made me feel muchbetter. I used two or three bottles and thought I was cured, but it cameback in three or four months, and as soon as I began to take themedicine again I got better. I took two or three bottles again, andnever felt anything of it since; and that is nearly four years ago, andI give all thanks to Dr. Pierce's Favorite Prescription. I use no othermedicine at all for stomach trouble but Dr. Pierce's Golden MedicalDiscovery. I have been troubled some with rheumatism, when nothing elsewould do any good, "Golden Medical Discovery" cured me; I had not takenmore than one-half bottle when I felt like another woman, and I wouldadvise 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 haveneglected to answer them. I am glad to say in this letter that my sisteris very much improved in health, and says she feels as if she had a newlease of life. She feels so much better since she commenced taking yourmedicine. I think it was just the medicine she needed, and am more thanthankful to you for the kindly interest you have taken, and hope thatothers will find the same benefit from your valuable books andmedicines, 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 medicinesfor twenty years. They are all they have been represented to be, anduntold benefits have been derived from them. 

Have been treated by you with your Special Remedies, and cured ofdifficulties that our family doctor failed to cure; and when ailing, bythe use of a few bottles of "Golden Medical Discovery, " have been alwaysbenefited. 

I recommend Dr. Pierce's Favorite Prescription to every one who ishaving a family--taken as directed, it works like a charm inconfinement. 

 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 worseuntil 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 inmy back, and I thank you kindly for the good your medicines done me. Ican do my housework now and not feel bad from it. I hope others willfind the same benefit from your valuable books and medicines that Ihave. 

 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. Ihope 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 greatlybenefited by Dr. Pierce's Pleasant Pellets. They act on the stomach andliver, and clear the complexion better than calomel, and you arerelieved of that awful sickness and constipation which other medicinesproduce. 

Dr. Pierce's Golden Medical Discovery is the greatest tonic in theworld, 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 wouldnot give a word of recommendation if I did not feel it my duty tosuffering 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 havedone me. I truly believe the "Favorite Prescription" saved my life; itis a sure and certain cure. I am having perfect health; I am stout andcan 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--knewnothing but pain and suffering. Began doctoring right away with our homedoctor. He not doing me any good, I went to another doctor who advisedme to wear an inside supporter, _which really did me more harm thangood_. Last spring was taken down sick and laid on my back for tenweeks; when I heard of Dr. Pierce's wonderful Favorite Prescription. Thefirst bottle helped me. I have now taken four bottles and feel perfectlycured. I cannot find language to express my gratitude for being restoredto 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 thereresulted internal troubles. I was a great sufferer for four years. I hadtried 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 soI 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 theInvalids' Hotel and Surgical Institute, under treatment for a chronicdisease of eighteen years' standing. I had given up to die. Going toyour Dispensary was a last resort with me; I had undergone a surgicaloperation at the hands of my family physician from which I grew worseevery day for eight months, so that I very despondently started for yourinstitution; and when I had traveled eleven hundred miles I was mademore despondent by inquiring of a man how far I had to travel to reachBuffalo, N. Y. : He answered, "Just one hundred miles. " I then inquired ofhim if he had ever been in Buffalo, N. Y. He replied, "Many a time. " Ithen asked him, what about Dr. Pierce's world-famed Surgical Institute?"Oh, it's a humbug. They have some drawings or pictures taken from somegovernment buildings, that's where they get that fine building you seepictured in their books and pamphlets. "

I don't suppose there ever was a sadder heart entered the door of theInvalids' Hotel than that heart of mine; but it was soon made glad to beglad ever since. During the first night in the Invalids' Hotel I met andtalked with patients afflicted as I was. Many of them were cured andtalking of going home next day, and sure enough, they went; but I nevermissed them in number for others kept coming. 

I can honestly and truthfully say that the World's Dispensary MedicalAssociation of Buffalo, N. Y. , is anything else than a humbug. The reasonwhy they are not humbugs is plain. They continue to perform wonderfulcures and treat their patients with unsurpassed nursing, and a kinderlot of physicians, surgeons and nurses I don't believe can be found inthe world. 

I cheerfully advise all persons suffering from chronic diseases not tostop to count the distance from where they live to Buffalo, N. Y. , but gostraight 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 aglorious change came, due solely to Dr. Pierce's Favorite Prescriptionand Dr. Sage's Catarrh Remedy. I have suffered more than tongue can evertell. I have been treated by good physicians but they only help metemporarily. I have taken a great many patent medicines with the sameresult. In 1890, I began taking Dr. Pierce's Favorite Prescription andDr. Sage's Catarrh Remedy, which gave me immediate relief and apermanent 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 healthbecame so poor that I was scarcely able to help with the householdduties. I was persuaded to try your medicine, and purchased six bottles. That, with the local treatment you advised, made me strong and well. Mysister 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 attimes were so acute as to render life a burden. I began using Dr. Pierce's Favorite Prescription. I used seven bottles in as many monthsand derived so much benefit from it and the home-treatment recommendedin his Treatise on Diseases of Women, that I wish every women throughoutour land, suffering in the same way, may be induced to give yourmedicines 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 thatI can say I enjoy good health most all the time. When I first commencedusing your medicine I was suffering from female weakness, leucorrhea, bearing-down pains and a soreness across me that at times I could hardlystand up straight when I would get up off of my chair to walk across theroom. I got a bottle of your "Favorite Prescription" and by the time Ihad used half of it, the soreness began to get better. I used threebottles altogether, and since that, you might say I am enjoying the bestof health most of the time. I have had two baby boys since--bothhealthy, although the baby is only three weeks old, and I am doing allof my own work since he was two and one-half weeks old. 

I always speak highly and recommend your medicine because I know itdeserves a good name; and I feel certain it will cure female diseases ifthey 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 triedthree doctors and none of them seemed to do me any good. When at last Ialmost despaired of health any more, I saw in a paper one of youradvertisements, and I sent for and got two bottles of Dr. Pierce'sGolden Medical Discovery, and I improved so rapidly that I sent for andgot three bottles of your "Favorite Prescription, " and now I am as wellas 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 walkacross my room without help, or rise from my chair. I suffered fromnervousness very much, and with the least excitement I would faint; andI think, in short, I suffered with female irregularities and that yourmedicine 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 inperson, 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. Iwould 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 MedicalDiscovery, " I commenced to improve. In two weeks could walk about thehouse--could eat--did not have any more pain in my stomach--threw awaymy morphine powders. When I first commenced taking the medicine it mademe feel worse. I was hoarse, could not speak aloud for three days; as Igot better my pains and bad feelings left me and I could sleep good; mynerves got better. Before I took your medicine I kept my bed fourmonths--got worse all the while. I am now quite fleshy and can work allday. 

 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 fromindigestion, sick headache, nervous prostration and all other complaintsthat the female sex is heir to, and, after trying many remedies anddoctors with but little or no relief, I persuaded her to try Dr. Pierce's Favorite Prescription and "Golden Medical Discovery. " She wasso out of heart, she returned the answer that it would be like all therest--of no good; but on my account, she said she would try it, so I gotone bottle each; and before she had used half of a bottle she felt thatit was benefiting her, and she has continued to improve ever since, andnow thinks it the most wonderful remedy on earth for her sex, andrecommends it to all suffering females. She has not been so well in tenyears. 

I write this without any solicitation and with a free, good will, sothat 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 confinementand never did so well in my life. It is only two weeks since myconfinement and I am able to do my work. I feel stronger than I ever didin 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 diseasespeculiar to my sex. I had to be carried from my bed, had horribledreams, sinking sensations, was very nervous and had little or noappetite. In short, my whole body was racked with pain. I had frequentattacks of hysteria, and was completely discouraged, for I found nomedicine did me any good. At last I determined to give your "FavoritePrescription" a trial. I had taken but two bottles before I felt so muchbetter! I took eleven bottles. To-day I am well. I have never felt theleast trace of my old complaint in the last six years. We use the"Golden Medical Discovery" whenever we need a blood-purifier. By itsuse, eruptions of all kinds vanish and the skin is rendered clear andsoft, 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 andinflammation--she was completely bed-ridden and lingered about one yearat death's door. Local applications were given her and Dr. Pierce'sFavorite Prescription; she gradually regained strength and continued todo so until she recovered. I am convinced that any case of womb diseasecan 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 acontinual pain and aching under my right shoulder and in or under myright breast; I could not eat anything but a little milk or bread, andeven that made my stomach pain and hurt me so I could not rest; I keptgetting weaker all the time and I could no longer sit up; I sent for ourfamily physician; he said I had dyspepsia and inflammation of the liver, and gave me medicine two or three months, but I kept getting weaker allthe time; it seemed to me that I was diseased all over; thought I hadheart disease; had the doctor examine my heart several times. I becameso discouraged that I gave up all hope of ever getting well, butconsented to send to Dr. Pierce for medicine. I commenced taking it andin a short time I was able to sit up; continued to take his medicinethree months and felt like a new person--didn't need any more medicineand 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 believeit 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 commencedtaking "Favorite Prescription" until now. She has been doing her ownhousework for the past four months. When she began taking it, she wasscarcely 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 ofthe best doctors here. She got so weak that I had to help her out of bedand draw her in a chair. She then tried some of Dr. Pierce's FavoritePrescription. In less than a week she was out of bed and has beenworking about five weeks now, and looks the picture of health. As formyself I am much better of my female complaint. Before taking the"Favorite Prescription, " I suffered most of the time from catarrhalinflammation. 

 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 theskill of the best medical aid procurable. I obtained no good effect, until I began the use of the "Favorite Prescription, " which lifted theburden which was seeking my life. My gratitude I owe to the"Prescription. " I hope that all suffering humanity (as in my case) mayprofit by the result of my experience. 

 Yours truly, Evoline Neil

 * * * * *

SPERMATORRHEA

(SEMINAL WEAKNESS), or emission of semen without copulation, is generally induced by theearly habit of masturbation. It is one of the evidences that passion, instead of prudence, has held sway. Passion may aptly be termed thevoice of the body, by which, if we listen, we are enchanted and ledastray. Conscience is the voice of the soul, which remonstrates, and ifwe obey, we shall be guided aright. We cannot reconcile theseconflicting voices, and if we indulge the passions when conscienceforbids gratification, the remembrance of the wrong remains forever, andconstant fear is an everlasting punishment. 

WRECKED MANHOOD. Man possesses few powers which are more highly prizedthan those of virility, which is the very essence of manhood. "He is butthe 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 secretedby the testicles and is intermixed with the fluids secreted by theprostate and by Cowper's glands. Its fertilizing property depends on thepresence of minute bodies, termed _spermatozoa_. These consist of littlepolliwig-shaped bodies (Fig. 3), having large heads and long filamentsor tails. Under the microscope these little bodies are seen to describemovements not unlike those of polliwigs. 

WHY EMISSIONS OF THE VITAL FLUID DEBILITATE. The seminal fluid consistsof the most vital elements in the human body. It not only assists inmaintaining the life of the individual, but communicates the essential, transforming principle which generates another mortal having animperishable existence. Its waste is a wanton expenditure, which robsthe blood of its richness and exhausts the body of its animating powers. No wonder that its loss enfeebles the constitution, and results inimpotency, premature decline, St. Vitus's dance, paralysis, epilepsy, consumption, softening of the brain, and insanity. No wonder thatconscience and fear become tormenting inquisitors, and that the symptomsare 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 theconstitution. 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 aresurrounded 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. Excessivelustful enjoyment produces feebleness, and finally terminates in diseaseand impotency. 

SEMINAL WEAKNESS may be the result of marital excesses. A _proper_sexual gratification contributes to the health and happiness of bothparties. On the other hand, intemperate indulgence not only preventsfruitfulness, but ultimately, if persisted in, renders the husbandentirely impotent, and undermines and destroys the constitution of thewife. Spermatorrhea may be induced by spinal irritation, intestinalworms, or piles. It may also result from inherited, as well as acquired, constitutional weakness. 

NOCTURNAL OR NIGHT EMISSIONS. Involuntary emissions of semen mostfrequently occur during amorous dreams at night, and are thereforetermed _nocturnal emissions_. Although they are at first occasioned bylascivious dreams, attended by erections and pleasurable sensations, yet, as the disease progresses, the erections become less perfect andthe losses are only revealed by the depression of spirits experiencedthe following morning, and by the stiffened and stained spots on thelinen. At first, these emissions may occur but once in two or threeweeks, unless the patient be excited by company, stimulation, food, drinks, or other causes; but, at a later stage of the disease, theysometimes take place every night. In aggravated cases, the seminal sacsare so weakened that the warmth of the bed, friction of the clothing, reading obscene literature, viewing indecent pictures, indulging in lewdconversation, or even being in the presence of women, produces a wasteof semen--many times unattended by erections. When there is greatweakness, 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 toexpel the last drops, which appear thick and viscid. If the urine beallowed to stand for a few hours, the seminal discharge will beprecipitated, and will form a light-colored deposit at the bottom of thevessel. If the sediment be examined with a microscope, spermatozoa canreadily be detected in it. 

WASTING AWAY OF THE TESTICLES. Masturbation not only occasions loss ofsemen, but frequently the testicles and other generative organs wasteand become reduced in size as a result of the abuse. Fig. 1 shows thetesticle in a healthy condition, while Fig. 2 represents one muchreduced, as a result of self-abuse. 

The celebrated Dr. Drewery, of London, speaking of the reason whymasturbation is so extremely injurious in its effects upon both body andmind, says:

"This is a question which I have often been asked by patients, and it isone which is rather difficult to explain to any one not acquainted withthe phenomena of reflex nervous action. 

"Perhaps the simplest mode of putting it is to say that the effectsproduced by the excitement of the parts are not the direct result of thestimulation, but that the excitement of the extremities of the nerves isconveyed through them to the spinal cord and brain, and that theemission which occurs, when sufficient stimulus has been applied, is theresult of nervous force reacting upon the parts from the spinal cordback again. This action is termed reflex, and is similar to that ofvomiting, which is only produced through the medium of the great nervouscentres; so that if the nervous communication between the stomach andspinal cord and brain is cut off, nothing in the stomach could possiblycause vomiting, whereas if the communication remains intact, this actioncan be immediately produced by irritation of nerves far away from thestomach, viz. , by tickling the fauces, as every drunkard is well awarewho has ever put his finger down his throat for the purpose of emptyinghis stomach of the contents which are poisoning him, but which withoutthe additional stimulus he is unable to expel. It will be seen, therefore, from this that the act of emission is only produced throughthe agency of the spinal cord, and not by any direct nervous actionbetween the parts which are stimulated, and those which are concerned inthe 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 ofthese phenomena, as are all the senses of the body; this is proved bythe fact that emissions occur during sleep, without any excitementbeyond the engorgement of the parts with blood, produced by thecerebellar congestion of the brain, usually found to follow lying uponthe back during sleep. This, however, is unnatural and unhealthy, and isusually the result, as before pointed out, of masturbation. But thesetwo important points must be remembered--that emission may be producedby friction merely as a purely spinal reflex action, and it may becaused by the action of the brain without any friction whatever. Boththese results are unhealthy and injurious. A true natural and healthyact of sexual intercourse demands the excitement of brain, spinal cord, and every nerve in the body simultaneously, and resembles the lightningflash which restores the equilibrium of electric force disturbed duringa thunderstorm. 

"It is useless to endeavor to describe the marvelous actions of nervousforce, but from what has been said it is not difficult to comprehendthat if a convulsive action is produced in any part of the body by thesole excitement of the spinal cord, when it is necessary for its healthyand natural production that the brain and senses generally should beequally excited, the balance of nerve power is destroyed, which factalone is proved by the effects upon the nervous system always followingmasturbation, which is the irritation of the spinal cord without theassistance of the brain. "

VARIOUS COMPLICATIONS are likely to arise in the progress of thismalady. 

STRICTURE of THE URETHRA, or water passage, is a very commoncomplication and, even when quite slight, generally interferes veryseriously with the cure of the spermatorrhea when overlooked by theattending physician, as is very commonly done, especially when theconstriction of the water passage is only slight. Very often it occursin our practice that on examining a case of this disease that has beenthe rounds of the doctors, we find a stricture, which had been entirelyoverlooked by other practitioners, being so slight as not to occasionserious obstruction to the flow of urine but yet sufficient to interferevery much with the cure of the spermatorrhea. The size of the urethra, or water passage, should bear an exact and proportionate relation tothat of the penis, and when from any cause the urethra is contractedbelow this normal size, it should receive attention, as otherwise thestricture is likely to increase and the passage becomes so constrictedas to produce serious disease of the bladder, and not fail to perpetuatespermatorrhea, when this disease exists. 

HYDROCELE (_Dropsy of the Scrotum_) consists of an undue secretion ofthe fluid which moistens the _tunica vaginalis_, and may arise from anirritation of the testicle, produced by masturbation. This subject isfully considered in the Medical Adviser. 

VARICOCELE is a dilatation of the veins of the spermatic cord andscrotum, and is frequently a result of masturbation. It is readilydistinguished under the form of a soft, doughy, compressible, knotty, and unequal enlargement of the veins, and a tumid condition of theadjacent parts. One writer, speaking of the enlargement of the spermaticvessels, describes them as "feeling like a coiled up bundle of worms. "

DISEASE OF THE PROSTATE GLAND is frequently caused by solitaryindulgence. Venereal excesses produce congestion and the gland isovernourished. It becomes greatly enlarged, a condition called_hypertrophy_. This affection gives rise to a heavy feeling or pressurein the region below the bladder, and often interferes seriously withurination, and gives great pain and uneasiness, and often results ingrave and dangerous complications. 

PROSTATORRHEA consists of an unnatural flowing or wasting of theprostatic 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 forspermatorrhea, or for gleet, by inexperienced and careless physicians. For a full consideration of diseases of the prostate gland, see Part IXof our Dime Series of pamphlets, which will be sent on receipt of tencents in postage stamps. 

Again, the habit of self-pollution weakens all the structures of thegenital organs, and induces seminal waste, which may lead to a morbiddiminution in the size of the prostate gland. This condition, which isexactly the opposite of the one above described, is _atrophy_. Anydisease which renders the circulation in the prostate gland languid andfeeble interferes with the nutrition of that organ and impairs itsfunction. 

IMPOTENCY (_Loss of Sexual Power_). Masturbation prevents theexcitability of the nervous system and sexual organs and causesdebility, which is indicated by the premature discharge of semen duringsexual intercourse. These premature emissions indicate not only partialimpotency, but also that the nerve-centres have become morbidlysensitive by the practice of solitary vice, or marital excesses. Atlength the powers of the erectile tissues are diminished, and there isweakness which prevents the act of copulation, or the erection may beslow and not last long enough, on account of a faulty functionalcondition of the spinal cord. 

A PECULIAR FORM OF IMPOTENCY is associated with certain abnormalnutritive changes which give rise to a lymphatic or fat condition of thesystem. Not that the temperament in all these cases is originallylymphatic, but the system degenerates in consequence of nutritiveperversion. With the loss of sexual ardor, there is also apathy of mind, loss of manliness, and the victim becomes cold, dispassionate, andtreacherous, devoid of any admiration or love for the opposite sex. Heacquires 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 arelosing their virile powers, and become irritable, jealous and oftendesperate; and (2) those who are completely indifferent to thisdeprivation. 

(1. ) Patients of the former class are readily restored to health byproper treatment, for they are willing to make an effort for therecovery of their manly powers. There is not complete loss of sexualdesire, yet their disappointment is so great that they may entertainsuicidal thoughts. They are moody, fickle, discontented, excitable, andremarkably impulsive. With proper treatment, they regain tone of body, vigor of mind, an increase of sexual desire, and become more attentiveto business affairs, and less indifferent to the gentler sex. With therestoration of the general health and the sexual functions, remarkableconstitutional changes occur. It is often the case that their intimatefriends hardly recognize them by looks or acts. 

(2. ) It is equally true that those who are wholly indifferent to theloss of virile power, uninterested in the evidences of their manhood, are sometimes incurable. In fact, it is useless to treat the latterclass, because they will neither co-operate with the physician, norpersist in the treatment necessary to effect a radical andconstitutional change. 

Masturbation perverts and finally destroys the secretory functions ofthe testicles. It sometimes causes chronic inflammation, which mayresult in obliteration of the minute seminal canals, or obstruction ofthe conveying ducts. The sperm is imperfectly elaborated and totallyunfit for procreative purposes. Sometimes the spermatozoa are entirelyabsent, and, when present, are very few in number, incomplete instructure, 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 tobe healthy, and _his_ inability to procreate may be erroneouslyconsidered a defect in his wife. 

SYMPTOMS OF SPERMATORRHEA. The indications of abuse of the sexual organsare loss of nervous energy, dullness of the mental faculties, anddelight 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 iscapricious, the throat irritated, and the patient makes frequentattempts to clear it, in order to speak distinctly. There are pains inthe chest, wakefulness, and during the night lascivious thoughts anddesires. The relish for play or labor is gone, and a growing distastefor business is apparent; there is a determination of blood to the head, headache, noises and roaring sounds in the ears, the eyes may beblood-shot and watery, weak or painful, the patient imagines brightspots or flashes passing before them, and there may be partialblindness. There is increasing stolidity of expression, the eye iswithout sparkle, and the face becomes blotched and animal-like in itsexpression. The victim is careless of his personal appearance, notunscrupulously neat, and not unfrequently a rank odor exhales from thebody. 

There are troublesome sensations, as of itching and crawling, in andabout the scrotum. Subsequently, there is obstinate constipation, andall the symptoms of dyspepsia follow. Gradually the pallor deepens, thepatient becomes emaciated. There is a shortness of breath, palpitationafter even moderate exercise, trembling of the knees, and eruptions onthe skin. There may also be cough, hoarseness, stitch in the side, lossof voice. The sleep is not refreshing, the patient has frequentnightmare, or the dreams are lascivious, and the involuntary emissionsof semen become more frequent. The weakness increasing, the suffererexperiences a weakness in his legs and staggers like a drunken man, hishands 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 whathe reads, and is mentally indolent. He begins to be suspicious of hisfriends, has less confidence in others, and desires to be alone, isdespondent and has suicidal thoughts. He has pain in the back, does notlike to walk, and is inclined to lie down. The semen is prematurelydischarged upon attempting coition, and if there be offspring, it is aptto be feeble or subject to scrofula, consumption, or convulsions. Thegenital organs, especially the penis and testicles, diminish in size, asthe disease progresses, lose their energy, and the glands of the penisbecome cold and flaccid. There is frequent desire to urinate, chronicirritation in the neck of the bladder, and pain in the spermatic cordand testicle, and sometimes in the end of the penis. The microscopeshows that semen involuntarily discharged may be devoid of spermatozoa, or if present, they are defective, their heads being without tails. Theurine is loaded with mucus or bears up a filmy, membranous, transparentmatter, or it may be covered with a thin fluid having an oilyappearance, but in rare cases is clear. Again, it may hold substances insolution, which are deposited in crystals or incrust the urine, or itmay precipitate a material having the appearance of brick-dust, andsometimes semen tinged with blood. The dyspeptic symptoms when presentare followed by diarrhea. The limbs are cramped and rigid, the feetbloated, and the patient becomes melancholy and relinquishes all hope ofrecovery. As the disease progresses, the patient lacks firmness and isabsent-minded. 

When the erections are imperfect and the semen is prematurelydischarged, or when a lengthy coition is required before the sperm canbe ejected, it is evident that the patient is rapidly becoming impotent;the virile powers are vanishing and manhood is surrendering sway to amerciless foe. We frequently witness this condition in men, even at theage of thirty-five, when the summit of vigor and strength should onlyhave been reached. How often are we solicited to restore these losthopes and powers! To what tales of ignorance and recklessness, orsubmission and remorse, do we repeatedly listen from these unfortunatesufferers! In patients of this class, sexual intercourse preventsspontaneous emissions, but it does not remove the functional and organicderangements of the nerve-centres; hence, at a time when the victims ofthis disease should be in the prime of life, they are impotent, andepilepsy, apoplexy, paralysis, softening of the brain, or insanity, frequently results. 

EPILEPSY (OR FITS). This dread disease is one of the most common andserious complications of the more advanced stages of spermatorrhea. Theinjury done to the nerve-centres by the practice of masturbation ismanifested in epileptic convulsions, more or less frequent. If propertreatment be early adopted, and faithfully pursued, the case is not yethopeless; though, in the majority of cases, the patient never recoversafter the disease assumes this phase. 

PARALYSIS. Paralysis, or Palsy, when occurring as a complication ofspermatorrhea, may be preceded by an attack of apoplexy, in which thepatient loses consciousness, and lays in a condition of profound stuporfor a time, and on recovery from his unconscious state, finds himselfunable to use one or more of his limbs, or the disability and loss ofpower, which may also be accompanied by more or less loss of sensation, may come on gradually, without any premonition or marked manifestationof its approach. In either case, its appearance is to be regarded as amatter of serious importance. Paralysis, when occurring as a consequenceof masturbation or sexual excesses, is usually difficult of cure; yet, now and then, cases are cured at our Institutions even after this gravemalady has appeared as a complication. 

SOFTENING OF THE BRAIN. This malady, although less common as a result ofmasturbation than the complications mentioned in the precedingparagraphs, is of sufficiently frequent occurrence to entitle it to apassing notice here. This condition usually results ultimately incomplete dementia, or loss of reason. It is an incurable disease. 

INSANITY. This deplorable malady is not a very uncommon result ofmasturbation and its various resultant morbid conditions, as the recordsof the many institutions for the unfortunate class of sufferers fromthis disease bear abundant witness. Sometimes it manifests itself in themilder forms of hallucination, or monomania, but in the majority ofcases, the patient sinks into a despondent hypochondria, which is manytimes followed, sooner or later, by a raving mania. 

In cases of monomania resulting from masturbation, the mentalderangement is often so slight as to escape detection by the patient'sfriends, the peculiar freaks of disposition being regarded rather aseccentricities of character than as symptoms of serious disease. Fits ofdespondency are usually common with such sufferers. The mentalderangement is not always accompanied or preceded by spermatorrhea orfrequent seminal emissions, the injury done to the nervous system by thepractice of self-abuse, or sexual excesses, being first noticeable invarious phantasms or imaginings on the part of the patient. These are, in different cases, so various, both in character and degree, as not toadmit of any classification, each case presenting phases peculiar toitself. In many cases, the patient imagines that his best friends areconspiring to injure him, or that some great calamity is about to befallhim. In most cases there is danger of the patient's committing suicide, if not closely watched. Especially is this true of those who suffer fromfits of hypochondria. 

Except in its milder forms, insanity resulting from masturbation andsexual excesses, is rarely curable. 

DON'T BE ALARMED. A nocturnal seminal emission now and then, or at longintervals is not, in and of itself, evidence of the existence ofspermatorrhea 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 notgratified naturally, or if he permit his mind to run much uponlascivious subjects, experience an emission while asleep and dreaming. As to whether such occurrences are evidence of disease or not, in anygiven case, depends upon their frequency, and as to whether they are theresult of a weakness of the organs and are followed by more or lessdepression and debility, or are merely the overflow of a robust system, or the outburst of restrained, pent-up, and ungratified passions. In thelatter case, and when only occurring at long intervals, the emissionsare not followed by any perceptible enervating or weakening effects. 

QUACKERY RAMPANT. This country is flooded with cheap circulars andpamphlets, circulated openly and broadcast, wherein ignorant, pretentious, blatant quacks endeavor to frighten young men who may neverhave practiced self-abuse, or been guilty of excesses in any way, andyet who experience, now and then at long intervals, nocturnal seminalemissions. In such cases, it is the duty of the conscientious, honest, and sympathetic practitioner of the healing art to give assurance, andnot to unnecessarily alarm those who experience nothing inconsistentwith a state of fairly good health. To frighten such young men intobelieving themselves diseased, when in reality they experience nothingbut 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 uselesstreatment by general practitioners who overlook the real disease, causedby pernicious youthful habits pursued in solitude, or later excesses invenery, but the female sex are also quite as often subjected totreatment for diseases which do not exist, the real trouble beingnervous debility and other weaknesses that have resulted from theyouthful pernicious practices common to both sexes, or later excesses inmarital pleasures. 

MORAL CONSIDERATIONS. Masturbation is a habit which tyrannizes over themind, perverts the imagination, and forces upon the victim venerealdesires, 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 gracefuland beautiful. 

SENSUAL LUST. The fancy creates an attractive partner, possessed ofgirlish beauty, a perfect type of goodness, blended with sexuality, andwhom the subject worships with all the ardor of passion. Around this_beau ideal_ all his affections are clustered; to her the purest of hisblood is offered in sacrifice, and it is no wonder that femaleassociates seem tame and unattractive when such imaginary and consummatedivinity is courted. In the sensual delirium is conceived an elysium ofcarnal bliss, where half-nude nymphs display their charms and invite tosensual enjoyments. Thus we see how this habit makes the spiritualfaculties subservient to morbid passion, and by what means elevatinginfluences are prostituted to vulgar and base-born creations. 

SYMPTOMS VARY IN DIFFERENT CASES. We can only partially delineate theterrible effects resulting from the abuse of the sexual organs. Thesymptoms are multitudinous, but, as we have before stated, no twopersons are similarly influenced by this disease. The symptoms will varyaccording to the severity of the affection, the age of the patient, andhis constitutional peculiarities. The presence of only a few of thesymptoms which we have enumerated is evidence of abnormal weakness, which demands treatment. 

Montaigne says: "We must see and get acquainted with our sins if weexpect to correct them. " Virtue presupposes trials just as much asvictory implies warfare. The triumph of virtue is to defeat morbid orexcessive passion, for virtue is only realized when it is a conqueringforce. Innocence is passive but virtue is an active quality, purified inthe fiery furnace of temptation. As men have in all ages been influencedby passions, so temptation has ever found its victims. It is anobligation that one owes to himself to overcome every evil passion orweakness to which he is subject, and the discharge of this personal dutyrequires moral courage. 

THE REWARD OF VIRTUE. Our Saviour invited all erring mortals to enterupon a higher life when He said, "Come unto Me, all ye that labor andare heavy laden, and I will give you rest. " The invitation isaccompanied with a promise. To all who are weary of excess and boweddown by passion, rest and restoration are promised, if they will butreform and employ proper means to that end. 

THE SUFFERERS MUST REFORM. Just as there is no spiritual restorationwithout obeying the Saviour, so there can be no physical restorationunless we fulfill nature's imposed conditions. There can be no salvationunless sin be discarded, and so there can be no redemption from the badeffects of a practice, so long as it is continued. It is no easy task tomaster a despotic passion. Appetite is often stronger than the will. Thetreatment must begin with moral reformation. Every manly impulse, andall the higher qualities of the patient's nature, must be enlisted inthe 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 certainas that which proceeds from the economical use of what you have"!_ Thepatient actually acquires confidence and manly courage by the retentionof the seminal fluid, which directly increases his virile powers. 

HYGIENIC ADVICE TO PATIENTS. Daily physical exercise and regular habitsmust be established. It is important that the mind, as well as thephysical powers, be directed into active and wholesome channels. Theremust be restraint and discipline. It is useless to begin medicaltreatment while the patient continues to read exciting, amorous storiesand obscene books, which are suggestive of lewd thoughts. Somethingpractical ought to occupy the thoughts and engage the hands. 

Regular and vigorous physical exercise is necessary to assist thecirculation of the blood, and compel its determination into the minuteand extreme parts of the vascular system. When the blood is thusdirected, nutrition is more vigorous and the activity of all thefunctions is augmented. 

Not only should there be regularity in eating, but sound discretionshould be exercised in selecting a plain, wholesome diet, consisting ofsuch articles of food as best favor a daily and free evacuation of thebowels. Avoid the use of those articles of food which produce excessiveacidity of the stomach. Hearty or late suppers are not allowable. Thepatient should use no alcoholic beverages, and should abstain from suchstimulants as tea, coffee, beer, wine, and tobacco. We cannot evenrecommend their _moderate_ use, for total abstinence is the better plan. 

The patient should sleep in a well-ventilated room, on a hard bed, andhave only sufficient covering for warmth and comfort. He should not lieupon the back, because in this position nightly emissions are morelikely to occur. The patient should go to bed when he feels sleepy, andnot resist the inclination until wakefulness is induced. 

He should rise early in the morning and immediately take a cold handbath. For this purpose a quart or two of water and a common hand towelonly are required. After bathing, rub the surface of the body with thedry hand or a crash towel, and continue the friction until the skin isred and a reaction is established. Do not excuse yourself from followingthese hygienic suggestions. A refreshing bath changes the morbidsensibilities to a more healthful state by the reaction of the nervoussystem. 

It is beneficial to apply a towel saturated with cold water to thegenital organs fifteen minutes before leaving the bed. Douching, orshowering the genital organs with cold water once or twice a day willalso be beneficial. It should not be practiced, however, just beforegoing to bed. It is well to bathe the head with cold water, and this canbe done much better if the hair be kept closely cut. 

Horseback riding, climbing, and all exercises which rub, chafe, orexcite the genital organs, should be avoided. Even the clothing shouldbe loose, so that walking will not produce friction or cause anyexcitement of these organs. The calls of nature should receive promptattention, and the urine be voided at any time (especially during thenight) when there is an inclination. If there be irritation of thebladder and lower bowels, the patient will receive decided benefit fromthe daily use of an injection of cold water into the bowels. From a halfpint to a pint of cold water may be used at one time, and the injectionshould be retained for a few minutes before going to bed. The bowelswill thus be relieved, the heat and irritation subdued, and theliability to seminal emissions lessened. 

Patients afflicted with spermatorrhea should not allow their thoughts todwell 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 companycultivated. They become suspicious, skeptical, and believe that they arevictims of imposture. When they lose self-reliance, their faith andtrust in others begins to waver, especially if their health does notimprove so rapidly as they had anticipated: As much depends upon thefaithful observance of the hygienic rules as upon the constant andproper use of medicines. The rapidity of recovery depends upon theconstitutional energies and the vigor of the vital resources. If theblood be greatly impoverished, or the nervous system much impaired, recovery will be necessarily slow. Time, patience, and perseverance, arejust as essential to a recovery from the effects of these abuses as thebest medical treatment that can be employed. 

THE MEDICAL TREATMENT OF SPERMATORRHEA AND IMPOTENCY. Few diseasesrequire so many modifications of treatment, to suit the peculiarities ofindividual cases as spermatorrhea, because it is attended with so manycomplications and morbid functional and structural changes. Everycomplication must be considered, and great judgment exercised in theselection of remedies. As this selection must depend upon thepeculiarities of the case involved, it is impossible to impart to thenon-professional readers sufficient medical knowledge to enable them tochoose the appropriate remedies for these intricate disorders. Hence itwould be useless to specify the various medicines which our specialistsemploy in treating them. It would only lead to many fruitlessexperiments, which might result in great harm to the afflicted. Forremedies powerful enough to effect cures of spermatorrhea and impotencyare capable, when improperly employed, of doing great harm. Especiallyshould all ready-made, proprietary or put-up medicines, such as are soldin drug stores and chemists' shops, be avoided, for reasons alreadymentioned. Great harm, also, often results from the employment of"galvanic belts, " "galvanic batteries and pads, " and other catch-pennydevices, with which the too confiding are not only duped and swindled, but terribly injured. They are all worse than useless, and often renderthe mildest case very difficult to cure by inducing seriouscomplications. It is better to take no medical treatment, but relysolely on the hygienic advice we have given, rather than to resort toany of the so-called "_specifics"_ found in the drug shops, or to anysuch silly, good-for-nothing trash as the various "Pastilles, ""Boluses, " "Curative Rings, " "Voltaic Belts, " or other quackishmedicines and contrivances. 

IMPORTANCE OF HYGIENIC DISCIPLINE. The invalid should restrict hisattention to hygiene, and learn that patient endurance and heroicperseverance are necessary, even when taking the most efficientremedies. His entire system having gradually become deranged, correctivemedicines must necessarily be _chronic_ in their operations; in otherwords, they must act insensibly, slowly, and progressively. Some of thesymptoms of sexual weakness will, under proper hygienic and medicaltreatment, generally begin to disappear within a month. If the nervoussystem be very much impaired, however, a longer time will elapse beforethe restorative effects of treatment will be observed. Neither thephysician nor the patient should expect that a broken-down constitutioncan be immediately repaired. The day of miracles is past. The mostrational method of treating the sick promises nothing supernatural, nothing which is not in accordance with science. Diseases of thischaracter are always slow in their inception, or development andprogress, and must be cured in like manner, step by step. Nature neverhurries; atom by atom, little by little, she achieves her work. 

OUR IMPROVED TREATMENT. Tears ago our specialists resolved to payparticular attention to the investigation and treatment of thesediseases, which are not only alarmingly prevalent, but sadly neglectedand 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 theirremedial effects. The great success which has attended the employment ofthese remedies has led us to rely upon them with implicit faith. Bytheir persistent use, spermatorrhea and threatened impotency can becured as readily as other chronic or lingering diseases. We particularlysolicit those cases which have heretofore been regarded as incurable. The patient is subjected to no surgical operation, and he can safely andaccurately follow the directions given, while the treatment does notinterfere with any ordinary occupation in which he may be engaged. Thesedelicate diseases should not be intrusted to physicians who advertiseunder fictitious names, or to those of ordinary qualifications. Thegeneral practitioner may be thoroughly read in these diseases, but hecannot acquire the skill of a specialist who annually treats thousandsof cases, while the former seldom, if ever, has occasion to prescribefor them. 

SIGNS OF IMPROVEMENT WHEN UNDER TREATMENT. Under our peculiar andimproved system of treatment, gradual improvement in the patient'scondition will be manifested. The eye becomes more brilliant andsparkling, the patient is less morose, his digestion improves, he isless listless and despondent, takes more interest in business and otheraffairs, his sleep is less disturbed and more refreshing, the strengthimproves, and, if the sexual organs had become wasted in size, weak infunction, and flaccid and soft, they begin, by and by, to have more toneand firmness, and to develope and increase in size, as their nutritionis restored, by the checking of the exhausting drain which they havesustained. If nocturnal emissions occur occasionally, the dischargewill, under the microscope, be found to be less watery, and to containincreased numbers of _spermatozoa_, with heads and filaments perfect. The patient now begins to gain in self-confidence, courage, and othermanly attributes, and, instead of the bashful, retiring, nervous, languid hypochondriac, we see a man of ambition and energy, competent tobattle with the adversities of life. Who can estimate the value of sucha transformation from nervousness and despondency to vigorous manhood?Who would begrudge all their earthly goods and treasures when thusafflicted, to be so restored to health and enjoyment for of what availare the greatest riches when health and manhood itself are lost?

OUR TERMS BUSINESS-LIKE AND FAIR. Occasionally persona solicit us toundertake the cure of these ailments, and, in case of failure, receiveno compensation. They write: "If you will _warrant_ that yourprescriptions will result in a _perfect restoration to health_, we willgladly pay the fees that you ask. " The absurdity of such a request isapparent, and therefore we answer: "We cannot _warrant_ that you willlive even for the next twenty-four hours. We do not bet, play forstakes, or wager our skill for money. Personal responsibility cannot beshifted or evaded, and life and health, with all their momentousconsiderations, are necessarily individual affairs. Therefore a proposalto make the conditions of health a subject of speculation is a challengeto gamble. " The patient may not comply with the specified conditions, and the physician's success depends upon a faithful application of theprescribed treatment. For these reasons only a quack will be a party toany such transaction. Ours is not a trading, hazardously speculativeprofession. Besides, thousands of our patients reside long distancesaway and we cannot know of their responsibility or honesty, nor spendtime inquiring after their financial standing. 

EVIDENCES OF THE CURABILITY OF SPERMATORRHEA AND IMPOTENCY. Manyindividuals afflicted with spermatorrhea and impotency, particularlythose who have been swindled by some of the many charlatans who are tobe found in nearly every city, are incredulous, and doubt our ability tocure these maladies. Others are skeptical, because their physician, whomay be a very skillful general practitioner, but who has had very littleor no experience in treating these delicate maladies, has failed torelieve them, and, perhaps, has told them the disease is incurable. 

We therefore beg the indulgence of our readers for here offering someindisputable evidence of the extraordinary success which we haveachieved, by our peculiar methods of treating these affections, aspursued at the World's Dispensary and Invalids' Hotel and SurgicalInstitute. 

This evidence is introduced for the encouragement of an unfortunateclass of invalids, for many of whom existence has ceased to possess anycharms. The grateful manifestations which we have received from thisclass of sufferers have afforded us one of the greatest pleasures of ourlives, and have alone been a rich remuneration for the diligent studyand arduous labors devoted to the investigation of these diseases and tothe perfecting of our peculiar and successful methods of treating them. 

SACREDLY CONFIDENTIAL. In introducing the following extracts from ourextensive files of letters, the names of the writers will be omitted, aswe regard all such correspondence, as well as facts communicated to usin personal consultations, as _sacredly confidential. _

Lack of space and fear of wearying the reader, prevent us fromintroducing more than a few extracts; but these are only fair samples of_thousands_ that have been received. Those given, present cases inalmost every stage of treatment, some soon after commencing, othersfurther advanced, and still others which are cured. If we could devotethe space, and had we time to select them, we could insert an almostunlimited number of those received from patients who have been perfectlycured; but we think the reader will be more interested in expressionscoming from patients in all stages of treatment, as they are dailyreceived. Therefore, without regard for literary excellence, we append anumber chosen miscellaneously, and given _verbatim_. They express thesentiments of persons in all stages of life, and illustrate the viewsand feelings generally entertained by those whom we have been calledupon 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 whichwe never indulge. Although ofttimes less expressive of satisfaction andgratitude than if the communication were presented in full, yet onlysufficient space can be spared for a brief quotation from each letter. 

 * * * * *

TESTIMONIALS

CASE 175, 827. IMPOTENCY, CONSTIPATION, AND SEMINAL LOSS AT STOOL ANDWITH THE URINE. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--Since I have takenthe remainder of a third month's treatment that you gave me I have beenrelieved of my trouble. The emissions have ceased and the losses atstool and in the water have left me. Eighteen months ago I was almost acomplete wreck; now I take an Interest in business and am in excellenthealth. 

Respectfully, S. , Waveland, Ind. 

CASE 177, 068. SPERMATORRHEA. LOSS OF VITAL STRENGTH. CARED WITH SEVENMONTHS' TREATMENT. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--You haveundoubtedly wondered at my long silence. Since last I wrote you therehas been a marked change in my life (of which I will speak further on), under your skillful treatment. I improved so rapidly, notwithstandingthe many interruptions which misfortune on my part occasioned, that sixmonths ago I considered myself cured. I have been married three monthsand a half to a worthy woman, who should have gained for herself ahusband who never deviated from a virtuous path as much as I; but theattachment formed was so strong that no misfortune seemed powerfulenough to sever it. The barrier which seemed insurmountable, and which Ihad erected myself by early indiscretions and excesses, has given way, thanks to your superior medical knowledge and skillful treatment. AgainI can hold up my head and say, "I am a man. I never fail to call theattention 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 twofriends of mine to you, who are under your treatment, and are gettingwell. One has tried all the local physicians, and many firms, but withno success. May God bless you, and may your Institution meet with allthe success it so richly deserves, is the prayer and wish of one youhave caved. J. , Leadville, Colo. 

CASE 178, 666. EMISSIONS, AND LOSS OF WEIGHT AND STRENGTH. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have had noemissions now for some time, and feel well in every way. I am gaining instrength and weight, and find I shall not need further medicaltreatment. The four months' medicines that you have sent me haveeffected 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 beingalso troubled with frequent urination, partial impotency, mucousdischarges from the urethra, and a burning sensation in the testicle andgroin. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N. Y. : _Gentlemen_--Itook the two months' treatment sent me by you as directed. After takingthe first month's treatment the emissions ceased entirely, my appetiteincreased, and I slept much better. Eight months ago I finished thesecond month's treatment and have since been in perfect health. I amfully 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, CUREDBY SIX MONTHS' TREATMENT. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have received thelast medicine sent me, and have taken all with the best results. I haveso improved in health that I think it unnecessary for me to take anymore medicine. It is now several days since I took the last of themedicine, and have not had any return of the disease. The desire tomasturbate 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 ofbeing restored from the ruinous habit I had practiced for many yearswithout knowing how fatal it was to health. I tried hard to stop thepractice, but it had grown so strong on me that I would always practiceit again, and was fast becoming impotent. Had emissions at night; wasnervous, downhearted; and I lost flesh, and felt miserable in many waystoo numerous to mention. But now I feel healthy and well. If I had beenmore careful, and had not stopped treatment so soon before, I might havebeen 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 toexpress my sincere thanks to you and your Institution, for I owe myrestoration to health and happiness to you. If in the future I need anymedical skill, I shall always apply to your Institution, being certainof receiving the best attention. Yours thankfully, S. , Pittsburgh, Pa. 

CASE 62, 365. VERY BAD CASE OF SPERMATORRHEA AND IMPOTENCY. CURED WITHSIX MONTHS' TREATMENT. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--It has now beennine months since I stopped your treatment, and as there has been noreturn of former symptoms, I judge there can be no doubt as to my curebeing permanent. I must confess that, having been duped and swindled byso many previous to visiting you, I had not much confidence when I wentto Buffalo to see you. But your specialists, and your Manager, seemed totalk so straightforwardly and without making any of those extravagantpromises that I have become so used to, that I became convinced of yourskill before I had been long in your wonderful Institution. I thinkalmost any invalid who will visit your Hotel, and see for themselves thewonderful appliances that you have accumulated for the cure of disease, must soon become convinced that if there can be any hope of relief itcan be secured there, if anywhere. There I saw those who told me theyhad been brought there on beds or couches for hundreds of miles, andthat they had not been able to walk for two to four years, and yet withtwo or three months' treatment were able to go about everywhere, andwere about ready to return home. Such experiences as these establishedmy 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 seldomhave cases to equal in severity the condition I was in when I applied toyou. I was so bad, as you will remember, though I do not suppose yourely upon any thing but your records in referring to cases, having somany under treatment at all times, at all events, if you will turn tothe record of my case, which is "File No. 62, 365, " you will see that Ihad discharges of semen every time my bowels moved and withouterections. In fact, I was completely impotent. I am now as strong andvigorous as any man. You told me it would probably take a year to cureme, but as you accomplished it in five months, though I continued totake medicine a month longer to insure against a relapse, I think myselfvery 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. URINARYIRRITATION. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--The reason for mynot continuing treatment further than the fourth month, is the fact thatmy health is so much improved that I do not need it. I feel like a newbeing. All of my bad symptoms are gone, and I feel that I am cured. Foreight months my health has continued to improve all the time. I owe youand 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 expressmy gratitude for what your treatment has done for me. I have gainedforty-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 tosay that as a result of eight months' treatment you have given me, thesymptoms of my disease have been entirely removed. My voice has gotstrong and clear, and my breathing is easy and natural. My weight isincreased, and in every way I am feeling well. I cannot refrain frompenning a few lines. 

H. , Port Hope, Ont. 

CASE 113, 274. SPERMATORRHEA. 

Mr. K. , of Kalamazoo, Mich. , writes: "I feel that you have proven to bethe best friend I have on earth. It is about three weeks now since Ifinished the last month's medicines, and I feel as strong as I ever didin my life. When I commenced taking your medicines I only weighed 155pounds, but now I weigh 170 pounds. I feel strong and rugged; my step isfirm and bold; and I feel altogether a new man, for which I return youmy sincere thanks. "

CASE 173, 399. EMISSIONS. LOSS OF WEIGHT AND APPETITE; DYSPEPSIA. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--I write to let youknow that my health is improved, and to thank you for the same. Theemissions occur only at intervals of several months, and I do not haveany more polluting dreams. I am better in every way. My appetite isimproved, and my digestion is perfect. Have gained in weight, and sleepwell. I have not required all of the last supply of medicine, the sixthmonth, and I think I will pull through all right. Please accept mythanks for the benefit effected. 

D. , Valparaiso, Ind. 

CASE 45, 757. SPERMATORRHEA. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--Received yoursdated Oct. 27th, and am happy to say that I have so far recovered as tobelieve further treatment unnecessary. I feel like a new man; am able todo a full day's work without pain or laziness. I am very thankful forthe benefits I have received through your skill, and should I think itnecessary at any time for me to renew the treatment, I will be glad tocall 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 goodhealth, and can say that I am cured. The emissions have stopped, and Ihave no unnatural discharges, nor dizziness in the head. My health isgood in general, and I work hard every day. Physically, I have a goodappetite and digestion, which is a great change from what it was whenyou first treated me. Although I continued the treatment for eightmonths, owing to the complications and severity of my case, yet I amthankful for the great relief. 

D. , Newport, Ark. 

CASE 39, 625. SEMINAL AND NERVOUS DEBILITY. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--My case was one oflong standing, and had brought me to think and meditate more of dying aconsumptive's death, than living. The ill success I had met in trying torecover my lost manhood, had put me in such a constantly low-spiritedcondition, that nothing was interesting or pleasurable. I am highlypleased to report the improvement in my condition. My voice, weak andhoarse when I commenced treatment, is now strong and masculine. Hope andself-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 greatpleasure that I write you. I have taken but one month's treatment fromyou, and if I should just give you a full history of my case before andsince I have taken your medicine, you would not believe the improvementcould be true. I feel better every way. I am without language to expressmy 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 thanksfor the great benefit received from your treatment. I never thought Icould 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 tosay 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 thelosses became less and less frequent, and now I am entirely relieved, and desire to return my sincerest thanks to you for the good you havedone 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 clearand I feel like myself again, and now only wish that the money I spentfor useless medicines and experimenting doctors, had at once found itsway to you. By recommending you to others suffering as I did, I hope toassist 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_--Isee no further use in continuing your medicines, as I now feel perfectlywell and the emissions have stopped entirely. I used to feel dizzy, exhausted, and irritable on arising in the morning, but now I feelnothing of the kind. 

Respectfully, K. , Johnstown, Pa. 

CASE 175, 391. SPERMATORRHEA, WITH SYMPTOMS OF BRIGHT'S DISEASE ANDTORPID LIVER. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--When I applied toyou for treatment, although a man of apparently perfect health, yet Iwas subject to an exhausting drain, and felt myself gradually decliningin vigor of intellect and constitution. The five months' treatment thatyou have sent me has effected a very remarkable change in my health. Mykidneys (which had troubled me so that I feared Bright's disease) andtorpid liver have become natural, and I feel like a new man. The onlyprecaution I now take is not to sleep on my back; and I feel that I amcured. I send you the names of some other patients, and close by sayingthat I thank you sincerely for the cure, and the great benefit in myhealth that has resulted from your treatment. 

M. , Manhattan, Kans. 

CASE 110, 837, STRICTURE AND SPERMATORRHEA. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--My seminal troublewas cured long since, and I had forgotten it. Your medicines relieved meof that in a short time, and I am satisfied that it will cure the worstcases in a few weeks. I am also satisfied that you and your facultyaccomplish more in the healing art than any other in the country, and Icannot say too much in recommendation of your institution. I have triedyour institution, and have found your words true in every sense, andtake pleasure in authorizing you to use my name in any way to suityourself. My appetite is good, and I have no pain or trouble whatever. The neuralgia in the lungs, the tough phlegm, weakness, etc. , have alldisappeared. 

A. 

CASE 111, 571. SPERMATORRHEA. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N. Y. :_Gentlemen_--Under the influence of your last course of medicine myhealth has improved so greatly that I feel any further treatment to beunnecessary. My health is better now than at any other period for years. The night emissions have ceased entirely, I not having had one now formany 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 yourmedicine I labored physically. I am cheerful, hopeful, joyous, glad, andgrateful for my restoration to sound and vigorous health. My friendsdaily express surprise at the great change in my personal appearance, and declare that I appear younger than I did fifteen years ago. I alwaysreply that I obtained my new lease of life from the World's DispensaryMedical Association, Buffalo, N. Y. 

With sincere gratitude and great respect, I subscribe myself W. , CanyonCity, 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_--Inclosedfind 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 thecure of her case, now so chronic, that no human skill will be ofbenefit. 

Some four or five years ago you treated me for general debility andpremature decay, with severe attacks of vertigo. The first month'smedicines, 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 waspromptly filled by mail. By these two months' treatment I was perfectlycured, my whole system renovated and invigorated. I have been repeatedlyasked what I had been doing to cause such an improvement in my personalappearance, 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 takenany medicine since last December, at which time I had closed the seventhmonths' treatment. I am happy to say that, as a result, my mind is clearand easy. I am steadily gaining in strength, and feel better than I havefor many years, and owe it all to your treatment and advice. I hope youwill live long and prosper, and continue to dispense a balm forsuffering humanity. I will close by giving your faculty my greatestdevotion 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_--Yourlast month's treatment has entirely cured me. I have been married threeweeks 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_--Sureenough I am well, and I desire to thank you for your medical skill. Mystrength is very greatly increased, my digestion and appetite areperfect. I sleep well and awake refreshed, and, in fact, feel betterevery way. My eyesight, which was weak, is wonderfully improved, and myphysical condition is now perfect in every way. All the emissions haveceased. 

 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 saythat your treatment, which I have taken four months, has effected aradical cure of my trouble, and you are at liberty to use my name andaddress 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_--Ican honestly say, as the result of your treatment, that I feel betternow than at any time previous for years. My disease is under completecontrol, and I have no fear of any further trouble in that direction. Ina word, I feel that I am cured and well; and you may rest assured that Ishall take great pains to avoid in the future the cause that brought meto my former condition. I am, indeed, thankful to you, as your treatmenthas made it possible for me to lead a better life, and effectually toresist 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_--itis with great thankfulness to you that I pen these few lines. I amto-day a strong and healthy man, which I never would have been but foryour kind and skillful attention. My health was completely broken downby the effects of self-abuse, and I doctored with other physicians fortwo years, but with no success. However, after a few months of yourtreatment I find my health fully restored. I am now in a condition toenjoy the world and take comfort wherever I am; in a word, I am "a manamong men. " I most cordially invite all persons requiring skillfulmedical 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 yourthree months' course of treatment some weeks ago, and am glad to saythat 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 FROMEXCESSES. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--I took yourmedicines according to directions, and I feel that I am fully restoredto health and the enjoyment of my manly powers. My health is better thanit has been for years, and is improving all the time. The headache anddizziness have entirely left me. You have my honest recommendations toall sufferers. 

Thankfully yours, M. , Hudson, N. Y. 

CASE 44, 573. IMPOTENCY. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--As a result of yourthree months' treatment, I am feeling better than I have for twentyyears, --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 haveelapsed since my case was cured by you with one month's treatment. Sincethat time I have not had the first symptom of the disease. I know I amcured. 

Yours with thanks, C. , Kalamazoo, Mich. 

CASE 175, 579. EMISSIONS, YELLOW COMPLEXION, BLACK HEADS AND ERUPTIONS ONTHE FACE. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION:, _Gentlemen_--I am happy to saythat 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 havehad no losses for many weeks, and my complexion is restored to itsnatural clearness and purity. The black heads and pimples have alldisappeared. 

K. , Neillsville, Wis. 

CASE 21, 437. IMPOTENCY. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--I have, as a resultof your treatment, been more of a man than before in six years. I havefelt, worked, and eaten better than ever before. My strength is in everyway fully restored. 

C. , Jordanville, N. Y. 

CASE 38, 005. IMPOTENCY. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--When I first wroteyou I had given up all hope of ever getting well. I had not worked fortwo years. I had not been under your treatment three months before Iwent 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, APPETITEREGULAR, SOMETIMES RAVENOUS AND THEN VERY POOR. INTELLECT AND MEMORYMUCH ENFEEBLED, THE RESULT OF LOSSES THROUGH THE URINE. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--The condition of myhealth is highly satisfactory, thank Heaven and you as the instrument. It has often been a cause of astonishment to me, to think now admirablyyour 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 diseaseand 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 tobe able to report my cure. My case was a severe one, the insidious drainupon my system producing general debility, attacks of severe palpitationof the heart, and obstinate dyspepsia. Since using your medicines, Ihave been cured of these troubles. I have no palpitation, digestiongood, not easily worried, able to work hard without undue fatigue, strength greatly increased. My weight is now 163. I am thankful to Godand 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 youfor medicines, I little expected the remarkable benefit that hasresulted. The rheumatic pains that have so long troubled me, ceasedwithin a week. I am now able to attend to my business with my formerability and energy. You have my gratitude for the cure effected in mycase. 

 Very respectfully, P. , Bloomington, Ill. 

CASE 146, 406. SPERMATORRHEA, WITH DYSPEPSIA, CATARRH, AND BACKACHE. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am happy to saythat as a result of five months' treatment, the weakness of my urinaryand generative organs has been entirely relieved. My catarrh is so muchbetter. The difficulty in the head is now gone, and I have nodiscomfort. The weakness in the back, and pain in the kidneys, has allleft me, and I rest well at night. There are now no unnaturaldischarges, and I am happy to say that your medicines have effected sucha 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 ANDEMACIATION. MOST SEVERE FORM OF THE DISEASE. CURE WITH THREE MONTHS'TREATMENT. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--I have waitedseveral months and find my cure perfect and permanent. Thanks to you myhealth and manhood have been perfectly restored, and I am as fat as abullock. 

 S. , Millbrook, Ont. 

CASE 4, 100. SPERMATORRHEA. ENTIRELY BROKEN DOWN. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--Over eight yearsago I visited you at your office this present month, very melancholy andthinking perhaps that in six months I would be lying in my cold andsilent grave, and now I am strong and healthy. I never was so healthy inmy life. Am married, and we have two of the nicest children you eversaw. I am the happiest man in town, and hope to ever be so. My sicknesswas contracted through ignorance and self-abuse. I am glad to say that Ihave had a permanent cure, and thank God. I feel grateful to you andthank 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 themonth's treatment sent for, and took it. It worked like a charm. I haveno more emissions, and my weight, energy and strength, are fullyrestored. 

 R. , Fort Collins, Colo. 

CASE 53, 859. SPERMATORRHEA. FIVE YEARS' STANDING. SYMPTOMS: FREQUENTNOCTURNAL EMISSIONS, LOSS OF MEMORY, NERVOUS, NO ENERGY OR STRENGTH. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--Pardon me for notsending you a report of my condition before this. Have been waiting tosee if there would be any relapse. I am assured that my cure is completeand perfect. None of the symptoms of the disease remain. Your medicinesI can recommend as the most powerful and direct to accomplish good Ihave ever taken. I feel it my duty now to give you my heart-feltacknowledgment 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 mesound and well of the terrible effects of early indiscretion. My casewas 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 fullyrestored. 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_--Pleaseaccept my sincere thanks. Words at my command are inadequate to expressmy feelings when I realize the great beneficial features of your mostexcellent remedy. I have spoken to several of my most intimate friendswho are similarly affected, and after I took the first dose I wascompletely relieved, and the flesh I gained was in such abundance that Iwas scarcely identified by them. I gave part of your _par excellence_medicine to a bosom companion of mine, named ----. He becameconvalescent, but desires another bottle. Write to him at once. Yourname 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 workedlike 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, hesaid. "J. , I think you will be an entire cripple. " I then thought Iwould write to you. I had not taken more than three months' medicinewhen I was out in the harvest field. I sleep all night, have a goodappetite, my back has got well, and I can lay all night. My limbs arestronger, and my nerves are again all right. Upon the whole I am a newman, and my mental powers are much relieved. In eighteen months from thetime I placed my case under your treatment, I was better than I had beenin 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 benefitI have derived from your two months' treatment. When I first wrote toyou 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 earlygrave as the results of self-abuse. Before I began treatment I was paleand sickly; I had palpitation of the heart so bad that I often expectedto drop dead in the street; I had loss of voice; always felt tired; Ihad involuntary emissions of semen in the night, which always made mefeel weak through the next day; whilst quite often my mind was filledwith suicidal thoughts. Such was the price I was compelled to pay forviolating the laws of God and nature. Now every thing is changed. Ithank 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 treatmentto everybody, and I will cheerfully answer any communication that I mayreceive in relation to this. W. , Lynn, Mass. 

CASE 140, 948. SPERMATORRHEA. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N. Y. : _Dear Sirs_--Ibelieve myself to be free of the trouble for which you have beentreating me. It seems too good to be true, yet I feel satisfied that Iam more of a man than ever before in my life. I have not the time norability to thank you in the high-flown language peculiar to testimonialwriters, 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, sufferedseverely from mental depression, weakened memory, nervous exhaustion, and lack of intellectual power, the result of the delicate drain uponthe nervous system and his severe labors. We append his letter afterfour months' treatment:

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--My friends allnotice and speak of my decided improvement. My health and faculties areagain 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 beenbeyond the reach of aid now but for your treatment. I am now enjoyingperfect health. Yours gratefully. H. , Gillie's Hill Ont. 

CASE 42, 921. SPERMATORRHEA, RESULTING IN DYSPEPSIA AND DECIDED LOSS OFSTRENGTH. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am deeplyindebted to you. The disagreeable head symptoms, dyspepsia and weaknessare all gone. I can now eat and digest as hearty a meal as any one, andfeel well, healthful and energetic. Never have any losses. I was verysick 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 TONEOF SYSTEM. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I took treatment ofyou last summer. The improvement was marked, and I have continued togrow healthier and stronger, notwithstanding I have been busy all thetime and nave studied very hard. Do not get fatigued as before. I readsix orations of CICERO in seven weeks and passed with honor a very closeexamination. 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 gratefullysay I am feeling like a new man since taking your prescription forseminal weakness. While I was in the West two months, my wife receivedtwo months' treatment from you, and on my return home, to my greatestsatisfaction, her cheeks were as red as roses and her health greatlyimproved, for which accept our profound thanks. May your honoredPresident live long and do good unto the sons and daughters of afflictedhumanity, is our prayer. W. , Aral, Va. 

CASE 44, 198. NERVOUS PROSTRATION, CAUSED BY SELF-ABUSE. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--Your kindness to meI can never forget. I cannot express half my feelings of gratefulness toyou. I had despaired of ever getting well. Thanks to your skill I am nowa 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 hasimproved so that I no longer need treatment. You have my heart-feltthanks for the good you have done me, and may you have as good successin treating the hundreds of others as you have had in mine. I remainyours very truly, K. , Hartford, Conn. 

CASE 53, 913. NERVOUS DEBILITY AND IMPOTENCY. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I shall everremember 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 saythat your medicines and treatment are always ahead of what they arerepresented, and I hope you will accept my deep and sincere thanks forthe good you have done me. My weakness and debility have entirelydisappeared, and I can say that the expense of the six months' treatmentI received from you, has been repaid a hundredfold, by the benefits ithas effected in my condition. F. , Starkey, N. Y. 

CASE 54, 803. NERVOUS DEBILITY AND IMPOTENCY. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have taken thelast of the medicine which you sent me, and feel satisfied it hasentirely cured me. I return my thanks to you for the good you have doneme. F. , East Liverpool, Ohio. 

CASE 69, 116. SEMINAL WEAKNESS, WITH CANCEROUS TESTICLE. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--It has now beenover two years since you treated me and found it necessary to remove onetesticle on account of cancerous disease, that must soon have destroyedlife had the operation not been performed. T feel myself a strong, healthy man, having had no symptoms of the seminal weakness for monthspast. Yours, P. , Pittsburgh. Penn's. 

CASE 51, 417. IMPOTENCY. 

I am getting along so well with the medicine that I am a standing wonderto my friends, and I shall not cease, while life lasts, to praise theskill 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 happyto say that I have fully recovered my powers in every particular sinceplacing myself under your treatment. I would not take $5, 000 for thegood you have done me. I am only sorry that I did not go to you beforewasting time and money on the quacks connected with that "Museum ofAnatomy" in New York. 

 T. , Philadelphia, Penn'a. 

CASE 67, 208. SPERMATORRHEA. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--When placing myselfunder your treatment, I was told that my case being an exceedingly badone, it would probably require six months in which to effect a perfectcure. After taking your remedies four months I found myself in perfecthealth, and have remained so ever since. I cannot express the gratitudeI feel for you, and can never half repay the debt of gratitude I oweyou. I have given your pamphlet, -"Abuse of the Male Generative Organsand the Diseases to which it Gives Rise, " to quite a number of young menwhom 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 returnedhome a now man, after four months' treatment from you. I need no moremedicines 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 ofmanly strength, nervous prostration, indigestion, torpid condition ofthe liver, headache, nausea, and constipation. After a course of fivemonths' treatment he writes:

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am very gratefulto you for the good you have done me, and I feel like a man now. It issometime since I left off medicine. I have continued to improve, and Ifeel better than I have for years before treatment. I am happy at therestoration of my health and vigor. I shall recommend you to allsufferers. 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, andstrength have improved wonderfully, and my sleep is sound, undisturbedand refreshing. Under the influence of your medicines I have completelyrecovered my mental and physical powers, and I feel that I am able todiscontinue further treatment. The emissions have become less and lessfrequent 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 pleasantprivilege to read concerning your skill in the treatment of all kinds ofdiseases, and concerning your reputation, which is most justly merited. Encouraged by these facts to place explicit confidence in you. I begleave to state my own case as clearly as I may be able. It is as sad asit is fatal if no thorough cure can be effected. I have from my twelfthyear onward been practicing, though not excessively, the evil, _self-abuse. _ Although I have been led to abandon the pernicious habitfor several years, my age being twenty-four, the horrible effects havenot disappeared. The serious result is that I am suffering fromspermatorrhea. An involuntary discharge of the seminal fluid occursinvariably once, not infrequently twice, every week during sleep. Thegenital organs have become diminished in size. I will proceed to statethe symptoms which I have been able to observe. They are--disposition tosolitude, inaptitude for study, indolence, forgetfulness, melancholy, weakness in the back (especially perceptible after standing), a lack ofconfidence in my own ability, want of energy, sometimes pain in thechest, elbow, arm, knees, and loins. Uneasy nights, disturbed and highlydisagreeable dreams becoming more and more irritating as the time forthe discharge of the seminal fluid draws nearer, also a desire to lielonger in bed in the morning. 

Now, dear Doctors, permit me to ask your kind advice as to what meansare to be taken. I have tried numerous remedies for more than a year, but to no effect. My suffering grows severer. Please reply as speedilyas 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 shallbe forwarded at once. Please find inclosed one dollar, remuneration foryour kind services. 

 Very respectfully, M. , Wheeling, Cook Co. , Ill. 

(At the close of treatment. )

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have finished theeight months' treatment; had I been able to follow the directions moreclosely, three months' treatment would have effected a permanent cure ofmy case. Now I am well, body strengthened, mind invigorated, memoryrevived, energy to work restored, cheerfulness and bright hopes, oncealtogether lost, are now fully regained. Indeed, I feel like a newbeing. And now, dear Doctors, in closing our important correspondence, permit me to render my heart-felt thanks for your kindness to me, andfor the benefit received from your invaluable treatment. Adieu; may Godgrant 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 monthsof your treatment, I find myself cured of one of the worst habits thatit has ever been the lot of man to fall into. My whole system isinvigorated; I have no more weak back nor legs; no more emissions; mystrength is greatly increased, and my weight is more than it has everbeen before. The dull, heavy feeling in my head is entirely past, and Ican truly say that I feel like a new man. Hoping you will do as muchgood 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_--Ihave 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 inme. The emissions have ceased entirely, and I am strong and well. I am athousand times obliged to you for the good your treatment has done forme. 

 Respectfully yours, U. , Topeka, Kansas. 

CASE 461, 306. ONANISM. MELANCHOLIA; CONTEMPLATED SUICIDE. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--Having waitedseveral weeks after finishing the last medicine, to see if there wouldbe any relapse, I now send you a report of treatment. I believe I amthoroughly cured, not only of poor health, but of all desire to abusemyself. I have regained health, spirits, and confidence. Am married, something I have long desired, but never before dared to attempt. Pleaseaccept my sincere thanks, gentlemen. Your medicine has saved me from asuicide's grave. 

 H. , Denver, Col. 

CASE 110, 838. SEMINAL WEAKNESS AND FISTULA IN ANO. 

A case of anal fistula that had been unsuccessfully treated byProf. ----, of Nashville, who had operated with the knife. He had alsobeen unsuccessfully treated by several home physicians who stated thathis symptoms of spermatorrhea were all that could be described, and moretoo. The sensations of crawling and itching in the rectum were verysevere, and as a result of weakness there was a serious palpitation ofthe heart, and general debility. The generative organs were undulyexcitable and weak. He complained of weakness in the rectum and loins, with irregularity of the bowels, trembling and weakness of the entiresystem. There was profuse discharge from the fistula and also from theurethra. We undertook his case without making any promises of a radicalcure, as it seemed that the disease had progressed so that it would beimpossible to effect more than satisfactory improvement in his generalcondition, and a palliation of the symptoms of disease. At the end ofseven months' treatment he writes as follows:

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--The result of thetreatment you have sent me is a permanent cure of the fistula beyond adoubt, and in a magical manner. My heart is very much improved, so thatit 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 thinkat any time that a little is required to keep me in good health, I willorder at once. I think that I am entirely through with the fistula andsympathetic weakness, and I can truly say that your remedies deliveredme from the jaws of death. With sincere thanks to you, I am, yours forever. D. 

CASE 140, 056. SPERMATORRHEA. 

The following long-standing and aggravated case of seminal debilitybegan to yield at once under the specific influence of our medicines. Frequent nocturnal emissions were present, and the semen also passedoff, unobserved and unsuspected, in the urine; of course a ceaselessvital drain of this character began quickly and profoundly to impressthe constitution, so that when the patient under consideration appliedto us for relief, the most unmistakable symptoms of commencing organicdisease of the heart and lungs had plainly declared themselves to bepresent. Like many hundreds, of similar cases which we cure annually, the disease yielded promptly and perfectly to the well-directed effortsof our specialist in this important branch of practice; indeed, so easy, swift and perfect was the cure that the patient failed to realize thenecessity of continuing the treatment a few weeks in order to insurehimself against the possibility of a relapse, and discontinued hiscorrespondence with us, whereas it is in precisely such cases that werecommend the treatment to be not too abruptly discontinued. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N. Y. : _Gentlemen_--Yourkind favor, thoughtfully inquiring after my health, came duly to hand. In answer, permit me to say that it was not my intention to take furthertreatment as I considered my cure to be perfect, all local and generalsymptoms having wholly subsided before I had finished the month'scourse, and thus far manifesting no disposition to return. However, inthe light of your wisdom and experience, I have reconsidered the matterand now believe with you that another month's course of treatment isadvisable, in order effectually to guard against the possibility of arelapse. I accordingly inclose you the price of the additional month'scourse. The second morning after commencing the use of your medicines Iawoke refreshed in body and mind, and this experience has been repeatedevery morning since. The emissions were arrested at once, and I have nothad a single unnatural discharge since, except once when I experienced aslight nocturnal emission, which, however, was followed by no depressingafter-effects, but altogether the reverse. I feel so much stronger andbetter in all respects that It is a positive pleasure for me to do ahard day's work now. 

 Respectfully, B. , Crystal Lake, Wis. 

CASE 86, 291. 

This gentleman had suffered during eleven years from seminal weakness asthe result of indiscretions in youth; nocturnal emissions were present, and there was also a seminal loss with the urine, and at stool; thepatient's memory was greatly impaired and his mind otherwise affectedfrom the vital drain; he was dyspeptic, his bowels were costive, andthreatening symptoms of consumption had already begun to manifestthemselves when he came under our care. Two months of our specialtreatment, at the patient's home, effected a perfect and permanent cure, and completely arrested all abnormal seminal losses. The followinggrateful 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 discontinuedyour treatment, my cure remains perfect. This great permanent andenduring benefit was secured to me through only two months of yourskillful treatment and careful management of my case. Your medicines hada wonderful control over my disease, driving away its terrible symptomsas if by magic; they imparted to me a new power, filled my body and mindwith unusual vigor, and transformed me from one racked with pain andliving death or worse, to a full measure of health and happiness. I feelthat if I had not been opportunely and successfully treated by you, thatmy life would have been permanently blighted, and that the happy andcontented mind that now inspires these lines would ere this have beendethroned of reason. I feel that you have been my savior. I have not hada single nocturnal emission since leaving your treatment, six monthsago. Thanking you, gentlemen, from the depths of a grateful heart, Iremain. 

 Your obedient servant, G. , Cayuta, Schuyler Co. , N. Y. 

 * * * * *

Did the interest of our readers demand it, we could add to the precedinglist an almost endless number of extracts from letters written bygrateful patients, expressing their heart-felt thanks for having beencured of spermatorrhea and impotency by our treatment. But we have wetrust given sufficient to illustrate our great success in dealing withthese maladies. 

A CAUTION TO THE AFFLICTED. We are daily consulted by persons sufferingfrom spermatorrhea and impotency who have been victimized by ignorantcharlatans. Some seek to dupe and swindle the unwary by claiming to havethemselves been cured of spermatorrhea or impotency by someprescription, which they offer to send free to any sufferer. When theprescription is obtained it is found to consist of a few articleswell-known to every druggist, coupled with certain arbitrary andfictitious terms, unknown to everybody and not to be found in anymedical work extant. Following the prescription is a modest suggestionthat if it cannot be filled by the home druggist, thebenevolently-disposed party furnishing the prescription will be pleasedto send the medicine, already prepared, for from three to five dollars. Of course, the whole scheme from beginning to end being a swindle, whenthe "medicine" is obtained and taken it proves entirely useless. Skilland genuine merit do not go begging. Men who spend hundreds of dollarsfor the publication of advertisements offering to give away valuableinformation 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 infallibleremedies for spermatorrhea and impotency. 

A vast experience in the treatment of these affections has satisfied usthat each case must be studied and treated according to the symptomsmanifested, and that medicines that are adapted to one stage of thedisease 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, exceptit be in the imagination. Although the proprietors of the most popularproprietary medicines in the market, medicines carefully adapted to thecure of the diseases for which they are recommended, yet, should weattempt to get up a general remedy to cure spermatorrhea and kindredmaladies, we are certain it would be an utter failure, and this isentirely true of all such preparations now and heretofore offered forsale, and, from the very nature of the diseases they are recommended tocure, ever must be. Each case must have medicines carefully prepared tomeet the conditions present, and when these conditions, from the effectsof treatment or other causes, change, the treatment must be variedaccordingly. 

POSITIVE INJURY instead of benefit often results from the employment ofsome of the nostrums advertised for the cure of spermatorrhea, impotencyand kindred affections. Especially have we found that the use of"Soluble Urethral Crayons, " "Boluses, " "Pastiles", and kindredcontrivances, which are so extensively advertised, are exceedinglyinjurious, and often render otherwise moderate and simple cases, complicated and incurable. 

Although of pretended French origin, they are evidently the invention ofan ignoramus, who knows nothing of the delicate anatomy of thegenerative organs or of the proper treatment of the diseases incidentthereto, for none other would have thought of such a preposterous planof treatment. No man should insert such absurdly devised and mischiefbreeding contrivances into his urethra (urinary canal), for thereby heis almost sure to do himself a permanent injury. So far from having beeninvented by an eminent French surgeon, as claimed, such treatment isentirely unknown in France, and ever has been, as the writer well knowsfrom personal observation and enquiry while sojourning in that countryand visiting its most noted hospitals and medical institutions. 

All the various "Troches, " "Boluses, " "Wafers, " "Suppositories, ""Pearls, " "Rectal Pearls, " "Rectal Capsules, " and other contrivanceswhich are recommended for the cure of Spermatorrhea and kindredweaknesses, and which are designed to be employed by inserting them intothe lower bowel (rectum), and there permitting them to dissolve, areonly so many irrational and filthy devices for duping the ignorant andinnocent 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 recommendedfor "Developing weak and wasted organs. " A simple, little, brass airpump, connected with a glass tube, or cylinder, fitted with a valve atone end, which costs not to exceed one dollar and a half, is theworthless device palmed off on the confiding ones _at from fifteen tothirty dollars_. This is done under the _false pretense_ that its dailyuse to pump blood into the weak or wasted organs, will cause theirdevelopment and growth. 

Thousands have invested their hard earned cash in this worse thanworthless, injurious, contrivance. In fact the head of the concernputting out this alluring device is said to have amassed a fortune outof the nefarious business. 

So far from benefiting any one, out of several hundreds of cases thathave come under our personal observation, in which this apparatus hasbeen faithfully used for a long period of time, we have never met with asingle case that had derived the slightest benefit therefrom. On thecontrary, 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 delicateblood-vessels of the organ operated upon, caused by placing it in avacuum, is liable to rupture these minute vessels, causing theinfiltration 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 areso weakened by the _strain_ put upon them as to induce varicocele andother diseased conditions. In spermatorrhea, it is the worst possiblething that can be applied, for by forcing an undue amount of blood intothe part the sensitiveness of the organ is increased, irritation is setup in the deep urethra, and the emissions are increased in frequency. Inthis, and other ways, hundreds of men but slightly out of health havebeen permanently injured. 

But this is only a small part of the story connected with thereprehensible business of palming off "The Vacuum Developing andStrengthening Appliance. " The precious rascals, not content with makingfrom a thousand to fifteen hundred per cent. Profit on the miserabledevice furnished, while advertising fifteen dollars ($15. 00) as theprice of the "appliance" and "accompanying preparations, " for "_ordinarycases_, " make a general practice, when they have secured the fifteendollars ($15. 00), of sending it by express _with a bill to be collectedon delivery_ FOR FIFTEEN DOLLARS ($15. 00) MORE. With this bill they sendan explanation, that "on re-examining the case" they "found itnecessary, or thought it advisable, to send their stronger and moreexpensive preparations and appliances _for the worst cases_ AND SO HAVECHARGED FIFTEEN DOLLARS ($15. 00) MORE TO COVER THE EXTRA EXPENSE. "

It is astonishing that there are those who can be induced to part withtheir money for such claptrap devices, and still more so that havingbeen duped and swindled out of their hard earned money through falsepretenses and promises of benefit held out to them, they should submitquietly to such extortion and not have the swindlers arrested andprosecuted for obtaining money under false pretenses as they richlydeserve. For what crime can be more deserving of punishment than theholding out of false hopes and pretenses to the unfortunate? Employingthe United States mails for swindling is a pretty dangerous business, and sooner or later these rascals will, we predict, find it out to theirsorrow. They are pretty sure to get hold of some men, ere long, who willinvoke the aid of the United States District Attorney to bring them tojustice. 

YOUNG MAN, if you have, through ignorance, fallen into practices thathave arrested your physical growth and development in any of your organsor parts, shun all such unscientific and worse than worthlesscontrivances as you would shun a pestilence. No matter how plausible theweb of arguments woven to entrap you, be assured, they are the utteranceof knaves who care not what false hopes they encourage so they secureyour money. 

Consult only those whose well known skill, experience and integrity willinsure 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 andfunctional derangements are overcome, the parts that have sufferedtherefrom, will regain all the strength and development possible toimpart to them through the aid of the physician's skill. Nature oftenaccomplishes wonders in this direction, when aided by the skillfulpractitioner. 

 * * * * *

VARICOCELE;

_OR, ENLARGED VEINS OF THE SCROTUM SOMETIMES CALLED FALSE RUPTURE_

Probably no affection of the generative organs has been given moreattention by surgeons than this. Its great frequency, being present inabout one-third of all cases of spermatorrhea, and its disposition toresult in impotency and wasting away of the testicles, bring itconstantly before the profession. 

[Illustration: Fig. 1. A healthy testicle. ]

[Illustration: Fig. 2. Testicle wasted from Varicocele. The enlarged andtorturous veins are shownto be about as large as thetesticle. ]

CAUSES. --Varicocele commonly results from long continued fatiguingexercise, 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 returnof blood through the spermatic veins. Self abuse and excessive sexualindulgence are also prolific causes of varicocele. 

When the spermatic veins are over-distended to such an extent that theirtonicity is impaired, they gradually lose their capacity fortransmitting the blood, and a slowly increasing enlargement andtortuously of veins results. This goes on, becoming steadily moremarked, until the pressure of the engorged vessels upon the spermaticcord impedes the full circulation of blood in the testicle and causes awasting and softening of this gland. A loss of sexual power andincreasing weakness of the generative organs generally follow thisgradual destruction of the testicle, and sometimes total and incurableimpotency results. 

This affection is also designated by the terms _circocele_ and_spermatocele_. It consists of an enlargement or varicose condition ofthe veins of the scrotum or spermatic cord, and affects the left sidemore frequently than the right. This is due to the fact that thespermatic veins of that side are longer, more dependent and tortuous, and, consequently, support a greater column of blood than the otherside. The enlarged veins feel like a bundle of earth-worms. The knottyand tortuous vessels sometimes form quite a large tumor, which is, nowever, but rarely sensitive to the touch, yet sometimes causes a feelingof weight in the scrotum and loins, and sometimes produces a sensationof 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 spermatorrheaor impotency, it must be cured before the organs can regain a healthycondition, as by the constant pressure of the abnormal quantity of bloodand enlarged veins upon the spermatic cord, arteries, and testicles, theirritability, weakness, and wasting, are increased. The use ofsuspensory bandages, with strongly astringent lotions, will, in mildcases, produce relief and many times cure. Except in the worst cases, itis well to try these means before resort is had to operative surgicaltreatment, unless the patient is anxious to be cured in a more speedymanner. The treatment by suspensory bandage and lotions is necessarilysomewhat slow in producing remedial results; yet, many quite well markedcases have, in our experience, been cured by such means perseveringlyapplied. Although many who have been unable to come to us for anoperation, have been cured by suspensory bandages and our improvedlotions applied to the affected parts, in all cases in which the veinsare very much enlarged, we recommend the sufferers to come here andundergo our surgical treatment, which is painless in its execution andradical 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 andpermanently effected by operation. Many have been the methods ofoperation advanced by the prominent surgeons of every age, but all havemet with such an alarming mortality, that they have been one by oneabandoned, except as a last resort in extremely bad cases. A late authorgives the percentage of deaths from the various old operations, now ingeneral use throughout this country and Europe, as varying from seven tofifteen per cent. Of all cases. In contrast to this, we point with prideto our records, by which we are shown to have operated upon over athousand cases by our original method, obtaining in each and everyinstance a perfect cure, without a single alarming symptom or a deathensuing. This we think is sufficient evidence of the perfect safety ofthe operation and its superiority over every other method. So everysufferer with the disease, we would recommend it as a positive means ofsecuring a permanent cure. Various worse than useless devices areadvertised by quacks, who, as a class, are afraid to undertake surgicaltreatment for the cure of varicocele. One has what he calls a "varixclamp, " or "clasp, " to be worn upon the enlarged veins. Many"compressors" and other equally useless devices are advertised and soldfor the same purpose. These are not only perfectly worthless, butpositively dangerous in their application. The pressure they make uponthe spermatic cord, nerves, and artery, is very apt to result inimpotency and a rapid wasting away of the testicles. Patients shouldavoid all the catch-penny devices recommended for varicocele, as none ofthem are worth a moment's consideration. 

Even a moderate degree of morbid enlargement of the spermatic veins willsometimes cause such engorgement and obstruction to the free circulationof the blood in the testicle, as to cause gradual wasting or shrivelingof that organ. In some cases the morbid condition will give rise toseminal weakness, or spermatorrhea. Many of these cases that can only becured by surgery, are trifled with by quacks, who attribute thespermatorrhea, or loss of semen, to everything else than its truecause--varicocele. 

To illustrate, Mr. B. , of Colorado, applied at the Invalids' Hotel andSurgical Institute, a few years ago, and said he had for five years beentroubled with nightly emissions of semen and his testicles weregradually wasting away. He had been under the treatment of men makinggreat pretensions as specialists, to whom he had paid several hundreddollars in the vain hope of getting cured of spermatorrhea. They treatedhim with medicines only, and did him no good whatever. On examination, we found a very varicose or enlarged condition of the left spermaticveins, and gave it as our opinion that the seminal loss was wholly dueto this abnormal condition and could only be cured by an operation thatwould remove the varicocele. The operation was promptly performed. Intwo days he was able to leave his bed, and in a week started home toColorado. Some months thereafter we received a letter from him whereinhe 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 experiencedcorresponding improvement in my general health, and the seminal lossesgrew less and less, and finally, long ago, disappeared entirely. I feelthat my manhood, with all the powers that should belong thereto, aremine to enjoy. In other words, my restoration to health is complete. HadI 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 onlyfairly paid for the great good you have done me. "

The foregoing is but a fair sample of letters that we are almostconstantly receiving from those who have pursued useless treatment forspermatorrhea, dependent upon varicocele, and have been speedily curedby our never-failing operation for this malady. Among the great varietyof operations in surgery for various diseased conditions, performed byour 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 toproduce such complete local anæsthesia as to render the operation_entirely painless_ without the administration of either chloroform orether. This is an important consideration, as many are averse to takingchloroform or ether, and now that we are possessed of an agent thatproduces, locally, _complete insensibility to pain_, we are very glad tobe able to dispense with their use in all such minor operations. Manyexaminations heretofore very painful, as of the bladder for stone, andof 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 surgeonspecialists, without any suffering on the part of our patients, by thelocal use of an anæsthetic solution injected into the parts to beoperated upon. Formerly we were obliged either to administer chloroformor ether, or subject our patients to a great deal of suffering. Ourspecialists were among the first surgeons in this country to employlocal anæsthesia successfully. We regard it as a great boon to ourpatients, and never withhold it in any case where it can be employed toprevent suffering, its use being attended with no danger and followed byno bad or disagreeable results. 

OUR PAINLESS OPERATION. 

Having operated with unvarying success, during the past twenty-fiveyears, upon several thousand cases of varicocele, at the Invalids' Hoteland Surgical Institute, we now invite special attention to the resultsof our peculiar operation, which is neither severe nor dangerous, andfrom which the patient makes a much more rapid, and in every respectmore satisfactory, recovery than from other operations in use bysurgeons generally. In our practice we have never failed to secure thehappiest results from our operation. The saving of time is also ofimportance to the laboring man as well as to the millionaire. Instead ofbeing confined to his bed for ten to twenty days, and to his room for amonth or more, as is the case following other operations, the patient isnot confined to bed at all, and can generally return home in a week orten days at the longest. The only precaution necessary is that heshould, for a reasonable time after the operation, wear a well-fittingsuspensory bandage. This can, in a little time, be entirely dispensedwith. When we contrast these results with those obtained from ligation, graduated pressure by "clamps, " suture pins, or the slicing off of apart of the scrotum, and suturing, or stitching, the wide gaping woundso caused, as is practiced to-day by other surgeons, the markedsuperiority of the results obtained, through our superior method ofoperating on this affection, must be apparent. 

A very large part of those cured by our treatment have previously spentfar more money for worthless "electric suspensories, " "equable scrotalcompressors, " "scrotal clamps, " various "rings, " and other "jim cracks, "than was paid us _for a radical and permanent cure_. Some of theseinstruments are so formidable as to suggest the racks and thumbscrews ofthe middle ages. Such useless appliances often weaken the scrotalmuscles by the unnatural compression which they produce and make thediscomfort 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 leavesthe scrotum and its contents in an improved, strengthened and morehealthful state. 

 * * * * *

TESTIMONIALS. 

If the following letters had been written by your nearest, mostrespected and trustworthy neighbors, they could not be entitled to moreconfidence than they now are, coming, as they do, from intelligentcitizens, each one of whom, in his own neighborhood, enjoys the fullconfidence of all his acquaintances. These letters are taken at randomfrom among hundreds of similar ones, received from former patients ofours, residing in all parts of the United States and Canada, and if itwould add anything to the endorsement in the way of giving greaterconfidence in our ability to treat successfully the malady underconsideration, we could multiply the letters which we here introducemany times over. To publish more, however, would seem to be tediousrepetition, for there necessarily must be a sameness in all such letterstestifying to our skill, and we must, therefore, be content to rest ourcase with the limited number of endorsements which we have room for onlyin this volume. 

VARICOCELE. 

A PERFECTLY PAINLESS OPERATION. PATIENT SMOKES A CIGAR AND TALKS WITHTHE 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, causedby a fall, and doctored for same about fifteen years, and obtained norelief. Renowned surgeons of Pittsburgh, New York, and other citiespronounced my case incurable. 

I heard of the Invalids' Hotel, No. 663 Main Street, Buffalo, N. Y. , andentered it as a last resource. On the third day after entering theInstitution I was treated, and during the operation (which was apainless one), I smoked a cigar and talked with the operating surgeons, feeling _no pain whatever_. I remained in the Hotel one week, and duringthat time I never once was unable to walk to the elevator and have mymeals in the dining room. The tables were laden with the best thecountry 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 thusafflicted 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 receivedat your Institution during the month of December, 1892. 

I was afflicted with varicocele on the left side, which caused me agreat deal of trouble and almost made me feel at times that I did notwant to live any longer if I could not be restored to soundness again. Hearing of your skill in the treatment of varicocele I determined togive you a trial, which I accordingly did, and with gratifying resultsfor now I am as sound and well as a gold dollar. 

The operation which was performed on me at your Institution for thepermanent cure of varicocele was, to my great surprise, entirelypainless and performed in a much briefer time than I expected. I onlyremained at your noble Institution ten days after the operation, at theend 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 operationand I felt that I could enjoy life fully. About six months after, I gotmarried and came to Utah where I now reside, and I am very much pleasedto say that I am now as sound and well as ever, and very happy in mymarried state. 

When I went to your Institution I was surprised to see such a greatnumber of young men from almost every State in the Union, who had comethere to be operated upon for varicocele; and they all told me that theoperation was painless to them, as it also was to me, and they said theywere fast improving and were glad they had come there for treatment. Inever experienced such great and unprecedented kindness as I did duringthe ten days I was at the "Invalids' Hotel. " I had an excellentroom--well furnished, plenty to eat, and was treated with the kindnessof a mother by the nurses and attending physician. 

I advise all who are afflicted with varicocele to go to your Institutionat once for an operation, which I assure them they will never regret. Trusting that those who require an operation of any kind, or who areafflicted in any way, may go to your Institution and be restored tohealth, and again thanking you for my restoration to health and YOURgreat 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 fromvaricocele to your skillful hands. I suffered with varicocele for sevenyears, caused by standing behind the counter at business from seven inthe 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 itsdoctrine. I immediately started for Buffalo--a distance of 1, 900 miles. During my stay of ten days at your Institution I was treated with theutmost kindness by the nurses and surgeons, all of whom are expertspecialists. 

The equipment of the Institution is something immense. I often think ofthe appetite those healthy exercises in the treatment room gave me whendinner time came. 

After being in the Institution three days I underwent an operation forvaricocele--an injection of medicine locally making the operation_absolutely free from pain_. The operation was performed in about thirtyminutes, immediately after which I could walk to my room, and, afterresting an hour, descended to the dining room and took my dinner asusual. 

While at the Institution I met numerous persons suffering fromvaricocele, and it was quite pleasing to contrast their happy looks asthey wished you "goodbye" with the haggard appearance they had uponentering. 

After leaving the Institution I traveled about 1, 400 miles by rail and500 miles by water without the least inconvenience, which I consider afair test of the operation. 

Five years have passed since that time, and I now feel as sound as it ispossible to feel. 

In conclusion, let me say to those suffering from varicocele that it isimpossible 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 scaffoldwhich in time almost killed me. I wasn't hurt very much at the time, buta 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 thatI had a rupture of the blood veins of the left testicle, and it wasincurable. I gave up in despair; but at last, a friend handed me some ofyour advertising papers, and I saw the Common Sense Medical Adviseradvertised and sent for the book and studied its contents carefully, andcame to the conclusion that I was suffering from varicocele. I found onconsulting you that my suspicions were right. I at once wrote you forparticulars, and in less than a week I was at the Invalids' Hotel fortreatment. At that time no one knows how I suffered; but I hadn't longto suffer. In ten days after _an entirely painless operation_ I was awell man and returned home. 

I cannot say too much in regard to the treatment and care from bothSurgeons and Nurses. Nothing was left undone to promote comfort and goodcare. It is the only place on earth that I would feel safe to trust mylife for a severe operation. There were, I think, over 100 patients atthe Invalids' Hotel and Surgical Institute, at the time I was there, andas I had a good chance to be with them, I found that they were all doingremarkably well. 

At the date of my operation which was the 7th of March, 1893, I weighedjust 165 pounds; to-day I weigh 189. I have gained in health, strengthand vigor every day, I believe. 

I would just say, in conclusion, that I can give my word as an honestman to any sufferer that I believe he can be cured of almost any chronicmalady 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 andSurgical Institute. Buffalo, N. Y. , for the radical cure of a varicoceleof the left side from which I had suffered for four years, I takepleasure in certifying to the speedy and certain relief afforded me, andthe painless nature of the operation, as performed by the surgeons ofthe World's Dispensary Medical Association. Fourteen days from the timeof the operation I returned home cured, and went to work. I desire toexpress my thanks to the Medical Staff for their skill and attention. Imet several patients while at the Sanitarium, and they all reported asgetting 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 thoughtthat 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 Irecommend the Invalids' Hotel and Surgical Institute to any one who issuffering 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, previouslyapplied, which made the parts insensible, and I returned home the ninthday. While there I met with patients from all parts of the country, andall spoke in the highest terms of the treatment received from thesurgeons 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 benefitreceived--due to an operation performed for the cure of a varicocele ofmany years' standing. All traces of the disease have disappeared. I wassurprised to know that so little pain was connected with the operation. 

Will say to those who think of visiting the Invalids' Hotel, that theywill be treated well, and their visit will be made as pleasant aspossible 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 andSurgical 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 previouslyapplied, which made the parts insensible to such a degree that theoperation was performed without any suffering on my part. Time of stay, after operation, was ten days. I cannot speak too highly of the care andattention I received from the surgeons and nurses while there;everything that was provided was of the best--the best of food, cleanapartments and pleasant rooms. 

I would recommend your Institution to any one suffering from any kind ofchronic or surgical disease; and if they will only go to yourInstitution, they will meet with patients cured and others on the way torecovery from the same difficulty they have themselves--no matter whatit 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 theoperation performed upon me for varicocele at your Institution somemonths ago. This operation was performed by one of your specialists in askillful and painless manner. 

I found the Invalids' Hotel just what it is represented to be, and allpatients who were there were well satisfied with the treatment. 

I was not confined to bed at all after the operation, and was able toleave at the end of ten days in an excellent condition. 

I am unable to express the great relief which your treatment has givenme and I cannot say too much in praise of your Institution. 

I take great pleasure in recommending you whenever I get a chance, andcannot thank you enough for what you have done for me. With kindestregards, 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 atyour Sanitarium I was treated with the utmost kindness, and foundeverything there just as represented in your pamphlet, if not indeedbetter. Your Institution is the best of the kind that I have ever seenand if it is possible for a person to be cured your specialists willaccomplish it. A visit there convinced me that you do not make promiseswhich you do not fulfill. After being there and having a surgicaloperation successfully performed, I heartily recommend all invalids togive your place a trial. Much to my surprise the operation which wasperformed was perfectly painless, no anæsthetic was given, and I was notconfined to my bed for an hour. I was able to leave your Institution atthe end of ten days completely cured. I can heartily commend yourefforts in the cause of suffering humanity, and shall be pleased tooffer my personal testimony at any time. With best wishes to the World'sDispensary 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, causingthe spermatic cord to swell badly. I applied for medical aid and wastold that no harm would result. But I grew worse, and spent over onehundred dollars with quacks and received no help. 

Four years ago while reading a chapter in Dr. Pierce's Common SenseMedical Adviser, I noticed that no hesitation was made in stating that apermanent and radical cure of varicocele could be made at the Invalids'Hotel and Surgical Institute. I went to the Hotel and the result was Ireturned home in eleven days permanently cured. I cannot speak in toohigh praise of the surgeon, and his delicacy and kindness in performinga painless operation; or of the nurses, who almost hourly visit theinvalids and minister to their comfort. The Institution is fullyequipped and nothing is left undone that can relieve suffering. Iconversed with a great many patients while at the Invalids' Hotel andlanguage could not express their delight at their treatment there. 

I earnestly urge all invalids to save time and suffering by beingtreated at the Invalids' Hotel and Surgical Institute where the latestand most improved methods are used, and operations are made painless andwhere everything is delightful and comfortable. I owe my life to thetenderness and skill of the surgeon and nurses at the Invalids' Hoteland 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 thebest of care and attention both by doctors and nurses; that youroperation was almost entirely without pain; that my virility hasincreased since then as well as the tone of my general health; that yourInstitution is as commodious and cheerful as one could wish. Yourpatients with whom I became acquainted while there nearly all seemed tobe well pleased with the ease and comfort of their surroundings as wellas 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 andSurgical Institute as first-class in every respect. Some four years agoI was there and had an operation performed on me for a very badvaricocele with which I had been troubled some 15 or 20 years. Theoperation was made painless by the use of local applications. Afterstaying at your place about twenty days (longer than is generallynecessary) I was able to make my long trip home. The operation was avery successful one, considering the long time my trouble had beenneglected, as I have suffered little or no inconvenience since. I saw avery large number of patients at the Invalids' Hotel from all parts ofthe United States and Canada, and all of them seemed to have a very highopinion of the treatment they were receiving from your Specialists, andI know personally, of several remarkably successful operations performedby 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 andSurgical Institute for the cure of Varicocele, which was caused fromheavy lifting, I take pleasure in informing you that it is entirelycured; it was a varicocele of a number of years' standing and a badcase. It has been three years since I was operated upon and I have notexperienced any trouble from it since; in fact, I feel that I am nowentirely cured. _The operation is painless_ and gives entiresatisfaction in every respect. 

I advise all who are suffering from this or any other chronic disease totake treatment at the Invalids' Hotel and Surgical Institute and theywill 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 forwhich you treated me, for I had been to experts in Philadelphia and theydid not know how to perform the operation, and said I could not becured. I was treated by experts in Albany and other cities, but all forno use. I went to the Invalids' Hotel and Surgical Institute and wasoperated upon and find I am cured. The treatment in every other respectwas good; everything was done to make patients happy and pleasant; thebest 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 andSurgical Institute, Buffalo, N. Y. , for the radical cure of a Varicoceleof the left side, from which I had suffered for twelve years, I takepleasure in certifying to the speedy and certain relief afforded, andthe painless nature of the operation as performed by the surgeon of theWorld's Dispensary Medical Association. Ten days from the time of theoperation, I returned home radically and permanently cured. I desire toexpress 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 ofgratefulness and gratitude that I owe to your Institution, for the ableand gentlemanly treatment that I was favored with during my stay withyou, by officials and attendants in their respective capacities, inevery department. Nothing was left undone that could possibly be ofbenefit to me or add to my comfort, and to your Institution, yourtreatment, which in my own experience I have found to be marvelouslywonderful, 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 painlesstreatment, instead of writing to you at this time, being in theenjoyment of health and strength, I would be filling a place in aninsane asylum or an invalid's grave. And it may not be more than just toyour wonderful treatment to say that the Varicocele and resultantweaknesses was of about fifteen years' standing, during which time I hadspent time and money with both physicians and quacks, without any resultfor the better, and when my life blood was daily wasting away, and thepowers of manly strength and vigor were completely gone, by an act ofProvidence I went to your Institution as a last resort, for life ordeath. I was painlessly operated upon by you for my complaint, fromwhich time I have steadily improved in health, strength, weight andvigor, 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 theafflicted everywhere could only realize that so many lives may be sparedby your wonderful treatment, none would stay away. 

You are at liberty to give my testimony to the world in whatever way itmay be of most benefit to you. I also enclose a photograph of myselfthat 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'SNEEDLE 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-classin every respect, presided over by a capable, honest and pleasant lot ofmedical experts who certainly know their business. I cannot speak of ittoo highly. 

I was treated there in the summer of 1887, for Rupture of the SpermaticVeins, 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 ofthe best in Northern Illinois, and an officer of the Chicago Eye and EarInfirmary. The operation at the Invalids' Hotel was perfectly painless, did not have to take any anæsthetic, neither was I confined to my bed atall, and the result a perfect success; while in the two previousoperations I had here at home, I was confined to my bed a week each timeand another week scarcely able to move about, be sides getting worseeach time with pain enough to drive one crazy. But the half has not beentold. About two and a half years after I had been cured of my difficultyat Buffalo, I commenced having terrible pains in my leg and abdomen, forwhich I could not account, and after standing it until it seemed asthough I would be glad to die, I again consulted the Invalids' Hotel;after a thorough investigation they operated on me where my pain seemedthe most apparent, and dug out a piece of a surgeon's needle somethingover half an inch in length, that had been broken off in the firstoperation I had by the doctor here at home, and so admitted by him whenconfronted with it. I have spent lots of money and nearly six years ofthe worst pain man ever stood getting relief, while had I known of thisplace on the start, an operation with no pain whatever and scarcely morediscomfort than a sore mouth after having a tooth removed, would haveended it all. 

In conclusion, I will say to any poor sufferer, don't do as I did andput your trust in the would-be greatest doctor you have at home, but goto this place at Buffalo, where you will have proof of their ability, and where you will surely meet patients about to leave, cured; others ontheir way to recovery for the same difficulty you may have yourself, nomatter what it is, if curable at all; a place where you will have thekindest of attention, the best of medical and surgical skill, and whereyou can see sufferers going away every day with hearts full of gratitudeand 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 oflumber to the ground, and at once felt a sharp severe pain along thespermatic cord of left side of scrotum, preventing my walking to thehouse without help. The veins near the cord filled to such extent thatthey seemed solid, and could not be reduced for some time. I went to agood doctor and by him was advised to "pay no attention to it, it willnot amount to much. " From that time I suffered continually, and will nottry to describe what I endured until I was relieved by a surgicaloperation performed on me by the surgeon-specialist of the Invalids'Hotel and Surgical Institute, of Buffalo, N. Y. After working-hard forseveral years my suffering increased and I was advised to consult Prof. L. , of Chicago Hahnemann College (of Homeopathic School) and by him wasinformed an operation of tieing the veins (choking them off) could beperformed but 90 per cent (if I remember rightly) of the operationsproved fatal. I decided not to try it. By accident I learned of yourgreat skill, and though my case was of twenty-one years' time, and myhealth and strength gone, I considered the method plausible andreasonably safe. I had the operation performed, and now after six yearshave passed, I can say with satisfaction, there is little to be noticedor remind me of the past years of misery. The parts are ofhealthy-color. Urine has assumed a natural appearance, both sides ofscrotum seem in size alike. No bandage is worn and for two years hasbeen discarded. My weight increased and for two years prior to thetaking of my photo, I did the work of handling a third-class postoffice, doing a money order business of $50, 000, not losing a day inthat time, and at the present time in this hot climate, I have beendoing outdoor work, some of it hard, and with mercury at 100 degrees. Ihave worked and found no need of a bandage; and no unnatural relaxationof the scrotum or veins is noticed. 

If anyone wishes to write me, they are at liberty to do so. If myexperience can be of benefit to any, I will answer all enquiries, and ina general way will now say no one should delay attending to suchdifficulty, for if the blood is in a reasonably healthy condition yoursurgeon will operate in such a way that the result will be all right intime. 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 manhoodand 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 operationitself is nothing to bear. It is painless and the result is a radicalcure. For this you have my sincere thanks. I take pleasure inrecommending your Institution to all sufferers and know that it is inevery respect just as claimed to be. I would say to all who suffer fromthis trouble: go to the Invalids' Hotel and Surgical Institute, atBuffalo, N. Y. , and you will get relief. You will receive kind attentionfrom 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, forwhich you treated me. I had been in the habit of getting out with theboys and trying to see which could kick the highest with one foot on theground, and it caused me to have varicocele. I went to my home doctorand he treated me with no success. It was getting worse all the time andI got out of shape all over. My health got bad and I thought my casehopeless. 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 andreceived word in a few days that you would treat me, so I sent off forone 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 hasbeen good ever since. 

You are at liberty to use my testimony in whatever way if may be of mostbenefit to you. 

I also enclose a photograph of myself that was taken soon after yourtreatment. 

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 fifteenyears' standing. 

I tried home doctors but found they were only aggravating my case. Ialso tried the Remedy Company, then of St. Louis, who claimed to performwonderful cures with their "Pastiles, " but they proved utterlyworthless. Having come in possession of Dr. Pierce's little book andcirculars, a perusal of the same convinced me that my health would notbe trifled with at his Institution. 

I was a poor man and could not afford much experimenting. I ordered onemonth's treatment, and at the end of this first month, I found, to mysurprise, that I was feeling different. The second month, still moresurprised at my returning health. Third month thought I was cured, andengaged myself to a young lady, and wrote you to that effect, and youadvised me with your congratulations to marry, and to order anothermonth'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 boyand a girl. I would never have dared to marry had it not been for yourmedicines. I must add that during this treatment I was troubled withvaricocele on left side. I wrote you this at third month of treatment, and you sent without extra charge, a Suspensory and Lotion, and twomonths' treatment cured me sound and well of this distressing malady; Ihave not felt the least symptoms of its return. 

I want the world to know what a competent and honorable firm the World'sDispensary Medical Association is. I would love to shake you by thehand. 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 wassurprised to find such a speedy cure of such a bad case of varicocele oflong standing; the operation was entirely painless and I felt a greatchange in myself, as a result of it. Am so glad to tell any sufferer ofthat terrible disease to apply to you at once and be cured, for I amsure 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 positionwas impossible. 

Now it has been five years since I was operated upon and I feel well ofthat disease--varicocele attended with impotency or weakness of thegenerative organs, caused by varicocele. 

Thanks to the good physician who relieved me--hope he may live long andbe able to relieve all that submit themselves to him for treatment, as Idid. I found everything that had been described to be just so in regardto 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 fornervous debility, and although I am not quite fully cured as yet, I havebeen greatly benefited, and believe, if I had come to you before I wasduped and swindled by different quacks and was more dead than alive, Iwould to-day be a thoroughly well man. 

I have also been to your Institute twice for surgical operations, andcannot too highly praise the Hotel, or the skill and care of theattending surgeons and nurses. They are gentlemen in every way and theInvalids' Hotel is just as represented. 

I shall advise all suffering from chronic diseases to go to you forrelief, as I have never seen any one there who was not cured or greatlybenefited. 

 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 Iam not entirely well, yet I have received much and lasting good fromyour treatment. My digestion was improved greatly, so that littletrouble is experienced after eating; my liver seems to act reasonablywell, and my bowels are much better. My varicocele I consider entirelycured, as I have not used the bandage for one half day for more than sixmonths, 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 andSurgical Institute for the radical cure of a bad varicocele, from whichI had suffered for eight years, I desire to express my thanks to you foryour kindness and skill. And I would advise all persons, needingsurgical or medical treatment, to go to the World's Dispensary MedicalAssociation. 

 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, Ifeel indebted to you for the cure of varicocele. I was troubled tenyears with this annoying disease, caused, I think, by being thrown froma horse. My case was of a very obstinate character. I was treated by aleading specialist of Omaha, Nebr. , without success and without being inthe least benefited. I expended the neat little sum of $500, and thensank back in despair, losing all hopes of a cure. I had previous to mytreatment in Omaha noticed a little hand or Memorandum Book of theWorld's Dispensary, and again one came to my notice. I mustered upcourage to write to you, and in June, 1892, I visited your Institute fortreatment. I was treated by the best skilled surgeons and given bestattention by experienced nurses. I met a number of patients while undertreatment troubled with various and complex diseases, who expressedtheir gratitude to the Faculty of the Invalids' Hotel and SurgicalInstitute. The operation performed was rendered painless, owing to localapplications previously applied. After the operation, which was about 11o'clock, A. M. , I rested until 12, noon, and responded to the dinner callas usual. I was required to remain but ten days, then returned home, adistance of some twelve hundred miles. I wore a neat fitting support forabout six months, and then abandoned it and have gone as nature createdme. Oh, what a relief. I had worn a "suspensory" for about six years. Ihave had no return of former trouble, it being now about two years sincethe operation. 

To any suffering with varicocele I must say, "don't delay, but placeyourself under treatment at the Invalids' Hotel and Surgical Institute, Buffalo, N. Y. , and you will say as I do, 'The half has never beentold. '" 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 mefor varicocele on the left side and its attendant weakness, etc. I amnow happy to say that through the agency of your surgical skill and theefficacy of your medicine, I am healthy, strong, and a perfect man. Isuffered for about two years previous to the operation with acute painin the parts, and continued mental anxiety. I desire to express myentire satisfaction that, during the ten days that I remained in theInvalids' Hotel, I never experienced such uniform kindness and attentionas I did from the attending surgeon and from all the attachees, and thatI recommend all persons similarly afflicted to consult you, and they canbe 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' Hoteland Surgical Institute. After trying my home physicians withoutobtaining any permanent relief, and growing constantly worse, I went tothis famous Institution and submitted to an operation for varicocele. This was a perfect success, and soon I felt like a new man, and asstrong as I ever did. I feel that nothing I could say would do justiceto this renowned Institution. In every way, it is kept in advance of theage. The staff of physicians and nurses spare no pains to make the visitof every one pleasant as well as beneficial in the highest degree. Iwould urge all sufferers afflicted as I was, or with any chronicdisease, to avail themselves, without delay, of the skillful treatmentto be obtained of the specialists of the World's Dispensary MedicalAssociation, for I am confident that they will receive all the benefitthat 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 hadgiven up ever being cured. After spending $500. 00, with medical quacks Ithen went to the World's Dispensary Medical Association as a lastresort. One of their skillful surgeons performed an operation upon mewhich was entirely painless. I conversed with several other patients, who had the same disease. They seemed happy to know that there was suchan Institution that could relieve suffering humanity. The surgeons andnurses were so good and kind to us and gave us the best of attention andeven 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 theskill of your specialist, and heartily thank you for the successfulmanner in which the operation was performed in my case. The result iscomplete and perfect relief, and as time advances I can each day morefully appreciate the value of your Institution. The time spent there Ishall never forget, as it was a time of extreme pleasure to me. Theoperation was _perfectly painless_ and did not confine me to my bed, andthis taken with the extreme kindness of every one connected with theInstitution, made the time pass in a very happy manner. 

I consider your Hotel first-class in every respect, and would heartilyadvise all sufferers from chronic ailments to visit you before giving uptheir 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, Icheerfully give you the following testimonial: "I was troubled for manyyears with a very bad varicocele, which I received when a boy whilejumping. The complaint troubled me exceedingly. I tried almost everyknown means to effect a cure, but with no avail, for the more I doctoredthe more aggravated became the disease. After thus suffering for manyyears and knowing of the fame your Institution had attained in curingsuch diseases, I at last consulted your specialist in that class ofdiseases--was operated upon and returned home in ten days, a sound andwell man. I can recommend your Institution to all suffering humanity asthe most home-like, your nurses the most attentive and specialists themost skillful the world can offer. May you long be the benefactors ofmankind. "

 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 halfago for a case of varicocele of twelve years' standing, and which hadtroubled me very much, has cured me entirely. I am thankful to God thatHe put it into my mind to visit your Surgical Institute. I cannotrecommend 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 andSurgical Institute, Buffalo, N. Y. , for the radical cure of a varicoceleon the left side from which I suffered four years, I take pleasure incertifying to the speedy and certain relief afforded, and the painlessoperation, as performed by the surgeon of the World's Dispensary MedicalAssociation. Ten days from the time of the operation I returned homepermanently cured. 

I desire to express my thanks to the Medical Staff for their skill andattention. 

 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 andSurgical Institute, Buffalo, N. Y. , and I was cured of a chronic troublethat had been maltreated by other physicians. While there I saw a manwho had been cured by the specialists, who had before been given up todie by the best doctors in Troy, N. Y. Of course, the case must have beena 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 andcare of his skilled doctors and nurses, I know would have most assuredlygot well. Why? Because it was only a cage of _stone in the bladder_, andthey are easily cured at Dr. Pierce's Surgical Institute. I think almostany chronic disease can be cured there, if taken in time, judging frommy 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 oneor both sides. In health the sac-like covering, or investing membrane, of the testicle secretes a limpid fluid which lubricates its innersurface. When secreted in excess, it accumulates and constitutes_hydrocele_. 

The tumor commences at the bottom of the scrotum and grows verygradually, 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 adistinguished surgeon had pronounced _double hernia_. On examining theenlargement, we found the disease to be dropsy of the scrotum, complicated with varicocele. 

CAUSES. Injuries from blows or bruises are among the most common causesof this disease. It may also result from inflammation of the testicle orfrom excited action in those parts. It has been known to result fromstricture of the urethra, or water-passage, and also from localirritation 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 afflictedas I was, I would advise them not to listen to any ordinary doctor, butleave at once for the Invalids' Hotel and Surgical Institute, Buffalo, N. Y. , where he could get the best of treatment and attendance that moneycould 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 fromHydrocele. 

I was cured in a short time, after having the Hydrocele for eighteenyears. 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 aninjury, for which home-treatment gave me no relief. 

Hearing of your Invalids' Hotel I went there and had an operationperformed for its cure. I have the greatest confidence in yourSpecialists, as the operation was a perfect success. It was perfectlypainless, and I was able to go home in less than two weeks with the curecomplete. 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, theInvalids' Hotel and Surgical Institute and undergone a painlessoperation for the cure of hydrocele and varicocele--which was performedto my entire satisfaction. I desire to express my thanks to the MedicalStuff for their skillful treatment of my case. Two weeks from the timeof the operation I returned home, radically and permanently cured. 

I recommend all similarly afflicted to consult the World's DispensaryMedical 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 worstcase that ever came within my knowledge, it having afflicted metwenty-two years. After I had suffered much from other surgeons withoutany cure being effected, and with only relief for a short time, youperformed a not only painless but very scientific operation, and withmedicine completed the cure. It is now five years since you treated meand no symptoms of the disease have shown themselves. I will also addthat while with you at the Invalids' Hotel I received the best of careand attention from the well trained nurses in your employ, for all ofwhich 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 therelative positions of the kidneys, bladder, and adjacent organs. 

THE KIDNEYS. 

It is hardly necessary to discuss the minute structure of these organsin a book intended for the non-professional reader. 

The function of the kidneys is to remove certain waste materials fromthe blood. As fast as excreted by the kidneys, the urine passes throughthe ureters, of which there are two, --one leading from each kidney, intothe bladder. The ureters are lined with a continuation of the mucousmembrane, reflected from the bladder upwards, and this lining alsoextends to the cavities of the kidneys. 

Calculi or gravel, and stones, forming, as they sometimes do, in thekidneys, and passing down through these delicate and sensitive canals, cause excruciating pain. The symptoms of renal calculi passing from akidney to the bladder are, as already indicated, severe cutting pain inthe loins, and along the ureter, attended with considerable fever. Avery rough stone, such, for instance, as a mulberry calculus, passeswith considerable difficulty, and the patient is often suddenly seizedwith excruciating agony in the loins and in the groin, the pain alsoshooting down into the testicle of the corresponding side, often causingit to retract. There is usually, also, sympathetic pain shooting downthe thigh. We have seen patients roll on the floor in the greatestagony, cold sweat meanwhile pouring down their faces, when thussuffering. The patient may also vomit violently, through nervoussympathy. The urine is apt to be bloody, and there is a constant desireto pass it. There is pain in the end of the penis, and also in the lowerportion of the abdomen. 

THE BLADDER. 

This is a sac, or reservoir, to receive and hold the urine as it comesfrom the kidneys through the ureters. Its walls are partly composed ofmuscle, and partly of a lining mucous membrane. The muscular coating isexternal, and it is by its contraction that the urine is expelled. Whenempty, the bladder shrinks down to a small size, as compared with itsdistended condition. When filled, it is capable of holding about onepint. If it is distended by the retention of urine much beyond thiscapacity, the muscular coats lose their force, and often the urinecannot be passed naturally. In health, when the bladder becomes filledand distended, there is a consequent desire to empty it by passingwater. 

[Illustration: Fig. 1. ]

The voiding of the urine should not be attended with the slightest painor disagreeable sensations, and the desire to pass it should not befrequent. When there is frequent desire to pass it, or when its passageis attended with pain, there is irritation, or inflammation, in thecoats of the bladder, or in the urethra. This may arise from anexcessively acid or irritating condition of the urine, as well as fromvarious other causes. Gonorrhea, or clap; stricture of the urethra, which impedes the free flow of the urine; enlargement or inflammation ofthe prostate gland; gravel, and stone in the bladder, are all capable ofcreating a frequent desire to pass water. Whatever the unhealthycondition may be which gives rise to this troublesome symptom, it callsfor prompt and skillful treatment, for the most trivial affections ofthese organs often pass into those that are exceedingly intractable, ifnot incurable. 

THE EXAMINATION OF THE URINE. The urine itself, when subjected tomicroscopical or chemical examination, as we shall hereafter more fullyexplain, offers the best means of determining the exact nature of thesedistressing affections. When normal, the urine is of a pale straw-color, and throws down no deposits on cooling. In passing it no difficulty orpain should be experienced, and it should spurt from the urethra in afull, round, and regular stream, until the bladder is entirely emptied. If the stream is forked, checked, or interrupted in any way before thebladder is completely emptied, it is evidence that something is wrong. Stricture of the urethra, prostatic disease, and gravel, or stone in thebladder, are all capable of producing obstruction to the free flow ofthe urine. 

HOW SLIGHT AILMENTS BECOME DANGEROUS DISEASES. As we have before stated, the mucous membrane lining the bladder is reflected upwards into theureters, lining these canals. By reason of this continuity of mucoussurfaces, patients suffering from urethral, prostatic, and bladderaffections, often die from disease of the kidneys. It must not besupposed that because stricture of the urethra does not co-exist with_Brights_ disease, that the latter may not have been caused by theobstruction in the urethra due to stricture. Pulmonary consumption, forinstance, often begins in the form of nasal catarrh, but, by thecontinuity of the mucous membrane, it travels, so to speak, into thethroat, or pharnyx; from the pharnyx into the larnyx, and then into thelung structure itself. The disease is transferred from the nose into thelung tissue. What occurs in the nasal, laryngeal, and pulmonary tract ofmucous membrane, happens, also, in the urinary tract. A gonorrhea, whichis a specific acute inflammation of the urethral canal, leaves behind ita slight gleet, or chronic inflammation of the mucous membrane of theurethra. This may give little inconvenience for a number of years, butgradually it culminates in a stricture, or, implicating the prostaticportion of the urethra, occasions inflammation of the prostate gland, and, perhaps, enlargement of this organ. This gradually gives rise tocystitis, or inflammation of the bladder. From the bladder, the diseasetravels up the ureters into the kidneys, and finally _Brights_ diseaseis 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 aprotection to the parts beneath, just as the skin on the exterior of thebody serves as a protection to the sensitive true skin and the tissuesunderneath it. 

THE CAUSE OF CERTAIN DISTRESSING SYMPTOMS. Close to the neck of thebladder is a triangular space, on which the mucous membrane is smoother, and devoid of folds, or rugae, and which is far more sensitive andvascular than other portions of the mucous membrane lining this organ. It is called the _trigone vesical_. This _trigone_ is the most dependingpart of the bladder. If there be stone in the bladder, it naturallygravitates and rests on this sensitive space, so that, when the bladderis empty, the foreign body occasions inconvenience, until the urine, trickling down through the ureters, and intervening between the mucousmembrane and the stone, serves as a temporary protection to the mucoussurface. Hence the pain becomes less as the urine is secreted, until thewater is again passed, and the intervening fluid thereby removed, whenthe stone again presses upon, and irritates, the sensitive _trigone_, bycoming into more immediate contact with it. The greater ease withpatients afflicted with stone experience in a recumbent position in bed, or on a sofa, compared with being in an erect posture, is easilyexplained. The foreign body, when the patient is standing, walking, orriding, falls by its own gravity on this sensitive spot; when in arecumbent position, it rolls away from this sensitive _trigone_ into theback part of the bladder, where the mucous membrane is less sensitive;consequently, the patient suffering from stone in the bladder is moreeasy at night, whereas, one suffering from prostatic disease, whether itbe inflammation of the prostate gland, or enlargement of that organ, isusually worse in bed. 

HOW BLADDER DISEASES COME TO BE CONFOUNDED WITH OTHER DISEASES. Thebladder 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 agreat measure, for the symptoms of bladder disease in those afflictedwith piles, or other diseases of the lower bowel, or of diseases of theuterus or womb in the female. We have frequently been consulted bypatients who had erroneously supposed themselves to be suffering fromdisease of the bladder, or of the prostate gland, but whom we found, onexamination, to be suffering from hemorrhoids, or piles. In these cases, by removal of the pile tumors, the frequent desire to urinate, and allpain in the region of the bladder, are promptly relieved. Sometimes, ulcers located in the rectum, give very little unpleasant sensation inthe bowel, but produce pain in the bladder, with frequent desire tourinate. Enlargement of the uterus, the womb, or displacements of thatorgan, as prolapsus, or anteversion, and all capable of producingsymptoms of bladder disease. A frequent desire to urinate and more orless sharp pain in the region of the bladder are usually experienced inthese cases. Disease of the bladder, in like manner, often produces anapparent disease of other organs through sympathy, and without greatcare in diagnosticating each case, the _effect_ may be taken for the_cause_, and the patient treated for a disease which does not reallyexist. 

THE URETHRA. 

The urethra, in the male, is the canal extending from the bladder to theend of the penis, through which the urine is passed. This canal startsfrom the base of the bladder, passes through the prostate gland, and, entering the penis, continues of about uniform size along the under partof the penis until it reaches the glans, or head of that organ, where itexpands somewhat into a bulb-like fossa, or cavity, and becomes reducedagain at the orifice. At a short distance from the bladder it receivesthe outlets of the seminal ducts. The urethra is a most delicate andsensitive canal, and is surrounded by tissues of like delicacy, and islined with a mucous membrane which is highly vascular, and filled withsensitive nerves. The introduction of any instrument into this canal isto be undertaken only when absolutely required, and when necessary. Itshould be so skillfully and carefully effected that no pain orirritation can result. The slightest awkwardness is liable to cause anunnoticeable injury, which may result in a false passage, or an effusionof plastic lymph around the canal, which, organizing, forms the mosttroublesome kind of organic structure. By proper and early treatment alldanger and pain is avoided, and a cure effected in a very short time. Inan extensive practice, in which we yearly treat thousands of cases, wehave never yet failed to give perfect and permanent relief fromstricture, or disease of the prostrate gland, without the necessity ofusing cutting instruments of any kind, when we have been consultedbefore injury to the urethra has been produced by the improper use ofinstruments. Having specialists who devote their entire time andattention to the study of these diseases, we are able to relieve andcure a large number painlessly and speedily, in which the awkwardmanipulations of physicians or surgeons, whose hands, untrained byconstant and skillful use, not only fail to effect any benefit, but setup new, or aggravate existing, disease. 

This subject will receive a more full and complete consideration inanother 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. Thesize of the prostate gland varies considerably with the age of theperson. In early life it weighs but a few grains. As puberty approachesit becomes larger, and in the adult weighs from half an ounce to anounce. In old age it enlarges considerably, and sometimes presses uponthe bladder so as to impede the flow of urine. This condition is oftenconfounded with stricture, gravel, or stone in the bladder, byinexperienced physicians. Hypertrophy, or enlargement of the prostategland, is not an unfrequent disease in the adult or middle-aged man. Being in close contact with the bladder, when it enlarges it encroacheson the bladder, pressing on it, and it has the effect of interferingwith the function of urination. As before indicated, enlargement orhypertrophy of the prostate gland, is often confounded with stricture, gravel, and stone in the bladder, by inexperienced physicians, andtreated accordingly. The true condition of this gland is readilydetermined by an examination through the rectum or lower bowel, thefinger of the expert surgeon being able to determine at once whether itis enlarged or not. 

THE DANGER OF BAD TREATMENT. In disease of the prostate gland, as wellas in inflammation of the kidneys and bladder, stricture of the urethra, and many other forms of urinary disease, the use of stimulatingdiuretics, and the much-advertised "kidney cures, " "buchus, " and similarpreparations, which largely increase the flow of urine, simplyaggravate, and do positive harm. In fact, the most difficult cases thatwe have had to deal with have been those that, through such treatment, either taken on their own account or prescribed by inexperiencedphysicians, have been rendered so much worse as to make their cases veryintractable, and tedious to relieve and cure. 

REQUIRE NICELY ADAPTED TREATMENT. As we have heretofore indicated, thereis no class of diseases that require nicer adaptation of medicines toeach individual case, than those of the urinary organs. Medicines which, in one stage of these diseases are beneficial and curative, in anotherstage are often exceedingly injurious. Hence it is that we claim it tobe impossible for any one to put up any set prescription, or proprietarymedicine, that will meet the wants of a large percentage of this classof cases. The only rational course to be pursued is to examine carefullyeach case as it is presented; find out the exact condition and stage ofthe disease with which the patient is afflicted, and then prescribe forit such special medicines as are nicely and exactly adapted to thepatient's condition. These, in many cases, will have to be changed fromtime to time, to suit the ever-changing condition of the disease, as itis modified by the treatment. Not only have the manufacturers of"buchus, " "kidney cures, " etc. , committed grave errors by prescribingstimulating diuretics for almost all kidney and bladder diseases, underthe impression that, as the patient passes only a small quantity ofurine at a time, the kidneys should be stimulated to secrete more, butphysicians in general practice have been very prone to commit the sameerror in their practices. When the bladder and kidneys are in a weak anddiseased condition, incapable of efficient action, the bladder beingalready unable to dispose of the diminished quantity of urine secreted, it is simply outrageous practice to administer medicines calculated tostimulate the kidneys to perform more work. By being thus forced, theseorgans become seriously diseased. It would appear most unreasonable towhip and spur a horse already jaded from overwork. Common sense woulddictate rest, which always does good; but, as the bladder is weak, thedoctor whips up the kidneys with drugs, thus endeavoring to force themto secrete more urine, and thereby the poor, crippled bladder, which isincapable of disposing of even the diminished quantity secreted, isactually made to do more work in a diseased and feeble condition, thanit would perform in a sound, strong, and healthy state. The results ofthis pernicious practice are _Bright's_ disease of the kidneys, cystitisor 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 theirpresence until they have assumed a formidable character. For this reasonthey are the more dangerous. Simple derangement of the urinary secretionis no evidence of disease of these organs, as changes in the color, quantity and specific gravity of the urine are often produced by changesof temperature, active or sedentary habits, mental emotion, andsometimes by articles of diet, or drink, as well as by the use ofdifferent drugs. 

The existence of disease of the kidneys in the early stages can only bepositively determined by a microscopical and chemical examination of theurine, which reveals to us the presence of casts, epithelia, blood, pus, etc. The microscope informs us not only of the presence of disease, butvery often of the particular portion of the kidney in which it islocated, as well as of the stage which the disease has reached. We arealso aided by chemistry in determining the exact abnormal condition ofthe kidneys by the detection of albumen, sugar, etc. These examinations, by aid of the microscope and chemical re-agents, should never beneglected by the physician. Without them his diagnosis, or judgment ofthe patient's condition, is simply guess-work. With them he is enabledto base his treatment upon certain and positive knowledge of thepatient's real and true condition. 

The usual symptoms of chronic disease of the kidneys, but which varymaterially with the age, constitutional peculiarities and temperament, are weakness in the small of the back, pains in the region of the loinsand groins, numbness of the thigh on the side of the affected kidney(for often only one organ is affected), high-colored and often scaldingurine, 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 orinability to pass the urine, gravel, stone in the bladder, dropsicalswellings, swelling of the testicles, irritability and pain in thebladder, mucous and sometimes seminal discharges oozing from theurethra. 

WHEN THE BLADDER IS AFFECTED the prominent symptoms usually complainedof are irritability of the bladder, accompanied by a frequent desire tourinate, inability to retain more than a small quantity of urine, andthis for a short time only, pain in the region of the bladder, extendinginto the back, thighs, etc. , hot scalding sensations in passing theurine, sediment in the urine, and sometimes bloody urine. The appetiteis usually diminished, there is a depression of spirits, the urine isoften 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 theurethra, attended with mucous and sometimes seminal discharges oozingfrom the urethra. Some of these symptoms may be present as the result offunctional or organic disease of other organs than the kidneys orbladder, and to distinguish them with positive certainty is impossiblewithout the aid of a microscopical and chemical examination of theurine. 

 * * * * *

BRIGHT'S DISEASE. 

This affection may appear in either an acute or chronic form. The acuteform is frequently a complication, or sequel of scarlet fever, diphtheria, cholera, typhoid fever, erysipelas or measles, and isfrequently developed by intemperance. The acute form of the disease isvery rapid in its progress, often destroying life by uraemicpoisoning--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 theearlier stages under the eyes, but gradually showing itself in theoedema, or swelling of the feet, and lower extremities generally. Unlesspromptly relieved, the patient dies of coma (stupor), or fromconvulsions. No person should be so rash as to attempt the treatment ofthis dangerous affection without the aid of the best medical skill thatcan be procured. 

IT IS THE CHRONIC FORM OF BRIGHT'S DISEASE that we propose principallyto discuss in this article. True Bright's disease of the kidneys is aninsidious and most fatal form of organic disease. 

We venture to assert that less than one per cent. Of those who imaginethey have "Bright's, " have this disease at all. We find that most ofthose who, as one of our Faculty puts it, _insist upon having_ Bright'sdisease, base their "diagnosis" upon the ever-changing condition of theurinary 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 inexcess they form a heavy pinkish deposit of a flocculent nature withinfrom five to thirty minutes after the urine has been passed--that is, after it has been passed sufficiently long to cool. To prove that thedeposit is urates, heat the specimen to the temperature of the blood, when the deposit in question will disappear. Excess of urates has nowbeen definitely traced, in the majority of instances, to functionaltorpidity of the liver. 

Another common form of deposit is that in which the reaction of theurine, instead of being acid, as in health, is either neutral oralkaline, and in which the earthy phosphates are precipitated for thisreason. The earthy phosphates, when thrown down by a neutral or analkaline condition of the urine, appear as a heavy white deposit, which, though usually devoid of clinical significance, is certainly calculatedto frighten timid patients who read of the "terrible ravages ofBright's" in the advertisements of various popular "kidney cures. " Toprove that the precipitate is phosphatic in its nature, add a few dropsof vinegar and it will disappear; whilst, if, after the vinegar has beenadded, the specimen be brought to the boiling point, not only both theurates and phosphates remain in solution, but there is only one singlesubstance known to pathological chemistry that can form a deposit underthese conditions--and that substance is albumen, which, if present inquantity, is always indicative of serious disease. 

The papers are filled with the plausible but unwarranted statements ofthe manufacturers of various "kidney cures, " who anxiously desire thatevery one should be impressed with the idea that all their troublesarise from kidney disease in order to sell large quantities of theirmedicines. In many cases the unfortunate patient is rendered much worseby the use of remedies that are not suited to his condition, and whichwill not cure the real trouble with which he is affected. 

Daily we are consulted by persons in whose cases these errors have beenmade. In reality, true Bright's disease is not a common affection, andnine out often individuals who think that they suffer from it, or theearly stages of the trouble, in fact have something more curable. Insome cases it is an affection of the liver, which forces an excretion ofunnatural salts by the kidneys, and thus renders the urine acrid andirritating, or they may be suffering from some other disease, such as adeformity or enlargement of certain glands, as the prostate; unnaturalposition of the organs, as with women who suffer from weakness, theuterus pressing forward on the bladder and urethra, and thus showingevery evidence of disease in the urinary canal. It is as common forpersons to suffer from deformity of the urinary canal as from misshapenlimbs, or from noses and ears not of proper size and proportion. 

The urinary canal, from the bladder outward, is narrow and delicate. Anydisease 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 thephysician who is not particularly alert and cautious in his diagnosis, are liable to cause error, and he will pronounce a given case Bright'sdisease, when in reality there is some simple cause for the irritationof the urinary canal, and the pains in the kidneys, etc. , all of whichfrequently result from a slight damming up of the flow of water, and theprevention of free expulsion from the system of the salts of which thebody 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 upso that a slight pressure is put upon the kidneys below, their secretionis most materially interfered with, and the many trains of symptoms thatusher in disease of the kidneys, appear. 

The true, and only sure way to relieve these conditions, as can beunderstood by any one, is to remove the real cause. The use of anymedicine that stimulates the kidneys to an irritable action, under suchpressure, is to be avoided, as it only makes the trouble worse, increases the amount of water that is dammed up, and results in moreserious manifestations of constitutional disease; whereas, by merelyrelieving the choked outlet, the flow of water becomes free, and thekidneys are speedily restored to their natural condition. This is wellillustrated 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 degenerationof the kidneys. Submitted to examination, after death by this disease, these organs present various appearances. Hence, the degeneration thatcharacterizes the disease has been designated as waxy degeneration. Somepathologists contend that the disease consists of several differentrenal maladies, all of which, however, agree in the one ever-presentsymptom of a more or less albuminous condition of the urine. 

As to the causes of kidney disease, it may be said that any thing whichwill give rise to a greater or less degree of congestion of the kidneywill induce either a temporary albuminous condition of the urine, or atrue Bright's disease of the kidneys. Suppression of perspiration, byexposure to cold and wet, want of cleanliness, deficiency of nutritiousdiet, liver disease, certain poisons in the system, as of scarlet fever, measles, erysipelas or diphtheria, taken in conjunction with sedentaryhabits, bad air, excessive mental labor or worry, may each occasion analbuminous urine, and finally result in Bright's disease, but of allcauses that appear to produce this disease, none are so prolific asintemperance. A scrofulous diathesis, or habit of body, may stronglypredispose to the disease, and chronic kidney disease frequently followsacute rheumatism and the practice of masturbation. In some instances thechronic form of Bright's disease follows an acute attack, but is moreoften developed slowly and insidiously without any known cause. 

THE SYMPTOMS of this fatal malady generally appear so gradually thatthey excite but little or no concern until it has reached its moreadvanced and dangerous stages. Frequently, a puffy, watery or flabbycondition of the face, particularly under the eyes, is the first symptomnoticed, and the patient may observe that his urine is diminished inquantity. The urine is sometimes abundant, but generally more scantythan in health, is acid in its reaction, and generally of a low specificgravity. The countenance is generally somewhat pale and bloodless, which, taken with the dropsical condition of the system, and theconstant albuminous condition of the urine, points the expert specialistto Bright's disease of the kidneys. Various circumstances and conditionsmay give rise to the temporary presence of albumen in the urine, and, although albumen may be temporarily absent from the urine even whenBright's disease exists, yet this is not common. There are certainindirect symptoms which point clearly and almost unmistakably to thepresence of this disease. These are deep-seated pain or weakness in theback, gradual loss of flesh, red, brown, or dingy urine, more or lessdrowsiness, and as the disease advances, a smothering sensation, ordifficulty in breathing, with dropsical puffiness or swelling. Occasional attacks of nausea and vomiting are common; pains in the limbsand loins, which are often mistaken for rheumatism. Irregularity of thebowels is also common. The skin becomes harsh and dry, not perspiringeven under active exercise. Sometimes these symptoms are years in theirdevelopment, being very obscure at first, and in some cases the diseasehas been known to prove fatal without the patient having experienced anyextraordinary symptoms. With those whose systems are enfeebled by want, intemperance, exposures or disease, as scrofula or syphilis, the firstsymptoms usually observed will be a frequent desire to urinate, occasional attacks of diarrhea, flatulency, dropsical swelling of theface, especially under the eyes, and afterwards of the extremities, paleness and increasing debility. Stupor, apoplexy and convulsions arethe forerunners of a fatal termination. 

Microscopical and chemical examinations of the urine are the onlyreliable means of diagnosis, and should be often repeated. (See UrinarySigns, in Appendix. ) As albumen is often present in the urine withoutthe existence of Bright's disease, it is impossible, except by the aidof the microscope, to distinguish true Bright's from other affections ofthe kidneys. In both purulent urine, and that containing blood, albumenwill be found by the usual tests, but in smaller quantity than inBright's disease. Albumen, with disintegrated epithelia, hyaline, andlarge granular casts, as well as waxy casts, are peculiar to, andcharacteristic of, this disease. 

In the treatment of this malady, our specialist's experience has beenvery great, and attended with marvelous success. Of course, after thesubstance of the kidney has degenerated and broken down, and becomedestroyed to any great extent, a cure is impossible. But that we nowpossess remedies of great value, and specific power over this terribledisease, we have the most positive evidence in the remarkable successattended in its treatment. Most cases that are curable can be managedsuccessfully at a distance, the necessary medicines being sent either bymail or express. Our specialists have cured many in this way who were sobloated from dropsical effusion as to weigh twenty-five to forty poundsmore than usual. In our Sanitarium, where we have had the advantage ofour Turkish baths and other appliances, we have cured some cases inwhich the removal of the dropsical effusion reduced the patient's weightsixty pounds. 

We cannot, In conclusion, too strongly condemn the general resort tostrong diuretics so often prescribed by physicians for all forms ofrenal maladies, but which, by over-stimulating the already weak anddelicate kidneys, only aggravate and render incurable thousands of casesannually. Not less harmful are the many advertised "kidney cures, ""kidney remedies, " "buchus, " and kindred preparations. They all containpowerful, stimulating diuretics, and, while they may appear for a shorttime to do good, invariably render the case worse and far more difficultto cure. The cases of Bright's disease reported cured by thesepreparations are cases of far less dangerous maladies, made to appear, by exaggerated accounts of them, as true Bright's disease. The use ofthese general, ready-made or proprietary remedies in any case of trueBright's disease is hazardous in the extreme. In no disease is theregreater necessity for treatment nicely adapted to the exact condition ofthe patient (which should always be carefully ascertained bymicroscopical and chemical examinations of the urine) than in this. Asit is a disease that runs a slow course, there is always time to sendsamples of the urine for examination by expert specialists, and no otherphysician than a specialist of large experience should be entrusted withthe treatment of a malady so dangerous in its character, and in thediagnosis and treatment of which general practitioners commit suchfrequent, and often fatal, errors. (SEE TESTIMONIALS. )

DIABETES. (POLYURIA AND GLYCOSURIA. )

There are two essentially different varieties of this disease, one ofwhich is called _Diabetes Insipidus_, or _Polyuria_, and the other_Diabetes Mellitus_, or _Glycosuria_. The first is characterized by anincrease in the amount of urine excreted, and yields readily to propertreatment. The second is characterized by the presence of sugar in theurine, and under ordinary treatment often proves fatal. 

The _causes_ are obscure, and are therefore not very well understood bythe profession. 

SYMPTOMS. A notable increase of the quantity of urine excreted is thefirst symptom which attracts the patient's attention. Frequently, several quarts, or even gallons, of urine are daily excreted, and it ispaler than natural. The patient experiences extraordinary thirst, andhas an almost insatiable appetite, though at the same time he losesflesh and strength. The tongue may be either clammy and furred orunnaturally clean and red. The bowels become constipated, and a peculiarodor is observed in the patient's breath and exhales from his body. Theskin becomes harsh, dry, and scurfy. There are dizziness, headache, dejection, lassitude, and not unfrequently blindness, caused bycataract, 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 diarrheasets in, and the patient dies from exhaustion. 

In this disease, as in Bright's, we have many medicines that producespecific curative effects, enabling our specialists to treat it withgreatly increased success. The disease is readily diagnosticated, ordetermined, by chemical examination of the urine, so that we have beenenabled to treat this class of cases very successfully at a distance, and without personal examinations. Great attention should be paid to thediet in these cases. It should be highly nutritious, but anything of asweet 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 wateracidulated 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 inflammationof 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 someobstruction 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 cutaneousaffections, gout, rheumatism, etc. ; but it more frequently results fromstricture of the urethra, enlarged prostate gland, gravel, andgonorrhea. It is also caused by an habitual retention of the urine, andsometimes results from masturbation or self-abuse. 

SYMPTOMS. There is an uneasy sensation in the bladder, and heaviness andsometimes 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 withdifficulty. If allowed to stand, it deposits more or less mucus, whichis sometimes mistaken for semen. As the disease progresses, the quantityof the mucus increases. It is very viscid, and adheres to the sides ofthe vessels, so that if an attempt be made to pour it out, it formslong, tenacious, ropy threads. Sometimes the quantity of mucus is sogreat that on exposure to cold the whole mass becomes semi-solid, andresembles 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 isexperienced in expelling it from the bladder. Nocturnal emissions, impotency, and loss of sexual desire are apt to ensue. Occasionallythere will be a spasmodic contraction of the bladder, with straining anda sensation of scalding in the urethra, and sometimes the patient isunable to urinate. 

When ulceration occurs in the progress of the disease, as it is apt toin its advanced stages, blood will occasionally be seen in the urine. Inthe advanced stages of the disease the system becomes greatlydebilitated, emaciation supervenes, with hectic fever, nervousirritability and, finally, death. 

TREATMENT. A strict observance of the rules of hygiene is essential to acure. We must ascertain the cause if possible, remove it, and thusprevent it from perpetuating the disease. The various causes andconditions involved in different cases demand correspondingmodifications of treatment; hence, it is useless for us to attempt toteach the non-professional how to treat this complex disease. We havesucceeded in curing many severe cases without seeing the patient, beingguided in prescribing by indications furnished by microscopical andchemical examinations of the urine. (See Urinary Signs in Appendix. ) Infact, nearly all cases can be cured at their homes, and without apersonal examination being made. In the worst cases, we have found itbest to have our patients at our institution, where we can wash out thebladder with soothing, healing lotions, and thus make directapplications to the diseased parts. (SEE TESTIMONIALS. )

GRAVEL. 

When the solid constituents of the urine are increased to such an extentthat they cannot be held in solution, or when abnormal substances aresecreted, they are precipitated in small crystals, which, if minute, arecalled _gravel_. Another cause of the precipitation of these salts is astricture of the urinary canal which, by interfering with the freeexpulsion of all the fluid from the bladder, results in the retention ofa portion, which gradually undergoes decomposition. Salts from the urineare thus precipitated in the same way that they are thrown down in urinewhich is allowed to stand in a vessel. Any one can illustrate this, byallowing a small quantity of the urinary secretion to stand for a fewdays either in an open or a closed bottle. Soon a white, flaky depositwill be observed, which will become more and more dense, and finallyfine grains will be seen precipitated at the bottom of the bottle. Similar grains, lodging in the folds of the bladder, gradually increasein size, by the precipitation of more salts around them, and ultimatelybecome a source of much irritation. When of large size, they are termed_calculi_ or stones. When these formations occur in the kidneys they aretermed _renal calculi_; when in the bladder, _vesical calculi_. Thereare several varieties of gravel, each depending upon differentconditions of the system for its formation. The two prominent varietiesare the red, containing uric acid, and the white, or phosphatic, gravel. 

SYMPTOMS. When the deposits are in the kidneys, there is pain in theback and loins, occasionally cutting and severe; sometimes it darts downthe 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 tourinate, with a bearing-down, straining pain; also a cutting orscratching sensation in the urethra during micturition. In the male, intense pain is often experienced at the end of the penis. When theurine is voided in a vessel and allowed to settle, a gravelly deposit isseen, generally of a red or a white color, and the particles varying insize. 

TREATMENT. These urinary deposits indicate a general derangement of thesystem, as well as a local disease. Nutrition is imperfect and some ofthe excretory organs are not properly performing their functions, or, perhaps, some portion of the body is being too rapidly wasted. Veryfrequently we find these gravelly formations as the result of arheumatic or a gouty diathesis. It is also a well-known fact thattorpidity of the liver throws an excessive amount of work on thekidneys. These organs then, in part, perform the function of the liver, and hence unnatural activity is required of them, and the secreting ofsuch substances as uric acid, which precipitates readily and gives riseto severe irritation of the urinary canal. 

In order to treat these cases rationally and successfully, it is firstnecessary to ascertain by microscopical and perhaps chemicalexaminations, the character of the deposit. By such an examination, theexact condition of the system which gives rise to these abnormalproducts may be definitely determined, and the remedies to be employedindicated. As the non-professional are not qualified to make suchexaminations, it would be useless for us to suggest specific treatmentfor the various forms of this affection. 

Samples of the urine may be sent to us with a brief description of thesymptoms experienced, and the proper medicines to cure can be returnedby 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 thanthis terrible affliction. The cutting operation heretofore required toremove it, is considered one of the most dangerous operations that thesurgeon is ever called upon to perform. 

The death of the Emperor Louis Napoleon, of France, from an operationfor the removal of a stone, at the hands of surgeons renowned for theirskill, gave new impetus to the efforts of surgeons to invent some methodthat would be less dangerous than that which has been heretoforecommonly employed. The cutting operations have been the rule. Of thesethe operation by median-section is the safest, and is most commonlyemployed for the removal of stones that are not too large, while thelateral operation is used where the stone is more than about one inch inits smallest diameter. 

As will be seen by the consultation of any hospital record, the deathsin these various operations have been, in adults, from one in three toone in every four cases--a very large percentage, and sufficient todeter any sufferer from undergoing an operation except for the relief ofa condition which is in itself worse than death. Even when this alarmingdeath-rate is explained to sufferers, they willingly undergo theoperation, feeling that they would rather die than longer continue intheir pain and anguish. 

Our specialists, not satisfied with the results of these operativemeasures, in their studies of the disease endeavored to perfect someother means by which these foreign bodies could be removed from thebladder without such great danger and pain. The operation by crushing, and removal without cutting, appeared to them to present the mostpracticable advantages, and they therefore devote their entire time tothe improvement of this method for the removal of stone. 

The method of crushing was first invented by a French surgeon many yearsago; but, owing to his crude instruments, and the difficulty that wasexperienced in expelling the pieces of stone, the operation was seldomemployed by surgeons. The improvements in these methods at the hands ofBigelow and Sir Henry Thompson, with those that have been made by ourspecialists, have resulted in our being able to present to suffererswith this disease, a means of cure which is, we are assured, the mostsuccessful known to modern medical science. 

There have been so far in the history of the treatment of this malady bythe new method of cure, one hundred and twenty-odd cases operated uponat the hands of prominent surgeons, all of which were with less perfectmethods than that of our specialists, and there were but four deaths inthis large number. By the advantages which are the result of furtherimprovements by our specialists, we can assure you that this mortalityis even less in our hands; in fact, approaches, as near as possible, toa perfect method of cure. 

We think that in a moderately healthy subject, one in which the kidneysare not badly diseased as the result of irritation from the calculus, the operation is almost absolutely safe. The method consists in thecrushing of the stone, and its removal from the bladder by means ofsmall silver catheters attached to an apparatus which gently andperfectly removes, by suction, all the pieces which are thrown to thebottom of the bladder. This operation has now been performed in ourinstitution in a very large number of cases with uniform success, andthe cures have been effected in from six to eight weeks without a singleunpleasant symptom arising during their progress. By this method it isnot necessary to remove the entire calculus at one operation, if it is alarge one. By the old cutting operation this was required, as thebleeding 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 apart 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 gainstrength for the second; or, if necessary, for the third operation. 

The largest stone removed by us in this way was one weighing betweenseven and eight hundred grains, for which three operations wererequired. It is necessarily performed under a mild anæsthetic, whichprevents suffering and secures the perfect relaxation of the patient. Inthe case in which this large amount of stone was removed we feel certainthat a cure could not possibly have resulted from a cutting operation, as the heart was seriously affected, and the physical condition of thepatient so low, as the result of years of suffering, that death wouldhave occurred while undergoing the operation. By carefully pursuing thenew method, and not prolonging the sittings more than a few minutes eachtime, the entire stone was evacuated. The health of the patientconstantly improved during the interval of three operations, whichcovered 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 bythe new method. In no case is there any bleeding. Instead of a large, gaping wound being left after the operation, from which secondaryhemorrhage may take place, or poisoning result from the irritation ofdecomposing urine, the parts are left in a healthy state with thesurface unbroken. The stone, a constant source of irritation, isremoved, and the health is speedily restored. 

When it is impossible for the patient to visit us, a careful examinationof the urine is made, and if gravel have been passed, these arecarefully examined also. An idea of the composition of the stone isarrived at by this means, and treatment is directed to dissolve it. Success has commonly followed this method of treatment, when the stonehas not been very large. With the gradual reduction of the size of thestone the irritation subsides, and the general health of the patientimproves. (SEE TESTIMONIALS. )

CHRONIC ENLARGEMENT OF THE PROSTATE GLAND. (HYPERTROPHY. )

The prostate gland lies just in front of the base of the bladder, andsurrounding the urethra, or urinary canal. Enlargement, therefore, ofthis body, if it be of considerable extent, causes it to encroach andpress upon the base of the bladder, and to more or less constrict theurinary canal near the base or outlet of the bladder. The enlargementmay be only slight, or the dimensions of the gland may be increased fromthe size of a large chestnut, its normal dimension, to the volume of apullet's egg, or even to the size of an orange. 

Hypertrophy of the prostate generally arises from causes which operatein a slow and permanent manner. Whatever has a tendency to produce adetermination of blood to, and an engorgement of, this organ, is capableof producing the affection, an augmented flow of blood to the the parthaving the effect to increase the nutrition. Among the most frequentcauses of this affection, are excessive venery, masturbation, disease ofthe bladder, stricture of the urethra, horseback exercise, gonorrhea, and the employment of strong, stimulating diuretics. Some of the worstcases that we have had to deal with have occurred in old men, and, infact, the malady is more common to those advanced in life; but it isfrequently produced in those of middle age by the causes enumerated. 

Among the earliest symptoms of the disease is an uneasy feeling in theregion of the base of the bladder. There is a more frequent desire tourinate than usual, and, in the course of time, this frequency becomesmore urgent; still no particular notice may be taken of it, it beingconsidered as "only a slight inconvenience. " After several months, or itmay be years, the discomfort increases, and nightly calls to empty thebladder become habitual. By and by the patient begins to find thediscomfort of getting out of his warm bed very troublesome; still nonotice to taken of it. He does not consider it worth his while toconsult a doctor for "such a trifle. " In the course of time the patientis obliged to get out of bed twice during the night instead of once. Afterwards, the calls become still more frequent and urgent; theinconvenience more evident; finally, pain is substituted forinconvenience, and then the doctor is consulted. Unless a specialist ofexperience be consulted, the bladder will most probably be examined, andmedicine will be prescribed only to excite the kidneys to secrete moreurine, which does harm instead of good; the disease slowly, but surelyprogressing. Patients often write us that they have had something wrongwith the bladder for a number of years, having to urinate morefrequently than they ought; sometimes having to do so three and fourtimes during the night; in extreme cases even every half hour or so, andthat they are not able to pass it freely, but only in small quantities, and attended with much pain. These symptoms are not always constant, butlet up for a few weeks and then appear again. Things go on in this wayfor a year or two, perhaps, when the passage of the urine is completelyshut off for several hours, and the patient is in great agony until thebladder is relieved by the use of the catheter. After such instrumentalrelief, for a day or two the urine may be natural again, coming atfirst, perhaps, in very small quantities, but by and by more freely. Then, after a week or two intervening, there may be another completestoppage, attended, as before, with intense suffering, which will haveto be again relieved by the use of an instrument. 

The foregoing is a fair account of the usual progress of the disease andits symptoms. As the prostate gland becomes more irritated and inflamedfrom the natural progress of the disease, or from the irritation causedby the passage of instruments, or the employment of strong, harsh, stimulating diuretics, the urine becomes cloudy, and still later isfound to have deposited during the night in the chamber utensil aquantity of thick, tenacious, and usually offensive mucus. There is aptto be more or less discomfort in the rectum, or lower bowel, produced bythe pressure of the enlarged prostate upon it. Rarely, the firstintimation of a large prostate occurs through a sudden retention of theurine, and the patient being under the impression that there was nothingwrong with the organ previously. Closely questioned, however, theinformation is elicited that there has been a long train of mildsymptoms, similar to those that we have described, preceding the attackof retention of the urine. This shows the importance of early attentionand proper treatment when such symptoms are manifested. However slightthe inconvenience experienced, it should not be neglected. The diseaseshould be brought under control at the outset by skillful andnicely-adapted treatment. Usually before a person suffers fromtoothache, the decay occasioning it has been gradually progressingwithout pain for from five to eight years. Just as the decay of thetooth may be arrested by the early attention of the dentist, so mayprostatic disease by early attention be not only promptly relieved, butpermanently cured. 

Disease of the prostate being slow in its inception and progress, isalso slow to yield even to the most skillful treatment. Being slow todevelop, patients rarely seek assistance until the organ has become solarge as to be seldom restorable to a size where mechanical means can bewholly dispensed with for relieving the bladder. Most surgeons are toomuch in the habit of depending on the catheter for the relief of thepatient, and usually instruct the sufferer how to use it, telling themthat this, the catheter, is to be their only doctor for life. Great asis the relief afforded by the catheter, which has often saved life, yetit is a fact that its frequent and prolonged use often renders diseaseof the prostate very intractable and often wholly incurable. Frequentuse of the catheter, without any treatment to prevent the furtherenlargement of the diseased gland, or to reduce its size, permits thepart to go on enlarging, and, besides, the constant use of the catheterirritates the prostatic portion of the urethra, causing thickening ofthe lining membrane, and sooner or later a more or less complete organicstricture of this canal, depending upon thickening of the lining mucousmembrane, as well as upon the encroachment of the gland itself upon thiscanal. Besides, when the use of the catheter is once commenced, evenwhen the enlargement is not very great, it is with the utmost difficultythat we have been able to induce patients to leave off its use. Thebladder, becoming accustomed to its use, refuses to obey the willwithout this help. The irritation set up in the parts by the friction ofthe catheter causes inflammation and exudation in the lining membrane. This extends to the structure of the prostate itself and increases thehypertrophy or enlargement. It will, therefore, be seen how important itis to early resort to treatment to relieve the first manifestations ofthis affection. A disease of so delicate a nature, and one so oftenconfounded with other maladies by inexperienced physicians, should onlybe intrusted for treatment to expert specialists of large experience inthe management of this and kindred maladies. 

 * * * * *

STRICTURE OF THE URETHRA. 

Stricture of the urethra generally results from some specific disease ofthe urethra, but may be caused by sexual excesses, exposure, or strain, or by the practice of masturbation or self-abuse. It runs a coursevarying in time from a few days to many weeks or months, during whichtime the patient is often unaware of the real cause of his sufferings. 

Commonly, the attention is first called to a stricture by a slightdischarge, or smarting sensation, or the appearance of an undue amountof mucous deposit in the urine. Occasionally, some difficulty instarting the water, or a diminution in the size and force, or a twistingof the stream as it flows, is the first symptom. This passive stage isof variable duration. When skillful treatment is instituted at thisstage of the disease, a speedy cure is easily effected without pain ordanger. Any exposure, improper use of instruments, or irritating cause, may speedily give rise to the alarming symptoms due to closure of theurethra, 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 toughstricture which surrounds the soft mucous membrane that lines theurinary canal. When irritated or inflamed, as the result of a cold orother cause, the mucous membrane becomes swollen and thickened, and, asthe stricture will not yield and enlarge, the result is that the urethrais almost completely closed, and it becomes impossible to pass theurine. Great pain is experienced, and the surgeon has to be called todraw off the urine with a catheter, which, at best, is a very difficultand painful operation, when the urethra is so irritable and constricted. 

TREATMENT. In the earlier stages of the malady, relief is given by theskillful use of instruments for dilating the canal, or, where this failsby the operation of urethrotomy, for which we employ an improved andingenious instrument, by which the stricture is readily and almostpainlessly divided. 

IMPROVED METHODS. Our surgeons have operated upon many hundreds of badcases by a very ingenious and almost painless method, that requires nouse of bougies in the after-treatment. This saves the patient an immenseamount of pain and annoyance, and enables him to go home almostimmediately after the operation. 

The ordinary after-treatment, by dilatation with bougies, is verytedious, and often more painful than the operation itself, so that ourpeculiar method of treatment has been hailed with joy by those familiarwith the old and unnecessarily-painful systems of treatment. Besides, our more improved method has been followed by far more perfect cures inevery case operated upon. 

In many of the cases coming under our observation and treatment, therehave been several strictures, as illustrated in Fig. 3, which shows theurethra constricted at three different points, besides a congenitalcontraction at its mouth or meatus. 

[Illustration: Fig. 3. Condition of the Urethra with three Strictures and a congenitalcontractionat the meatus or outlet. ]

SPERMATORRHEA not infrequently results from stricture of the urethra, even when the affection is quite slight. Our attention was first calledto this subject by the consideration of the numerous cases in whichepileptic convulsions or "fits, " and other serious diseases of thenervous system in children, have resulted from an unnatural contractionof the prepuce or foreskin, constituting what is termed _phimosis_. 

Every surgeon of experience has met with many of these cases of reflexirritation. It occurred to us, that, inasmuch as these contractions ofthe foreskin give rise to nervous diseases of an alarming nature, maynot an unnatural narrowing of the urethral canal, which must haveexactly the same effect in retarding the flow of the urine, give rise toirritable nervous affections in adults. May not unnatural irritation andexcitement of the sexual organs, so set up, cause loss of semen to occurduring sleep, and consequent nervous and general debility?

It is a well recognized fact that the urethral canal should bear acertain definite and proportionate size to that of the penis, just asthe length of the arm should naturally bear a certain proportion to thelength of the body. In the case of some parts of the body, disproportionate development of the part may not give rise to anythingfurther than unsightliness; but when we find the small size of theurethra retarding the free passage of the urine, then we may expect, ifthis condition is long continued, to find more or less irritation of theurethra and, perhaps, of the bladder, also. When there is a contractionof the urethra at its external orifice, or at any point along itscourse, unnatural pressure is put upon the urinary canal behind theconstricted portion, and these parts must bear an undue strain duringthe passage of the urine. 

It is a well established fact that improper diet, cold, exposure, andover-work exert a very powerful modifying influence upon the urinarysecretion, frequently causing an acrid and irritating condition of thisfluid. This condition, when associated with a contracted urethra, mustresult in irritation of the mucous membrane lining this canal back ofthe stricture, if long continued or frequently repeated. As anillustration, we have a hose pipe from which, by means of a smallnozzle, water is expelled a considerable distance, but a great tensionis put upon the hose behind the nozzle. If the pressure is increasedgreatly the hose will burst; but, if the small nozzle be replaced with alarger one, the projection of the stream will be quite as great, but allundue tension of the pipe is overcome and the danger of bursting is doneaway with. We have, in an unnaturally contracted urethra, a favorablecondition for the development of disease in the urinary canal andadjacent parts of the generative organs. Irritation is set up in theurethra behind the stricture by undue strain in passing water, and thefrequent reoccurrence of acrid urine, as the result of any of the causeswe have already mentioned, this irritation keeps gradually increasing. It will be felt more during the periods when the urine is acrid, but maypass unnoticed even at such times. The seminal sacs and the prostate andCowper's glands communicate with the deeper portions of the urethra bymeans of canals or ducts, lined with mucous membrane which is continuouswith the urethral mucous membrane. Hence we can readily see that notonly by reflex nervous irritation are those parts debilitated, throughthe contraction of the urethra, but the affection is apt to extend bycontinuity of the mucous membrane, and thus become more and moremanifest, through symptoms of disease of the testicles, prostate glandand seminal vesicles, and these disorders become more and more seatedthe longer the morbid condition of the urethra is allowed to run on, until there may be an entire loss of the sexual functions, occurring atan age when there should be present the most vigorous manhood. From noother cause can we explain the common prevalence of disease of thedeeper portions of the urethral canal and bladder, many times confoundedwith other diseases of the urinary and generative organs. 

The following is the history of a case that fully illustrates theforegoing 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 theInvalids' 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 thebladder, an affection that is elsewhere herein fully treated of, andchronic inflammation of the kidneys, and true Bright's disease, as wellas prostatic disease, are all liable to result from strictures of theurethra. Hence, it behooves one suffering from this malady to have itpromptly and skillfully treated. 

FALSE PASSAGES. In very rare cases of impassable stricture, or in whichfistulous openings, or false passages, have formed, through which theurine flows or dribbles away, we have resorted to the operation ofperineal section with the most gratifying results. The cases requiringthis operation are rare ones, in which death must generally result butfor the relief afforded by the operation. 

DANGEROUS USE OF INSTRUMENTS. The worst and most dangerous cases ofstricture 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 recklesslycareless or unskilled in the use of these most dangerous instruments, asthe many cases of false passage or stricture of the most painful anddangerous 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 shorttime. In an extensive practice, in which we yearly treat hundreds ofcases, we have never yet failed to give perfect and permanent relieffrom stricture, or diseased prostate or urethra, without the necessityof cutting instruments of any kind, when we have been consulted beforeinjury of the urethra has been produced by improper use of instruments. Having specialists who devote their entire time to the study and cure ofthese diseases, we are thereby enabled to attain the highest degree ofskill in the management of these cases. 

GREAT SKILL REQUIRED. The urethra is a sensitive and delicate canal, andis surrounded by tissues the most delicate, and lined with mucousmembrane which is highly vascular and filled with sensitive nerves. Theintroduction of any instrument is to be undertaken only when absolutelyrequired, and, when necessary, it should be so skillfully and carefullyeffected that no pain or irritation can result. The slightestawkwardness is liable to cause an unnoticeable injury, which results infalse passage or an effusion of plastic lymph around the canal, and asit organizes, the formation of the most troublesome organic stricture. The attention not only of sufferers, but also of the profession, iscalled to the remarkable success of our operation, perineal section, bywhich a cure of extremely bad cases of impassable stricture and falsepassages, or urinary fistulas, is effected in from thirty to forty days, and with very little suffering. That we have been successful in suchcases must be considered as conclusive evidence that no case ofstricture, false passage, or urinary fistula, is beyond the reach of ourskill. 

 * * * * *

TESTIMONIALS. 

In a practice embracing the treatment of a vast number of cases ofdiseases of the Urinary Organs, it has been our good fortune to effectmany remarkable cures. The experience gained in this field of practicehas made our specialists skilled experts, and hence hundreds consultthem as a last resort. In fact we seldom get a case, in this line, thathas not been the rounds of the home physicians before applying to us forrelief and cure. The cures, therefore, which we shall introduce here arethe more remarkable because of the failure, in nearly every case, ofother medical men to benefit or cure. They are not the every-day, ordinary cases met with in the general practitioner's rounds, butcomplicated, obstinate ones, which had generally been given up ashopeless before coming to us. 

CASE 4A-3431. "WASTED TO A SHADOW. " BLEEDING FROM KIDNEYS. A SEVERECASE. 

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. Inthe year 1886 I was seized with inflammation of the bladder and passednothing but thick blood, owing to heavy work, and I consulted a doctorand he said there was no cure for such a bad case; but he gave memedicine and it relieved me at the time I used it; and I took 16 bottlesand I got worse and wasted to a shadow. I quit taking the medicine, andother complaints came, as rupture in the spermatic cord, for which Iapplied to you and soon got relief. And in 1891 the bladder disease madeits appearance, and I wrote to the Invalids' Hotel and SurgicalInstitute and got no reply as our mails were stopped on account of snowdrifts. 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 stoppageof the disease. And I got so weak that I had to support myself by thefurniture in my room; and I wasted down to 100 lbs. In two weeks; and Iapplied to your Institute and I received my medicine in a few days, andin two weeks I began to gather strength and now I am hearty and well andmy weight is 145 lbs. I feel so thankful to the Medical Association andits Staff of skilled men. It is 15 months since I quit taking yourmedicines 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 andBladder. It became gradually worse and I endured extreme pain, so muchso that I was laid up for weeks at a time, and almost gave up indespair. I was persuaded to go to the Invalids' Hotel and SurgicalInstitute. I have never regretted following this advice. While there Isubmitted to an operation by their specialist. This was entirelypainless and the result perfectly satisfactory. I left in a short timedelighted, and have since been strong and well. I cannot speak in toohigh praise of this famous Institution; the rooms are large andpleasant, the food the very best, the attendants kind and attentive andthe staff of physicians skillful and of large experience. I highlyrecommend all invalids to the World's Dispensary Medical Association. Ifeel confident that all the benefit to be derived from medical treatmentis 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 severalweeks, I take great pleasure in telling other sufferers of my treatmentwhich I received under your efficient staff of physicians, surgeons andnurses, and I will say with clear conscience that every care and comfortwas given me that could be wished for. I am sure that your Institutionis far in advance of the age, and would wish that every invalid couldavail himself of the treatment that I received in your most excellentlykept Invalids' Hotel. I cheerfully give this as my testimonial toindividuals, friends and sufferers. My health is so fully restored thatI look upon life with pleasure and comfort, whereas before I was asuffering, nervous invalid, unable to sleep and much of the time intorment. 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 URINARYORGANS ONE MASS OF SORES. " "DESPAIRED OF CURE. "

[Illustration: S. C. Tracy, Esq. ]

My disease was caused by the roughness and exposure incidental to thelife of a miner, working in the gold mines of California and Montana. Ihad much of the time to work in water, with my clothes wet, whichfinally brought on a severe pain In my kidney, which ere long completelyprostrated me. I employed and was treated by six different physicians, the best I could obtain in my section of country, and who while seemingto understand the nature of my disease, yet gave me no remedy thatafforded me any real relief. I grew worse under the treatment of themall. The pain in the kidney left me, but immediately located in thebladder. My bladder became very painful and commenced to ulcerate andfill up. It seemed from the excruciating agony I suffered, that theremust have been an abscess in either the kidney or bladder, and from thelarge amount of pus discharged at one time, it appeared to me that mykidneys, bladder and the entire urinary organs were one mass of soresand pus mixed with blood. I had to use injections of laudanum daily inthe lower bowels to ease the pain and live. Was reduced by longsuffering, looking for each day to be my last. I felt that no humanpower on earth could help me. No language can describe, and God onlyknows, the agony I suffered. From what I have already written, you mayform some faint conception of my physical condition at the end of sixyears' treatment by the best medical aid I could get in the sectionwhere 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 hearof, but to no permanent relief. Such was my condition when I was ledfinally to consult and be treated by your Association, though I had butfaint hope of obtaining any relief from any one. With the very bestdescription I could give in writing of my case, and all the informationyou got from me, you would not undertake the case until you were furtherinformed, and for which caution I sincerely thank you. You wrote me--"weare at a loss to definitely determine your condition. We have an opinionbased upon the facts before us, but we feel that we must have a personalexamination. " In the condition I was then in, I could not have been keptalive to reach the first railroad station, which was only six miles frommy house, and much less to travel to Buffalo. Indeed I wrote you, thatif 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 couldimprove sufficiently to go to Buffalo for examination. Now this frankanswer of yours, removed every doubt from my mind, and convinced me thatyou were _honorable physicians_. On March 10th, 1883, I began takingyour "Special Remedies, " as you prescribed them, and at the end of threeyears' constant treatment, I was improved sufficiently to go to Buffaloto your Institute, where I was examined as you required of me. When Ireached your Institute, I was there carefully examined and received amonth's treatment. When I reflect on my condition and my suffering whenI first began to use your specifics, and see what I am now, I feel thatno words can too glowingly express my gratitude to your Association forthe physical benefits you have conferred upon me by your treatment of mydespaired-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 fornervous debility, and although I am not quite fully cured as yet, I havebeen greatly benefited, and believe, if I had come to you before I wasduped and swindled by different quacks and was more dead than alive, Iwould to-day be a thoroughly well man. 

I have also been to your Institute twice for surgical operations, andcannot too highly praise the Hotel, or the skill and care of theattending surgeons and nurses. They are gentlemen in every way and theInvalids' Hotel is just as represented. 

I shall advise all suffering from chronic diseases to go to you forrelief, as I have never seen any one there who was not cured or greatlybenefited. 

 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 yourgrand Institution. I had an operation performed at your place two yearsago 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 healthsince. I earnestly recommend your Institution to all who are suffering, and still further let me thank you for the kindness I received at thehands 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 onlyspeak in the highest terms of your Institution. After suffering for tenor twelve years with retention of the urine, and bladder difficulties, Ican say that I found immediate relief at your hands. When going to yourplace, about six years ago, I was suffering with intense pain, loss ofappetite, and unable to eat a good meal. I now weigh 170 lbs. , do a goodday's work and feel well in every respect. I am only too glad that I amable to praise your Institution, and can highly recommend it to any onewho 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 OFBLADDER. 

[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 wasafflicted with an enlarged prostate and chronic Inflammation, orcatarrhal condition of the bladder. I was largely benefited by thetreatment I received there, and had I remained a little longer, as I wasadvised to do by the doctor who attended me, I should have fullyrecovered. I was so nearly cured that I did not think it necessary toremain longer, as I supposed nature would do for me what remained to bedone, to effect a perfect cure. My business was urgent. I could not wellremain 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 theability of the medical staff and the interest the doctors take in thewelfare of their patients. The nurses and all the subordinates were verykind and seemed to vie with each other to contribute to the pleasure andhappiness of the inmates of the Institute. One will find the Instituteequipped with all the improvements known to modern science, for thepromotion and restoration of health. It is impossible to do justice toits merits in a short article of this kind. Persons must go there andsee and judge for themselves, of the wonders of this extraordinarymedical establishment. If they cannot recover their health there, in myJudgment, 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 complywith your request. Having suffered for many years with a complication ofdiseases and feeling conscious that they were rapidly making seriousinroads upon my constitution, and that I was speedily becoming unableand incapacitated to attend to my ordinary business. I resolved, afterreading a number of testimonials from your patients, to place myselfunder your treatment at the Invalids' Hotel and Surgical Institute. Withheart-felt gratitude I can truthfully say I am relieved of my trouble. Imost cheerfully and earnestly recommend this Institution to all who areafflicted 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-feltgratitude 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 theInvalids' Hotel and Surgical Institute at No. 663 Main Street, Buffalo, N. Y. , I feel warranted in its highest recommendation. While there I sawand talked with a great number of people who came there as a lastresort, to be cured of almost every chronic disease to which flesh isheir, and they were unanimous in their praise of the Institution and theskilled specialists who constitute its professional staff. 

 ANDREW HOLES, Moorhead, Minn. 

CASE 654, 500. DISEASE OF KIDNEYS AND OTHER COMPLICATIONS CAUSED BYEXPOSURE 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' Hoteland Surgical Institute, No. 663 Main Street, Buffalo, N. Y. , I must say Ifound it fully equal in every respect to the claims made for it by theproprietors. It was filled with invalids who were under the care of acorps of physicians and surgeons and the fact that all the sick peopleappeared to be improving, and that they were both cheerful and hopeful, and that they all spoke well of the Institution and of its doctors, wascalculated to inspire confidence in one who went there himself to betreated. The greater number of these cases, as far as I was able tolearn, were chronic and of a complicated character. They represented awide range of the States and Territories of the Union, and had in eachexhausted the resources of the home physicians. Having myself beentreated by your Faculty for a complication of troubles induced byexposure and malaria, I feel that I owe my restoration to health to yourskill and devotion, at a time when I was unable to perform labor and wasmuch discouraged, and had failed to obtain relief elsewhere. You are atliberty 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 HOMEDOCTORS AS SURE TO DIE IN A FEW WEEKS. RESTORED TO ACTIVE WORK ON HISFARM. 

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 hearfrom you and have no objection to your making use of my name in any wayto help the sick and suffering, for I know what it is to be sick. I wassick for seven years; could not do anything; was visited by sevendoctors and was treated by four, and was given up to die by one of thebest doctors of Russellville. He said I could not live longer than fall. He treated me for Sugar Diabetes, while the rest said I had inflammationof the bladder. After giving up all hopes of being cured at home, afriend got me to write to Dr. Pierce's Institution and aftercorresponding: awhile I decided to go and be treated. I was there onemonth and I never was cared for or treated more kindly by any one. Noparents could have been better to their sick children. I cannot speaktoo highly of the Institution, and I believe I would have been in mygrave to-day if I had not gone and been treated. 

I feel great pleasure in expressing to you my sincere thanks for thecure that has been effected in my case, by your very skillful treatment, whereby I am now entirely and I trust permanently cured from a dangerousdisease, which had defied the utmost skill of all former medicalattendants for the past five years, and from which I had despaired ofbeing: relieved. I am happy to state that my health is so good sincetaking the month's course of treatment at your Institute, and, the hometreatment since my return, that I am now able to carry on the work of myfarm. 

I would cheerfully recommend all persons requiring medical or surgicalaid to consult you at the earliest possible opportunity, as I know bypersonal experience that the facilities cannot be surpassed fortreatment 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 wasthe cause of F. M. Brasher taking treatment, who was cured after twodoctors gave him up. J. D. P. 

CASE 820, 426. COMPLICATION OF DISEASES. A GRATEFUL PATIENT'S WORDS OFPRAISE. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N. Y. :

[Illustration: William Henkel, Esq. ]

Gentlemen--Having been in your Institution as a sufferer from twodistinct chronic diseases of years' standing, and having been placedunder the charge of your specialists, I was speedily relieved of myafflictions. The Invalids' Hotel is a place as much like home as it ispossible for such an institution to be. The physicians and surgeons areall expert specialists and thoroughly efficient; the nurses are verycompetent, attentive and kind; and, in fact, the whole _personnel_ ofthe Invalids' Hotel endeavor to do their best to make the patients feellike being at home. I always felt while there as if I was one of thefamily. I gladly recommend your Institution to all persons who areafflicted 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 mydiseases, and I think your Institution is worthy of the highestendorsement. 

 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 Eriefor sixty-two years, and for thirty-six years have been an elder in theFirst Presbyterian Church. During four or five years I suffered from apainful affection of the bladder; the severity permitted neither freedomfrom pain by day nor calm repose by night. Meanwhile, I consultedleading physicians and visited numerous health resorts. Neither time, means nor effort were spared that I might be free from pain. Relief cameunexpectedly. A signal act of Providence, that should be acknowledgeddaily, brought your Institution to my notice, though I had then noacquaintance with any one connected with it. With me it was a questionof life or death. Up to last March I was in a condition of unendurabletorture. I knew that at my age, after the months of pain already borne, that any operation would be serious, perhaps fatal. Accordingly, Iarranged my temporal affairs and carefully "set my house in order. " Onthe 13th of March last, I started for Buffalo to your Institution. Stilluninformed as to the cause of my trouble, I submitted to a searchingexamination, as to my habits, constitution, parentage, the age and causeof death of my parents, and other facts, from which a tolerablebiography could have been prepared. All was kindly intended. Their aimwas to locate my ailment and then to determine my ability to undergo anoperation. Having found a stone in the bladder, they advised that it becrushed and extracted. By a strange coincidence as this was announced, Ilearned of Col. Elliott F. Shepard's death under an operation for thesame disease. He was many years my junior, and seemingly far better ableto undergo the operation. Still, in my desperation, I determined to goon. During five days, I was under treatment for the coming operation. Onthe 18th of March the stone was crushed and extracted. It was a completesuccess. Of the consideration, tenderness and skill of the surgeon andhis assistants, I cannot too strongly speak. Of the gentle and assiduousnurses, the system and completeness of the whole establishment, as itmoved along as one harmonious whole, in all its departments, I cannotsufficiently express my admiration. I am now relieved of a state oftorture, and restored to health and happiness equal to any period of mylife. This I say with sincerity and emphasis. Since then I have gainedtwenty-two pounds in flesh. I wish my words could reach the ear of everyone similarly affected, throughout our land, to banish all doubts andtake advantage of the science, skill and pleasant surroundings sohappily blended in your Institution, for the removal of pain and themitigation of distress. 

 DAVID S. CLARK, Erie, Pa. 

CASE 520, 123. STONE IN BLADDER. 1200 GRAINS OF STONE REMOVED WITHOUTCUTTING. PASSED BLOOD IN GREAT QUANTITIES FROM THE BLADDER. DOCTORS ATHOME (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 youaccomplished in my case. For ten years I was a sick man, and duringthree years I suffered so much that life was a burden. My business hadto be given up and the torments were something that could not bedescribed. Every little while I had to urinate, and each time suffered aspasm of pain, like a knife thrust; the use of a catheter was painfuland often it took long and painful trials before the water could bedrawn off. I passed blood, in quantities at times. When I went to yourplace we had given up hope of a cure, and relief was all that I lookedfor. My doctors at home discouraged me. I spent four weeks in yourInvalids' Hotel, and now at the age of sixty-seven years am sound andhearty as any one, work from five in the morning until seven at night. Imanage a large and active business and enjoy life. I cannot express myhigh praise of your Institution. Your doctors are skillful and thenurses all kind and good. All understand their business and attend toit. I came home a new man and cannot say enough for your praise, and toexpress 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 andsince, 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 REMOVEDWITHOUT 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 SurgicalInstitute in our local newspapers, called to my mind the treatment Ireceived there in 1887. I had been suffering for ten or twelve yearswith bladder trouble, and our home physicians did not seem to understandthe 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 greatsufferer and was so weak that I could hardly walk from the hotel to thedepot, and those who saw me start said that I would be brought home in abox. Soon after my arrival an examination revealed a stone in mybladder. After a few days' treatment to strengthen up the system, thestone was taken out, weighing 530 grains. Four or five others wereafterwards taken out of smaller size, and I am still alive. Will soon beseventy-six years old, and I cannot speak too highly of the care andattention I received from the physicians and nurses while there. Everything that was provided was of the best; good food, gleanapartments; and no better place can be found for treatment of the manydiseases they advertise to cure. 

Anyone suffering from bladder or kindred trouble can find relief at theInvalids' Hotel, Buffalo, N. Y. 

 Respectfully, C. A. CHURCH, New Berlin, N. Y. 

CASE 620, 258. STONE IN THE BLADDER--GREAT SUFFERING FORYEARS--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 Ishould have done long ago), with words of gratitude, the wonderfulrelief I received at your Institution five years ago. It affords me thegreatest pleasure to say to you and to the world at large, that thetreatment and operation I received at your Institution was an entiresuccess and a miraculous cure. After twenty-five long years of sufferingsuch as few people endure, caused from exposure while in the militaryservice of the United States, I contracted kidney and bladder disease, which shortly afterwards resulted in the formation of a calculus orstone. I experimented with medicines. Special Prescriptions, etc. , fromsome of the most eminent physicians in the world, in fact everythingthat promised relief and help for my kidneys was used, but received norelief, until the bladder discomfort became unendurable. As a lastresort, knowing full well that life with me would be very short unless Icould receive immediate relief, I went to your famous Institute, where Iwas treated and operated upon and a large stone was removed from thebladder. The old method of cutting, which is so dangerous, was notemployed, but the new and painless process of crushing; this process wasan agreeable surprise to me, no pain and no risk, as in the old methodof cutting. From the day of the operation I began to improve, and in afew weeks thereafter I returned home to my wife, family and friends, awell and happy man, and I have spent the last five years with ease, comfort and pleasure--a living, walking testimonial for your renownedInstitute. Believe me, when I say that words fail me to express to youmy sincere gratitude for your marvelous and almost miraculous cureeffected in my case. I feel sure no invalid could receive more skillfuland kindly attention anywhere in the world. I would urge every suffererto take treatment at the Invalids' Hotel and Surgical Institute, believing it to be the most skillful, and feel sure that it is the mostadvanced 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 DIAMETERSUCCESSFULLY REMOVED WITHOUT CUTTING OR PAIN. 

[Illustration: Thos. Daltry, Esq. ]

From severe exposure when in the army, I brought upon myself an acuteattack of rheumatism, from which I suffered terrible pain. Followingthis I began to be troubled with my bladder and kidneys. For three yearsI experienced considerable discomfort. There was severe burning andscalding, and urination caused much pain. I passed two pieces of graveland became convinced that I had stone in the bladder. Was examined by myhome physician, who said there was no stone. I was not satisfied, however, and went to the Invalids' Hotel and Surgical Institute. I wasexamined by their specialist. After an injection of cocaine andcarefully cleansing out the bladder, a stone was found about one inchand a half in diameter, probably similar in its composition to thepieces already passed. I was advised to have it operated upon andremoved, which I arranged to do. The process used was their new andpainless one of crushing, no knife or other cutting instrument beingemployed. The stone was readily grasped by the crusher and reduced tosmall fragments. The evacuator was then introduced and the stoneentirely removed. After a few weeks' careful attention my health wasentirely restored and I was able to leave for home. I take greatpleasure in making public my wonderful cure. I could not speak in toohigh praise of those who took charge of my case, nor recommend toohighly this famous Institution. It is about three years since I wasoperated 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 Kidneyand Bladder complaint and told by the best physicians that I was but tendays out of the grave. I applied to your Institute for help and receivedtreatment, and now after nearly nine years am in comparatively goodhealth. All this time I have been able to do much work and to oversee myfarm. Two stones or gravel were passed while under home treatment. Nofurther formations have developed. The many cases I have recommended toyou have all been more than satisfied with the results of theirtreatment. I wish to thank you for the great benefit and care I receivedat 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 andSurgical Institute, Buffalo, N. Y. , and I was cured of a chronic troublethat had been maltreated by other physicians. While there I saw a manwho had been cured by the specialists, who had before been given up todie by the best doctors in Troy, N. Y. Of course, the case must have beena 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 andcare of his skilled doctors and nurses, I know would have most assuredlygot well. Why? Because it was only a case of _stone in the bladder_, andthey are easily cured at Dr. Pierce's Surgical Institute. I think almostany chronic disease can be cured there, if taken in time, judging frommy 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 yourtreatment, and as I have had no return of the old symptoms, I considerit unnecessary to take more medicine. When I visited your Institutionsome two years ago, I had but faint hopes of ever being restored tohealth, as I was suffering from a complication of diseases. My case wasan unusually obstinate one, yet I am satisfied that a cure could havebeen accomplished in half the time, had I been able to follow yourdirections in regard to diet more closely. I hereby tender you mysincerest thanks for the kind treatment received while at yourInstitution. Those days will always be the happiest in my memory. I willclose by giving your faculty my sincere thanks, and hope success willcrown your business. 

 Yours very gratefully, J. F. RITTER, Medford, Jackson Co. , Oreg. 

Stricture, the result of injury from falls and accidents, isparticularly difficult of permanent cure. The following gratuitousrecommendations are from cases belonging to this class who entirelyapprove of the publication, with full name, photo-gravure and address. 

CASE 820, 507. STRICTURE CURED AFTER MANY OPERATIONS BY OTHER SURGEONSHAD 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 aboutseventeen years ago I fell from a scaffold, a distance of eighteen feet, across a beam, striking upon the perineum. A physician was immediatelycalled and I was treated by him for about eight or ten weeks. A catheterwas introduced into the bladder, but caused such intense pain andanguish that it had to be withdrawn. It was tried again but could not beintroduced on account of the lacerations in the urethra, caused by theviolence used. A consultation was held and an operation recommended. Ananæsthetic was used and a cut made through the perineum from the outsideinto the bladder. A catheter was inserted into the bladder, tied inplace and left in position for about eight weeks. After eight or nineweeks the catheter was removed, but it was four or five weeks before thewound in the perineum healed. After a few months I began to have aurinary difficulty, and symptoms of urethral stricture. This conditioncontinued until the urethra was entirely closed, and it was impossibleto make water. A physician attempted to pass a catheter, but could notdo so. He continued to treat me by the process of dilation for five orsix months. I began to feel more comfortable, but the symptoms ofstricture would manifest themselves again. I then went to a hospital atToronto. There I was treated also by the dilating method. The treatmentwas continued for about four weeks, but became so very painful, andthere was so much irritation in the urethra, that it was impossible toendure it longer. They then called an electrical specialist and he begantreatment by electrolysis. In about three weeks I went home, but in ashort time the stricture again manifested itself; the contraction wasvery marked, and micturition very difficult. It grew gradually worse andI could not receive any comfort or benefit. I returned to Toronto totake further treatment from the electrical specialist. During theoperations of dilation of the urethra, I passed some gravel. After fourweeks treatment I returned home, but in about two months was as bad asever, and last October went back to Toronto and was again treated by theelectrical method. The doctor had much difficulty in inserting thesmallest catheter, and it caused intense pain and suffering. The lasttime he attempted to insert a catheter, there seemed to be somethinggive 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 triedto keep as comfortable as possible, but could not micturate with anydegree of satisfaction or comfort. I gradually began to grow worse andthere was a return of the stricture with inflammation of the bladder. InMarch, 1892, there began to be formed gravel in the bladder. They wouldat times obstruct the flow of urine entirely. I kept going from bad toworse, until the urethra appeared to be entirely closed. The physician Icalled found it impossible to pass a catheter Into the bladder, andadvised me to go to some hospital where I could receive propertreatment, and where proper appliances for this class of cases wereused, as he felt satisfied nothing could be accomplished for me at home. I then came to the Invalids' Hotel and Surgical Institute in Buffalo toreceive treatment, and the treatment has been so successful that theurethral stricture as well as the gravel have been removed. After Ireturned home I felt as if a great load had been lifted from myshoulders. I have no irritation at all as I used to have, and I can keepmy water for six or seven hours without any trouble, and the water seemsto be clear and free from sediment of any sort, and in general I feel asI never expected to again. The doctors here were dumb-founded at theshort time I was in getting fixed at your Institution, and feel ashamedto ask any questions as to treatment. Many months have passed and Icontinue well and active in my profession. Any one I can send the way ofyour Institution you may be sure I shall do so, and thanking youpersonally 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 youafter twelve months since I was treated in your Institution, to add tomy former testimonial. With the blessing of good health I have been ableto attend to my business as well as ever, and have the greatest ofcomfort in every respect, and feel about ten years younger than I waswhen I came to your Institution for treatment, and I have still again tothank you, gentlemen, for the kind and courteous attention I receivedfrom every one I came in contact with in your Institution, while undertreatment, and shall ever remember my visit to your Hotel with pleasure, and shall advise any one suffering under the same trouble, with whom Imay 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 maylong be kept up to minister to suffering humanity. God bless your staffof physicians, and may success attend you, is the wish and prayer ofever 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 SurgicalInstitute, at Buffalo, N. Y. , for treatment, and cannot speak in too highterms of the staff of physicians and surgeons, or of the treatment whichI received. I consider the Hotel one of the best in the country, thetable being excellent, and the treatment the very best to be found inthe land. It is a most pleasant place to stay. The attention which isgiven by the nurses could not be better. As surgeons I think yourspecialists possess the finest skill that can be found. Any personsuffering 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 themost 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 greatlyaggravated by uric acid crystals which were continually forming in theurine. Patient had rheumatism, causing this acid state of the system. Hehad been a great sufferer for many years, continually experiencing thenervousness, smarting, pain and burning, with occasional attacks ofurethritis, common to the malady in this form. This made the stricturealmost unbearable, and he was practically incapacitated for his labor atthe time that treatment was undertaken in our Institution. He had beento the Hot Springs and in the care of other physicians with nosatisfactory results. The relief of the stricture by our new andpainless 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 hisdifficulty. Patient afterwards embarked in business as a proprietor of ahotel of his own, and has been ever since very active in carrying on thebusiness, and extremely successful. The stricture showed no tendency torecur, as is commonly the case where it is cured by other methods thanemployed by us. Many years elapsed from the time that it was treatedbefore the testimonial appended was written. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N. Y. :

_Dear Doctors_--I want to thank you, but words cannot express mygratitude, for your treatment white at your Institution, but I will sayfor the benefit of persons afflicted with stricture, that I was entirelycured by you, and after several years have not seen any signs of itsreturning. 

 Yours truly, FAY SAWDY, Proprietor Hotel Sawdy, Earlville, Madison Co. , N. Y. 

CASE 551, 864, URETHRAL STRICTURE--NASAL CATARRH--CURED IN TWENTY DAYS--APREVIOUS 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 ofphysicians and was found to be suffering with a bad form of nasalcatarrh and with two strictures in the urethra (water passage). After afew days' general treatment, I was operated upon and turned over to becared for by the nurse, from whom I received all the attention that wasnecessary. To my utter astonishment I was dismissed in twenty days fromthe Surgical Institute, cured of the stricture. I had been operated onby one able surgeon of Nashville, Tenn. , and was worse after theoperation than before. I have never had a symptom of the stricture sinceI was dismissed from the Invalids' Hotel and Surgical Institute, andhave 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--COULDPASS 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 insurgery, I will say that I suffered with stricture of the urethra, dueto an injury, for about three years. It became so bad that at times Icould pass water only in drops and with great pain. I went to a doctorhere, who used sounds which helped me for a time, but in less than sixweeks I was worse than ever. Hearing of your place, I came to you andhad a painless operation performed, and have ever since been thoroughlycured. I experience no trouble or pain. It is three years since I hadthe operation, and the cure has proved permanent. You have my deepestgratitude. 

 Yours truly, FRANK BRENDELL, Olean, Catt. Co. , N. Y. 

CASE 820, 472. COMPLICATED AFFECTION OF NERVOUS SYSTEM AND URINARYORGANS. 

[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 theprofessional staff, both physicians and nurses, of the world-renownedInvalids' Hotel and Surgical Institute. In every way It verifies theirstatement--"Not a hospital but a pleasant remedial home, " and as such Iadd 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 myobservation while there, so I say to the afflicted--visit them if youcan and if your case (no matter of what character) is Within humanskill, 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 thebladder. 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 andsubmitted to an operation. The method employed was their new andpainless one of crushing, no knife or cutting instrument being used. Ifelt no pain afterward, there was no fever, and I could have gone homethe day after. The operation was witnessed by one of my friends, whosays it was very artistic and done with skill. It was a completesuccess, for I have not been troubled in the least, although nearlyseven years have passed. 

I feel that I cannot speak in too high praise of this renownedInstitution and its staff of skilled physicians. No invalid need fear toplace himself under the skillful treatment and kindly care to bereceived there, for I am confident that all the benefit known to medicalscience, can be obtained at the Invalids' Hotel and Surgical Institute. 

 ROBERT WORTHINGTON, Staunton, Fayette Co. , Ohio. 

CASE 114, 747. NERVOUS DEBILITY, DYSPEPSIA, KIDNEY AND LIVERDISEASE--CURED. 

WORLD'S DISPENSARY MEDICAL ASSOCIATION:

[Illustration: B. V. Wright, Esq. ]

_Gentlemen_--I take pleasure in informing you that the treatment yougave me for the relief of an affection of the spine and nervous system, disease of the digestive organs, kidneys and liver, has been entirelysuccessful. I had feared that my health was gradually being undermined, prior to entering your institution, and I can testify to the perfectappointment that you have, the excellent apparatus for theadministration of electrical and other massage treatment and baths. Myrelief 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 diseasesknown, and I have had an opportunity to satisfy myself, fromconversation with other invalids in your Institution, of the care andskillful treatment that you administer, and its excellent effects. Ibelieve that it is fully abreast of the times, and equal to anyinstitution 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 terribledisease, diabetes. The symptoms were indeed alarming; my strength beingso completely exhausted that my walking from room to room was attendedwith difficulty. My nerves were in a constant tremor, and in fact noother words than that, "I was completely out of fix all over, " willexpress my condition. Having purchased a bottle of Dr. Pierce's FavoritePrescription for my daughter, and in looking over the directions of theaccompanying circular and finding my own case so thoroughly described, Idecided at once to give his special home treatment a trial, which I didduring the three months that followed. This proved to be all that wasrequired for the restoration of my usual health, and during the fouryears which have since elapsed I have had not the slightest reason forbelieving otherwise than that a perfect cure has been effected, and canmost heartily recommend Dr. Pierce's medicines and treatment to any orall 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 humanityto acknowledge the benefit that I have received from your treatments. From babyhood till I was twenty years old I was continually botheredwith a weakness of the muscles of the bladder, that gave me muchtrouble, both by night as well as day. I doctored with severalphysicians and tried all patent medicines, but could not get any reliefuntil I took your medicine about six months, and now I am sound andwell. It has been over two years since I quit taking your medicine, andhave 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 HOMETREATMENT. 

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 youcured me of what the doctors here called Bright's Disease and Stone inthe Bladder. They did me no good, so I concluded to write to you, whichI did, and am happy to say your medicine worked like a charm. God andmyself only know how I suffered. I lost fifty-six pounds of flesh in sixweeks and I thought my time had come, but when I commenced taking yourmedicine, 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 healthand can do as hard a day's work as any man. Again I thank you. Yourcharges were reasonable and any one suffering as I was should write youat once. 

Any person writing to me must send stamped addressed envelope if wantingan 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 Bladdertrouble. I had experienced the greatest discomfort, and tried in vain tofind relief. I was persuaded to go to the Invalids' Hotel and SurgicalInstitute, I went and while there submitted to a course of treatmentthat gave me relief, and was entirely satisfactory. Three years haveelapsed and I continue well. I take the greatest pleasure in makingpublic my cure. No sufferer going there can fail to receive all thebenefit to be derived from medical treatment. The staff of physiciansare skillful and of large experience; the attendants kind and attentive, and the Institution, in all its appointments, not to be excelled in thecountry. 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 Idisregarded their advice. 

 E. A. BROWN, Corfu, N. Y. 

 * * * * *

RUPTURE. (BREACH OR HERNIA. )

By the term _Hernia_, we mean a tumor, which is formed by thedisplacement of the intestines, the omentum (covering of the bowels), orboth, and which protrudes from the abdominal cavity. The most commonvarieties are _umbilical, inguinal_ and _femoral_ hernia. Children aremost subject to umbilical, males to inguinal, and females to femoral, hernia. 

[Illustration: Fig. 1. Indirect Inguinal Hernia. 

Sketched from a case subsequentlycured by our improved methodof treatment. ]

CAUSES. These are either _predisposing_ or _exciting_. Any thing whichoccasions general or local muscular debility, as dropsy, pregnancy, abscesses, wounds, obstructions to natural evacuations, etc. , is apredisposing cause of hernia. The exciting cause is pressure applied tothe contents of the abdomen, as straining in evacuating the bowels andbladder, lifting heavy weights, or violent physical exertion. 

SYMPTOMS. The only characteristic symptom of hernia is the presentationof an elastic, or doughy tumor of variable size, which either graduallyor suddenly makes its appearance. There is flatulence, uneasiness, andsometimes pain in the abdomen. 

Sharp and dull pains frequently recurring and confined to the locationswhere ruptures appear should receive attention. Examination will notinfrequently reveal a small enlargement. If a hernia, this will usuallydisappear after a night's rest and may not be again noticed until thenext day, or for several days. On coughing, with the finger applied tothe enlargement, a sensation of an impulse (succussion), or slightadditional protrusion will be felt

The trouble appears at any time of life, an analysis of seventy thousandcases indicating that it is most common in debilitated persons, and thatthere is a constant decrease in the frequency of the affection from thefirst to the thirteenth year, after which rupture is more and morefrequently met with as age advances. 

[Illustration: Fig. 2. 

This figure illustrates a case of FemoralHernia which was radically cured by ourimproved method. This tumor is a littlelower on the thigh than in cases of inguinalhernia. Femoral Hernia is most commonto females, and inguinal in males. ]

INGUINAL HERNIA (see Fig. 1) is more common than all other forms ofrupture. It is more frequently met with in men, and when severe there isusually a mass of intestine which falls into the scrotum and has an evileffect, by pressing upon the testicle. The protrusion follows thespermatic vessels and hence it usually appears low down in the abdomenand on one or both sides of the pubic bone. 

FEMORAL HERNIA (see Fig. 2), most common in women of mature life, isfelt as a lump below the strong ligament in the groin which forms theline of separation between the thigh and the abdomen. On its outer sideand close to it can be felt the beating or pulsation of the large arteryof the thigh. 

UMBILICAL HERNIA (see Fig. 3) appears at or near the navel and is mostcommon in children. It may be present from birth, or it may result fromfretting and crying at any period of childhood. 

[Illustration: Fig. 3. 

UMBILICAL HERNIA. 

Sketched from a case subsequentlycured by our new method. ]

Sufferers from any form of rupture are constantly subject to the dangerof strangulation. This occurs when, from any cause the free return ofthe contents of the protruded part of the intestine is prevented. It isan accident of a serious nature, inasmuch as nearly fifty per cent. Dieif 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 properexercise, diet, and rest, a condition of vigor and tonicity of themuscular system. 

When debilitated, all strains and exertions should be care fully avoideduntil 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 toits proper place through the opening by which it escaped. This isaccomplished 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 patientshould assume the recumbent posture, with his shoulders and feetelevated. The patient or an attendant should grasp the hernia, and withgentle, but gradually increasing pressure upon the tumor attempt toreplace it. At the same time let the patient knead the bowels upward bypressing upon the integument, so that the intestine may, as far aspossible, be pushed away from the point of protrusion. Sometimes thecontraction of the muscular fibres at a point where the hernia makes itsexit is so great that the tumor cannot be replaced. In this case thesystem should be relaxed with lobelia (not given in doses to producevomiting), and as soon as the patient is thoroughly under its influence, the manipulations may be resumed. When there is any difficultyexperienced in putting back the "breach, " or rupture, professionalassistance should be promptly summoned. After the reduction of therupture, a truss should be properly adapted, applied, and constantlyworn, to prevent the protrusion of the intestine. 

[Illustration: Fig. 4. The above cut fairly illustrates a case of DoubleInguinal Hernia, complicated with Hydrocele, cured at the Invalids' Hoteland Surgical Institute. ]

Of the latter instruments there are several hundred varieties for salethroughout the country. With the exception of about one-half dozenforms, which embody the true principles of a proper truss, they are, without exception, harmful. Unless proper support be given to the wallsof 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 whereit is not required; otherwise, as in the case where a small ring is wornupon a finger, there is a gradual loss of strength and a depressionformed in the healthy tissue, which can be plainly seen and felt. Inthis 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 cannotbe returned by manipulation, a surgical operation is necessary. Wheneverthe necessity for such a procedure is apparent, it should be performed_immediately_, for the greater the delay the greater the liability tofatal results. The operation consists in cutting down upon thestrangulated bowel, thus relieving it of its constriction andfacilitating its replacement. It is a delicate operation, and must beskillfully performed. After the operation, the patient requiresappropriate hygienic treatment. 

[Illustration: Fig. 5. 

This figure illustrates a Double InguinalHernia, of large size, which was permanentlycured by our improved method oftreatment. The left side (_b_) shows the _direct_descent of the bowel into (_c_) the scrotum, while on the right side (_a_) the ruptureis indirect, the bowel descending throughthe internal ring and inguinal canal. ]

THE RADICAL CURE. A small percentage of cures will follow the proper useof a good truss, and the advertisements of the so-called rupture curesare founded upon such cases. These impostors pretend that the use ofsome 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 thatare relieved, and for it but few dollars should be charged instead ofthe exorbitant prices demanded by these impostors. 

Improvements in surgery in this age of wonders, have kept apace with theadvances in electricity and other branches of science. Diseases anddeformities which only a few years ago were considered incurable are nowovercome 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 ofrupture, or breach, with the most gratifying results. Formerly weemployed and advocated the use of the injection treatment only. Thismethod 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 thecases that are presented at our Institution. This plan of cure, as usedby 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 iscommon to the use of the injection fluids that have been advised on theHeatonian method. The fluid we use is a bland and healing agent, whichproduces an exudation behind the cords that surround the inguinal rings, and forms a well defined truss pad of moderate size in such positionthat the rupture cannot pass by it and appear externally. It causes alsoan adhesive inflammation limited to the hernial sac, that completelycloses it. 

This treatment is rendered _entirely painless_ by the use of a solutionwhich is injected underneath the skin with a fine hollow needle attachedto a small syringe, and which tends to produce complete localanæsthesia, or loss of feeling so that the procedure is thoroughly andcarefully carried out without any risk or discomfort. 

The needle used by us for the treatment of the hernia is so perfectedthat any possible injection of the fluid into the abdominal cavity, orupon the coating of the intestine, is an impossibility, and in no waycan an injection be made into a blood vessel or nerve so as to produceany discomfort or trouble. We thus avoid all the risks that pertain tothe usual plan of injection. 

There is a small percentage of cases, as before stated, in which thisform of treatment is not likely to give a permanent cure, from the factthat the omentum or intestine has become adherent externally, to thesac, or in the scrotum, to the coverings of the testicle. This makes thecomplete replacement of the rupture without cutting an impossibility, and in such cases even where the hernial opening is closed, treatment byinjection only would not result in a permanent cure. 

Our aim is to treat all cases of rupture that we undertake in such amanner that _by no possibility can the deformity return_. We thereforehave for the cure of these cases another method, by which with our localanæsthetic fluid, we are able to perform a surgical operation withoutany distress whatever to the patient. The greatest risk of the oldoperation for rupture was the danger of general anæsthesia withchloroform or ether, or some similar agent. The great majority ofindividuals cannot bear the inhalation of the large quantities of theseanæsthetics necessary to secure loss of feeling without consequentnausea, and at times an effect upon the heart that often resultsseriously. The risk from the anæsthetic is much greater than from thesurgical procedure. By our method, this risk is entirely done away with. The pain dispelling fluid enables our operator to pursue his methodWITHOUT GIVING THE PATIENT ANY PAIN OR DISCOMFORT WHATEVER. During theoperation he is in full possession of all his faculties, and can assistin any way desired by coughing, or straining, in order, at any time, tocomplete the protrusion of the rupture and show its entire extent ofsurface when the sac is laid bare. We then replace the rupturecompletely; suture the sac so that the rupture will have no pocket intowhich to descend, and then firmly unite the rings by a plan that we haveinvented, and BY WHICH THEY ARE MADE MORE STRONG AND FIRM THAN IN THEIRORIGINAL STATE. 

Early in our experience, and while using the plan of treatment that isusually employed for the radical cure of rupture, we had occasionalrelapses of the difficulty, but since using our improved method we havehad no such trouble. We can assure our patients that there is less riskof the appearance of the rupture at the point where the operation isperformed than there is of a new breach forming. The success of thistreatment has been invariable. None of the plans of treatment that wepursue for the cure of rupture tend to keep the patient in bed more thana few hours. There is little or no pain, after either of our plans oftreatment, and out of the many hundreds which we have treated andperfectly cured, in no instance have we had any inflammation or seriousmanifestation--there being no fever or general reaction. It is a matterof great surprise to our patients, who undergo our treatment for theradical cure of rupture, that by our varied methods, the object isaccomplished with so little discomfort and with no pain whatever. 

From two to three weeks' personal attention of our specialist, isusually all that is required even in the worst cases. 

NO TRUSS IS NEEDED AFTER OUR TREATMENT. WE CONSIDER A CASE CURED ONLYWHEN THE PATIENT IS ABLE TO DO WITHOUT A TRUSS OR SUPPORT IN ALL THEUSUAL WALKS AND VOCATIONS OF LIFE. 

 * * * * *

TESTIMONIALS. 

The testimonials that we append are but a small number out of the greatmass that we have received. A very large percentage of individuals whohave been treated by us for rupture desire that their disability be helda matter of sacred confidence and with all such we take pleasure inguarding their confidence with the greatest care. Others are quitewilling that their experience may be made public in this manner for thebenefit of similar sufferers. 

If the following letters had been written by your best known and mostesteemed neighbors they could be no more worthy of your confidence thanthey now are, coming, as they do, from well known, intelligent andtrustworthy citizens, who, in their several neighborhoods, enjoy thefullest confidence and respect of all who know them. 

A LOCOMOTIVE ENGINEER

TESTIFIES TO HIS CURE OF RUPTURE. THE CONSTANT JAR OF A LOCOMOTIVE ISONE 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, Iwent to the Invalids' Hotel and Surgical Institute, at Buffalo. Whilethere, I submitted to an operation which was not painful. It was donewithout chloroform, ether or any dangerous anæsthetic. Under theskillful treatment of your specialists and the very close and kindattention of your nurses, in less than a month, I left the Institutionfeeling like a new man. I have every reason to believe that the Herniawill never return, and that I am permanently cured. It it a great reliefto 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 ISONE 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 Divisionof the Fitchburg Railroad. I had a severe case of double Hernia; still, have always worked along with them until this winter. One side was oftwenty-five years' standing--the other of about eight years. This winterI was laid up sick with pneumonia; in coughing so much, which of coursewas made necessary by that terrible disease, I strained myself so thatafter getting up from my sick-bed, I was not able to go to work, as Icould get no truss that would hold the rupture. I was talking withBrother 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 trussentirely. 

I wish to say this comes from me direct; it was my own proposition thatthis 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 DispensaryMedical Association after suffering from boyhood until the age oftwenty-five from a hernia, or rupture, by a treatment of twenty days. Itis now five years since I was cured, and can say that I was permanentlycured. You have my most sincere gratitude for your skillful operationand the good care received in your Institution while there. I canrecommend your nurses and physicians most highly, and I think yourInstitution 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 mostwonderful cure I received at the Invalids' Hotel and Surgical Instituteof Buffalo. 

I had suffered severely for eight years with a left inguinal hernia; hadtried many physicians and medicines, but found only temporary relief. Iwas greatly run-down, and my nervous system considerably shattered. Myfriends persuaded me to go to the Invalids' Hotel and SurgicalInstitute. While there I was operated on by their specialist, and in afew 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 invalidsto go there, feeling confident that they could no where receive moreskillful 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 haveme give you a testimony of my case I will say in reply that I wastreated at the Invalids' Hotel and Surgical Institute, for Hernia on theleft side. It was not large but it gave me severe pain while working. Iwore a truss but it did not relieve the pain very much. I read in thepaper one night your advertisement and a week after I started for theInvalids' Hotel, and took the treatment for rupture and went home soundand happy, like a new man, and I can work harder than ever and canassure 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 fulladdress and I will inform them about it, if they enclose return stampedand 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 theradical cure for rupture received at your Institution in May, 1889, hasproved entirely successful. I am sound as a dollar. My case was anextremely troublesome and dangerous one. Many times I required theassistance of a surgeon to reduce it. No truss would hold it a wholeday. My two weeks' stay with you was worth thousands of dollars to me. Will gladly answer any inquiry and would advise any one suffering fromhernia 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 theKingsley House at Ashuelot, N. H. : "It may seem useless to add testimonyto the overwhelming mass already given of the many remarkable curesperformed at your Institution, but I deem it a pleasure and a duty toadd mine to your long list as _very remarkable_. I had a rupture oftwenty-seven years' standing, with hemorrhage of the kidney for sixmonths, preceding my visit to your Institute, and was also troubledbadly with indigestion, all of which ailments had reduced me in strengthand 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 distancewhen I left my home on the 8th of July, 1892, for treatment at yourInstitution, with but little faith or hope of ever being any better. Butthrough your skillful treatment I was able to return to my home on the9th of August, 1892, and consider myself permanently cured, having hadto take no medicine since. Considering my case _almost a miracle_, Icannot speak too highly of your Institute and skillful treatment, towhich I feel that I am indebted for my continued existence. You are atliberty 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 gaveway, and I fell a few feet and the strain and jar caused a rupture inthe right side. I did not pay very much attention to this until Inoticed 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 toan operation which was entirely painless and proved most satisfactory inevery respect. Since then I have been well and able to do hard work fora 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 ofhelp. I can highly recommend the physicians and nurses and the kindattention 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 forpiles and also rupture of the left side. 

Your institution is all it claims to be, and the treatment of my casewas accomplished without pain and apparently any risk. Your method ofusing locally cocaine as an anæsthetic is such a decided improvement. Idid not have to take any dangerous ether or chloroform, but had a smallquantity of medicine injected that made the operation as painless asthough it was being done on some one else. At the same time I kneweverything and could see what was being done. 

You have my kindest thanks for the good care and many attentions givenme. 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, causedby heavy lifting. It was on the right side and the protrusion sufficientto extend into the scrotum. I purchased trusses, but none of them couldbe worn with comfort, and I suffered very much. I concluded to go to theInvalids' Hotel and Surgical Institute and see if I could not obtainrelief. While there I submitted to an operation. The result was entirelysatisfactory. The pain in my back subsided; my general health began totone up, and in a short time, thanks to the skill of their specialistand the kind attention of their nurses, I felt like a new man. I takepleasure in highly recommending the Institution to all the afflicted. Ifeel confident that all the benefit to be derived from medical orsurgical treatment is to be received at the Invalids' Hotel and SurgicalInstitute. 

 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 testimonialof the wonderful cures you have performed for me. 

[Illustration: D. Hartley, Esq. ]

In the year 1883, I became ruptured on the _left_ side. I immediatelywrote you (having heard of your fame in curing all kinds of diseases)for your terms of treatment which I received by return mail, you alsostating you were positive you could cure me. Through unavoidablecircumstances I was unable to come to your Institution until December, 1886. During this time I had tried wearing a truss, which only made itworse, and very much aggravated my complaint as it was impossible tohold the rupture in its place. However I arrived at the Invalids' Hotelon December 8th, 1886. On being examined by one of your staff, I waspronounced a bad case, but by your mode of treatment you could cure it. I was therefore, operated upon by one of your specialists, without anycutting however and comparatively little pain, by your scientificmethod, and in thirty days returned home cured. The time I had to remainthere, I believe, was much longer than most persons treated for the samecomplaint. 

Since then I have worked very hard sometimes (my occupation being thatof a farmer, ) so much so that I became ruptured on the _right_ sidethree years ago, --the other side remaining perfectly sound without anyprotection. I considered myself very unfortunate in being in thisposition again, fortunate in knowing where to go for relief, and verysoon was back in your Institution where I was successfully treated andperfectly cured and am to-day a sound man and able to do any kind ofwork on my farm. 

I write this testimonial for the sake of suffering humanity, and wishyou to use it in any way that the greatest number of persons may readit. As for myself, I would not be in the condition I once was and notknow of your Institution for all I could see. I not only recommend yourInstitution for the complaint of which I was cured but for all chronicdiseases or anything requiring a skillful surgical operation, believingyour Staff of Physicians and Surgeons to be second to none anywhere. Your nurses and attendants, and every accommodation, also, being allthat is necessary to make your Institution everything that its nameimplies--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 MedicalDiscovery" for dyspepsia and liver complaint, and being broken downgenerally. A few bottles worked wonders, and I have been well eversince, 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 twodistinct chronic diseases of years' standing, and having been placedunder the charge of your specialists, I was speedily relieved of myafflictions. The Invalids' Hotel is a place as much like home as it ispossible for such an institution to be. The physicians and surgeons areall expert specialists and thoroughly efficient; the nurses are verycompetent, attentive and kind; and, in fact, the whole _personnel_ ofthe Invalids' Hotel endeavor to do their best to make the patients feellike being at home. I always felt while there as if I was one of thefamily. I gladly recommend your Institution to all persons who areafflicted 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 mydiseases, and I think your Institution is worthy of the highestendorsement. 

 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 healthierthan ever before, so that I presume, the rupture, or a part of it, mayhave existed since his birth. Even that small lump in the groin has, asmuch as I can feel by touching, completely disappeared. I take thisopportunity of expressing my heart-felt thanks for the kind andchristian-like treatment my wife and boy experienced from you and thenurses. God bless you and let you live long for the welfare of sufferingmen. Dr. Pierce's Invalids' Hotel of Buffalo, N. Y. , deserves to berecommended to every sufferer of whatever disease. Eight years ago Iunderwent a successful operation, saving my body a member. The dangerousoutgrowth, which made the operation a necessity, never returned. Inregard to your specialist, I wish to remark, that his skillful way ofperforming 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 famousdirector of the Prussian Royal Clinical Hospital has been. As to themedicines of Dr. Pierce, I recommended them to members of mycongregation, who told me that they did them good. Dr. Bastian, ofDansville, N. Y. , a druggist, told me that your medicines are bought bythe same persons again and again. I consider this to be the bestrecommendation. A medicine which is of no effect will not be bought asecond 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 abovereported, writes: "In respect to your medicines I can only say that theyhave done me and others much good, especially when I suffered withchronic catarrh and doctored with your physicians. I shall never forgetthe kind treatment I received from your physicians and nurses during thetime I had to stay in your house, while our Herman had to go throughthat dangerous operation which was necessary to cure his strangulatedrupture. I can recommend your Institute and medicines to all sufferingpeople. "

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 kindlymake inquiry in regard to my physical condition, I would say, that I amnow, I think, as sound as a dollar, and consider that after I had badfourteen years of suffering with Hernia, and being cured as I was lastwinter at your Institute, makes me under great obligations to thescience 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 trussfor a long period, and that I have been at work steadily at my businessof binding and printing, running a large establishment, for over fouryears, without any trouble whatever from the rupture. It has remainedpermanently and perfectly cured. You will remember my case as a mostsevere one. I am a man of sixty years of age, and the disease had beenthe source of serious discomfort to me since childhood. The protrusionwas the size of a man's head, and could not be replaced. I was forced togive up all exercise, and suffered much at my daily work frominconvenience and pain. Any injury upon the protrusion, which could notalways be protected, was followed with much discomfort, and my generalhealth was seriously affected. The passage of the food through theconfined intestines was a painful process often times, and kept me ingreat misery. I am thankful to state that since your operation therupture has remained sound and well, and I have been relieved of alldifficulty of the kind. I now enjoy excellent health, and am at mybusiness daily from twelve to sixteen hours, and on my feet constantly, yet without any manifestations whatever of the re-appearance of therupture. You have my most sincere gratitude for the skillful operationand the good care received in your Institution while there. I canrecommend your nurses and physicians most highly, and think yourInstitution 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-feltgratitude 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 theInvalids' Hotel and Surgical Institute at No. 663 Main Street, Buffalo, N. Y. , I feel warranted in its highest recommendation. While there I sawand talked with a great number of people who came there as a lastresort, to be cured of almost every chronic disease to which flesh isheir, and they were unanimous in their praise of the Institution and theskilled 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 andbenefits received at the hands of your skillful staff of surgeons andnurses. I had been a sufferer from Hernia for eleven years and triedeverything, but was no better. I finally went to the Invalids' Hotel andSurgical 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 INPLACE--AFTER TREATMENT SUBJECTED TO THE TRYING TEST OF THE CONSTANT JAROF 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 curefor the benefit of all those persons who have suffered in like manner. Ihad a rupture that was very large and difficult to hold in place. Trusses of all kinds were tried. They were painful and would not holdit. The rupture would come down constantly when at my engine and give mefearful 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 beenpermanent, 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 frommalarial fever each year for ten years past. The hernia was caused bylifting her father, who was on his sick-bed, during five differenttimes, causing terrible suffering. The hernia was treated by ourSpecialist, 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 wasat 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 inducedto 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 aliving 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, appliancesand remedies, each one in successive repetition, a failure. In Januaryand 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 itwas my last chance, and that it would be my last effort, and to becandid I had very little hope that a cure would be effected. To me mycondition seemed appalling, as I dare not eat, drink, laugh, exercise orperform any of the functions of life without having to reduce myrupture, frequently as often as forty or fifty times _per diem_, whileon occasions the reduction would occupy hours of untold agony. No trussor appliance that I could get would retain the rupture, and I had triedall sorts as fast as they came to my knowledge. Marvelous as it mayappear to all sufferers from this distressing affliction, I wasdischarged from your Institute in thirty days, a well and sound man, andonly from memory and the record do I know that I was ever ruptured. Ihave at times since performed some of the hardest kinds of work for longperiods, but no sign of weakness has ever appeared. I do not considerthe necessary operation performed as attended with any danger; it is nocomparison to the chances a person takes who in the daily walks of lifeis tortured with a rupture. 

While an inmate of your Institution, I was accorded the kindest and mostconsiderate treatment from all members of your staff and employees withwhom I came in contact. I consider the appointments and cuisine of theestablishment as perfection. You are at liberty to make the fullest andfreest use of this testimonial you may see fit in your judgment, and Iwill cheerfully answer any communication from any sufferer referred tome 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 specimenin Dr. Gross' cabinet. ]

Every family should be made acquainted with the symptoms and treatmentof this disease. Especially is this true in the case of those livingremote from a physician. From the lack of this knowledge on the part ofparents, many a little one has perished before medical assistance couldbe 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, deathensues. 

There are several quite distinct pathological conditions of the vocaland respiratory organs which have, in popular parlance, been designatedas croup. But two of these are worthy of consideration here. These are_true_ or _membranous_ croup, in which a false, semi-organized membraneis formed, and _spasmodic croup_. Both may result fatally, but theformer is much the more dangerous. 

MEMBRANOUS CROUP is supposed to originate in the trachea, from which, asit progresses, it often extends upward to the larynx, and downward tothe bronchial tubes. It is the result of severe inflammation of themucous membrane, and is characterized by the formation of a falsemembrane, which covers or lines the inner surface of the true structure(see Fig. 1). It is formed of a coagulable, semi-fluid exudation fromthe mucous membrane. On being brought to the surface and into contactwith the inspired air, this substance grows thick and tough, orleathery, as we find it. It is the obstruction in the respiratory canalwhich this foreign matter causes that gives rise to the laboredbreathing, and the ringing, brassy cough, together with the crowing orwhistling inspiration characteristic of croup. Before recovery can takeplace this membrane must be detached and expelled. The cough is nature'seffort to accomplish this work. 

The formation of this adventitious membrane in the larynx is attendedwith more danger than when it is confined to the trachea. In most casesin which the disease has had a very speedily fatal termination, anexamination 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 thepeculiar _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 coughceases to be loud and barking, and is very much suppressed; the voice isalmost gone; the face is very pale; the head thrown back; the nostrilsdilated and in perpetual motion, the pulse at the wrist very feeble, great exhaustion, more or less delirium, and, finally, death comes tothe relief of the little sufferer. Convulsions sometimes occur in thelast stages, and soon terminate fatally. 

TREATMENT. No time should be lost in commencing treatment. Hotfomentations should be applied to the throat and upper portions of thechest. The free inhalation of steam should be employed early. Thefollowing treatment has been found very effectual in membranous croup, and is recommended by the highest authorities: Yellow subsulphate ofmercury, or turpeth mineral, three to five grains, depending upon theage of the child, for one dose. If it does not cause vomiting in fifteenminutes, give a second dose. This, however, is seldom necessary. If theturpeth mineral cannot be obtained, sulphate of copper or sulphate ofzinc may be given instead, as directed under the head of Emetics, inPart III, Chapter II. If there be a quick pulse, hot skin, a hurriedbreathing, and an occasional ringing cough, the child should be kept inbed, comfortably covered, but not overloaded with clothes, and thetincture or fluid extract of veratrum viride administered as follows:Take fluid extract of veratrum, five drops; sweet spirits of nitre, oneteaspoonful; pure water, twenty teaspoonfuls; mix, sweeten with whitesugar, and give a teaspoonful of the mixture every half-hour to twohours, according to the age of the child and the severity of the case. If there be great prostration, with cold extremities, the carbonate ofammonia 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 frequentlysponged with warm water in which a sufficient quantity of saleratus orordinary baking-soda has been dissolved to render it quite stronglyalkaline. If the bowels be constipated they should be moved by aninjection of starch-water. Beef tea and other concentrated, supportingdiet should be administrated. In those cases in which there is atendency to croup, the Golden Medical Discovery, together with iron andthe bitter tonics, should be given to build up the system and counteractsuch tendency. The treatment which we have advised has been put to theseverest tests in the most severe forms of the disease, and has resultedmost successfully. If, however, in any case it does not give promptrelief, our advice is to lose no time in summoning a physician who isknown to be skilled in the treatment of diseases of children. 

SPASMODIC CROUP. In this affection no false membrane is formed. It seemsto have a nervous origin. Most frequently the child is awakened in thenight by a sense of suffocation. He may cry out that he is choking. Thecountenance is livid, the breathing is hurried and each respiration isattended 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 spasmodiccharacter with no inflammation. 

Apply hot fomentations to the throat, and give frequent small doses oftincture or fluid extract or syrup of lobelia, to produce slight nausea;or, better still, an acetic syrup of blood-root, made by adding oneteaspoonful of the crushed or powdered root to one gill of vinegar andfour teaspoonfuls of white sugar. Heat this mixture to the boilingpoint, strain, and administer from one-fourth to one teaspoonful everyhalf-hour or hour. Slight nausea should be kept up, but it isunnecessary to produce vomiting. This is usually all the treatment thatis required. 

WHOOPING-COUGH. (PERTUSSIS. )

This is primarily a disease of the nervous system, involving therespiratory organs through the medium of the pneumogastric nerve. It isconsidered a disease of childhood, though we have met with it in _oldage_. It is eminently a contagious affection, and occurs generally butonce during life. 

SYMPTOMS. It is at first manifested by a catarrhal cough, graduallydeveloped. After a while it becomes paroxysmal, generally worse atnight. The cough is severe, and long-continued; when a prolongedinspiration occurs, it is accompanied by a peculiar shrill sound, thecharacteristic _whoop_, which, when once heard, is never forgotten. Thecough is attended by a copious secretion of glairy mucus, which isbrought up at the latter part of the paroxysm. During, or at the end ofthe paroxysm, vomiting frequently occurs, and sometimes nosebleed. Thecough is so severe at times, that the patient turns purple, gasps forbreath, and presents all the symptoms of suffocation. Bronchitissometimes is a troublesome complication. Immediately preceding aparoxysm of coughing a sense of impending danger appears to seize thechild, and it runs to its mother, or grasps some support, as if forprotection. Until the paroxysmal character and peculiar _whoop_ isdeveloped, the disease is diagnosed with difficulty. 

TREATMENT. We have found the Golden Medical Discovery to modify thedisease and cut it short. The philosophy of its action can be readilyunderstood by its effect on the pneumogastric nerve, as explained underconsumption and bronchitis. Jaborandi, described under the head ofdiaphoretics, often speedily arrests this disease. The employment of aninfusion of red clover blossoms, in small doses, is of undoubted valuein modifying the irritation of the air-passages, and may be used to goodadvantage 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 oran inflammatory condition of the nasal mucous membrane. Individuals aresusceptible to it who are oppressed by fever or constitutional diseasesthat reduce the strength. There is also a condition of the nervoussystem in which there is congestion of the nerve centres which favorsmanifestations of this somewhat troublesome difficulty. 

CAUSES. In some instances an examination of the nose will reveal thepresence of a small point of congested vessels, usually about the sizeof a split pea. Upon this portion of the mucous membrane small scabsform, and at any time when they may be dislodged, by accident orotherwise, a hemorrhage will ensue. 

The constitutional conditions that produce the tendency to hemorrhageare most important. In individuals of a debilitated condition, itresults from the lack of a proper amount of fibrin in the blood. Wherethe blood becomes thin, or loses a large share of its red corpuscles, the individual is pale, and hemorrhages are frequent from the mucoussurfaces of any portion of the body, the nasal mucous surface beingespecially liable to such attacks. 

TREATMENT. This is local and constitutional. Where there isconstitutional imperfection, it should be remedied. Usually in youngwomen 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, accompaniedwith troublesome headache. The correction of this form is by the use ofthe "Favorite Prescription" and "Golden Medical Discovery, " using ofeach a teaspoonful three times a day, taking the "Prescription" beforemeals and the "Discovery" after meals. If the bowels are constipated, the "Pellets" should be employed, in order to overcome any congestion ofthe liver which favors the manifestation of nosebleed. In children thereis usually a debilitated state of the system, which is best remedied bythe use of a half teaspoonful dose of the "Discovery, " taken three timesa day, after meals, with sweetened water. This treatment should becontinued for a month or six weeks. By this means the blood-makingorgans rapidly improve in their activity and functions, the bloodbecomes rich in corpuscles and fibrin, thus strengthening the walls ofthe blood-vessels and tending to prevent a hemorrhage following undueexcitement or injury. With men the use of laxatives is of greatimportance. One or more of the "Pellets, " taken on retiring at night, are most beneficial. Where the blood is not up to the standard ofpurity, even though the individual be fleshy, the "Discovery" should beused, a teaspoonful or two, three times a day, after meals, inconjunction with plenty of outdoor exercise and the best of food. Wherethe hemorrhages occur in those having too much blood, the diet must becorrected by the use of vegetables and fruit, diminishing the amount ofmeat and pastries to a minimum. The amount of fibrin should also beincreased by the use of the "Golden Medical Discovery. "

LOCAL TREATMENT. Of those applied directly to the membrane, Dr. Sage'sCatarrh Remedy, used according to the directions which wrap the bottle, is excellent in bringing about a normal condition of the mucoussurfaces. Following this, a small amount of Subnitrate of Bismuth may besnuffed into each nostril. Usually the amount required to cover athree-cent silver piece is sufficient. The powder dries the surface andfavors the speedy formation of a coagulum, or clotted covering, whicheffectually checks any further hemorrhage. The application of a firmcompress to the upper lip will also diminish the flow of blood throughthe 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 thenape of the neck. This, with a reclining posture, will cause contractionof the blood-vessels. If the Subnitrate of Bismuth is not to be readilyobtained, the use of any other powder such as starch, finely divided andbaked so as to be free from a tendency to form starch paste when appliedto a mucous surface, is equally good. Well-browned flour is alsoserviceable. The use of the contents of a puff-ball, which contains manymillions of fine spores, has been employed from time immemorial. The useof 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 ofwater, applying with a small pledget of soft cotton wrapped about, orfastened to, the end of a pencil or stick. In this way the solution maybe applied in very small amount to the spot where the hemorrhageappears, and will give immunity from future attacks. Any of the styptics(see pages 320-325) can be called into service. Those who have theadvantage of the city drug store may use a solution of basic ferricsulphate (Monsell's solution), or the spray of a three or four percent. Solution of cocaine. The latter is one of the most pleasant andeffective remedies in these emergencies. Before its administration thenasal cavity should be cleansed by snuffing up the nostrils salt andwarm water. When washed, immediately apply the spray. If theconstitutional condition which led to the hemorrhage continues, thegeneral remedies--of which the "Golden Medical Discovery" is the mostefficacious--should be administered. This agent increases the number ofred blood corpuscles, and enriches the blood in fibrin, so that therelief obtained is absolutely permanent. 

INFLAMMATION OF THE STOMACH. (GASTRITIS. )

Gastritis is generally defined as an inflammation of the mucous membraneof the stomach. However, the cellular, muscular, and serous tissues areall 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 otherdiseases. It is an occasional feature In scarlatina, serious cases ofbilious fever, and in cutaneous affections of every description. Themucous membrane of the stomach is placed in intimate communication withall the vital organs, by means of the nerves of the solar-plexus, hencethe sympathy between the stomach and skin, and the morbid condition ofthe stomach occasioned by disease of other organs. 

THE EARLY SYMPTOMS of acute gastritis are a burning sensation in thestomach, accompanied by nausea and frequent vomiting. The respiratorymovements are rapid and shallow, the pulse is hard and short, and as thedisease progresses, becomes small, frequent, and thready. The tongueusually retains its natural appearance, but it is sometimes dry andtinged with a vivid scarlet at the tip and edges. Intense thirst andhiccough are occasional symptoms. The facial expression is haggard, andindicative of the most intense suffering. The stomach will not retainthe mildest liquids. In the early stages of the disease, the ejectionsconsist of chyme and mucus, streaked with blood. As it progresses, thevomiting becomes a sort of regurgitation, the contents of the stomachbeing ejected without any apparent nausea or effort. The ejections thenconsist of a dark-colored granular matter, resembling what is known inyellow 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 ofsymptomatic fever. But late clinical and pathological investigationsclearly indicate that acute gastritis is of rare occurrence. It may becaused by the excessive and habitual use of alcoholic drinks, especiallyif taken without food, by copious draughts of cold water, or by intenseemotions. But its _general_ cause is the ingestion of irritating andcorrosive poisons. 

Where the former causes are known not to exist, the presence of poisonshould always be suspected. As the cause sometimes becomes a matter oflegal investigation, it is very important that the practitioner shouldbe able to determine the _real_ origin. If caused by poison, the diseaseis very suddenly developed, the patient complaining of a very intenseburning sensation in the throat and the lining membrane of the mouth, which will generally show the action of the poison. A diarrhea is alsomore apt to accompany the disease. If inorganic or vegetable poisons areknown or suspected irritants, the appropriate antidotes should bepromptly administered. For a list of the principal poisons and theirantidotes, with practical suggestions for treatment, the reader isreferred to the article in this volume, on Accidents and Emergencies. 

TREATMENT. The inflammation should be allayed, and a tea made ofpeach-tree leaves is very serviceable. Small pieces of ice, swallowed, will generally allay the thirst and vomiting, and a mucilage ofslippery-elm is very soothing to the inflamed mucous membrane. This isan important disease, and its management should be entrusted to askillful 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 theappropriate remedies of the latter will often only aggravate and augmentthe former. 

A chronic inflammation of the stomach is a very common affection and hasmany phases, but the term chronic gastritis is applied only to thatspecies of inflammation occasioned and accompanied by irritation. It isseldom a result of the _acute_ form. 

THE SYMPTOMS of chronic gastritis are various and sometimes vague. Amongthose which are prominent we may mention an irregular appetite. At timesit is voracious and the patient will consume every available article ofdiet, while at others he will experience nausea and disgust at the sightof food. Even when very hungry, one mouthful of food will sometimesproduce satiety and cause vomiting. The appearance of the tongue isvariable, sometimes natural, at others thickly coated. The desire fordrink is capricious, varying from intense thirst to indifference. Another prominent symptom is a sense of heaviness and heat in theepigastric region, after partaking of food. Often a small quantity, as ateaspoonful of milk, will produce a sensation of weight, as a heavy balllying at the pit of the stomach. This symptom is frequently accompaniedby a frontal headache, and a small and wiry pulse. Dull or shootingpains are experienced in the stomach and between the shoulders, and thepatient becomes weary, melancholy, and emaciated. 

CAUSES. The general cause of chronic gastritis is excess in eating ordrinking, and the use of alcoholic liquors. We have known it to beproduced by drinking _hard_ cider. Great mental excitement predisposesthe system to this affection. Occasionally it is a result of febrilediseases, as scarlatina, typhoid fever, etc. In some families there is aconstitutional tendency to its development. 

TREATMENT. All medicines which tend to irritate the stomach, should bestudiously avoided. The bowels should be kept regular, and the skinclean by frequent bathing. Stimulants of all kinds must be avoided. As aprinciple article of diet, we would recommend milk and farinaceousarticles. If these precautions be observed, nature will sometimes effecta cure. Lime water and the subnitrate of bismuth, in twenty-grain dosesthree or four times a day, are useful to allay irritation. Othersuggestions applicable to its domestic management, maybe found under thehygienic and medicinal treatment of dyspepsia, to which we refer thereader. 

NEURALGIA OF THE STOMACH. (GASTRALGIA. )

Gastralgia is a neuralgic affection of the stomach, unaccompanied byinflammation. It is sometimes mistaken for chronic gastritis, althoughthere is a marked difference in the symptoms. 

A PROMINENT SYMPTOM OF GASTRALGIA is a _paroxysmal_ pain radiating fromthe epigastric region, to all parts of the thoracic cavity. The pain issometimes lessened by walking, lying on left side, or by gentlepressure, and usually abates after eating, but is renewed in a fewhours. The patient occasionally experiences a sense of heaviness at thepit of the stomach, nausea, and frequent salty eructations. The tongueis white, the appetite variable, and there is no desire for liquids. Thesleep is usually refreshing, and when not suffering from acute pain, thepatient is apparently well. 

The _distinguishing_ symptom of this disease is a feeling of intensedespondency, and, sometimes, a morbid fear of death. 

An effectual method of distinguishing between gastralgia and chronicgastritis is by the administration of an alcoholic stimulant. Ifgastritis be the affection the pain will be augmented; whereas, if it begastralgia, it will be relieved. 

CAUSE. The cause of gastralgia is a local or sympathetic irritation ofthe nerves distributed to the stomach. 

TREATMENT. The pain of gastralgia is sometimes allayed by using half ateaspoonful of subcarbonate of bismuth, and repeating the dose, if theattack is not relieved. The following is a very effectual remedy: taketwenty grains of quinine, combined with one drachm of prussiate of iron, and divide it into ten powders, and administer a powder every threehours until the pain is completely arrested. Temporary relief may begiven by administering one-quarter of a grain of morphine, or ten totwenty drops of chloroform in a teaspoonful of glycerine, slightlydiluted, taken in one dose. One of the most effective remedies forpreventing a return of the attacks is that invigorating tonic andalterative, the "Golden Medical Discovery. " The patient should becareful in diet, and not eat too much food, which should not only be ofa nutritious kind, but easy of digestion. Cleanliness, suitableclothing, bodily warmth, exercise, and rest must not be neglected. Sometimes it is lingering and requires long persistence in hygienic andmedicinal treatment. Everything tending to promote the tone of thedigestive organs, and improve the functions of the system generally maybe considered advantageous in this neuralgic affection. 

PERITONITIS. 

The _peritoneum_, or serous membrane which lines the abdominal cavityand invests the intestines, is liable to become inflamed. When thisoccurs, 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 toone 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 andvomiting, severe pain in the abdomen, which is extremely sensitive topressure and becomes very much distended. There is also pain in thelimbs, the bowels are constipated, and, in exceptional cases, diarrheais a prominent symptom. The urine is deficient in quantity, and there issleeplessness, chilliness, and great general prostration. Vomiting andcoughing or sneezing increase the pain. An erect position occasionsintense suffering. The patient is compelled to assume a recumbentposture and is inclined to lie on the back, for in that position thesufferer experiences the least pressure of the vital organs against theperitoneum. There is also an inclination to draw up the lower limbs andretain them in a flexed position. 

CAUSES. Prominent among these are injuries which have been inflictedupon the intestines, compression of the colon, or rectum, perforation ofthe stomach or bowels, either by violence or some pre-existing disease, thus allowing the discharge of blood, urine, bile, or fecal matter intothe abdominal cavity; also abortion, over-exertion, and exposure to wetor cold. As acute peritonitis is always a grave disease, involving moreor less danger to life, it is the wisest course to employ a physicianand trust the case to his management. The same remark is equallyapplicable 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 associatedwith some cutaneous affection pertaining to the abdominal cavity, andthe inflammation is induced by the tumor. If chronic peritonitis beconnected with the _tubercular_ diathesis, tubercles may be discoveredupon the surface of the stomach and alimentary canal, and may also befound in the lungs and brain. 

When the affection is not tubercular there will appear in the abdominalcavity an effusion of serous fluid of greater or less quantity, mingledwith blood and pus. When such an effusion takes place, the abdomengradually increases in size, or becomes smaller than is natural. Thereis pain, attended by soreness upon pressure, and the patient becomesemaciated. 

Inflammation of the peritoneum is frequently an accompaniment of_puerperal fever_, which is a disease peculiar to childbirth, and whichmay arise from cold, or be communicated from one parturient patient toanother by midwives. 

TREATMENT. In the remedial management of acute peritonitis, it isobviously necessary to use some agent which will at once influence andchange the congested state and inflammatory condition. One of the bestagents employed to make a decided impression upon the vascular system, subdue inflammation, and modify its action, is the fluid extract ofveratrum viride, administered in full doses, and repeated until thesystem shows its effects in a decided manner. Warm fomentations appliedto the abdomen are sometimes very serviceable, and are objectionableonly because of their liability to dampen the bed-clothes. When theabdomen will bear a thick, warm poultice, apply it, and then cover theentire surface with oiled silk. The tincture of opium, in dosessufficient to relieve pain and quiet the peristaltic action of theintestines, is generally necessary. 

EPIDEMIC CHOLERA. 

This is an epidemic disease, supposed to be due to an impalpablespecific poison, but as to the exact nature of this poisonous matternothing definite is known. 

This plague first made its appearance on our continent in 1834. Owing toits great fatality, it is a disease much to be dreaded. 

SYMPTOMS. These are well defined. It is characterized in its earlierstages by pain in the stomach and bowels, especially in the umbilicalregion, nausea, vomiting, diarrhea; later, the purging is excessive, andthe matter dejected resembles rice-water, and contains white, solid, curd-like matter. The patient loses strength, and sinks rapidly. Thesecretory organs fail to perform their functions normally, the skin issometimes moist, but oftener cold and dry; but little if any bile isfound in the excretions, and the urine voided is very scanty. There isgeneral nervous derangement, as indicated by the spasmodic contractionor cramping of the muscles. This first attacks the extremities, but soonaffects the entire body, and gives rise to excruciating pains. The headis affected by singing, roaring, disagreeable noises in the ears, thepulse is feeble, but quick, the nails are of a bluish color, the tongueis coated white, the eyes are sunken, and the patient has a corpse-likeappearance; the temperature of the body rapidly falls, the surfacebecomes deathly cold, and, unless the disease is promptly arrested inits course, speedy dissolution follows. The disease is rarely prolongedbeyond twenty-four hours, and sometimes terminates within three or fourhours after its first attack. 

TREATMENT. The kind of medicine required depends upon the severity ofthe attack and stage of the disease. In all cholera epidemics, there arepremonitory symptoms, such, as an uneasy sensation at the pit of thestomach, and a rumbling of the bowels. This is apt to be followed by apainless diarrhea, which occasions no alarm, and the patient pays butlittle attention to it. Herein is the great and dangerous mistake. Thepatient is already in the stage of _invasion_, which must be promptlyarrested, or he will suddenly be precipitated into the stage of_collapse_. The patient should lie down, and have placed about himbottles filled with hot water, thereby exciting warmth upon the surfaceof the body. At the same time, administer two teaspoonfuls of theExtract of Smart-weed. If the symptoms are urgent, repeat the dose everyfifteen minutes. Brandy, thickened with sugar, may also be given. Ineither the stage of _invasion_ or _collapse_, the leading indication isto establish _reaction_ by promoting perspiration. Bathe the feet inwater as hot as can be borne, give the Extract of Swart-weed freely, andthus endeavor to excite profuse diaphoresis. No time should be lost, fordelays are dangerous. When the reaction is established, the patientshould remain quiet, and not attempt to exert himself. 

After reaction has taken place, the sweating should be maintained fortwelve hours, and the patient should drink slippery-elm tea andtoast-water, and partake sparingly of soft toasted bread and chickenbroth. The food should be fluid and nutritious, but taken in smallquantities. Do not disturb the bowels with laxatives until the third dayafter the patient begins to improve, and then they may be moved by aninjection of warm water. Great care should be taken that the patientdoes not indulge too soon or too freely in the use of food. When askillful physician can be had, no time should be lost in securing hisservices, but since in epidemics of this nature, medical men aregenerally overworked, and not always easily and promptly to be had, wehave 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 colickypains 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 contentsproper of the bowels have been evacuated, the dejections have a biliousappearance. Severe cramps and pain accompany the vomiting. The vomitingand purging usually occur in paroxysms, but finally become lessfrequent, a reaction takes place, the extremities grow warm, and thepatient gradually recovers. It may be accompanied by intense thirst anda quick pulse, yet the surface may be cool. 

CAUSES. Cholera morbus is most prevalent in warm climates, andespecially in malarial districts. It is generally the result of eatingindigestible articles of food, such as unripe fruit or uncookedvegetables. Stimulating drinks, or those articles which furnish theelements for fermentation, also favor the production of this disease. 

TREATMENT. If the attack be superinduced by eating unripe or stalefruit, it may be proper to give an emetic or a cathartic, but ordinarilyfirst give a full dose of the Extract of Smart-weed, and, if the vomitedmatter is very sour, give the patient a weak, alkaline drink, which maybe 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 patientthrow up the first dose of the Extract of Smart-weed, a second should begiven. Do not allow the patient to drink cold water, and give onlytablespoonful doses of the alkaline solution every thirty minutes. Ifthe thirst is great, occasionally give a tablespoonful of a tea madefrom 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 ofthe leaves or bark of the peach tree. The patient should be well coveredin bed and kept warm. Laudanum by the stomach, or by enema, may henecessary in severe cases to relieve the pain and check the purging. Hotfomentations applied to the bowels are very valuable. A mustard plasterapplied over the abdomen will assist materially in relieving the nauseaand vomiting. It should not be left on sufficiently long to blister. When the affection is promptly treated as we have suggested, the patientgenerally quickly recovers. If, however, it does not yield to thesemeasures, the family physician should be called in. 

ACCIDENTS AND EMERGENCIES. 

Accidents and emergencies which require immediate attention frequentlyoccur. Professional aid cannot always be quickly obtained and hencefatal results often follow. It is, therefore, important that all personsshould not only know how to proceed under such circumstances, but thatthey should be able to exercise that deliberation and self-control sonecessary in emergencies of all kinds. Most persons are more or lessaffected by the sight of blood or severe wounds, and it requires aneffort to maintain self-possession. One should act resolutely; otherwisehe 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, cuttinginstrument, and are characterized by their extent of surface. 

_Punctured_ wounds are made with a pointed instrument, and distinguishedfor 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 somepoisonous 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_ producedupon the nervous system, and in the liability to _hemorrhage_. 

SHOCK. If severe, the shock is attended with symptoms of extremeprostration, such as a feeble pulse, shivering, partial unconsciousness, fainting, hiccough, vomiting, and involuntary discharges of the urineand feces. 

[Illustration: Fig. 2. Mode of employing flexion for thearrest of hemorrhage from a woundlocated below the elbow. ]

TREATMENT OF SHOCK. The clothing should be loosened immediately afterthe accident, so that the blood may have free circulation, and thepatient should be kept in a recumbent position. He should have plenty offresh air. Camphor or ammonia may be inhaled. If he can swallow, stimulants may be given, as whiskey or brandy, but with care that theydo not run into the trachea, or windpipe. If he be unable to swallow, they may be administered as injections, but should gradually bediscontinued as reaction takes place. A warm pillow placed at the backand 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_ consistsof several folds of cloth laid upon a wound, the edges of which havebeen brought together, and made secure by a moderately tight bandage. 

[Illustration: Fig. 3. Mode of employing flexion for the arrest of hemorrhage from a woundbelow the knee. ]

_A tourniquet_ may be extemporized by rolling a handkerchief into a cordand tying it around the limb, over a compress, between the wound and theheart. A stick should then be thrust between the handkerchief and skinand twisted around several times, until the pressure is sufficientlygreat to arrest the circulation of the blood in the wounded part. Arepresentation of this operation may be seen in Fig. 1. 

[Illustration:Mode of employing flexion for the arrest of hemorrhage from a woundlocated between the thigh and knee. ]

_Flexion of the joint_, as represented in Figs. 2, 3, and 4, is adaptedto many cases of hemorrhage. As water cannot flow through a rubber tubebent at a sharp angle, so the acute flexion of a limb prevents the freeflow of blood through the arterial tubes. 

In some cases, _styptics_ may be directly applied to the woundedtissues. Cold acts as a powerful styptic, and may generally be madeavailable for arresting hemorrhage. 

POISONED WOUNDS. The treatment of these should chiefly consist in theprevention of the spread of the poison. This may be done by tightlyapplying 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 ofturpentine. 

FRACTURES AND DISLOCATIONS. 

The treatment of injuries received from the fracture of bones and thedislocation 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 ligamentsand 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 partshould be kept at rest in an elevated position, and hot or cold waterapplied frequently. If there is much inflammation, fomentations of hopsmay be used. The Compound Extract of Smart-weed is an excellentapplication. 

When the acute symptoms have disappeared, absorption should be favoredby systematic rubbing and the application of stimulating liniments, orby the use of a well-adjusted bandage. Passive motion may be resorted togradually and the subject may use the joint moderately. Should anystiffness remain, warm salt water douches should be employed and theExtract of Smart-weed applied once a day. 

BRUISES. 

Bruises or contusions are caused by falls, wrenches, or blows from bluntinstruments, without breaking the skin. The soft tissues are laceratedand blood is poured out into them, constituting _ecchymosis_. Thediscoloration passes through various shades from a bluish-black to aviolet, a green, and finally, a yellow. 

If the bruise is severe, the affected part should be kept at rest andfrequently bathed with the Compound Extract of Smart-weed or thetincture of arnica. If inflammatory symptoms supervene, fomentations andpoultices should be applied. 

FOREIGN BODIES IN THE NOSE. 

Foreign bodies, such as beads, peas, coffee-grains, and smallgravel-stones are occasionally introduced into the nostrils of children, becoming fastened there, and causing great anxiety and alarm. If allowedto remain, they generally cause inflammation and suffering. 

Such bodies may generally be washed out by gently injecting a stream oftepid salt water with a syringe or Dr. Pierce's Nasal Douche. In no caseshould force be used. If these means fail, a competent surgeon should beconsulted. 

FOREIGN BODIES IN THE THROAT AND AIR-PASSAGES. 

Foreign bodies are generally arrested so high up that they may be seenby simply depressing the tongue, and removed with the finger or a pairof forceps. The head should be thrown back in such a position as tocause the chin to project as little as possible beyond the prominenceknown as Adam's apple, in order that the finger or forceps may bereadily introduced and the body released and ejected. When the foreignbodies are so small as to pass out of sight in the larynx, windpipe, oresophagus, it is generally difficult to extract them, and the servicesof a surgeon are required. Fortunately, however, there is not muchimmediate 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 begiven in the open air, unless the weather be too cold. 

TREATMENT. The patient should be gently placed upon the face with hiswrists under his forehead. The tongue will then fall forward and thewater run out of his mouth and throat, while the windpipe, orair-passage, will be free. To restore respiration, he should beinstantly turned upon his right side, his nostrils excited with snuff orammonia, and cold water dashed upon his face and chest. If thisoperation prove unsuccessful, replace the patient upon his face, carebeing taken to raise and support his chest, turn the body gently on theside and quickly again upon the face. Alternate these movements aboutevery four seconds, and occasionally change sides. When the body isturned on the face, gentle but efficient pressure should be made alongthe back, between the shoulder blades, to assist in forcing the air outof the lungs, but this pressure ought to be removed before the patientis turned back on his side. Persistently repeat this operation, andsuccess will often be the reward. As soon as respiration is established, warmth may be promoted by the application of warm flannels to the bodyand bottles of hot water to the stomach, armpits, thighs, and feet. During the entire process of restoration, the body should be thoroughlyrubbed _upwards_. Turning the body upon the back or handling it roughlyshould be avoided. The person should not be held up by his feet, or berubbed with salt or spirits. Rolling the body on a cask is improper, andinjections of the smoke infusion of tobacco are injurious. Avoid theconstant application of the warm bath, and do not allow a crowd tosurround the body. 

FAINTING. 

When a person faints, _he should be allowed to remain or be placed in arecumbent posture_, and his clothing immediately loosened. Theextremities should be rubbed, the patient permitted to have plenty offresh air, and, if at hand, ammonia or camphor should be applied to thenostrils. 

BURNS AND SCALDS. 

The danger arising from burns and scalds depends not only upon theextent of surface involved, but also upon the depth of the injury. Burnsare 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 ofcarbolic acid and two ounces of glycerine, and linseed oil and whitelead, are all beneficial for the treatment of burns. If internaltreatment be necessary, it should be given under the direction of acompetent physician. 

SUN-STROKE. 

In cases of sun-stroke, the patient should be at once removed into theshade. 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 andthe head slightly elevated. If the countenance is pale, the symptomsdenote exhaustion, and the patient should be kept in a recumbentposition, the extremities rubbed, camphor and ammonia inhaled, mustardapplied to the spine, and stimulants, such as brandy or whiskey, shouldbe 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 beforethe seventh year. Children of a scrofulous diathesis are especiallyliable to this affection. It is generally due to disease of theinter-vertebral cartilages and bodies of the vertebræ. It comes on in aslow, insidious manner, hence, it often makes serious inroads upon thespine and system before its character is even suspected. 

[Illustration: Fig. 1. 

The above portion of the spinal column shows the manner of the breakingdown of the vertebræ from caries, and the absorption of their bonystructure. ]

Generally the first point of invasion is the cartilaginous substancesbetween the bodies of the vertebræ, beginning with inflammation, andfinally resulting in ulceration and a breaking-down of the cartilages. It next invades the vertebræ themselves, and producing caries, or deathand decay of the bony substance, which softens and wastes away, as shownin Fig. 1. The vertebræ become softened and broken down, and weight ofthe 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 ofthe disease, and during its progress, we deem it necessary to mentiononly a few of the more prominent ones. While the patient is yet able togo around, the disease manifests itself by occasional pain in thebowels, stomach, and chest. Often there is a hacking cough, nervousness, lassitude, and a generally enfeebled condition of the whole system. Thepatient is easily fatigued; there is apparent loss of vitality, impairedappetite, a feeling of tightness across the stomach and chest, graduallydeclining health, and loss of flesh and strength, torpidity of theliver, deficient secretions, constipation, and morbid excretions fromthe kidneys. The victim, in passing chairs, tables, and other objects, instinctively places his hands upon them, and, as the diseaseprogresses, when standing, leans upon some support whenever possible. Inwalking, he moves very carefully and cautiously, with elbows thrown backand chest forward, to assist the body in keeping its equilibrium. Thebody being kept in an upright position, the patient bends the kneesrather than the back in stooping, as illustrated in Fig. 5, and the bodyis frequently supported by the hands being placed upon the thighs orknees. 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 theposterior part of the pelvis is experienced; numbness and coldness ofthe extremities are felt; locomotion becomes more difficult, and aslight projection is observed upon the back. Even in this somewhatadvanced stage of the disease, when the symptoms are so apparent, manycases are shamefully neglected because an ignorant adviser says it isnothing serious and that the patient will outgrow it. The pain andtenderness not always being in the back, the inexperienced are veryoften misled as to the true character of the trouble. This distortion ordeformity of the back now becomes painfully prominent; the diseasedvertebræ quickly soften and waste away; the pressure upon the spinalcord increases, and paralysis of the limbs supervenes; the power oflocomotion is lost, and, at last, the danger is realized and thestruggle 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 withthis terrible disease, the great importance of placing them under thecare of surgeons who have for many years made the treatment of suchcases a specialty, and who have every facility and all necessarysurgical appliances for insuring success in every case undertaken. 

[Illustration: Fig. 4. Appearance of a child suffering fromPott's disease of the spine. ]

[Illustration: Fig. 5. Mode of stooping adopted by a childsuffering from spinal disease. ]

TREATMENT. The great essentials for the successful treatment of diseaseand deformities of the spine are first, a thorough knowledge of thestructure and parts involved by the disease; secondly, the adjustment ofmechanical appliances perfectly adapted to the requirements andnecessities of each individual case, and the proper use of our system of"vitalization, " applied to the spinal muscles to strengthen the weakerand relieve the undue contraction of the stronger. For many years ourspecialists have experimented, and have given the various appliances incommon use in these cases most thorough and practical tests, and havefound them very defective, being generally constructed upon wrongprinciples. The physician who sends to a mechanic for an appliance, suchas are now made in the shops of most instrument makers, and uses thesame, is doing himself an injustice, and barbarously torturing hispatient by forcing him to wear an apparatus which is heavy, clumsy, andinevitably injurious, instead of being beneficial in its results. In thetreatment of diseases and deformities of the spine, there should be nocompromising; the appliance that fails to give complete support shouldnot be worn. In our treatment of these maladies we employ onlyappliances which are constructed under the personal supervision of ourspecialists, upon principles dictated by common sense and the actualnecessities 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 delicatechildren without pain or inconvenience. It gives proper support to allparts, and is so nicely adjusted as to produce pressure only upon thosepoints which should receive support, leaving the muscles of the spinefreedom of action, thereby assisting in their development. In manyhundreds of cases treated by our specialists, the disease has beenentirely cured and the deformity removed. After seeing the patients andadjusting 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 theflexibility and elasticity of the muscles are weakened, than in those ofa plethoric habit. It is generally contracted during youth, between theages of twelve and eighteen. Persons of sedentary and indolent habitsare especially liable to this deformity, hence, girls are mostfrequently its victims. It is never seen among the natives of tropicalcountries who habitually live in the open air, and seldom among thebarbarous races of northern latitudes. A distinguishing feature of theAmerican Indian is his erect carriage. The _primary_ curvature isgenerally 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 thusforced into an unnatural position, and the vital organs contained in thecavity of the chest are compressed or displaced, thus distorting theform of the whole upper portion of the body. 

[Illustration: Fig. 8. Lateral curvature in anadvanced stage. ]

[Illustration: Fig. 9. Lateral curvature in anadvanced stage. ]

SYMPTOMS. The first indication of lateral curvature of the spine is amarked projection of the right scapula, or shoulder-blade. It issometimes first observed by the dressmaker, or, accidentally, whilebathing. The right shoulder is slightly elevated, while the left hip isdepressed and projects upward. If not corrected while in its earlierstages, it progresses very rapidly, and a second curvature is developed. The symptoms vary in different cases, and in the early stages aresomewhat obscure and undefined, but generally the patient feels a senseof uneasiness, languor, stupor, and nervousness, loss of energy andambition, general debility, poor appetite, gradually declining health, loss of strength and flesh, and, as the disease progresses, a slightelevation of one of the shoulder-blades is noticed, as well as thedeviation of the spine to one side. The curve, or distortion, of thespine increases more rapidly as the body becomes heavier, the spineoften assuming the shape of the letter S, and, from compression bytorsion of the vertebræ and distortion of the ribs, the vital organs areencroached upon, causing serious functional derangement of the heart, lungs, liver, and stomach, producing, as its inevitable consequence alist of maladies fearful to contemplate. 

CAUSES. In rare instances, the lateral curvature of the spine is due todefects of certain bones of the pelvis or limbs. Cases are recorded inwhich this deformity was caused by diseases of the abdominal organs, but, as we have intimated, it is generally due to a lack of tonicity ofthe muscles, or, as a late writer has expressed it, "Want ofcorrespondence in the antagonism of those muscles which control themotions of the spinal column. " Habitual sitting or standing in a leaningposture, or standing upon one foot, thus constantly using one set of themuscles of the back, while the other becomes enfeebled by the lack ofexercise, is a common cause of this deformity. The habit which so manyschool-girls contract of drawing up one foot under the body whilesitting, often produces a lateral curvature of the spine. 

TREATMENT. No disease or deformity of the spine is so easily cured andperfectly corrected, if the proper plan of treatment is pursued. Tocorrect this deformity, many ingenious forms of apparatus have beendevised and invented by our specialists, which should be carefullyadjusted to each individual case. In addition to this, our method oftreatment by "vitalization, " and by mechanical movements andmanipulations, is almost indispensable in these cases. It never fails togive relief, and, if properly pursued, invariably results in a permanentcure. 

DEFORMED FEET, HANDS AND LIMBS. 

There are thousands whose feet, hands, and limbs are almost entirelyuseless, besides having an unsightly appearance. Their condition hasbeen helpless so long, their treatment so varied, and their hopes ofrelief or cure have been so often disappointed, that few can believe thetruth of our statement, when we positively assert that we can correctand cure nearly all cases of talipes, club, or crooked feet and deformedhands, and make them as perfect in appearance, and as useful in action, as feet and hands which have never been deformed. While this may seemmiraculous, or even impossible, to those who are unacquainted with thewonderful improvements and rapid progress made in this department ofsurgical science, it is attested and verified by living witnesses whosefeet and hands were once deformed and useless, but which have been madeperfect by our new and improved method of treatment. We do not makethese statements in a spirit of vain boastfulness, but having devotedmany years to improving and perfecting surgical appliances andapparatus, and having had practical experience in the successfultreatment of thousands of cases, we do say that our manner of treatmentis original and employed only by us. We entirely ignore the ineffectualmethods usually employed in such cases. Our treatment causes no pain, and little inconvenience, yet the curative results are speedy andcertain, and a hundredfold more satisfactory than those obtained by anyother course. 

[Illustration: Fig. 10. Talipes Equinus. ]

[Illustration: Fig. 11. Talipes Calcaneus. ]

We have most thoroughly tested all the best forms of treatmentheretofore devised and employed in this class of diseases, and haveadopted the best features of all the various methods heretofore pursued. We have combined these with our own improvements and, as the result, wehave perfected a thorough and efficient system of treatment, based uponscientific 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 ourSpecialistsat 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 ofingeniously 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 andadaptability of these valuable mechanical appliances, yet we willendeavor to illustrate and explain a few of our machines for theapplication of transmitted motion. 

[Illustration: Fig. 1. The Manipulator. ]

Fig. 1 represents a machine, called the Manipulator, which transmitsmotion through suitable attachments, which are adjustable by means ofthe ratchet _G_, so as to reach all parts of the body. It is equallyavailable for applying motion to the head, feet, or any intermediatepart of the body. 

 _B, B_ are rubbing attachments, with two opposing elastic, adherentsurfaces, between which an arm or a leg may be included. These havealternate reciprocating action from the rock-shaft _H_, and are made toapproach each other, and press the included part at the will of thepatient. This is sometimes called the double-rubber, and is madedetachable if desired. 

_A_ is the lever, by which the two parts of the double-rubber are madeto 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 eitherside of the machine, so as to present the rubbing surface in fourdifferent directions, as may be most convenient. It will actperpendicularly, horizontally, or diagonally, and from below or fromabove the part receiving the action, according to requirements. Theshank 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 oroscillating motion of the rock-shaft. It may be attached to either endof the rock-shaft. 

_E_ is the _hand holder, _ which, grasped by the hand, communicatesmotion to the arm, shoulder, and chest; or the hand may be insertedpassively, when the effect of motion is more confined to the hand andfore-arm. 

In the position shown in Fig. 2, by means of the single rubberattachment, the manipulator acts upon the upper portion of the trunk, neck, head, and arms; by means of the hand-holder, upon the arms; bymeans 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, themachine occupies the least space. In this position, by means of thefoot-holder it communicates oscillation to the legs; by means of thesingle-rubber, it acts upon the feet, ankles, and lower leg; by means ofthe double-rubber, it acts upon the legs, including the feet, thepatient either sitting or lying. 

In all of these applications of motion, energy travels from inanimate toanimate matter; non-vital contributes to vital energy: and the variousprocesses through which vital power is developed are promoted andcarried forward in a degree till the point which constitutes health isattained. 

[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. Itis, however, impossible for the unaided hand to impart the degree ofrapidity necessary to secure the effects easily attained by thismachine; and, practically, restoration is often secured in cases inwhich 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 itis a great assistance in effecting a cure; while, in chronic affections, whatever the local symptoms, it supplies the additional energy which isindispensable 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 andSurgical Institute, but may be worked by hand, as here represented. Onearm is inserted between the double-rubbing pads, which are raised toabout the height of the shoulders, the patient being seated at the sideof the machine; the other hand is placed on the lever, and as muchpressure is applied as is perfectly agreeable, care being taken todiminish the pressure at any part which is unusually sensitive. Allportions of the arm from the shoulder down are successively included inthe rubbers, while a suitable degree of reciprocating or rubbing actionis obtained by giving motion to the wheel. 

To apply the same operation to the other arm, the patient may eitherturn in his seat or change his position to the opposite side of themachine. 

If any portion of the extremity is affected with inflammation orswelling, it is necessary to apply the action described to the whole ofthe unaffected portion first; after this the affected part may bebeneficially operated on, provided that the sensations are strictlyheeded, and that it is so managed that only a comfortable feeling isproduced. 

[Illustration: Fig. 8. Oscillating the Arms and Chest. ]

In Fig. 5, the patient is so seated beside the machine that he caninsert one thigh between the pads of the rubber, and also control thelever with the hand. It is sometimes more convenient to suspend amovable weight from the lever. While the machine is running, he canwithdraw the leg gradually, as each portion receives its proper amountof action, till the whole, including the foot, becomes glowing with theeffect. The boot or shoe affords no impediment to the effect, and shouldremain on. 

[Illustration: Fig. 9. Oscillating the Legs. ]

Sometimes, especially in the beginning, or when the feet are habituallycold, 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 theright 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 beginningshould be used in preference. In Fig. 6, the patient sits on an ordinarystool, or, if feeble, in a chair, and presents any portion of the chestor abdomen to the action of the rubber. The instrument is raised orlowered to suit convenience, while the patient gently presses portionsof the trunk successively upon the rubbing-pad. The degree of the effectis thus always under the absolute control of the one receiving theaction. This operation, like the preceding, produces great heat, reddensthe skin, relieves pain, and greatly stimulates the functions, not onlyof the skin, but of the organs contained in the cavities of the chestand the abdomen. 

[Illustration: Fig. 10. Vibrator operated by Manipulator. ]

The same operation may be applied also to the legs while the patient isstanding. 

In Fig. 7, the back is presented to the action of the rubbing-pad. Theaction will, if desired, be made to reach from the neck to the hips, andeven to the thighs. All sensitive portions of the back should at firstbe omitted, in order that they may be benefited by thecounter-irritation or drawing away of the blood. This is easily producedby those familiar with the use of the machine. The rubbing of the backshould be deferred till the close of each application, in order that thespinal centers may be relieved of hyperaemia, or excess of blood. 

The machine, as represented by Fig. 8, is brought to the desiredelevation, about as high as the shoulders, and the hand-holder isattached. One arm is extended horizontally, and the hand grasps thehand-holder, while rapid motion is given by turning the wheel. Analternate twisting motion is communicated to the arm, which causescorresponding pressure and relaxation of all the soft tissues of thelimb, combined with slight rubbing or attrition. The action is increasedby contracting the muscles, and also by grasping at greater distancefrom the center. Both hands may grasp at the same time, or the two sidesmay receive the motion in turn. The effect is similar to that of therubbing before described, but it is less limited; by grasping firmly, itmay extend to the whole chest. 

[Illustration: Fig. 11. Vibrating Kneader. ]

The foot-holder is attached, as shown in Fig. 9, and brought by themeans before described to a position to receive one foot at acomfortable elevation, the leg being extended, while the patient isseated in an ordinary chair in an easy position. The action is preciselylike that above described as applied to the arm, and extends to thethigh and pelvis. If the knee is slightly flexed, the action is almostentirely confined to the lower leg. Each leg may be operated on in turn. 

_Mode of Applying Mechanical Movements to Very FeebleInvalids_. --Experience demonstrates that no degree of feeblenessexcludes the beneficial use of these operations. Invalids too weak tostand, or able to help themselves in the least degree are often treatedwith 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 forthese cases additional conveniences, so that the applications can bemade in the recumbent position, and also that proper intervals of restbe allowed between successive operations. For this purpose couches areprovided, each containing a certain portion of the Manipulator. Theseare operated by means of a short connecting-rod, joining the rock-shaftsof the two pieces of mechanism, as shown in Fig. 10. The Vibrator hastwo small discs, or heads acting through an opening in the couch onwhich the invalid rests. These impinge with a rapid, direct stroke uponthe portion of the body exposed to the action. The top of the couch isadjustable, and is quickly placed at the elevation which secures theproper force of the instrument, as shown in Fig 11. By simply turningand moving the body, the patient brings any part in contact with thevibrating discs. The cut represents the Vibrator, in which the forceimpinges at right angles with the surface of the body, sending waves ofmotion 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 partsof the body in a recumbent position. A couch is required of similarconstruction to the vibrating couch, but with a rubbing-pad instead ofvibrating heads acting through the opening and operated by appropriateconnections, as shown in Fig. 12. The top is adjustable, and the degreeof effect desired is capable of easy regulation. The patient turnsdifferent portions of the body to the action of the rubber as required. 

KNEADING. Kneading is a process applied chiefly to the abdomen. Thepurpose of this operation is to increase nutrition, the muscular powerand action of the abdominal walls, and the function of the organs whichthey contain. Three modes of applying this operation by the mechanicalapparatus are in use, effected by the Direct, the Rotary, and theRevolving Kneader. 

[Illustration: Fig. 13. Apparatus for Rotary Kneading. ]

THE DIRECT KNEADER. This resembles in form and action the vibratinginstrument shown in Fig. 11. The impinging heads, however, are madebroader, the motion greater in extent, and the rate of motion less thanone-tenth of that employed for the purpose of vibrating. This slownessof motion seems to increase the action of the muscles. 

THE ROTARY KNEADER. The action of the kneading heads in this form ofapparatus, as shown in Fig. 13, is _inward_ and _upward_ alternately, and it is eminently well calculated to stimulate the action of theabdominal 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 ofarms, 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 actingon the body is governed by an arrangement for elevating or depressingthe upholstered top of the couch upon which the patient rests, andthrough which the action is transmitted to the body. 

If this form of apparatus is driven at a rate ten times more rapidlythan is desired for kneading, the effect is vibratory, and it is, infact, 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 todiminish under its use. In these cases the vessels of the affected partare distended with stagnant blood, and a portion of the fluid passesthrough their walls, distending the surrounding tissues, which becomemore or less hardened. By the transmission of active motion to theaffected parts, the contents of the vessels are urged forward; theoutside fluids are thus permitted to return to the general circulationand 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 andwholesome nutritive materials for vital use. In short, normal functionalactivity is established, both locally and generally. Scrofulous, dropsical, rheumatic, and other local accumulations disappear, and eventumors are dispersed, by the use of the Manipulator, in cases in whichthe knife would otherwise be required. 

COUNTER-IRRITATION AND REVULSION. 

Artificial means have always been employed to produce an energetic flowof blood in different parts of the body, thereby relieving morbiddistention of the vessels, and consequent irritation and pain inneighboring parts. Cupping, hot applications, mustard, capsicum, blisters, and other irritants, are resorted to, but their effects, whilegenerally very good in acute cases, are too transient to be of materialaid in chronic affections. By the use of the Manipulator, we can producethe most thorough revulsive effects, operating upon large surfaces, andcausing 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; onthe contrary, they are strengthened by the application, which can berepeated as often as necessary till relief is permanent. Thus, the head, heart, digestive organs, liver, chest, or whatever part is oppressed byexcess of blood, may be speedily and permanently relieved. By means ofthis ability to relieve any part of the system from engorgement, andconsequent inflammation and its results, are we enabled to permanentlycure a large variety of chronic inflammatory, ulcerative, and nervousaffections. 

Local inflammations by this method of treatment may be speedily cured. 

CURE OF NEURALGIA. 

By the transmission of motion through the Manipulator and otheringeniously devised apparatus and machinery, we increase the functionalpower and activity of the muscles, and thereby diminish morbidsensibility of the nerves, which is present in neuralgia. Prolonged andexcessive nervous action is attended with too great a rush of blood tothe nerve-centers, which can only be relieved by increasing the flow inthe muscles. Congestion, or hyperaemia, in the spinal cord or brain, orboth, is a condition ever present in neuralgia. The application ofmotion 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 theManipulator proved more thoroughly efficacious than in _paralysis_. Themost prominent requirements in these cases seem to be the following:

Excess of blood in the brain and spinal cord needs to be removed anddiverted 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 ofoxidation through increased circulation. 

These and many more wants of disordered nerves, are readily supplied bytransmitted motion. 

The Manipulator combines, in a single ingenious mechanical contrivance, the several movements best adapted for the promotion of healthyfunctional activity. 

CURE OF DEFORMITIES. 

"Deformities arising from _paralysis and contractions of muscles andtendons_, producing stiffened joints and distorted limbs, are of commonoccurrence. A rational explanation of the wonderful curative resultswhich follow the employment of transmitted motion in these cases may notbe without interest to the reader. The muscles are composed of _bundles_of little fibers which glide upon one another in every movement. Anotherset of fibers called _connective tissue_, holds the fibers together inbundles or separate muscles, and interlaces and crosses them in everydirection. Now, if these fibers remain long in a fixed position, or areinvolved in inflammation, there is danger of adhesions forming betweenthem, producing permanent immobility; gliding movements are interferedwith, and the muscle ceases to perform its function. Inflammation givesrise to effusion, or the formation of a kind of cement which bindstogether the muscular fibers and prevents motion. 

Rubbing, kneading, and actively manipulating the affected parts withthat intensity of administration secured by the manipulator, rendsasunder and breaks up these minute adhesions, re-establishing glidingmotions, causes absorption of effused materials, and restores theaffected part to a normal condition. 

[Illustration: Fig. 15. Muscular fibre highlymagnified. ]

The deformed limb is straightened by the filling out of themuscle-cells, and increasing the length and also the nutrition of theaffected muscles. No pulling or _forced extension_ is required. Deformity ceases when the conditions upon which it depends are removedby rational appliances, which are always agreeable. No brace, splints, or other confining appliances are necessary, except in rare cases inwhich the bones are very badly distorted. 

In withered and deformed limbs, resulting from infantile paralysis, themanipulator furnishes the most agreeable, direct, and certain remedy. Itrestores nutrition, sensation, and power, and dispenses almost whollywith mechanical supports. Club-feet, wry neck, spinal curvature, hip-joint disease, white swellings, and stiffened joints, are allreadily amendable to the curative effects of motion administered by themanipulator and other machinery. 

Contracted and shortened muscles are gradually lengthened by vigorous, long-continued, and frequently repeated rubbing with the manipulatoracross their longitudinal fibers; bound-down and confined tendons areliberated and normal movements established. 

DISEASES OF WOMEN. 

Uterine and ovarian congestion, chronic inflammation, discharges, morbidenlargement, prolapsus, anteversion and retroversion, anteflexion andretroflexion, and other derangements of the womb and its appendages, areradically cured by the vibratory, rubbing, kneading, and othermovements, administered through the manipulator and other mechanicalappliances employed at the Invalids' Hotel and Surgical Institute. 

To those who are tired of taking medicine, this mode of treatmentcommends itself as being both agreeable and efficient. There is no casetoo weak, nervous, or helpless for the use of this curative agent. It isentirely devoid of objectionable features, being _always applied outsidethe clothing_. 

CAUSE OF FEMALE WEAKNESS. The true relations of cause and effect arevery liable to be misunderstood, when considering the various diseasesincident to the organs contained in the female pelvis. Treatmentintended to be remedial is therefore very often misdirected and fails toafford relief, positive injury frequently resulting instead. When thenature of these diseases is properly understood, their cure can beeffected with comparative ease. 

These diseases are always attended with weakness, which is often verygreat, of the muscles that hold the diseased organs in position. Themuscles forming the walls of the abdomen, and the diaphragm, or midriff, all of which are concerned in the act of respiration, become feeble andonly partially perform their functions. In health, they act constantly, even during sleep, producing a rhythmical movement, which iscommunicated to the contents of the abdominal and pelvic cavities. Thismotion promotes a healthy circulation in the parts. In almost allaffections of the pelvic organs, this normal condition is greatlydiminished. 

Diminution of the motions of respiration is attended with an increase ofthe amount of the blood in the pelvic organs, constituting anengorgement of the parts, called congestion, or inflammation. This givesrise to enlargement of the womb, ulcerations, tumors, and a multitude ofkindred secondary effects, usually considered as the primary disease andtreated as such. The contents of the cavity of the trunk, weighingseveral pounds, are allowed to gravitate down and rest upon the contentsof the pelvis, forcing the congested uterus and ovaries down out oftheir natural positions, and often bending or tipping the womb invarious directions. A long list of symptoms follows as the naturalconsequence of these abnormal conditions. 

RATIONAL TREATMENT. Ovarian congestion and inflammation, inflammation ofthe uterus, ulceration of this organ, deranged menstruation, leucorrheawith the attendant pain, nervousness, and other derangements dependingupon loss of supporting power in the abdominal muscles, all result fromloss of the _natural_ motions of respiration, and consequent derangedcirculation. These several conditions can be cured by removing theircause. When the power of the parts involved in the weakness is restored, all these morbid conditions disappear. Judicious cultivation of power inthe weakened supports is attended with certain curative results. This isbest accomplished by mechanical motion, by which the normal circulationis restored, inflammations and congestions are subdued, displacementscorrected, ulcers healed, and functional activity is re-established. 

RECAPITULATION. 

Motion properly transmitted to the human system by mechanical apparatusis transformed into other forms of force identical with vital energy, bywhich the ordinary processes of the system are greatly promoted. 

It increases animal heat and nervous and muscular power to the normalstandard. 

It removes engorgement or local impediments to the circulation. 

The electrical induction produced renders it a most efficacious remedyfor paralysis of all kinds. 

It removes interstitial fluids and causes rapid absorption anddisappearance of solid and fluid accumulations. 

It is a powerful alterative, or blood-purifier, increasing oxidation andstimulating excretion. 

It diminishes chronic nervous irritability and promotes sleep. 

Deformities are easily cured without the cutting of tendons, or use ofmechanical supports. 

It hardens the flesh by increasing muscular development and improvesdigestion 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 treatmentof Chronic Diseases, resulting in a professional business far exceedinghis individual ability to conduct, some years ago induced severalmedical gentlemen of high professional standing to associate themselveswith him, as the Faculty of the World's Dispensary and SurgicalInstitute, the Consulting Department of which has since been merged intothe Invalids' Hotel. The organization is duly incorporated under astatute enacted by the Legislature of the State of New York, and underthe name and style of the "WORLD'S DISPENSARY MEDICAL ASSOCIATION, " ofwhich Dr. PIERCE is President, and in the affairs of which he will, asheretofore, 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 inCongress, has since been able to devote his whole time and attention tothe interests of the Association, and those consulting our Medical andSurgical Faculty have the full benefits of his council and professionalservices. That he should prefer to give up a high and honorable positionin the councils of the nation, to serve the sick, is conclusive evidenceof 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 thelarge number of invalids who visit Buffalo from every State andTerritory, as well as from many foreign lands, that they may availthemselves of the professional services of the Staff of SkilledSpecialists in Medicine and Surgery that compose the Faculty of thiswidely-celebrated institution. 

DESTROYED BY FIRE. 

On the sixteenth of February 1881, the original Invalids' Hotel wastotally destroyed by fire. Although occupied at the time by a largenumber of invalids, yet, through the extraordinary exertions of theFaculty and employees, all were safely removed from the building withoutinjury to any one. The Board of Trustees took prompt steps to rebuild, for the accommodation of the many sufferers who apply, to availthemselves of the skill, facilities and advantages of treatment whichsuch a perfectly equipped establishment affords. Profiting by theexperience afforded by several years' occupancy of the originalInvalids' Hotel building, which at the date of its erection was thelargest and most complete establishment of its kind in the world, webelieve we have, in the building of the elegant structure illustratedherein, made great improvements over the original Invalids' Hotel, forthe accommodation of our patients. Although our new building has onlybeen occupied about two years, yet almost immediately our businessrequired the erection of a very large addition thereto, to accommodateour growing practice. This large _Annex_, which is about the size of theoriginal building, has ever since been kept well filled with patients, hailing from every State and Territory of the United States, Canada andoccasionally 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 bustleof this Queen City of the Lakes. It is easily reached from the railroaddepots by the Exchange and Main Street car lines (see map on last pageof this book). It is a substantially built brick building, trimmed withsandstone, well lighted and provided with a patent hydraulic elevator, so that its upper stories are quite as desirable as any, being morequiet than those lower down. It is well provided with fire escapes, and, in fact, nothing has been neglected that can add to the comfort andhome-like make-up of this popular national resort for the invalid andafflicted. Great pains and expense have been assumed in providingperfect 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 thefinest built part of the city, among the most elegant residences. 

STAFF OF PHYSICIANS AND SURGEONS. 

Only men who are, by thorough education and experience, especiallyfitted to fill their respective positions, have been chosen to serve asphysicians and surgeons in this institution. After having spent a verylarge sum of money in erecting and furnishing this national resort forinvalids with every requirement and facility for the successfultreatment of all classes of chronic diseases, it is the determination ofthe Board of Directors that the Faculty of Physicians and Surgeons shallbe superior in culture, experience and skill. 

We have not the space to speak, individually, of the eighteenprofessional gentlemen composing the Faculty, but will say that amongthem are those whose long connection with the World's Dispensary andSurgical Institute has given them great experience and rendered them_experts_ in their specialties. Several of them had previouslydistinguished themselves in both private and hospital practice, had heldimportant chairs as lecturers and teachers in Medical Colleges, and hadfilled responsible positions in military and civil hospitals; also insome of the most noted Asylums, Dispensaries, and Sanitary Institutionsin the land. 

With such a staff of Physicians and Surgeons, efficient and trainednurses, and with all the most approved sanitary, medical and surgicalappliances which study, experience, invention and the most liberalexpenditure of money, can produce and bring together in one institution, the Invalids' Hotel and Surgical Institute affords the afflicted unusualopportunities for relief. 

THE GRAND ENTRANCE. 

The entrance to the Invalids' Hotel and Surgical Institute is covered bya lofty porch of beautiful design, the roof of which is supported uponheavy iron columns. Above the massive double doors, through which thevisitor enters, are large, heavy panels of beautifully wrought stainedglass, on which the words "Invalids' Hotel and Surgical Institute" standout conspicuously. 

[Illustration:Gentlemen's Reception-room, Invalids' Hotel and Surgical Institute. ]

FIRST FLOOR. 

The first floor of the building is reached through a beautifullyfinished vestibule, by a short flight of broad, easy stairs, and onceinside the visitor is struck by the beauty of design as well as by thehome-like appearance of the surroundings. The wood-work is mainly ofhard woods, oak and cherry predominating. In a large part of the housethe floors are of oak, with a cherry border, neatly finished in oil andshellac, and covered with rich rugs and elegant carpets of the very bestquality. 

[Illustration: Ladies' Parlor. --Invalids' Hotel and Surgical Institute. ]

On the first floor is the gentlemen's reception-room, which is throngedwith patients from early in the morning until late in the afternoon. Itis entirely distinct from the large reception-room and parlors for ladypatients, and the utmost privacy is secured throughout the wholearrangement of the Institution. On this floor are the suites of offices, parlors, and private consultation-rooms, some fifteen in all; also awell furnished reading-room and circulating library, for the use of theinmates of the Institution. On all sides are beautifully frescoed wallsadorned with numerous choice engravings and other pictures. All therooms throughout the house are furnished in the best of style, and in amanner to afford the utmost comfort and cheerfulness of surroundings forthe sick and afflicted who seek this remedial resort. The Turkish andother baths are elegantly fitted up on the first floor, opposite thereading-room. 

THE UPPER FLOORS. 

Above the first, or main floor, the building is divided into separaterooms and suites of rooms for the accommodation of patients. All arewell lighted, have high ceilings, and are cheerful and well ventilatedapartments. On the second floor is the large medical library and medicalcouncil-room, for the exclusive use of the Faculty, also themuseum-room, which contains a large and valuable collection ofanatomical and morbid specimens, many of them being obtained from casestreated in this Institution. On this floor are also suites of rooms, occupied by the Bureau of Medical Correspondence, wherein from ten totwelve physicians, each supplied with the improved graphophone, areconstantly employed in attending to the vast correspondence receivedfrom invalids residing in all parts of the United States and Canada. Every important case receives the careful consideration of a councilcomposed of from three to five of these expert specialists, before beingfinally 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 andappliances for the successful management of every chronic maladyincident to humanity. Electrical apparatus of the latest and mostapproved kinds, some of it driven and operated by steam-power, drycupping and equalizing-treatment apparatus, "vitalization" apparatus, numerous and most ingenious rubbing and manipulating apparatus andmachinery, driven by steam-power, are among the almost innumerablecurative agencies that are here brought into use as aids in the cure ofhuman ailments. Our

ELECTRICAL OUTFIT

[Illustration: President Pierce's Business Office--Invalids' Hotel andSurgical Institute. ]

is the finest to be found in any sanitarium in the United States and, webelieve, in the world. There are two forty-cell galvanic batteries withswitch boards for controlling the voltage, or force, from the wholepower to one-fortieth of this amount, at the will of the physician. Safe-guards in the shape of milli-ampere meters continually indicate tothe operator the force of the current. There is a dynamo for chargingthe storage batteries, which may be used in a patient's room when thismethod is found more convenient or more comfortable for the invalid. There are two static or Franklin machines. These are used when themilder current is desired, and for spraying, sparking, etc. One of theinstruments is of high voltage and furnishes us with the X rays forexamining the interior parts of the body. The largest treatment roomalso contains a powerful ozone generator, operated by a dynamo. Thissupplies the room with allotropic oxygen and is invaluable in treatingdiseases of the lungs and air passages. This supplies the patient withvitalized air, equal to the most salubrious atmosphere in any part ofthe globe. 

Beyond this and separated by a court, across which is an iron bridge, are the large dispensing-rooms, stocked with drugs and medical compoundsof almost endless variety, and representing every branch of the _materiamedica_. Here all medicines prescribed are most carefully and speciallyprepared for each individual case. Those to be sent away by mail orexpress, to patients being treated at a distance, are placed in trays, with full directions for use, and sent to another large room, where theyare carefully packed, and shipped thence to their destination. 

FOURTH FLOOR. 

On the fourth floor are located the surgical operating-rooms andsurgical ward. There are also a large number of nice, large, wellfurnished separate rooms on this floor, used principally for theaccommodation of surgical cases. Strong, broad, iron staircases connectall the upper floors with the ground, so that in case of fire, patientsneed have no fear of being unable to get out safely. In fact, thebuilding has been constructed so as to render the rapid spread of firethrough 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 thoselower down. The dining-rooms for gentlemen, as well as those forladies, are located in the basement, which is reached either bystairways 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 topreserve, secure from observation, as well as from fire, all records ofcases examined and treated by the Faculty. 

Throughout all this vast building the visitor is struck with thewonderful 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 atreatment-room, fitted up with vacuum and movement-treatment apparatusof the most modern and approved style. These and much more ingeniouslydevised apparatus and appliances are brought into use in a great varietyof chronic affections with marvelously successful results. A perfectsystem of physical training, especially adapted to the wants of theinvalid and weak, and most skillfully conducted and applied, is not theleast important among the many advantages that the chronic sufferershere find. 

THE SURGICAL DEPARTMENT. 

In the Surgical Department, every instrument and appliance approved bythe modern operator is provided, and many and ingenious are theinstruments and devices that the Faculty of this institution haveinvented and perfected to meet the wants of their numerous cases. 

OUR REMEDIES. 

In the prescribing of remedies for disease, the Staff resort to thewhole broad field of _materia medica_, allowing themselves to behampered by no school, _ism_, _pathy_, or sect. The medicines employed areall prepared by skilled chemists and pharmacists, and the greatest careis exercised to have them manufactured from the freshest and purestingredients. Our Faculty probably employ a greater number and variety ofextracts from native roots, barks and herbs in their practice than areused in any other invalids' resort in the land. All of the vegetableextracts employed in our practice are prepared in our own Laboratory. 

REGULATION OF DIET. 

The table is supplied with an abundance of wholesome and nutritiousfood, especially adapted and prepared to suit the invalid, it beingvaried to suit each particular case. The Faculty recognize theimportance of proper food as one of the greatest factors in thetreatment of chronic diseases. While properly regulating and restrictingthe food of the invalid when necessary, they also recognize the factthat many are benefited by a liberal diet of the most substantial food, as steaks, eggs, oysters, milk, and other very nutritious articles ofdiet, which are always provided in abundance for those for whom they aresuited. 

[Illustration: View of Lake and Boat-house. --Buffalo Park. ]

From previous experience somewhere, some people get the impression thatthey are to be half starved at such an institution as this. If this isthe case anywhere it is not so here, as any one who has ever resided atour sanitarium will attest. 

TRAINED ATTENDANTS. 

A sufficient number of trained and experienced nurses are employed, thatthose requiring attendance may have the very best of care. 

GOOD ORDER. 

The institution is conducted in an orderly manner, that the utmost quietmay be secured. The Faculty insist, upon the part of the invalid, whileunder treatment, on the observance of habits of regularity in eating, sleeping, bathing and exercise. Only by such observance of hygienic lawscan they succeed in their course of remedial training, and make thetreatment curative. 

AMUSEMENTS. 

While insisting upon strict observance of rules established for the goodof the patient, they do not make their requirements so rigid as tointerfere with the comfort and enjoyment of their patients, but, on thecontrary, endeavor, in every manner possible, to provide innocent andentertaining amusements for all, recognizing the great importance ofpleasant occupation of the mind, as an essential part of the treatment. Hence the introduction of music, amusing games, light reading, andkindred 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 littlecapital, to build up a business in the treatment of chronic diseases anddevoted himself diligently to that end. His reputation for skill in hischosen field of practice gradually extended until, to-day, his fame andthat of the World's Dispensary and Invalids' Hotel and SurgicalInstitute, are simply world-wide. As the business increased thoseeminent for skill have been induced to join the Faculty, until eighteenprofessional gentlemen, each devoting his attention to a special branchof 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 thefact that we are supplied with all the modern improvements in the way ofinstruments, appliances and remedial agents used in the healing art, theexpense of which deters the local physician in general practice fromprocuring, for the treatment of the limited number of cases that comewithin the circuit of his practice. The treatment of such cases requiresspecial attention and special study to be successful. 

A COMMON SENSE VIEW. 

It is a well-known fact, that appeals to the judgment of every thinkingperson, that a physician who devotes his whole time to the study andinvestigation of a certain class of diseases, must become betterqualified to treat them than he who attempts to treat every ill to whichflesh is heir, without giving special attention to any particular classof diseases. Men, in all ages of the world, who have _made their marks_, or who have become famous, have devoted their lives to some specialbranch of science, art or literature. 

LIBERALITY. 

We wage no war against any physician, no matter what school of medicinehe may represent; but, on the other hand, we invite the co-operation ofall regular physicians. We are always ready and willing to impart tothem any information or render any assistance that will be of mutualbenefit to them and their patients. 

OUR PHYSICIANS AND SURGEONS

do not travel to solicit practice, having all the business that they canattend to at our institution, nor do we employ any agents to travel andpeddle or otherwise sell our medicines. If any one engaged in suchbusiness, represents himself as in any way connected with ourinstitutions, he is a swindler and should be apprehended and prosecutedas such. And any one who will give us such information as will lead tothe arrest and conviction of any person so misrepresenting will beliberally rewarded. 

[Illustration: Undergoing Examination of the Lungsat the Invalids' Hotel and Surgical Institute. ]

While not permitting any member of our professional staff to travel andsolicit practice, yet we are always willing to accommodate and send aspecialist to visit important or critical cases in consultation, orotherwise, or to perform important surgical operations as explained onpage 971 of this book. 

Let none deceive you by representing that they have heretofore beenconnected with our institution and have thereby learned our original andimproved methods of treatment. We have a large and competent Staff ofSpecialists and while we have sometimes found it necessary to makechanges, yet we always manage to retain the most expert and skillful, aswe cannot afford to part with the services of those who excel. 

[Illustration: Chemists' Department. --Invalids' Hotel and SurgicalInstitute. ]

By adopting similar names to those which have long designated ourworld-famed institutions, some have endeavored to deceive and misleadinvalids 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-knownprofessional standing. Neither the Doctor nor this Association have anyinterest in any such articles. 

NO BRANCHES. --Remember we have no branches except the one at No. 3 NewOxford Street, London, England. 

Those desiring to consult us by letter, should address allcommunications plainly to

 World's Dispensary Medical Association, _No. 663 MAIN STREET, _ BUFFALO, N. Y. 

 * * * * *

WORLD'S DISPENSARY. 

The immense building erected and occupied by the World's DispensaryMedical Association as a Laboratory, wherein are manufactured our Dr. Pierce's Standard Family Medicines, as well as all the variousTinctures, Fluid Extracts and other pharmaceutical preparations used bythe Staff of Physicians and Surgeons of the Invalids' Hotel and SurgicalInstitute in their practice, is not inappropriately called the _World'sDispensary_, for within its walls is prepared a series of remedies ofsuch exceeding merit that they have acquired world-wide fame, and aresold 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 inthe rear of the Invalids' Hotel and Surgical Institute, is of brick, with sandstone trimmings, six stories high, and 100 feet square. Itsmost 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 Streetsidewalk, and is occupied by a plant of two large boilers, which supplythe steam to run a huge American engine, of 100 horse-power, built bythe American Engine Co. , Bound Brook, N. J. It drives all the machineryof the establishment, including drug mills, pill machines, packingmachinery, a large number of printing presses, folding machines, stitching, trimming, and many other machines, located on the differentfloors, and used in the manufacture of medicines, books, pamphlets, circulars, posters, and other printed matter. On this floor is locatedsteam bottle-washing machinery, and also the shipping department. Heremay be seen huge piles of medicine, boxed, marked, and ready forshipment to all parts of the civilized world. A large steam freightelevator 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-powerupright engine for running the dynamo for electric lighting, with acapacity of three hundred (300) lights. This engine and dynamo were alsomanufactured 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 usedduring the day to light safes, vaults, dark closets and hallways. Allthe offices and rooms of patients are supplied with electric light, aswell as illuminating gas. An automatic Worthington pump is also locatedin the basement. This supplies the elevator and sprinkling system. Thesprinklers come into play only in case of fire, when they areself-acting. This pump at its best is capable of forcing nearly twohundred gallons of water a minute. There is no place in which pure wateris more desirable than in the manufacture of medicines. Our New Yorkfilter could, if such a large quantity were ever required, furnish theDispensary with one hundred (100) barrels of pure water a day. Justbeyond the south wall and buried several feet under ground is aboiler-shaped tank capable of storing ten thousand (10, 000) gallons ofmedicine. 

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, theadvertising department and mailing rooms. Large, fire-proof vaults areprovided for the safe keeping of books, papers, and valuables, whilstthe counting-room and offices are elegantly finished in hard woods, andpresent a beautiful and grand appearance. 

THIRD FLOOR. 

On this floor are the Association's extensive printing and bindingworks. Fourteen large presses, driven by power, with numerous foldingmachines, trimming, cutting, and stitching machinery, are constantlyrunning in this department. Here is printed and bound Dr. Pierce'spopular work of over a thousand pages, denominated "The People's CommonSense Medical Adviser, " over 1, 200, 000 copies of which have been sold. Millions of pocket memorandum books, pamphlets, circulars and cards arealso issued from this department and scattered broadcast to everyquarter 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. Extensivedrying-rooms, in which articles to be ground in the drug mills areproperly dried, are also located upon this floor, as are also thousandsof reams of paper ready for printing the different books, pamphlets, labels, etc. In large rooms set aside for that purpose, are stored vastquantities of labels and wrappers, for use in putting up medicines. 

FIFTH FLOOR. 

On this floor is located ingeniously devised filling and bottlingmachinery, also rooms for labeling, wrapping, and packing medicines;others are occupied for the storage of crude drugs, glass, corks, andsupplies 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 ofmedicines. Every process is conducted under the watchful care of anexperienced chemist and pharmacist, and in the most perfect and orderlymanner; the apparatus employed being of the most approved character. Here are manufactured all the various medicinal preparations andcompounds 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 isstruck with the perfect system which everywhere prevails, and thewonderful accuracy with which every process and transaction is carriedon and consummated; hence the uniformity of purity and strength forwhich the medicines here manufactured have so long been celebrated. Tothis, also, is due much of the marvelous success attained in thedepartment established for the special treatment of chronic andobstinate cases of disease. In this department the Faculty are not atall limited or hampered in prescribing, and do not confine themselves inthe least to the proprietary or standard medicines manufactured forgeneral sale through druggists, but employ a series of curative agentsunsurpassed in variety and range of application. They aim to carefullyadapt their prescriptions to each individual case. 

 * * * * *

THE

INVALIDS' HOTEL AND SURGICAL INSTITUTE

_SOME OF THE CAUSES THAT LED TO ITS ERECTION, AND THE ADVANTAGES WHICHIT AFFORDS. _

[Illustration: One of the Private Consultation-rooms, Gentlemen'sDepartment. ]

The destinies of institutions, like those of men, are often determinedby pre-existing causes. The destinies of some men are like those ofway-side plants, springing up without other apparent cause than thecaprice of nature, developing without any apparent aim, yielding noperfected fruit, and finally, dying, leaving scarcely a trace of theirexistence. Thus it is with institutions which have their origin only inman's caprice. To be enduring, they must be founded upon the needs andnecessities of humanity. Many of the great men of the world owe theirgreatness more to surrounding circumstances than to the genius withinthem. The highest genius can be dwarfed or deformed by the force ofadverse circumstances; hence the poetic truth of Gray in those exquisitelines:

 "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 woulddrift hither and thither upon the restless, ever-changing waves ofcircumstance, never casting anchor in a secure haven. Upon opportunity, too, depends the success of institutions. By opportunity we mean a realand acknowledged public want. Whoever undertakes to supply this wantfinds himself upon the crest-wave of prosperity. It was to supply such awant that this institution was erected. 

A REMEDIAL HOME. 

Of the seventy millions of people living in the United States to-day, itis estimated that nearly twelve millions are sufferers from chronicdisease. Think for a moment! Twelve millions of people slowly but surelydying by the insidious and fatal development of chronic diseases! Thisis an appalling fact. And yet this is the very class of diseases withwhich 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 grandunpardonable sin of the medical profession was the neglect to morethoroughly study and investigate this class of diseases. 

The profession is diligently cauterizing and poulticing the sores whichnow and then appear on the surface, but the internal chronic disease, ofwhich these are merely the external signs, is too often overlooked orneglected. 

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 reasonedthat the physician has abundant opportunity to accurately determine thenature of most chronic diseases without ever seeing the patient. Insubstantiating that proposition, we cited the perfect _accuracy_ withwhich scientists are enabled to deduce the most minute particulars intheir several departments, which appears almost miraculous, if we viewthe subject in the light of the early ages. Take, for example, theelectro-magnetic telegraph, the greatest invention of the age. Is it nota marvelous degree of accuracy which enables an operator to _exactly_locate a fracture in a sub-marine cable nearly three thousand mileslong? Our venerable "clerk of the weather" has become so thoroughlyfamiliar with the most wayward elements of nature that he can accuratelypredict their movements. He can sit in Washington and foretell what theweather will be in Florida or New York, as well as if hundreds of milesdid not intervene between him and the places named. And so in alldepartments of modern science, what is required is the knowledge ofcertain _signs_. From these, scientists deduce accurate conclusionsregardless of distance. A few fossils sent to the expert geologistenables him to accurately determine the rock-formation from which theywere taken. He can describe it to you as perfectly as if a cleft of itwere lying on his table. So also the chemist can determine theconstitution of the sun as accurately as if that luminary were notninety-five million miles from his laboratory. The sun sends certain_signs_ over the "infinitude of space, " which the chemist classifies bypassing them through the spectroscope. Only the presence of certainsubstances could produce these solar signs. 

[Illustration: Medical Library and Council-room. --Invalids' Hotel andSurgical Institute. ]

So, also, in medical science, DISEASE HAS CERTAIN UNMISTAKABLE SIGNS, or symptoms, and, by reason of this fact, we have been enabled tooriginate and perfect a system of determining with the greatest accuracythe nature of chronic diseases without seeing and personally examiningour patients. In recognizing diseases without a personal examination ofthe patient, we claim to possess no miraculous powers. We obtain ourknowledge of the patient's disease by the practical application ofwell-established principles of modern science to the practice ofmedicine. And it is to the accuracy with which this system has endowedus that we owe our almost world-wide reputation for the skillfultreatment of all lingering, or chronic, affections. This system ofpractice, 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 andunmistakable data to guide the judgment of the skillful practitioneraright in determining the nature of diseased conditions. 

So successful has been this method of treating patients at a distancethat there is scarcely a city or a village in the United States that isnot represented by one or more cases upon the "Records of Practice" atthe Invalids' Hotel and Surgical Institute. In all chronic diseases thatare curable by medical treatment, it is only in very rare cases that wecannot do as well for the patient while he or she remains at home, as ifhere in person to be examined. But we annually treat hundreds of casesrequiring surgical operations and careful after-treatment, and in thesecases our Invalids' Hotel, or home, is indispensable. Here the patienthas the services not only of the most skillful surgeons, but also, whatis quite as necessary in the after treatment, of thoroughly trained andskilled 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 thedeserved rank of a science. The influence of the climate of a country onthe national character has long been observed and acknowledged. Thelanguid 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 theearth with passionate rain; or like its winds, to-day soft, balmy, withhealing on their wings, to-night the wind fiend, the destroying simoom, rushing through the land, withering and scorching every flower and bladeof herbage on its way. On the other hand, the calm, phlegmatictemperament of the North accords well with her silent mountains, herserener skies, and her less vehement, but chilling winds. The South, too, is the native home of the most violent acute diseases, such asyellow fever and cholera. But, aside from this general climaticinfluence, there is the yet more restricted one of locality. It hasoften been observed that certain classes of diseases are most prevalentin certain localities, the prevalence in every instance being due topeculiarities of climate. 

EXTREME HEALTHFULNESS OF BUFFALO. 

In the published records of the examination for military service in thearmy, during our late civil war, this fact was clearly and definitelystated, and maps were prepared and presented showing the comparativeprevalence of certain diseases in the several States and districtsrepresented. The maps are prepared by a graduation of color, the lightershades indicating the localities where the special disease underconsideration is least prevalent; and it is a very significant andimportant fact that in all chronic diseases not due to occupation oraccident, Buffalo and its immediate vicinity is marked by the lightershades. Thus, in epilepsy, paralysis, scrofula, rheumatism, andconsumption, our city is little more than tinted with the several colorsused to denote these diseases. 

[Illustration: A Patient's Room. --Invalids' Hoteland Surgical Institute. ]

There is a popular, but unfounded, belief that Buffalo is a hot-bed forpulmonary diseases. This idea could have originated only in an ignorantdisregard of facts; for medical statistics prove that in her freedomfrom this class of diseases she is unrivaled by any city in America, notexcepting those on the seaboard. 

EVIDENCE OF HEALTH STATISTICS. 

Compare, if you please, the statistics of Buffalo with those of thegreat Eastern cities in this respect. In Boston and New York thedeath-rate from consumption shows a ratio of about 1 to 5 of the wholenumber 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--veryremarkable difference in favor of our city. Only last summer a gentlemanresiding in the eastern part of our State collected and compared thehealth statistics for 1876 of all the prominent cities in the UnitedStates. 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 sometimesironically termed. It seems to be a popular belief among our sistercities that old Boreas has chosen Buffalo for his headquarters. When wehear a person dilating upon "Buffalo's terrific winds, " we are remindedof one of our lady acquaintances who recently returned from a Europeantour. She was asked how she enjoyed her sea voyage, and she replied, "Oh, it was delightful, really charming! There is something so grandabout the sea!" We were not a little surprised at this enthusiasticoutburst, as we had been told by a member of her party that the lady hadindustriously vomited her way to Hamburg and back again. But the lady'senthusiasm was easily explained. It is fashionable to characterize seavoyages as delightful, charming, etc. Now, we suspect this popularnotion about our "trying winds" is traceable to the same source. It hasbecome customary to call Buffalo a "windy place, " and so, when thetraveler feels a slight lake breeze, he imagines it to be a terrificgale. Whatever may have originated this notion, certain it is that it isutterly, undeniably false; and, in making this denial, we are not alonedependent 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 year1873. An examination of the table shows that the total velocity for theyear was the _lowest in Buffalo_ of any of the lake ports; whilePhiladelphia and New York showed far higher aggregates of velocity thanour city. On this subject, in the issue of August 21st of the same year, the editor pleasantly remarks: "Only the interior and southern seaboardcities, and not many of them, show a lower total velocity of wind thanis marked against this city; and as for those places, heaven help theirunfortunate inhabitants in the sultry nights of the summer season, whenthey are gasping in vain for a breath of that pure, cool lake air, whichbrings 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 forinvalids in any locality, here again sentiment and science are greatlyat variance. An examination of the official records of the SignalService Bureau, and the statistics of the Smithsonian Institute, showedthat out of a list of forty cities on the continent Buffalo rankedhighest for equability of climate. Thus we quote from an editorial inthe _Advertiser_ of the same issue: "While the aggregate of change forBuffalo stood at 67 for the year, that of Philadelphia reached 204, Washington was 224, Cincinnati 205, St. Louis 171. Winchester, in one ofthe healthiest parts of Virginia, reached as high as 201. Aiken, inSouth Carolina, a famous resort for invalids, touched 220. St. Augustine, one of the lowest in the list, showed a much less equableclimate than that of Buffalo, being 94 to our 67. " The transition fromsummer to winter, and _vice versa_, is exceedingly gradual, and, consequently, Buffalonians are seldom afflicted with those epidemicdiseases which generally appear in other localities during the springand summer months. Thus the thermometric readings of the Signal ServiceBureau for 1873, show that the average temperature for July and Augustwas 74°. For September it was about 64°, which was again reduced byabout 10° for October. The monthly average for November was 73°, and forDecember 25°, which was also the average for January. Then the readingsfor February showed an average of 26°, for March 32°, and 43° for April. A more equable and gradual transition from midsummer heat to midwintercold cannot be shown by any locality on this continent. Seldom does themercury rise above ninety during our warmest summers, or fall below zeroin our most severe winters. In J. Disturnal's work, entitled "TheInfluence of Climate in North and South America, " published by VanNostrand, in 1867, the climate of Buffalo is thus characterized: "Fromcertain natural causes, no doubt produced by the waters of Lake Erie, the winters are less severe, the summers less hot, the temperature nightand day more equable, and the transition from heat to cold less rapid, in Buffalo than in any other locality within the temperate zone of theUnited States, as will be seen by the following table. " The tablereferred to shows that, "during the summer months, the temperature ofBuffalo 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 andinvigorating lake breeze is felt night and day. " The author further addsthat "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 severalgreat social and commercial centers, proved _Buffalo to be superior toall others in the climatic requirements for the invalid_. Besides, ithas the important advantage of being a central point of traffic andtravel between the West and the East. 

ADVANTAGES OF LOCATION. 

The second important consideration in projecting this home for invalidswas _location_. It has generally been customary to locate institutionsof this character in rural districts, removed from the advantages ofcity life, on the plea of escaping the confusion and excitement sodetrimental to recovery. The result is well known. Invalids haveregarded them more as pleasure resorts than health resorts, spending thesummer months there, but fleeing to their homes at the fall of the firstsnow-flake. The good that was done in the summer is undone bycarelessness and exposure in the winter. A location that would combineboth 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, ourworld-famed Niagara, --certainly a more desirable selection of ruralscenes and pleasures cannot be found in another locality in America. 

A GENUINE HOME. 

In erecting the Invalids' Hotel and Surgical Institute, our paramountdesign was to make it a genuine home--_not a hospital_--a home where thechild of fortune would miss none of the comforts of her palatial home, while the poor man would find not only health but his pleasuresmultiplied a thousand fold. 

OUR TERMS MODERATE. 

The wholesale merchant's prices are far less than those of the retaildealer. He can afford it, his sales are so much larger. It is onprecisely the same principle that we are able to make the rates at theInvalids' Hotel and Surgical Institute comparatively low. If we had onlya limited number of patients, we should be obliged to make the chargescommensurate with our expenses; but our practice having become veryextensive, and the income being correspondingly large, we are enabled tomake the rates at the Invalids' Hotel and Surgical Institute so moderatethat all who desire can avail themselves of its medical, surgical, andhygienic advantages. 

[Illustration: Prescription Department--Invalids' Hotel and SurgicalInstitute. ]

FACILITIES FOR TREATMENT. 

Of the many advantages afforded by the Invalids' Hotel and SurgicalInstitute, in treating disease, we can make only brief mention of a fewof the more prominent. 

DIVISION OF LABOR. 

In the examination and treatment of patients, our practice is dividedinto specialties. Each member of the Faculty, although educated topractice in _all_ departments of medicine and surgery, is here assignedto a special department only, to which he devotes his entire time, studyand attention. 

ADVANTAGES OF SPECIALTIES. 

The division-of-labor system proves as effectual in the exercise of theprofessions as in manufactures. In the legal profession this has longbeen a recognized fact. One lawyer devotes his attention specially tocriminal law, and distinguishes himself in that department. Anotherdevelops a special faculty for unraveling knotty questions in matters ofreal estate, and, if a title is to be proved, or a deed annulled, he isthe preferred counselor. In a certain manner, too, this has long beenpracticed by the medical profession. Thus some physicians (and we mayadd physicians who call themselves "regular, " and are specially causticin their denunciation of "advertising doctors") are accustomed todistribute cards among their patrons, certifying that they give specialattention to diseases of women and children. In this institution eachphysician and surgeon is assigned a special department of medicine orsurgery. By constant study and attention to his department, each hasbecome a skillful specialist, readily detecting every phase andcomplication of the diseases referred to him. Not only is superior skillthus attained, but also _rapidity_ and _accuracy_ in diagnosis. 

Thoroughness and efficiency in any branch of learning can be securedonly by devoting to it special study and attention. When the faculty ofa university is to be chosen, how are its members selected? Forinstance, how is the chair of astronomy filled? Do they choose the manwho is celebrated for his general scholastic attainments, or do they notrather confer it upon one who is known to have devoted special attentionand study to the science of astronomy, and is, therefore, especiallyqualified to explain its theories and principles? Thus all the severalchairs are filled by gentlemen whose general scholarship not only isknown to be of the highest standard, but who devote special attention tothe departments assigned them, thus becoming proficient specialiststherein. The same system of specialties is observed in the departmentsof a medical college. The professor who would assume to lecture in allthe departments with equal ease and proficiency would be severelyridiculed by his colleagues; and yet it is just as absurd to supposethat the general practitioner can keep himself informed of the many newmethods of treatment that are being constantly devised and adopted inthe several departments of medicine and surgery. 

PROGRESS IN MEDICINE. 

In no other science is more rapid and real progress being made at thepresent time than in that of medicine. Even the specialist must bestudious and earnest in his work to keep himself well and accuratelyinformed of the progress made in his department. Thus it so oftenhappens that the general practitioner pursues old methods of treatmentwhich science has long since replaced with others, acknowledged to besuperior. The specialist, on the contrary, by confining his studies andresearches to one class of diseases only, is enabled to inform himselfthoroughly and accurately on all the improvements made in the methodsand means of practice in his special department. 

The difference between the practice of specialists and that of generalpractitioners is aptly illustrated by the difference between theold-fashioned district school, in which the school-master taught all thebranches, from a-b-abs to the solution of unknown quantities and thecharmed mysteries of philosophy, and the modern seminary, with itsefficient corps of teachers, each devoting his or her whole attention tothe study and teaching of one special department of learning. 

We attribute the success which has attended the practice at theInvalids' Hotel and Surgical Institute, in a great measure, to a wiseadoption of this system of specialties. 

ADVANTAGES OFFERED TO INVALIDS. 

Obviously, the most important of these advantages is _facility oftreatment_. Of the thousands whom we have cured of chronic diseases, wehave probably not seen one in five hundred, having accomplished thedesired result through remedies sent either by mail or express, andadvice given by letter. Yet in some obstinate forms of disease, we canhere 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 perfecthealth, is conclusively proved by the records of practice at theInvalids' Hotel and Surgical Institute. Here, in obstinate cases, arebrought to bear all the most scientific remedial appliances and methodsof treatment. 

A system of mechanical movements, passive exercises, manipulations, kneadings and rubbings, administered by a large variety ofingeniously-contrived machinery, driven by stream-power, has been foundespecially efficacious and valuable, as an aid to medical and surgicaltreatment, in the cure of obstinate cases of nervous and sick headache, constipation, paralysis, or palsy, stiffened joints, crooked andwithered limbs, spinal curvature, tumors, diseases of women, especiallydisplacements of the uterus, or womb, such as prolapsus, retroversionand anteversion, chronic inflammation, enlargement and ulceration of theuterus, and kindred affections; also in nervous debility, sleeplessness, and other chronic diseases. Mechanical power, or force, is by thesemachines transmitted to the system, in which it is transformed intovital energy and physical power or strength. This mechanical, passiveexercise, or movement-cure treatment, differs widely from, and shouldnot be confounded with, "Swedish movements, " to which it is far superiorin efficacy. Coupled with our improved and wonderful system of"Vitalization" treatment, it affords the most perfect system of physicaltraining and development ever devised. For the restoration of power towasted, undeveloped, or weakened organs or parts, for their enlargement, this combined movement and "Vitalization" treatment is unequaled. It canbe applied to strengthen or enlarge any organ or part. We also employboth Dynamic and Static electricity, "Franklinism" and Electrolysis, andchemical, Turkish and other baths, in all cases in which they areindicated. Inhalations, administered by means of the most approvedapparatus, are employed with advantage in many obstinate lung, bronchial, and throat affections. We have no hobby or one-idea system oftreatment, no good remedial means being overlooked or neglected. 

[Illustration: A glimpse of someof the rooms for theapplication of Electricity, MechanicalMassage, "Vitalization"treatment, andother agencies prescribed by our Staff;furnishing a perfect system of physicaland remedial training, carefully adaptedto 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 consultyour own reason and best interests? If so, then do not heed the counselof skeptical and prejudiced friends, or jealous physicians, but listento what we have to say. 

You perhaps know nothing of us, or our systems of treatment, or of thebusiness methods we employ. You may _imagine_, but you _know nothing_, perhaps, of our facilities and advantages for performing cures in casesbeyond the reach or aid of the general practitioner. Knowing nothing, then, of all these advantages, you still know as much as the would-befriend or physician who never loses an opportunity to traduce andmisrepresent us, and prejudice the afflicted against us. 

Now to the point--are you listening? Then permit us to state that wehave the largest, the best, and the finest buildings of any likeAssociation, company, or firm in this country. We employ _more_ and_better_ Medical and Surgical Specialists in our Invalids' Hotel andSurgical Institute than any similar Association, company, or individual, and actually have more capital invested. We have a thoroughly qualifiedand eminent Specialist for every disease that we treat. We treat morecases, _and absolutely cure more patients_ than any similar institutionin America. In addition to those we treat medically, we perform all themost difficult surgical operations known to the most eminent Surgeons, and so frequently do many of these operations occur with us that some ofour Specialists have become the most expert and skillful Surgeons onthis continent. 

We wish to add further that we are responsible to _you_ for what werepresent; 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 incuring Chronic Diseases, _we will gladly and promptly refund to you allthe expenses of your trip_. We court honest, sincere investigation, andare glad and anxious to show interested people what we can do and aredaily doing for suffering humanity. Can a proposition be plainer? Can anoffer 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 sufferingour mission. 

Whether arriving in our city by day or night, _come directly to theInvalids' Hotel and Surgical Institute, 663 Main Street_, where you willbe 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 Instituteand World's Dispensary has devoted himself very closely to theinvestigation and treatment of chronic diseases. Some few specificshave, during this time, been developed for certain forms of chronicailments, and given to the public, but they have not been lauded as"cure-alls, " or panaceas, but only recommended as remedies for certainwell-defined and easily recognized forms of disease. These medicines aresold through druggists very largely, and have earned great celebrity fortheir many cures. So far from claiming that these proprietary medicineswill cure all diseases, their manufacturers advise the afflicted that, in many complicated and delicate chronic affections, they are notsufficient to meet the wants of the case. These must have specialconsideration and treatment by a competent physician and surgeon, themedicines and other remedial means required being selected and preparedwith reference to each particular case. 

In order to be able to offer those afflicted with chronic ailments themost skillful medical and surgical services, Dr. Pierce, many years ago, associated with himself several eminent physicians and surgeons, as theFaculty of the old and renowned World's Dispensary, the consultingDepartment of which is now merged with the Invalids' Hotel and SurgicalInstitute. 

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 onephysician the examination and treatment of diseases of the nervoussystem; to another, surgical operations and the treatment of surgicaldiseases; a third had charge of catarrhal and pulmonary diseases andaffections of the heart; a fourth attended to diseases peculiar towomen; a fifth, to diseases of the eye and ear; a sixth, to diseases ofthe digestive organs; a seventh, to special surgical cases; to anotherwe entrusted diseases of the urogenital organs; and to others, variousother specialties. Now that our practice has become so very extensive asto require for its conduct a greatly increased number of physicians andsurgeons. Thus four physicians and surgeons devote their undividedattention to the examination and treatment of diseases of the urinaryand generative organs of men. Three physicians give their sole attentionto diseases peculiar to women and three to those of the nasal organs, throat and chest, embracing all chronic diseases of the respiratoryorgans. Thus we have a full council of three and four physicians inthese several specialties. In several other divisions we have twospecialists. No case is slighted either in the examination or in thetreatment. All doubtful, obscure or difficult cases are submitted to acouncil composed of several physicians and surgeons. Skilledpharmaceutists are employed to compound the medicines prescribed. Forthe purpose of enabling us to conduct our extensive correspondence (forwe have an extensive practice en every part of the United States andCanada, as well as in Great Britain from our London branch), graphophones are employed, to which replies are dictated, recording thewords 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 canthink of the letters which compose a word, each operator thusaccomplishing the work of several copyists. This system, by which we areenabled to correspond with our patients as rapidly as we can talk, hasbeen rendered necessary by the growth of our business, which hasattained immense proportions, giving rise to so large a correspondencethat a dozen physicians cannot possibly conduct it all and give eachpatient's case careful attention, without the employment of graphophonesand all other facilities which modern invention has given us. By theadoption of these various means, we are enabled to fully meet thedemands of the afflicted, and give every case the most carefulattention. 

[Illustration: Faculty of Invalids' Hotel and Surgical Institute inSession. --Council-room. ]

As many persons, particularly young ladies and gentlemen, having catarrhor almost any other chronic disease, especially if of the urogenitalorgans, are very sensitive and fearful that somebody will know that theyare afflicted and employing medical treatment, precautions are takenthat none who consult us may incur the least risk of exposure. Althoughnone but the most honorable and trustworthy gentlemen are employed asassistants, yet as a _guarantee_ of perfect security to our patients, that every communication, whether made in person or by letter, will betreated as _sacredly confidential_, each professional associate, clerk, or assistant, is required to take a solemn oath of secrecy. Great careis also taken to send all letters and medicines carefully sealed inplain envelopes and packages, so that no one can even _suspect_ thecontents or by whom they are sent. 

ADVANTAGES OF SPECIALTIES. 

By thorough organization and a perfect system of subdividing thepractice of medicine and surgery in this institution, every invalidconsulting us is treated by a specialist--one who devotes his undividedattention to the particular class of diseases to which his or her casebelongs. The advantage of this arrangement must be obvious. Medicalscience offers a vast field for investigation, and no physician can, within the limit of a single life-time, achieve the highest degree ofsuccess in the treatment of _every_ malady incident to humanity. Adistinguished professor in the medical department of one of ouruniversities, in an address to the graduating class, recently said:"Some professional men seem to be ashamed unless they have the characterof universal knowledge. He who falls into the error of studyingeverything will be certain to know nothing well. Every man must have agood foundation. He must, in the first place, be a good generalpractitioner. But the field has become too large to be cultivated in itsentirety by any individual; hence the advantage of cultivating specialstudies in large towns, which admit of the subdivision of professionalpursuits. It is no longer possible to know everything; something mustbe wisely left unknown. Indeed, a physician, if he would know anythingwell must be content to be profoundly ignorant of many things. He mustselect something for special study, and pursue it with devotion anddiligence. This course will lead to success, while the attempt to doeverything eventuates unavoidably in failure. Let there be single handsfor special duties. " Our institution is the only one in this country inwhich these common-sense-ideas are _thoroughly_ carried out. Thediversified tastes and talents of physicians cause each to excel intreating some one class of diseases, to which he devotes more attentionand study than to others. One medical student manifests great interestin the anatomy, physiology, pathology, and treatment of diseases of theeye. He becomes thoroughly familiar with all the minutest detailsrelative to that organ and its diseases, and so thoroughly qualifieshimself in this branch of knowledge that he is able to cure aninflammation or other affection of the eye in a very short time. Anotherstudent is more interested in some other class of diseases, for thestudy of which he has a liking, and neglects to inform himself in theophthalmic branch of medical and surgical science. If after engaging inthe practice of his chosen profession, he is consulted by personssuffering from diseases of the eye, he tortures them with unnecessaryand oftimes injurious applications, clumsily and carelessly made, and, as the result of such unskillful treatment, the inestimable blessing ofsight may be sacrificed. 

[Illustration: A Corner in Printing Department. --World's Dispensary. ]

The great majority of physicians allow acute maladies, diseases ofchildren, and the practice of midwifery, to engross most of their timeand attention. They manifest an absorbing interest in everything thatrelates to these subjects, and devote little or no time to acquiring anintimate knowledge of the great variety of chronic maladies whichafflict mankind. They acquire skill and reputation in their favoriteline of practice, but are annoyed if consulted by one suffering fromsome obscure chronic affection, usually turn the invalid off with a verysuperficial examination, and, perhaps, only prescribe some placebo, [6]apparently indifferent as to the result, but really desiring thus toconceal their lack of familiarity with such diseases. The specialist, the treatment of chronic diseases being his vocation, is equally annoyedif consulted by those suffering from acute diseases, but does not pursuethe inconsistent course of assuming to treat them. He refers them tothose of his medical brethren whose daily dealings with such cases makethem, in his way of thinking, more competent than himself to rendervaluable service to such sufferers. He recognizes the fact that no manis likely to succeed in any line of study or business for which hepossesses 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 particularbranch of the healing art, the specialist sees no impropriety inacquainting the public with his ability to relieve certain forms ofsuffering. He believes that medical men should possess equal rights withother business men, and that any code of medical ethics which woulddeprive him of any of the sacred rights guaranteed to all by the liberallaws of the country, is professional _tyranny_, and merits only hiscontemptuous disregard. Nor does he display any false modesty in the_manner_ of making known his skill. He maintains that he has anundoubted right to place his claim to patronage before the public byevery fair and honorable means. He recognizes the display of goods inthe merchant's show-windows as no less an advertisement and in no bettertaste than the publication of a card in the newspaper. So, likewise, heregards the various devices by which the extremely _ethical_ physicianseeks to place himself conspicuously before the public, as but so manyways of advertising, and as not more modest than the publication ofcures actually performed, or than his announcement through the publicpress of his professional resources for treating certain maladies. 

The physician who expresses a "holy horror" of the "_advertisingdoctor_, " 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 uponthe mind of the patient and family his skill, frequently exaggerates asto the extent of his practice, rides furiously about when he has noprofessional calls, keeps up business appearances by driving severalhorses, or joins influential societies. He may make a great display instyle, manner, dress, pretensions, writing for the newspapers, exhibiting literary pedantry, referring to the superior facilitiesafforded by some particular school or society to which he belongs; or byediting and publishing a medical journal, ostensibly for the advancementof 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 thedistinguished families he is treating. All these are but _modes ofadvertising_ professional wares; in short, are artful, though notrefined, tricks, resorted to for private announcement. We say to allsuch adventurers in modern advertising diplomacy, that these indirect, clandestine methods are not half so candid and honorable as a directpublic statement of the intentions and proposals of a medicalpractitioner, who thereby incurs an individual responsibility before thelaw 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 inmedical skill, may not publish facts and evidence to disclose it, especially when these are abundant and conclusive. The followingextracts from an able article by the Rev. THOMAS K. BEECHER embodies asound view of the subject of medical advertising. He says:

* * "I am glad that the doctor cured him; I am glad that the doctor putit in the paper that he could cure him. And if any doctor is certainthat he can cure such diseases and don't put it in the paper, I amsorry. What a pity it would have been had this doctor come to town withhis wealth of science and experience and gone away leaving him uncured!What a pity it would have been if he had been so prejudiced againstadvertising as to read the responsible certificate of the doctor andgive him the go-by as a quack! What are newspapers for, if not tocirculate information? What more valuable information can a newspapergive than to tell a sick man where he can be cured? If a man has devotedhis life and labor to the study of a special class of diseases, thenecessity of his saying so becomes all the more pressing. His _duty_ toadvertise 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) ofCanterbury would preach at another time and place; again, that an Oxfordprofessor would preach. In short, religious notices were sprinkled inamong the theater bills, and the highest church dignitaries wereadvertised side by side with actors, singers, and clowns. Of course, Iwas shocked by it, but in a moment I bethought me--if it be all rightand dignified to hire a sexton to ring a bell when the minister is goingto preach, it is all the same to silence the bell and hire abill-sticker to tell the same news, the essential thing being to tellthe truth every time. The remedy for the lying advertisements is forhonest 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 thosegifts through want of advertising. "

If a physician possesses knowledge that enables him to remedy diseasesheretofore regarded as incurable, what virtue or modesty is there to"hide his light under a bushel"? In this free country the people thinkand act for themselves, and hence all have a deep concern in the subjectof health. The strong popular prejudice against the doctors whoadvertise is due to the fact, that by this method so many ignorantcharlatans are enabled to palm off their worthless services upon theuneducated and credulous; but the practice of such imposition should notcause a presumption against the public announcement of real skill, forthe baser metal bears conclusive evidence that the pure also exists. 

Every step in scientific investigation, every proposition which relatesto the interest and happiness of man, every statement and appealinvolving a valuable consideration, must be submitted to the scrutinyand judgment of individual reason; for every person has the right toform his own conclusions, and justify them by experience. Those claimswhich are only supported by empty assertion are very doubtful. Mistytheories vanish before the sun of truth. He who renders professionalservices 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 apersonal consultation, as our vast experience enables us to correctlydetermine the malady from which the patient is suffering, from a historyof the symptoms, and answers to questions furnished. We have not seenone 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 himto treat the case successfully; but a large experience in this practicehas proved the contrary to be true, for some of the most remarkablecures have been effected through the medium of correspondence. In mostlong-continued cases, the patient has thought over his symptoms hundredsof times. The location of every pain, whether acute or mild, constant oroccasional, and the circumstances under which it occurs, have beencarefully noted. He has observed whether he had a rush of blood to thehead, was feverish or chilly, whether troubled with cold hands and feet, whether full of blood, or pale and bloodless; and he states thesematters with accuracy and common sense when writing to us, for he has avery good, if not a professional, knowledge of the relative importanceof these symptoms. So in regard to digestion, he states what kinds offood agree with him, or whether he is troubled with excessive acidity ora flatulent condition of the stomach. He also informs us whether histongue is coated and bilious, or clean and healthy, and gives many otherparticulars too various to enumerate, by which we are enabled to gain aperfect understanding of the case. If his description be notsufficiently complete to enable us to obtain a definite understanding ofthe case, he is requested to answer a list of important questions whichare sent him. The people are far more intelligent in these matters thanphysicians are generally willing to admit. A patient is often confusedwhile being personally examined by a physician, and gives imperfect orincorrect answers. After he has left the presence of the physician, hefinds that he has failed to enumerate many of the most importantsymptoms. In consulting by letter, the patient is not embarrassed, hestates the exact symptoms, and carefully reads over the letter to see ifit is a complete and accurate description of his sufferings. In this wayhe conveys a much better idea of the case than if present in person, andsubjected to the most thorough questioning and cross-examination. Thetimid lady and nervous young man write just as they feel; and oneimportant reason why we have had such superior success in treatingintricate and delicate diseases, is because we have obtained such trueand natural statements of the cases from these letters, many of whichare perfect pen-pictures of disease. As bank-tellers and cashiers, whodaily handle large quantities of currency, can infallibly detectspurious money by a glance at the engraving or a touch of the paper, sothe experienced physician, by his great familiarity with disease, becomes equally skilled in detecting the nature and extent of a chronicmalady from a written description of its symptoms. 

URINARY SIGNS. 

A careful microscopical examination and chemical analysis of the urineis 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 isnot overlooked at the Invalids' Hotel and Surgical Institute, where anexperienced chemist is employed to make such examinations and report theresult to the attending physicians. Medical authors, professors, andpractitioners of all schools, admit and even insist upon the importanceof such examinations in diagnosticating diseases. Many practitionersneglect to take advantage of this invaluable aid, while others fear thatif they attach much importance to such examinations they will be rankedwith "uroscopian" or "water" doctors, a class of enthusiasts who claimto be able to correctly diagnosticate every disease by an examination ofthe urine. Persons consulting us and wishing to avail themselves of theadvantages afforded by these examinations can send small vials of theirurine by express. The vials should be carefully packed in saw-dust orpaper and enclosed in a light wooden box. All charges for transportationmust be prepaid, and a complete history of the case including the ageand sex of the patient, must accompany each package, or it will receiveno attention. This saves valuable time by directing the examination intothe 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 andSurgical Institute. ]

[Illustration: Fig. 1. ]

There is a natural, definite proportion of the component elements ofevery solid and fluid of the human body. These proportions have beenreduced to definite standards, a deviation from which affords evidenceof disease. Thus, there being a fixed standard in a normal proportion ofthe elements of the blood, any deviation from it, as in anæmia, leucocythæmia, etc. , indicates disease. So also the standard proportionof the urinary elements being known, any considerable change, either inquantity or quality of its parts, bears unmistakable evidence ofdisease. The invention of the microscope has provided increasedfacilities for detecting diseases by examination of the urine. By theaid of this wonderful instrument, we are enabled to discover withabsolute certainty the various urinary deposits characteristic ofdifferent maladies; thus in Fig. 1, A represents in a general way thesediment of abnormal urine as seen under the microscope. In division Bis represented oxalate of urea upon precipitation by oxalic acid. Nitrate of urea is represented in division C. A deficiency of urea inthe urine, with albumen and casts present, is a most important guide inthe diagnosis of Bright's disease. The average quantity of urea presentduring health is 21. 57 parts in 1, 000. The microscopic examination ofthe urine, notwithstanding the distaste, and even contempt, which manyphysicians 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, withall our other modes of investigation, we might have been unable todetect. 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 aderangement of the digestive functions. It is a matter of surprise thatphysicians generally pay so little attention to the urine when dyspepsiais suspected, since all admit that an examination of that excretionfurnishes unmistakable evidence of the nature and complications of thedisease. In this way we are many times enabled to determine whether theindigestion is caused by congestion or functional disease of the liveror kidneys or by nervous debility. And when such cases are treated inaccordance with the indications furnished, increased success attends ourpractice. In Fig. 2 highly magnified urinary deposits, which indicateimpairment of the digestive functions, are represented. The crystals arecomposed of oxalate of lime and appear in the different forms shown inthe five sections, of octahedral, decahedral, round and dumb bellshapes. The latter are formed in the kidneys, and are sometimesdiscovered 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 otherfunctional and organic diseases of the urinary organs effectcharacteristic changes in the urine, thus enabling us to distinguishthem with certainty and exactness. Some of the various microscopicalappearances of the urinary deposits in diseases of the kidneys andbladder, are represented in Fig. 3. In division A is represented pus andmucus, with decomposition, indicating suppuration somewhere along theurinary tract. In B pus globules are alone represented. In the divisionmarked C are shown blood corpuscles as they are arranged in blood drawnfrom a vein or artery. D represents the same separated, as they alwaysare when present in the urine. In E highly magnified oil globules arerepresented. If present in the urine, they indicate disease of thekidneys. In F are represented epithelial cells, the presence of which inlarge numbers is indicative of diseases of the mucous lining of theurinary organs. 

Fig. 4 represents the microscopic appearance of phosphates in theurine. These are present in great quantity in cases of nervous debilityand kindred affections. By attaching the _camera lucida_ to themicroscope we can throw an image of these urinary deposits upon paper. By the art of the engraver this may be faithfully traced, and thus weare enabled to produce an accurate representation of them. Some of thebeautiful crystalline deposits shown in Fig. 4 represent less than amillionth part of a grain, yet their forms are delineated withgeometrical precision. Earthy phosphates are often mistaken for pus andalso 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 withphosphates is a forerunner of cystitis, or enlargement of the prostategland, or both. In fact, persons so affected are "prone to seriousconsequences 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 indiabetic urine. Pasteur asserts that the germs of this fungus get intothe urine after it has been passed. Urates appear in division B. Theseindicate waste of flesh, as in fevers, consumption, prolonged physicalefforts, etc. Division C pictures urates of ammonia. These appear inalkaline decomposition of the urine; it is isomeric with uric acid inacid urine. In division D is represented urate of soda, which is presentin the tissues of persons suffering from gout. The crystals shown indivision E consist of the same salt. 

[Illustration: Fig. 6. ]

In Fig. 6, division A, is represented purulent matter as it appears inthe urine. The formation of pus in different parts of the genitourinarysystem 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 ofthe cells found in the urine of persons suffering from cystitis or otherinflammatory 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 presenthowever it indicates liability to, or the actual presence of, a calculusor stone in the bladder. In division C is a representation of thedeposits seen in the urine of those who are greatly debilitated. Indivision D are seen epithelial cells mixed with mucus. 

[Illustration: Fig. 8. ]

In Fig. 8, division A, are represented the caudated cells from the deepstructure of the bladder. The cells represented in division B areamyloid 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 semenin the renal excretions. 

We might add many other illustrations of urinary deposits and statetheir several indications, but a sufficient number has been introducedto show the importance and practical value of microscopic examinationsof the urine in revealing obscure diseases. 

Although the microscope is of inestimable value in examining the renalexcretion, it does not entirely supersede other valuable instruments andchemical re-agents in determining constitutional changes. By theurinometer we determine the specific gravity of the urine; by the use oflitmus its acid or alkaline reaction, is ascertained; while variouschemicals, when added to it, produce certain specific changes, accordingto the morbid alterations which it has undergone by reason of disease. By the application of heat, or the addition of a few drops of nitricacid, the albumen, which is invariably present in Bright's disease ofthe kidneys, is coagulated. By the employment of other re-agents we maydetermine the presence of sugar--a characteristic of diabetic urine. Andthus we might mention almost innumerable chemical tests by which theseveral changed conditions of the urine, _characteristic_ of differentdiseases, may be ascertained with _absolute certainty_. 

THE MOST EMINENT MEDICAL AUTHORITIES ENDORSE IT. 

Dr. Eberle, a distinguished allopathic author, thus writes: "Whatevermay be the disease, the urine seldom fails in furnishing us with a clueto the principles upon which it is to be treated. "

Dr. Braithwaite also says: "We can arrive at a more accurate knowledgerespecting the nature of diseases from examining the urine than from anyother symptom. "

Golding Bird, whose writings are regarded as sound and practical by themost learned of the medical profession, says: "The examination of theurine in disease is now regarded as one of the most important aids indiagnosis, and which it would be injurious alike to the welfare of thepatient and the credit of the practitioner to avoid. "

[Illustration: Fig. 9. ]

The eminent Dr. F. Simon writes as follows: "From the physical andchemical state of the urine, the attentive and observing physician mayobtain a great quantity of information for ascertaining and establishinga diagnosis. More than all other signs, the correct examination of thesediment is of importance to the physician. * * * For the medical man itis the compass which guides him in the unlimited chaos of disease andits 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 thatthe fluctuations of the column of mercury are closely associated withthe variable conditions of the atmosphere; so, to the practicalobserver, variations of the urine, as well as the elements composing it, point out with certainty the changes in health, and the condition of theorgans. "

While we recognize the importance of examining the urine as an aid indistinguishing diseases, and have made this old German method ofdiagnosis a special study, yet we do not claim that _all_ diseases canbe unmistakably distinguished by such examinations _alone_. We take aconservative position and have no confidence in that class of ignorantfanatics whose pet hobby is "uroscopy. "

From every person who solicits our professional services, we requireexplicit answers to numerous important questions, that we may know theage, sex, vocation, etc. , as well as the prominent symptoms manifested. 

CONSULTATIONS BY LETTER. 

Formerly, we published in this book a very extensive list of questionsto be answered by those consulting us, but a large experience hasconvinced us that beyond requiring answers to a few leading questions, which we still retain, it is better to let the patient describe themalady in his or her own way and language. After receiving andconsidering such a history, if we do not fully understand the patient'smalady, we will ask such further questions as may be necessary. Thepatient should, however, in addition to writing name, post-office, county, and state, _plainly_, state the name of the town containing thenearest 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 necessaryfor you to labor hard now, how long you have been out of health, andfrom what particular symptoms you suffer most. Follow this with ahistory of your case in your own language. If you find in this volume anaccurate description of your disease, state the page and paragraph whereit occurs. 

FREE CONSULTATION. 

We now make no charge for consultation by letter, but, instead of theone dollar formerly charged by us as a consultation fee, as we aredesirous of making our facilities for treatment known to invalids farand near, we request that all persons writing to us for advice send usthe names of all those within the circle of their acquaintance who arein any way in need of medical or surgical treatment for chronicdiseases. 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 areexcluded from the mails, when discovered, and yet we have receivedhundreds of samples through the mails safely when put in homoeopathic orother _very small_ vials, well corked and carefully packed in a lighttin can or _wooden_ box, or in a light pine stick bored out hollow, thevial being carefully packed in sufficient saw-dust or blotting paper toabsorb all liquid should the vial get broken. Letter postage, that is, two cents for each one ounce or fraction thereof, must be paid uponthese sealed packages. Send the first urine that is passed after risingin 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 themedicines employed by physicians engaged in general practice areprepared from old drugs that have lost all their medicinal virtues, andhence are utterly useless and ineffectual. Many vegetable extracts areinert, because the plants from which they are produced were not gatheredat the proper time. To give the reader an idea of the great care whichwe exercise in the selection and preparation of our medicines, he isrequested 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 thepatient to medicines specially prepared for and adapted to his or herparticular case, and to all necessary attention and advice. Our fees fortreatment are moderate, varying according to the nature and requirementsof each particular case, and will be made known at the time ofconsultation. 

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 thatcredit could be dispensed so indiscriminately. It would not be a correctbusiness transaction for a merchant to send a barrel of sugar or a rollof cloth to a stranger living hundreds of miles away, to be paid forwhen used. Our knowledge and medicines constitute our capital inbusiness, and an order upon that capital should be accompanied with anequivalent. Some applicants refer us to their neighbors for atestimonial of their integrity. We cannot spare the time or employassistants to make such inquiries for the sake of trusting any one. Should credit be thus indiscriminately given, there would necessarily belosses, and, to compensate for these, and the extra expense incurred bythe employment of assistants, our fees would have to be much larger, thereby imposing the burden upon those who _do_ pay. Instead offollowing this method of procedure, we place professional serviceswithin the reach of all, so that a greater number may be benefited. Manyinvalids say that they have paid large sums of money to medical men fortreatment without obtaining relief. Unfortunately our land is cursedwith quacks and unprincipled practitioners, who seek no one's good buttheir own, and it is a defect in our law that it permits such swindlersto go unpunished. Not so reprehensible is the family physician whofails, because his limited and varied practice does not permit him tobecome proficient in treating chronic diseases. 

The following beautiful sentiment of Hood truthfully expresses thesacredness 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, andcordially invite those who desire further evidence of our success incuring chronic diseases to come to the Invalids' Hotel and SurgicalInstitute and satisfy themselves of the truthfulness of our statements. 

We are warranted in saying that our responsibility and disposition forfair dealing are known to many of the principal mercantile houses, aswell as to all prominent American editors. We also refer to our presentand former patients, one or more of whom may be found in almost everyhamlet of America. To all who are under our treatment we devote ourhighest energies and skill, fully realizing that an untold blessing isconferred upon every person whom we cure, and that such cures insure thepermanency of our business. On the contrary, we realize how unfortunateit is for us to fail in restoring to health any person whom we haveencouraged to hope for relief. We are careful, therefore, not to assumethe treatment of incurable cases, except when desired to do so for thepurpose of mitigating suffering or prolonging life; for we never wish toencourage false hopes of recovery. 

TERMS FOR BOARD AND TREATMENT AT THE INVALIDS' HOTEL AND SURGICALINSTITUTE

are moderate, varying with the nature of the case and the apartmentsoccupied. At times so great is the number applying to avail themselvesof the skill of our Faculty, and the advantages which our institutionaffords, that we are unable to receive all applicants. To be sure ofsecuring good apartments, it is well to engage them sometime ahead, andmake an advance payment of fifty dollars or more upon them, which willbe refunded in case acute sickness or any similar cause should preventthe patient from occupying them at the time specified. Complete termsfor treatment and board can be arranged only when personal applicationfor entrance to the institution is made, and the nature and extent ofthe disease and the necessary treatment fully determined by personalexamination of the case. If satisfactory terms and arrangements cannotat that time be agreed upon, or if the case be deemed incurable, anyadvance payments that have been made to secure good apartments will bepromptly refunded. 

SPECIAL ADVICE. 

Those coming here to consult us personally, should bring the money topay for our services and for board and care while remaining here, in theform of drafts on New York City, Boston or Chicago, and _not_ in theform of checks on a local or home bank. Such drafts can be purchased inthe home bank by paying a small amount for the exchange. If moreconvenient, 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 milesaway, that we may personally examine their cases, or perform difficultsurgical operations. We can seldom comply with such requests as the timeof our professional Staff is generally very fully occupied. 

TO PHYSICIANS

wishing to consult us in intricate cases of chronic diseases under theirtreatment, we desire to say that we shall, as in the past, take pleasurein responding to their solicitations. We have all the necessaryinstruments and appliances required in executing the most difficultsurgical operations, and, as we have had much experience in thisdepartment, we are always ready and able to assist physicians who do notpractice operative surgery. In this age of railways and telegraphsmedical and surgical aid can be summoned from a distance and promptlyobtained. 

OUR MEDICINES

as put up for sale through druggists, are not recommended as"cure-alls, " or panaceas, but only as superior remedies for certaincommon and easily-recognized diseases. They are our favoriteprescriptions, improved and perfected by long study and a vastexperience in the treatment of chronic diseases, and have gainedworld-wide celebrity and sale. We are well aware that there are manychronic diseases that can only be successfully treated and cured bycareful adaptation of remedies to each individual case. This isespecially true of the ever-varying and delicate diseases of the kidneysand bladder. It is not less so with reference to nervous debility, involuntary vital losses, with which so many young and middle-aged menare afflicted; and we may also include in this list epilepsy or fits, paralysis or palsy, obstinate gleety discharges, and many other chronicand delicate ailments of which our staff of physicians and surgeons cureannually 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 worldover, been adapted to all classes and forms of chronic diseases, therewould have been no necessity for our organizing a competent staff ofphysicians and surgeons to act as experts in the treatment of difficult, obscure, and complicated cases of chronic diseases. That we keepconstantly employed, in our Buffalo and London institutions, eighteenmedical gentlemen, with such helpers as chemists, clerks, etc. , isindisputable proof that the medicines we offer for sale throughdruggists should not be classed with the humbug nostrums recommended tocure everything. They are the outgrowth of our vast and extendedpractice in the treatment of chronic diseases; are well-tried, world-famed, and _honest medicines_. They are not unduly puffed andlauded, but simply recommended for such diseases as are easilyrecognized and which they are _known to cure. _

NOT CONFINED IN PRESCRIBING

Our physicians, in the treatment of cases consulting us, prescribe justsuch medicines as are adapted to each particular case. _They are notconfined in the least_ to our list of a few put-up or proprietarymedicines (valuable as they are when applicable to the case) but resortto the whole broad range of the _materia medica_, employed by the mostadvanced 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 skilledchemists and pharmacists, and the greatest care is exercised to havethem manufactured from the freshest and purest ingredients. Our Facultyprobably employ a greater number and variety of native roots, barks, andherbs, in their practice then are used in any other invalids' resort inthe land. Using vast quantities of these indigenous medicines, we canafford and do not neglect to have them gathered with great care, at theproper seasons of the year, so that their medicinal properties may bemost reliable. Too little attention is generally paid to this matter, and many failures result from the prescribing of worthless medicines byphysicians who have to depend for their supplies upon manufacturers whoare careless or indifferent in obtaining the crude plants and roots fromwhich to manufacture their medicines for the market. While dependinglargely upon solid and fluid extracts of native plants, roots, barks, and herbs, in prescribing for disease, yet we do not use them to theexclusion of other valuable curative drugs and chemicals. We aim to beunprejudiced and independent in our selection of remedies, adopting atall times a rational system of therapeutics. This liberal course ofaction 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 theinstitutions which he has founded were held by the lamented Garfield, who was one of the Doctor's intimate friends and colleagues while he wasserving 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 contentsnoted. I am perfectly satisfied with the explanation, and ask pardon forthe sharp letter written you some days since. The mails are veryirregular, as you know, and we are too apt to be impatient and attributeour mishaps to the wrong cause. Your honesty, integrity and ability arenot doubted in the least by me. 

I have, perhaps, a higher endorsement of you than any other patientunder your care, and for your gratification I will give it to you. 

Some time since I was in conversation with Congressman Pettibone, ofthis State, when the following conversation took place: "You say, " saidthe Major, "that you have visited Dr. Pierce's medical establishment inBuffalo, New York?" "Yes, sir, I did. " "You found everything asrepresented?" "Yes, sir, as was represented, and which I assure you wasquite encouraging to a man who had traveled as far as I had to visit aninstitution of that kind. " "That man, Dr. Pierce, " said the Major, "isone of the best men of the times. While at Washington, during my firstterm, " he continued, "one day I was in President Garfield's room and afine-looking, broad-foreheaded gentleman came in, and President Garfieldarose and took him by the hand and said, 'Good morning, Doctor, I am soglad to see you, ' and then turned and introduced him to me as Dr. Pierce, of Buffalo, New York. Knowing the Doctor by reputation, andhaving 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 bestmen in the world, and he is at the head of one of the best medicalinstitutions in the world. '"

With this high endorsement, I have unbounded confidence in yourintegrity 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 medicaland surgical staff of the Invalids' Hotel and Surgical Institute is agraduate in medicine and surgery from one or more legally charteredmedical colleges, and several of the members have had many years ofexperience as army surgeons, and in hospital and general as well as inspecial practice. One is a licentiate of the Royal College ofPhysicians, Edinburgh; licentiate of the Faculty of Physicians andSurgeons, Glasgow; licentiate of midwifery, Glasgow; member of the RoyalCollege of Surgeons, London, England; extraordinary member of the RoyalMedical Society, Edinburgh, etc. Another is a graduate of the Universityof Pennsylvania, at Philadelphia; another of the New York MedicalCollege; another of the Buffalo Medical College, and of the College ofPhysicians and Surgeons, New York; another of Cincinnati MedicalCollege, and of the University of New York; another from Buffalo MedicalCollege, and diplomas from all these institutions, as well as from manyothers equally noted, can be seen at the offices of this institution, ifany 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 treatmentof chronic ailments is the Invalids' Hotel and Surgical Institute atBuffalo, under the control of the World's Dispensary MedicalAssociation, of which Dr. R. V. PIERCE is President. The hotel itself isa wonderful affair, combining all the comforts and conveniences of aluxurious home with the most complete facilities for the successfultreatment of all chronic diseases incident to humanity. Dr. PIERCE has aworld-wide fame as a skillful practitioner, and his corps of assistantscomprises many physicians and surgeons of great ability and largeexperience in the treatment of chronic and surgical diseases. Those whohave been treated by the Association are loud in their praises, and weunderstand that the number of its patients increases with eachsucceeding year. The country is full of people who have been "doctoring"year after year without successful results, and the probabilities arethat in a majority of such cases a few months spent at the Invalids'Hotel and Surgical Institute in the care of its medical experts, wouldresult 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 capableprofessional people have established an "Invalids' Hotel and SurgicalInstitute, " under the comprehensive direction and control of the"World's Dispensary Medical Association" at 663 Main Street, in thatbeautiful city. This Institute is organized with a full staff ofeighteen physicians and surgeons, and the hotel is exclusively devotedto treatment of chronic diseases. This corps of doctors make a specialtyof chronic maladies, and the Institute is reputed to have abundantskill, facilities and apparatus for the successful treatment of everyform of chronic ailment, whether requiring for its cure medical orsurgical 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 achievedextraordinary success is Dr. R. V. PIERCE, of Buffalo, N. Y. Theprominence which he has attained has been reached through strictlylegitimate means, and so far, therefore, he deserves the enviablereputation which he enjoys. This large measure of success is the resultof a thorough and careful preparation for his calling, and extensivereading during a long and unusually large practice, which has enabledhim to gain high commendation, even from his professional brethren. Devoting his attention to certain specialties of the science he has socarefully investigated, he has been rewarded in a remarkable degree. Inthese specialties he has become a recognized leader. Not a few of theremedies prescribed by him have, it is said, been adopted and prescribedby physicians in their private practice. His pamphlets and larger workshave been received as useful contributions to medical knowledge. He hasrecently added another, and perhaps more important work, because of moregeneral application, to the list of his published writings. This book, entitled "The People's Common Sense Medical Adviser, " is designed toenter into general circulation. For his labors in this direction, Dr. PIERCE has received acknowledgments and honors from many sources, andespecially scientific degrees from two of the first medical institutionsin 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 enablethe formation of a careful estimate of the efficiency of his treatmentand his medicines, and the verdict, we are glad to know, has beenuniversally 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 andwell-directed effort, not attempting too much, nor creating false ideasas to ability. The only reliable physician, in these days of complicateddisorders and high-pressure living, is the "Specialist, " the man whounderstands his own branch of the business. Such, in his line, is Dr. Pierce. He has written a "Common Sense Medical Adviser, " which is wellworth reading. With strict business honor, high professional skill, reasonable fees, and a large corps of competent assistants Dr. Piercehas made his name as familiar as "household words. "

 * * * * *

From _the Rocky Mountain Herald_. 

Dr. R. V. PIERCE, the greatest American specialist, and proprietor of theWorld's Dispensary, Buffalo, N. Y. , has sent us his new book entitled"The People's Common Sense Medical Adviser, " which is a handsome, largevolume, elegantly got up, with hundreds of wood-cuts and coloredplates, and a complete cyclopedia of medical teachings for old and youngof both sexes. _It has every thing in it, _ according to the latestscientific discoveries, and withal is wonderfully _commomensical_ in itsstyle and teachings. 

 * * * * *

_From the Lafayette Daily Courier. _

Dr. R. V. PIERCE, of Buffalo, distinguished in surgery, and the generalpractice of the profession he honors, has made a valuable contributionto the medical literature of the day, in a comprehensive work entitled"The People's Common Sense Medical Adviser. " While scientificthroughout, it is singularly free from technical and stilted terms. Itcomes right down to the common-sense of every-day life, and, to quotefrom the author himself, seeks to "inculcate the facts of science ratherthan the theories of philosophy. " This entertaining and reallyinstructive work seems to be in harmony with the enlarged sphere ofthought, as touching the open polar sea of evolution. He considers manin every phase of his existence, from the rayless atom to the grandupbuilding of the noblest work of God. Dr. PIERCE is a noble specimen ofAmerican manhood. He has sprung from the people, and with manysympathies in common with the masses, has sought to render them asubstantial 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 whohas been "the architect of his own fortune"--the man who has made forhimself, with his own hands and brain, a princely fortune and anenduring fame. From COMLEY'S History of New York State, containingbiographical sketches of the men who "have given wealth, stamina, andcharacter" to the Empire State, we clip the following brief sketch ofthe distinguished physician, Dr. R. V. PIERCE, of Buffalo: "Every nationowes its peculiar character, its prosperity--in brief, every thing thatdistinguishes it as an individual nation, --to the few men belonging toit who have the courage to step beyond the boundaries prescribed bypartisanship, professional tradition, or social customs. In professionalno less than in political life there occasionally arise men who burstthe fetters of conventionalism, indignantly rejecting the arbitrarylimits imposed upon their activity, and step boldly forward into newfields of enterprise. We call these men _self-made. _ The nation claimsthem as her proudest ornaments--the men upon whom she can rely, in peacefor her glory, in war for her succor. Of this class of men the medicalprofession has furnished a distinguished example in the successful andjustly-celebrated physician, Dr. R. V. PIERCE, of Buffalo, N. Y. , and anyhistory treating of the industries of the Empire State would beincomplete without a sketch of his useful and earnest work. * * *Specially educated for the profession which he so eminently adorns, heearly supplemented his studies by extensive and original research in itsseveral departments. He brought to his chosen work acute perceptive andreflective powers, and that indomitable energy that neither shrinks atobstacles nor yields to circumstances. In physique, Dr. PIERCE is anideal type of American manhood. Of medium stature, robust, hisappearance is characterized by a healthful, vigorous vitality, while thefull, lofty brow and handsomely cut features are indicative of thatcomprehensive mental power and remarkable business sagacity which havecombined to place him among the distinguished men of the age. * * * Asan earnest worker for the welfare of his fellow-men, Dr. PIERCE has wontheir warmest sympathy and esteem. While seeking to be their servantonly, he has become a prince among them. Yet the immense fortunelavished upon him by a generous people he hoards not, but invests in theerection and establishment of institutions directly contributive to thepublic good, the people thus realizing, in their liberal patronage, anew meaning of the beautiful Oriental custom of casting bread upon thewaters. Noted in both public and private life for his unswervingintegrity and all those sterling virtues that ennoble manhood, Dr. PIERCE ranks high among those few men whose names the Empire State isjustly proud to inscribe upon her roll of honor. " Dr. PIERCE has latelyerected a palatial Invalids' Hotel for the reception of his patients, ata cost of over half a million dollars. 

 * * * * *

A MAN OF THE TIME. 

Speaking of Dr. R. V. PIERCE, the _Buffalo_ (N. Y. ) _Commercial_ says: "Hecame here an unknown man, almost friendless, with no capital except hisown manhood, which, however, included plenty of brains and pluck, indomitable perseverance, and inborn uprightness, capital enough for anyman in this progressive country, if only he has good health and habitsas well. He had all these great natural advantages, and one thing more, an excellent education. He had studied medicine and been regularlylicensed to practice as a physician. But he was still a student, fond ofinvestigation and experiment. He discovered, or invented, importantremedial agencies or compounds. Not choosing to wait wearily for thesick and suffering to find out (without any body to tell them) that hecould do them good, he advertised his medicines and invited the wholeprofession of every school, to examine and pronounce judgment on hisformulas. He advertised liberally, profusely, but with extraordinaryshrewdness, and with a method which is in itself a lesson to all whoseek business by that perfectly legitimate means. His success has beensomething marvelous--so great, indeed, that it must be due to intrinsicmerit in the articles he sells, more even than to his unparalleled skillin the use of printer's ink. The present writer once asked adistinguished dispensing druggist to explain the secret of the almostuniversal demand for Dr. PIERCE'S medicines. He said they were in factgenuine medicines--such compounds as every good physician wouldprescribe for the diseases which they were advertised to cure. Ofcourse, they cost less than any druggist would charge for the samearticle, supplied on a physician's prescription, and, besides, there wasthe doctor's fee saved. Moreover, buying the drugs in such enormousquantities, having perfect apparatus for purifying and compounding themixture, he could not only get better articles in the first place, butpresent the medicine in better form and cheaper than the same mixturecould 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, andproved a devoted student, graduating at twenty-three with the highesthonors. 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 inthe prevailing "schools" and accepted truths belonging to thoseprohibited. Every one knows how such daring and destructive innovationsare regarded by the medical profession generally. Dr. PIERCE was noexception to the rule. But he paid no attention to detraction, pursuinghis own way with that energy which proves now to be a most excellentally of his medical instincts. 

The World's Dispensary is to-day the greatest institution of its kind inthe world. More than two hundred persons are employed, eighteen beingskillful physicians and surgeons, each devoting himself to a specialbranch of the profession, all acting together when required, as acouncil. The printing department of the Dispensary is larger than thesimilar 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 theAmerican public as a physician of fine attainments, and his FamilyMedicines are favorite remedies in thousands of our households. As acounselor and friend, Dr. PIERCE is a cultured, courteous gentleman. Hehas devoted all his energies to the alleviation of human suffering. Withthis end in view and his whole heart in his labors, he has achievedmarked and merited success. There can be no real success without truemerit. That his success is _real_, is evidenced by the fact that hisreputation, as a man and physician, does not deteriorate; and the factthat there is a steadily increasing demand for his medicines, provesthat they are not nostrums, but reliable remedies for disease. Thevarious departments of the World's Dispensary in which his FamilyMedicines are compounded and his special prescriptions prepared, areprovided with all modern facilities. 

 * * * * *

_The New York Tribune says:_

"The American mind is active. It has given us books of fiction for thesentimentalist, learned books for the scholar and professional student, but _few books for the people_. A book _for the people_ must relate to asubject of universal interest. Such a subject is the physical man, andsuch a book 'The People's Common Sense Medical Adviser, ' a copy of whichhas been recently laid on our table. The high professional attainmentsof its author, --Dr. R. V. PIERCE, of Buffalo, N. Y. , --and the advantagesderived by him from an extensive practice, should alone insure for hiswork a cordial reception. " Price $1. 50, post-paid. Address, WORLD'SDISPENSARY 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 byability and professional skill, is shown by the magnificent buildings ofthe World's Dispensary and the Invalids' Hotel and Surgical Institute, at Buffalo. While models of architectural beauty and completeness, theirreal worth and usefulness consist rather in the humanitarian objectsthey are made to serve. They stand superior to all institutions of theirkind, not only in material proportions but as well in the medicalknowledge and practical experience of those connected with them. In eachdepartment are those and those only who by natural bent and training arespecially adapted to combating their particular class of "the ills whichflesh is heir to. "

VOCABULARY

OF THE

COMMON SENSE MEDICAL ADVISER, _GIVING EACH TECHNICAL WORD EMPLOYED, REFERRING TO ITS IMAGES/ADVISEWHEN POSSIBLE, AND IN CASE THE WORD WILL NOT PERMIT OF A SHORTDEFINITION, REFERRING TO THE PAGE WHERE A FULL DESCRIPTION OF ITSMEANING 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 withoutthe 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 theteeth. 

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, whichresembles 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, andin some diseases of a painful nature. 

ANGINA (PECTORIS). Violent pain about the heart, attended with anxietyand difficult breathing. 

ANIMALCULA, ANIMALCULE. An animal so small as to be invisible, or nearlyso, 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 stomachand 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 similarsymptoms 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 theexcrement leaves the body. 

AORTA. The great artery of the body arising from the heart. Illus. Page58. 

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 thebrain, lungs, etc. Brain pressure, from rupture of a blood-vessel. 

AQUEOUS HUMOR. The clear fluid contained in the front chambers of theeye. 

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 ofthe 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 beingcut off; as in drowning, inhalation of gases, sun-stroke, etc. 

ASPIRATOR. An instrument for the evacuation of fluids from the cavitiesof 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 andemployed in exercising the sense of hearing. 

AUSCULTATION. Diagnosing diseases by listening, either with or withoutinstruments. 

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, whichholds 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 anda core. See page 443. 

BOLUS. A large pill. 

BOUGIE. A long, flexible instrument used for dilating contracted canalsand passages. 

BREACH. Some form of hernia of the abdomen. See page 862. 

BROAD LIGAMENTS OF THE UTERUS. Folds of the peritoneum which support thewomb 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 depositof solid matter; of lime, soda, uric acid, urates, oxalates, etc. 

CALISTHENICS. Healthful exercise of the body and limbs, for purposes ofstrength and agility. 

CANCELLATED STRUCTURE. Cells communicating with each other forming astructure 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 intestinesby 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 theribs, 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 urethrafor 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. Thewhole 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 agreenish 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 backof 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, attachedby 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 arousethe 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 abandage pressure can be applied, or by wetting in hot water, a part canbe 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 theeyeball. 

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 prostategland. 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-likeshell. 

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 thebladder. 

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 theproper 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 cellsescape with the urine. 

DIABETES. Defined on page 835. 

DIAGNOSIS. The determination of a disease by its symptoms orcharacteristics. 

DIAGNOSTIC. The symptoms by which a disease is distinguished fromothers. 

DIAPHORETIC. Medicines which increase perspiration. 

DIAPHRAGM. Defined on page 32. 

DIATHESIS. Peculiarity of constitution. Predisposition to certaindiseases. 

DIGESTION. The function by which food passing along the alimentary canalis 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 andprotects underlying parts from injury. 

DISINFECTANTS. Substances which arrest putrefaction. 

DISLOCATION. The act of or state of, being forced from its propersituation. 

DISTILLED. Separated by heat from other substances and collected bycondensation. 

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 ofthe 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 phosphoricacid and a base. 

ECCHYMOSIS. Black or yellow spots produced by effused blood. Black eyeIs 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 ofelectricity. 

ELIMINATED. Discharged, expelled. 

EMACIATION. Leanness in flesh. 

EMBRYO. The young of an animal at the beginning of its development inthe womb. 

EMETICS. Medicines which empty the stomach upwards. 

EMMENAGOGUES. Medicines which favor or cause menstruation. 

EMPIRICISM. Practicing medicine upon results of experience, generally bya 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, butpreventing the introduction of foreign bodies. 

EPITHELIAL CELLS. Cells belonging to the epithelium. 

EPITHELIUM. The thin covering upon the lips, nipple, mucous and serousmembranes 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 theblood, 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 anddoes 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 ovaryto the womb. 

FARADIZATION. The application of electricity by inductive currents. 

FASCIA. The white fibrous expansion of a muscle which binds partstogether. 

FATTY DEGENERATION. The deposit of particles of fat instead of propermuscular 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 theformation of pus. 

FISSURE. A crack. 

FISTULA: FISTULÆ. Small canals or tubes which carry pus or otherliquids through the flesh. 

FISTULA, URINARY. The abnormal communication between the urinarypassages and the external surface. 

FISTULOUS OPENINGS. The outer end of canals or tubes which carry pus tothe surface. 

FLATULENCY. Wind gathered in the stomach or bowels. 

FLEXION OF THE WOMB. A partial misplacement in which the womb is bentupon 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 andfore-finger. Pincers. Obstetrical forceps embrace the head of thefoetus. 

FORESKIN. That part of the skin of the penis which is prolonged over thehead 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 boneprojects 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 itsupper 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 ofthe 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 orvagina, caused by impure connection. Clap. 

GRANULAR CASTS. Moulds of epithelium found by the microscope in chronicBright'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 itsscar. 

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 bodybecome emaciated. 

HEMIPLEGIA. Paralysis affecting only one side of the body. 

HEMORRHOIDAL VEINS. The veins about the rectum which enlarge and formpiles. 

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 thespinal column within the pelvis. 

HOMEOPATHY. Defined on page 294. 

HYALINE CASTS. Glassy appearing substances found by the microscope inurine 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 ofhealth. 

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 andneedle-like point, by which medicines are lodged immediately under theskin. 

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 along time. 

IMPERFORATE. Without a natural opening. 

IMPOTENCY. Loss of sexual power. 

IMPREGNATION. Imparting the vital principle of the sperm-cell to thegerm-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, asitch, syphilis, etc. 

INFILTRATION. The passage of fluid into the cellular tissue; as inGeneral Dropsy. 

INFLAMMATION. Defined on page 398. 

INFUSION. Defined on page 303. 

INGUINAL CANAL. A canal situated in the groin, through which thespermatic cord passes. The common seat of Hernia. Illus. Page 862. 

INOCULATE. To communicate a disease by inserting matter in the flesh; asby 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; theheadquarters 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 ofa lance. 

LARYNX. That portion of the air-passage indicated in the male by "Adam'sApple. "

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, previouslycontinuous. 

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 arresthemorrhage. 

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 theliver, 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 lymphaticvessels. 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 improvecirculation 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 theperineum and part of the urethra are cut; the prostatic portion of theurethra 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 andmental 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 cavitieswhich secretes a fluid by which it is constantly lubricated. 

MUCUS. A mucilaginous fluid found on the surface of certain membraneswhich 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. Page111. 

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, fordiagnostic purposes. 

OPTIC NERVE. The nerve connecting the brain and eye, and employed in thesense 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 oflime. 

OS UTERI. Mouth of womb. Illus. Page 206. 

OVA. Plural of ovum. 

OVARIES. Two ovoid bodies situated either side of the womb. Illus. Page206. 

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 releasefrom 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 thebody

PARASITES. Animals which live in the bodies of other animals; as thetape-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 ofthe lower jaw, and secrete saliva. 

PAROXYSMS. The periodical attack, fit or aggravation in the course of adisease. 

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 isthe knowledge of disease. 

PEDICLE. The stalk or narrow part of a tumor by which it is attached andsupported. 

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 issupported 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 ofthe 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 andthe 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 foodis moved forward. 

PERITONEUM. The membrane (serous) which lines the abdominal cavities andsurrounds the intestines. 

PERITONITIS. Inflammation of serous membrane lining abdominal and pelviccavities. 

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 airpasses when breathing and the food when swallowing. 

PHIMOSIS. Elongated prepuce

PHLEGMONOUS. Affecting the cellular membrane. The common boil is anexample. 

PHOSPHATE. A substance containing phosphorus. 

PHOSPHATES, EARTHY. The white deposit in urine composed of phosphoricacid and a base. 

PHTHISIC. Consumption. By some the word is used for Asthma, ordifficulty in breathing. 

PHTHISIS. Consumption. See p. 497. 

PHYSIOLOGICAL ANATOMY. The branch of medicine that defines the organs ofthe body and their particular actions. 

PHYSIOLOGY. The science which treats of the phenomena and functions ofanimal 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 otherunnatural 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 thenasal 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 acloth 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 wirewith 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: asthe 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 ofthe 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, coveredwith 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, " andhaving 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 isfirst perceptible; between the fourth and fifth months of pregnancy. 

R

RADICAL CURE. A cure in which the disease is entirely removed, root andbranch. 

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 anunnatural 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 redblood 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 topfalls back against the rectum. 

REVULSION, REVULSIVE. Calling the blood away from the diseased part. 

RICKETS. A disease in children characterized by crookedness of the spineand long bones resulting from scrofula or poor and insufficient food. 

RICKETY. Affected with rickets. 

RINGS (HERNIAL). Circular openings with muscular edges through which avessel 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 openocean, 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 healthyretreat. 

SCALES. The epidermis or outer part of the skin consists of minutescales. 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 orinsufficient food. 

SCORBUTUS. Scurvy. 

SCROFULOUS. Suffering from a condition of the system characterized byenlargement of the glands, eruptions, etc. , with great susceptibility tocontagion. 

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 acanal 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 thenervous system. 

SEDENTARY. Requiring much sitting. 

SELF-POLLUTION. See SELF-ABUSE. 

SEMEN. The secretion of the testicles which is thrown out during sexualintercourse 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 page207. 

SEPTIC. That which corrodes or produces putrefaction. 

SEPTICÆMIA. Blood-poisoning; usually by absorption. 

SEQUEL. That which follows; the condition or malady which follows adisease. 

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 healthypart, 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 ortreatment. 

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 and718. 

SPERM. See SEMEN. 

SPERMATIC CORD. The mass of arteries, veins, nerves, absorbents andtheir 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 theother, 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 GumArabic, 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 thefood-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 theperspiration. Illus. Page 70. 

SUPPORTERS (UTERINE). Instruments intended to hold the womb in itsnatural 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 ofwounds to bring them together. Thread is then wound around the pin tohold the edges in place. 

SUTURES. The ragged edges of bones by which they are joined to eachother. Stitches of thread to bring the edges of a wound together fortheir union. 

SYMPATHETIC NERVE. Defined on page 101. 

SYMPTOM. A change in the body or in its functions which indicatesdisease. 

SYMPTOMATIC. Pertaining to symptoms. 

SYNOVIAL MEMBRANE. The lining of a joint, which from its oily secretionallows the bones to move freely upon each other. 

SYNOVITIS. Described on page 452. 

T

TAPPING. Removing collected fluid by introducing a hollow tube throughthe flesh. 

TEMPERAMENT. Peculiarities of the constitution manifested by traitswhich we denominate character. 

TENESMUS. Straining at stool. 

TENT. A compressed, dried cylinder of sponge, previously treated withGum Arabic, which enlarges the canal in which it is placed by expansionfrom 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 inthe 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 determineits 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 seendistinctly. 

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 ofa perforator within a cylinder. 

TRUNCATED. Shaped like a pyramid with its top cut off. 

TRUSS. A mechanical appliance for preventing protrusion orstrangulation. 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 thefoetus from the placenta or afterbirth. 

UMBILICUS. The Navel. 

UNSTRIATED. Not grooved or striped. 

URÆMIC. Pertaining to blood-poisoning from the presence of urea in thecirculation. 

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 urineis voided. Illus. Page 207. 

URETHROTOMY. The operation for opening the urethra for the removal ofstricture. 

URIC ACID. A constituent of the urine. 

URINARY FISTULA. Abnormal communication between the urinary passages andthe 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 constrictioncalled the internal orifice, is a cylindrical space called the canal. Above this to the fundus or base is a triangular and flat space calledthe cavity. 

V

VAGINA. A canal, five or six inches long, situated between the vulva andwomb. 

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; distinguishesbetween 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 openingbetween these projecting parts. 

W

WALLS. The sides of an enclosure, as the walls of the vagina, which tosoma 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 timesmade it their business to watch for sick and infirm people on the way toour institutions, and divert them into the hands of "sharpers, "confidence men and swindlers. These men have watched for the coming ofinvalids on the cars, in and around the depots, in the offices of thehotels located near the depots, and if inquiry was made for ourinstitutions, or if the object of the visit to the city was made knownor suspected from the invalid appearance of the traveler, they at oncecommenced 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 TOBE POLICEMEN, IN OR ABOUT OUR DEPOTS. CONFIDENCE MEN OFTEN ASSUME ASTYLE OF DRESS SIMILAR TO THAT WORN BY POLICEMEN. 

SECOND. --LET THE OBJECT OF YOUR VISIT TO THE CITY BE KNOWN TO NO ONEWHOM YOU MEET ON THE CARS, OR IN THE DEPOTS OR NEAR THEM. 

THIRD. --IF YOU HAVE A CHECK FOR BAGGAGE, WHEN THE BAGGAGE-MAN COMESTHROUGH 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 FORIT, PAY HIM 25 CENTS ONLY AND HE WILL HAVE IT DELIVERED AT THE INVALIDS'HOTEL AND SURGICAL INSTITUTE. 663 MAIN STREET. (Do not forget thenumber). You had better, also, procure a ticket from this baggage-man, or agent, for a _coupe_ or carriage to our place, for which you willhave to pay only fifty cents. (Outside prices are higher. ) This savesall trouble and anxiety, as the agent will look carefully after bothyourself and baggage, and you are sure of reaching our place promptlyand safely. If you have only hand-baggage, such as bundles, traveling-bags, or similar luggage, you can take it with you in thecarriage without extra cost. 

Mr. C. W. Miller, whose agents solicit on all the in-coming trains forthe delivery of passengers and baggage, has an office in every passengerdepot in this city, to which you can apply if, by any chance, you misshis agent on the train. 

THE INVALIDS' HOTEL AND SURGICAL INSTITUTE IS OPEN DAY AND NIGHT, ANDYOU 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 COMFORTABLEINVALIDS' HOME. 

If all we say of our institutions, and our advantages and facilities forthe successful treatment of disease is not found, on your arrival andinvestigation, to be just as we have represented them, WE WILL PAY ALLTHE 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, maynot be out of place. 

KEEP YOUR BUSINESS TO YOURSELF WHILE ON THE ROAD HERE, ALSO WHEN ABOUTTHE 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, 663MAIN 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 marineanimals, 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 haveobserved the distinction which metaphysicians have recently made. Theyemploy the term psychical to indicate the relation of the human soul tosense, appetite, propensity, etc. , and psychological, as indicating theultimates of spiritual being. In this manner we use the word psychicalas describing the relationship of the soul to animal experiences andbeing, and psychological as referring to the spiritual potencies of thesoul. The distinction being introduced, we continue its use rather thencoin new words. 

Footnote 5: Certain disturbances of the bodily organs excite fear. Theapprehension of danger, or simply mental excitement, does not explainwhat is called "water fright, " "stage fright, " terror excited by theraging of a storm, or the rocking of a boat. In such instances the heartmay beat heavily, the respiration be irregular and attended byprecordial oppression, giddiness, weakness, and physical inability toarticulate a word or recall a thought. These bodily conditions are notsubject to the control of the will, but arise when individuals areperfectly assured that no danger threatens. At other times, as in afearful tempest upon the sea, although the danger be imminent, if thebodily functions are not disturbed, there is not the least manifestationof fear. 

Footnote 6: A _placebo_ is a harmless and valueless prescription, whichphysicians sometimes make merely to gratify the patient, as a dose of"bread pills, " etc.