ON THE TREATMENT 
OF 
FIBROIDS OF THE UTERUS 
BY MEANS OF 
DRY EARTH. 
WITH OUTLINE TRACINGS OF THREE CASES SO TREATED, 
IN THEIR VARIOUS STAGES OF PROGRESS. 
y^Y 
ADDINELL HEW SON, Senior, A.M., M.D., 
PHILADELPHIA, PA. - 
READ BEFORE THE OBSTETRICAL SECTION OF THE AMERICAN MEDICAL ASSOCIATION, 
June 10, 1880. 
PHILADELPHIA: 
COLLINS PRINTER, 105 JAYNE STREET, 
1880. ON THE TREATMENT 
OF 
FIBROIDS OF THE UTERUS 
BY MEANS OF 
DRY EARTH. 
WITH OUTLINE TRACINGS OF THREE CASES SO TREATED, 
IN THEIR VARIOUS STAGES OF PROGRESS. 
ADDINELL HEWSON, Senior, A.M., M.D., 
PHILADELPHIA, PA. 
READ BEFORE THE OBSTETRIC A Ij SECTION OF THE AMERICAN MEDICAL ASSOCIATION, 
June 10, 1880. 
PHILADELPHIA: 
COLLINS PRINTER, 105 JAYNE STREET, 
1880. ON THE TREATMENT OF FIBROIDS OF THE UTERUS 
BY MEANS OF DRY EARTH. 
WITH OUTLINE TRACINGS OF THREE CASES SO TREATED 
IN THEIR VARIOUS STAGES OF PROGRESS. 
Gentlemen:— 
I must first acknowledge the compliment paid to me, and which 
I highly prize, namely, that of having been asked to make this 
address before you to-day. As many of you are aware, I have 
been for more than twelve years most zealously engaged in study- 
ing the “Uses of Earth in Surgery.” All of the work involved 
in such stud}7 has been done under the bans of ridicule, of mal- 
ice, and, if worse, of assertions of unsoundness of mind, and that, 
too, by men in the profession who knew such to be untrue. 
Thank God! I have not only outlived such villany, but can 
even boast of having been well rewarded in my successes of the 
treatment in the single subject on which I shall have the honor 
to address you to-day. 
Some eight years ago I was, one morning, in the south of 
France, and whilst eating my breakfast was commenting on the 
public spirit of the famous resort in which we then Avere, on its 
having a daily paper with a list of the most recent arrmils at 
its hotels. I had scarcely uttered my remark, when the waiter 
presented me with a telegram, the direction of which, for me, 
Avas correct in every detail. I exclaimed, “why even this is 
better than Avhat I get at home! They have spelt all my name 
right!” I immediately opened the message, and to my utter 
surprise it was from one of the most famous anatomists of Ame- 
rica. It was, to come cut his thigh off—he was then over ten 
miles away from me. I hastened without dela}7, as I Avould to 
any stranger in a strange land avIio I kr.eAv Avas such a suf- 
ferer, as he must be from the wording of bis summons. I, how- 4 
TREATMENT OF FIBROIDS OF THE UTERUS 
ever, had nothing to take with me but my pocket case and a 
pound of prepared clayey earth. Such, indeed, had often been 
my only resources when caught away from home on this side 
of the Atlantic, travelling, as then, for rest and recreation. 
I was not long in reaching the doctor, and in determining his 
condition, and what was to be done for him. lie had an open, 
suppurating knee-joint of the right side, which had evidently 
been fully laid open on each side of the patella by the hands of 
a skilful surgeon. Such an operation, he told me, had been done 
by one of the best of American surgeons, and the same high au- 
thority had told him, some time previous to his leaving home 
for Europe, that if he should have another attack of suppuration 
in the joint like that for which he had made these free incisions, 
he should send to the nearest surgeon and have the limb re- 
moved above the knee. I examined it carefully, took into con- 
sideration all the details of the case, and then said, candidly, 
“My dear doctor! I am, like yourself, a stranger in a strange 
land, and have come promptly and honestly to you to see what 
I could do for 3*011 in m3* desolate state as to instruments. But,” 
said I, further. “ even if I had the necessary instruments I would 
not 3’et sacrifice that limb.” “What!” he exclaimed, “ would 
you still do?” I said I would make still another attempt to 
save it, and that by covering it with clean earth. “Ah!” said 
he, “that is just the thing I had in my mind when I telegraphed 
for 3*ou this morning after reading of 3rour arrival in . I 
wanted to try the dry earth treatment.” “Hurrah!” said I, 
“ not onl3* for Mother Earth, hut for the public spirit of j>eople 
in the place which sustains a 1 ively enough paper to keep all 
advised of the most recent arrivals in it. If it had not been for 
that paper I would have been away in twenty-four hours’ time, 
and my whereabouts afterwards discovered too late for me to do 
3*ou any service.” I went to work at once, and soon had the 
joint enveloped with the earth, and he was expressing himself, 
constantty*, delighted with the relief it gave him before I got 
everything property adjusted about him. The application of 
the earth was made in my usual manner, namely, that of filling 
the cavities and suppurating surfaces with clean, finety pow- 
dered claye3* earth, and retaining this in place by strij« of ban- 
dage two and a half inches wide, which were spread with a 
thick paste made of the earth and water. The layer of bandag- 
ing was made in the ordinary way of strapping the knee, and, BY MEANS OF DRY EARTH. 
5 
when dried, held everything intact. When I saw my patient 
the next morning, he reported that he had the best night’s rest 
he had had for many a night, and that, too, without any of the 
anodynes lie had been in the habit of using, and which I tabooed 
at my interview the day previous. He was delighted with the 
relief he had gotten. Each subsequent day he improved, and 
at the end of two weeks he was out of doors on one of his old 
catches, free of pain or suffering of any kind, and confident of 
his radical cure being at hand. 
lie then (at the end of two weeks) stated that there was a 
lady in the town—an old patient of his—on whom he had made 
an explorative operation for ovariotomy some years previous, 
lie had then made a section in the left side over nine inches 
long where he found a multilocular fibroid involving the uterus, 
ligaments, and deep pelvic tissues to such an extent as to render 
its removal absolutely impossible. There was nothing for him 
to do hut to return the mass and close up the wound. Prior to 
doing this, however, he put the immense mass in scales and 
determined its weight, as accurately as he could under such cir- 
cumstances, to be over thirty pounds. He then returned it into 
the abdomen and closed up the wound. The patient recovered 
from this operation, and then expressed her determination never 
to let the doctor be beyond her reach. 
When he was sent to Europe she was constantly near him, 
always in the same town where he was. And now, from what 
she had seen from my treatment with him, she was sure I could 
cure her, and nothing would satisfy her until I had seen and 
examined her, and given her a positive opinion as regards this 
point. I was candid with her, and said one’s prognoses in all such 
cases must always be guarded, but that if I could not make a 
cure of her I could give her some positive relief. Of this I was 
sure. For, from the effect observed immediately after the appli- 
cation of the earth dressing, I had learnt long since to make 
this as a positive promise, not always before or after the first 
application, but certainly within the time of the first five of 
them. If there was relief then, we might always look for that 
being positive and permanent. 
She readily let me apply the dressing. It was a layer of the 
paste of clay over the abdomen, made to lay close by smearing 
it with a wooden spatula, and then retaining this layer in place 
by a series of bandage-strips well smeared on their inner side 6 
TREATMENT OF FIBROIDS OF THE UTERUS 
with the paste of clay, and arranged on a hroad board so as to 
overlap each other slightly, just as the scnltitus is applied. This 
dressing of the clay I had originally made a full half inch thick, 
hut soon had learned that a quarter of an inch was sufficient. 
My purpose of mixing it into a thick paste was to adopt the 
easiest way of applying it with security for its remaining in situ 
when it became dry. To increase this security I had in the ear- 
liest of my uses of the clay, or earth-dressings, resorted to tfec 
expedient of laying a piece of tarlatan gauze of loose texture on 
this layer of earth before applying the retaining bandage. This 
practice I have frequently continued, and have never found a 
better expedient for the purpose. The four years’ experience 
and experimentation, which I had then gone through with, had 
taught me, also, that the efficiency of earth as a discutient 
agent was essentially due to the earth being dry, and in that 
state kept in complete contact with the cutaneous covering of 
the growth. To make it stick I have mixed it into a paste 
with water; the rapidity of this drying has been dependent, not 
only on the locality and the thinness of the application, but also 
on the intensity of the action almost immediately set up in the 
dressing. For here, as in every other previous case in which I 
had applied the earth, heat was quickly generated, so as to make 
such an increase of temperature readily perceptible in contrast 
with that of the mixture of clay and water in the bowl. 
The details of the preparation, mode of applying, and direct 
effects of the earth-dressing, which were the same in this as in 
many other cases familiar to me at this time, must, however, 
he postponed until I have completed the details of this and some 
other cases which I think proper to introduce to you as illus- 
trative of the earth’s action on fibroids of the uterus. 
Dr. ’s patient the next day, the day after my first appli- 
cation of the earth-dressing, was relieved in every respect. She 
was not only relieved of pain, hut diminished in size in every 
direction. My plan was to measure her by a tai»e measure 
around the chest at the xyphoid; three inches above the umbili- 
cus; at the same; three inches below the same; and across from 
one anterior superior spinous process to the other. This was 
done with a strong, unyielding measure, drawn as tightly as 
possible. Such a method of measuring I have now abandoned 
for a more accurate one. Its use was, however, definite and 
accurate enough to show the changes occurring daily in her BY MEANS OF DRY EARTH. 
7 
case. My present plan of making measurements I will explain 
hereafter. 
The patient’s condition steadily improved from day to day, 
so that at the end of three weeks from my first application of 
the dressing she was reduced nearly one-half in size. She was 
full of life and spirits, declaring that she was going to desert 
her old doctor, and hang on to her dirty one. “Oh!” said I, 
“ that won’t do. I am no poacher, even in a foreign land. You 
are Dr. ’s patient, and it is only with his consent that you 
will adopt any such plan.” “ I will make that all right,” said 
she, “ the doctor and I are old friends.” “ Very well,” was my 
reply. 
The next day the doctor came to me, and said, “Do let Mrs. 
join your party. You will be the means of curing her.” 
“Very good,” was my reply; “I will he most happy to do all 
I can towards such a result. But it was not to be done in her 
way without your approbation.” “ Take her, by all means,” 
said he, “you have already been detained by the two of us over 
a month, and you must be getting impatient to be moving on 
with your family.” I said, “Yes, it is high time I was moving. 
I have been here five weeks, but would not, except for the 
attraction of your cases, have staid here twenty-four hours. I 
am well satisfied with the relief I have given you both, and 
would not now be thinking of leaving you, except that I think 
you can take care of each other.” “ Oh, no,” said he, “you are 
entitled to the credit in both our cases.. Take her with you, and 
I will be most ready and the first to credit you with our cases.” 
My party started in a few days, the lady in the same train, 
and she was always for twelve weeks from the time I began her 
treatment constantly under my observation. We went through 
Switzerland, Austria, Prussia, Holland, and the north of France, 
reaching Paris the Monday of a week made famous by the 
assembling of a great medical congress there. 
Beading over the list of arrivals to my patient, I came to the 
name of our mutual friend, the doctor; but I quickly said, 
“ this is Dr. and wife, and it cannot be our doctor, for he 
was a widower when I left him.” “ Oh !” said she, “ that is all 
right; you made such a good cure of him before leaving 
that he has got married again.” 
And so it was. I went immediately to see him, found him 
well, with the joint all closed, and free of osteal and periosteal 8 
TREATMENT OF FIBROIDS OF THE UTERUS 
pains. His first inquiries were, as anticipated, about the lady. 
I said she was doing well, and had sent a message by me for 
him to invite all the great gynaecologists who had seen her with 
him, and were then in Paris, to come to see her with him on 
Wednesday. They all came, making a party of eleven. She 
was ready in bed to see them. They were marched in single 
file, surrounded the bed, and all made their bows, and, as it 
were with one voice, congratulated the patient on her looking 
so well. She did look wonderfully well, entirely free of that 
expression which she wore when I first saw her, and which is 
universally recognized as so characteristic of the sufferers from 
these tumors. They all, however, iin.mediately cast their eyes 
to the locality of her tumor. This was done so instantaneously 
that her eyes and mine involuntarily met, and neither of us 
could restrain a smile. I at once invited the head of the party 
to examine the patient. He said: “Certainly, if it is the lady’s 
wish.” She exclaimed: “Ob, yes! I want you all to examine 
me.” This great surgeon, famous in Paris for the gentleness 
of his manners, approached closer to the bed, and gently drew 
off the bed-covering. As be did so, she as quietly straightened 
out her limbs, which had been previously Hexed high up, and 
removed from off her abdomen a pillow, and then there was no 
tumor visible. “My G.»d!” said the great man, “what have 
you been doing here!” “Only practising a Yankee notion,” 
was my answer. 
Since then (1873) there has not been a j’ear passed without my 
seeing or hearing of this lady as a perfect cure. It has certainly 
been not a mere coincidence or a want of previous care and 
treatment—she had been thoroughly explored. There was no 
mere phantom tumor—the doctor bad once had it in his bands 
and found it to weigh over thirty pounds, and that, too, by 
actual weight. Had it undergone cure by a spontaneity of na- 
ture? Strange such did not begin before, and only manifested 
itself after the first earth dressing! The doubter, still more the 
denier of a cure here, is, I think, beyond being convinced. Is 
he to be satisfied by multiplying such cases? That I can now 
readily do. I can furnish the details of over fifty such cases 
which I have seen, and but one fatal case, made so by an inter- 
current malady, the particulars of which I shall hereafter show 
were not merely accidental! 
Such results must be consequent on what was done for the BY MEANS OF DRY EARTH. 
9 
eases, and that, too, after they came under my treatment. They 
had all been under previous treatment; they had all been exam- 
ined and diagnosed by others; most of this number had been 
pronounced incurable, beyond the reach of the knife, and had 
tried the muriate of ammonia and the ergotine and hyposulphite 
treatment long enough to demonstrate that their cases were 
growing worse under them. No one can expect me to make a 
comparison of them with a like number of cases of a skilful 
ovariotomist. I cannot, indeed, follow to their results all those 
for whom I have chosen this treatment. Many of such have 
come from the country and have remained but a short time—a 
week, or ten days at the utmost—and having been quickly re- 
lieved of pain and feeling confident that they could pursue the 
treatment without me, have gone home. When they got there 
they were in a condition easily to be persuaded or ridiculed out 
of perseverance with it by their family doctor, who, knowing 
nothing about it, would argue that it was absurd in the very 
conception of the idea of using dirt to cure anything. 
Many men in the profession, who were possessed of a little 
more courage and liberality than the above, or than those who 
relied on the dictum of their former teachers, have sought infor- 
mation of me, and in doing so, have shown how little they had 
endeavored to study the subject. One man, a doctor, wrote me 
a letter that he had tried the dirt, in the case of his wife, who 
had an intra mural fibroid, but that she could not endure the 
effect of the stones in the dirt he had used with her over eight 
or ten hours. Was that man a competent judge of the value of 
dry earth in surgery? I think not. 
A case of fibroid was once under my care some six weeks, and 
did not improve as rapidly as she thought she should ; she was, 
however, doing well. She went home, consulted a surgeon on 
her way, and submitted to his plan, excision of the uterus and 
all. Forty-eight hours afterward her body was in the hands of 
the undertaker. Such a case is not to be considered as a fair 
test of the earth-treatment, whatever it may be as to excision 
of the uterus. I certainly have the right to ignore it, in mak- 
ing out a list of cases treated by my plan. We might as well 
saddle on the ovariotomist all the cases which seek his advice, 
but do not follow it by undergoing his operation. 
But I must give some details of cases which I hope will con- 
vince the doubter of there being an action in earth of extraor- 10 
TREATMENT OF FIBROIDS OF THE UTERUS 
dinary value. I will here rely on my most recent experience; 
but before giving these details, I must explain my mode of secur- 
ing the most'essential points, the memoranda of the changes in 
the form and size of each growth. This I have recently done 
effectually by using a strip of sheet-lead, an inch wide, one-eighth 
or sixteenth of an inch thick, and about twenty or more inches 
long. This is a recognized means of making tracings. Draw- 
ing this quickly and several times through a folded towel, it 
becomes more flexible, and can readily he adapted to the contour 
of the patient; and after allowing it, when placed flat on the 
parts, a few minutes to get cooler, it is easily lifted up, and a 
tracing of its margin made on a strip of paper. Such tracings I 
make at each dressing, always from xiphoid to symphysis, and 
across from one anterior superior spine to the other. With 
these I have preserved accurate memoranda of sensational and 
other effects of the earth, and the histories of the cases. 
With this preliminary point of the mode of preserving rec- 
ords of the changes in cases, from day to day, or a longer period 
of time being decided, I will pass to the reciting of a few cases, 
demonstrating more fully than I have done, the effect of the 
earth on their reduction in size. 
Case I.—Mrs. II , aged 40 years, noticed six years pre- 
vious, when menstruating, a swelling on the right side of the 
median line; this was very painful. She had had but one 
child, then (when I saw her) fourteen years old; ami although 
always regular after that birth, never was so without great 
pain. When I first saw her, she was a remarkably thick-set 
person, and looking as though she was near her time of de- 
livery. Then she measured from xiphoid to symphysis full 
sixteen and a half inches, by a broad steel measure. The same 
measure, drawn as tightly as possible around her body at the 
xiphoid, yielded thirty-one inches; at three inches above the 
navel, thirty-four inches; at tlie navel, thirty-eight inches, and 
at three inches below the navel, thirty-six inches. The surface 
of the abdomen was very painful all over, hut especially so in 
the region of the navel. She was suffering too acutely at this 
time (when I first saw her) to allow of any explorations j>er 
vaginam, or heavy palpations. I applied the dressing at once, 
and she said it was very pleasant and soothing. I forbade her 
taking any anodynes, to which she had been accustomed, and I BY MEANS OF DRY EARTH. 
11 
did not visit her for the purpose of removing the dressing until 
the end of forty-eight hours. She was then entirely free of 
pain, with the dressing so loose that I could pass my hand rea- 
dily between it and the walls of the abdomen, and push it down 
below the navel. After peeling off all that was adherent of the 
dressing, and dusting off the surface—I never wash it off—I 
measured her for the effects of this first, dressing, and got from 
xiphoid to symphysis, only thirteen and a half inches; absolutely 
three inches less than it was two days previous; at the waist, or 
three inches above the navel, there was the same reduction of 
three inches; at the navel, the reduction was four inches; whilst 
at the lowest point below the navel, previously taken, there was 
a reduction of but one inch. At the end of the next period of 
forty-eight hours, when I went to renew the dressing for the 
Fig. I.1 
1 This and all other figures represent accurately one-fourth the size of the 
originals. 12 
TREATMENT OF FIBROIDS OF THE UTERUS 
second time, there was a similar reduction, as you can readily 
see from my tracing then taken. (See Fig. 1.) Now I could 
not only handle the abdomen, hut knead it everywhere. There 
was no tenderness about it then; I could isolate a mass extend- 
ing up the mesial line above the navel; it felt about the size of 
a child’s head, and could be moved to either side; the sound in 
utero showed this to he growing from the fundus, and fixed 
closely to it. 
The last tracing in this case, taken four weeks after the first, 
shows what intermediate effect the earth had had on the 
growth. The third and the fourth set, which you will notice 
are very close to each other, record the condition during the 
menstrual flux. This patient, as all I have treated, not only 
wore the dressing, but had it renewed, if it became detached 
during this period. Her freedom from pain was constant, and 
the flux not only healthier than formerly, but more abundant. 
The next case I shall recite briefly is of interest, on account 
of the complication associated with the tumor, and which pre- 
vented its recognition until the tumor had been in existence 
some time. 
Case II. Miss , set. 28 years, a fair brunette, has been 
under treatment over eleven years by a specialist of great expe- 
rience for curvature of the spine. She had always suffered much 
with her menstruation, which was always profuse and too fre- 
quent. The curvature of her spine, when detected at seventeen 
years of age, had been looked uj>on previously as a sequence of 
carelessness of carriage and stooping at school. It was a lateral 
curvature to the left in the upper dorsal region, with the usual 
projection of the base of the scapula there. 
The treatment that had been adopted for this was essentially 
steel apparatus pressing on the crests of the ilia. Soon she com- 
plained of pain there on the right side. Then the doctor dis- 
covered some swelling in the abdomen, deep down, and to the 
right of the median line. This spot was always painful, hut 
esj»ecially so when the time approached, or was actually present, 
for her menses. The pain with her menses had now much in- 
creased. The swelling each week was greater, and becoming 
evidently clearly connected with the womb. She was sent home 
to be treated by her family physician. After treatment there 
without benefit for some time, she one day heard of one of my 
patients, whom she went immediately to see, and then con- BY MEANS OF DRY EARTH. 
13 
eluded to come on and put herself under my care. This was at 
the date of the first tracing of Figs. 2 and 3, when I diagnosed 
an extra-mural fibroid growing from 
the right side of the uterus, firm in its 
attachment there, but free elsewhere. 
Her contour you can form an idea of as 
regards the abdomen by the continuous 
line of the diagram (Figs. 2 and 3). 
There yon can see the effects of the 
earth in twenty-four hours by compar- 
ison of it (the continuous line) with that 
of the single dotted line. The reduction 
then across from one anterior superior 
process spent to the other was more 
marked than that vertically. 
This patient was relieved in twenty- 
four hours of pain, and allowed me to 
manipulate and thoroughly examine her, 
so as to complete my diagnosis—that of 
three fibroids of the external walls of 
the uterus. The two prominent points 
on the vertical line and those on the 
transverse line indicate the site of these 
fibroids. 
She remained in Philadelphia under 
my care just sixty-five days. During 
that time the dressing was renewed only 
seven times, for the reason that the pa- 
tient was one who had had previously 
good training, and retained her dress- 
ing without difficulty. 
Fig. 2. 
Fig. 3. 14 
TREATMENT OF FIBROIDS OF THE UTERUS 
My purpose in all these cases is, as I have said before, to keep 
them covered as constantly as possible with an impervious coat 
of dry clayey earth. 
At the end of the sixty-five days the line of the abdomen was 
quite natural in form,although not as even as in the other cases 
I have reported. 
Here I will occupy a few moments in showing the facilities 
this method gives of studying the diagnosis of cases, and of pre- 
paring them for laparotomy, if such become imminently neces- 
sary. In Figs. 2 and 3,4 and 5, and 6 and 
7, as well as in Fig. 1, you can all see the 
immediate effect of the earth on the tume- 
faction, in its rapid removal of the cel- 
lular infiltration. This allows of better 
definition of the growth than the re- 
moval of tenderness allows of free palpa- 
tion, and even of thorough reading and 
internal exploration. I have in these 
ways been able to determine a growth 
free of complication (which would be 
adverse to excision), or define its form 
accurately. Thus in Case (Figs. 2 and 
3) No. 2, the distension was such on the 
first day, and the tenderness so great 
that I could not detect the presence of 
the three fibromas of the uterus, which 
were readily recognized after that day. 
Case III. (Figs. 4 and 5).—In this case 
the retrocession was so uniform that the 
diagnosis of an ovarian cyst was quickly 
made and confirmed, and finally in Case 
IV. (Figs. 6 and 7), where there was a 
j>endulous belly, I was as readily aided 
in my diagnosis. 
I stated, awhile ago, that I have had 
but one opportunity of studying by post- 
mortem examination the effects of the 
application of earth over the abdomen on these growths of the 
uterus. The details of this case have been published before.' 
I will now read some abstracts of them. 
Fig. 4. 
1 Transactions of the College of Physicians of Philadelphia. Third scries, 
vol. iv. Head by me February 5, 1873. 15 
BY MEANS OF DRY EARTH. 
“Miss , a tall blonde, bad been suffering for six years 
prior to October, 1878, from a steadily growing tumor in her 
Fig. 5. 
abdomen, which was first detected after suppression of menses 
then, caused by bathing in the river on the second day of the 
flow. The suppression was attended by severe pains in the loins 
and inguinal regions. The pains and suppressions continued 
until I saw her. When first seen by me in October, 1878, her 
appetite was very good, and all her functions save menstruation 
healthy. She was very much emaciated in her limbs and face 
however. Four years prior to seeing me she had consulted a 
distinguished ovariotomist in New York City, who proposed 
operating on her at once, as he said she could not live over a 
month. Subsequently she placed herself under homoeopathic 
care. The man tapped her in the left side, and got less than a 
tablespoonful of bloody fluid from the operation. When I first 
saw her she was propped up in bed suffering with much dyspnoea 
and exhaustion. The day she came to Philadelphia she was 
weighed whilst waiting at the depot. This showed that she 
had gained in weight during the past six years fully fifty-eight 
pounds, and that in spite of the emaciation of her limbs, chest, 
and face. Before starting on her journey to Philadelphia she 16 
TREATMENT OF FIBROIDS OF THE UTERUS 
measured herself arournl at the navel, and her circumference 
there was fifty-four inches. The integuments covering her 
tumor were in this lower portion (from the umbilicus down) in 
a state of marked hypertrophy (like elephantiasis), and in singu- 
lar contrast with the blue, attenuated skin above the umbilicus. 
This hypertrophied portion was weeping freely a watery fluid 
so constantly that it had been heretofore impossible to keep her 
dry or prevent itching and excoriation. The distension of this 
portion of the walls of the belly had indeed been such as to occa- 
sion a hernial protrusion in each groin. The whole projecting 
mass made it impossible for me to reach the vulva*, whilst she 
was sitting up, by the full length of my forearm. Her vulvas 
were occasionally infiltrated. The results of the first application 
of the clay were like those obtained from other cases which had 
proved successful. Her urine, which was examined on the second 
day, was found free of albumen, but loaded with phosphates. 
Deep explorations then showed fluid confined to a portion of 
the peritoneal cavity, with dulness, and feeble succussion the 
jelly-like movement of a fibro-cyst confined to the central por- 
tion of the body. By various changes of position, etc., of the 
patient I concluded then that I had a large tihro-cyst of the 
uterus with extensive adhesions to deal with. The patient im- 
proved steadily, with the dressing renewed every day, for the 
first week, and after that period the-dressing was renewed every 
third or fourth da}’. At the end of the first two weeks all the 
major measurements (as can he seen by the accompanying table) 
had each diminished about 4 inches (some of them 3J and others 
4f). She was then walking about her room, sleeping comfort- 
ably on both sides, but most preferably on the left. She was 
then even dressing herself with a silk dress, which she had not 
before been able to make meet on her [>erson for more than two 
years. At the end of three weeks of the treatment she went 
out and rode in a street car, not going very far however. This 
did her no harm. On the contrary, she measured (two days after 
it) much less. 
At the end of the fourth week of her using the earth dress- 
ing, this lady had got to going out freely every day, generally 
walking on our chief streets for shopping, interested in the 
excitement of others who constitute the crowds on such streets. 
On one occasion she was so influenced as to protract her prom- 
enade beyond what was propter, and so caused a on the BY MEANS OF DRY EARTH 
17 
This table contains her measurements for over two months. 
Circumferences at 
Inches from Umbilicus to 
ClKCUMFKHENCE 
THREE INCHES 
Date. 
4 
® 
a 
® 
o 
T3 
ft 
ft 
£ g 
zz 
cn 
o.S 
A 
ft 
M 
s 
a 
D 
A 
ft 
fi 
ft 
a 
m 
◄ 
« 
◄ 
c 
a 
p 
cq 
w a 
p 
Oct. 21 
36 
48? 
12 
17 
16* 
15 
48? 
46 
“ 22 
34* 
47* 
12 
16 
16 
47* 
“ 23 
34 
45* 
12 
15 
15* 
15 
45* 
45* 
“ 24 
35 
46 
12 
14* 
15* 
14 
46 
45* 
“ 25 
33 
46 
12 
14* 
14* 
14 
45 
44? 
44* 
*• 26 
33 
44 
12 
14 
14? 
14* 
44 
“ 27 
34 
44? 
11* 
16 
14* 
14 
44* 
44* 
“ 28 
33* 
32* 
44? 
11* 
14 
15 
14* 
43* 
44 
“ 30 
42* 
11 
14 
14 
14* 
44 
43* 
Nov. 1 
32? 
32* 
43? 
11 
14 
13 
13 
44 
43* 
“ 4 
43* 
m 
13* 
14 
14* 
43 
42* 
“ 8 
32 
44 
9 
12* 
12* 
13* 
43 
43 
“ 11 
32 
43 
10* 
14 
13* 
14 
44* 
44 
“ 14 
33 
43 
10* 
12* 
13 
13? 
48' 
43 
“ 18 
32 
42* 
9* 
12* 
13 
13 
42 
42 
“ 21 
31* 
42 
9* 
13 
12* 
13 
41 
41* 
“ 26 
31* 
43 
9* 
13 
13 
13* 
41 
41 * 
“ 29 
31* 
42 
9* 
12* 
12 
13 
40 
42 
Dec. 2 
31* 
42 
H 
13 
13 
18 
41* 
42* 
“ 7 
81 
43 
9 
12 
12* 
13* 
41 
42 
“ 11 
31 
42* 
io* 
13 
13* 
14 
43 
43 
“ 14 
31 
41* 
9 
12 
12* 
12* 
41 
42 
“ 18 
3U 
41* 
10 
12 
13 
13 
41 
42 
“ 23 
32 
42 
9* 
12 
13 
13 
41 
42 
“ 26 
32 
41* 
10 
12 
13 
13 
40 
42 
Jan. 21 
32* 
41* 
10* 
10 
13* 
14 
42* 
42 
“ 27 
81 2 
42 
10 
11* 
12 
13 
41 
41 
* 
— 
street. From tliis she made but a slow recovery, evincing the 
effects of heart clot; and before they disappeared, a colliquative 
diarrhoea set in, which caused her death on February 1st, from 
exhaustion. 
Post-mortem revealed no recent effects of inflammatory action 
in the peritoneum, but numerous extensive adhesions. The 
tumor was of a fibro-cystic character. It had a firm, jelly-like 
feeling when handled, and showed numerous rounded projec- 
tions. It was connected by a short flat pedicle to the fundus of 
the uterus, and adherent to the abdominal walls on the left of 
the median line. The womb itself was slightly elongated; 
a probe passed in its cavity over three inches, a vertical section 
of the organ showed its peritoneal covering to be thickened and 
roughened on its serous side, with one or two firm fibroids in 
contact with the womb. A section of the tumor proper showed 18 
TREATMENT OF FIBROIDS OF THE UTERUS 
it to be sub-peritoneal, with a thick firm capsule, and the pro 
jections, especially on its anterior portion, were partly collapsed, 
containing a tremulous jelly-like fluid; those which deserved to 
be distinctly termed cysts varied in size from one to two inches 
in diameter, down to the size of a pea ; none of them contained 
a positively watery fluid. Many were like shrivelled fibroids. 
Various sections made through the tumor presented the appear- 
ance of a low grade of sponge, with various sized cavities, some 
filled with solid matter, others empty. 
A microscopic examination made by Dr. Morris Longstreth, 
the micro8copist of the Pennsylvania Hospital, showed, in a 
band of fibrous tissue from the periphery of a cyst of the 
growth, fibrillre closely felted, with a few nuclear bodies be- 
tween them; then, at another point of the same cyst, the 
fibrillffi appeared swollen and more separated, with greater infil- 
tration of nuclei; and at another point the fibroid tissue was at 
a minimuifi; the fibrillse were widely separated, with the inter- 
vening spaces filled with a nearly transparent mucoid-looking 
fluid. 
“A microscopic examination of the firmer parts of the tumor 
showed, in oidy very limited areas, an appearance typical of 
fibroid structure, but still sufficient to establish the undoubted 
nature of the growth. In general, the picture presented was of 
short tracts of fibres, of almost a purely fibrous character, end- 
ing abruptly sometimes, or sometimes fading out or lost in 
tissue quite transparent and homogeneous, in which rarely a 
fibre was distinguishable.” In some areas a nearly complete 
myxomatous degeueratioh had taken place. This was still more 
evident in the contents of the larger cysts. 
Dr. Longstreth concluded his report by the expressions “An- 
atomical Diagnosis. Fibroma of the uterus undergoing cystic 
degeneration.” 
This is what would seem to be, from my experience, the mode 
of cure set up by the continued use of the earth applications, a 
most positive imitation of the way in which nature effects such 
sometimes. The great frequency of such cures occurring after a 
prolonged use of this treatment show I think, beyond all doubt, 
that those results are directly due to it. If time would allow, 
I could readily adduce further demonstrations of cures than 
those already brought forward ; but I must pass to the consid- 
eration of the earth itself, the best kind, its mode of prepara- BY MEANS OF DRY EARTH. 
19 
tion and application, its points of essential value to those of 
my hearers who are desirous of trying the treatment. 
1st. As to the earth itself. My experiments have included all 
kinds of earth. I soon learned, however, from such experiments, 
that the virtue of healing the flesh and that of disintegrating 
and dissipating morhid products in the flesh, were essentially 
due to the clayey element—the double silicate of alumina; and 
that the efficiency of this was materially influenced by the state 
of its ferruginous elements. A clay recently exhumed, and hav- 
ing been exposed to the light and air for but a short time, always 
was more efficient than one exposed for a long time. So a strata 
of clay of a light yellow color proved itself far more active than 
one either of red, blue, or putty color. The pipe clay or the 
potter’s clay are inefficient, and have always shown themselves 
too strongly alkaline. It is important to get a clayey earth free 
of grit or sand, for the opposite kind of earth cannot form an 
impervious cover, and will not hold flrmly to the parts. For all 
these reasons, I have for a long time had prepared a clean article 
of yellow clayey earth, which, by tasting, can easily be deter- 
mined to be free of foreign matter. The strata of clay used for 
making the best red brick furnishes from its uppermost extrem- 
ity—that immediately below the soil—the best article I have 
ever been able to find. If one will take some from this region 
and compare it with that from the lower end of the strata, where 
it is in direct contact generally with gravel, the difference I am 
pointing out will readily be recognized. The former will also 
be found cleaner, more tenacious, and capable of drying more 
readily when it is wet than the latter, and it will adhere more 
firmly when well applied to the flesh. 
2d. So much for the kind of earth I am in the habit of using, 
and the reasons for its preference. I will now detail the mode 
of preparation to which I have it subjected—this is one essen- 
tially of cleansing. I have it collected in masses or large pieces 
and kept in that state, in an open box and in a dry place to pre- 
vent its becoming mouldy, covering the box with a thin texture 
to keep out insects. When about to use it, I have it dried on 
a hoard in the sun, crushing it then into small pieces so as to 
facilitate its drying; it is then rolled between a slab of smooth 
stone—a piece of marble or the like—and a glass bottle, mak- 
ing the bottle do the rolling; all grit or pieces of foreign matter 
will then he detected at the first rolling and be removed by 20 
TREATMENT OF FIBROIDS OF THE UTERUS 
hand or sifting; another rolling will reduce it to a perfectly fine 
powder, which is to be passed once or twice through a fine flour 
sieve. The necessity for these last siftings being repeated will 
depend much upon the weather, a damp day making the parti- 
cles adhere to each other more than they would on a clear, dry 
one. This powder I have put in clean boxes on a lining of bib- 
ulous white paper—if the boxes are wooden—or in glass jars of 
a size to hold a single dressing, and closed by an air-tight cover. 
Samples of the jars and earth in them were here exhibited. A 
single dressing of an abdominal tumor requires about one pound 
of this earth. As I have had positive proof that a recently pul- 
verized article of earth is more active than one so prepared for 
a long time, I have always been in the habit of having it got 
fresh in lumps, dried, and then pulverized as I was likely to need 
it, keeping a good stock on hand always in lumps in a dry [dace. 
I am thus sure against its getting mouldy or musty. 
Finally. As to the mode of making this dressing. It consists 
essentially in applying the earth in such a manner as to make 
it adhere in a dry state as long as possible, and, at the same time, 
making an impervious covering from the air to the parts immedi- 
ately over the growth. Here I have resorted to numerous expe- 
dients, but have found the simplest and the best to be that of 
mixing, for one dressing, about’one pound of the powdered 
earth, with water in a bowl, by the aid of a wooden spatula, 
made on the occasion out of a clean piece of wood, with one’s 
pocket-knife. This mixing is best made in a deep, wide bowl, 
and by whipping with the spatula rapidly, so as to get it into a 
perfectly smooth paste of such thickness as will allow its being 
easily smeared over the parts to the depth of one-eighth to a 
quarter of an inch every where, save on the margins of the dress- 
ing, where it should be as thin as possible, so as to favor its 
being retained the longest time. I always insist on this appli- 
cation being made directly on the skin, and that, too, without 
any preliminary washing, especially one with soap. Immediately 
on this layer having been made, I apply either a sheet of thin 
tissue-paper, some tarlatan gauze, or very thin cotton wadding 
directly to it, and favor their becoming imbedded in the clay, 
by passing my hands over the texture several times, in a way to 
smooth it down into the earth. By this time the surgeon will 
become aware of a marked increase of temperature in the earth; 
the patient herself may remark the fact, and will usually state 21 
BY MEANS OF DRY EARTH. 
that her pain is becoming less; that her diminution of pain 
will steadily go on, reminding one of his school-boy experience 
of the effect of mud in allaying the pains of the bee stings which 
he had got from his meddling with that industrious little insect. 
When the layer of tissue has been applied, a many-tailed ban- 
dage—with a gore on its back part to make it fit closely there— 
is to be put on for the purpose of retaining all the application 
in place and so completing the dressing. This bandage should 
be secured only so tight as to give good support to the clay in 
every direction. 
All of this dressing should be made with the patient in her 
night-gown and flat on her back in the bed. There she should re- 
main quiet for three or four hours to let the earth dry and become 
firm in its place, when she may be allowed to get up and move 
about. The first dressing should be made in the forenoon, and, 
owing to the rapid absorption of fluid in the tissues, calculations 
are to be made for its removal the next day. The surgeon will 
then find that his patient has passed a good night, and that, too, 
without any anodyne even, if she has been in the habit of their 
use, and in a condition remarkably free of pain. The shrinkage 
from absorption of the fluid in the cellular tissue will quickly 
demonstrate the necessity for a new dressing. The old one is 
to be removed by peeling it oft' in its dry state ; a resort to water 
here, once, will satisfy any one that this injunction should never 
he disregarded. In its dry state the clay can be easily detached 
from the surface of the skin by gentle handling with the spa- 
tula, and made to come off far more readily and completely than 
by any means where water is used. The dry surface now ex- 
posed is ready for measurement, and tracing can readily be made 
of it by the broad tape of sheet lead, which can be preserved on 
a sheet of paper on which the subsequent tracings are to be pre- 
served. 
After one, two, or three daily dressings, made according to 
the exigencies of each individual case, it will cease to be neces- 
sary to make them so frequently ; the rule here must be the 
amount of shrinkage each day—or any specific period of time. 
The virtue of the earth applications has been shown, according 
to my experience, to be dependent essentially on the complete 
contact of such a layer of earth in its dry state with the diseased 
part, so as to thoroughly exclude the air from such parts. The 
rule must then be to renew such only when it is not so closely 22 
TREATMENT OF FIBROIDS OF THK UTERUS. 
adherent to the surface as when first applied. The renewal of 
the dressing must, however, not be made too frequently; we 
want its contact with the diseased surface or the surface cover- 
ing the diseased part as constantly and as perfectly in the dry 
state of the earth as possible. This is, according to my notion, 
only to be determined by personal inspection every twenty-four 
hours; if the dressing is then dry, and firmly adherent all round 
in every direction, let it alone. If it should be wet in the groin 
or over the pubes—us may happen in hot weather—remove only 
those portions and replace them by fresh. This is not likely 
often to occur, unless with patients of marked obesity. Where 
you have a very large tumor in a thin patient the reduction 
will be so positive the second day as to enable you to pass your 
hand under the upper border of this first dressing; then it has 
all to be removed and reapplied. And remember here, that this 
removal is all to be accomplished by peeling it off with the spa- 
tula or the handle of a spoon, so as to preserve the surface in as 
dry a state as possible; anyway, by using water one only retards 
the cure—of this I am very certain. It is the earth in its dry 
state that has proved the efficient agent, hence I exclude all 
other use of water than that absolutely required in making its 
contact complete with the surface. The second and all sub- 
sequent dressings are to be made like the first—and are to be 
disturbed like that—only when they have ceased to afford a 
perfectly impervious covering to the surface covering the growth. 
Ilence, in my experience, it is imperative for the surgeon to 
watch the case and make the dressings constantly for a j>eriod 
of three or four weeks, when the patient may have then become 
so familiar with all the details as to be able, with the aid of 
some devoted friend or attendant, to make them perfectly her- 
self. Then she will not need the surgeon’s care so constantly. 
His visits once a week may be sufficient, or she may go home, 
if it is remote, and pursue the treatment without him. The 
best and quickest cures are, how’ever, always to be obtained 
where the patient remains faithfully under the care of one who 
understands his work and perseveres in it.