CAUSES 
AND... 
RECENT 
TREATMENT 
OF... 
NEURASTHENIA 
BY. 
JOHN D. QT TACKENBOS 
A. M„ „ D. CAUSES MB RECENT TREATMENT 
OF 
NEURASTHENIA 
BY 
JOHN D. QUACKENBOS, A.M., M. D. 
Fellow of the New York Academy 0/Medicine 
Member of Ihe New York Academy of Sciences 
Fellow of the New Hampshire Medical Society 
PRESENTED AT THE ANNUAL MEETING 
OF THE 
NEW HAMPSHIRE MEDICAL SOCIETY 
MAY 25th, 1897. 
Compliments of RIGAUD & CHAPOTEAUT 
With permission of the Author. 
Mobbison Pbint, 
43 Broad Street, New York. CAUSESAND RECENT TREATMENT 
OP NEURASTHENIA. 
JOHN D. QXJACKENBOS, M. D., NEW YOKE. 
A paper presented at the Annual Meeting of the New 
Hampshire Medical Society, May 25th, 1897. 
Neurasthenia or Nervous Exhaustion, the so-called 
“American disease,’’ is not modern, but belongs to that 
category which the man of wisdom had in mind when 
he remarked, “There is no new thing under the sun.” 
It has afflicted the human race from the beginning of 
history. Indeed, if we believe Milton, before man knew 
what suffering is, the arch-enemy of our kind, after that 
“dubious battle on the plains of Heaven,” and the fall 
to that state where “peace can never dwell, hope never 
comes,” tasted to the full the agony of the neurasthenic: 
“Me miserable ! which way shall I fly, infinite despair? 
Which way I fly is Hell; myself am Hell; 
And in the lowest deep, a lower deep 
Still threat’ning to devour me opens wide, 
To which the Hell I suffer seems a Heaven.” 
A political outcast, object of the ridicule of a disso- 
lute court, shattered in health and in fortune, blind and 
helpless, and not a stranger to that ingratitude which 
Shakespeare described as sharper than a serpent’s 
tooth—John Milton seems to me to have put into the 
mouth of Satan an accurate description of his own 
mental suffering. As I glance over the biographical records of the past 
in search of evidence confirmatory of Arndt’s assertion 
that neurasthenia has been recognized for thousands of 
years, I find the Greek and Sanscrit classics replete 
with instances of emotional exhaustion; melancholia 
from disappointment in love; piqued women like 
Lesbian Sappho, who flung themselves from Leucadian 
capes; sexual neurasthenics and perverts; with a few 
overworked cases like the scholastikoi, or befuddled 
book-worms, that figure in the “Facetiae” of Hierocles. 
The typical neurasthenic figure in Semitic history is Job, 
with his malassimilation, his auto-infection, and his 
cell-exhaustion from mental strain. And the Lord, 
his physician, gave him the advice we are so ready to 
extend to the modern neurasthenic, “Gird up thy loins 
like a man.” 
Perhaps the most marked case of neurasthenia in an- 
tiquity is that of Maecenas, who certainly affords a 
conspicuous instance of nervous prostration. Accord- 
ing to Seneca (de Provid., iii: 9), he was an insomniac. 
Horace (Odes, ii: 17) pictures him as a hypochondriac, 
and Pliny (vii: 51) as troubled with a continual restless- 
ness. In fact, he exhibited all the stigmata of degen- 
eration, including what seems to be effemination, if 
not androgyny, inasmuch as he dressed like a woman 
(Seneca Epistles, 114), and was noted for his want of 
manliness. The accounts of his life indicate that his 
neurasthenia was the result of the same causes that 
operate to-day to produce the disease. 
Although thus not an American affection in its origin, 
neurasthenia is peculiarly American in its distribution— 
the rush and tear and overwork, the emotional excite- 
ment connected with failure and success, the slavery to 
social obligations and pleasures, so characteristic of 
American women, sufficiently accounting for its wide 
spread existence in this country. American fashionable 
4 and business life is a continuous nerve-storm. Nor again 
is it peculiarly the rich man’s disease, for it afflicts as 
frequently the poorer classes, on whom fall so heavily the 
burdens incident to battle with the world. I have been 
surprised at its prevalence among the resident popula- 
tion of this state, especially as a sequel of the grip or 
influenza, of typhoid and of the zymotic diseases gen- 
erally (toxic neurasthenia), and in its climacteric phase 
with the native women, broken down by a life-long 
domestic service or by excessive child bearing and lac- 
tation. The symptoms are generally misunderstood, 
and the condition is improperly treated, or regarded 
with suspicion, indifference, or ridicule. It is not 
my purpose to dwell upon the symptoms of neu- 
rasthenia—the parsesthesias and hyperaesthesias; the 
asthenopia and atonic voice; the deficient thirst (all 
neurasthenics are hydrophobiacs, with desiccated nerves); 
the constipation and fermentative dyspepsia, with their 
accompanying intoxications; the oxaluria and uricaci- 
daemia; the vertigoes and helmet headaches; the loss of 
vaso-motor tone; the sensitiveness to noises, vibrations, 
and jars incident to existence in a land of electric and 
steam cars, of jostling crowds, clanging factories, and 
crowded streets and stores; the failure of sexual power 
and pleasure in the sexual act; the intractable sleepless- 
ness; the agonizing tension as though under some 
frightful brain pressure; the sickening oppression about 
the praecordia ( praecordialangst) ; the morbid fears, es- 
pecially monophobia (fear of solitude) and anthropo- 
phobia (fear of society); the dread of responsibility; the 
indecision and folie du douie; the fixed conviction of 
incompetence and uselessness; and the delusional men- 
tal state, with its imperative conceptions. I need hardly 
picture the climax of this condition, at which faith and 
hope and love are, as Milton said, turned to Hell; at 
which Christian principle at last relaxes its hold on the 
5 tortured soul, and the sufferer of woes indescribable 
buries his agony in a self-sought grave. 
There is a distinct line of demarkation between this 
state and insanity, in that it is amenable to curative 
treatment. The neurasthenic, if properly dealt with, 
may, in the great majority of cases, be saved, restored 
to comparative health, and made a useful and happy 
member of society again. 
Permit me now briefly to discuss the direct physiolo- 
gical cause of the neurasthenic condition, and acquaint 
you with the treatment which I consider philosophical, 
and which I have found invariably to a greater or less 
degree successful. 
Neurasthenia is a depraved state of the nervous sys- 
tem, caused by malnutrition of the nerve elements, 
through the abnormal disassimilation of the complex 
phosphorus-bearing nerve substances. 
A nerve cell is a cell-body under control of a nucleus, 
and provided with branches or processes, the principal 
one of which, regarded as the true outgrowth of the cell, 
is called a neuron. It is the seat of ceaseless metabolic 
change, conditioning the replenishment of the contained 
phosphorus-bearing substances that represent so much 
stored or potential nerve energy, and that are trans- 
formed and consumed in the evolution of such energy. 
Physiologists believe that the passage of nerve im- 
pulses alters the osmotic powers of the cell wall toward 
the surrounding plasma, and that by endosmosis and 
exosmosis the nutritive exchange takes place. The 
dense network of capillaries environing the cells indi- 
cates that they are the centres of this nutritive metabo- 
lism. In neurasthenia, not only are the nutritive 
properties of the cell encircling plasma altered by auto- 
intoxication, the poison of infectious diseases, or by 
alcoholism, cocainism, morphinism, etc., but in some 
instances, through the action of the same causes, the 
6 cells appear measurably to have lost the power to ap- 
propriate what limited amount of nourishment may be 
present. In either case, the cell-bodies are more or less 
starved and their energy-projecting powers corres- 
pondingly impaired. 
No doubt the commonest cause of this cell-exhaus- 
tion and consequent impoverishment of nerve force— 
the cause of the cause of neurasthenia—is the intemperate 
exercise of the intellectual faculties and the excessive 
indulgence of the emotions and passions. I believe 
emotional unrest to be a far more prolific cause than 
labor dissociated from irritation and anxiety. The 
greater number of neurasthenics are unmarried persons, 
the operative causes in single men being the excitements 
connected with sexual and alcoholic excesses and with 
gambling; in single women, the harrassing struggle for 
bread. Sexual abstinence is in itself a predisposing 
cause of neurasthenia ; but sexual excesses and irregu- 
larities are an every-day active cause. Sexual intercourse, 
naturally and temperately used, is a nerve sedative and 
tonic; intemperately or unnaturally indulged in, a 
nerve irritant and drain. It is not the passage of semen, 
nor the secretion of mucous fluid by the glands of Bar- 
tholini, that does the mischief; but the repeated orgasm 
or reflex act of ejaculation, which, like an epileptic con- 
vulsion, implies a nerve shock, and which exhausts the 
protoplasm and shrinks the nuclei of the cells as do elec- 
tric discharges through them. 
In some ill-understood manner, all such abuses pro- 
duce cell-degenerating toxines not apparent to the 
microscope or appreciable by chemical anaylsis. What- 
ever, by prolonged or excessive action, enfeebles the 
system, must exhaust the cell-bodies faster than they can 
reproduce themselves. A sufficient amount of nutritive 
material is not floated to the centres of abnormal cell- 
activity to compensate for the extra demand made upon 
7 them, nor are the waste products removed as speedily 
as is consistent with health and safety. And what are 
the results? Malnutrition and auto-intoxication. 
When we exercise our muscles merely for the sake of 
pleasure, the amusement is called play. When we 
similarly exercise eye and ear, the amusement is known 
as aesthetic feeling. The first is active; the second 
passive. In each case pleasure accompanies the activity 
of well-nourished and underworked organs. On this 
principle human health and happiness hang—well- 
nourished and underworked cells—a normal amount of 
activity in the terminal nerve organs of the cerebro-spinal 
nervous system. But let certain nerves be called upon 
to perform an excess of work, and painful feeling results. 
Note the effect of dynamo-generated electric light upon 
the eye. Those who use the incandescent lamps for 
reading may refer the massive pain and feeling of irrita- 
tion in the eyeball that follows an evening’s work, to the 
imperceptible unsteadiness in the white-hot filament of 
carbon. This light really pulsates—rises and falls with 
the passage of each commutator bar under the brushes 
in the dynamo. If the engine be slowed down, the 
fluctuations become visible; but whether they are con- 
sciously appreciated or not, the nerve fibres in the retina 
must certainly respond, and the eyes become wearied ; 
because, although the optic fibres are renewed seven- 
teen times a second in order that we may learn so much 
and so unremittingly of the world about us, the destruc- 
tive metamorphosis here is in excess of repair. In like 
manner, in all normal cerebral and nervous activity, we 
have constantly induced partial fatigues, followed by 
partial stimulations. In over use, the reparative processes 
are distanced by destructive metamorphosis; nutritive 
regeneration is unable fully to restore the wasted sub- 
stance of the nerve-organs; and where the hours of 
sleep are invaded to meet the demands of a growing 
8 business or an imperious ambition, these nerve-organs 
rapidly lose the power of regeneration and become in- 
capacitated for the fulfillment of their functions. Hence 
the morbid impulse to ingest more food than can be 
oxidized; hence the phosphaturia and uricacidaemia, 
the indigestion, and the neurasthenic liver. I hold that 
these are the effects of nerve starvation, not the origin of 
it; and here the mistake is made by many practitioners 
who treat merely the symptoms, forgetful to remove the 
causes that give rise to the symptoms. The nerve ex- 
haustion primarily acts to produce the oxaluria, uricaci- 
daemia, gastric and intestinal dyspepsia, prostatic neu- 
roses, irritable and depressing sexual functions, muscular 
insufficiencies of the eyes and general asthenopia, 
praecordialangst, insomnia, and cardiac breakdown; and 
these results react as causes to perpetuate the nerve ex- 
haustion. In neurasthenia, effects immediately assume 
the role of causes, and hence the danger of error in 
treating the disease. 
You ask whether the microscope has revealed any 
deviation from the normal in cells that are in a condition 
of pathological fatigue. We all know from autopsies 
the toxic effects of infectious and acute inflammatory 
diseases in shrinking the nuclei and curtailing the pro- 
cesses of cephalic and cornual cells. We also know 
from experiments made on the lower animals that at the 
end of a day of active toil, the nuclei appear small and 
shrunken, but after a night of rest the cells are turgid 
with large, well rounded nuclei. Hence we certainly are 
justified in the inference that the cell-bodies of neuras- 
thenics exhibit peculiar signs of defective nutrition. 
Says Gray: “The same cell that can become organi- 
cally altered can become functionally altered; or the 
pathological alteration which we call general paresis, 
poliomyelitis, or peripheral neuritis, may have its func- 
tional analogue in cerebral, spinal, or peripheral 
9 neurasthenia, with this difference, that the cell which is 
originally altered in its molecular constitution cannot be 
made to return to the normal so readily as the functionally 
impaired cell.” 
Dr. Ira Van Gieson, the state pathologist of New York, 
writes me, under date of April 2, that his opinion coin- 
cides with my own, viz.: that there is some measure of 
toxicity degeneration in the nerve cells of neurasthenics. 
But the demonstration of such changes must involve 
very great difficulties, as well on account of the enor- 
mous amount of territory in the cortex to be examined, 
as by reason of the difficulty of obtaining neurasthenic 
material for autopsy purposes. As yet no work has been 
done along the new lines of research in the application 
of the methods and principles of modern cellular biology 
to the study of neurasthenia. However, treatment on 
the theory of cell-exhaustion and the practicability of 
cell-feeding has been the most successful. I believe that 
if the rest be made long enough, the food stimulating 
enough, the sleep regular, the change of employment 
judicious, and all worry removed, most cases of neuras- 
thenia may be greatly improved, if not entirely cured. 
The trend of this treatment is wholly in the line of nutri- 
tion and direct stimulation af the spinal cord. 
Chemistry has demonstrated the presence of a phos- 
phorus-bearing substance in the nerve cells. This is 
known as lecithin (lecilhos, literally yolk of an egg), a 
hygroscopic white, waxy solid, composed of carbon, 
hydrogen, nitrogen, phosphorus, and oxygen. It is a 
constituent of every cell in our bodies, but especially 
characteristic of those that makeup brain and nerve sub- 
stance. Chemically, lecithin is a phospho-glycerate of 
neurin—neurin constituting the albuminous basis of nerve 
tissue and occuring in the gray granular vesicular ner- 
vous matter and in the white fibrous nervous matter, 
lecithin is found also in pus, in the white corpuscles. 
10 and in semen. In combination with cerebrin, it consti- 
tutes protagon, the principal form in which it is met 
with in the brain. Life depends on the presence of 
healthy lecithin. Neurasthenia is due to a diminished 
amount or a reduced quality of this phospho-glycerate. 
Hence the philosophy of administering a phospho-glycerate 
of lime* in conditions characterized by defective nutri- 
tion of nerve and brain cells, which means a diminution 
of phosphorus in the cerebral and nervous matter. 
Attention was first called to the value of phospho- 
glycerate of lime in the treatment of neurasthenia by Dr. 
A1 bert Robin, before the ‘ ‘ Academie de Medecine” of Paris, 
as recently as 1894, and Chapoteaut's French preparations 
began to be used by a few American physicians in 1895. 
Phospho-glycerate of lime has been found rapidly to re- 
store to the system the phosphorus eliminated in excess 
through the urine, and was proved by Robin to di- 
minish the excretion of incompletely oxidized phosphorus 
there present and indicative of pathological waste. It 
supplies the exhausted and enervated cells with phos- 
phorus in a state of combination essentially the same as 
that naturally contained in them—an organic or physio- 
logical phosphorus, as it were—readily assimilable, and 
thus differing from the mineral phosphorus of the popu- 
lar syrups of the hypophosphites and the ordinary 
unassimilable phosphate of lime. Its administration at 
once stimulates nutrition, promoting metabolism, and 
hastening the rapid tissue interchange which constitutes 
health. In sexual neurasthenia and the impotence of 
old age, the effect of the phospho-glycerate is especially 
marked. Sexual energy and the pleasure connected 
with the sexual act are quickly restored. I have notes 
of cases in which persons upward of seventy years of 
age regained under its influence the full powers of 
* Sometimes written glycero-phosphate or glyco-phosphate 
of lime. 
11 middle life. Treatment of neurasthenia with phospho- 
glycerate of lime is the treatment that ignores reflexes 
and directly addresses the seat of the disease. 
It would be trespassing on your time to retail here the 
ideas of treatment that are to be found in the standard 
text books. With me they have too often proved un- 
satisfactory. But I will briefly outline for your consider- 
ation the method that I follow. I administer fourtoeight 
grains of the phospho-glycerate of lime in capsules with 
each meal, and continue this treatment unremittingly 
for a year, or until cure is effected, not expecting results 
that are apparent and gratifying to the patient until after 
three or four weeks of medication. There are cases 
characterized by marked physical depression in which I 
prefer the wine * of the phospho-glycerate of lime—a sherry- 
glassful before meals. Its action is immediate, and the 
slight stimulation due to the alcohol seems to be main- 
tained by the absorption of the phospho-glycerate with 
the food. 
With the phospho-glycerate of lime at meal time, I 
combine a fortieth or fiftieth of a grain of strychnia, to 
promote the nutrition of the cord ; and this I continue 
for a month, then drop it for a week or two, and resume 
for another month. In connection with this nerve feed- 
ing, I seek to accelerate, through the several channels 
of exit, the elimination of waste products and toxins. 
At every relapse, I give calomel; during the treatment, 
cathartic mineral waters before breakfast, in sufficient 
quantity to produce a laxative and not a daily cathartic 
effect. I insist on the drinking of plenty of water, hot 
or cold, between meals, to keep the kidneys flushed, 
Vichy, if obtainable, preferred. Stimulate the skin with 
a daily bath and rub-down, and where the patient can 
endure the shock, the cold douche to the spine on rising. 
Keep the mind interested in something. Physicians are 
* 50 centigrammes to the fluid ounce. 
12 finding out that the occupation cure is preferable to the 
rest cure, which is responsible for an overproduction of 
confirmed invalids. Dr. Skene’s latest conclusion is to 
the effect that most neurasthenic women are either dis- 
appointed spinsters or spoiled wives who have been 
improperly treated—or rather cosseted—for trivial dis- 
orders. For these he recommends the exercise cure, 
preeminently dancing and horseback riding, not the 
bicycle. And yet the bicycle has been recommended by 
Hammond, and is, as we all know, a most useful adju- 
vant in the treatment of nervous disease. 
Where insomnia persists, sleep must be induced by 
artificial means. This is of supreme importance, for in 
normal sleep the changes throughout the nervous sys- 
tem are recuperative, and the loss of sleep is fraught 
with greater damage to nerve substance than starvation 
through overwork or under-feeding. It is through phy- 
siological sleep, where there is no opportunity for nervous 
discharge, that the system attains its highest degree of 
efficiency, and becomes possessed of an unusual quantity 
of potential energy, which physicists ingeniously define 
as capacity for performing work. 
Some neurologists contend that it is better for the 
patient to lie awake night after night than to resort to 
hypnotics, but this is not true. If sleep be induced by 
suitable hypnotics, it is seldom necessary to administer 
them two evenings in succession. Where all drugs fail, 
hypnotism will succeed, and the current of the disease 
may be changed by post-hypnotic suggestion. 
The psychical treatment consists in securing the con- 
fidence of the patient and making him believe that he is 
curable—that there is a time ahead when he will be en- 
tirely well again ; but that he must have faith and not be 
discouraged at the chain of relapses which mark the 
course of the disease. When he gains a higher plane, 
he should be instructed to obey strictly the laws of work 
13 and play and diet that he has discovered to be good 
government for him. 
If the case be one of traumatic neurasthenia, com- 
monly called “railroad spine,” with indisposition, 
sometimes inability, to use mind or muscles, it is our 
duty to discourage litigation. Worry thereabout, brood- 
ing over trouble, transforms the neuroses into a cortex 
habit, and the patient may become an invalid for life. 
If anything is to be added to this treatment, it is 
exercise within the limits of fatigue, any kind of riding 
or rowing preferred to walking ; fresh air at an altitude 
not exceeding two thousand feet; a nutritious and easily 
digested diet, in which phosphorus-bearing grains play 
an important part, and red wines rich in phosphate of 
iron are judiciously used ; and finally, the most con- 
scientious observance of the old Greek law—Meden agan 
or Nothing too much. 
SAMPLES OF 
CHAPOTEAUT’S WINE (OR THE CAPSULES) 
OF 
PHOSPHO-GLYCERATE OF LIME 
Can be had from the agents, E. FOUGERA & CO., New York. 
(ADV.) 
14 CHAPOTEAUT’S 
phogpho-glijcei'&tse of Lime. 
(Syn. Glycero-phosphate of Lime.) 
A Nerve Food, Restorative and Stimulant. 
The value of phospho-glycerate of lime was first 
brought before the notice of the French Academy of 
Medicine by Dr. A. Robin, but it has long been known 
that the phosphoric elements of the lecithin of food, 
are first converted into phospho-glyceric acid before 
assimilation. 
Phospho-glycerate of lime therefore, being a deriva- 
tive of lecithin and consequently almost identical with 
the phosphatic principle found in the nerve cells, is 
distinctly indicated in diseases where nervous nutrition 
is irregular and insufficiently compensated for, by the 
food ingested. 
These facts explain at a glance the incontestable 
merits of phospho-glycerate of lime, in all diseases 
where nervous exhaustion is at the root of the trouble. 
The preparation of a pure and soluble phospho- 
glycerate of lime, has been the constant study of 
Chapoteaut for the last 25 years, and as the impure and 
insoluble salts are useless, physicians are urged to use 
only the “Chapoteaut” preparations in the treatment of 
Convalescence, Phthisis, Anemia, Chlorosis, 
Ataxia, Phosphaturia, Phosphatic Albuminuria, 
Sciatica, Tic=douIoureux, Sexual Debility, Ra- 
chitis, Cachexia, Addison’s disease and in all 
Neurasthenic conditions. 
RIQAUD & CHAPOTEAUT, Paris. 
(for preparations see next page.) 
(ADV.) 
15 CHAPOTEAUT’S 
piiogpho-gliJCBi'afce of Lime. 
(Syn. Glycero-phosphate of Lime.) 
PREPARATIONS AND DOSES. 
Wine of Phospho-glycerate of Lime (Chapo- 
teaut), 50 centigrammes (10 grains) to the fluid ounce, 
in doses of one to two tablespoonfuls for adults, half 
the quantity for children, two or three times a day at 
meals. 
Syrup of Phospho-glycerate of Lime (Chapo- 
teaut), 20 centigrammes (4 grains) to the tablespoon- 
ful, in doses of from one to two tablespoonfuls for adults, 
half the quantity for children two or three times daily. 
Capsules of Phospho=glycerateof Lime (Chap- 
oteaut), in phials of 30 or 100 spherical capsules, con- 
taining each 20 centigrammes (4 grains) of pure phos- 
pho-glycerate of lime.—The dose is from two to four 
capsules for adults with meals and half the quantity for 
children. 
Phospho-glycerate of Lime (Chapoteaut), may 
also be had for dispensing purposes in original bottles 
('only) of one and four ounces. Dose: three to six 
grains in aqueous solution with meals. Half the quan- 
tity for children. 
PREPARED IN THE LABORATORIES OF 
R1GAUD & CHAPOTEAUT, 
Paris, France. 
Dispensed by leading Pharmacists in the United Statea. 
WHOLESALE AGENTS, 
E. FOUGERA & CO., 
26,28 & 30 North William St., New York. 
16 
(ADV.) PURE STRONTIUM SALTS. 
(PARAF-JAVAL). 
The Bromide and Lactate are made by the Paraf-Javal 
process and are free from every trace of Barium. 
The investigations of Dr. Laborde communicated 
to the French Academy of Medicine, prove that the 
chemically pure Strontium salts (Paraf-Javal) have 
certain advantages which are not found in those of 
Potassium and Sodium. 
Since their introduction in 1891, the Bromide, 
Iodide and Lactate have been the subject of a great 
number of communications on the clinical results 
observed in every country, and they may be now 
looked upon as belonging to our most valuable modern 
therapeutic agents. 
BROMIDE. 
The Bromide is recommended by F6r6, Constantin 
Paul, Dujardin-Beaumetz and Coronedi, as a sedative, 
analgesic and anti-emetic, and has been found specially 
useful in all nervous affections and epilepsy, as well as 
in suppressing the most incoercible cases of vomiting of 
pregnancy. The same happy effects have been observed 
in gastritis, hysteria, acute gastric catarrh, the chronic 
glandular gastr tis of Brunton, chronic lead poisoning, 
and the septicaemia consequent upon abortion. 
As a gastric analgesic in vomiting of nervous origin, 
it acts by diminishing the excitability of the nerve 
centres and then of the nerve endings in the stomach. 
It relieves nervo-gastric irritation and controls morbid 
gastro-intestinal fermentation, without causing depres- 
sion or any toxic symptom. 
17 IODIDE. 
The Iodide has proved very valuable in the treatment 
of Scrofulous, Rheumatoid and Cardiac disorders and 
Syphilis. 
The Standard Solution of Iodide of Strontium (Paraf- 
Javal) contains 30 grains to the fluid ounce, and the 
Standard Solution of the Bromide of Strontium (Paraf- 
Javal) 3 i to the fluid ounce. As a general rule the 
Iodide and Bromide are indicated in the same cases and 
in the same doses as the Potassium and Sodium prepara- 
tions. The eruptions however, caused by the Potas- 
sium salts are not produced. 
LACTATE. 
The Lactate is indicated in certain forms of diabetes 
and is found to diminish the amount of albumin excreted 
in Bright’s disease, and in the parenchymatous and 
rheumatical nephrites of nephritic and scrofulous 
patients, as well as in the albuminuria of pregnant or 
recently delivered women. Dose : a teaspoouful of the 
Standard Solution ( 3 i to the fluid ounce) three times 
a day. 
The Strontium Salts (Paraf-Javal) and their Standard 
Solutions, are made only in the laboratories of 
RIGAUD & CHAPOTEAUT, Paris, 
u. s. agents: E. FOUGERA d. CO., N. y. 
18 APIOLINE, 
(CHAPOTEAUT). 
NOT TO BE CONFOUNDED WITH SO-CALLED APIOL. 
The true active principle of parsley 
dispensed in capsules of 20 centigrammes. 
M. Chapoteaut has adopted a process for the extrac- 
tion of the true active principle of parsley, which is a 
thick reddish liquid boiling at 275°C. (5270 F.) 
specific gravity 1.113, called Apioline. 
Professor Laborde’s * exhaustive study of the action 
of Apioline, indicates that it stimulates the intestinal and 
genital vaso-motor system and hence has a decided 
action on the utero-ovarian reproductive apparatus. 
Apioline is indicated in spasmodic and congestive 
dysmenorrhoea and is decidedly the most reliable agent 
we know of in amenorrhcea. 
DOSES: 
In Amenorrhcea.—One capsule 2 or 3 times a day 
during the week preceding menstruation ; continue the 
dose for 2 days when the flow is established. 
In Dysmenorrhoea (spasmodic or congestive).—One 
capsule twice daily, immediately before and during the 
menses. 
Dispensed in original packages containing 24 capsules 
only. 
Apioline is made in the laboratories of 
RIGAUD & CHAPOTEAUT, Paris, 
U. S. AGENTS: E. FOUGERA &. CO., N. Y. 
• J. Laborde, directeur des travaux physiologiques a la Faculty 
de medicine de Paris.—Tribune medicale, January 8,1891. 
19 Imitations and 
Substitutions! 
Wc take this opportunity of stating, 
that we cannot be held responsible for 
disappointing therapeutical results, unless 
physicians insist upon druggists 
using only those preparations made 
in our laboratories. 
RIGAUD & CHAPOTEAUT. We are actively introducing to the profession, some new special- 
ties for which we are agents, and believe you will shortly have calls 
for the same. 
The Jobbers throughout the United States and Canada hold 
stocks and the prices are given below. 
CYPRIDOL Capsules, (Bottles of 50,) - - - $9.00 per doz. 
Injection, (6 tubes for hypodermic use,) - $18.00 “ 
HYDRARGYIME (Antiseptic leaves, 10 in a packet,) - $3.00 “ 
CEREVISIIME (in 3 ounce Bottles,) - $9.00 “ 
C0LCHIFL0R Capsules, (Bottles of 30,) - - $12.00 “ 
GRIMAULT’S Indian Cigarettes, - $4.50 “ 
E. FOUQERA & CO., 26, 28, 30 N. William St., N. Y. City.