ivyc-i<G< W THE PEOPLE'S j?,? y s 
' COMMON SENSE 
MEDICAL ADVISEE 
IN PLAIN ENGLISH; 
OR, 
MEDICINE SIMPLIFIED. 
/ BY 
:r_ Fierce, id_3 
.. 
ONE OF THE STAFF OF CONSULTING PHYSICIANS AND SURGEONS, 
AT THE INVALIDS' HOTEL AND SURGICAL INSTITUTE, AND 
PRESIDENT OF THE WORLD'S DISPENSARY 
MEDICAL ASSOCIATION. 
EIGHTEENTH EDITION. 
355th THOUSAND. 
Carefully Revised by the Author, assisted by his full Staff of Asso- 
ciate Specialists in Medicine and Surgery, the Faculty of 
the Invalids'1 Hotel and Surgical Institute. 
BUFFALO, N. Y. : 
Published at the World's Dispensary Printing Office and Bindery. 
1888. Entered according- to Act of Congress, in the year 1886. by the 
World's Dispensary Medical Association, 
In the office of the Librarian of Congress, at Washington. D. C. TO 
MY PATIENTS, 
WHO HAVE SOLICITED MY PROFESSIONAL SERVICES, 
FROM THEIR HOMES 
IN EVERY STATE, CITY, TOWN, AND ALMOST EVERY HAMLET, 
WITHIN THE AMERICAN UNION ; 
ALSO TO THOSE DWELLING IN EUROPE, MEXICO, SOUTH AMERICA. 
THE EAST AND WEST INDIES, AND OTHER 
FOREIGN LANDS, 
I RESPECTFULLY DEDICATE 
THIS WORK. PREFACE TO THE PRESENT EDITION. 
The popular favor with which former editions of this work 
have been received has required the production of such a vast 
number of copies, that the original electrotype plates from 
which it has heretofore been printed, have been completely 
worn out. 
The book has been re-produced in London, England, where 
four editions have already been necessary to supply the demand 
for it. 
In order to continue its publication to meet the demand which 
is still active in this country, it has been necessary, inasmuch as 
the original electrotype plates have become worn and useless, to 
re-set the work throughout. This has afforded the Author an 
opportunity to carefully revise the book and re-write many 
portions, that it may embody the latest discoveries and im- 
provements in medicine and surgery. In performing this labor 
he has been greatly assisted by contributions and valuable aid 
kindly supplied by his staff of associate, specialists in medicine 
and surgery who constitute the Faculty of the Invalids' Hotel 
and Surgical Institute. 
That part of the book treating of Diseases and Their Reme- 
dies will be found to be thoroughly reliable ; the prescriptions 
recommended therein having all received the sanction and 
endorsement of medical gentlemen of rare professional attain- 
ments and mature experience. 
THE AUTHOR. 
Buffalo, N. Y., January, 1886. 
5 PREFACE TO THE FIRST EDITION. 
Every family needs a Common Sense Medical Adviser. The 
frequent inquiries from his numerous patients throughout the 
land, suggested to the Author the importance and popular de- 
mand for a reliable work of this kind. Consequently, he has 
been induced to prepare and publish an extensive dissertation 
on Physiology, Hygiene, Temperaments, Diseases and Domestic 
Remedies. It is for the interest and welfare of every person, 
not only to understand the means for the preservation of health, 
but also to know what remedies should be employed for the 
alleviation of the common ailments of life. 
The frequency of accidents of all kinds, injuries sustained by 
machinery, contusions, drowning, poisoning, fainting, etc., and 
also of sudden attacks of painful diseases, such as headache, 
affections of the heart and nerves, inflammation of the eye, ear 
and other organs, renders it necessary that non-professionals 
should possess sufficient knowledge to enable them to employ 
the proper means for speedy relief. To impart this important 
information is the aim of the author. 
Moreover, this volume treats of Human Temperaments, not 
only of their influence upon mental characteristics and bodily 
susceptibilities, but also of their vital and non-vital combinations, 
which transmit to the offspring either health, hardihood, and 
longevity, or feebleness, disease, and death. It clearly points out 
those temperaments which are compatible with each other and 
harmoniously blend, and also those which, when united in mar- 
riage, result in barrenness, or produce in the offspring imbecility, 
deformity, and idiocy. These matters are freely discussed from 
original investigations and clinical observations, thus rendering 
the work a true and scientific guide to marriage. 
7 PREFACE. 
While instruction is imparted for the care of the body, those 
diseases (alas how prevalent!) are investigated which are sure 
to follow as a consequence of certain abuses, usually committed 
through ignorance. That these ills do exist is evident from the 
fact that the Author is consulted by multitudes of unfortunate 
young men and women, who are desirous of procuring relief 
from the weaknesses and derangements incurred by having 
unwittingly violated physiological laws. 
Although some of these subjects may seem out of place in a 
work designed for every member of the family, yet they are 
presented in a style which cannot offend the most fastidious, and 
with a studied avoidance of all language that can possibly dis- 
please the chaste, or disturb the delicate susceptibilities of 
persons of either sex. 
This book should not be excluded from the young, for it is 
eminently adapted to their wants, and imparts information 
without which millions will suffer untold misery. Tt is a false 
modesty which debars the youth of our land from obtaining 
such information. 
As its title indicates, the Author ajms to make this book a 
useful and practical Medical Adviser. He proposes to express 
himself in plain and simple language, and, so far as possible, to 
avoid the employment of technical words, so that all his readers 
may readily comprehend the work, and profit by its perusal. 
Written as it is amid the many cares attendant upon a practice 
embracing the treatment of thousands of cases annually, and 
therefore containing the fruits of a rich and varied experience, 
some excuse exists for any literary imperfections which the 
critical reader may observe. 
THE AUTHOR. 
Buffalo, N. Y., July, 1875. INTRODUCTORY WORDS. 
Health and disease are physical conditions upon which pleasure 
and pain, success and failure, depend. Every individual gain 
increases public gain. Upon the health of its people is based 
the prosperity of a nation ; by it every value is increased, every 
joy enhanced. Life is incomplete without the enjoyment of 
healthy organs and faculties, for these give rise to the delightful 
sensations of existence. Health is essential to the accomplish- 
ment of every purpose ; while sickness thwarts the best inten- 
tions and loftiest aims. We are continually deciding upon those 
conditions which are either the source of joy and happiness or 
which occasion pain and disease. Prudence requires that we 
should meet the foes and obviate the dangers which threaten 
us, by turning all our philosophy, science, and art, into practical 
common sense. 
The profession of medicine is no sinecure; its labors are 
constant, its toils unremitting, its cares unceasing. The physi- 
cian is expected to meet the grim monster, " break the jaws of 
death, and pluck the spoil out of his teeth." His ear is ever 
attentive to entreaty, and within his faithful breast are concealed 
the disclosures of the suffering. Success may elate him, as con- 
quest flushes the victor. Honors are lavished upon the brave 
soldiers who, in the struggle with the foe, have covered them- 
selves with glory, and returned victorious from the field of 
battle ; but how much more brilliant is the achievement of those 
who overwhelm disease, that common enemy of mankind, whose 
victims are numbered by millions! Is it meritorious in the 
physicians to modestly veil his discoveries, regardless of their 
importance? If he have light, why hide it from the world? 
Truth should be made as universal and health-giving as sunlight. 
We say, give light to all who are in darkness, and a remedy to 
the afflicted everywhere. 
We, as a people, are becoming idle, living in luxury and ease, 
and in the gratification of artificial wants. Some indulge in the 
9 INTRODUCTORY WORDS. 
use of food rendered unwholesome by bad cbokery, and think 
more of gratifying a morbid appetite than of supplying the body 
with proper nourishment. Others devote unnecessary attention 
to the display of dress and a genteel figure, yielding themselves 
completely to the sway of fashion. Such intemperance in diet 
and dress manifests itself in the general appearance of the un- 
fortunate transgressor, and exposes his folly to the world, with 
little less precision than certain vices signify their presence by a 
tobacco-tainted breath, beer-bloated body, rum-emblazoned nose, 
and kindred manifestations. They coddle themselves instead of 
practicing self-denial, and appear to think that the chief end of 
life is gratification, rather than useful endeavor. 
I purpose to express myself candidly and earnestly on all topics 
relating to health, and appeal to the common sense of the reader 
for justification. Although it is my aim to simplify the work, 
and render it a practical common-sense guide to the farmer, 
mechanic, mariner, and day-laborer, yet I trust that it may not 
prove less acceptable to the scholar, in its discussion of the 
problems of Life. Not only does the method adopted in this 
volume of treating of the Functions of the Brain and Nervous 
System present many new suggestions, in its application to 
hygiene, the management of disease, generation and the develop- 
ment and improvement of man, but the conclusions correspond 
with the results of the latest investigations of the world's most 
distinguished savants. My object is to inculcate the facts of 
science rather than the theories of philosophy. 
Unto us are committed important health trusts, which we 
hold, not merely in our own behalf, but for the benefit of others. 
If we discharge the obligations of our trusteeship, we shall enjoy 
present strength, usefulness, and length of days ; but if we fail 
in their performance, then inefficiency, incapacity, and sickness, 
will follow, the sequel of which is pain and death. Let us, then, 
prove worthy of this generous commission, that we may enjoy 
the sweetest of all pleasures, the delicious fruitage of honest toil 
and faithful obedience. PART I. 
PHYSIOLOGY. 
CHAPTER I. 
BIOLOGY. 
In this chapter we propose to consider Life in its primitive 
manifestations. Biology is the science of living bodies, or the 
science of life. Every organ of a living body has a function 
to perform, and Physiology treats of these functions. 
Function means the peculiar action of some particular 
organ or part. There can be no vital action without change, 
and no change without organs. Every living thing has a 
structure, and Anatomy treats of the structures of organized 
bodies. Several chapters of this work are devoted to Physio- 
logical Anatomy, which treats of the human organism and its 
functions. 
The beginning of life is called generation; its perpetuation, 
reproduction. By the former function, individual life is insured; 
by the latter, it is maintained. Since nutrition sustains life, it 
has been pertinently termed perpetual reproduction. 
Latent Life is contained in a small globule, a mere atom 
of matter, in the sperm-cell. This element is something which, 
under certain conditions, develops into a living organism. The 
entire realm of nature teems with these interesting phenomena, 
thus manifesting that admirable adjustment of internal to 
external relations, which claims our profound attention. We 
11 12 
COMMON SENSE MEDICAL ADVISER. 
are simply humble scholars, waiting on the threshold of nature's 
glorious sanctuary, to receive the interpretation of her divine 
mysteries. 
Some have conjectured that chemical and physical forces 
account for all the phenomena of life, and that organization is 
not the result of vital forces. Physical science cannot inform 
us what the beginning was, or how vitality is the result of 
chemical forces; nor can it tell us what transmutations will 
occur at the end of organized existence. This mysterious life- 
principle eludes the grasp of the profoundest scientists, and its 
presence in the world will ever continue to be an astonishing 
and indubitable testimony of Divine Power. 
The physical act of generation is accomplished by the union 
of two cells; and as this conjugation is known to be so generally 
indispensable to the organization of life, we may fairly infer that 
it is a universal necessity. Investigations with the microscope 
have destroyed the hypothesis of "spontaneous generation." 
These show us that even the minutest living forms are derived 
from a parent organization. 
Generation. So long as the vital principle remains in 
the sperm-cell, it lies dormant. That part of the cell Which 
contains this principle is called the spermatozoon, which con- 
sists of a flattened body, having a long appendage tapering 
to the finest point. If it be remembered that a line is 
the one-twelfth part of an inch in length, some idea may 
be formed of the extreme minuteness of the body of a hu- 
man spermatozoon, when we state that it is from to ■po- 
part of a line, and the filiform tail of a line, in length. This 
life-atom, which can be discerned only with a powerful magnify- 
ing glass, is perfectly transparent, and moves about by executing 
a vibratile motion with its long appendage. Within this speck 
of matter are hidden the multifarious forces which, under 
certain favorable conditions, result in organization. Magnify 
this infinitesimal atom a thousand times, and no congeries of 
formative powers is perceived wherewith to work out the 
wonders of its existence. Yet it contains the principle, which 
is the contribution on the part of the male toward the gener- 
ation of a new being. 
The ovum, or germ-cell, is the special contribution on the GENERATION. 
13 
part of the female for the production of another being. The 
human ovum, though larger than the spermatozoon, is also 
extremely small, measuring not more than from to T\j- of a 
line, or from to of an inch, in diameter. 
Fig. 1. 
A. Human Spermatozoon 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. 
Q. Cell of the sponge resembling a spermatozoon. 
H. Vesicles of evolution from the seminal fluid of the dog in the parent cell. 
I. Single vesicles of different sizes. 
J. Human spermatozoon forming in its cell. 
K. Rupture of the cell and escape of the spermatozoon. 
The sperm and the germ-cells contain the primary elements of 
all organic structures, and both possess the special qualities and 
conditions by which they may evolve organic beings. Every 
cell is composed of minute grains, within which vital action takes 14 
COMMON SENSE MEDICAL ADVISER. 
place. The interior of a cell consists of growing matter; the 
exterior, of matter which has assumed its form and is less active. 
When the vital principle is communicated to it, the cell under- 
goes a rapid transformation. While this alteration takes place 
within the cell, deteriorating changes occur in the cell-wall. 
Although vital operations build up these structures, yet the 
animal and nervous functions are continually disintegrating, or 
wasting, them. 
Throughout the animal kingdom, germ-cells present the same 
external aspect when carefully examined with the microscope. 
No difference can be observed between the cells of the flowers 
of the oak and those of the apple, but the cells of the one 
always produce oak trees, while those of the other always pro- 
duce apple trees. The same is true of the germs of animals, 
there being not the slightest apparent difference. We are 
unable to perceive how one cell should give origin to a dog, 
while another exactly like it becomes a man. For aught we 
know, the ultimate atoms of these cells are identical in physical 
character; at least we have no means of detecting any difference. 
Species. The term species is generally used merely as a 
convenient name to designate certain assemblages of individuals 
having various striking points of resemblance. Scientific writers, 
as a rule, no longer hold that what are usually called species are 
constantly unvarying and unchangeable quantities. Recent 
researches point to the conclusion that all species vary more or 
less, and, in some instances, that the variation is so great that the 
limits of general specific distinctness are sometimes exceeded. 
Our space will not permit us to do more than merely indicate 
the two great fundamental ideas upon which the leading theories 
of the time respecting the origin of species are based. These 
are usually termed the doctrine of Special Creation and the doc- 
trine of Evolution. According to the doctrine of Special Crea- 
tion, it is thought that species are practically immutable produc- 
tions, each species having a specific centre where it was originally 
created, and from which it spread over a certain area until 
its further progress was obstructed by unfavorable conditions. 
The advocates of the doctrine of Evolution hold, on the contrary, 
that species are not permanent and immutable, but that they are 
subject to modification, and that " the existing forms of life are THE PROCESS OF GENERATION. 
15 
descendants by true generation of pre-existing forms." * Most 
naturalists are now inclined to admit the general truth of the 
theory of evolution, but they differ widely respecting the mode 
in which it occurred. 
THE PROCESS OF GENERATION 
The vital principle, represented in the sperm-cell by a sperm- 
atozoon, must be imparted to a germ-ce\\ in order to effect 
impregnation. After touching each other, separate them im- 
mediately, and observe the result. If, with the aid of a power- 
ful lens, we directly examine the spermatozoon, it will be per- 
ceived that, for a short time, it preserves its dimensions and 
retains all its material aspects. But it does not long withstand 
the siege of decay, and, having fulfilled its destiny, loses its 
organic characteristics, and begins to shrink. 
If we examine the fertilized germ, we discover unusual activ- 
ity, the result of impregnation. Organic processes succeed one 
another with wonderful regularity, as if wrought out by inexpli- 
cable intelligence. Here begin the functions which constitute 
human physiology. 
Generation requires that a spermatozoon be brought into actual 
contact with a germ that fecundation may follow. If a sperm- 
atic cell, or spermatozoon, together with several unimpregnated 
ova, no matter how near to one another, if not actually touching, 
be placed on the concave surface of a watch-crystal, and covered 
with another crystal, keeping them warm, and even though the 
vapor of the ova envelops it, no impregnation will occur. Place 
the spermatozoon in contact with an ovum, and impregnation is 
instantly and perfectly accomplished. Should this vitalizing 
power be termed nerve-force, electricity, heat, or motion? It is 
known that these forces may be metamorphosed; for instance, 
nervous force may be converted into electricity, electricity into 
heat, and heat into motion, thus illustrating their affiliation and 
capability of transformation. But nothing is explained respect- 
ing the real nature of the vital principle, if we assert its iden- 
tity with any of these forces; for who can reveal the true nature 
of any of these, or even of matter? 
* Darwin. 16 
COMMON SENSE MEDICAL ADVISER. 
ALTERNATE GENERATION. 
In several insect families, the species is not wholly represented 
in the adult individuals of both sexes, or in their development, 
but, to complete this series, supplementary individuals, as it 
were, of one or of several preceding generations, are required. 
The son may not resemble the father, but the grandfather, and 
in some instances, the likeness re-appears only in latter gener- 
ations. Agassiz states: "Alternate generation was first observed 
among the Salpse. These are marine mollusks, without shells, 
belonging to the family Tunicata. They are distinguished by 
the curious peculiarity of being united together in considerable 
numbers so as to form long chains, which float in the sea, the 
mouth (m) however being free in each. 
Fig. 2. 
Fig. 3. 
" Fig. 2. The individuals thus joined in floating colonies pro- 
duce eggs ; but in each animal there is generally but one egg 
formed, which is developed in the body of the parent, and from 
which is hatched a little mollusk. 
" Fig. 3, which remains solitary, and differs in many respects 
from the parent. This little animal, on the other hand, does not 
produce eggs, but propagates, by a kind of budding, which gives 
rise to chains already seen in the body of their parent (<?), and 
these again bring forth solitary individuals, etc." 
It therefore follows that generation in some animals requires 
two different bodies with intermdiate ones, by means of which, 
and their different modes of reproduction, a return to the original 
stock is effected. 
Universality of Animalcular Life.-Living organ- 
isms are universally diffused over every part of the globe. The 
gentle zephyr wafts from flower to flower invisible, fructifying 
atoms, which quicken beauty and fragrance, giving the promise 
of a golden fruitage, to gladden and nourish a dependent 
world. Nature's own sweet cunning invests all living things, THE ORIGIN OF LIFE. 
17 
constraining into her service chemical affinities, arranging the 
elements and disposing them for her own benefit, in such num- 
berless ways that we involuntarily exclaim, 
" The course of Nature is the art of God." 
The microscope reveals the fact that matter measuring only 
tWo'ot °f an inch in diameter may be endowed with vitality, 
and that countless numbers of animalcules often inhabit a single 
drop of stagnant water. These monads do not vary in form, 
whether in motion or at rest. The life of one, even, is an inex- 
plicable mystery to the philosopher. Ehrenberg writes: " Not 
only in the polar regions is there an uninterrupted development 
of active microscopic life, where larger animals cannot exist, 
but we find that those minute beings collected in the Antarctic 
expedition of Captain James Ross exhibit a remarkable abun- 
dance of unknown, and often most beautiful forms." 
Even the interior of animal bodies is inhabited by animalcules. 
They have been found in the blood of the frog and the salmon, 
and in the optic fluid of fishes. Organic beings are found in the 
interior of the earth, into which the industry of the miner has 
made extensive excavations, sunk deep shafts, and thus revealed 
their forms; likewise, the smallest fossil organisms form subter- 
ranean strata many fathoms deep. Not only do lakes and inland 
seas abound with life, but also, from unknown depths, in vol- 
canic districts, arise thermal springs which contain living insects. 
Were we endowed with a microscopic eye, we might see myriads 
of ethereal voyagers wafted by on every breeze, as we now be- 
hold drifting clouds of aqueous vapor. While the continents of 
earth furnishes evidences of the universality of organic beings, 
recent observations prove that "animal life predominates amid 
the eternal night *of the depths of the liquid ocean." 
THE ORIGIN OF LIFE. 
The ancients, rude in many of their ideas, referred the origin 
of life to divine determination. The thought was crudely ex- 
pressed, hut well represented, in the following verse: 
" Then God smites his hands together, 
And strikes out a soul as a spark, 
Into the organized glory of things, 
From the deeps of the dark." 18 
COMMON SENSE MEDICAL ADVISER. 
According to a Greek myth, Prometheus formed a human image 
from the dust of the ground, and then, by fire stolen from heaven, 
animated it with a living soul. Spontaneous generation once 
held its sway, and now the idea of natural evolution is popular. 
Some believe that the inpenetrable mystery of life is evolved 
the endowments of nature, and build their imperfect theory 
on observations of her concrete forms and their manifestations, 
to which all our investigations are restricted. But every func- 
tion indicates purpose, every organism evinces intelligent design, 
and all proclaim a Divine Power. Something cannot come out 
of nothing. With reason and philosophy, chance is an impossi- 
bility. We, therefore, accept the display of wisdom in nature 
as indicative of the designs of God. Thus " has He written His 
claims for our profoundest admiration and homage all over every 
object that He has made." If you ask: Is there any advantage 
in considering the phenomena of nature as the result of Divine 
Volition? we answer, that this belief corresponds with the 
universally acknowledged ideas of accountability; for, with a 
wise and efficient Cause, we infer there is an intelligent creation, 
and the desire to communicate, guide and bless, is responded to 
by man, who loves, obeys, and enjoys. Nothing is gained by 
attributing to nature vicegerent forces. Is it not preferable to 
say that she responds to intelligent, loving Omnipotence ? Our 
finiteness is illustrated by our initiation into organized being. 
Emerging from a rayless atom, too diminutive for the sight, we 
gradually develop and advance to the maturity of those conscious 
powers, the exercise of which furnishes indubitable evidence of 
our immortality. We are pervaded with invisible influences, 
which, like the needle of the compass trembling on its pivot, 
point us to immortality as our ultimate goal, where in the sunny 
clime of Love, even in a spiritual realm of joy and happiness, we 
may eternally reign with Him who is all in all. CHAPTER II. 
PHYSIOLOGICAL ANATOMY. 
THE BONES. 
All living bodies are made up of tissues. There is no part, 
no organ, however soft and yielding, or hard and resisting, 
which has not this peculiarity of structure. The bones of ani- 
mals, as well as their flesh and fat, are composed of tissues, and 
all alike made up of cells. When viewed under a micros- 
cope, each cell is seen to consist of three distinct parts, a 
nucleolus, or dark spot, in the center of the cell, around which 
lies a mass of granules, called the nucleus; and this, in turn, is 
surrounded with a delicate, transparent membrane, termed the 
envelope. Each of the granules composing the 
nucleus assimilates nourishment, thereby growing 
into an independent cell, which possesses a triple 
organization similar to that of its parent, and in 
like manner reproduces other cells. 
A variety of tissues enters into the composition 
of an animal structure, yet their differences are 
not always distinctly marked, since the character- 
istics 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 com- 
plete network of delicate fibers, spread over the 
body, and serves to bind the various organs and parts together. 
The fibrous and serous tissues are modifications of the areolar. 
-4- 
Nucleated cell. 
FromGoeber. 1. 
Periphery of the 
cell, or cell-wall. 
2. Nucleus. 3. 
Nucleolus in the 
center. 
19 20 
COMMON SENSE MEDICAL ADVISER. 
The Nervous Tissue is of two kinds: The gray, which is 
pulpy and granulated, and the white fibrous tissue. The Adi- 
pose Tissue is an extremely thin membrane, composed of closed 
cells which contain fat. It is found 
principally just beneath the skin, 
giving it a smooth, plump appear- 
ance. 
The Cartilaginous Tissue consists 
of nucleated cells, and, with the 
exception of bone, is the hardest 
part of the animal frame. The 
Osseous Tissue, or bone, is more 
compact and solid than the cartil- 
aginous, for it contains a greater 
quantity of lime. The Muscular 
Tissue is composed of bundles of 
fibers, which are enclosed in a cellular membrane. 
Various opinions have been entertained in regard to the 
formation, or growth, of bone. Some anatomists have sup- 
posed that all bone is formed 
in cartilage. But this is not 
true, for there is an intra- 
membranous, as well as an 
intra-cartilaginous, formation 
of bone, as may be seen in 
the development of the cran- 
ial bones, where the gradual 
calcification takes place upon 
the inner layers of the fibrous 
coverings. Intra cartilaginous 
deposit is found in the vicin- 
ity of the blood-vessels, within the cartilaginous canals; also, 
there are certain points first observed in the shafts of long 
bones, called centers of ossification. These points are no sooner 
formed than the cartilage corpuscles arrange themselves in 
concentric zones, and, lying in contact with one another, 
become very compact. As ossification proceeds, the cup-shaped 
cavities are converted into closed interstices of bone, with 
extremely thin lamellae, or layers. These, however, soon increase 
Fig. 5. 
Arrangement of fibers in the 
Areolar Tissue. Magnified 135 dia- 
meters. 
Fig. 6. 
Human Adipose Tissue. THE BONES. 
21 
iii density, and no blood-vessels can be observed within them 
The bony 
plates form 
the boundaries 
of the Haver- 
sian, or nutri- 
tive canals of 
the bones. In 
the second 
stage of ossifi- 
cation, the 
cartilage cor- 
puscles are 
converted into 
bone. Becom- 
ing flattened 
against the os- 
seous lamellae 
already form- 
ed, they crowd 
upon one another so as 
to entirely obliterate the 
lines that distinguish 
them; and, simulta- 
neously with these 
changes, a calcareous de- 
Fig. 7. 
Fig. 8. 
Thigh-bone, 
sawn open 
lengthwise. 
Fig. 9. 
Vertical section of cartilage near the surface of 
ossification. 1. Ordinary appearance of the tem- 
porary cartilage. 1'. Portion of the same more 
highly magnified. 2. The cells beginning to form 
into concentric zones. 2'. Portion more magni- 
fied. 3. The ossification is extending in the inter- 
cellular spaces, and the rows of cells are seen 
resting in the cavities so formed, the nuclei being 
more separated than above. S'. Portion of the 
same more highly magnified. 
Lower end of fhe thigh_bone 
gawn acrogs, showing its centra) 
cavb;y 
posit takes place upon 
their interior. Bones 
grow by additions to 
their ends and surfaces. In the child, their extremities are 22 
COMMON SENSE MEDICAL ADVISEE. 
separated from the body of the bone by a layer of car- 
tilage, and the cancellated, or cellular structure, which remains 
for a time in the interior, represents the early condition of the 
ossifying substances. 
The bones contain more earthy matter in their composition 
than any other part of the human body, being firm, hard, and of 
a lime color. They compose the skeleton or frame work, and, 
when united by natural ligaments, form what is known as the 
natural skeleton; when they are wired together, they are called 
an artificial skeleton. 
The number of bones 
in the human body is 
variously estimated; for 
those regarded as single 
by some anatomists are 
considered by others to 
consist of several distinct 
pieces. There are two 
hundred distinct bones 
in the human skeleton 
besides the teeth. These 
may be divided into 
those of the Head, 
Trunk, Upper Extrem- 
ities, and Lower Ex- 
tremities. 
The Bones of the 
Head are classed as 
follows: eight belong- 
ing to the Cranium, and 
fourteen to the Face. 
The bones of the 
Cranium are the occip- 
two parietal, two temporal, frontal, sphenoid, and ethmoid. 
Those composing the face are, the two nasal, two superior 
maxillary, two lachrymal, two malar two palate, two infer- 
ior turbinated, vomer, and inferior maxillary. The cranial 
bones are composed of two dense plates, between which there is, 
in most places, a cancellated or cellular tissue. The external 
Fig. 10. 
The bones of the skull separated. 1. Frontal, 
only half is seen. 2. Parietal. 3. Occipital, only 
half is seen. 4. Temporal. 5. Nasal. 6. Malar. 
7. Superior maxillary (upper jaw). 8. Lachry- 
mal. 9. Inferior maxillary (lower jaw). Between 
4 and 6 a part of the sphenoid or wedge-shaped 
bone, is seen. Another bone assisting to form 
the skull, but not here seen, is called the ethmoid 
(sieve-like, from being full of holes), and is situ- 
ated between the sockets of the eyes, forming the 
roof of the nose. THE TRUNK. 
23 
plate is fibrous, the internal, compact and vitreous. The skull is 
nearly oval in form, convex externally, the bone being much 
thicker at the base than elsewhere, and it is, in every respect 
admirably adapted to resist any injury to which it may be 
exposed, thus affording ample protection to the brain substance 
which it envelops. The internal surface of the cranium presents 
eminences and depressions for lodging the convolutions of the 
brain, and numerous furrows for the ramifications of the blood- 
vessels. The bones of the cranium are united to one anothei' by 
ragged edges called sutures, which are quite distinct in the adult, 
but which in old age are nearly Some authorities sup- 
pose that by this arrangement 
the cranium is less liable to be 
fractured by blows; others 
think that the sutures allow 
the growth of these bones, 
which takes place by a grad- 
ual osseous enlargement at the 
margins. The bones of the 
Face are joined at the lower 
part and in front of the cran- 
ium, and serve for the attach- 
ment of powerful muscles 
which assist in the process of 
mastication. Although the soft 
parts of the face cover the 
bony structure, yet they do 
not conceal its principal feat- 
tures, or materially change its 
proportions. The form of the 
head and face presents some 
remarkable dissimilarities in 
different races. 
The Trunk has fifty-four 
bones, which are as follows: The Os Hyoides, the Sternum, 
twenty-four Ribs, twenty-four vertebrae, or bones of the Spinal 
Column, the Sacrum, the Coccyx, and two Ossa Innominata. 
The Os Hyoides, situated at the base of the tongue, is the most 
isolated bone of the skeleton, and serves for the attachment of 
Fig. 11. 
1. The first bone of the sternum (breast- 
bone). 2. The second bone of the sternum. 
3. The cartilage of the sternum, k. The 
first dorsal vertebra (a bone of the spinal 
column). 5. The last dorsal vertebra. 6. 
The first rib. 7. Its head. 8. Its neck. 9. 
Its tubercle. 10. The seventh or last true 
rib. 11. The cartilage of the third rib. 12. 
The floating ribs. 24 
COMMON SENSE MEDICAL ADVISER. 
muscles. The Sternum, or breast-bone, in a child is composed 
of six pieces, in the adult of three, which in old 
age are consolidated into one bone. The Ribs are 
thin, curved bones, being convex externally. 
There are twelve on each side, and all are at- 
tached to the spinal column. The seven upper 
ribs, which are united in front of the sternum, are 
termed true ribs; the next three, which are not at- 
tached to the sternum, 
but to one another are 
called false ribs; and 
the last two, which are 
joined only to the ver- 
tebra?, are designated 
as floating ribs. The 
first rib is the shortest, 
and they increase in 
length as far as the 
eighth, after which this 
order is reversed. 
The Spinal Column 
or back-bone, when viewed from the front presents 
a perpendicular appearance, but a side view shows 
four distinct curves. 
The bones composing 
it are called vertebra?. 
The body part of a ver- 
tebra is light and 
spongy in texture, hav- 
ing seven projections 
called processes, four 
of which are the artic- 
ular processes, which 
furnish surfaces to join 
the different vertebrae 
of the spinal column. 
Two are called trans- 
verse, and the remain- 
ing one is termed the spinous. The transverse 
Fig. 11,.. 
' 
A vertebra of the neck. 1. The 
body of the vertebra. 2. The spi- 
nal canal. Z>. The spinous process 
cleft at its extremity. 5. The 
transverse process. 7. The in- 
terior articular process. 8. The 
superior articular process. 
Fig. 13. 
Back-bone, spinal 
column, or verte- 
bral column. All 
animals possessing 
such a row of bones 
are called verte- 
brates. Above b are 
the cervical (neck) 
vertebrae: b to c, 
dorsal (back) or 
chest vertebrae; c 
to d, lumbar (loins) 
vertebrae; d to e, sa- 
crum ; e to/,coccyx. 
1. The cartilaginous substance 
which connects the bodies of 
the vertebra?. 2. The body of tbe 
vertebra. 3. The spinous pro- 
cess. h. It. The transverse proces- 
ses. 5,5. The articular processes. 
6, 6. A portion of the bony bridge 
which assists in forming the spi- 
nal canal (7). BONES OF THE UPPER EXTREMITIES. 
25 
and spinous processes serve for the attachment of the muscles 
belonging to the back. All these processes are more compact 
than the body of the vertebra, and, when naturally connected, 
are so arranged as to form a tube which contains the medulla 
spinalis, or spinal cord. Between the vertebrae is a highly-elas- 
tic, cartilaginous and cushion-like substance, which freely admits 
of motion, and allows the spine to bend as occasion requires. 
The natural curvatures of the spinal column diminish the shock 
produced by falling, running or leaping, which would otherwise 
be more directly transmitted to the brain. The ribs at the sides, 
the sternum in front, and the twelve dorsal bones of the spinal 
column behind, bound the thoracic cavity, which contains the 
lungs, heart, and large blood-vessels. 
The Pelvis is an open bony structure, consisting of the Os In- 
nominata, one on either side, and the Sacrum and Coccyx behind. 
The Sacrum, during 
childhood, consists of 
live bones, which in 
latei* years unite to 
form one bone. It is 
light and spongy in 
texture, and the upper 
surface articulates 
with the lowest verte- 
bra, while it is united 
at its inferior margin 
to the coccyx. The 
Coccyx, is the terminal 
bone of the spinal col- 
umn. In infancy it is 
cartilaginous and com- 
posed of several pieces, but in the adult these unite and form one 
bone. The Innominata, or nameless bones, during youth, con- 
sist of three separate pieces on each side; but as age advances 
they coalesce and form one bone. A deep socket, called the 
acetabulum, is found near their junction, which serves for the 
reception of the head of the thigh-bone. 
The Bones of the Upper Extremities are sixty- 
four in number, and are classified as follows: The Scapula, 
Fig. 15. 
A representation of the pelvic bones, e. The 
lumbo-sacral joint. 2. The sacrum. 3. Coccyx. 1, 
1. The innominata. 4, 4. Acetabula. 26 
COMMON SENSE MEDICAL ADVISER. 
Clavicle, Humerus, Ulna, Kadius, Carpus, Metacarpus, and 
Phalanges. The Scapula, or shoulder-blade, is an irregular, thin, 
triangular bone, situated at 
the posterior part of the 
shoulder, and attached to 
the upper and back part 
of the chest. The Clavicle, 
or collar-bone, is located at 
the upper part of the chest, 
between the sternum and 
scapula, and connects with 
both. Its form resembles 
that of the italic letter f, 
and it prevents the arms 
from sliding forward. The 
Humerus, the first bone of 
the arm, is long, cylindrical, 
and situated between the 
scapula and fore-arm. The 
Ulna is nearly parallel with 
the radius, and situated on 
the inner side of the fore- 
arm. It is the longer and 
larger of the two bones, and 
in its articulation with the 
humerus, forms a perfect 
hinge-joint. The Radius, 
so called from its resem- 
blance to a spoke, is on the 
outer side of the fore-arm, 
and articulates with the 
bones of the wrist, forming 
a joint. The ulna and ra- 
dius also articulate with 
each other at their extrem- 
ities. The Carpus, or wrist, 
consists of eight bones, ar- 
ranged in two rows. The 
Metacarpus, or palm of the hand, is composed of five bones, 
Fig. 16. 
1. 1. Portions of the back-bone. 2. Cranial 
bones. 4. Breast-bone. 5. Bibs. 7. Collar- 
bone. 8. Arm-bone (humerus). 9. Shoulder- 
joint. 10,11. Bones of the fore-arm (ulna and 
radius). 12. Elbow-joint. 13. Wrist-joint. 14. 
Bones of the hand. 15,16. Pelvic bones. 17. 
Hip-joint. 18. Femur. 19, 20. Bones of the 
knee-joint. 21, 22. Fibula and tibia. 23. Ankle 
bone. 24. Bones of the foot. BONES OE THE LOWER EXTREMITIES. 
27 
situated between the carpus and fingers. The Phalang es, four- 
teen in number, are the bones of the fingers and thumb, the 
fingers each having three and the thumb two. 
The Bones of the Lower Extremities, sixty in 
number, are classed as follows: The Femur, Patella, Tibia, Fibula, 
Tarsus, Metatarsus, and Phalanges. The Femur, or thigh-bone, 
is the longest bone in the body. It has a large round head, 
which is received into the acetabulum, thus affording a good 
illustration of a ball and socket joint. The Patella,or knee-pan, 
is the most complicated articulation of the body. It is of a round 
form, connects with the tibia by means of a strong ligament, and 
serves to protect the front of the joint, and to increase the 
leverage of the muscles attached to it, by causing them to act at 
a greater angle. The Tibia, or shin bone, is enlarged at each 
extremity and articulates with the femur above and the astragalus, 
the upper bone of the tarsus, below. The Fibula, the small bone 
of the leg, is situated on the outer side of the tibia, and is firmly 
bound to it at each extremity. The Tarsus, or instep, is com- 
posed of seven bones, and corresponds to the carpus of the upper 
extremities. The Metatarsus, the middle of the foot, bears a 
close resemblance to the metacarpus, and consists of five bones 
situated between the tarsus and the phalanges. The tarsal and 
the metatarsal bones are so united as to give an arched appear- 
ance to the foot, thus imparting elasticity. The Phalanges, the 
toes, consist of fourteen bones, arranged in a manner similar to 
that of the fingers. 
We are not less interested in tracing the formation of bone 
through its several stages, than in considering other parts of the 
human system. The formation of the Haversian canals for the 
passage of blood-vessels to nourish the bones, the earlier con- 
struction of bony tissue by a metamorphosis of cartilaginous 
substance, and also the commencement of ossification at distinct 
points, called centers of ossification, are all important subjects, 
requiring the student's careful attention. The bones are pro- 
tected by an external membranous envelope, which, from its 
situation is called the periosteum. The bones are divided into 
four classes, long, short, flat and irregular, being thus adapted to 
subserve a variety of purposes. 
The Long Bones are found in the limbs, where they act as 28 
COMMON SENSE MEDICAL ADVISER. 
levers to sustain the body and aid in locomotion. Each long 
bone is composed of a cylinder, known as the shaft, and two 
extremities. The shaft is hollow, its walls being thickest in the 
middle and growing thinner toward the extremities. The extrem- 
ities are usually considerably enlarged, for convenience of con- 
nection with other bones and to afford a broad surface for the 
attachment of muscles. The clavical, humerus, radius, ulna, 
femur, tibia, fibula, the bones of the metacarpus, metatarsus 
and the phalanges, are classed as long bones. 
Where the principal object to be attained is strength, and the 
motion of the skeleton is limited, the individual bones are short 
and compressed, as the bones of the carpus and tarsus. The 
structure of these bones is spongy, except at the surface, where 
there is a thin crust of compact matter. 
Fig. 17. 
Fig. 18. 
Anatomy of the knee-joint. 
1. Lower end of thigh-bone. 
3. Knee-pan. 2, 4. Ligaments 
of the knee-pan. 5. Upper 
end of the tibia, or shin-bone. 
6, 12. Cartilages, 
Anatomy of a joint, I, 1. 
Bones of a joint. ®, 3. Car- 
tilage. 3, 3, 3, 3. Synovial 
membrane. 
When protection is required for the organs of the body, or a 
broad flat surface for the attachment of the muscles, the bones 
are expanded into plates, as in the cranium and shoulder-blades. 
The irregular or mixed bones are those which, from their 
peculiar shape, cannot be classed among any of the foregoing 
divisions. Their structure is similar to the others, consisting of 
cancellar tissue, surrounded by a crust of compact matter. 
The vertebrre, sacrum, coccyx, temporal, sphenoid, ethmoid, 
malar, two maxillary, palate, inferior turbinated, and hyoid are 
known as irregular bones. 
The formation of the joints requires not only bones, but also BONES OE THE LOWER EXTREMITIES. 
29 
cartilages, ligaments, and the synovial membrane, to complete 
the articulation. Cartilage is a smooth, elastic substance, softer 
than bone, and invested with a thin membrane, called perichon- 
drium. When cartilage is placed upon convex surfaces, the 
reverse is true. The Ligaments are white, inelastic, tendinous 
substances, softer than cartilage, but harder than membrane. 
Their function is to bind together the bones. The Synovial 
Membrane covers the cartilages, and is then reflected upon the 
ligaments, thus forming a thin, closed sac, called the synovial 
capsule. 
All the synovial membranes secrete a lubricating fluid, termed 
synovia, which enables the surfaces of the bones and ligaments 
to move freely upon one another. When this fluid is secreted in 
excessive quantities, it produces a disease known as " dropsy of 
the joints." There are numerous smaller sacs besides the syno- 
vial, called bursae mucosae, which in structure are analogous to 
them, and secrete a similar fluid. Some joints permit motion in 
every direction, as the shoulders, some in two directions only, as 
the elbows, while others do not admit of any movement. The 
bones, ligaments, cartilages, and synovial membrane, are supplied 
with nerves, arteries, and veins. 
When an animal is provided with an internal bony structure, 
it indicates a high rank in the scale of organization. An elaborate 
texture of bone is found in no class below the vertebrates. 
Even in the lower order of this sub-kingdom, 'which is the highest 
of animals, bone does not exist, as is the case in some tribes 
of fishes, such as sharks, etc., and in all classes below that of the 
cartilaginous fishes, the inflexible substance which sustains the 
soft parts is either shell or some modification of bone, and is 
usually found on the outside of the body. True bone, on the 
contrary, is found in the interior, and, therefore, in higher 
animals, the skeleton is always internal, while the soft parts are 
placed external to the bony frame. While many animals of the 
lowest species, being composed of soft gelatinous matter, are 
buoyant in water, the highest type of animals requires not only a 
bony skeleton, but also a flexible, muscular system, for locomo- 
tion in the water or upon the land. Each species of the animal 
kingdom is-thus organically adapted to its condition and sphere 
of life. CHAPTER HJ. 
PHYSIOLOGICAL ANATOMY. 
THE MUSCLES. 
The Muscles are those organs of the body by which motion 
is produced, and are commonly known as flesh. A muscle is 
composed of fasciculi, or bundles of fibers, parallel to one 
another. They are soft, varying in size, of a reddish color, and 
inclosed in a cellular, membranous sheath. Each fasciculus 
contains a number of small fibers, which, when subjected to a 
microscopic examination, are found to consist of fibrillae, or 
little fibers; each of these fibrillae in turn 
being invested with a delicate sheath. The 
fibers terminate in a glistening, white tendon, 
or hard cord, which is attached to the bone. 
So firmly are they united, that the bone will 
break before the tendon can be released. 
When the tendon is spread out, so as to 
resemble a membrane, it is called fascia. 
Being of various extent and thickness, it is 
distributed over the body, as a covering and 
protection for the more delicate parts, and 
aids also in motion, by firmly uniting the 
muscular fibers. The spaces between the 
muscles are frequently filled with fat, which 
gives roundness and beauty to the limbs. The muscles are of 
various forms; some are longitudinal, each extremity terminat- 
ing in a tendon, which gives them a fusiform or spindle-shaped 
appearance; others are either fan-shaped, flat, or cylindrical. 
Fig. 19. 
Muscular fibers highly 
magnified. 
30 THE MUSCLES. 
31 
Every muscle has an origin and an insertion. The term 
origin is applied to the more 
fixed or central attachment of 
a muscle, and the term inser- 
tion to the movable point to 
which the force of the muscle 
is directed; but the origin is 
not absolutely fixed, except in 
a small number of muscles, as 
those of the face, which are 
attached at one extremity to 
the bone, and at the other to 
the movable integument, or 
skin. In most instances, the 
muscles may act from either 
extremity. The muscles are 
divided into the Voluntary, or muscles of animal life, and the 
Involuntary, or muscles of organic life. There are, however, 
some muscles which cannot properly be classified with either, 
termed Intermediate. 
The Voluntary Muscles 
are chiefly controlled 
by the will, relaxing 
and contracting at its 
pleasure, as in the mo- 
tion of the eyes, mouth, 
and limbs. The fibers 
are of a dark red color, 
and possess great 
strength. These fibers 
are parallel, seldom in- 
terlacing, but present- 
ing a striped or striated 
appearance; and a mi- 
croscopic examination 
of them shows that even the most minute consist of parallel 
filaments marked by longitudinal and transverse striae, or minute 
channels. The fibers are nearly the same length as the muscles 
to which they belong. Each muscular fiber is capable of 
Fig. 20. 
1. A spindle-shaped muscle, with tendi- 
nous terminations. 2. Fan-shaped muscle. 
3. Penniform muscle. A. Bipenniform 
muscle. 
Fig. 21. 
Striped muscular fibers showing cleavage in 
opposite directions. 1. Longitudinal cleavage. 
2. Transverse cleavage. 3. Transverse section of 
disc. 4. Disc nearly detached. 5. Detached disc, 
showing the sarcous elements. 6. Fibrillae. 7, 8. 
Separated fibrillae highly magnified. 32 
COMMON SENSE MEDICAL ADVISER. 
contraction; it may act singly, though usually it acts in unison 
with others. By a close inspection, it has 
been found that fibers may be drawn 
apart longitudinally, in which case they 
are termed or they may be sep- 
arated transversely, forming a series of 
discs. The Sar colemma, or investing sheath 
of the muscles, appears to be formed even 
before there are any visible traces of the 
muscle itself. It is a transparent and deli- 
cate membrane, but very elastic. The 
Involuntary Muscles are influenced by the 
sympathetic nervous system, and their 
action pertains to the nutritive functions 
of the body. They differ from the volun- 
tary muscles in not being striated, having 
no tendons, and in the net-work arrange- 
ments of their fibers. The Intermediate 
Muscles are composed of striated and 
unstriated fibers; they are, therefore, both 
voluntary and involuntary in their func- 
tions. The muscles em- 
ployed in respiration 
are of this class, 
for we can breathe rap- 
idly or slowly, and, for 
a short time, even 
suspend then- action; 
but soon, however, the 
organic muscles assert 
their instinctive con- 
trol, and respiration is 
resumed. 
The Diaphragm, 
or midriff, is the mus- 
cular division between 
the thorax and the ab- 
domen. It has been 
compared to an inverted basin, the concavity of which is 
Fig. 22. 
Unstriated muscular 
fiber; at b, in its natural 
state; at a, showing the 
nuclei after the action of 
acetic acid. 
Fig. 23. 
A view of the under side of the diaphragm. THE MUSCLES. 
33 
Fig. ZJf. 
A representation of the superficial layer of muscles on the anterior 
portion of the body. 34 
COMMON SENSE MEDICAL ADVISER. 
directed toward the abdomen. The muscles receive their nour- 
ishment from the numerous blood-vessels which penetrate their 
tissues. The voluntary muscles are abundantly supplied with 
nerves, while the involuntary are not so numerously furnished. 
The color of the muscles is chiefly due to the blood which they 
contain. They vary in size according to their respective func- 
tions. For example, the functions of the heart require large 
and powerful muscles, and those of the eye, small and delicate 
ones. There are between four hundred and sixty and five 
hundred muscles in the human body. 
Very rarely is motion produced by the action of a single muscle, 
but by the harmonious action of several. There is infinite variety 
in the arrangement of the muscles, each being adapted to its 
purpose, in strength, tenacity, or elasticity. While some invol- 
untarily respond to the wants of organic life, others obey, with 
mechanical precision, the edicts of the will. The peculiar char- 
acteristic of the musclesis their contractility; for example, when 
the tip of the finger is placed in the ear, an incessant vibration, 
due to the contraction of the muscles of the ear, can be heard. 
When the muscles contract, they become shorter; but what is 
lost in length is gained in breadth and thickness, so that their 
actual volume remains the same. Muscles alternately contract 
and relax, and thus act upon the bones. The economy of 
muscular power thus displayed is truly remarkable. In easy and 
graceful walking, the forward motion of the limbs is not alto- 
gether due to the exercise of muscular power, but partly to the 
force of gravity, and only a slight assistance of the muscles is 
required to elevate the leg sufficiently to allow it to oscillate. 
Motion is a characteristic of living bodies. This is true, not 
only in animals, but also in plants. The oyster, although not 
possessing the power of locomotion, opens and closes its shell at 
pleasure. The coral insect appears at the door of its cell, and 
retreats at will. All the varied motions of animals are due to 
a peculiar property of the muscles, termed contractility. Al- 
though plants are influenced by external agents, as light, 
heat, electricity, etc., yet it is supposed that they may move in 
response to inward impulses. The sensitive stamens of the 
barberry, when touched at their base on the inner side, resent 
the intrusion, by making a sudden jerk forward. Venus's THE MUSCLES. 
35 
Fig. 25. 
A representation of the superficial layer of muscles on the posterior 
portion of the body. 36 
COMMON SENSE MEDICAL ADVISER. 
fly-trap, a plant found in North Carolina, is remarkable for the 
sensitiveness of its leaves, which close suddenly and capture 
insects which chance to alight upon them. The muscles of the 
articulates are situated within the solid frame-work, unlike the 
vertebrates, whose muscles are external to the bony skeleton. 
All animals have the power of motion, from the lowest radiate 
to the highest vertebrate, from the most repulsive polyp to that 
type of organized life made in the very image of God. 
The muscles, then, subserve an endless variety of purposes. 
By their aid the farmer employs his implements of husbandry, 
the mechanic deftly wields his tools, the artist plies his brush, 
while the fervid orator gives utterance to thoughts glowing with 
heavenly emotions. It is by their agency that the sublimest 
spiritual conceptions can be brought to the sphere of the senses, 
and the noblest, loftiest aims of to-day can be made glorious 
realizations of the future. CHAPTER IV. 
PHYSIOLOGICAL ANATOMY. 
THE DIGESTIVE ORGANS. 
Digestion signifies the act of separating or distributing, 
hence its application to the process by which food is made avail- 
able for nutritive purposes. The organs of digestion are the 
Mouth, Teeth, Tongue, Salivary Glands, Pharynx, Esophagus, 
the Stomach and the Intestines, with then* glands, the Liver, 
Pancreas, Lacteals, and the Thoracic Duct. 
The Mouth is an irregular cavity, situated between the upper 
and the lower jaw, and contains 
the organs of mastication. It 
is bounded by the lips in front, 
by the cheeks at the sides, by 
the roof of the mouth and teeth 
of the upper jaw above, and 
behind and beneath by the teeth 
of the lower jaw, soft parts, and 
palate. The soft palate is a 
sort of pendulum attached only 
at one of its extremities, while 
the other involuntarily opens 
and closes the passage from 
the mouth to the pharynx. 
The interior of the mouth, as 
well as other portions of the alimentary canal, is lined with a 
delicate tissue, called mucous membrane. 
The Teeth are firmly inserted in the alveoli or sockets, of 
the upper and the lower jaw. The first set, twenty in number, 
are temporary, and appear during infancy. They are replaced 
Fig. 26. 
A view of the lower jaw. 1. The body. 
3. 2. Rami, or branches. 3, 3. Processes of 
the lower jaw. m. Molar teeth, b. Bi- 
cuspids. c. Cuspids, i. Incisors. 
37 38 
COMMON SENSE MEDICAL ADVISER. 
by permanent teeth, of which there are sixteen in each jaw ; 
four incisors, or front teeth, four cuspids, or eye teeth, four 
bicuspids, or grinders, and four molars, or large grinders. Each 
tooth is divided into the crown, body, and root. The crown is 
the grinding surface ; the body, the part projecting from the 
jaw, is the seat of sensation and nutrition ; the root is that por- 
tion of the tooth which is inserted in the alveolus. The teeth 
are composed of dentine, or ivory, and enamel. The ivory 
forms the greater portion of the body and root, while the 
enamel covers the exposed surface. The small white cords 
communicating with the teeth are the nerves. 
The Tongue is a flat oval organ, the base of which is attached 
to the os hyoides, 
while the apex, 
the most sensi- 
tive part of the 
body, is free. Its 
surface is cov- 
ered with a mem- 
brane, which, at 
the sides and 
lower part, is 
continuous with 
the lining of the 
mouth. On the 
lower surface of 
the tongue, this 
membrane is thin 
and smooth, but 
on the upper side 
it is covered with 
numerous papillae, which, in structure, are similar to the sensitive 
papillae of the skin. 
The Salivary Glands are six in number, three on each side 
of the mouth. Their function is to secrete a fluid called saliva, 
which aids in mastication. The largest of these glands, the 
Parotid, is situated in front and below the ear; its structure, like 
that of all the salivary glands, is cellular. The Submaxillary 
gland is circular in form, and situated midway between the 
Fig. 27. 
The salivary glands. The largest one, near the ear, is the 
parotid gland. The next below it is the submaxillary gland. 
The one under the tongue is the sublingual gland. THE DIGESTIVE ORGANS. 
39 
angle of the lower jaw and the middle of the chin. The Sub- 
lingual is a long flattened gland, and, as its name indicates, is 
located below the tongue, which when elevated, discloses the 
saliva issuing from its porous openings. 
The Pharynx is nearly four inches in length, formed of mus- 
cular and membranous cells, and situated between the base of 
the cranium and the esophagus, in front of the spinal column. 
It is narrow at the upper part, distended in the middle, contract- 
ing again at its junction with the esophagus. The pharynx 
communicates with the nose, mouth, larynx, and stomach. 
The Esophagus, a cylindrical organ, is a continuation of the 
pharynx, and extends through the diaphragm to the stomach. 
It has three coats: first, the muscular, consisting of an exterior 
layer of fibers running longitudinally, and an interior layer of 
transverse fibers; second, 
the cellular, which is 
interposed between the 
muscular and the mu- 
cous coat; third, the 
mucous membrane, or 
internal coat, which is 
continuous with the mu- 
cous lining of the phar- 
ynx. 
The Stomach is a mus- 
culo-membranous, 
conoidal sac, coinmuni- 
cating with the 
esophagus by means of 
the cardiac orifice (see 
Fig. 28). It is situated obliquely with reference to the body, 
its base lying at the left side, while the apex is directed toward 
the right side. The stomach is between the liver and spleen, 
subjacent to the diaphragm, and communicates with the intes- 
tinal canal by the pyloric orifice. It has three coats. The 
peritoneal, or external coat is composed of compact, cellular 
tissue, woven into a thin, serous membrane, and assists in 
keeping the stomach in place. The middle coat is formed of 
three layers of muscular fibers: in the first, the fibres run 
Fig. 28. 
A representation of the interior of the stomach. 
1. The esophagus. 2. Cardiac orifice opening into 
the stomach. 6. The middle or muscular coat. 
7. The interior or mucous coat. 10. The begin- 
ning of the duodenum. 11. The pyloric orifice. 40 
COMMON SENSE MEDICAL ADVISER. 
longitudinally; in the second, in a circular direction; and in the 
third, they are placed obliquely to the others. The interior, 
or mucous coat, lines this organ. The stomach has a soft, 
spongy appearance, and, when not distended, lies in folds. Dur- 
ing life, it is ordinarily of a pinkish color. It is provided with 
numerous small glands, which secrete the gastric fluid necessary 
for the digestion of food. The lining membrane, when divested 
of mucus, has a wrinkled appearance. The arteries, veins, and 
lymphatics, of the stomach are numerous. 
The Intestines are those convoluted portions of the alimentary 
canal into which the food is received after being partially 
digested, and in which the 
separation and absorption of 
the nutritive materials and the 
removal of the residue take 
place. The coats of the intes- 
tines are analogous to those of 
the stomach, and are, in fact, 
only extensions of them. For 
convenience of description, the 
intestines may be divided into 
the small and the large. The 
small intestine is from twenty 
to twenty-five feet in length, 
and consists of the Duodenum, 
Jejunum, and Ileum. The Duo- 
denum, so called because its 
length is equal to the breadth 
of twelve fingers, is the first 
division of the small intestine. 
If the mucous membrane of 
the duodenum be examined, it 
will be found thrown into 
numerous folds, which are 
called valvulas conniventes, the 
chief function of which ap- 
pears to be to retard the course of the alimentary matter, and 
afford a larger surface for the accommodation of the absorbent 
vessels. Numerous villi, minute thread-like projections, will be 
Fig. 29. 
Small and large intestines. 1, 1, 3, s. 
Small intestine. 3. Its termination in the 
large intestine. 4. Appendix vermi- 
formis. 5. Caecum. 6. Ascending colon. 
7. Transverse colon. 8. Descending colon. 
9. Sigmoid flexure of colon. 10. Rectum. THE DIGESTIVE ORGANS. 
41 
found scattered over the surface of these folds, set side by side, 
like the pile of velvet. Each villus contains a net-work of 
blood-vessels, and a lacteal tube, into which the ducts from the 
liver and pancreas open, and pour their secretions to assist in the 
conversion of the chyme into 
chyle. The Jejunum, so 
named because it is usually 
found empty after death, is a 
continuation of the duode- 
num, and is that portion of 
the alimentary canal in which 
the absorption of nutritive 
mattei* is chiefly effected. 
The Ileum, which signifies 
something rolled up, is the 
longest division of the small 
intestine. Although some- 
what thinner in texture than 
the jejunum, yet the differ- 
ence is scarcely perceptible. The large intestine is about five 
feet in length, and is divided into the Caecum, Colon, and 
Rectum. The Caecum is about three inches in length. Between 
the large and the small 
intestine is a valve, which 
prevents the return of ex- 
crementitious matter that 
has passed into the large 
intestine. There is attached 
to the caecum an appendage 
about the size of a goose- 
quill, and three inches in 
length, termed the appen- 
dix vermiformis. The Co- 
lon is that part of the large 
intestine which extends 
from the caecum to the 
rectum, and which is di- 
vided into three parts, dis- 
tinguished as the ascending, the transverse, and the descending. 
Fig. 30. 
Villi of the small intestine greatly 
magnified. 
Fig. 31. 
A section of the Ileum, turned Inside out, 
so as to show the appearance and arrange- 
ment of the villi on an extended surface. 42 
COMMON SENSE MEDICAL ADVISER. 
The Rectum is the terminus of the large intestine. The intes- 
tines are abundantly supplied with blood-vessels. The arteries 
of the small intestine are from fifteen to twenty in number. 
The large intestine is furnished with three arteries, called the 
colic arteries. The ileo-colic artery sends branches to the lower 
part of the ileum, the head 
of the colon, and the ap- 
pendix vermiforinis. The 
right colic artery forms 
arches, from which branches 
are distributed to the as- 
cending colon. The colica 
media separates into ' two 
branches, one of which is 
sent to the right portion of 
the transverse colon, the 
other to the left. In its 
course, the superior hemor- 
rhoidal artery divides into 
two branches, which enter 
the intestine from behind, 
and embrace it on all sides, 
almost to the anus. 
The Thoracic Duct is the 
principal trunk of the ab- 
sorbent system, and the canal 
through which much of the 
chyle and lymph is conveyed 
to the blood. It begins by a 
convergence and union of the 
lymphatics on the lumbar 
vertebrae, in front of the 
spinal column, then passes 
upward through the dia- 
phragm to the lower part of 
the neck, thence curves forward and downward, opening into 
the subclavian vein near its junction with the left jugular vein, 
which leads to the heart. 
The Liver, which is the largest gland in the body, weighs 
Fig. 32. 
c, c. Right and left subclavian veins, b. 
Inferior vena cava. a. Intestines, d. En- 
trance of the thoracic duct into the left 
subclavian vein. 4. Mesenteric glands, 
through which the lacteals pass to the 
thoracic duct. THE DIGESTIVE ORGANS. 
43 
about four pounds in the adult, and is located chiefly on the 
right side, immediately below the diaphragm. It is a single 
organ, of a dark red color, its upper surface being convex, while 
the lower is concave. It has two large lobes, the right being 
nearly four times as large as the left. The liver has two coats, 
the serous, which is a complete investment, with the exception 
of the diaphragmatic border, and the depression for the gall- 
bladder, and which 
helps to suspend and 
retain the organ in 
position; and the 
fibrous, which is the 
inner coat of the liver, 
and forms sheaths for 
the blood-vessels and 
excretory ducts. The 
liver is abundantly 
supplied with arteries, 
veins, nerves, and lym- 
phatics. Unlike the 
other glands of the 
human body, it re- 
ceives two kinds of blood; the arterial for its nourishment, and 
the venous, from which it secretes the bile. In the lower 
surface of the liver is lodged the gall-bladder, a membranous 
sac, or reservoir, for the bile. This fluid is not absolutely 
necessary to the digestion of food, since this process is effected 
by other secretions, nor does bile exert any special action upon 
starchy or oleaginous substances, when mixed with them at a 
temperature of 100° F. Experiments also show that in some 
animals there is a constant flow of bile, even when no food has 
been taken, and there is consequently no digestion to be per- 
formed. Since the bile is formed from the venous blood, and 
taken from the waste and disintegration of animal tissue, it 
would appear that it is chiefly an excrementitious fluid. It does 
not seem to have accomplished its function when discharged from 
the liver and poured into the intestine, for there it undergoes 
various alterations previous to re-absorption, produced by its con- 
tact with the intestinal juices. Thus the bile, after being 
Fig. 33. 
The inferior surface of the liver. 1. Right lobe. 
2. Left lobe. 3. Gall-bladder. 44 
COMMON SENSE MEDICAL ADVISER. 
transformed in the intestines, re-enters the blood under a 
new form, and is carried to some other part of the system 
to perform its mission. 
The Spleen is oval, 
smooth, convex on its 
external, and irregularly 
concave on its internal, 
surface. It is situated 
on the left side, in con- 
tact with the diaphragm 
and stomach. It is of a 
dark red color, slightly 
tinged with blue at its 
edges Some physiolo- 
gists affirm that no 
organ receives a greater 
quantity of blood, ac- 
cording to its size, than 
the spleen. The struc- 
ture of the spleen and 
that of the mesenteric 
glands are similar, al- 
though the former is 
provided with a scanty 
supply of lymphatic ves- 
sels, and the chyle does 
not pass through it, as 
through the mesenteric 
glands. The Pancreas 
lies behind the stomach, 
and extends transversely 
across the spinal column 
to the right of the spleen. 
It is of a pale, pinkish 
color, and its secretion is 
analogous to that of the 
salivary glands; hence it 
has been called the Abdominal Salivary Gland. 
Digestion is effected in those cavities which we have described 
Fig. 3Jh 
Digestive organs. 3. The tongue. 7. Parotid 
gland. 8. Sublingual gland. 5. Esophagus. 9. 
Stomach. 10. Liver. 11. Gall-bladder. lit. Pan- 
creas. 13,13. The duodenum. The small and 
large intestines are represented below the 
stomach. THE DIGESTIVE ORGANS. 
45 
as parts of the alimentary canal. The food is first received 
into the mouth, where it is masticated by the teeth, and, 
after being mixed with mucus and saliva, is reduced to a 
mere pulp; it is then collected by the tongue, which, aided by 
the voluntary muscles of the throat, carries the food backward 
into the pharynx, and, by the action of the involuntary muscles 
of the pharynx and esophagus, is conveyed to the stomach. 
Here the food is subjected to a peculiar, churning movement, by 
the alternate relaxation and contraction of the fibers which 
compose the muscular wall of the stomach. As soon as the 
food comes in contact with the stomach, its pinkish color 
changes to a bright red; and from the numerous tubes upon its 
inner surface is discharged a colorless fluid, called the gastric 
juice., which mingles with the food and dissolves it. When the 
food is reduced to a liquid condition, it accumulates in the 
pyloric portion of the stomach. Some distinguished physiolo- 
gists believe that the food is kept in a gentle, unceasing, but 
peculiar motion, called peristaltic, since the stomach contracts 
in successive circles. In the stomach the food is arranged in a 
methodical manner. The undigested portion is detained in the 
upper, or cardiac extremity, near the entrance of the esophagus, 
by contraction of the circular fibers of the muscular coat. 
Here it is gradually dissolved, and then carried into the pyloric 
portion of the stomach. From this, then, it appears, that the 
dissolved and undissolved portions of food occupy different 
parts of the stomach. After the food has been dissolved by 
the gastric fluid, it is converted into a homogeneous, semi-fluid 
mass, called chyme. This substance passes from the stomach 
through the pyloric orifice into the duodenum, in which, by 
mixing with the bile and pancreatic fluid, its chemical properties 
are again modified, and it is then termed chyle, which has been 
found to be composed of three distinct parts, a reddish-brown 
sediment at the bottom, a whey-colored fluid in the middle, and 
a creamy film at the top. Chyle is different from chyme in two 
respects: First, the alkali of the digestive fluids, poured into 
the duodenum, or upper part of the small intestine, neutralizes 
the acid of the chyme; secondly, both the bile and the pancre- 
atic fluid seem to exert an influence over the fatty substances 
contained in the chyme, which assists the subdivision of these 46 
COMMON SENSE MEDICAL ADVISER. 
fats into minute particles. While the chyle is propelled along 
the small intestine by the peristaltic action, the matter which it 
contains in solution is absorbed in the usual manner into the 
vessels of the villi by the process called osmosis. The fatty 
matters being subdivided into very minute particles, but not 
dissolved, and consequently incapable of being thus absorbed 
by osmosis, pass bodily through the epithelial lining of the 
intestine into the commencement of the lacteal tubes in the 
villi. The digested substances, as they are thrust along the 
small intestines, gradually lose their albuminoid, fatty, and solu- 
ble starchy and saccharine matters, and pass through the 
ileo-caecal valve into the caecum and large intestine. An acid 
reaction takes place here, and they acquire the usual faecal smell 
and color, which increases as they approach the rectum. Some 
physiologists have supposed that a second digestion takes place 
in the upper portion of the large intestine. The lacteals, filled 
with chyle, pass into the mesenteric glands with which they 
freely unite, and afterward enter the receptaculum chyli, which 
is the commencement of the thoracic duct, a tube of the size of 
a goose-quill, which lies in front of the backbone. The lym- 
phatics, the function of which is to secrete and elaborate lymph, 
also terminate in the receptaculum chyli, or receptacle for the 
chyle. From this reservoir the chyle and lymph flow into the 
thoracic duct, through which they are conveyed to the left 
subclavian vein, there to be mingled with venous blood. The 
blood, chyle, and lymph, are then transmitted directly to the 
lungs. 
The process of nutrition aids in the development and 
growth of the body; hence it has been aptly designated a 
"perpetual reproduction." It is the process by which every 
part of the body assimilates portions of the blood distributed 
to it. In return, the tissues yield a portion of the material 
which was once a component part of their organization. The 
body is constantly undergoing waste as well as repair. One 
of the most interesting facts in regard to the process of 
nutrition in animals and plants is, that all tissues originate in 
cells. In the higher types of animals, the blood is the source 
from which the cells derive their constituents. Although 
the alimentary canal is more or less complicated in different THE DIGESTIVE ORGANS. 
47 
classes of animals, yet there is no species, however low in 
the scale of organization, which does not possess it in some 
form.* The little polyp has only one digestive cavity, which 
is a pouch in the interior of the body. In some animals circu- 
lation is not distinct from digestion, in others respiration and 
digestion are performed by the same organs; but as we rise 
in the scale of animal life, digestion and circulation are accom- 
plished in separate cavities, and the functions of nutrition 
become more complex and distinct. 
* The males of Cryptophialus and Alcippe, species of marine animals, are ap- 
parent exceptions to this rule. They are parasitic, possess neither mouth, stomach, 
thorax, nor abdomen, and are, necessarily, short-lived. CHAPTER V. 
PHYSIOLOGICAL ANATOMY. 
ABSORPTION. 
Absorption is the vital function by which nutritive materials 
are selected and imbibed for the sustenance of the body. Ab- 
sorption, like all other functional processes, employs agents to 
effect its purposes, and the villi of the small intestine, with 
their numberless projecting 
organs, are specially em- 
ployed to imbibe fluid sub- 
stances; this they do with a 
celerity commensurate to the 
importance and extent of 
their duties. They are little 
vascular prominences of the 
mucous membrane, arising 
from the interior surface of 
the small intestine. Each 
villus has two sets of vessels. 
(1.) The blood-vessels, which, 
by theii' frequent blending, 
form a complete net-work 
beneath the external epithelium; they unite at the base of the 
villus, forming a minute vein, which is one of the sources of 
the portal vein. (2.) In the center of the villus is another 
vessel, with thinner and more transparent walls, which is the 
commencement of a lacteal. 
The Lacteals originate in the walls of the alimentary canal, 
Fig. 35. 
Villi of the small intestine greatly 
magnified. 
48 ABSORPTION. 
49 
are very numerous in the small intestine, and, passing between 
the laminae of the mesentery, they terminate in the receptaculum 
chyli, or reservoir for the chyle. The mesentery consists of a 
double layer of cellular and adipose tissue. It incloses the 
blood-vessels, lacteals, and nerves of the small intestine, to- 
gether with its accessory glands. It is joined to the posterior 
abdominal wall by a narrow root; anteriorly, it is attached to 
the whole length of the small intestine. The lacteals are known 
as the absorbents of the intestinal walls, and after digestion is 
accomplished, are found to contain a white, milky fluid, called 
chyle. The chyle does not represent the entire product of 
digestion, but only the fatty substances suspended in a serous 
fluid. 
Formerly, it was supposed that the lacteals were the only 
agents employed in absorption, but more recent investigations 
have shown that the blood-vessels participate equally in the 
process, and are frequently the more active and important of 
the two. Experiments upon living animals have proved that 
absorption of poisonous substances occurs, even when all com- 
munication by way of the lacteals and lymphatics is obstructed, 
the passage by the blood-vessels alone remaining. The absor- 
bent power which the blood-vessels of the alimentary canal 
possess, is not limited to alimentary substances, but through 
them, soluble matters of almost every description are received 
into the circulation. 
The Lymphatics are not less important organs in the process 
of absorption. Nearly every part of the body is permeated by a 
second series of capillaries, closely interlaced with the blood- 
vessels, collectively termed the Lymphatic System. Their 
origin is not known, but they appear to form a plexus in the 
tissues, from which their converging trunks arise. They are. 
composed of minute tubes of delicate membrane, and from their 
net-work arrangement they successively unite and finally ter- 
minate in two. main trunks, called the great lymphatic veins. 
The lymphatics, instead of commencing on the intestinal walls, 
as do the lacteals, are distributed through most of the vascular 
tissues as well as the skin. The lymphatic circulation is not 
unlike that of the blood; its circulatory apparatus is, however, 
more delicate, and its functions are not so well understood. 50 
COMMON SENSE MEDICAL ADVISER. 
Fig. 36. 
A general Anew of the Lymphatic System. ABSORPTION. 
51 
The lymph which circulates through the lymphatic vessels 
is an alkaline fluid composed of a plasma and corpuscles. It 
may be considered as blood deprived of its red corpuscles and 
diluted with water. Nothing very definite is known respecting 
the functions of this fluid. A large proportion of its constit- 
uents is derived from the blood, and the exact connection of 
these substances to nutrition is not properly understood. Some 
excrementitious matters are sup- 
posed to be taken from the tissues 
by the lymph and discharged 
into the blood, to be ultimately 
removed from the system. The 
lymph accordingly exerts an im- 
portant function by removing a 
portion of the decayed tissues 
from the body. 
In all animals which possess a 
lacteal system there is also a 
lymphatic system, the one being 
the complement of the other. 
The fact that lymph and chyle 
are both conveyed into the 
general current of circulation, 
leads to the inference that the 
lymph, as well as the chyle, 
aids in the process of nutrition. 
The body is continually under- 
going change, and vital action 
implies waste of tissues, as well as their growth. Those organs 
which are the instruments of motion, as the muscles, cannot 
be employed without wear and waste of their component parts. 
Renovated tissues must replace those which are worn out, and 
it is a part of the function of the absorbents to convey nutritive 
material into the general circulation. Researches in micros- 
copical anatomy have shown that the skin contains multitudes 
of lymphatic vessels and that it is a powerful absorbent. 
Absorption is one of the earliest and most essential functions 
of animal and vegetables tissues. The simpler plants consist of 
only a few cells, all of which are employed in absorption; but 
Fig. 37. 
1. A representation of a lymphatic 
vessel highly magnified. 2. Lymphatic 
valves. 3. A lymphatic gland and its 
vessels. 52 
COMMON SENSE MEDICAL ADVISEE. 
in the flowering plants this function is performed by the roots. 
It is accomplished on the same general principles in animals, 
yet it presents more modifications and a greater number of 
organs than in vegetables. While animals receive their food 
into a sac, or bag called the stomach, and are provided with 
absorbent vessels such as nowhere exist in vegetables, plants 
plunge their absorbent organs into the earth, whence they derive 
nourishing substances. In the lower order of animals, as in 
sponges, this function is performed by contiguous cells, in a 
manner almost as elementary as in plants. In none of the 
invertebrate animals is there any special absorbent system. 
Internal absorption is classified by some authors as follows: 
interstfitaW, recrementitial, and excrementitial; by others as acci- 
dental, venous, and cutaneous. The general cutaneous and 
mucous surfaces exhale, as well as absorb ; thus the skin, by 
means of its sudoriferous glands, exhales moisture, and is at the 
same time as before stated, a powerful absorbent. The mucous 
surface of the lungs is continually throwing off carbonic acid 
and absorbing oxygen; and through their surface poisons are 
sometimes taken into the blood. The continual wear and waste 
to which living tissues are subject, makes necessary the provision 
of such a system of vessels for conveying away the worn-out 
materials and supplying the body with new. CHAPTER VI. 
PHYSICAL AND VITAL PROP- 
ERTIES OF THE BLOOD. 
Blood is the animal fluid by which the tissues of the body 
are nourished. This pre-eminently vital fluid permeates every 
organ, distributes nutritive material to every texture, is essen- 
tially modified by respiration, and, finally, is the source'of every 
secretion and excretion. Blood has four constituents: Fibrin, 
Albumen, Salts (which elements, in solution, form the liquor 
sanguinis), and the Corpuscles. Microscopical examination 
shows that the corpuscles are of two kinds, known as the red 
and the white, the former being 
by far the more abundant. 
They are circular in form and 
have a smooth exterior, and are 
on an average part of 
an inch in diameter, and are 
about one-fourth of that in 
thickness. Hence more than ten 
millions of them may lie on a 
space an inch square. If spread 
out in thin layers and subjected 
to transmitted light, they pre- 
sent a slightly yellowish color, 
but when crowded together and 
viewed by refracted light, ex- 
hibit a deep red color. These blood-corpuscles have been 
termed discs, and are not, as some have supposed, solid material, 
but are very nearly fluid. The red corpuscles, although 
Fig. 38. 
ited corpuscles of human blood, rep- 
resented at a, as they are seen when 
rather beyond the focus of the micros- 
cope; and at b as they appear when 
within the focus. Magnified 400 diam- 
eters. 
53 54 
COMMON SENSE MEDICAL ADVISER. 
subjected to continual movement, have a tendency to approach 
one another, and when their flattened surfaces come in contact, 
so firmly do they adhere that they change their shape rather 
than submit to a separation. If separated, however, they 
return to their usual form. The colorless corpuscles are larger 
than the red and differ from them in being extremely irregular 
in their shape, and in their tendency to adhere to a smooth 
surface, while the red corpuscles float about and tumble over 
one another. They are chiefly remarkable for their continual 
variation in form. The shape of the red corpuscles is only 
altered by external influences, but the white are constantly 
undergoing alterations, the result of changes taking place 
within their own 
substance. When 
diluted with water 
and placed under 
the microscope they 
are found to con- 
sist of a spheroidal 
sac, containing a 
clear or granular 
fluid and a spheroid- 
al vesicle, which is 
termed the nucleus. 
They have been re- 
garded by some 
physiologists as 
identical with those 
of the lymph and 
chyle. Dr. Carpen- 
ter believes that the function of these cells is to convert albumen 
into fibrin, by the simple process of cell-growth. It is generally 
believed that the red corpuscles are derived in some way from 
the colorless. It is supposed that the red corpuscle is merely 
the nucleus of a colorless corpuscle enlarged, flattened, colored 
and liberated by the bursting of the wall of its cell. When 
blood is taken from an artery and allowed to remain at rest, it 
separates into two parts: a solid mass, called the clot, largely 
composed of fibrin; and a fluid known as the serum, in which 
Fig. 39. 
Development of human lymph and chyle-corpuscles 
into red corpuscles of blood. A. A lymph, or white 
blood-corpuscle. B. The same in process of conversion 
into a red corpuscle. C. A lymph-corpuscle with the 
cell-wall raised up around it by the action of water. D. 
A lymph-corpuscle, from which the granules have 
almost disappeared. E. A lymph-corpuscle, acquiring 
color; a single granule, like a nucleus, remains. FA 
red corpuscle fully developed. PHYSICAL AND. VITAL PROPERTIES OF THE BLOOD. 
55 
the clot is suspended. This process is termed coagulation. The 
serum, mostly composed of albumen, is a transparent, straw- 
colored fluid, having the odor and taste of blood. The whole 
quantity of blood in the body is estimated on an average 
to be about one-ninth of its entire weight. The distinctions 
between the arterial and the venous blood are marked, since in 
the arterial system the blood is uniformly bright red, and in the 
venous of a very dark red color. The blood-corpuscles contain 
both oxygen and carbonic acid in solution. When carbonic acid 
predominates, the blood is dark red; when oxygen, scarlet. In 
the lungs, the corpuscles give up carbonic acid, and absorb a 
fresh supply of oxygen, while in the general circulation the 
oxygen disappears in the process of tissue transformation, and is 
replaced, in the venous blood, by carbonic acid. The nutritive 
portions of food are converted into a homogeneous fluid, which 
pervades every part of the body, is the basis of every tissue, 
and which is termed the blood. This varies in color and com- 
position in different animals. In the polyp the nutritive fluid 
is known as chyme, in many mollusks, as well as articulates, 
it is called chyle, but in vertebrates, it is more highly organized 
and is called blood. In all the higher animal types it is of a 
red color, although redness is not one of its essential qualities. 
Some tribes of animals possess true blood, which is not red; thus 
the blood of the insect is colorless and transparent; that of the 
reptile yellowish; in the fish the principle part is without color, 
but the blood of the bird is deep red. The blood of the 
mammalia is of a bright scarlet hue. The temperature of the 
blood varies in different species, as well as in animals of 
the same species under different physiological conditions; for 
this reason, some animals are called cold-blooded. Disease also 
modifies the temperature of the blood; thus in fevers it is 
generally increased, but in cholera greatly diminished. The 
blood has been aptly termed the "vital fluid," since there is 
a constant flow from the heart to the tissues and organs of 
the body, and a continual return after it has circulated 
through these parts. Its presence in every part of the body 
is one of the essential conditions of animal life, and is effected 
by a special set of organs, called the circulatory organs. CHAPTER VII. 
PHYSIOLOGICAL ANATOMY. 
CIRCULATORY ORGANS. 
Having considered the formation of chyle, traced it through 
the digestive process, seen its transmission into the vena cava, 
and, finally, its conversion into blood, we shall now describe how 
it is distributed to every part of the system. This is accom- 
plished through organs which, from the round of duties they 
perform, are called circulatory. These are the Heart, Arteries, 
Veins, and Capillaries, which constitute the vascular system. 
Within the thorax or chest of the human body, and enclosed 
within a membranous sac, called the pericardium, is the great 
force-pump of the system, the heart. This organ, to which all 
the arteries and veins of the body may be either directly or 
indirectly traced, is roughly estimated to be equal in size to 
the closed fist of the individual to whom it belongs. 
It has a broad end turned upwards, and a little to the right 
side, termed its base; and a pointed end called its apex, turned 
downwards, forwards, and to the left side, and lying beneath a 
point about an inch to the right of, and below, the left nipple, 
or just below the fifth rib. Attached to the rest of the body 
only by the great blood-vessels which issue from and enter it 
at its base, the heart is the most mobile organ in the economy, 
being free to move in different directions. 
The heart is divided into two great cavities by a fixed parti- 
tion, which extends from the base to the apex of the organ, 
and which prevents any direct communication between them. 
Each of these great cavities is further subdivided transversely 
56 CIRCULATORY ORGANS. 
57 
by a movable partition, the cavity above each transverse parti- 
tion being called the auricle, and the cavity below, the ventricle, 
right or left, as the case may be. 
The walls of the auricles are much thinner than those of the 
ventricles, and the wall of the right ventricle is much thinner 
than that of the 
left, from the fact 
that the ventricles 
have more work 
to perform than 
the auricles, and 
the left ventricle 
more than the 
right. 
In structure, 
the heart is com- 
posed almost 
entirely of mus- 
cular fibers, which 
are arranged in a 
very complex and 
wonderful man- 
ner. The outer 
surface of the 
heart is covered 
with the pericar- 
dium, which 
closely adheres to the muscular substance. Inside, the cavities 
are lined with a thin membrane, called the endocardium. At 
the junction between the auricles and ventricles, the aper- 
tures of communication between their cavities are strengthened 
by fibrous rings. Attached to these fibrous rings are the 
movable partitions or valves, between the auricles and the 
ventricles, the one on tjie right side of the heart being called 
the tricuspid valve, and the one on the left side the mitral 
valve. A number of fine, but strong, tendinous chords, called 
chordae tendinece, connect the edges and apices of these valves 
with column-like elevations of the fleshy substance of the 
walls of the ventricles, called columnar carneoe. 
Fig. Jfi). 
General view of the heart and lungs, t. Trachea, or 
wind-pipe, a Aorta. p. Pulmonary artery.1 2. 
Branches of the pulmonary artery, one going to the 
right, the other to the left lung. h. The heart. 58 
COMMON SENSE MEDICAL ADVISER. 
The valves are so arranged that they present no obstacle 
to the free flow of blood from the auricles into the ven- 
tricles, but if any is forced 
the other way, it gets between 
the valve and the wall of the 
heart, and drives the valve 
backwards and upwards, thus 
forming a transverse partition 
between the auricle and ventri- 
cle, through which no fluid can 
pass. 
At the base of the heart are 
given off two large arteries, one 
on the right side, which conveys 
the blood to the lungs, called 
the pulmonary artery, and one 
on the left side, which conveys 
the blood to the system in gen- 
eral, called the aorta. At the 
junction of each of these great 
vessels with its corresponding 
ventricle, is another valvular 
apparatus, consisting of three 
pouch-like valves, called the 
semilunar valves, from their 
resemblance, in shape, to a half- 
moon. Being placed on a level 
and meeting in the middle line, 
they entirely prevent the passage 
of any fluid which may be forced 
along the artery towards the heart, but, flapping back, they 
offer no obstruction to the free flow of blood from the 
ventricles into the arteries. 
The Arteries, being always found empty after death, were 
supposed by the ancients, who were ignorant of the circulation 
of the blood, to be tubes containing air; hence their name, 
which is derived from a Greek word and signifies an air-tube. 
Arteries are the cylindrical tubes which carry blood to every 
part of the system. All the arteries, except the coronary 
fflg. Jfl. 
1. The descending vena cava. S. 
The ascending vena cava. 3. The 
right auricle. 4. The opening be- 
tween the right auricle and the right 
ventricle. 5. The right ventricle. 6. 
The tricuspid valves. 7. The pul- 
monary artery. 8, 8. The branches 
of the pulmonary artery which pass 
to the right and the left lung. S. The 
semilunar valves of the pulmonary 
artery. 10. The septum between the 
two ventricles of the heart. 11, 11. 
The pulmonary veins. 13. The left 
auricle. 13. The opening between 
the left auricle and ventricle. 14. 
The left ventricle. 15. The mitral 
valves. 16, 16. The aorta. 17. The 
semilunar valves of the aorta. CIRCULATORY ORGANS. 
59 
which supply the substance of the heart, arise from the two 
main trunks, the pulmonary artery and the aorta. They are 
of a yellowish-white color, and their inner surface is smooth. 
The arteries have three coats. (1.) The external coat, which 
is destitute of fat, and composed chiefly of cellular tissue, 
is very firm and elastic, and can readily be dissected from 
the middle coat. (2.) 
The middle,or fibrous 
coat, is thicker than 
the external, and 
composed of yellow- 
ish fibers, its chief 
property is con- 
tractility. (3.) The 
internal coat consists 
of a colorless, thin, 
transparent mem- 
brane, yet so strong 
that it can, it is 
thought, better resist 
a powerful pressure 
than either of the 
others. Arteries are 
very elastic as well 
as extensible, and 
their chief extensi- 
bility is in length. 
If an artery of a 
dead body be di- 
vided, although 
empty, its cylindrical 
form will be pre- 
served. 
The Veins are the 
vessels through which the venous blood returns to the auricles 
of the heart. They are more numerous than the arteries, and 
originate from numerous capillary tubes, while the arteries are 
given off from main trunks. In some parts of the body, 
the veins correspond in number to the arteries; while in 
Fig. 1$. 
A representation of the venous and arterial 
circulation of the blood. 60 
COMMON SENSE MEDICAL ADVISER. 
others, there are two veins to every artery. The veins com- 
mence by minute roots in the capillaries, which are everywhere 
distributed through the body, and gradually increase in size, 
until they unite and become large trunks, conveying the dark 
blood to the heart. The veins, like the arteries, have three 
coats. The external, or cellular coat, resembles that of the 
arteries; the middle is fibrous, but thinner than the corre- 
sponding one of the arteries; and the internal coat is serous, 
and analogous to that of those vessels. The veins belong 
to the three following classes: (1.) The systemic veins, which 
bring the blood from different parts of the body and discharge 
it into the vena cava, by means of which it is conveyed 
to the heart; (2), the pulmonary veins, which bring the arterial, 
or bright red blood from the lungs and carry it to the left 
auricle; (3), the veins of the portal system, which originate 
in the capillaries of the abdominal organs, then converge into 
trunks and enter the liver, to branch off again into divisions 
and subdivisions of the minutest character. 
The Capillaries form an extremely fine net-work, and are 
distributed to every part of the body. They vary in diameter 
from -g-g'wTj- to -gVjyir an inch- They are so universally 
prevalent throughout the skin, that the puncture of a needle 
would wound a large number of them. These vessels receive 
the blood and bring it into intimate contact with the tissues, 
which take from it the principal part of its oxygen and other 
elements, and give up to it carbonic acid and the other waste 
products resulting from the transformation of the tissues, 
which are transmitted through the veins to the heart, and 
thence by the arteries to the lungs and various excretory 
organs. 
The blood from the system in general, except the lungs, is 
poured into the right auricle by two large veins, called the 
superior and the inferior vena cava; and that returning from 
the lungs is poured into the left auricle by the pulmonary 
veins. 
During life the heart contracts rhythmically, the contractions 
commencing at the base, in each auricle, and extending towards 
the apex. 
Now it follows, from the anatomical arrangement of this CIRCULATORY ORGANS. 
61 
organ, that when the auricles contract, the blood contained in 
them is forced through the auriculo-ventricular openings into 
the ventricles; the contractions then extending to the ventricles, 
in a wave-like manner, the great proportion of the blood, being 
prevented from re-entering the auricles by the tricuspid and 
mitral valves, is forced onward into the pulmonary artery from 
the right ventricle, and into the aorta from the left ventricle. 
When the contents of the ventricles are suddenly forced into 
these great blood-vessels, a shock is given to the entire mass of 
fluid which they contain, and this shock is speedily propagated 
along their branches, being known at the wrist as the pulse. 
On inspection, between the fifth and sixth ribs on the left 
side of the chest, a movement is perceptible, and, if the hand 
be applied, the impulse may be felt. This is known as the 
throbbing, or beating of the heart. 
If the ear is placed over the region of the heart, certain 
sounds are heard, which recur with great regularity. First 
is heard a comparatively long, dull sound, then a short, sharp 
sound, then a pause, and then the long, dull sound again. 
The first sound is caused mainly by the tricuspid and mitral 
and the second is the result of sudden closure of the 
semilunar valves. 
No language can adequately describe the beauty of the 
circulatory system. The constant vital flow through the larger 
vessels, and the incessant activity of those so minute that they 
are almost imperceptible, fully illustrate the perfectness of the 
mechanism of the human body, and the wisdom and goodness 
of Him who is its author. 
Experiments have shown that the small arteries may be 
directly influenced through the nervous system, which regulates 
their caliber by controlling the state of contraction of their 
muscular walls. The effect of this influence of the nervous 
system enables it to control the circulation over certain areas; 
and, notwithstanding the force of the heart and the state of 
the blood-vessels in general, to materially modify the circula- 
tion in different spots. Blushing, which is simply a local 
modification of the circulation, is effected in this way. Some 
emotion takes possession of the mind, and the action of the 
nerves, which ordinarily keep up a moderate contraction of COMMON SENSE MEDICAL ADVISER. 
62 
the muscular coats of the arteries, is lost, and the vessels relax 
and become distended with arterial blood, which is a warm 
and bright red fluid; thereupon a burning sensation is felt, and 
the skin grows red, the degree of the blush depending upon the 
intensity of the emotion. 
The pallor produced by fright and by extreme anxiety, is 
purely the result of a local modification of the circulation, 
brought about by an over-stimulation of the nerves which 
supply the small arteries, causing them to contract, and to thus 
cut off more or less completely the supply of blood. CHAPTER VIII. 
PHYSIOLOGICAL ANATOMY. 
THE ORGANS OF RESPIRATION. 
The Organs of Respiration are the Trachea, or 
windpipe, the Bronchia, formed by the subdivision of the 
trachea, and the Lungs, with their air-cells. The Trachea is a 
vertical tube situated between the lungs below, and a short 
quadrangular cavity above, called the larynx,, which is part 
of the windpipe, and used for the purpose of modulating the 
voice in speaking or singing. In the adult, the trachea, in 
its unextended state, is from four and one-half to five inches 
in length, about one inch in diameter, and, like the larynx, is 
more fully developed in the male than in the female. It is 
a fibro-cartilaginous structure, and is composed of flattened 
rings, or segments of circles. It permits the free passage of 
air to and from the lungs. 
The Bronchia are two tubes, or branches, one proceeding 
from the windpipe to each lung. Upon entering the lungs, 
they divide and subdivide until, finally, they terminate in 
small cells, called the "bronchial or air-cells, which are of a 
membranous character. 
The Lungs are irregular conical organs rounded at the apex, 
situated within the chest, and filling the greater part of it, since 
the heart is the only other organ which occupies much space 
in the thoracic cavity. The lungs are convex externally, and 
conform to the cavity of the chest, while the internal surface 
is concave for the accommodation of the heart. The size of 
the lungs depends upon the capacity of the chest. Their 
63 64 
COMMON SENSE MEDICAL ADVISER. 
color varies, being of a pinkish hue in childhood but of a 
gray, mottled appearance in the adult. They are termed the 
right and left lung. Each lung resembles a cone with its base 
resting upon the diaphragm, and its apex behind the collar- 
bone. The right lung is larger though shorter, than the left, 
not extending 
so low, and has 
three lobes., 
formed by deep 
fissures, or lon- 
gitudinal divi- 
sions, while the 
left has but two 
lobes. Each 
lobe is also 
made up of 
numerous lob- 
ules, or small 
lobes, connect- 
ed by cellular 
tissue,and these 
contain great 
nu mbers Of 
cells. The 
lungs are abun- 
dantly supplied 
with blood- 
vessels, lym- 
phatics, and 
nerves. The 
(tensity of a lung depends upon the amount of air which it 
contains. Thus, experiment has shown that in a foetus which 
has never breathed, the lungs are compact and will sink in 
water; but as soon as they become inflated with air, they 
spread over a larger surface, and are therefore more buoyant. 
Each lung is invested, as far as its root, with a membrane, 
called the pleura, which is then continuously extended to the 
cavity of the chest, thus performing the double office of lining 
it, and constituting a partition between the lungs. The part 
Fig. Jfi. 
An ideal representation of the respiratory organs. 3. The 
larynx. A. The trachea. 5, 6. The bronchia, .9, 9,9, 9. Air- 
cells. 1,1, J, 2, 2. Outlines of the lungs. THE ORGANS OF RESPIRATION. 
65 
of the membrane which forms this partition is termed the 
mediastinum. Inflammation of this membrane is called 
pleurisy. The lungs are held in position by the root, which 
is formed by the pulmonary arteries, veins, nerves, and the 
bronchial tubes. Respiration is the function by which the 
venous blood, conveyed to the lungs by the pulmonary artery, 
is converted into arterial blood. This is effected by the 
elimination of carbonic 
acid, which is expired 
or exhaled from the 
lungs, and by the ab- 
sorption of oxygen 
from the air which is 
taken into the lungs, 
by the act of inspira- 
tion or inhalation. 
The act of expiration 
is performed chiefly by 
the elevation of the 
diaphragm and the de- 
scent of the ribs, and 
inspiration is princi- 
pally effected by the 
descent of the dia- 
phragm and the eleva- 
tion of the ribs. 
When the muscles 
of some portions of the air-passages are relaxed, a peculiar 
vibration follows, known as snoring. Coughing and sneez- 
ing are sudden and spasmodic expiratory efforts, and generally 
involuntary. Sighing is a prolonged deep inspiration, followed 
by a rapid, and generally audible expiration. It is remarkable 
that laughing and sobbing, although indicating opposite states 
of the mind, are produced in very nearly the same manner. 
In hiccough, the contraction is more sudden and spasmodic than 
in laughing or sobbing. The quantity of oxygen consumed 
during sleep is estimated to be considerably less than that 
consumed during wakefulness. 
It is difficult to estimate the amount of air taken into the 
Fig. 44. 
A representation of the heart and lungs. 4. The 
heart. 5. The pulmonary artery. 8. Aorta. 9,11. 
Upper lobes of the lungs. 10,13. Lower lobes. 13. 
Middle lobe of the right lung. 3. Superior vena 
cava. 3. Inferior vena cava. 66 
COMMON SENSE MEDICAL ADVISER. 
lungs at each inspiration, as the quantity varies according to 
the condition, size, and expansibility of the chest, but in 
ordinary breathing it is supposed to be from twenty to thirty 
cubic inches. The consumption of oxygen is greater when 
the temperature is low, and during digestion. All the respi- 
ratory movements, so far as they are independent of the 
will of the individual, are controlled by that part of the 
brain called the medulla oblongata. The respiratory, or breath- 
ing process, is not instituted for the benefit of man alone, for 
we find it both 
in the lower 
order of ani- 
mals and in 
plant life. Na- 
ture is very 
economical in 
the arrange- 
ment of her 
plans, since the 
carbonic acid, 
which is useless 
to man, is in- 
dispensable to 
the existence of 
plants, and the 
oxygen, reject- 
ed by them, is 
appropriated to 
his use. In the 
lower order of 
animals, the respiratory act is similar to that of the higher 
types, though not so complex ; for there are no organs of 
respiration, as the lungs and gills are called. Thus, the higher 
the animal type, the more complex its organism. The effect 
of ail' upon the color of the blood is Very noticeable. If a 
quantity be drawn from the body, thus being brought into 
contact with the air, its color gradually changes to a brighter 
hue. There is a marked difference between the properties of 
the venous and the arterial blood. 
Fig. 45. 
View of the pulmonary circulation. THE ORGANS OK RESPIRATION. 
67 
The venous blood is carried, as we have previously described, 
to the right, side of the heart and to the lungs, where it is 
converted into arterial blood. It is now of uniform quality, 
ready to be distributed throughout the body, and capable of 
sustaining life and nourishing the tissues. Man breathes by 
means of lungs; but who can understand their wonderful me- 
chanism, so perfect in all its parts? Though every organ is 
subservient to another, yet each has its own office to per- 
form. The minute air-cells are for the aeration of the blood; 
the larger bronchial tubes ramify the lungs, and suffuse them 
with air; the trachea serves as a passage for the air to and 
from the lungs, while at its upper extremity is the larynx, 
which has been fitly called the organ of the human voice. At 
its extremity we find a sort of shield, called the the 
office of which is supposed to be to prevent the intrusion 
of foreign bodies. CHAPTER IX. 
PHYSIOLOGICAL ANATOMY. 
THE SKIN. 
Through digestion and respiration, the blood is continually 
supplied with material for its renewal; and, while the nutritive 
constituents of the food are retained to promote the growth 
of the body, those 
which are useless or in- 
jurious are in various 
ways expelled. There 
are, perhaps, few parts 
of the body more ac- 
tively concerned in this 
removal than the skin. 
The skin is a mem- 
branous envelope 
covering the entire 
body. It consists of 
two layers, termed the 
Cutis Vera, or true 
skin, and the Epi- 
dermis, or cuticle. The 
Cutis Vera is com- 
posed of fibers similar 
to those of the cellular tissue. It consists of white and yellow 
fibers, which are more densely woven near the surface than 
deeper in the structure; the white give strength, the yellow 
Fig. Jf.6. 
An ideal view of the papillae. 1, I. Cutis vera. 
2. 2. Papillary layer. 3, 3. Arteries of the papillae. 
A, 4. Nerves of the papillae. 5, 5. Veins of the 
papillae. 
68 THE SKIN. 
69 
strength and elasticity combined. The true skin may be 
divided into two layers, differing in their characteristics, and 
termed respectively the superficial or papillary layer, and the 
deep or fibrous layer. Upon the external surface, are little 
conical prominences, known as papillae. The papillae are 
irregularly distributed over the body, in some parts being 
smaller and more numerous than in others, as on the finger- 
ends, where their summits are so intimately connected as to 
form a tolerably smooth surface. It is owing to their perfect 
development, that the finger-tips are adapted to receive 
the most delicate 
impressions of touch. 
Although every part of 
the skin is sensitive, 
yet the papillae are 
extremely so, for 
they are the principal 
means through which 
the impressions of 
objects are communi- 
cated. Each papilla 
not only contains a 
minute vein and artery, 
but it also incloses 
a loop of sensitive 
nerves. When the 
body is exposed to 
cold, these papillae can be more distinctly seen in the form 
of prominences, commonly known as "goose-pimples." 
The internal, or fibrous layer of the skin, contains numerous 
depressions, each of which furnishes a receptacle for fat. 
While the skin is supplied with a complete net-work of ar- 
teries, veins, and nerves, which make it sensitive to the slightest 
touch, it also contains numerous lymphatic vessels, so minute 
that they are invisible to the naked eye. 
Among the agents adapted for expelling the excretions from 
the system, few surpass the Sudoriferous G-lands. These are 
minute organs which wind in and out over the whole extent 
of the true skin, and secrete the perspiration. Though much 
Fig. KI. 
A section of the skin, showing its arteries and 
veins. A, A. Arterial branches. B, B. Capillaries 
in which the branches terminate. C. The venous 
trunk into which the blood from the capillaries 
flows. 70 
COMMON SENSE MEDICAL ADVISER. 
of it passes off as insensible transpiration, yet it often ac- 
cumulates in drops of sweat, during long-continued exercise 
or exposure to a high temperature. 
The office of the perspiration is 
two-fold. It removes noxious mat- 
ter from the system, and diminishes 
animal heat, and thereby equalizes 
the temperature of the body. It 
also renders the skin soft and pli- 
able, thus better adapting it to the 
movements of the muscles. The 
Sebaceous Glands, which are placed 
in the true skin, are less abundant 
where the sudoriferous glands are 
most numerous, and vice versa. 
Here, as elsewhere, nature acts with 
systematic and intelligent design. 
The perspiratory glands are distrib- 
uted where they are most needed, 
-in the eyelids, serving as lubri- 
cators; in the ear passages, to 
produce the cerumen, or wax, which 
prevents the intrusion of small in- 
sects; and in the scalp, to supply 
the hair with its natural pomatum. 
The Epidermis, or Cuticle, so 
called because it is placed upon the 
skin, is the outer layer of the skin. 
Since it is entirely destitute of 
nerves and blood-vessels, it is not 
sensitive. Like the cutis vera, 
it has two surfaces composed of 
layers. The internal, or JRete 
Jfucosum, which is made up chiefly 
of pigment cells, is adapted to the 
irregularities of the cutis vera, and 
sends prolongations into all its 
glandular follicles. The external surface, or epidermis proper, 
is elastic, destitute of coloring matter, and consists of mere 
Fig. 48. 
A perspiratory gland, highly 
magnified. 1,1. The gland. 2, 2. 
Excretory ducts uniting to form 
a tube which tortuously perfor- 
ates the cuticle at 3, and opens 
obliquely on its surface at 4. THE SKIN. 
71 
horny scales. As soon as dry, they are removed in the form 
of scurf, and replaced by new ones from the cutis vera. 
These scales may be 
removed by a wet- 
sheet pack, or by 
friction. The cuticle 
is constantly under- 
going renewal. This 
layer serves to cover 
and protect the 
nervous tissue of the 
true skin beneath. 
We may here observe 
that the cuticle con- 
tains the pigment for 
coloring the skin. In 
dark races, as the 
negro, the cuticle is 
very thick and filled with black pigment. The radiation 
of animal heat is dependent upon the thickness and color 
of this cuticle. 
Thus, in the dark 
races, the pigment 
cells are most 
numerous, and in 
proportion as the 
skin is dark or fair 
do we find these 
cells in greater or 
lesser abundance. 
The skin of the 
Albino is of pearly 
whiteness, devoid 
even of the pink 
or brown tint 
which that of the 
European always 
possesses. This 
peculiarity must be attributed to the absence of pigment cells, 
Fig. Jf.9. 
A representation of oil-tubes from the scalp 
and nose. 
Fig. 50. 
Anatomy of the skin. 5, 5. Cutis vera (true skin). 
A, I*. Nervous tissue. 3, 3. Sensitive layer in which are 
seen the nerves. 3, 2. The layer containing pigment 
cells. 1,1. Epidermis (cuticle). 72 
COMMON SENSE MEDICAL ADVISER. 
which, when present, always present a more or less dark 
color. The theory that climate alone is capable of producing 
all these diversities is simply absurd. The Esquimaux, who 
live in Greenland and the arctic regions of America, are re- 
markable for the darkness of their complexion. Humboldt 
remarks that the American tribes of the tropical regions 
have no darker skin than the mountaineers of the temperate 
zone. Climate may modify the complexion, but it cannot 
make it. 
Hairs are horny appendages of the skin, and, with the 
exception of the hands, the soles of the feet, the backs of the 
Fig. 51. 
Structure of the human hair. A. External surface of the shaft, showing the 
transverse striae and jagged boundary, caused by the imbrications of the scaly 
cortex. B. Longitudinal section of the shaft, showing the fibrous character of 
the medullary substance, and the arrangement of the pigmentary matter. C. 
Transverse sections, showing the distinction between the cortical and medullary 
substances, and the central collection of pigmentary matter, sometimes found in 
the latter. Magnified 310 diameters. 
lingers and toes, between the last joint and the nail, and the 
upper eyelids, are distributed more or less abundantly over 
every part of the surface of the body. Over the greater part 
of the surface the hairs are very minute, and in some places 
are not actually apparent above the level of the skin; but the 
hair of the head, when permitted to reach its full growth, 
attains a length of from twenty inches to a yard, and, in rare 
instances, even six feet. A hair may be divided into a middle 
portion, or shaft, and two extremities; a peripheral extrem- 
ity, called the point; and a central extremity, inclosed within THE SKIN. 
73 
the hair-sac, or follicle, termed the root. The root is some- 
what greater in diameter than the shaft, and cylindrical in 
form, while its lower part expands into an oval mass, called 
the bulb. The shaft of the hair is not often perfectly 
cylindrical, but is more or less flattened, which circumstance 
gives rise to waving and curling hair; and, when the flat- 
tening is spiral in direction, the curling will be very great. 
A hair is composed of three different layers of cell-tissues: 
a loose, cellulated substance, which occupies its center, and 
constitutes the medulla, or pith; the fibrous tissue, which 
incloses the medulla, and forms the chief bulk of the 
hair; and a thin layer, which envelops this fibrous struc- 
ture, and forms the smooth surface of the hair. The me- 
dulla is absent in the downy hairs, but in the coarser class 
it is always present, especially in white hair. The color of 
hair is due partly to the granules and partly to an inter- 
granular substance, which occupies the interstices of the gran- 
ules and the fibers. The quantity of hail- varies according 
to the proximity and condition of the follicles. The average 
number of hairs of the head may be stated at 1,000 in a 
superficial square inch; and, as the surface of the scalp has an 
area of about one hundred and twenty superficial square inches, 
the average number of hairs on the entire head is 120,000. 
The hair possesses great durability, as is evinced by its endur- 
ance of chemical processes, and by its discovery, in the tombs 
of mummies more than two thousand years old. The hair is 
remarkable for its elasticity and strength. Hair is found to 
differ materially from horn in its chemical composition. Accord- 
ing to Vauquelin, its constituents are animal matter, a greenish- 
black oil, a white, concrete oil, phosphate of lime, a trace of 
carbonate of lime, oxide of manganese, iron, sulphur, and silex. 
Red hair contains a reddish oil, a large proportion of sulphur, 
and a small quantity of iron. White hair contains a white oil, 
and phosphate of magnesia. It has been supposed that hair 
grows after death, but this theory was probably due to the 
lengthening of the hair by the absorption of moisture from 
the body or atmosphere. 
The nails constitute another class of appendages of the 
skin. They consist of thin plates of horny tissue, having a 74 
COMMON SENSE MEDICAL ADVISEE. 
root, a body, and a free extremity. The root, as well as the 
lateral portion, is implanted in the skin, and has a thin margin 
which is received into a groove of the true skin. The under 
surface is furrowed, while the upper is comparatively smooth. 
The nails grow in the same manner as the cuticle. CHAPTER X. 
PHYSIOLOGICAL ANATOMY. 
SECRETION. 
The term Secretion, in its broadest sense, is applied to that 
process by which substances are separated from the blood, 
either for the reparation of the tissues or for excretion. In 
the animal kingdom this process is less complicated than in 
vegetables. In the former it is really a separation of nutritive 
material from the blood. The process, when effected for the 
removal of effete matter, is, in a measure, chemical, and 
accordingly the change is greater. 
Three elementary constituents are observed in secretory 
organs: the cells, a basement membrane, and the blood-vessels. 
Obviously, the most essential part is the cell. 
The physical condition necessary for the healthy action of 
the secretory organs is a copious supply of blood, in which 
the nutritive materials are abundant. The nervous system 
also influences the process of secretion to a great extent. In- 
tense emotion will produce tears, and the sight of some 
favorite fruit will generally increase the flow of saliva. 
The process of secretion depends upon the anatomical and 
chemical constitution of the cell-tissues. The principal secre- 
tions are (1), Perspiration; (2), Tears; (3), Sebaceous matter; 
(4), Mucus; (5), Saliva; (6), Gastric juice; (7), Intestinal juice; 
(8), Pancreatic juice; (9), Bile; (10), Milk. 
Perspiration is a watery fluid secreted in minute glands, 
which are situated in every part of the skin, but are more 
numerous on the anterior surfaces of the body. Long thread- 
like tubes, only of an inch in diameter, lined with 
75 76 
COMMON SENSE MEDICAL ADVISER. 
epithelium, penetrate the skin, and terminate in rounded coils, 
enveloped by a net-work of capillaries, which supply the 
secretory glands with blood. It is estimated by Krause that 
the entire number of perspiratory glands is two million three 
hundred and eighty-one thousand two hundred and forty-eight, 
and the length of each glandular coil being of an inch, we 
may estimate the length of tubing to be not less than two 
miles and a third. This secretion has a specific gravity of 
1003.5, and, according to Dr. Dalton, is composed of 
Water, . . . ' 995.50 
Chloride of Sodium, 2.23 
Chloride of Potassium, • 0.24 
Sulphate of Soda and Potassa, 0.01 
Salts of organic acids, with Soda and Potassa. . 2.02 
1000.00 
Traces of organic matter, mingled with a free volatile acid, 
are also found in the perspiration. It is the acid which imparts 
to this secretion its peculiar odor, and acid reaction. The pro- 
cess of its secretion is continuous, but, like all bodily functions, 
it is subject to influences which augment or retard its activity. 
If, as is usually the case when the body is in a state of 
repose, evaporation prevents its appearance in the liquid form, 
it is called invisible or insensible perspiration. When there 
is unusual muscular activity, it collects upon the skin, and 
is known as sensible perspiration. This secretion performs 
an important office in the animal economy, by maintaining 
the internal temperature at about 100° Fahr. Even in the 
Arctic regions, where the explorer has to adapt himself to 
a temperature of 40° to 80° below zero, the generation of 
heat in the body prevents the internal temperature from fall- 
ing below this standard. On the contrary, if the circulation 
is quickened by muscular exertion, the warmer blood flowing 
from the internal organs into the capillaries, raises the temper- 
ature of the skin, secretion is augmented, the moisture exudes 
from the pores, and perceptible evaporation begins. A large 
portion of the animal heat is thrown off in this process, and 
the temperature of the skin is reduced. A very warm, dry 
atmosphere can be borne with impunity, but if moisture is SECRETION. 
77 
introduced, evaporation ceases, and the life of the animal is 
endangered. Persons have been known to remain in a tem- 
perature of about 300° Fahr, for some minutes without 
unpleasant effects. Three conditions may be assigned as effect- 
ive causes in retarding or augmenting this cutaneous secretion, 
variations in the temperature of the atmosphere, muscular 
activity, and influences which affect the nerves. The emotions 
exert a remarkable influence upon the action of the perspiratory 
glands. Intense fear causes great drops of perspiration to 
accumulate on the skin, while the salivary glands remain 
inactive. 
Tears. The lachrymal glands are small lobular organs, 
situated at the outer and upper orbit of the eye, and have 
from six to eight ducts, which open upon the conjunctiva, 
between the eyelid and its inner fold. This secretion is an 
alkaline, watery fluid. According to Dr. Dalton, its composition 
is as follows: 
Water, 982.0 
Albuminous matter,5.0 
Chloride of Sodium,13.0 
Mineral Salts, a trace, 
1000.0 
The function of this secretion is to preserve the brilliancy 
of the eye. The tears are spread over this organ by the 
reflex movement of the eyelid, called winking, and then 
collected in the puncta lachrymalia and discharged into the 
nasal passage. This process is constant during life. The effect 
of its repression is seen in the dim appearance of the eye 
after death. Grief or excessive laughter usually excite these 
glands until there is an overflow. 
Sebaceous Matter. Three varieties of this secretion are 
found in the body. A product of the sebaceous glands of the 
skin is found in those parts of the body which are covered 
with hairs; also, on the face and the external surface of the 
organs of generation. The sebaceous glands consist of a group 
of flask-shaped cavities, opening into a common excretory duct. 
Their secretion serves to lubricate the hair and soften the skin. 
The ceruminous glands of the external auditory meatus, or 78 
COMMON SENSE MEDICAL ADVISER. 
outer opening of the ear, are long tubes terminating in a 
glandular coil, within which is secreted the glutinous matter 
of the ear. This secretion serves the double purpose of moist- 
ening the outer surface of the membrana tympani, or ear-drum, 
and, by its strong odor, of preventing the intrusion of insects. 
The Meibomian glands are arranged in the form of clusters 
along the excretory duct, which opens just behind the roots 
of the eyelashes. The oily nature of this secretion prevents 
the tears, when not stimulated by emotion, from overflowing 
the lachrymal canal. 
UllClIS. The mucous membranes are provided with minute 
glands which secrete a viscid, gelatinous matter, called mucus. 
The peculiar animal matter which it contains is termed mu- 
cosin. These glands are most numerous in the Pharynx, Esoph- 
agus, Trachea, Bronchia, Vagina and Urethra. They consist 
of a group of secreting sacs, terminating at one extremity in 
a closed tube, while the other opens into a common duct. 
The mucus varies in composition in different parts of the body; 
but in all, it contains a small portion of insoluble animal 
matter. Its functions are threefold.- It lubricates the mem- 
branes, prevents their injury, and facilitates the passage of food 
through the alimentary canal. 
Saliva. This term is given to the first of the digestive 
fluids, which is secreted in the glands of the mouth. It is a 
viscid, alkaline liquid, with a specific gravity of about 1005. 
If allowed to stand, a whitish precipitate is formed. Exami- 
nations with the microscope show it to be composed of minute, 
granular cells and oil globules, mingled with numerous scales 
of epithelium. According to Bidder and Schmidt, the com- 
position 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 is SECRETION. 
79 
obtained from the secretions of the parotid, submaxillary and 
sublingual glands; another, which is not glutinous, is distin- 
guished by the property of coagulating when subjected to 
heat. The saliva is composed of four elementary secretions, 
derived respectively, from the mucous follicles of the mouth, 
and the parotid, the submaxillary, and the sublingual glands. 
The process of its secretion is constant, but is greatly aug- 
mented by the contact of food with the lining membrane. 
The saliva serves to moisten the triturated food, facilitate its 
passage, and has the property of converting starch into sugar; 
but the latter quality is counteracted by the action of the 
gastric juice of the stomach. 
Gastric Juice. The minute tubes, or follicles, situated 
in the mucous membrane of the stomach, secrete a colorless, 
acid liquid, termed the gastric juice. This fluid appears to 
consist of little more than water, containing a few saline mat- 
ters in solution, and a small quantity of free hydrochloric 
acid, which gives it an acid reaction. In addition to these, 
however, it contains a small quantity of a peculiar organic 
substance, termed pepsin, which in chemical composition, is 
very similar to ptyalin, although it is very different in its 
effects. When food is introduced into the stomach, the per- 
istaltic contractions of that organ roll it about, and mingle 
it with the gastric juice, which disintegrates the connective 
tissue, and converts the albuminous portions into the substance 
called chyme, which is about the consistency of pea-soup, and 
which is readily absorbed through the animal membranes into 
the blood of the delicate and numerous vessels of the stomach, 
whence it is conveyed to the portal vein and to the liver. 
The secretion of the gastric juice is influenced by nervous 
conditions. Excess of joy or grief effectually retard or even 
arrest its flow. 
Intestinal Juice. In the small intestine, a secretion is 
found which is termed the intestinal juice. It is the product 
of two classes of glands situated in the mucous membrane, 
and termed respectively, the follicles of Lieberkuhn and the 
glands of Brunner. The former consist of numerous small 
tubes, lined with epithelium, which secrete by far the greater 
portion of this fluid. The latter are clusters of round follicles 80 
COMMON SENSE MEDICAL ADVISEE. 
opening into a common excretory duct. These sacs are com- 
posed of delicate, membranous tissue, having numerous nuclei 
on their walls. The difficulty of obtaining this juice for ex- 
periment is obvious, and therefore its chemical composition 
and physical properties are not known. The intestinal juice 
resembles the secretion of the mucous follicles o£ the mouth, 
being colorless, vitreous in appearance, and having an alkaline 
reaction. 
Pancreatic Juice. This is a colorless fluid, secreted 
in a lobular gland which is situated behind the stomach, and 
runs transversely from the spleen across the vertebral column 
to the duodenum. The most important constituent of the 
pancreatic juice is an organic substance, termed pancreatin. 
The Bile. The blood which is collected by the veins of 
the stomach, pancreas, spleen, and intestines, is discharged 
into a large trunk called the portal vein, which enters the 
liver. This organ also receives arterial blood from a vessel 
called the hepatic artery, which is given off from the aorta 
below the diaphragm. If the branches of the portal vein 
and hepatic artery be traced into the substance of the 
liver, they will be found to accompany one another, and to 
subdivide, becoming smaller and smaller. Finally, the portal 
vein and hepatic artery will be found to terminate in capil- 
laries which permeate the smallest perceptible subdivisions of 
the liver substance, which are polygonal masses of not more 
than one-tenth of an inch in diameter, called the lobules. 
Every lobule rests upon one of the ramifications of a great 
vessel termed the hepatic vein, which empties into the in- 
ferior vena cava. There is also a vessel termed the hepatic 
duct leading from the liver, the minute subdivisions of which 
penetrate every portion of the substance of that organ. Con- 
nected with the hepatic duct, is the duct of a large oval sac, 
called the gall-bladder. 
Each lobule of the liver is composed of minute cellular 
bodies known as the hepatic cells. It is supposed that in 
these cells the blood is deprived of certain materials which 
are converted into bile. This secretion is a glutinous fluid, 
varying in color from a dark golden brown to a bright yel- 
low, has a specific gravity ranging from 1018 to 1036, and a SECBETION. 
81 
slightly alkaline reaction. When agitated, it has a frothy 
appearance. Physiologists have experienced much difficulty 
in studying the character of this secretion from the instability 
of its constituents when subjected to chemical examination. • 
Bilinerdir\ is an organic substance peculiar to the bile, 
which imparts to that secretion its color. When this constit- 
uent is re-absorbed by the blood and circulates through the 
tissues, the skin assumes a bright yellow hue, causing what is 
known as the jaundice. Cholesterin is an inflammable crystal- 
lizable substance soluble in alcohol or ether. It is found in 
the spleen and all the nervous tissues. It is highly probable that 
it exists in the blood, in some 
state or combination, and as- 
sumes a crystalline form only 
when acted upon by other sub- 
stances or elements. Two 
other constituents, more im- 
portant than either of the 
above, are collectively termed 
biliary salts. These elements 
were discovered in 1848, by 
Strecker, who termed them 
glycocholate and taurocholate 
of soda. Both are crystalline, 
resinous substances, and, al- 
though resembling each other 
in many respects, the chemist 
may distinguish them by their 
reaction, for both yield a pre- 
cipitate if treated with subacetate of lead, but only the glyco- 
cholate will give a precipitate with acetate of lead. In testing 
for biliary substances, the most satisfactory method is the one 
proposed by Pettenkoffer. A solution of cane-sugar, one 
part of sugar to four parts of water, is mixed with the sus- 
pected substance. Dilute sulphuric acid is then added until 
a white precipitate falls, which is re-dissolved in an excess of 
the acid. On the addition of more sulphuric acid, it becomes 
opalescent, and passes through the successive hues of scarlet, 
lake, and a rich purple. Careful experiments have proved 
Fig. 52. 
Section of the Liver, showing the 
ramifications of the portal vein. 1. Twig 
of portal vein. 2, 3,' 2," 2.'" Interlobu- 
lar vein. 3, 3,' 3." Lobules. COMMDN sense medical adviser. 
82 
that it is a constant secretion; but its flow is more abundant 
during digestion. During the passage through the intestines 
it disappears. It is not eliminated, and Pettenkoffer's test 
has failed to detect its existence in the portal vein. These 
facts lead physiologists to the conclusion, that it undergoes 
some transformation in the intestines and is re-absorbed. 
After digestion has been going on in the stomach for 
some time, the semi-digested food, in the form of chyme, 
begins to pass through the pyloric orifice of the stomach into 
the duodenum, or upper portion of the small intestine. Here 
it encounters the intestinal juice, pancreatic juice, and the 
bile, the secretion of all of which is stimulated by the pres- 
ence of food in the alimentary tract. These fluids, mingling 
with the chyme, give it an alkaline reaction, and convert it 
into chyle. The transformation of starch into sugar, which is 
almost, if not entirely, suspended while the food remains in 
the stomach, owing to the acidity of the chyme, is resumed 
in the duodenum, the acid of the chyme, being neutralized 
by the alkaline secretions there encountered. 
Late researches have demonstrated that the pancreatic 
juice exerts a powerful effect on albuminous matters, not 
unlike that of the gastric juice. 
Thus, it seems that while in the mouth only starchy, and 
while in the stomach only albuminous substances are digested, 
in the small intestine all kinds of food materials, starchy, 
albuminoid, fatty and mineral, are either completely dissolved, 
or minutely subdivided, and so prepared that they may be 
readily absorbed through the animal membranes into the 
vessels. 
Milk. The milk is a white, opaque fluid, secreted in the 
lacteal glands of the female, in the mammalia. These glands 
consist of numerous follicles, grouped around an excretory 
duct, which unites with similar ducts coming from other 
lobules. By successive unions, they form large branches, 
termed the lactiferous ducts, which open by ten to fourteen 
minute orifices on the extremity of the nipple. The most im- 
portant constituent of milk is casein ; it also contains oily and 
saccharine substances. This secretion, more than any other, 
is influenced by nervous conditions. A mother's bosom will SECRETION. 
83 
fill with milk at the thought of her infant child. Milk is 
sometimes poisoned by a fit of ill-temper, and the infant 
made sick and occasionally thrown into convulsions, which in 
some instances prove fatal. Sir Astley Cooper mentions two 
cases in which terror instantaneously and permanently arrested 
this secretion. It is also affected by the food and drink. Malt 
liquors and other mild alcoholic beverages temporarily increase 
the amount of the secretion, and may, in rare instances, have a 
beneficial effect upon the mother. They sometimes affect the 
child, however, and their use is not to be recommended unless 
the mother is extremely debilitated, and there is a deficiency 
of milk. CHAPTER XL 
PHYSIOLOGICAL ANATOMY. 
EXCRETION. 
The products resulting from the waste of the tissues are 
constantly being poured into the blood, and, as we have seen, 
the blood being everywhere full of corpuscles, which, like all 
living things, die and decay, the products of theii' decomposi- 
tion accumulate in every part of the circulatory system. 
Hence, if the blood is to be kept pure, the waste materials 
incessantly poured into this fluid, or generated in it, must 
be as continually removed, or excreted. The principal sets 
of organs concerned in effecting the separation of excrementi- 
tious substances from the blood are the lungs, the skin, and 
the kidneys. 
The elimination of carbonic acid through the lungs has 
already been described on page 66, and the excretory func- 
tion of the skin on page 70. 
The kidneys are two bean-shaped placed at the back 
of the abdominal cavity, in the region of the loins, one on 
each side of the spine. The convex side of each kidney is 
directed outwards, and the concave side is turned inwards 
towards the spine. From the middle of the concave side, 
which is termed the hilus, a long tube of small caliber, called 
the ureter, proceeds to the bladder. The latter organ is an 
oval bag, situated in the pelvic cavity. It is composed princi- 
pally of elastic muscular fibers, and is lined internally with 
mucous membrane, and coated externally with a layer of the 
peritoneum, the serous membrane which lines the abdominal 
84 EXCRETION. 
85 
and pelvic cavities. The ureters enter the bladder through 
its posterior and lower wall, at some little distance from each 
Fig. 53. 
View of the kidneys, ureters, and bladder. 
other. The openings through which the ureters enter the 
bladder are oblique, hence it is much easier for the secretion 86 
COMMON SENSE MEDICAL ADVISER. 
of the kidneys to pass from the ureters into the bladder than 
for it to get the other way. Leading from the bladder to 
the exterior of the body is a tube, called the urethra, through 
which the urine is voided. 
The excretion of the kidneys, termed the urine, is an amber- 
colored or straw-colored fluid, naturally having a slightly acid 
reaction, and a specific gravity ranging from 1,015 to 1,025 
Its principal constituents are urea and uric acid, together with 
various other animal matters of less importance, and saline 
substances, held in solution in a proportionately large amount 
of water. The composition of the urine and the quantity 
excreted vary considerably, being influenced by the moisture 
and temperature of the atmosphere, by the character of the 
food consumed, and by the empty or replete condition of the 
alimentary tract. On an average a healthy man secretes about 
fifty ounces of urine in the twenty-four hours. This quantity 
usually holds in solution about one ounce of urea, and ten or 
twelve grains of uric acid. In the amount of other animal 
matters, and saline substances, there is great variation, the 
quantity of these ranging from a quarter of an ounce to an 
ounce. The principal saline substances are common salt, 
the sulphates and phosphates of potassium, sodium, calcium, 
and magnesium. In addition to the animal and the saline 
matters, the urine also contains a small quantity of carbonic 
acid, oxygen and nitrogen. CHAPTER XII. 
PHYSIOLOGICAL ANATOMY. 
THE NERVOUS SYSTEM. 
Hitherto, we have only considered the anatomy and functions 
of the organs employed in Digestion, Absorption, Circulation, 
Respiration, Secretion and Excretion. We have found the vital 
process of nutrition to be, in all its essential features, a result 
of physical and chemical forces; in each instance we have 
presupposed the existence and activity of the nerves. There 
is not an inch of bodily tissue into which their delicate fila- 
ments do not penetrate, and form a multitude of conductors, 
over which are sent the impulses of motion and sensation. 
Two elements, nerve-fibers and ganglionic corpuscles, enter 
into the composition of nervous tissue. Ordinary nerve- 
fibers in the living subject, or when fresh, are cylindrical- 
shaped filaments of a clear, but somewhat oily appearance. 
But soon after death the matter contained in the fiber coagu- 
lates, and then the fiber is seen to consist of an extremely 
delicate, structureless, outer membrane, which forms a tube 
through the center of which runs the axis-cylinder. Inter- 
posed between the axis-cylinder and this tube, there is a 
fluid, containing a considerable quantity of fatty matter, from 
which is deposited a highly refracting substance which lines 
the tube. There are two sets of nerve-fibers, those which 
transmit sensory impulses, called afferent or sensory nerves, 
and those which transmit motor impulses, called efferent or 
motor nerves. The fibers when collected in bundles are 
termed nerve trunks. All the larger nerve-fibers lie side by 
side in the nerve-trunks, and are bound together by delicate 
87 88 
COMMON SENSE MEDICAL ADVISER. 
Fig. 54. 
The Nervous System. THE CEREBRO-SPINAL SYSTEM. 
89 
connective tissue, enclosed in a sheath of the same material, 
termed the neurilemma. The nerve-fibers in the trunks of the 
nerves remain perfectly distinct and disconnected from one 
another, and seldom, or never, divide throughout their entire 
length. However, where the nerves enter the nerve-centers, 
and near their outer terminations, the nerve-fibres often divide 
into branches, or at least gradually diminish in size, until, 
finally, the axis-cylinder, and the sheath with its fluid con- 
tents, are no longer distinguishable. The investing membrane 
is continuous from the origin to the termination 
of the nerve-trunk. 
In the brain and spinal cord the nerve-fibers 
often terminate in minute masses of a gray or 
ash-colored granular substance, termed ganglia, 
or ganglionic corpuscles. 
The ganglia are cellular corpuscles of irreg- 
ular form, and possess fibrous appendages, 
which serve to connect them with one another. 
These ganglia form the cortical covering of the 
brain, and are also found in the interior of the 
spinal cord. According to Kblliker, the larger 
of these nerve-cells measure only of an 
inch in diameter. The brain is chiefly composed 
of nervous ganglia. 
Nerves are classified with reference to their 
origin, as cerebral-those originating in the brain, 
and spinal-those originating in the spinal cord. 
There are two sets of nerves and nerve-centers, which are 
intimately connected, but which can be more conveniently 
studied apart. These are the cerebrospinal system, consisting 
of the cerebro-spinal axis, and the cerebral and spinal nerves; 
and the sympathetic system, consisting of the chain of sym- 
pathetic ganglia, the nerves which they give off, and the 
nervous trunks which connect them with one another and 
with the cerebro-spinal nerves. 
Fig. 55. 
Division of a 
nerve, showing a 
portion of a ner- 
vous trunk (a) 
and separation of 
its filaments (b, c, 
d, e.) 
THE CEREBRO-SPINAL SYSTEM. 
The Cerebro- Spinal Axis consists of the brain 
and spinal cord. It lies in the cavities of the cranium and 90 
COMMON SENSE MEDICAL ADVISER. 
the spinal column. These cavities are lined with a very tough 
fibrous membrane, termed the dura mater, which serves as 
the periosteum of the bones which enter into the formation 
of these parts. The surface of the brain and spinal cord is 
closely invested with an extremely vascular, areolar tissue, 
called the pia mater. The numerous blood-vessels which 
supply these organs traverse the pia mater for some distance, 
and, where they pass into the substance of the brain or 
spinal cord, the fibrous tissue of this membrane accompanies 
them to a greater or less depth. The inner surface of the 
dura mater and the outer surface of the pia mater are 
covered with an extremely thin, serous membrane, which is 
termed the arachnoid membrane. Thus, one layer of the 
arachnoid envelopes the brain and spinal cord, and the other 
lines the dura mater. As the layers become continuous with 
each other at different 
points, the arachnoid, like 
the pericardium, forms a 
shut sac, and, like other 
serous membranes, it se- 
cretes a fluid, known as 
the arachnoid fluid. The 
space between the internal 
and the external layers of 
the arachnoid membrane 
of the brain is much 
smallei* than that enclosed by the corresponding layers of the 
arachnoid membrane of the spinal column. 
The Spinal Cord is a column of soft, grayish-white 
substance, extending from the top of the spinal canal, where 
it is continuous with the brain, to about an inch below the 
small of the back, where it tapers off into a filament. From 
this nerve are distributed fibers and filaments to the muscles 
and integument of at least nine-tenths of the body. 
The spinal cord is divided in front through the middle 
nearly as far as its center, by a deep fissure, called the 
anterior fissure, and behind, in a similar manner, by the pos- 
terior fissure. Each of these fissures is lined with the pia 
mater, which also supports the blood-vessels which supply 
Fig. 56. 
Cross-section of spinal cord. THE SPINAL CORD. 
91 
the spinal cord with blood. Consequently, the substance of 
the two halves of the cord is only connected by a narrow 
isthmus, or bridge, perforated by a minute tube, which is 
termed the central canal of the spinal cord. 
Each half of the spinal cord is divided lengthwise into 
three nearly equal parts, which are termed the anterior, lateral, 
and posterior columns, by the lines which join together two 
parallel series of bundles of nervous filaments, which compose 
the roots of the spinal nerves. The roots of those nerves, 
which are found along that line nearest the posterior surface 
of the cord, are termed the posterior roots; those which spring 
from the other line are known as the anterior roots. 
Several of these anterior and posterior roots, situated at 
about the same height on opposite sides of the spinal cord, 
converge and combine into what are called the anterior and 
posterior bundles; then two bundles, anterior and posterior, 
unite and form the trunk of a spinal nerve. 
The nerve trunks'make their way out of the spinal canal 
through apertures between the vertebra, called the inter-verte- 
bral foramina and then divide into numerous branches, their 
ramifications extending principally to the muscles and the 
skin. There are thirty-one pairs of spinal nerves, eight of 
which are termed cervical, twelve dorsal, five lumbar, and six 
sacral, with reference to that part of the cord from which 
they originate. 
When the cord is divided into transverse sections, it is 
found that each half is composed of two kinds of matter, a 
white substance on the outside, and a grayish substance in 
the interior. The gray matter, as it is termed, lies in the 
form of an irregular crescent, with one end considerably larger 
than the other, and having the concave side turned outwards. 
The ends of the crescent are termed the horns, or cornua, the 
one pointing forward being called the anterior cornu, the 
other one the posterior cornu. The convex sides of these 
cornua approach each other and are united by the bridge, 
which contains the central canal. 
There is a marked difference in the structure of the gray 
and the white matter. The white matter is composed entirely 
of nerve fibers, held together by a framework of connective 92 
COMMON SENSE MEDICAL ADVISER. 
tissue. The gray matter contains a great number of gang- 
lionic corpuscles, or nerve-cells, in addition to the nerve-fibers. 
When the nerve-trunks are irritated in any manner, whether 
by pinching, burning, or the application of electricity, all 
the muscles which are supplied with branches from this nerve- 
trunk immediately contract, and pain is experienced, the 
severity of which depends upon the degree of the irritation; 
and the pain is attributed to that portion of the body to 
which the filaments of the nerve-trunk are distributed. Thus, 
persons who have lost limbs often complain in cold weather 
of an uneasiness or pain, which they locate in the fingers or 
toes of the limb which has been amputated, and which is 
caused by the cold producing an irritation of the nerve-trunk, 
the filaments, or fibers of which, supplied the fingers or toes 
of the lost member. 
On the other hand, if the anterior bundle of nerve-fibers 
given off from the spinal cord is irritated in precisely the 
same way, only half of these effects is 'produced. All the 
muscles which are supplied with fibers from that trunk con- 
tract, but no pain is experienced. Conversely, if the posterior 
bundle of nerve-fibers is irritated, none of the muscles to 
which the filaments of the nerve are distributed contract, but 
pain is felt throughout the entire region to which these fila- 
ments are extended. It is evident, from these facts, that the 
fibers composing the posterior bundles of nerve-roots only 
transmit sensory impulses, and the filaments composing the 
anterior nerve-roots only transmit motor impulses; accordingly, 
they are termed respectively the sensory and the motor nerve- 
roots. This is illustrated by the fact that when the posterior 
root of a spinal nerve is divided, all sensation in the parts to 
which the filaments of that nerve are distributed is lost, but 
the power of voluntary movement of the muscles remains. 
On the other hand, if the anterior roots are severed, the power 
of voluntary motion of the muscles is lost, but sensation 
remains. 
It appears from these experiments, that, when a nerve is 
irritated, a change in the arrangement of its molecules takes 
place, which is transmitted along the nerve-fibers. But, if the 
nerve-trunks are divided, or compressed tightly at any point REFLEX ACTION OF THE SPINAL CORD. 
93 
between the portion irritated, and the muscle or nerve-centre, 
the effect ceases immediately, in a manner similar to that in 
which a message is stopped by the cutting of a telegraph 
wire. When the nerves distributed to a limb are subjected 
to a pressure sufficient to destroy the molecular continuity of 
their filaments, it "goes to sleep," as we term it. The power 
of transmitting sensory and motor impulses is lost, and only 
returns gradually, as the molecular continuity is restored. 
From what has been said, it is plain that a sensory nerve is 
one which conveys a sensory impulse from the peripheral or 
outer part of a nerve to the spinal cord oi* brain, and which 
is, therefore, termed afferent; and that a motor nerve is one 
which transmits an impulse from the nerve centre, or is 
efferent. No difference in structure, or in chemical or physical 
composition, can be discerned between the afferent and the 
efferent nerves. A certain period of time is required for the 
transmission of all impulses. The speed with which an im- 
pulse travels has been found to be comparatively slow, being 
even less than that of sound, which is 1,120 feet per second. 
The experiments heretofore related have been confined solely 
to the nerves. We may now proceed to the consideration of 
what takes place when the spinal cord is operated upon in a sim- 
ilar way. If the cord be divided with a knife or other instru- 
ment, all parts of the body supplied with nerves given off below 
the division will become paralyzed and insensible, while all parts 
of the body supplied with nerves from the spinal cord above the 
division will retain their sensibility and power of motion. If, 
however, only the posterior half of the spinal cord is divided, or 
destroyed, there is loss of sensation alone; and, if the anterior 
portion is cut in two, and the continuity of the posterior part is 
left undisturbed, there is loss of voluntary motion of the lower 
limbs, but sensation remains. 
Reflex Action of the Spinal Cord. In relation to 
the brain, the spinal cord is a great mixed motor and sensory 
nerve, but, in addition to this, it is also a distinct nervous 
centre, in which originate and terminate all those involuntary 
impulses which exert so potent an influence in the preservation 
and economy of the body. That peculiar power of the cord, 
by which it is enabled to convert sensory into motor impulses, 94 
COMMON SENSE MEDICAL ADVISER. 
is that which distinguishes it, as a central organ, from a nerve, 
and is called reflex action. 
The gray matter, and not the white, is the part of the cord 
which possesses this power. This reflex action is a special func- 
tion of the spinal cord, and serves as a monitor to, and regulator 
of the organs of nutrition and circulation, by placing them, ordi- 
narily, beyond the control of conscious volition. 
If the foot of a decapitated frog is irritated, there is an instant 
contraction of the corresponding limb; if the irritation is intense 
the other limb also contracts. These motions indicate the exist- 
ence, in some part of the spinal cord, of a distinct nerve-centre, 
capable of converting and reflecting impulses. It has been found 
by experiment, that the same movements will take place if the 
irritation be applied to any portion of the 
body to which the spinal nerves are dis- 
tributed, thus giving undoubted evidence 
that the spinal cord in its entirety is 
capable of causing these reflections. 
Fig. 57 represents the course of the nerv- 
ous impulses. The sensory impulse passes 
upward along the posterior root, a, until 
it reaches the imbedded gray matter, b, 
of the cord, by which it is reflected, as 
a motor impulse, downward along the 
anterior root, c, to the muscles whence 
the sensation was received. This is the reflex action of the 
spinal cord. There is no consciousness or sensation connected 
with this action, and the removal of the brain and the sym- 
pathetic system does not diminish its activity. Even after 
death it continues for some time, longer in cold-blooded than 
in warm-blooded animals, on account of the difference in tem- 
perature, thus showing this property of the spinal cord. By 
disease, or the use of certain poisons, this activity may be 
greatly augmented, as is frequently observed in the human 
subject. A sudden contact with a different atmosphere may 
induce these movements. The contraction of the muscles, 
or cramp, often experienced by all persons, in stepping into 
a cold bath, or emerging from the cozy sitting-room into 
a chilly December temperature, are familiar illustrations of 
Fig. 57. THE BRAIN. 
95 
reflex movements. It has been demonstrated that the irri- 
tability of the nerves may be impaired or destroyed, while 
that of the muscles to which they are distributed remains 
unchanged ; and that the motor and sensory classes of fila- 
ments may be paralyzed independently of each other. 
The reflex actions of the spinal cord have been admirably 
summed up by Dr. Dalton, as exerting a general, protective 
influence over the body, presiding over the involuntary action 
of the limbs and trunk, regulating the action of the sphinc- 
ters, rectum, and bladder, and, at the same time, exercising an 
indirect influence upon the nutritive changes in all parts of 
the body to which the spinal filaments are distributed. 
The Brain. The brain is a complex organ, which is 
divided into the medulla oblongata, the cerebellum, and the 
cerebrum. 
The medulla oblongata is situated just above the spinal cord, 
and is continuous with it below, and the brain above. It has 
distinct functions which are employed in the preservation and 
continuance of life. It has been termed the " vital knot," 
owing to the fact that the brain may be removed and the 
cord injured and still the heart and lungs will continue to 
perform their functions, until the medulla oblongata is 
destroyed. 
The arrangement of the white and gray matter of the 
medulla oblongata is similar to that of the spinal cord; that 
is to say, the white matter is external and the gray internal; 
whereas in the cerebellum and cerebrum this order is reversed. 
The fibres of the spinal cord, before entering this portion of 
the brain, decussate, those from the right side crossing to the 
left, and those from the left crossing to the right side. By 
some authors this crossing of the sensory and motor filaments 
has been supposed to take place near the medulla oblongata. 
Dr. Brown-Sequard shows, however, that it takes place at 
every part of the spinal cord. The medulla oblongata is 
traversed by a longitudinal fissure, continuous with that of 
the spinal cord. Each of the lateral columns thus formed 
are subdivided into sections, termed respectively the Corpora 
Pyramidalia, the Corpora Olivaria, the Corpora Restiformia 
and the Posterior Pyramids. 96 
COMMON SENSE MEDICAL ADVISER. 
The Corpora Pyramidalia (see 1, 1, Fig. 58) are two small 
medullary eminences or cords, situated at the posterior surface 
of the medulla oblongata; approaching the Pons Varolii they 
become larger and rounded. 
The Corpora Olivaria (3, 3, Fig. 58) are two elliptical prom- 
inences, placed exterior to the corpora pyramidalia. By some 
physiologists these bodies are considered as the nuclei, or 
vital points, of the medulla oblongata. Being closely connected 
with the nerves of special sensation, Dr. Solly supposed that 
they presided over the movements of the larynx. 
Fig. 58. 
Fig. 59, 
The Corpora Restiformia (5, 5, Fig. 59) are lateral and pos- 
terior rounded projections of whitish medulla, which pass 
upward to the cerebellum and form the crura cerebelli, so 
called because they resemble a leg. The filaments of the 
pneumogastric nerve originate in the ganglia of these parts. 
The Posterior Pyramids are much smaller than the other 
columns of the medulla oblongata. They are situated (4, 4, 
Fig. 59) upon the margin of the posterior fissures in contact 
with each other. 
The functions of the medulla oblongata, which begin with 
the earliest manifestations of life, are of an instinctive THE BRAIN. 
97 
character. If the cerebellum and cerebrum of a dove be 
removed, the bird will make no effort to procure food, but if 
a crumb of bread be placed in its bill, it is swallowed natu- 
rally and without any special effort. So also in respiration, 
the lungs continue to act after the inter-costal muscles are 
paralyzed; if the diaphragm loses its power, suffocation is the 
result, but there is still a convulsive movement of the lungs 
for sometime, indicating the continued action of the medulla 
oblongata. 
The Cerebellum, or little brain, is situated in the posterior 
chamber of the skull, beneath the tentorium, a tent-like process 
of the dura mater which separates it from the cerebrum. It 
is convex, with a transverse diameter of between three and one- 
half and four inches, and is little more than two inches in thick- 
ness. It is divided on its upper and lower surfaces into two 
lateral hemispheres, by the superior and inferior vermiform 
processes, and behind by deep notches. The cerebellum is 
composed of gray and white matter, the former being darker 
than that of the cerebrum. From the beautiful arrangement of 
tissue, this organ has been termed the arbor vitae. 
The peduncles of the cerebellum, the means by which it 
communicates with the other portions of the brain, are divided 
into three pairs, designated as the superior, middle and inferior. 
The first pass upward and forward until they are blended with 
the tubercles of the corpora quadricjemina. The second are the 
crura cerebelli, which unite in two large fasciculi, or pyramids, 
and are finally lost in the pons varolii. The inferior peduncles 
are the corpora restiformia, previously described, and consist 
of both sensory and motor filaments. Some physiologists 
suppose that the cerebellum is the source of that harmony or 
associative power which co-ordinates all voluntary movements, 
and effects that delicate adjustment of cause to effect, dis- 
played in muscular action. This fact may be proved by 
removing the cerebellum of a bird and observing the results, 
which are an uncertainty in all its movements, and difficulty 
in standing, walking, or flying, the bird being unable to direct 
its course. In the animal kingdom we find an apparent 
correspondence betw'een the size of the cerebellum and the 
variety and extent of the movements of the animal. Instances 98 
COMMON SENSE MEDICAL ADVISEE. 
are cited, however, in which no such proportion exists, and 
so the matter is open to controversy. The general function 
of the cerebellum, therefore, cannot be explained, but the 
latest experiments in physiological and anatomical science 
seem to favor the theory that it is in some way connected 
with the harmony of the movements. This co-ordination, by 
which the adjustment of voluntary motion is supposed to be 
effected, is not in reality a faculty having its seat in the brain 
substance, but is the harmonious action of many forces through 
the cerebellum. 
The Cerebrum occupies five times the space of all the other 
portions of the brain together. It is of an ovoid form, and 
becomes larger as it approaches the posterior region of the 
skull. A longitudinal fissure covered by the dura mater sep- 
arates the cerebrum into two hemispheres, which are connected 
at the base of the fissure, by a broad medullary band, termed 
the corpus callosum. Each hemisphere is subdivided into three 
lobes. The anterior gives form to the forehead, the middle 
rests in the cavity at the base of the skull, and the posterior 
lobe is supported by the tentorium, by which it is separated 
from the cerebellum beneath. One of the most prominent 
characteristics of the cerebrum is its many and varied convo- 
lutions These do not correspond in all brains, nor even on 
the opposite sides of the same brain, yet there are certain 
features of similarity in all; accordingly, anatomists enumerate 
four orders of convolutions. The first order begins at the 
substantia perforata and passes upward and around the corpus 
callosum toward the posterior margin of that body, thence 
descends to the base of the brain, and terminates near its 
origin. The second order originates from the first, and 
subdivides into two convolutions, one of which composes the 
exterior margin and superior part of the corresponding hemi- 
sphere, while the other forms the circumference of the fissure 
of Sylvius. The third order, from six to eight in /lumber, is 
found in the interior portion of the brain, and inosculates 
between the first and second orders. The fourth is found 
on the outer surface of the hemisphere, in the space between 
the sub-orders of the second class. A peculiar fact relating to 
these convolutions is observed by all anatomists: mental THE BRAIN. 
99 
development is always accompanied by an increasing dis- 
similarity between their proportional size. 
The cerebral hemispheres may be injured or lacerated without 
any pain to the patient. The effect seems to be one of stupe- 
faction without sensation or volition. A well-developed brain 
is a very good indication of intelligence and mental activity. 
That the cerebrum is the seat of the reasoning powers, and 
all the higher intellectual functions, is proved by three facts. 
(1.) If this portion of the brain is removed, it is followed by 
the loss of intelligence. (2.) If the human cerebrum is in- 
jured, there is an impairment of the intellectual powers. (3.) 
In the animal kingdom, as a rule, intelligence corresponds to 
the size of the cerebrum. This general law of development 
is modified by differences in the cerebral texture. Men pos- 
sessing comparatively small brains may have a vast range 
of thought and acute reasoning powers. Anatomists have 
found these peculiarities to depend upon the quantity of 
gray matter which enters into the composition of the brain. 
In the cerebro-spinal system there are three different kinds 
of reflex actions. (1.) Those of the spinal cord and medulla 
oblongata are performed without any consciousness or sensation 
on the part of the subject. (2.) The second class embraces 
those of the tuber annulare, where the perception gives rise 
to motion -without the interference of the intellectual faculties. 
These are denominated purely instinctive reflex actions, and 
include all those operations of animals which seem to display 
intelligent forethought; thus, the beaver builds his habitation 
over the water, but not a single apartment is different from 
the beaver homestead of a thousand years ago; there is no 
improvement, no retrogression. Trains of thought have been 
termed a third class of reflex actions. It is evident that the 
power of reasoning is, in a degree, possessed by some of 
the lower animals: for instance, a tribe of monkeys on a 
foraging expedition will station guards at different parts of 
the field, to warn the plunderers of the approach of danger. 
A cry from the sentinel, and general confusion is followed 
by retreat. Reason only attains its highest development in 
man, in whom it passes the bounds of ordinary existence, 
and, with the magic wand of love, reaches outward into the 100 
COMMON SENSE MEDICAL ADVISER. 
vast unknown, lifting him above corporeal being, into an 
atmosphere of spiritual and divine Truth. 
The Cranial Nerves. From the brain, nerves are 
given off in pairs, which succeed 
one another from in front back- 
wards to the number of twelve. 
The first pair, the olfactory nerves, 
are the nerves of the sense of smell. 
The second pair are the optic, or 
the nerves of the sense of sight. The 
third pair are called the motores 
oculi, the movers of the eye, from 
the fact that they are distributed 
to all the muscles of the eye with 
the exception of two. The fourth 
pair and the sixth pair each sup- 
ply one of the muscles of the eye, 
on each side, the fourth extending 
to the superior oblique muscle, and 
the sixth to the external rectus 
muscle. The nerves of the fifth 
pair are very large; they are each 
composed of two bundles of fila- 
ments, one motor and the other sen- 
sory, and have, besides, an additional 
resemblance to a spinal nerve by 
having a ganglion on each of their 
sensory roots, and, from the fact 
that they have three chief divisions, 
are often called the trigeminal, or 
trifacial, nerves. They are nerves 
of special sense, of sensation, and 
of motion. They are the sensitive 
nerves which supply the cranium 
and face, the motor nerves of the 
muscles of mastication, the bucci- 
nator and the masseter, and their 
third branches, often called the gustatory, are distributed 
to the front portion of the tongue, and are two of the 
Fig. 60. 
Section of the brain and an ideal 
view of the pneumogastric nerve 
on one side, with its branches, a. 
Vertical section of the cerebrum. 
b. Section of the cerebellum, c. 
Corpus callosum, d. Lower sec- 
tion of medulla oblongata. Above 
d, origin of the pneumogastric 
nerve. 1. Pharyngeal branch. 2. 
Superior laryngeal. 3. Branches 
to the lungs. 4. Branches to the 
liver. 5. Branches to the stomach. THE GREAT SYMPATHETIC. 
101 
nerves of the special sense of taste. The seventh pair, 
called also the facial nerves, are the motor nerves of the 
muscles of the face, and are also distributed to a few other 
muscles; the eighth pair, termed the auditory nerves, are the 
nerves of the special sense of hearing. As the seventh and 
eighth pairs of nerves emerge from the cavity of the skull 
together, they are frequently classed by anatomists as one, 
divided into the facial, or portio dura, as it is sometimes 
called, and the auditory, or portio mollis. The ninth pair, 
called the glosso-pharyngeal, are mixed nerves, supplying motor 
filaments to the pharyngeal muscles and filaments of the special 
sense of taste to the back portion of the tongue. The tenth 
pair, called the pneumogastrlc, or par vagum, are very im- 
portant nerves, and are distributed to the larynx, the lungs, 
the heart, the stomach, and the liver, as shown in Fig. 60. 
This pair and the next are the only cerebral nerves which 
are distributed to parts of the body distant from the head. 
The eleventh pair, also called spinal accessory, arise from the 
sides of the spinal marrow, between the anterior and posterior 
roots of the dorsal nerves, and run up to the medulla 
oblongata, and leave the cranium by the same aperture as 
the pneumogastric and glosso-pharyngeal nerves. They supply 
certain muscles of the neck, and are purely motor. As the 
glosso-pharyngeal, pneumogastric, and spinal accessory nerves 
leave the cranium together, they are by some anatomists 
counted as the eighth pair. The twelfth pair, known as the 
hypo-glossal, are distributed to the tongue, and are the motor 
nerves of that organ. 
THE GREAT SYMPATHETIC. 
A double chain of nervous ganglia extends from the 
superior to the inferior parts of the body, at the sides and 
in front of the spinal column, and is termed, collectively, the 
system of the great sympathetic. These ganglia are intimately 
connected by nervous filaments, and communicate with the 
cerebro-spinal system by means of the motor and sensory fila- 
ments which penetrate the sympathetic. The nerves of this 
system are distributed to those organs over which conscious 
volition has no direct control. 102 
COMMON SENSE MEDICAL ADVISEE. 
Fig. 61. 
Course and distribution of the great Sympathetic Nerve. THE GREAT SYMPATHETIC. 
103 
Four of the sympathetic centers, situated in the front and 
lower portions of the head, are designated as the ophthalmic, 
spheno-palatine, submaxillary and otic ganglia. The first of 
these, as its name indicates, is distributed to the eye, pene- 
trates the sclerotic membrane (the white, opaque portion of the 
eyeball, with its transparent covering), and influences the 
contraction and dilation of the iris. The second division is situ- 
ated in the angle formed by the sphenoid and maxillary bone, 
or just below the ear. It sends motor and sensory filaments to 
the palate, and velum palati. Its filaments penetrate the 
carotid plexus, are joined by others from the motor roots of 
the facial nerve and the sensory fibres of the superior max- 
illary. The third division is located on the submaxillary gland. 
Its filaments are distributed to the sides of the tongue, the 
sublingual, and submaxillary glands. The otic ganglion is 
placed below the base of the skull, and also connects with the 
carotid plexus. Its filaments of distribution supply the internal 
muscles of the malleus, the largest bones of the tympanum, 
the membranous linings of the tympanum and the eustachian 
tube. Three ganglia, usually designated as the superior, middle, 
and inferior, connect with the cervical and spinal nerves. Their 
interlacing filaments are distributed to the muscular walls of 
the larynx, pharynx, trachea, and esophagus, and also penetrate 
the thyroid gland. The use of this gland is not accurately 
known. It is composed of a soft, brown tissue, and consists 
of lobules contained in lobes of larger size. It forms a spongy 
covering for the greater portion of the larynx, and the first 
section of the trachea. That it is an important organ, is 
evident from the fact that it receives four large arteries, and 
filaments from two pairs of nerves. 
The sympathetic ganglia of the chest correspond in number 
with the terminations of the ribs, over which they are situated. 
Each ganglion receives two filaments from the intercostal 
nerve, situated above it, thus forming a double connection. 
The thoracic ganglia supply with motor fibres that portion of 
the aorta which is above the diaphragm, the esophagus, and 
the lungs. 
In the abdomen the sympathetic centers are situated upon 
the coeliac artery, and are termed, collectively, the semilunar, 104 
COMMON SENSE MEDICAL ADVISER. 
coeliac ganglion. Numerous inosculating branches radiate 
from this center and are called, from the method of their dis- 
tribution, the solar plexus. From this, also, originate other 
plexi which are distributed to the stomach, liver, kidneys, 
intestines, spleen, pancreas, supra-renal glands, and to the 
organs of generation. Four other pairs of abdominal ganglia 
connected with the lumbar branches are united by filaments to 
form the semilunar ganglion. 
The sympathetic ganglia of the pelvis consist of five pairs, 
which are situated upon the surface of the sacrum. At the 
extremity of the spinal column this system terminates in a 
single knot, designated as the ganglion impar. 
Owing to the position of the sympathetic ganglia, deeply 
imbedded in the tissues of the chest and abdomen, it is ex- 
ceedingly difficult to subject them to any satisfactory experi- 
ments. A few isolated facts form the basis of all our knowl- 
edge concerning their functions. They give off both motor 
and sensory filaments. The contraction of the iris is one of 
the most familiar examples of the action of the sympathetic 
system. 
In the reflex actions of the nerves of special sense, the 
sensation is transmitted through the cerebro-spinal system, 
and the motor impulse is sent to the deep-seated muscles by 
the sympathetic system. Physiologists enumerate three kinds 
of reflex actions, which are either purely sympathetic, or 
partially influenced by the cerebro-spinal system. Dr. -Dalton 
describes them as follows: 
First.-" Reflex actions taking place from the internal organs, 
through the sympathetic and cerebro-spinal systems, to the 
voluntary muscles and sensitive surfaces.-The convulsions of 
young children are often owing to the irritation of undigested 
food in the intestinal canal. Attacks of indigestion are also 
known to produce temporary amaurosis [blindness], double 
vision, strabismus, and even hemiplegia. Nausea, and a dimin- 
ished or capricious appetite, are often prominent symptoms 
of early pregnancy, induced by the peculiar condition of the 
uterine mucous membrane." 
Second.-"Reflex actions taking place from the sensitive 
surfaces, through the cerebro-spinal and sympathetic systems, THE GREAT SYMPATHETIC. 
105 
to the involuntary muscles and secreting organs.-Imprudent 
exposure of the integument to cold and wet, will often bring on 
a diarrhea. Mental and moral impressions, conveyed through 
the special senses, will affect the motions of the heart, and 
disturb the processes of digestion and secretion. Terror, or an 
absorbing interest of any kind, will produce a dilatation of 
the pupil, and communicate in this way a peculiarly wild and 
unusual expression to the eye. Disagreeable sights or odors, 
or even unpleasant occurrences, are capable of hastening or 
arresting the menstrual discharge, or of inducing premature 
delivery." 
Third.-"Reflex actions taking place through the sympa- 
thetic system from one part of the body to another.-The 
contact of food with the mucous membrane of the small 
intestine excites a peristaltic movement in the muscular coat. 
The mutual action of the digestive, urinary, and internal gener- 
ative organs upon each other takes place entirely through the 
medium of the sympathetic ganglia and their nerves. The 
variation of the capillary circulation in different abdominal 
viscera, corresponding with the state of activity or repose of 
their associated organs, are to be referred to a similar nervous 
influence. These phenomena are not accompanied by any 
consciousness on the part of the individual, nor by any ap- 
parent intervention of the cerebro-spinal system." CHAPTER XIII. 
THE SPECIAL SENSES. 
SIGHT. 
The eye is the organ through, which we perceive, by the 
agency of light, all the varied dimensions relations, positions, 
and visible qualities of external objects. 
The number, position, and perfection of the eyes, vary 
remarkably in different orders, in many instances corresponding 
to the mode of life, habitation, and food of the animal. A 
skillful anatomist may ascertain by the peculiar formation of 
the eye, without reference to the general physical structure, 
in what element the animal lives. Sight is one of the most 
perfect of the senses, and reveals to man the beauties of 
creation. The aesthetic sentiment is acknowledged to be the 
most refining element of civilized life. Painting, sculpture, 
architecture, and all the scenes of nature, from a tiny wayside 
flower to a Niagara, are subjects in which the poet's eye sees 
rare beauties to mirror forth in the rhythm of immortal verse. 
In the vertebrates, the organs of vision are supplied with 
filaments from the second pair of cranial nerves. In mammalia, 
the eyes are limited to two in number, which in man are 
placed in circular cavities of the skull, beneath the anterior 
lobes of the cerebrum. Three membranes form the lining of 
this inner sphere of the eye, called respectively the Sclerotic, 
Choroid, and Retina. 
The Sclerotic, or outer covering, is the wThite, firm membrane, 
which forms the larger visible portion of the eyeball. It is 
covered in front by a colorless, transparent segment, termed 
the cornea, which gives the eye its lustrous appearance. Within 
the sclerotic, and lining it throughout, is a thin, dark membrane, 
106 SIGHT, 
107 
termed the Choroid. Behind the cornea it forms a cur- 
tain, called the ms, which gives to the eye its color. The 
muscles of the iris contract or relax according to the amount 
of light received, thus enlarging or diminishing the size of 
the circular opening called the pupil. The Retina is formed 
by the optic nerve, which penetrates the sclerotic and choroid 
and spreads out into a delicate, grayish, semi-transparent mem- 
brane. The retina is one of the most essential organs of vision, 
and consists of two layers. A spheroidal, transparent body, 
termed the crystalline lens, is situated directly behind the 
pupil. It varies in density, increasing from without inward, 
and forms a perfect re- 
fractor of the light 
received. The space in 
front of the crystalline 
lens is separated by the 
iris into two compart- 
ments called respec- 
tively the anterior and 
posterior chambers. The 
fluid contained within 
them, termed the aque- 
ous humor, is secreted 
by the cornea, iris, and 
ciliary processess. The space behind the crystalline lens is 
occupied by a fluid, called the vitreous humor. This humor is 
denser than the other fluids and has the consistency of jelly, 
being perfectly transparent. " The function of the crystalline 
lens is to produce distinct perception of form and outline." * 
The transparent humors of the eye also contribute to the 
same effect, but only act as auxiliaries to the lens. 
The figure on the next page represents the course of the 
rays of light proceeding from an object a b, refracted by the 
lens, and forming the inverted image x y on the screen. All 
rays of light proceeding from b are concentrated at y, and 
those proceeding from a converge at x. Rays of light eman- 
ating from the center of the object a b pursue a parallel course, 
Fig. 62. 
* Dalton-Human Physiology. 108 
COMMON SENSE MEDICAL ADVISER. 
and form the center of the image. Rays of light passing 
through a double convex lens converge at a point called the 
focus. In the organ of vision, if perfect, the focus is on the 
retina, which serves as a screen to receive the image or im- 
pression. We have a distinct perception of the outline of a 
distant hill, and also of a book lying before us. The rays of 
light we receive from these objects cannot have the same 
focus. How, then, can we account for the evident accommoda- 
tion of the eye to the varying distances? Various theories have 
been advanced to explain this adjustment; such as changes 
in the curvature of the cornea and lens; a movement of the 
lens, or a general change in the form of the eyeball, by 
which the axis may be lengthened or shortened. 
Two facts comprise all the positive knowledge which we pos- 
sess on this subject. Every person 
is conscious of a muscular effort in 
directing the eye to a near object, 
as a book, and of fatigue, if the 
attention is prolonged.. If, now, 
the eyes be directed to a distant 
object, there will result a sense 
of rest, or passiveness. By vari- 
ous experiments it has been proved that the accommodation 
or adjustment of the eye for near objects requires a muscular 
effort, but for distant objects the muscles are in an essen- 
tially passive condition. An increase in the convexity of the 
crystalline lens is now admitted to be necessary for a distinct 
perception of near objects. We may give two simple illus- 
trations, cited by Dr. Dalton in his recent edition of Human 
Physiology. If a candle be held near the front of an eye 
which is directed to a distant object, three reflected images 
of the flame will be seen in the eye, one on each of the anterior 
surfaces of the cornea and lens, and a third on the posterior 
surface of the latter. If the eye is directed to a near object, 
the reflection on the cornea remains unchanged, while that on 
the anterior surface of the lens gradually diminishes and 
approximates in size the reflection on the cornea, thus giving 
conclusive evidence that, in viewing a near object, the anterior 
surface of the crystalline lens become more convex, and at 
63- HEAEIXG. 
109 
the same time approaches the cornea. Five or six inches is 
the minimum limit of the muscular adjustment of the eye. 
From that point to all the boundless regions of space, to 
every star and nebulae which send their rays to our planet, 
human vision can reach. It is the sense by which we receive 
knowledge of the myriads of worlds and suns which circle 
with unfailing precision through infinite space. 
HEARING. 
Hearing depends upon the sonorous vibrations of the atmos- 
phere. The waves of sound strike the sensitive portions of 
the ear, and their 
impressions upon the 
auditory nerves are 
termed the sensa- 
tions of hearing. 
The ear is divided 
into three parts, 
called respectively 
the External, Middle, 
and Internal ear. 
The external organs 
of hearing are two in 
number, and placed 
on opposite sides of 
the head. In most 
of the higher order 
of vertebrates, they 
are so situated as to. 
give expression and 
proportion to the facial organs, and, at the same time, to 
suit the requirements of actual life. 
The External ear is connected with the interior part by a 
prolongation of its orifice, termed the external auditory meatus. 
In man, this gristly portion of the auditory apparatus is about 
one inch in length, lined by a continuation of the integument 
of the ear, and has numerous hairs on its surface, to prevent 
the intrusion of foreign substances. Between the external 
meatus and the cavity of the middle ear is the membrana 
Fig. GJh 
Internal and external ear. 1. External ear. 2. In- 
ternal auditory meatus. 3. Tympanum. A. Labyrinth. 
5. Eustachian tube. 110 
COMMON SENSE MEDICAL ADVISER. 
tympani, which is stretched across the opening like the head 
of a drum. The tympanum, or ear-drum, communicates with 
the pharynx by the eustachian tube, which is a narrow passage 
lined with delicate, ciliated epithelium. On the posterior por- 
tion it is connected with the mastoid cells. Three small bones 
are stretched across the cavity of the tympanum, and called, 
from their form, the malleus, incus and stapes, or the hammer, 
anvil, and stirrup. Agassiz mentions a fourth, which he terms 
the os orbiculare. Each wave of sound falling upon the 
membrana tympani, throws its molecules into vibrations which 
are communicated to the chain of bones, which, in turn, trans- 
mits them to the membrane of the foramen ovale. The three 
muscles which regulate the tension of these membranes are 
termed the tensor tympani, locator tympani, and stapedium 
tympani. 
The Labyrinth, or Internal ear, is a complicated cavity, 
consisting of three portions termed the vestibule, cochlea, and 
semi-circular canals. The vestibule is the central portion and 
communicates with the other divisions. The labyrinth is filled 
with a transparent fluid, termed perilymph, in which are sus- 
pended, in the vestibules and canals, small membranous sacs, 
containing a fluid substance, termed endolymph (sometimes 
called vitrine auditive from its resemblance to the vitreous 
humor of the eye). The filaments of the auditory nerve pen- 
etrate the membranous tissues of these sacs, and also of those 
suspended at the commencement of the semi-circular canals. 
These little sacs are supposed to be the seat of hearing, and 
to determine, in some mysterious way, the quality, intensity 
and pitch of sounds. 
The determination of the direction of sound is a problem of 
acoustics. Some have contended that the arrangement of the 
semi-circular canals is in some way connected with this sensa- 
tion. But this supposition, together with the theory of the 
transmission of sound through the various portions of the 
cranial bones, has been exploded. 
From the foregoing description, it will be seen that the 
labyrinth and tympanum are the most essential parts of 
the organs of hearing. In delicacy and refinement this 
sense ranks next to sight. The emotions of beauty and SMELL. 
111 
sublimity, excited by the warbling of. birds and the roll 
of thunder, are scarcely distinguishable from the intense emo- 
tions arising from sight. It is a remarkable fact, that the 
refinement or cultivation of these senses is always found 
associated. Those nations which furnish the best artists, or 
have the highest appreciation of painting and sculpture, 
produce the most skillful musicians, those who reduce music 
to a science. 
SMELL. 
Next in order of delicacy, and more closely allied with 
the physical functions, is the 
sense of smell. Delicate per- 
fumes, or the fragrance of 
a flower, impart an exhilar- 
ating sensation of delight, 
while numerous odors excite 
a feeling of disgust. The 
organ of smell is far less 
complicated in its structure 
than the eye or the ear. 
It consists of two cavi- 
ties having cartilaginous 
walls, and lined with a 
thick mucous coat, termed 
the pituitary membrane, 
over which are reflected the 
olfactory nerves. Particles 
of matter, too minute to 
be visible even through the 
microscope, are detached 
from the odorous body and 
come in contact with the 
nerves of smell, which 
transmit the impressions or 
impulses thus received to 
the brain. Fig. 65 shows 
the distribution of the 
olfactory nerves in the 
nasal passages. The nose is supplied with two kinds of 
Fig. 65. 
1. Frontal sinus. 2. Nasal bone. 3. Olfac- 
tory ganglion and nerves. A. Nasal branch 
of the fifth pair. 5. Spheno-palatine gan- 
glion. 6. Soft palate. 7. Hard palate, a. 
Cerebrum, b Anterior lobes, c. Corpus 
callosum, d. Septum lueidum. /. Fornix. 
g. Thalami optici. h. Corpora striata. 112 
COMMON SENSE MEDICAL ADVISER. 
filaments which are termed respectively nerves of special and 
nerves of general sensation. Compared with the lower ani- 
mals, especially with those belonging to the carnivorous species, 
the sense of smell in man is feeble. The sensation of smell 
is especially connected with the pleasures and necessities of 
animal life. 
TASTE. 
The sense of taste is directly connected with the preserva- 
tion and nutrition of the body. A delicious flavor produces a 
desire to eat a savory substance. Some writers on hygiene have 
given this sense an instinctive character, by assuming that 
all articles having an agreeable taste are suitable for diet. 
The nerves of taste are distributed over the surface of the 
tongue and palate, and their minute extremities terminate in 
well developed papillae,. These papillae are divided into three 
classes, termed, from their microscopic appearance, filiform, 
fungiform and circumvallate. The organ of taste is the mucous 
membrane which covers the back part of the tongue and the 
palate. The papillae of the tongue are large and distinct, and 
covered with separate coats of epithelium. The filiform papillae 
are generally long and pointed and are found over the entire 
surface of the tongue. The fungiform are longer, small at the 
base and broad at the end. The circumvallate are shaped like 
an inverted V and are found only near the root of the tongue; 
the largest of this class of papillae have other very small papillae 
upon their surfaces. It is now pretty satisfactorily established 
that the circumvallate, or fungiform papillae are the only ones 
concerned in the special sense of taste. 
The conditions necessary to taste are, that the substance be 
in solution either by artificial means, or by the action of the 
saliva; and that it be brought in contact with the sensitive 
filaments imbedded in the mucous membrane. The nerves 
of taste are both general and special in their functions. If 
the general sensibility of the nerves of taste is unduly excited, 
the function of sensibility is lost for some time. * If a pepper- 
mint lozenge is taken into the mouth, it strongly excites 
the general sensibilities of taste, and the power of distinguish- 
ing between special flavors is lost for a few moments. A touch 
113 
nauseous drug may then be swallowed without experiencing 
any disagreeable taste. 
Paralysis of the facial nerve often produces a marked effect 
in the sensibility of the tongue. Where this influence lies 
has not been fully explained; probably it is indirect, being pro- 
duced by some alteration in the vascularity of the parts or a 
diminution of the salivary secretions. 
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 know- 
ledge of certain qualities of a body, such as form consist- 
ency, roughness, or smoothness of surface, etc. The tip of 
the tongue possesses the most acute sensibility of any portion 
of the body, and next in order are the tips of the fingers. The 
hands are the principal organs of tactile sensation. The nerves 
of general sensibility are distributed to every part of the cuta- 
neous tissue. The contact of a foreign body with the back, 
will produce a similar tactile sensation, as with the tips of the 
fingers. The sensation, however, will differ in degree because 
the back is supplied with a much smaller number of sensitive 
filaments; in quality it is the same. 
TOUCH. CHAPTER XIV. 
CEREBRAL PHYSIOLOGY. 
By means of the nervous system, an intimate relation is 
maintained between mind and body, for nervous energy super- 
intends the functions of both. The fibres of nervous matter 
are universally present in the organization, uniting the physical 
and spiritual elements of man's being. Even the minutest 
nerve-rootlets convey impressions to the dome of thought and 
influence the intellectual faculties. We recognize muscular 
force, the strength of the body, molecular force, molecules 
in motion, as heat, light, chemical force, electricity, and 
nervous force, a certain influence which reacts between the 
animal functions and the cerebrum, thus connecting the con- 
ditions of the body with those of the mind. We cannot 
speak of the effects of mind or body separately, but we must 
consider their action and reaction upon each other, for they 
are always associated. There are many difficulties in under- 
standing this relationship, some of which may be obviated 
by a study of the development of nervous matter, and its 
functions in the lower orders of organization. 
Within the plant-cells is found a vital, vegetable substance 
termed bioplasm, or protoplasm, which furnishes the same 
nutritive power as the tissues of the polyp and jelly fish. 
Many families of animals have pulpy bodies, and slight in- 
stinctive motion and sensibility, and in proportion as the nervous 
system is developed, both of these powers are unfolded. Plants 
have a low degree of sensibility, limited motion, respiratory 
and circulatory organs. Animals possess quicker perceptions 
and sensibilities, the power of voluntary motion, and, likewise, 
114 CEREBRAL PHYSIOLOGY. 
115 
a rudimental nervous system. Some articulates have no bony 
skeleton, their muscles being attached to the skin which con- 
stitutes a soft contracting envelope. One of the simplest forms 
of animal life in which a ner- 
vous system is found, is the five- 
rayed star-fish. In each ray 
there are filaments which con- 
nect with similar nerve-filaments 
from other rays, and form a cir- 
cle around the digestive cavity. 
It probably has no conscious 
perception, and its movements 
do not necessarily indicate sen- 
sation or volition. In some 
worms a rudimentary nervous 
system is sparingly distributed 
to the cavities of the thorax and 
abdomen, and, as in the star-fish, 
the largest nerve-filament is found around the esophagus, pre- 
presiding over nutrition. 
A higher grade of organization requires a more complete 
arrangement of nervous substance. Stimulus applied to one 
organ is readily communi- 
cated to, and excites 
activity in another. 
The nervous system of 
some insects consists of 
two long, white cords, 
which run longitudinally 
through the abdomen, and 
are dilated at intervals 
into knots, consisting of 
collections of nerve-cells, 
called ganglia. They are 
really nerve-centers, which 
receive and transmit impulses, originate and impart nervous 
influence according to the nature of their organic surroundings. 
The ganglia situated over the esophagus of insects-correspond 
to the medulla oblongata in man, in which originate the spinal 
Fig. 66. 
Fig. 67. 
A. Nervous system of a Crab, showing its 
ganglia. B. The nervous system of a Cater- 
pillar. 116 
COMMON SENSE MEDICAL ADVISER. 
accessory, glosso-pliaryngeal, and pneumogastric nerves. The 
latter possess double endowments, and not only participate 
in the operations of deglutition, digestion, circulation, and 
respiration, but are also nerves of sensation and instinctive 
motion. The suspension of respiration produces suffocation. 
In insects, these ganglia are scarcely any larger than those dis- 
tributed within the abdomen, with which they connect by 
means of minute, nervous filaments. Insects are nimble in 
their movements, and manifest instinct, corresponding to the 
perfection of their muscular and nervous systems. When we 
ascend to vertebrates, those animals having a backbone, the 
amount of the nervous substance is greater, the organic func- 
tions are more complex, and the actions begin to display intel- 
ligence. 
Man possesses not only a complete sympathetic system, the 
rudiments of which are found in worms and insects, and a 
complete spinal system, less perfectly displayed in fishes, birds, 
and quadrupeds, but, superadded to all these is a magnificent 
cerebrum, and, as we have seen, all parts of the body are con- 
nected by the nervous system. The subtle play of sensory and 
motor impulses, of sentient and spiritual forces, indicates, a 
perfection of nervous endowments nowhere paralleled, and 
barely approached by inferior animals. This meager reference 
to brainless animals, whose knots of ganglia throughout their 
bodies act automatically as little brains, shows that instinct 
arises simultaneously with the development of the functions 
over which it presides. Here begins rudimentary, unreasoning 
intelligence. It originates within the body as an inward, vital 
impulse, is manifested in an undeviating manner, and therefore 
displays no intention or discretion. While Dr. Carpenter likens 
the human organism " to a keyed instrument, from which any 
music it is capable of producing can be called forth at the will 
of the performer," he compares " a bee or any other insect to a 
barrel organ, which plays with the greatest exactness a certain 
number of tunes that are set upon it, but can do nothing else." 
Instinct cannot learn from experience, or improve by practice; 
but it seems to be the prophetic germ of a higher intelligence. 
It is nearly as difficult to draw the dividing line between 
instinct and a low grade of intelligence, as it is to distinguish CEREBRAL PHYSIOLOGY. 
117 
between the psychical and psychological* functions of the 
brain. 
The intimate relation of instinct to intelligence is admirably 
illustrated in the working honey-bee. With forethought it 
selects a habitation, constructs comb, collects honey, provides 
a cell for the ova, covers the chrysalis, for which it deposits 
special nourishment, and is disposed to defend its possessions. 
It is a social insect, lives in colonies, chastises trespassers, 
fights its enemies, and defends its home. It manifests a degree 
of intelligence, but its sagacity is instinctive. Reason, though 
not so acute as instinct, becomes, by education, discerning and 
keenly penetrative, and reveals the very secrets of profound 
thought. We recall the aptness of Prof. Agassiz's remark: 
" There is even a certain antagonism between instinct and 
intelligence, so that instinct loses its force and peculiar char- 
acteristics, whenever intelligence becomes developed." Animals 
having larger reasoning powers manifest less instinct, and some, 
as the leopard, exercise both in a limited degree. This double 
endowment with instinct and low reasoning intelligence, is indi- 
cated by his lying in ambush awaiting his prey, the hiding- 
place being selected near the haunt of other animals, where 
nature offers some allurement to gratify the appetite. 
Simple reflex action is an instinctive expression, manifesting 
an intuitive perception, almost intelligent, as shown by the 
contraction of the stomach upon the food, simply because it 
impinges upon the inner coats, and thus excites them to action. 
A better illustration, because it displays sympathy, is when 
the skin, disabled by cold, cannot act, and its duties are largely 
performed by the kidneys. Though reflex action is easily 
traced in the lower organic processes, some writers have placed 
it on a level with rational deliberation. Undoubtedly, all 
animals having perception have also what perception implies 
-consciousness-and this indicates the possession, in some 
*In the use of the terms psychical and psychological, we have observed the 
distinction which metaphysicians have recently made. They employ the term 
psychical to indicate the relation of the human soul to sense, appetite, pro- 
pensity, etc., and psychological, as indicating the ultimates of spiritual being. In 
this manner we use the word psychical as describing the relationship of the soul 
to animal experiences and being, and psychological as referring to the spiritual 
potencies of the soul. The distinction being introduced, we continue its use 
rather than coin new words. 118 
COMMON SENSE MEDICAL ADVISEE. 
degree, of reason. Compound reflex action extends into the 
domain of thought. Simple reflex action, or instinct, answers to 
the animal faculties, such as acquisitiveness, secretiveness, selfish- 
ness, reproductiveness, etc., and accomplishes two important 
purposes; self-preservation and the reproduction of the species. 
With many persons, these appear to be the chief ends of life I 
The psychical functions connect, not only with animal pro- 
pensities, but also with the highest psychological faculties. 
Instinct is the representative of animal conditions, just as the 
highest spiritual faculties are indicative of qualities and prin- 
ciples. The consistent mean of conduct is an equilibrium 
between these ultimate tendencies of our being. The psycho- 
logical functions render the animal nature subservient to the 
rule of purity and holiness, and deeply influence it by the 
essential elements of spiritual existence. The psychical organs 
sustain an intermediate relation, receiving the impressions of 
the bodily propensities, and, likewise, of the highest emotions. 
Obviously, these extreme influences, the one growing out of 
animal conditions, the other, the result of spiritual relations, 
pass into the psychical medium and are refracted by it, or 
made equivalent to one force. The body requires the qualify- 
ing influences of mind. The tendencies of the animal facul- 
ties are selfish and limiting, those of the emotive, general, 
universal. The propensities, like gravity, expend their force 
upon matter; the emotions pour forth torrents of feeling, and 
produce rhapsodies of sentiment. The propensities naturally 
restrict their expression to a specific object of sense; the 
emotions respond to immaterial being. The tendencies of the 
former are acquisitive, selfish, gratifying; of the latter, bestow- 
ing, expanding, diflusing. The one class is restricted to the 
orbits of time and matter, the other flows on through the 
limitless cycles of infinity and immortality. The former is 
satiated in animal gratification, the latter in spiritual beatifi- 
cation. The one culminates in animal enjoyment, the other 
expands to its ultimate conceptions in the perfections of Divine 
Love. 
In the present life, mind and body are intimately connected 
by nervous matter. In this dual constitution, the spiritual, 
mental, and animal functions are made inseparable, and modify CEBEBBAL PHYSIOLOGY. 
119 
one another. The ultimate tendencies of each extreme exist, 
not absolutely for themselves, but for qualifying purposes, to 
establish a basis for the deeper economy of life. By the 
employment of reason, animal and spiritual experiences are 
mutually benefited, and the consciousness rendered ' account- 
able. The bodily and mental workings are in many senses 
one, and. help to interpret each other. 
Every fact of mind has many aspects. A brain force, which 
results in thought, is simultaneously a physiological force, if 
it influences the bodily functions. Likewise, spiritual concep- 
tions take their rise in the same blood that feeds the grosser 
tissues. This vital fluid is momentarily imparting and receiving 
elements from all the bodily organs, and these, in turn, must 
influence the process of thought, and, in a degree, determine 
its quality. The delicate outline, yea, even the substance of 
an idea, may depend upon the condition of the animal organs. 
Thought is subject to the laws of biology, and, therefore, is 
a symbol of health. Morbid conditions of the system hang 
out their signs in words and utterances. Words which express 
fear are as true symptoms of functional difficulty as is exces- 
sive palpitation. The organ representing fear sustains a special 
relation to the functions of the heart both in health and disease. 
Bright hopes characterize pulmonary complaints as certainly 
as cough. Exquisite susceptibility of mind indicates equally 
extreme sensibility of body, and those persons capable of fully 
expressing the highest emotions are especially susceptible to 
bodily sensations. Tears are physical emblems of grief, and 
fellow-feeling calls forth sympathetic tears. Excessive anxiety 
of mind produces general excitability of body, which soon 
results in chronic disease. Pleasurable emotions stimulate the 
processes of nutrition, and are restorative. This concomitance 
of mental and bodily states is very remarkable. Joy and Love, 
as well as jealousy and anger, flash in the eye and mould the 
features to their expression. Grief excites the lachrymal, 
and rage the salivary glands. Shame reddens the ears, drops 
the eyelids, and flushes the face; but profligacy destroys these 
expressions. The blush which suffuses the forehead of the 
bashful maiden betrays her love, and maternal love, stirred by 
the appeals of an idolized infant, excites the mammary gland 120 
COMMON SENSE MEDICAL ADVISER. 
to the secretion of milk. The sigh of melancholia indicates 
hepatic torpor, thus showing a special relation between the 
liver and respiratory organs. These conditions of mind and 
body react upon one another. Even the thought of a luscious 
peach may cause the mouth to water. The thought of tasting 
a lemon fills the mouth with secretions, and a story with un- 
savory associations may completely turn the stomach. 
The relationship of mental and physical functions may be 
illustrated by entirely removing the spleen of an animal, as 
that of a dog. An invariable result of its extirpation is an 
unusual increase of the appetite, for at times the animal will 
eat voraciously any kind of food. The dog will devour, with 
avidity, the warm entrails of recently killed animals, and thrive 
in consequence of such an appetite. Another symptom, which 
usually follows the removal of the spleen, is an unnatural 
ferocity of disposition. Without any apparent provocation, 
the animal will attack others of its own, or of a different species. 
In some instances, these outbursts of irritability and violence 
are only occasional, but the experiments show quite conclusively 
that the spleen moderates combativeness, restrains the appetite, 
and co-operates with the will and judgment in controlling them. 
We shall briefly consider the practical question whether 
the elements of mind can be ideally arranged and presented, 
so as to more completely reveal their relations to, and disclose 
their effects upon the bodily functions. Modern philosophers 
conceive that mind consists of a triad of essentials; Intellect, 
Emotion, and Volition. Physiologists assign to the cerebrum 
its functions, and neurological, as well as phrenological writers, 
have located them as represented in Fig. 68. True, there is 
no structural division between the parts of the cerebrum to 
indicate this diversity of function, nor is there any percepti- 
ble limit between the sensory and motor filaments of the 
same nerve. As no one has any reason for denying that 
separate portions of the brain may manifest distinct functions 
of the mind, we shall assume it as a conceded proposition. The 
regions of the cerebrum, thus ideally represented, occupy but 
little more than half of the arc of a circle, whereas it is 
evident that the base of the nervous mass is not idle, and is 
equally entitled to our consideration. In the posterior chamber CEBEBBAL PHYSIOLOGY. 
121 
of the skull is the cerebellum, anterior to, and below which, is 
the medulla oblongata, connecting with the spinal cord and 
sympathetic system. These various parts are essential to the 
harmonious blending of mind and body. To this end, two 
conditions are necessary. (1.) 
All the nervous forces must 
be so related that action and 
reaction may be fully estab- 
lished. (2.) A complete ner- 
vous circuit is requisite for 
the reciprocal influence of 
mind and body. 
Nature answers to mind in 
physical correspondences. 
The planetary system is 
fashioned after a circle. Life 
itself springs from a spherule 
of forces. The perfection of 
an idea, or the completeness 
of a conception may be ex- 
pressed by a circle. The elements of Science, Astronomy, 
Geology, and Natural History, are pictorially represented in 
this manner. How appropriately and logically can a fragment 
of natural history, this epitome of all nature and science-the 
mind-be illustrated by a 
simple circle ! Every ele- 
ment must act and react, 
and be equal and opposite. 
Thus may the existence of 
the opposing energies and 
functions of each faculty be 
equally represented. The 
contrast aids us in under- 
standing their ultimate ten- 
dencies, and enables us to 
correctly value and define their nature. Faculties of kindred 
qualities may be grouped together, and their antagonisms rep- 
resented in the opposite arc of the circle. Let us employ a 
circle to represent mind. The conception of the abstract 
Fig. 68. 
Fig. 69. 
Good. 
P°sitive 
Negative. 
Bad. 122 
COMMON SENSE MEDICAL ADVISER. 
quality of good, requires contrast with one of a converse 
nature, bad, (see Fig. 69). Opposite faculties may be portrayed 
in the same manner. The functions of the cerebrum and spinal 
system may be symbolically represented as those of the highest 
and lowest organs, thus giving rise to the positive and negative 
extremes of feeling. The writer conceives of no other way 
in which the widely contrasted facts of human experience 
can be so perfectly symbolized. Good (Fig. 69) may repre- 
sent moral faculties, and bad, their opposites. Undoubtedly, 
nature is not so arbitrary in her arrangements as we are in 
shadowing forth our imperfect conceptions, yet is not this a 
decided improvement in determining cerebral faculties and 
their relations? We observe how scholars and philosophers 
confound the noblest and most exalted emotions with the 
animal propensities instead of distinguishing between them. 
" The emotions are a department of the feelings, formed by 
the intervention of intellectual processes. Several of them 
are so characteristic that they can be known only by individual 
experiences' as Wonder, Fear, Love, Anger" See Logic: 
Deductive and Inductive, by Alexander Bain, LL. D., page 508, 
(1874). 
This is not an exceptional, but a common example of classi- 
fying Love, the highest and purest of the emotions, with 
Anger, an animal propensity. Is it not more practical and 
philosophical to group the emotional faculties together, and 
upon an opposite arc represent their antagonistic energies, the 
ultimate tendencies of which are criminal? Both groups are 
mutually modifying and restraining; the one relates instinc- 
tively to the bodily wants, the other to the requirements of 
mind, and each is essential to a consistent life. Accordingly, 
we deem it philosophical to consider words as symbols of 
mental faculties, and to classify together such spiritual unities 
as joy, hope, faith, and love, the tendencies of which are to 
quicken and transform the ultimates of carnal life into the 
rudiments of an immortal one, the beginning of heaven on 
earth. These restrain those opposites, which lead to crime 
and death. Love and Hate are as antagonistic as heat and cold, 
and the usefulness of both depends upon their proper tempera- 
ment. Fig. 70 represents the antagonism of the Intellectual CEREBRAL PHYSIOLOGY. 
123 
faculties to the Animal, the Emotional to the Criminal, the 
Volitive to the Enfeebling. It is not essential to discover in 
the nerve-substance the precise power from which an impulse 
originates. We may reasonably interpret the functions of the 
brain, and yet be unable to dis- 
close the duties of any gang- 
lionic corpuscle composing it. 
We may foretell what each 
season of the year will bring 
forth, when we cannot forecast 
the history of a blade of grass 
or a single grain of any kind. 
We may predict the amount of 
rain for a month, and be unable 
to prognosticate correctly, the 
character of any storm, or give 
the history of a special drop of 
water. Although we cannot fol- 
low the movements of indi- 
viduals in a battle, yet we may 
predict the result of the combat; and thus, we judge of the 
functions of the brain .without the ability to reveal the actions 
of one of the organic molecules of which it is composed. We 
aim to give a general, reasonable, and popular description of 
cerebral functions and their bearing upon health and disease. 
Fig. 70. 
REGIONAL DIVISIONS. 
The anterior portion of the cerebrum is devoted to intellec- 
tual processes, which freely expend the vital energies. The 
Intellectual faculties are classified as represented in Fig. 71. 
The lower portion of the brain, bounded exteriorly by the 
superciliary ridge, corresponds to the Perceptive, the middle 
region to the Recollective, and the upper to the Reflective 
faculties. (See also Fig. 65, Z>.) If we divide the forehead 
by vertical lines, as shown in Fig. 71, the divisions thus formed 
represent respectively, the Active, Deliberative, and Contem- 
plative departments of the intellect, all the processes of which 
are sustained by vital changes, the transformation of organized 
materials. No mental effort can be made without waste of 124 
COMMON SENSE MEDICAL ADVISEE. 
nervous matter. The gardener's hoe wears by use, and so does 
every part of the animal organism. Otherwise, nutrition would 
be unnecessary for the adult. The production of thought 
wears away the cerebral substance. In ordinary use, the brain 
requires one-fifth of the blood to support its growth and repair. 
Great mental efforts are attended by a corresponding expendi- 
ture of vital treasures, which are abstracted from the total 
forces available for the necessities of the system. To repair 
the losses thus occasioned, materials are appropriated from 
the blood, which furnishes supplies in proportion to the de- 
mands made by the mental activities. The production of 
thought wears away the gray matter of the cerebrum as surely 
as the digging of 
a canal wears 
away the iron 
particles of the 
spade. The brain 
would soon wear 
out did not the 
nutritive func- 
tions constantly 
make good the 
waste. The in- 
tellect, whether 
engaged in obser- 
vation, generali- 
zation, or pro- 
found study con- 
sumes the brain and blood, hence intellectual activity implies 
vital expenditure. Expenditure is an emphatic word because 
all functions are essential to the production of this nerve- 
energy, which returns to the system no equivalent. Physical 
exercise, although attended by structural waste, is advantage- 
ous to the circulation of the blood, nutrition, secretion, and, in 
fact, beneficial to all the organic processes. This is not true 
of vigorous and prolonged mental labor, which is not attended 
by any of these incidental advantages. If a child attends a 
school in which mental development supersedes physical cul- 
ture, an inordinate ambition sways the youthful mind, and 
Fig. 71. CEREBRAL PHYSIOLOGY. 
125 
its baneful effects upon the health soon become manifest. 
Rigorous application of the intellectual faculties consumes 
the blood, exhausts the vital forces, weakens the organic 
functions, while pallor covers the face, and the eyes sparkle with 
a hectic radiance. The family physician pronounces the con- 
dition Anaemia (a deficiency of red corpuscles in the blood), 
and this change in the quality of the blood is owing to the 
undue appropriation by the brain. Conversely, if the blood be 
destroyed, or its vitality reduced, in the same proportion will 
the mental energies be weakened and all the functional powers 
of the physical system enfeebled. In brief, if the intellect be 
unduly exercised, the red corpuscles of the sanguine fluid will 
be gradually destroyed, and the serum allowed to predominate. 
The blood becomes weak and watery, the subject is nervous, 
dropsical, consumptive, and a derangement of the important 
functions follows almost invariably. Excessive intellectual 
activity often produces a weak state of the system, and the 
person thus affected becomes languid, spiritless, and an easy 
prey to disease. This mental cause and its bodily results may 
be classified in the following order. Mental Cause: Excessive 
Mental Exertion, which produces waste of the brain sub- 
stance and blood. 
Vital Expenditure, 
Anjemia, 
A Weak Condition. 
Bodily results: 
This kind of waste is best summed up in the words, Vital 
Expenditure. Upon the forehead, as represented in Fig. 72, 
we will therefore inscribe Intellect, Activity, and Vital 
Expenditure. Intellectual employment is usually accompa- 
nied by sedentary habits, neglect of healthful exercise, and a 
deprivation of pure air, to all of which ill health may be 
attributed. Were the intellectual expenditure arrested, and 
the forces turned into recuperative channels, many a person 
would become beautiful with the ruddy glow of health. With- 
out health there is no use for thought; cultivation of the mind 
is just as natural and essential as the culture of the body, 
and the trained development of both is needed for mutual 
improvement. 126 
COMMON SENSE MEDICAL ADVISER. 
What results follow the natural and the excessive exercise 
of the Emotive Faculties? As distinct organs of the body 
have diverse functions, so, in like manner, different parts of 
EMOTIVE FACULTIES. 
Fig. 72. 
the brain perform the separate operations of the mind. It 
is easier to discriminate between the products of these dissimi- 
lar endowments than to determine the location of the faculties. 
The intellect deals with concrete subjects, and the emotions 
with abstractions; the intellect is exercised with material 
things, the emotions dwell upon attributes; the intellect 
considers the forces of matter, the emotions, the powers of CEREBRAL PHYSIOLOGY. 
127 
the soul; the former deliberates upon the truths of science, 
the latter is concerned with duties, obligations, or moral respon- 
sibilities; the first is satisfied only with new truths, original 
ideas, and rational changes, the last rest securely on funda- 
mental principles, moral certainties, and the absolute constancy 
of perfect love. The intellectual faculties are wakeful, question- 
ing, mistrustful; the emotions are blind, hopeful, confiding; 
the one reasoning, exacting, demonstrating; the other, believ- 
ing, inspiring, devout. The intellect sees, the emotions feel; 
and, though these functions may blend, the one can never 
supersede the other. 
The quality of the emotional faculties is represented by 
Benevolence, Sympathy, Joy, Hope, Confidence, Gratitude, 
Love, and Devotion, all of which are the very antitheses of the 
attributes of animal feeling, described as Melancholy, Fear, 
Anger, Hate, Malevolence, and Despair. To the emotions we 
refer the highest qualities of character, while their opposites 
represent the animal or baser impulses. True, the emotions 
modify the propensities, as sympathy softens grief. They may 
subdue and refine the animal feelings, and thus veil them with 
a delicacy characteristic of their own purity; but the unre- 
strained influences of grief find vent in loud lamentations, 
and the bitter disappointments of the selfish faculties are 
passionate and violent. 
The Emotive Faculties-the organs of spiritual perceptions- 
are impersonal, outflowing, bestowing. The function repre- 
sented by Benevolence, is willing, giving. Devotion expresses 
dedication, consecration; Gratitude manifests a warm and 
friendly feeling toward a benefactor. 
" The depth immense of endless gratitude."-Milton. 
Love flames toward its object, is out-pouring, blessing; in- 
deed, all the emotions are gushing, effusive, impetuous, and 
profusely flowing; grand, torrent-like, overwhelming; employ- 
ing ideal, immaterial, spiritual expressions, developing principles 
and perfections while aspiring to happiness and immortality. 
Though beginning with humanity, they embody the Divine. 
They expand to their ultimate conceptions in the sublime 
attributes: the perfections of the God of Love; associating 128 
COMMON SENSE MEDICAL ADVISER. 
with mortality a divine destiny commencing on earth, extending 
through time, pausing not at the portals of death, the gateway to 
eternity, but flowing onward into the realms of eternal day. 
We may consider their counteracting influences, for, without 
doubt, by checking the selfish tendencies and restraining the 
animal propensities, they assist in controlling the sensual pas- 
sions, and thus balance the mind and body. Such an equilib- 
rium we call happiness. If the emotions be acute and vehement, 
they will absorb all other impressions and revel in their culmi- 
nating and delightful experiences. They exhaust all the bodily 
energies, and a functional suspension, termed ecstasy, follows. 
It is a swooning, or fainting, a temporary loss of sensation and 
volition, accompanied by involuntary movements of the arms, 
smiting of the hands, sighing, and short ejaculatory expressions 
of rapture. This condition, occasioned by excessive emotion, as 
in praying, singing, exhortations, and sympathetic appeals, is 
contagious, often spreading with mysterious rapidity. Its 
culmination, ecstasy, is popularly termed "the power" When 
gradually induced, it is called trance, and each state is regarded 
by many as supernatural, caused by the immediate influence 
of the Holy Spirit. The explanation is this: when the emotive 
faculties are suddenly and powerfully excited, they quickly 
expend the organic forces, so that the individual swoons from 
sheer exhaustion. Undue expenditure of this class of brain 
functions not only consumes the bodily powers, but exhausts 
and prevents other mental operations. The sudden collapse 
of all voluntary functions resembles the fainting produced by 
blood-letting. We may sum up this rapid expenditure of 
energy in one expressive word, Exhaustion, which results in 
Ecstasy, or trance, and which, if carried a degree further, 
terminates in death. Beginning with the natural exercise of 
the emotions, we may state the order of sequences thus: 
Ordinary exercise leads to . . . . Calmness. 
Proper exercise " " . . . . Happiness. 
Increased exercise " " . . . . Ecstasy. 
Excessive exercise " " . . . . Syncope. 
Prolonged exercise " " . . . . Trance. 
Fatal exercise " " . . . . Mortality. 
Their tendencies areEXHAUSTIVE. CEREBRAL PHYSIOLOGY. 
129 
VOLITIVE FACULTIES. 
What are the physiological and morbid results attending the 
ordinary and the immoderate exercise of the Volitive Fac- 
ulties ? 
The generic term will, comprehends those faculties, the 
action of which is termed volition. The faculties of the will 
are Determination, Firmness, Decision, Ambition, Authority, 
and Vigilance, all of which indicate strength and continuity 
of purpose. Bordering upon the emotions are Patience and 
Perseverance, while adjoining the animal faculties are Power, 
Coarseness, and Love of Display. The former exhibit moral, 
the latter animal heroism. A sense of power urges forward, 
whether it be higher or lower, just as the sense of greatness 
makes a man great by inspiring him with confidence to put 
forth exertion. Nature is truthful in her aspirations. We 
know that courage, assurance, and conscious power are neces- 
sary for the fulfillment of purpose, because intention precedes 
action. Will-power is an indication of Health, and the con- 
stant exercise of these mental faculties exerts a steady, regular, 
and strengthening influence over the bodily functions. We 
translate mental energies into physiological industry. These 
faculties impart tone to the system, sustain the processes of nu- 
trition, circulation, assimilation, secretion and excretion, and their 
distinguishing characteristics are vigor, tension, and elasticity. 
They temper each element of character, as well as every vital 
act. They infuse the organism with a resisting power which 
renders it proof against the influence of miasma and malaria, 
and overcomes that passivity and impressionability so favorable 
to disease. Firmness expresses a physiological cohesiveness 
which strongly binds together the fibers of the tissues, and 
renders the organization compact and powerful. He, who can 
skillfully employ these energies, is already master of half of 
the diseases incident to mankind, and wields an indispensable 
adjunct to medicine, in the practice of the healing art. It is 
the key to success, for it unlocks difficulties and opens wide the 
door which leads to favorable results. 
Surplus energy sustains the circulation, increases capillary 
action, as if the excess of nerve-power were discharged from COMMON SENSE MEDICAL ADVISER. 
130 
the distant extremity of each nerve and pervaded every tissue. 
The voluntary muscles indicate their participation in this 
energy, and, indeed, the whole organism is exalted by the 
influence of the mental faculties. They oppose the tendencies 
of Feebleness, Relaxation, and Derangement, and modify their 
proclivities to Disease. The will is the servant of the intellect, 
emotions, and propensities, and the executive agent of all the 
faculties. When the volitive faculties are in excess, they may 
overdo the other functions, prematurely break down the bodily 
organs, and, by overtaxing the system, subject it to pain and 
disorder. 
VOLITIVE FA6ULTIES. 
The natural effect of Firmness is physiological stability. 
The exercise of the volitive faculties displays both mental 
and bodily Energy. 
Their tendencies are to 
Temperance, 
Sanity, 
Health. 
ANIMAL FACULTIES. 
Under this generic term we will group those cerebral powers 
which are common to the inferior animals, and closely allied to 
Fig. 73. 
Fig. 74. 
Fig. 73 is a representation of the cranial conformation of Alexander VI., exhib- 
iting a full development of the conservative faculties. His character, according 
to history, brought reproach upon the papal chair. 
Fig. 74 represents Zeno, a profound thinker and moral philosopher. The con 
trast in their cranial developments was no greater than that of their lives. 
bodily conditions and necessities. As denoting a group of 
animal faculties they relate not only to the organic functions 
and self-preservation, but combat the action of the intellect, CEREBRAL PHYSIOLOGY. 
131 
oppose the evolution of new ideas, resist investigation, and 
discredit the value of truth. Adhesiveness, being blindly con- 
servative, clings to old ideas and traditionary opinions. The 
animal faculties tend to stifle investigation, and put author- 
ity above truth and science. Having a fixity of nature, a 
stationary attachment, they treat all intellectual developments 
as absurd. When these faculties predominate, thought is 
obscured, intolerance of disposition is manifested, and mental 
progress is arrested. Thus they evince their conservative 
nature, and, since they relate to individual interests, they rep- 
resent the elements of instinct. Such are the functions of 
Acquisitiveness, Secretiveness, Selfishness, and Combativeness, 
as well as the Generative powers. If these faculties predom- 
inate, all intellectual advancements are treated as experiments 
or theoretical novelties, and rejected as evanescent and worth- 
less. If the promptings of these be followed, there will be 
no innovation, and the orthodoxy of the dark ages will remain 
the standard for all time. The animal faculties coincide with 
Lethargy, Sleep, and Nutrition, thus favoring organic restora- 
tion The intellectual faculties are wakeful, active, irrepressi- 
ble, while the animal powers tend to repose, sleep, and reno- 
vation, and thus suspend the activities of thought, sense, and 
motion The intellect expends the energy of the sensorial 
centers, induces fatigue and suffering, whereas the animal 
faculties overcome the vigils of thought, and produce refresh- 
ing slumber. Dr. Young styles sleep "tired nature's sweet 
restorer." Swedenborg declared that, "in sleep the brain folded 
itself up, and the soul journeyed through the body, repairing 
the wastes of the previous day." When sleep is natural, the 
insane are in a fair way to recovery, the sick become convales- 
cent, ulcers granulate, and lesions are made whole. 
The animal faculties are skeptical, stubborn, and dogmatic, 
readily combining with those of the violent class, the ultimate 
tendencies of which are criminal. They are likewise conceited, 
assuming, and clannish. Any person distinguished by them, 
will cling to old associations, perpetuate the status of existing 
parties, be a stickler for creed, ceremonies, and stale opinions, 
and adhere to ancient orthodoxy in medicine and religion. The 
animal faculties, since they are staid and regular, are naturally 132 
COMMON SENSE MEDICAL ADVISER. 
antagonistic to genius, sensibility, and originality. Their men- 
tal tendencies have been fairly described and their physiological 
results may be represented as follows: 
Restraint, 
Sleep, 
N U TRITION, 
Restoration, 
Conservation. 
The animal faculties produce 
BASILAR FACULTIES. 
The ultimate tendencies of the faculties, represented by the 
posterior base, of the cerebrum, are violent and . criminal. 
Being contiguous to the junction of the cerebrum and spinal 
system, they are subject to the influence of animal experiences. 
A large development of these faculties is indicated by an 
unusual breadth and depth of the back part of the base of 
the brain, and a full, thick neck, both of which denote good 
alimentary and digestive powers. Active nutrition, plethora 
of the circulation, vigorous secretion, a well developed muscu- 
lar system, a large heart and lungs, are accessory conditions. 
We do not associate corpulence or surplus of vitality with 
a long, slender neck. The character of cerebral manifestations 
is represented by the baser faculties of mind, such as Combat- 
iveness, Destructiveness, Desperation, Turbulence, Hatred, and 
Revenge. If unrestrained, these culminate in violent and 
criminal acts; if regulated, they are employed in personal 
defense. When unduly excited, they lead to dissipation, ob- 
scenity, swearing, rowdyism, and licentiousness; when perverted, 
they are the source of recklessness, quarrels, frauds, falsehoods, 
robberies, and homicides. They are unlike instinct, inasmuch 
as they are not self-limiting. The intimate relation which 
they sustain to the stomach and nutritive functions is strikingly 
displayed in the habit of alcoholic intoxication. Spirituous 
drinks deprave the appetite, derange and destroy the stomach, 
poison the blood, and pervert all the functions of mind and 
body; and their injurious influence upon the nerves and basilar 
faculties is equally remarkable. They excite combativeness, 
selfishness, irritability, and exaggerate the influence of the ani- 
mal organs. Intemperance results in disputes, fights, brawls, CEREBRAL PHYSIOLOGY. 
133 
and murders-the legitimate consequences of which are mis- 
understandings, suits at law, criminal proceedings, imprisonment, 
and the gallows. It is, therefore, evident that the ultimate 
tendencies of these faculties are tyrannical, cruel, violent, and 
atrocious. They are opposed to the noble, moral faculties- 
Faith, Love, and Devotion-and, whenever tempation inordi- 
nately allures, the course of life is likely to be characterized 
by dishonorable, deceptive, and treacherous conduct. 
The pangs of hunger cause soldiers to act more like ravenous 
beasts, than rational beings. It is animal instinct which im- 
pels the soldier to seek first for the gratification of his appetite. 
Some persons, instigated by carnivorous desires, yearn for raw 
meat, and will not be satisfied unless their food is flavored with 
the flesh of animals. Their bodies increase and thrive, even 
to repletion. Contrast these individuals with pale, lean, anaemic 
people, who crave innutritions articles of diet, and eat soft 
stones, slate, chalk, blue clay, and soft' coal. Such perversions 
of the appetite are manifested only when there is either a dimi- 
nution in the volume of blood, deficient alimentation, defective 
assimilation, or a general depravity of the nutritive functions. 
Morbid conditions generate vitiating tendencies and destroy 
the natural appetite. 
While alcoholic stimulants affect the medulla oblongata 
principally, opium acts chiefly on the cerebrum, and excites 
reverie, dreamy ideality, optical delusions, and the creative 
powers of the imagination; some of these hallucinations are 
said to be grotesquely beautiful and enjoyable. The effects 
of this agent differ from those of alcoholic intoxication by not 
deadening the moral sensibilities, or arousing the animal pro- 
pensities. Opium smokers are dreamy and abstracted, not 
quarrelsome or violent. Those who use ardent spirits lose 
their moral delicacy, their intellect becomes dull, the reason 
cloudy, and the judgment is overruled by appetite. It is 
conceded that the trophic center is principally in the medulla 
oblongata; the cerebellum and lower cerebral ganglia, how- 
ever, favorably influence the nutritive functions, and, when 
these organs are large and active, a plethoric condition is the' 
natural consequence. Redundancy of blood in the body in- 
dicates preponderance of the basilar organs. These faculties 134 
COMMON SENSE MEDICAL ADVISER. 
being vehement in character, an excess of animal characteristics 
produces those conditions which result in acute and inflamma- 
tory diseases. We may express these conditions of the system 
as follows: 
The Animal Faculties correspond to the lower instinctive 
manifestations. 
The elements of character are 
Acquisitiveness, 
Selfishness, 
Combativeness. 
Turbulence, 
Crime. 
They tend to 
They relate especially to the 
functions of 
Alimentation, 
Secretion, 
Nutrition, 
Reproduction. 
A large development of them 
indicates 
Vitality, 
Plethora, 
(con- 
gestion). 
These naturally give rise to the following diseases: Inflamma- 
tion, Rheumatism, Gout, Convulsions, etc., which, in these con- 
ditions, pursue a violent course. 
REGION OF FEEBLENESS. 
Although the middle lobe of the cerebrum, at the base of the 
brain, does not denote decided force of character, or energy of 
constitution, yet it has a certain sphere of normal action which 
is essential to the harmony of mind and body. If this region is 
largely developed, the constitution is languid, inefficient, sensi- 
tive, and abnormally disposed. But if it be deficient, the 
volitive energies preponderate, and there is a lack of those 
susceptibilities of constitution, which prevent excessive waste. 
The cerebral faculties are Fear, Anxiety, Sensibility, Servility, 
Relaxation, and Melancholy, and their' excessive predominance 
indicates a weak, vacillating, irresolute character, and the exist- 
ence of those bodily conditions which produce general excita- 
bility and chronic derangement. A full development of this 
portion of the brain indicates that the person is naturally 
dependent, inferior, and subservient to stronger characters. Such 
a one is fearful, fretful, complaining, irritable, dejected, morose, CEREBRAL PHYSIOLOGY. 
135 
and, sooner or later, becomes a fit subject for chronic disease.* 
The ultimate result of excessive fear, excitability, and irrita- 
bility, is functional or organic derangement,-the morbid con- 
ditions represented by the word Disease. The medulla oblongata 
and portions of the middle lobe of the brain, the functions 
of which represent Excitability, Anxiety, 
Fear, and Irritability (symbols of physical 
profligacy), are located just between the 
ears (see Figs. 60 and 62). Inferior ani- 
mals distinguished for breadth between 
the ears are not only cunning and treach- 
erous, but very excitable and irritable. 
The head of the Fox is remarkable for 
its extreme width at the region of Fear. 
He is proverbially crafty and treacherous, 
always excitable, and so variable in tem- 
per that he can never be trusted. He is 
a very timid thief, exceedingly suspicious, 
irregular in habits, and frequently driven by hunger into mis- 
chievous depredations. 
The organ of alimentiveness, located directly in front of the 
ear, indicates the functional conditions of the stomach, which, 
when aroused by excessive hunger, exerts a debasing influence 
upon this and all of the adjacent organs, and is demoralizing to 
both body and mind. In obedience to the instinct of hunger, 
children will slyly plunder gardens and orchards, displaying 
profligate, if not reckless tendencies in the gratification of the 
appetite. In this regional division we include the medulla, the 
posterioi' and middle portions of which give rise to the pneu- 
mogastric nerve. This nerve receives branches from the spinal 
accessory, facial, hypoglossal, and the anterior trunks of the first 
and second cervical, and its filaments are distributed to the 
Fig. 75. 
Sly Reynard. 
♦Certain disturbances of the bodily organs excite fear. The apprehension of 
danger, or simply mental excitement, does not explain what is called " water 
fright," "stage fright," terror excited by the raging of a storm, or the rocking of 
a boat. In such instances the heart may beat heavily, the respiration be irregular 
and attended by precordial oppression, giddiness, weakness, and physical inability 
to articulate a word or recall a thought. These bodily conditions are not subject 
to the control of the will, but arise when individuals are perfectly assured that no 
danger threatens. At other times, as in a fearful tempest upon the sea, although 
the danger be imminent, if the bodily functions are not disturbed, there is not the 
least manifestation of fear. 136 
COMMON SENSE MEDICAL ADVISER. 
lungs, stomach, liver, spleen, pancreas, and gall bladder (see 
Fig. 60, with explanation) Its agency is necessary to maintain 
the circulation, and the respiration, since, as the' medium of 
communication, it conveys from the brain large supplies of 
nervous force to sustain these vital functions. It likewise 
instantly reports the impressions of these physiological processes 
to the brain, and especially to those parts which, by analogy of 
functions. It likewise instantly reports the impressions of these 
physiological processes of the brain, and especially to those 
parts which, by analogy of functions, are intimately related to 
the stomach. Hence, we observe that the conditions of the 
stomach give rise to reflex impulses, which involuntarily excite 
the animal faculties to the gratification of the appetite. That 
the stomach has an intimate connection with the rest of the 
organism is evident from the fact that when it is inflamed the 
body is completely prostrated. 
We have already alluded to the perverting tendencies of alco- 
holic stimulants. Their peculiar influence upon the cerebellum 
causes the subject to reel and stagger, as though a portion of 
that organ were removed; the group of energetic faculties is 
stupefied, and mental as well as corporeal lethargy is the result. 
The reaction, which inevitably follows, is almost unbearable, and 
relief is sought by repeating and increasing the poisonous 
draughts, the primary influence of which is stimulating, the 
ulterior, depressing. Alcoholic stimulants unduly excite the 
nervous centers, the heart, and the arteries, and, consequently, 
the blood is carried to the surface of the body, where it coun- 
teracts the influence of cold and exposure, the frequent atten- 
dants upon drunkenness. The use of alcoholic beverages per- 
verts the appetite, interrupts habits of industry and destroys 
all force of character. Pecuniary, physical, and mental ruin, 
therefore, are sure to follow as the consequences of habitual, 
alcoholic intoxication. 
That ordinary alimentation, which includes the process of 
digestion, the subsequent vital changes involved in the conver- 
sion of food into blood, and its final transformation into tissue, 
causes mental languor and dullness, as well as bodily exhaustion, 
is attested by universal experience. A torpid condition of the 
liver, one of the most inveterate of chronic derangements, is cerebral physiology. 
137 
indicated by sullenness, melancholy, despondency, loss of in- 
terest in the affairs of life, sluggishness, etc., and the ultimate 
tendency of this morbid state is towards suicide. A broad and 
deep development of the middle lobe of the brain, shown by a 
fullness under the chin, and of the adjacent portion of the neck, 
denotes tendencies to somnambulism, delirium, and insanity. If 
such characteristics of the organization do not culminate in 
mental derangement, they exhibit childishness, helplessness, and 
great dependence. Age abates the vigor of the executive fac- 
ulties, and old people manifest not only bodily infirmities, but 
the relaxing and enfeebling influences proceeding from the 
lower portions of the brain. They totter about in their second 
childhood, mentally and physically enervated. Those who be- 
come dissipated by the use of intoxicating beverages are not 
only weak, trifling, and foolish, but walk with an unsteadiness 
which betrays their condition. These illustrations show that this 
part of the brain is destitute of energy. Diseases of the diges- 
tive organs also indicate it. Cholera, whether induced by 
invisible animalcules in the air, or in water, takes the route of 
the alimentary canal, opens the vital gates, and myriads of 
victims are swept down to death. It proves remarkably fatal 
to those having this cerebral conformation. Perhaps enough 
has been said to indicate the relaxing and enfeebling tend- 
encies of this region of the brain. They may be classified as 
follows: 
REGION OF FEEBLENESS. 
Servility, 
Cautiousness, 
Fear, 
Anxiety, 
Sensibility, 
Cunning, 
Profligacy. 
Cerebral Functions: 
Physiological conditions 
and tendencies: 
Atonic, 
Excitability, 
Relaxation, 
Feebleness, 
Disease. 
This classification shows their tendencies to chronic disease, 
functional derangement, insanity, and suicide. 138 
COMMON SENSE MEDICAL ADVISER. 
GENERAL CONSIDERATIONS. 
Before the structure of the brain was understood, Buffon 
spoke of it as a "mucous substance of no great importance." 
Its functional significance was so slightly appreciated that some 
people hardly suspected they had any brains, until an accident 
revealed their existence. Latterly, however, it is generally 
understood that the perfection of an animal depends upon 
the number and the development of the organs controlled by 
the nervous system, the sovereign po-wer of which is symbol- 
ized by a grand cerebrum, the throne of Reason. That animal 
which is so low in the scale of organization as to resemble a 
vegetable, belongs to an ascending series ending in man. The 
lowest species have no conscious perception, and their move- 
ments do not necessarily indicate sensation or volition. Instinct 
culminates in the Articulates, especially in Insects ; while 
created intelligence reaches its acme in man, the highest repre- 
sentative 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. 
Man, in the faculties of mind, possesses more than a comple- 
ment for instinct; some 
of the lower animals, 
however, seem to share 
his rational nature, and 
to a certain degree be- 
come responsible to 
him. Finally, the man- 
ifestations of mind 
bear a relation to the 
development of cere- 
bral substance, and to 
the bodily organization 
which supplies the 
brain with blood. Fig. 
76 shows the relative 
amount of brain matter in the lower animals, compared with 
Fig. 76. 
Outline of Skulls. 1. European. 2. Negro. 3. 
Tiger. A. Hedge Hog. 5. Sloth. CEREBRAL PHYSIOLOGY. 
139 
that of man; the peculiarities of each agreeing with its cere- 
bral conformation. It is easier to measure the capacity of 
skulls in different races than to procure and weigh their brains. 
The following table has been published. 
RACE. CUBIC INCHES. 
Swedes, . . . '100.00 
Anglo-Saxons, . . . 96.00 
Finns,95.00 
Anglo-Americans,94.30 
Esquimaux, 86.32 
North America Indians,84.00 
Native Africans,83.70 
Mexicans,81.70 
American Negros,80.80 
Peruvians and Hottentots,75.30 
Australians,75.00 
Gorilla, adult,34.50 
Idiot,22.57 
Mr. Davis, of England, having a collection of about eighteen 
hundred cranial specimens obtained from different quarters of 
the globe, ascertained the relative volume of brain in different 
races, by filling the skulls with dry sand. He found that the 
European averaged 92 cubic inches, the Oceanic 89, the Asiatic 
88, the African 86, the Australian 81. Dr. Morton, of Philadel- 
phia, had a collection of over one thousand skulls, and his con- 
clusions were that the Caucasian brain is the largest, the Mon- 
golian next in size, the Malay and American Indian smaller, 
and the Ethiopian smallest of all. The average weight of 
brain, in 278 Europeans, was 49.50 oz., in 24 White American 
soldiers, 52.06 oz., indicating a greater average for the Ameri- 
can brain. 
OUNCES. 
The brain of Cuvier, the celebrated naturalist, weighed 64.33 
Ruloff, the murderer and linguist,59.00 
Dr. Spurzheim-phrenologist,55.06 
Celebrated philologist,47.90 
Celebrated mineralogist,43.24 
Upholsterer,40.91 
The weight of the human brain varies from 40 to 70 oz.; 
that of idiots from 12 to 36 and 40 oz. The average of 278 
CRANIAL CAPACITY OF HUMAN RACES. 140 
COMMON SENSE MEDICAL ADVISER. 
male European brains was oz., while that of 191 females 
was 44 oz. If we compare the weight of the female brain with 
that of the body, the ratio is found to be as 1:36.46, while that 
of the male is as 1:36.50; showing that, relatively, the female 
brain is the larger. It appears that neither the absolute nor 
relative size of the cerebrum, but the amount of gray matter 
which it contains, is the criterion of mental power. Although 
a large cerebrum is generally indicative of more gray matter 
than a small one, yet it is ascertained that the grey substance 
depends upon the number, and depth of the convolutions of 
the brain, and the deeper its fissures, the more abundant is this 
tissue. It is this substance which is the source of thought, 
while the white portion only transmits impressions. 
We do not wish to underrate any attempt heretofore made 
to classify the functions of mind and assign to them an appro- 
priate nomenclature. It is not unusual for scientists to give 
advice to phrenologists and point out the fallacies of their 
system; but it is hardly worth while to indulge in destructive 
criticism, unless something better is offered, as the day has 
passed for ridiculing endeavors to understand and interpret 
the physiology of the brain. The all important question is, 
not whether phrenologists have properly located and rightly 
named all the faculties of mind, but have their expositions 
been useful in the development of truth. While endeavoring 
to connect each mental power with a local habitation in the 
brain, the system of phrenology may be chargeable with some 
incongruous classification of the faculties, and yet it has 
furnished an analysis of the mind which has been of incal- 
culable service to writers upon mental philosophy. Phre- 
nology, in popularizing its views, has interested thousands in 
their own organizations and powers, who would otherwise 
have remained indifferent. It has called attention to mental 
and bodily unities, has served as a guide to explain the physical 
and psychical characteristics of individuals, and has been 
instrumental in applying physiological and hygienic principles 
to the habits of life, thus rendering a service for which the 
world is greatly indebted. Samuel George Morton, M. D., 
whose eminent abilities and scholarship are unquestionable, 
employs the following language: CEREBRAL PHYSIOLOGY. 
141 
" The importance of the brain as the seat of the faculties of 
the mind, is pre-eminent in the animal economy. Hence, the 
avidity with which its structure and functions have been studied 
in our time; for, although much remains to be explained, much 
has certainly been accomplished. We have reason to believe, 
not only that the brain is the center of the whole series of 
mental manifestations, but that its several parts are so many 
organs, each one of which performs its peculiar and distinctive 
office. But the number, locality, and functions of these several 
organs are far from being determined; nor should this uncer- 
tainty surprise us, when we reflect on the slow and devious 
process by which mankind has arrived at some of the' simplest 
physiological truths, and the difficulties that environ all inquiries 
into the nature of the organic functions." 
We may here allude to the recent experimental researches 
with reference to the functions of various portions of the brain, 
prosecuted by Dr. Ferrier, of England. He applied the electric 
current to different parts of the cortical substance of the cere- 
brum in lower animals which had been rendered insensible by 
chloroform, and by it could call forth muscular actions expres- 
sive of ideas and emotions. Thus, in a cat, the application of 
the electrodes at 
point 2, Fig. 77, 
caused elevation 
of the shoulder 
and adduction of 
the limb, exactly 
as when a cat 
strikes a ball with 
its paw; at point 
4, corrugation of 
the left eye-brow, 
and the drawing 
inward and down- 
ward of the left 
ear; when applied at point 5, the animal exhibited signs of 
pain, screamed, and kicked with both hind legs, especially the 
left, at the same time turned its head around and looked behind 
in an astonished manner; at point 6, clutching movement of the 
Fig. 77. 
Side view of the brain of a Cat. A. Crucial sulcus 
dividing anterior convolutions. B. Fissure of 
Sylvius. 0. Olfactory bulb. 142 
COMMON SENSE MEDICAL ADVISER. 
left paw, with protrusion of the claws; at point 13, twitching 
backward of the left ear, and rotation of the head to the left 
and slightly upward, as if the animal were listening; at point 
17, restlessness, opening of the mouth, and long-continued cries 
as if of rage or pain; at a point on the-under side of the hemi- 
sphere, not shown in this figure, the animal started up, threw 
back its head, opened its eyes widely, lashed its tail, panted, 
screamed and spit as if in furious rage; and at point 20, sudden 
contraction of the muscles of the front of the chest and neck, 
and of the depressors (muscles) of the lower jaw, with panting 
movements. The movements of the paws were drawn inward 
by stimulating the region between points 1, 2, and 6; those of 
the eyelids and face were excited between 7 and 8; the side 
movements of the head and ear in the region between points 9 
and 14; and the movements of the mouth, tongue and jaws, with 
certain associated movements of the neck, being localized in the 
convolutions bordering on the fissure of Sylvius (B), which 
marks the division between the anterior and middle lobes of the 
cerebrum. Dr. Ferrier made similar experiments on dogs, 
rabbits, and monkeys. The series of experiments made on the 
brain of the monkey is said to be the most remarkable and inter- 
esting, not only because of the variety of movements and 
distinctly expressive character of this animal, but on account of 
the close conformity which the simple arrangement of the 
convolutions of its brain bears to their more complex dispo- 
sition in the human cerebrum. It is premature to say what 
import we shall attach to these experiments, but they have 
established the correctness of the doctrine, advanced on page 
105, that thought, the product of cerebral functions, is a class 
of reflex actions. The cerebrum is not only the source of ideas 
but also of those co-ordinate movements which correspond to 
and accompany these ideas. Certain cerebral changes call forth 
mental states and muscular movements which are mutually 
responsive. They indicate that various functions are automatic, 
or dependent upon the will, and, as we have seen, experiments 
indicate that the electric current, when applied to the cerebrum, 
excites involuntary reflex action. We cannot say how far these 
experimental results justify the phrenological classification of 
the faculties of mind, by establishing a causative relation CEREBRAL PHYSIOLOGY. 
143 
between the physical and psychical states. This short and un- 
satisfactory account furnishes one fact which seems to support 
the claim of such a relation: the apparent similarity between the 
motor center of the lips and tongue in lower animals, and that 
portion of the human cerebrum in which disease is so often 
found to be associated with Aphasia, or loss of voice. While 
these experiments are by no means conclusive in establishing a 
theory, yet they favor it. 
It is wonderful that nervous matter can be so arranged as 
not only to connect the various organs of the body, but 
at the same time to be the agent of sensation, thought, and 
emotion. It is amazing, that a ray of light, after traversing a 
distance of 91,000,000 miles, can, by falling upon the retina, and 
acting as a stimulus, not only produce a contraction of the 
pupil, but excite thoughts which analyze that ray, instantly 
spanning the infinitude of trackless space! The same penetra- 
tive faculties, with equal facility, can quickly and surely dis- 
cern the morbid symptoms of body and mind, become familiar 
with the indications of disease, and classify them scientifically 
among the phenomena of nature. The symptoms of disease 
which follow certain conditions as regularly as do the signs 
of development, and mind itself is no exception to this 
uniformity of nature. Thoughts result from conditions, and 
manifest them as evidently as the falling of rain illustrates 
the effect of gravity. The perceptive and highest emotive 
faculties of man depend upon this simple, but marvelously 
endowed nervous substance, which blends the higher spiritual 
with the lower physical functions. The functions of the body 
are performed by separate organs, distinguished by peculiar 
characteristics. To elucidate the distinctions between dissimi- 
lar, mental faculties, we have assigned their functions, with 
characteristic names, to different regions of the head. As 
they unquestionably influence the bodily organs, we are sus- 
tained by physical analogy, in our classification. Our knowl- 
edge of the structure and functions of the nervous system 
is yet elementary, and we are patiently waiting for scientists 
to develop its facts, and verify them by experimental investi- 
gations and such researches as time alone can bring to per- 
fection. While real progress moves with slow and measured 144 
COMMON SENSE MEDICAL ADVISER. 
foot-steps, the inspirations of consciousness and the inferences 
of logic prepare the popular mind for cerebral analysis. No 
true system can contradict the facts of our inner experience; 
it can only furnish a more complete explanation of their rela- 
tion to the bodily organs. It should be expected that such 
careful and pains-taking experiments, as are necessary to estab- 
lish a science, will be preceded by intuitive judgments and 
accredited observations, which may be, for a time, the substi- 
tutes of those more abstruse in detail. 
We have, in accordance with popular usage, treated the 
organs of thought as having anatomical relations. The views 
which we have presented in this chapter may seem speculative, 
but the facts suggesting the theory demand attention, and we 
have attempted to gather a few of the scattered fragments 
and arrange them in some order, rather than leave them to 
uncertainty and greater mystery. It is by method and classifi- 
cation that we are enabled to apply our knowledge to practical 
purposes. Possibly, to some, especially the non-professional, 
an allusion to the fact that cerebral physiology contributes to 
successful results in the practice of medicine, may seem to 
be an exaggerated pretension. None, however, who are con- 
versant with the facts connected with the author's experience, 
will so regard this practical reference, for the statement might 
be greatly amplified without exceeding the bounds of truth. 
Physicians generally undervalue the nervous functions, and 
overlook the importance of the brain as an indicator of the 
conditions of the physical system, because they are not suf- 
ficiently familiar with its influence over the bodily functions. 
Pathological conditions are faithfully' represented by the 
thoughts, and words, when used to describe symptoms, become 
the symbols of feelings which arise from disease. How few 
physicians there are who can interpret the thoughts, and glean, 
from the expressions and sentences of a letter, a correct idea 
of the morbid conditions which the writer wishes to portray! 
Each malady, as well as every temperament, has its character- 
istics, and both require careful and critical analysis before 
subjecting the patient to the influence of remedial agents. 
In a treatise by Dr. J. R. Buchanan, entitled " Outlines of 
Lectures on the Neurological System of Anthropology," are CEBEBBAL PHYSIOLOGY. 
145 
presented original ideas pre-eminently useful to the physician. 
His researches, and those of later writers, together with our 
own investigations, have greatly increased our professional 
knowledge. It is by such studies and investigations that we 
have been prepared to interpret, with greater facility, the indi- 
cations of disease, and diagnose accurately from symptoms, 
which have acquired a deepei' significance by the light of cere- 
bral physiology. We are enabled to adapt remedies to constitu- 
tions and their varying conditions, with a fidelity and scientific 
precision which has rendered our success in treatment widely 
known and generally acknowledged. We annually treat thou- 
sands of invalids whom we have never beheld, and relieve them 
of their ailments. This has been accomplished chiefly through 
correspondence. When patients have failed to delineate their 
symptoms correctly, or have given an obscure account of their 
ailments, we have been materially assisted in ascertaining the 
character of the disease by photographs of the subjects. 
The cerebral conformation indicates the predisposition of the 
patient, and enables us to estimate the strength of his recuper- 
ative energies. Thus we have a valuable guide in the selection 
of remedies particularly suited to different constitutions. In 
the treatment of chronic diseases, the success attending our 
efforts has been widely appreciated, not only in this, but in 
other countries where civilization, refinement, luxurious habits, 
and effeminating customs, prevail. This fact is mentioned, not 
only as an illustration of the personal benefits actually derived 
from a thorough knowledge of the nervous system, but to show 
how generally and extensively these advantages have been 
shared by others. 
A careful study of cerebral physiology leads us deeper into 
the mysteries of the human constitution, and to the philosophical 
contemplation of the relations of mind and body. Self-culture 
implies not only a knowledge of the powers of the mind, but also 
how to direct and use them for its own improvement, and he 
who has the key to self-knowledge, can unlock the mysteries 
of human nature and be eminently serviceable to the world. 
For centuries the mind has been spreading out its treasury of 
revelations, to be turned to practical account, in ascertaining 
the constitution, and determining better methods of treating 146 
COMMON SENSE MEDICAL ADVISER. 
disease. Since comparative anatomists and physiologists have 
revealed the structure of animals and the functions of their 
organs, from the lowest protozoan to the highest vertebrate, the 
physician may avail himself of this knowledge, and thus gain 
a deeper insight into the structure and physiology of man. 
An intimate acquaintance with the physical, is a necessary 
preparation for the study of the psychical life, for it leads 
to the understanding of their mutual relations and reactions, 
both in health and disease. 
Consciousness, or the knowledge of sensations and mental 
operations, has been variously defined. It is employed as 
a collective term to express all the psychical states, and is the 
power by which the soul knows its own existence. It is the 
immediate knowledge of any object whatever, and seems to 
comprise, in its broadest signification, both matter and mind, 
for all objects are inseparable from the cognizance of them. 
Hence, the significance of the terms, subjective-consciousness 
and objective-consciousness. People are better satisfied with 
their knowledge of matter than with their conceptions of the 
nature of mind. 
THE NATURE OF MIND. 
Since this subject is being discussed by our most distinguished 
scientists, we will conclude this chapter with an extract from a 
lecture delivered by Prof. Burt G. Wilder, at the American 
Institute: 
"There now remains to be disposed of, in some way, the 
question as to the nature and reality of mind, which was rather 
evaded at the commencement of the lecture. The reason was, 
that I am forced to differ widely from the two great physiolo- 
gists whom I have so often quoted this evening. Most people, 
following in part early instruction, in part revelation, in part 
spiritual manifestations, and in part trusting to their own con- 
sciousness, hold that the human mind is a spiritual substance 
which is associated with the body during the life of the latter 
in this world, and which remains in existence after the death 
of the body, and forms the spiritual clothing or embodiment of 
the immortal soul; and that the individual, therefore, lives after 
death as a spirit in the human form; that of this spiritual man, CEREBRAL PHYSIOLOGY. 
147 
the soul is the essential being, of which may be predicted a 
good or evil nature, while the mind, which clothes it as a body, 
consists of the spiritual substances, affections, and thoughts, 
which were cherished and formed during the natural life. 
Together with the above convictions respecting themselves, 
most people, when thinking independently of theological subli- 
mations, feel willing to admit that animals have, in common 
with man, fewer or more natural affections and thoughts which 
make up their minds, but that the inner and immortal soul, 
which would retain them as part of an individual after death 
of the body, is not possessed by the beasts that perish. In 
short, the vast majority of mankind, when thinking quietly, and 
especially in seasons of bereavement, feel well assured of the 
real and substantial existence of the human mind, independently 
of its temporary association with the perishable body. 
But in antagonism to this simple and comforting faith, stand 
theological incomprehensibilities on the one hand, and scientific 
skepticism on the other. The former would have us believe that 
the soul is a mere vapor, a cloud of something ethereal, of which 
can be expected nothing more useful than 'loafing around the 
Throne,' while the latter asks us to recognize the existence of 
nothing which the eyes cannot see and fingers touch; to cease 
imagining that there is a soul, and to regard the mind as merely 
the product of the brain; secreted thereby as the liver secretes 
bile. Let us hear what the two leading nervous physiologists, 
of this country, have to say upon this point: 
£ The brain is not, strictly speaking, the organ of the mind, for 
this statement would imply that the mind exists as a force, inde- 
pendent of the brain; but the mind is produced by the brain 
substance; and intellectual force, if we may term the intellect a 
force, can be produced only by the transmutation of a certain 
amount of matter; there can be no intelligence without brain 
substance.'-Flint. 
' The mind may be regarded as a force, the result of nervous 
action, and characterized by the ability to perceive sensations, 
to be conscious, to understand, to experience emotions, and 
to will in accordance therewith. Of these qualities, conscious- 
ness resides exclusively in the brain, but the others, as is clearly 
shown by observation and experiment, cannot be restricted to 148 
COMMON SENSE MEDICAL ADVISER. 
that organ, but are developed with more or less intensity, in 
other parts of the nervous system.'-Hammond. 
Thus do the two extremes of theology and science meet upon 
a common ground of dreamy emptiness, and we who confess our 
comparative ignorance are comforted by the thought that some 
other things have been 'hid from the wise and prudent and 
revealed unto babes.' Yet, while feeling thus, it must be admit- 
ted that the existence of spirit and of a Creator do not yet seem 
capable of logical demonstration. The denial of their existence 
is not incompatible with a profound acquaintance with material 
forms and their operations; and, on the other hand, the belief in 
their existence and substantial nature, and in their powers as 
first causes, have never interfered with the recognition of the 
so-called material forces, and of the organisms through which 
they are manifested. At present, at least, these are purely mat- 
ters of faith; but although the Spiritualist (using the term in its 
broadest sense as indicating a belief in spirits), may feel that his 
faith discloses a beauty and perfection in the union, otherwise 
imperceptible by him, there is no reason why this difference in 
faith should make him despise or quarrel with his materialist 
co-worker, for the latter may do as good service to science, may 
be as true a man, and live as holy a life, although from other 
motives. 
The differences between religious sects are mainly of faith, 
not of works, and the wise of all denominations are gradually 
coming to the conviction that they will all do God more service 
by toleration and co-operation than by animosity and disunion. 
And so I hold that, until the spiritualist feels himself able to 
demonstrate to the unbeliever the existence of spirit and of 
God, as convincingly as a mathematical proposition, there should 
be no hard words or feelings upon these points. For the pres- 
ent they are immaterial in every sense of the word; and so long 
as he bows to the facts and the laws of Nature, and deals with 
his fellow men as he would be done by, so long will 1 work with 
him, side by side, knowing, even though 1 cannot tell him so, 
that whether or not he joins me in this world, we shall meet in 
the other world to come, where his eyes will be opened, and 
where his lips will at least acquit me of bigotry and intol- 
erance." CHAPTER XV. 
THE HUMAN TEMPERA- 
MENTS. 
Organization implies vital energy, since there can be no 
organization without it. The sperm cell, as we have previously 
seen, exists before the initiation of the life of every individual 
organism. The early history of this fertilizing cell, which is 
composed of infinitesimal molecules which contain the embryo 
powers of life, is only partially written. It is a fact, authenti- 
cated by Faraday, that one drop of water contains, and may 
be made to evolve, as much electricity as, under a different 
mode of display, would suffice to produce a lightning-flash. 
Chemical force is of a higher order than physical, and vital 
force is of a still higher order. Within the microscopic com- 
pass of the sperm, cell are a great number of forces acting 
simultaneously, which require the answering conditions of a 
germ cell, and are so blended as to occupy a minimum of space. 
The union of these subtle elements through the agency of their 
physical, chemical, and vital forces, constitutes the initiation of 
life. Elementary matter is transformed into chemical and 
organic compounds, by natural forces, upon the cessation of 
which, it is liberated by nature's great destroyer, and reappears 
in the world . of elements. Thus, man is formed out of the 
very dust by means of energies which reconstruct the crude, 
inert matter, and to dust he returns when those energies cease. 
When we enter upon the consideration of the temperaments, 
we should bear in mind one peculiarity of life: that it combines, 
in a small space, many complex powers. In the process of 
reproduction, there is a complex combination of organic 
elements. Structures differ as greatly as their functions. So 
149 150 
COMMON SENSE MEDICAL ADVISER. 
likewise do animals vary in their nature and organization, and 
individuals of the same species are, in some respects, dissim- 
ilar. Yet the characteristics which have distinguished the races 
of mankind, are fundamental and faithfully maintained. Time 
does not obliterate them. Within race-limits are found enduring 
peculiarities, and, although each individual is weaving out some 
definite pattern of organization, it follows the type of the race, 
as well as the more immediate, antecedent condition. 
What then is a Temperament but a mixing together of these 
determining forces, a certain blending manifested in the con- 
stitution by signs, or traits, which we denominate character. 
The different races of mankind must have their several stan- 
dards of temperament, for the peculiarities of one are not fully 
descriptive of, and applicable to the other. 
The term temperament is defined by Dunglison, as being " a 
name given to the remarkable differences that exist between 
individuals, in consequence of the variety of relations and 
proportions between the constituent parts of the body. 
For its simplicity and scope, we prefer the following defini- 
tion, suggested by our friend, Orin Davis, M. D.: A Tempera- 
ment IS A COMBINATION OF ORGANIC ELEMENTS SO ARRANGED 
AS TO CHARACTERIZE THE CONSTITUTION. 
This leads us to consider some of the elements, conditions 
and forces which give character to the organization. External 
circumstances supply necessary conditions to inward activity, 
for without air, food, or sunlight all living animals would 
perish. Everywhere, life is dependent upon conditions and 
circumstances; it is not self-generating. But the conditions of 
reproduction are very complex. External forces are trans- 
formed, and, in turn, become vital or formative powers. De- 
velopment is a transmutation of physical and chemical forces 
into vital energy. Although unable to compute the ultimate 
factors of life, yet we may illustrate their reproductive possi- 
bilities and results by comparing them with those of a lower 
order. 
Animal structures are mainly composed of four elements: 
oxygen, hydrogen, nitrogen and carbon. Other constituents, 
such as phosphorus, sulphur, potassium, sodium, calcium, 
magnesium, and iron, enter into their composition, but are THE HUMAN TEMPERAMENTS. 
151 
found in much smaller quantities. From these elements is fabri- 
cated an organism which manifests peculiar properties and 
marvelous functions. If the proportion of these chemical 
elements be varied, the organic compound will be changed, or, 
the proportions remaining the same, if the grouping of the 
elements be altered, different compounds will be produced, 
showing that the properties of organized substances depend 
upon the molecular constitution of matter. 
Rising in the scale of organization, we observe that every 
variation of the physical and chemical processes implies a corre- 
sponding modification of the vital. This is verified by the 
peculiarities of the several races of mankind. Individual dif- 
ferences are likewise modifications of these processes. Dynam- 
ical or vital differentiation depends upon these modifications 
for the display of vital energy, and is always associated with 
molecular changes. But it should be borne in mind that an 
effect may not resemble its cause in properties, and the qualities 
of a chemical compound may be quite different from those 
of its individual constituents. Organic matter, although more 
complex, may exhibit properties, both like and unlike its con- 
stituent elements. Within certain boundaries, the elements 
seek to satisfy their affinities. We discover that there are 
limits between the genera of animals, as well as the races 
of mankind. Not less really, though perhaps not as absolutely, 
are there individual precincts within the sphere of the human 
temperaments, which cannot be passed. 
If we cannot satisfactorily explain, we can at least discover 
a reason for temperamental limitation. It is not designed to 
circumscribe healthful reproduction, but to serve as an effectual 
hindrance to abnormal deviations. We may state our belief 
in more positive terms: that the temperamental variations are 
essential to genesis and fertility, and indispensable to health 
and normal development. 
Every individual is susceptible to impressions which dispose 
to action. Impressions which excite or increase this disposition, 
are called stimuli. Vital change implies the existence of 
stimuli and susceptibility to stimulation. The stimulus may not 
be furnished because the conditions on which it depends are 
wanting; again, susceptibility may exist at one time and not 152 
COMMON SENSE MEDICAL ADVISER. 
at another. Stimuli and susceptibility may be present in differ- 
ent degrees, but for the purpose of healthful reproduction they 
must not be impaired. No single class of foods, albuminous, 
starchy, saccharine, or mineral, is sufficient for the nutrition 
of the body, but the food must contain substances belonging 
to each of the different classes. If an animal be fed exclusively 
upon albumen, though this substance constitutes the largest 
part of the bodily mass, exhaustion will rapidly follow, since 
the food does not contain all the essential, nutritive elements. 
Again, when the solids of the body have been wasted, they 
lose their susceptibility to stimuli, and the food does no good. 
Thus patients become emaciated during acute attacks of dis- 
ease, upon the cessation of which they are too feeble to recover, 
simply because they have lost the power to digest and assimi- 
late their food. 
In inanimate bodies, as in crystals, forces come to rest, but 
the very idea of life implies action and continual change. 
Hence diversity of constitutions and different temperaments 
are essential in order that marriage may result in the re- 
production of vigorous beings. 
VITAL AND NON-VITAL TEMPERAMENTS. 
In the preceding chapter, we attempted to illustrate the 
unique blending of mind and body by means of the nervous 
system, and we now propose to exem- 
plify the physical conditions of the 
organism by certain correspondences, 
observed in the development and con- 
ditions of that system. If nature 
answer to mind in physical cor- 
respondences, she will observe 
the same regularity in physical develop- 
ment. The simplest classification of 
the temperaments is represented in Fig. 
78. Not only is mental activity de- 
pendent upon a vital activity in the 
brain, but the development of the cere- 
brum is dependent upon the supply of blood. The growth of 
the intellect requires the same conditions that aided in the 
Fig. 78. THE HUMAN TEMPERAMENTS. 
153 
development of Vulcan's right arm: waste and supply; disinte- 
gration and reparation of tissue. Our modern iron forges produce 
many an artisan whose great right arm proclaims him to be a 
son of power as. well as of fire. Thus the fervid intellect, while 
forging out its thoughts, increases in size and strength. The 
difference between the development of the two is this; that 
the exercise of the blacksmith's right arm quickens the activi- 
ties of all the bodily functions, whereas the employment of 
the intellect does not offer any healthy equivalent. Physical 
exercise is a hygienic demand, but intellectual employment 
exerts no salutary influence on the body, while it is constantly 
expending the nutritive energies of the blood. The emotions, 
likewise, make exhaustive draughts upon nutrition to supply 
the waste of brain substance, just as certainly as physical 
labor causes muscular change, and demands reparation. One 
expends cerebral, the other, muscular substance. The one is 
healthful in its general tendencies, the other, comparatively 
wasteful and destructive. 
Disintegrating, 
Expending, 
Deriving. 
The intellectual faculties are 
Engrossing, 
Exhausting, 
Devitalizing. 
The emotive faculties are 
These nervous forces are transformed into spiritual products. 
The base of the anterior lobes of the brain belong to the 
atonic region-the source of those languid, deranging in- 
fluences which coincide with morbidity and disease. A dis- 
turbance of the corporeal organs, which especially influence 
this portion of the brain, naturally tends to the development 
of insanity or imbecility. Morel has traced, through four 
generations, the family history of a youth who was admitted 
to the asylum at Rouen while in a state of stupidity and 
semi-idiocy. The following summary of his investigations 
illustrates the natural course of degeneracy as it extends 
through successive generations: immorality, depravity, alcoholic 
excess, and moral degradation, in the great-grandfather, who 
was killed in a tavern brawl; hereditary drunkenness, mani- 
acal attacks, ending in general paralysis, in the grandfather; 154 
COMMON SENSE MEDICAL ADVISER. 
sobriety, but hypochondriacal tendencies, delusions of persecu- 
tions, and homicidal tendencies in the father; defective 
intelligence in the son. His first attack of mania occurred 
at sixteen, and was followed by stupidity, and finally ended 
in complete idiocy. Furthermore, there was probably an ex- 
tinction of the family, for the son's reproductive organs were 
as little developed as those of a child of twelve years of age. 
He had two sisters who were both defective physically and 
morally, and were classed as imbeciles. To complete the 
proof of heredity in this case, Morel adds that the mother 
had a child while the father was confined in the asylum, 
and that this child exhibited no signs of degeneracy. Statistics 
show that multitudes of human beings are born with a destiny 
against which they have neither the will nor the power to 
contend; they groan under the worst of all tyrannies, the 
tyranny of a bad organization, which is theirs by inheritance. 
We may represent the tendencies of the anterior portion of 
the brain by Fig. 79. The functional exercise of the anterior 
and superior portions of the cerebrum is disintegrating and 
devitalizing, while the anterior and inferior portions coincide 
with mental and physical derangement, unless counteracted by 
opposing forces. It is therefore evident that in any organiza- 
tion, upon which is entailed a perverted or excessive action 
of this portion of the cerebrum, the tendencies are non-vital, 
i. e., unfavorable to fertility and physical health. 
If the antagonizing regions are well developed, the tendencies 
are favorable to life. 
Sanity, 
Temperance, 
Hardihood. 
The volitive organs promote 
N UTRITION, 
Restoration, 
Conservation. 
The animal organs tend to 
The basilar faculties instigate 
Secretion, 
Circulation, 
VITALIT Y. 
Energy, 
Health, 
Reproduction. 
The combined action of these 
faculties express 
If this portion of the brain indicates a full development, we THE HUMAN TEMPERAMENTS. 
155 
say of such a temperament that it is vital, because the functions 
of its nerve-centers are favorable to evolution. As degeneration 
observes conditions, so endurance and development conform to 
certain laws, and it is the duty of all truthful inquirers, who 
Fig. 79. 
devitalizing 
exhausting 
ENGROSSING 
? DERIVING 
'expending 
' DISINTEGRATING 
NON-VITAL 
VITAIj 
nutrition 
RESTORATION 
CONSERVATION 
INDOLENCE 
MORBIDITY 
DEBILITY 
SECRETION 
CIRCULATION 
VITALITY 
believe not only in the progress of human intelligence, but in 
physical improvement from generation to generation, to ascer- 
tain and comply with these essential conditions. When the 
anterior and middle lobes of the brain are fully developed at 
their inferior surfaces, it is regarded as an insane temperament, 
i. e., containing the germs of mental and bodily derangement. 156 
COMMON SENSE MEDICAL ADVISER. 
How shall we distinguish the combination of organic elements, 
if not by the manner in which they characterize the constitution? 
Every human being is distinguished by natural peculiarities, 
both mental and physical. These are indicated not only by the 
color of the eyes, hair, and skin, and the mental expressions, 
but in the conformation and capabilities of the corporeal system. 
The color, form, size, and texture of a leaf indicate to the 
expert pomologist the nature of the fruit which the tree will 
bear, but how much more important is it to understand the har- 
monies of human development. If Prof. Agassiz could deter- 
mine the form and size of a fish by seeing its scales, and Prof. 
Owen outline the skeleton of an unknown animal by viewing a 
portion of its fossil, why should not the physician understand 
the language of temperaments, since it opens to him the revela- 
tions of human development? The sculptor blends character 
with form, the artist endows the face with natural expression, 
the anatomist accurately traces the nerves and arteries, the 
physiognomist reads character, which the novelist delineates 
and the actor personates, because there are facts behind all 
these, the materials wherewith to construct a science. In or- 
ganization there are permanent forces which operate uniformly, 
thus revealing the order of nature. 
THE TEMPERAMENTS CLASSIFIED 
We propose to speak of four constitutional variations entitled 
to separate consideration; the lymphatic, 
the sanguine, the volitive, and the en- 
cephalic. The brain controls all the 
voluntary, and modifies the involuntary 
functions of the body. A particular 
cerebral development modifies the func- 
tions of all the bodily organs, and 
thus tempers the constitution. We 
shall, therefore, base our classification 
of temperaments upon the mental and 
physiological characteristics, which are 
portrayed by cerebral development. 
Such an arrangement is illustrated by Fig. 80. 
Fig. 80. THE HUMAN TEMPERAMENTS. 
157 
THE LYMPHATIC TEMPERAMENT. 
The lymphatic temperament predominates when the anterior 
base of the brain and the middle lobe are developed so as to 
exert a preponderating influence over the bodily functions. 
The character of this influence we have described in cerebral 
physiology. It is difficult to state precisely the normal influ- 
ences and nerve-forces which arise from these faculties, but 
it is evident that they are specially related to nutritive at- 
traction, in opposition to volitive repulsion. It is only their 
excessive influence which produces worthless, miserable, morbid 
characters. A constitution marked by this development is 
indolent, relaxative, and an easy prey to epidemics. This 
treatment is also characterized by a low grade of vitality 
or resistance. When life is sustained by the volitive powers, 
it is distinguished by a softness of the bodily tissues, and the 
prevalence of lymph. The fact that all the organic functions 
are performed indolently, indicates lack of vital power. An 
excellent illustration of this temperament is found in Fig. 81, 
which represents a Chinese gentleman of distinction. In the 
lower order of animals, as in sponges, absorption is performed 
by contiguous cells, which are quite as effortless as in plants. 
Because of their organic indolence, sponges are often classed 
as vegetables. A body having an atonic or a lymphatic tem- 
perament is abundantly supplied with absorbent organs, which 
are very sluggish in their operations. In the lymphatic tem- 
perament, there seems to be less constructive energy, slower 
elaboration, and greater frugality. Lymph is a colorless or 
yellow fluid containing a large proportion of water. It is not 
so highly organized as the blood, but resembles it, when that 
fluid is deprived of its red corpuscles. In the sanguine tem- 
perament, circulation in the blood-vessels is the most active, 
in the lacteals next, and in the lymphatics the least so, but in 
the lymphatic temperament, this order is reversed. 
Dr. W. B. Powell has observed that a lymphatic man has 
a large head, while a fat man has a small one, and also that 
fat and lymph are convertible, one following the other, i. e., 
"a repletion consisting of fat may be removed, and one of 
lymph may replace it, and vice versa " He could not account 158 
COMMON SENSE MEDICAL ADVISER. 
for these alternations. The bear goes into his winter quarters, 
sleek and fat, and comes forth in the spring just as plump with 
lymph, but he loses this fat appearance soon after obtaining 
food. This simply indicates that, during lymphatic activity, the 
digestive organs are comparatively quiescent. But when these 
are functionally employed again, lymphatic economy is not 
required. It is the duty of the lymphatics to slowly convert 
Fig. 81. 
the fat by such transformation, that when it reaches the general 
circulation, it may there unite with other organic compounds, 
the process being aided by atmospheric nitrogen, introduced 
during the act of respiration. In this way it may become 
changed into those chemically indefinite, artificial products, 
called proteid compounds. This view is supported by the dis- 
appearance of fat as an organized product in the lymph of the 
lymphatic vessels, indicating that such transformation has oc- 
curred. In this way, by uniting with other organic compounds, THE HUMAN TEMPERAMENTS. 
159 
it appears that lymph may serve as a weak basis for blood; 
that atmospheric nitrogen is also employed in forming these 
artificial compounds, is indicated by the fact that there is some- 
times less detected in arterial than in venous blood. 
This temperament is indicated by lymphatic repletion, soft 
flesh, pale complexion, watery blood, slow and soft pulse, oval 
head, and broad skull, showing breadth at its base. Fig. 82 
illustrates this temperament combined with sanguine elements. 
Fig. 82. 
Judge Green, of the United States Court. 
In all good illustrations of this temperament, there is a breadth 
of the anterior base of the skull extending forward to the 
cheek bones. There is likewise a corresponding fullness of the 
face under the chin, and in the neck, denoting a large develop- 
ment of the anterior base of the cerebrum. The cerebral 
conformation of the Hon. Judge Green indicates mental 
activity, and we have no reason to suppose that lymph was 
particularly abundant in his brain. 
While this description of the lymphatic temperament is cor- 
rect, when illustrated by the civilized races of men who are 160 
COMMON SENSE MEDICAL ADVISER. 
accustomed to luxury, ease, and an abundance of food, it does 
not apply with equal accuracy to the cerebral organization 
of the American Indian. His skull, though broad at its anterior 
base, and high and wide at the cheek bones, differs from the 
European in being broader and longer behind the ears. Fig. 
83 is an excellent representation of a noted North American 
Indian. While a great breadth of the base of the brain 
indicates morbid susceptibilities, yet these, in the Indian, are 
opposed by a superior height of the posterior part of the skull. 
Consequently, he is restless, impulsive, excitable, passionate, 
a wanderer upon the earth. The basilar faculties, however, are 
large, and he is noted for instinct- 
ive intelligence. His habits alter- 
nate from laziness to heroic effort, 
from idleness and quiet to the 
fierce excitement of the chase, from 
vagabondism to war, sometimes in- 
dolent and at other times turbu- 
lent, but under all circumstances, 
irregular and unreliable. In this 
case, lacteal activity is greater than 
lymphatic, as his nomadic life in- 
dicates. Nevertheless, he manifests 
a morbid sensibility to epidemic 
diseases, especially those which en- 
gender nutritive disorders and cor- 
rupt the blood. Figs. 84 and 85 
represent the brain of an American Indian, and that of a Euro- 
pean, and show the remarkable difference in their anatomical 
configuration. Evidently it is a race-distinction. Observe the 
greater breadth of the brain of the Indian, which according to 
cerebral physiology indicates great alimentiveness, indolence, 
morbid sensibility, irritability, profligacy, but also note that it 
differs materially in the proportion of all its parts, from the 
European brain. Judging the character of the Indian from the 
aforesaid representation, we should say that he was cunning, 
excitable, treacherous, fitful, taciturn, or violently demonstra- 
tive. His constitution is very susceptible to diseases of the 
bowels and blood. His appetite is ungovernable, and his 
Fig. 83. THE HUMAN TEMPERAMENTS. 
161 
love of stimulants is strong. Syphilitic poison, small-pox, and 
strong drink will annihilate all these tribes sooner than 
gunpowder. Their physical traits of constitution are no less 
contradictory than their extremes of habit and character, for 
while there is evidence of lymphatic elements, yet it is contra- 
Fig. 8Jf.. 
Fig. 85. 
American Indian. 
(From Morton's Crania Americana.) 
European. 
In the American Indian, the anterior lobe, lying between A A, and B B, is small, 
and in the European it is large, in proportion to the middle, lying between B B 
and G G. In the American Indian, the posterior lobe, lying between C and D is 
much smaller than in the European. In the Indian, the cerebral convolutions 
on the anterior lobe and upper surface of the brain, are smaller than the 
European. If the anterior lobe manifests the intellectual faculties-the middle 
lobe, the propensities common to man with the lower animals-and the posterior 
lobe, the conservative energies, the result seems to be, that the intellect of the 
American Indian is comparatively feeble-the European, strong; the animal 
propensities of the Indian will be great-in the European, more moderate; while 
reproduction, vital energy, and conservation of the species in the Indian is not as 
great as with the European. The relative proportions of the different parts of 
the brain differ very materially. 
dieted by the color of the hair, eyes, and skin. This peculiar 
organization will not blend in healthful harmony with that of 
the European, and this demonstrates that the race-temperaments 
require separate and careful analytical consideration. 
By physical culture and regulation of the habits, the exces- 
sive tendencies of this temperament may be restrained. Solid 
food should be substituted for a watery diet. If it be limited 162 
COMMON SENSE MEDICAL ADVISER. 
in quantity, this change will not only diminish the size, 
but increase the strength of the body. The body should be 
disciplined by daily percussion until the imperfectly constructed 
cells, which are too feeble to resist this treatment, are broken 
and replaced by those more hardy and enduring. Add to this 
treatment brisk, dry rubbing, calisthenic exercises, and daily 
walks, which should be gradually extended. Continue this 
treatment for three months, and its favorable effects upon the 
temperament will surprise the most skeptical; if continued for 
a year, a radical alteration will be effected, and the hardihood, 
health, and vigor of the constitution will be greatly increased. 
This temperament may be improved physiologically, by being 
blended with the sanguine and volitive. The offspring will 
be stronger, the structures firmer, the organization more dense. 
Nutrition, assimilation, and all the constructive functions will 
be more energetic in weaving together the cellular fabric 
of the body. The sanguine temperament will add a stimulus 
to the organic activities, while the volitive will communicate 
manly, brave, and enduring qualities. When this temperament 
is united with the encephalic, if such a union does not result in 
barrenness, it adds expending and exhaustive tendencies to the 
enfeebling ones already existing, and, consequently, the offspring 
lacks both physical power and intellectual activity. 
The peculiarities of this temperament are observed in the 
diseases which characterize it. It is specially liable to derange- 
ments of digestion, nutrition, and blood-making. The blood 
is easily poisoned by morbid products formed within the body, 
as well as by those derived from the body of another. This 
is seen in pyaemia, produced by the introduction of decomposing 
pus, or " matter," into the blood. This condition is most likely 
to occur when the vital powers are low and the energies weak, 
for then the fibrin decreases, the red corpuscles diminish in 
number, the circulation becomes languid, the pulse grows flutter- 
ing and weak, and this increases until death ensues. An indi- 
vidual of this temperament is more easily destroyed than any 
other by the poison of syphilis, small-pox, and other contagious 
diseases. If the blood has received any hereditary taint, the 
lymphatic glands not only reproduce it but often increase the 
virulency of the original disease. This temperament indicates THE HUMAN TEMPERAMENTS. 
163 
a necessity for the employment of stimulating, alterative, and 
anti-septic medicines. The torpid functions need arousing, the 
blood needs depuration, i. e., the elimination of corrupting 
matter, and the system requires alteratives to produce these 
salutary changes. The secretions need the correcting influence 
of cleansing remedies for the purification of the blood. 
Persons of this temperament are more liable to absorption 
of morbid products within the body, which are in a state of 
decomposition, producing an infection of the blood, technically 
termed septicaemia. The fatal results which so suddenly follow 
child-bed fever are thus produced. This kind of poisoning 
sometimes takes place from the absorption of decomposed 
exudation in diphtheria, and, though rarely, from decomposing 
organic products collected in the lungs. Whenever the absorp- 
tion of poison does take place, fatal consequences usually follow. 
This passive temperament is more likely to sink under acute 
attacks of disease, especially alimentary disorders, such as diar- 
rhea, dysentery, and cholera. It quickly succumbs to their 
prostrating effects, such as depression, congestion, and fatal col- 
lapse which rapidly succeed one another, Venesection and 
harsh purgatives are contra-indicated, and the physician who 
persists in their employment kills his patient. How grateful 
are warmth and stimulating medicines! The most powerful, 
diffusible, and nervous stimulants are required in cholera, when 
the system is devastated by the disease, as the plain is laid 
waste by the fierce tornado. 
THE SANGUINE TEMPERAMENT. 
Lymph is the characteristic of the lymphatic temperament, 
and its specific gravity, temperature, and standard of vitality 
are all lower than that of red blood. In the sanguine tempera- 
ment all the vital functions are more active, the blood itself 
has a deeper hue, its corpuscles carry more oxygen, the com- 
plexion is quite florid, and the arterial currents impart to 
every faculty a more hopeful vigor. The blood-vessels are 
the most active absorbents, eagerly appropriating nutritive 
materials for the general circulation, while the respiration adds 
to it oxygen, that agent which makes vital manifestation 
possible. This temperament exhibits greater sensibility, the 164 
COMMON SENSE MEDICAL ADVISER. 
conceptions are quicker, the imagination more vivid, the appe- 
tite stronger, the passions more violent, and there is found 
every display of animal life and enjoyment. 
A full development of the basilar faculties, indicated by 
an unusual breadth and depth of the base of the brain, ac- 
companies this temperament. Its cerebral area includes the 
posterior and inferior portions of the cerebrum, the entire 
cerebellum, and that part of the medulla which connects with 
the spinal cord, all of which sustain intimate relations to vital 
conditions. Accordingly, such a development indicates good 
digestion, active nutrition, vigorous secretion, large heart and 
lungs, powerful muscles, and surplus vitality. The violent 
faculties, such as Combativeness, Destructiveness, and Hatred, 
are natural adjuncts, and their excess tends to sensuality and 
crime. They are not only secretive, appropriative, selfish, 
and self-defensive, but when redundant are aggressive and 
tend to destructiveness, the gratification of animal indulgence, 
intemperance, and debauchery. The correspondence between 
the cerebral conformation and the physical development is 
very obvious. Lower orders of animals possess these faculties, 
and their spontaneous exhibition is called instinct. They 
possess the acquisitive, destructive, and propagative propensi- 
ties, which lead them to provide for their wants and secure 
to themselves a posterity. The exercise of their bodies causes 
a continual waste which demands incessant reparation, and they 
are governed measurably by these animal impulses. 
All of these lower psychical faculties have a physiological 
significance. Acquisitiveness functionally expresses assimila- 
tion, accretion, animal growth, and tends to bodily repletion. 
Secretiveness expresses concealing, separating, withdrawing, and 
functionally signifies secretive action. Secretion is the separ- 
ating and withdrawing from the blood some of its constituents, 
as mucus, bile, saliva, etc. This latter process indicates com- 
plex conditions of organization, so that the higher and more 
complex the tissue, the greater the number of secretory or- 
gans. Unrestrained selfishness, while it naturally conserves 
the individual interests, in its ultimate tendencies, is the very 
essence of human depravity. Without qualification, clearly, 
it is crime, for blind devotion to the individual must be in THE HUMAN TEMPERAMENTS. 
165 
utter disregard for the good of others. The ultimate tendencies 
of these faculties are, therefore, criminal. 
Exaggerate the faculty of acquisitiveness, and it becomes 
avariciousness. Develop secretiveness and selfishness, and they 
become cunning and profligacy, desperation and crime. Their 
functional development tends to produce physical disorder and 
violent disease. All of these faculties are vehement, conten- 
tious, thriving by opposition. Life itself has been called a 
forced state, because it wars with the elements it appropriates, 
and transmutes their powers into vitality. 
We find men and women of this temperament, who aro 
models of character and organ- 
ization. George Washington is 
an excellent illustration. The 
impression that his presence 
made upon the Marquis de 
Chastellux, is given in the fol- 
lowing words: "I wish only 
to express the impression Gen- 
eral Washington has left on my 
mind; the idea of a perfect 
whole, brave without temerity, 
laborious without ambition, 
generous without prodigality, 
noble without pride, virtuous 
without severity." Gen. Scott, 
Lord Cornwallis, Dr. Wistar, 
Bishop Soule, John Bright, 
Jenny Lind Goldsmidt, and Dr. 
Gall are good representatives of this temperament. Fig. 86 
is an excellent illustration of it, finely blended and well 
balanced, in the person of Madame de Stael. This tem- 
perament requires fewer tonics and stimulants than the lym- 
phatic. This constitution is best able to restore vital losses. 
It is a vital temperament, in other words, it combines favorably 
with all the others, and better adapts itself to their various 
conditions. Some regard it as the best adjusted one in all 
its organs and tissues, and as the most satisfactory and 
serviceable. 
JFlg. 86. 166 
COMMON SENSE MEDICAL ADVISER. 
Excess of nutrition tends to plethora, to animal indulgence, 
and gross sensuality. Not only do the propensities rouse 
desire, but they excite the basilar faculties, and portray their 
wants in the outlines of the face, mould the features to their 
expression, and flash their significance from the eye. Who 
can mistake the picture of sensuality represented by Fig. 87? 
It is enough to shock the sensibility of a dumb animal, and 
to say that such a face has a beastly look, is an unkind 
reflection upon the brute creation. A large neck and corre- 
sponding development of the occipital half of the brain 
indicate nervous energy, yet nutrition is not absolutely depend- 
ent upon it, for the nutritive processes are active before a 
nervous system is formed. The 
lower faculties of the mind 
exert a remarkable influence 
over nutrition, secretion, and 
the molecular changes incident 
to life. Anger or fear may 
transmute the mother's nourish- 
ing milk into a virulent poison. 
The following incident, taken 
from Dr. Carpenter's Physi- 
ology, illustrates this state- 
ment: "'A carpenter fell into 
a quarrel with a soldier billeted 
in his house, and was set-upon 
by the latter with his drawn 
sword. The wife of the car- 
penter at first trembled from 
fear and terror, and then sud- 
denly threw herself between 
the combatants, wrested the sword from the soldier's hand, 
broke it in pieces, and threw it away. During the tumult, 
some neighbors came-in and separated the men. While in 
this state of strong excitement, the mother took up her 
child from the cradle, where it lay playing, and in the 
most perfect health, never having had a moment's illness; 
she gave it the breast, and in so doing sealed its fate. In 
a few minutes the infant left-off sucking, became restless, 
Fig. 87. THE HUMAN TEMPERAMENTS. 
167 
panted, and sank dead upon the mother's bosom. The phy- 
sician who was instantly called-in, found the child lying in 
the cradle, as if asleep, and with its features undisturbed; but 
all resources were fruitless. It was irrecoverably gone.' In 
this interesting case, the milk must have undergone a change, 
which gave it a powerful sedative action upon the susceptible 
nervous system of the infant." 
Anxiety, irritation, hatred, all tend to the vitiation of the dis- 
position and bodily functions, perverting the character and 
constitution at the same time. Depravity of thought and 
secretion go together. Degradation of mind and corruption of 
the body are concomitants. There is a very close affinity 
between mental and moral perversion and physical prostitu- 
tion, of which fact too many are unconscious. Nervous influ- 
ence preserves the fluidity of the blood and facilitates its 
circulation, for it appears that simple arrestment of this in- 
fluence favors the coagulation of the blood in the vessels; clots 
being found in their trunks within a few minutes after the brain 
and spinal marrow are broken down. Habitual constipation is 
the source of many ills. Perversion of the functions of the stom- 
ach, and of the circulation of the blood, produce general disaster. 
Diseases which characterize this temperament are acute, vio- 
lent, or inflammatory, indicating repletion and active conges- 
tion; intense inflammation, burning fevers, severe rheumatism, 
a quick, full pulse, great bodily heat, and functional excitement 
are its morbid accompaniments. These diseases will bear 
thorough depletion of the alimentary canal, active, hydragogue 
cathartics being indicated. Sedatives and anodynes are also 
essential to modify the circulatory forces, and to relieve pain. 
Violent disturbance must be quelled, and among the remedial 
agents required for this duty we may include Veratrum, Ipecac, 
Digitalis, Opium, Conium, and Asclepias. While equalizing the 
circulatory fluids, restoring the secretions, and thoroughly evac- 
uating the system, and thus endeavoring to remove disturbing 
causes, we find that the conditions of this temperament are 
exceedingly favorable for restoration to health. True, many 
chronic diseases are obstinate, yet a course of restorative medi- 
cation persistently followed, promises a fortunate issue in this 
tractile temperament. 168 
COMMON SENSE MEDICAL ADVISER. 
Hygienic management of the lymphatic and sanguine temper- 
aments consists in the vigorous toning of the former, while 
restraint of the latter will greatly exempt it from the anxieties, 
contentions, and vexations which excite the mind, disturb the 
bodily functions, and end in chronic disease. People of the 
latter organization love mental and physical stimulants, are 
easily inflamed by passion, and their excitability degenerates 
into irritability, succeeded by serious functional derangements, 
which prematurely break down the individual with inveterate, 
deep-seated disorder. Serenity, hope, faith, as well as firmness, 
are natural hygienic elements. It is a duty we owe ourselves 
to promptly relinquish a business which corrodes with its cares, 
and depresses with its increasing troubles. Constant solicitude, 
and the apprehension of financial disaster, frustrate the bodily 
functions, disconcert the organic processes, and lead to mental 
aberration as well as physical degeneracy. Melancholy is 
chronic, while despair is acute mania, whose impulses drive the 
victim desperately toward self-destruction. The chronic de- 
rangement of these organs exerts with less force the same 
morbid tendency. Hence the necessity for exercising those 
hygienic and countervailing influences born of resolution, assur- 
ance, and confident trust, and the belief which strengthens all of 
the vital operations. 
Doubtless, this temperament is the source of the reproductive 
powers. It is the corner-stone essential to the foundation of all 
other temperaments. It has been supposed by some that the 
cerebellum is the seat of sexual instinct. The fact appears 
that an ample development of the posterior base of the cere- 
brum and the cerebellum indicates nutritive activity, which 
is certainly a condition most favorable to the display of 
amativeness. In a double sense, then, this temperament is a 
vital one; both by nutritive repletion, and by reproduction. It 
is the blood-manufacturing, tissue-generating, and body-con- 
structing temperament, causing growth to exceed waste, and 
promptly repairing the wear which follows continual labor. 
While the sleazy structures of the lymphatic temperament 
are favorable to the functions of transudation, exhalation, and 
mutual diffusion of liquids, the sanguine, as its name indicates, 
is adapted to promote the circulation of the blood, to favor THE HUMAN TEMPERAMENTS. 
169 
nutrition and reproduction. The former temperament does not 
move the world by its energies, or impress it vividly with its 
wisdom, and the latter is more enthusiastic, enjoyable, and 
quickening. Each temperament, however, possesses salient qual- 
ities and advantages. 
THE LIFE LINE. 
Dr. W. B. Powell, in his work on "The Human Tempera- 
ments," announces the discovery of a measurement which indi- 
cates the tenacity of life, and the vital possessions of the 
individual. He has observed that some persons of very feeble 
appearance possess remarkable powers of resistance to disease, 
and continue to live until the machinery of life literally wears 
out. Others, apparently stronger and more robust, die before 
the usual term of life is half completed. He also noticed that 
some families were remarkable for their longevity, while others 
reached only a certain age, less than the average term of life, 
and then died. He remarked also that some patients sank 
under attacks of disease, when, to all appearances, they should 
recover, and that others recovered, when, according to all 
reasonable calculations, they ought to die. He, therefore, not 
only believed that the duration of human life was more .defi- 
nitely fixed by the organization than is supposed, but he set 
himself to work to discover the line of life, and the meas- 
ure of its duration. He made a distinction between vital 
vigor, and vital tenacity. Vital vigor he believed to be 
equivalent to the condition of vitality, which is indicated 
by the breadth of the brain found in the sanguine tem- 
perament; and vital tenacity to be measured by the depth 
of the base of the brain. Dr. Powell was an indefatigable 
student of nature, and followed his theory through years of 
observation, and measured hundreds of heads of living per- 
sons, in order to verify the correctness of the hypothesis. His 
method of measuring the head may be stated as follows: 
He drew a line from the occipital protuberance on the back 
of the head to the junction of the frontal and malar bones, 
extending it to a point above the center of the external orbit 
of the eye, near the termination of the brow. Then he meas- 
ured the distance between this line and the orifice of the 170 
COMMON SENSE MEDICAL ADVISEE. 
ear and thus obtained the measure indicating the vital te- 
nacity or duration of life. Fig. 88 is a representation of 
the skull of Loper, who was executed for murder in Mis- 
sissippi. He might have attained a great age, had not his 
violent and selfish faculties led him into the commission of 
crime. In this illustration, 
B represents the occipital pro- 
tuberance, and A the junc- 
tion of the frontal and malar 
bones at the external angle 
of the eye. The distance be- 
tween this line (A B) and the 
external orifice of the ear, is 
the measure of the life-force 
of Loper at the time of his 
execution. 
The tenacity of an individ- 
ual's life, Dr. Powell determined by the following scale of 
measurements: three-fourths of an inch from the orifice of the 
ear to the life-line, is the average length in the adult, and in- 
dicates ordinary tenacity of life. As the distance decreases 
to five-eighths, one-half, or three-eighths of an inch, vital te- 
nacity diminishes. If the 
distance is more than three- 
quarters of an inch, it de- 
notes great vital endurance, 
excellent recuperative 
powers, and is indicative of 
longevity. If it measures 
less than half an inch, it 
shows that the constitution 
has a feeble, uncertain hold 
upon life, and an acute dis- 
ease is very likely to sunder 
the vital relations. Dr. 
Powell contended that "life force and vital force are not 
equivalent terms, because much more vital force is expended 
upon our relations, than upon our organization in the preser- 
vation of life. Every muscular contraction, every thought, 
Fig. 88. 
Fig. 89. THE HUMAN TEMPERAMENTS. 
171 
and every emotion requires an expenditure of vital force." 
He asserted that we inherit our life force or constitutional power, 
and that we can determine by this the amount which 
we so receive. And he believed that it could be increased by 
intellectual effort, just as we can increase vital force by physical 
exercise. Fig. 89 represents the skull of a man who died, at 
nearly the same age as Loper, of consumption, in the Charity 
Hospital, at New Orleans. The measurement of the skull in 
this case gives a space between the life-line and the orifice 
of the ear of one-sixteenth of an inch, showing that the 
consumptive had lived the full term of his life. Dr. Powell 
contended that the depth of a man's brain may be increased 
after maturity; muscular effort, mental activity, and a sense 
of responsibility being favorable to longevity, while idleness 
and dissipation are adverse to it. In justice to the Doctor, we 
have stated fully his theory and his method of determining 
the hardihood and endurance of the constitution, and we 
bespeak for it a candid examination. Without doubt it em- 
bodies a great deal of truth. Hereafter we shall endeavor to 
indicate by cerebral configuration, a better system of judging 
of the vital tenacity, hardihood, and constitutional energies, 
both inherited and acquired. 
By reference to Figs. 72 and 80, the reader will be able to 
locate the region of the volitive faculties, previously described 
under' the generic term will. This temperament is character- 
ized by ambition, energy, industry, perseverance, decision, vigi- 
lance, self-control, arrogance, love of power, firmness, and 
hardihood. These faculties express concentration of purpose 
and their functional equivalents are power of elaboration, con- 
structiveness, condensation, firmness of fiber, compactness of 
frame, and endurance of organization. The pulse is full, firm, 
and regular, the muscles are strong and well marked, the hair 
and skin dark, the temporal region is not broadly developed, the 
face is angular, its lines denoting both power of purpose and 
strength of constitution, with resolution and hardihood blended 
in the expression. The volitive temperament is distinguished 
by height of the posterior, superior occipital region, called the 
THE VOLITIVE TEMPERAMENT. 172 
COMMON SENSE MEDICAL ADVISER. 
crown of the back head, and by corresponding breadth from 
side to side. The rule given by Dr. J. R. Buchanan applies not 
only to the convolutions, but to the general development of 
the brain; length gives power, or range of action, and breadth 
gives copiousness, or activity of manifestation. Thus a high, 
narrow back head indicates firmness and decision, but it is 
not as constant and copious in its manifestation as when 
it is associated with breadth. An individual having a narrow, 
high head, may determine readily enough upon a course 
of action, but he requires a longer period for its completion 
than one whose head is both high and broad. Such a cerebral 
conformation cannot accomplish its objects without enjoying 
regular rest, and maintaining the best of habits. Breadth of 
this region of the brain indicates ample resources of energy, 
both psychical and physical. It denotes greater vigor of con- 
stitution, one that continually generates volitive forces, and its 
persistency of purpose may be interpreted as functional tenac- 
ity. Inflexibility of will and 
purpose impart their tenacious 
qualities to every bodily func- 
tion. The will to recover is 
often far more potent than 
medicine. We have often wit- 
nessed its power in restraining 
the ravages of disease. The 
energetic faculties, located at 
the upper and posterior part 
of the head, are the invigorat- 
ing, or tonic elements of the 
constitution, imparting hardy, 
firm, steady, and efficient in- 
fluences, checking excess of 
secretion, repressing dissipa- 
tion, and tending to maintain 
self-possession, as well as 
healthy conditions of life. Fig. 90 is a portrait of V. S. Grant, 
which shows a well-balanced organization, with sufficient voli- 
tive elements to characterize the constitution. 
The old term bilious temperament might possibly be retained 
Fig. 90. THE HITMAN TEMPERAMENTS. 
173 
in deference to long usage, did it not inculcate a radical error. 
Bilious is strictly a medical term, relating to bile, or to de- 
rangements produced by it, and it was used originally to 
distinguish a temperament supposed to be characterized by 
a predominance of the biliary secretion. In the volitive tem- 
perament, the firm, tenacious, toning, and restraining faculties 
repress, rather than encourage biliary secretion, and hence the 
necessity for administering large doses of cholagogues, remedies 
which stimulate the secretion of bile. When the system is 
surcharged with bile, from a congested condition of the liver, 
we use these agents in order to obtain necessary relief. In 
this temperament there is moderate hepatic development, lack 
of biliary activity, deficiency in the secretion of bile, and a 
sluggish portal circulation. Therefore, to apply the term bilious 
to this temperament is not only unreasonable, but it is calcu- 
lated to mislead. The condition of the bowels is generally 
constipated, the skin dark and sometimes sallow. For these 
and other obvious reasons, we dismiss the word bilious, and 
substitute one which is more characteristic. 
We will not dwell upon the volitive as psychical organs, 
except to show that, when their influence is transmitted to the 
body, they act as physiological organs, and thus demonstrate 
that all parts of the brain have their physiological, as well as 
mental functions. When Andrew Jackson uttered with great 
emphasis the memorable words, " by the eternal," the effect 
was like a shock from a galvanic battery, thrilling the cells in 
his own body, and paralyzing with fear every one in Calhoun's 
organization. This is an illustration of the power or range of 
action of these faculties. Breadth or copiousness is illustrated 
in Gen. Grant's reply, "I propose to fight it out on this 
line, if it takes all summer." Such a temperament has a 
profusion of constitutional power, great durability of the life- 
force, and, in our opinion, the combined height and breadth of 
this region correctly indicate the natural hardihood of the body 
and its retentiveness of life. No one need doubt its influence 
upon the sympathetic system, and, through that system, its power 
over absorption, circulation, assimilation, and secretion, as well 
as the voluntary processes. Mental hardihood seems wrought 
into concrete organization. It checks excess of glandular 174 
COMMON SENSE MEDICAL ADVISEE. 
absorption, restrains the impulses of tumultuous passion, tones 
and regulates the action of the heart, and helps to weave 
the strands of organization into a more compact fabric. The 
Fig. 91. 
toning energies of the volitive faculties are better than quinine 
to fortify the system against miasma or malaria, and they 
co-operate with all tonic remedies in sustaining organic action. 
Fig. 91 is a portrait of Prof. Tyndall, the eminent chemist, THE HUMAN TEMPERAMENTS. 
175 
whose likeness indicates volitive innervation, showing great 
strength of charactei* and of constitution; he is an earnest, 
thorough, and intense mental toiler; ambitious, but modest; 
brilliant, because persevering; diligent in scientific inquiry, and 
who follows the star of truth, whithersoever it may lead him. 
The expression of his countenance indicates his honest intentions, 
and displays strength of conscientious purpose; his physical 
constitution may be correctly interpreted in all of its general 
characteristics by the analysis of his energetic temperament, 
the great secret of his strength and success. 
We desire to offer one more illustration of a marvelous 
blending of this temperament with large mental and emotional 
faculties. Fig. 92 is a representation 
of the martyred President Abraham 
Lincoln. During an eventful career, 
his temperament and constitution ex- 
perienced marked changes, and while 
always distinguished for strength of 
purpose and corresponding physical 
endurance, he was governed by noble, 
moral faculties, manifesting the deep- 
est sympathy for the down-trodden 
and oppressed, blending tenderness 
and stateliness without weakness, ex- 
hibiting a human kindness, and dis- 
playing a genuine compassion, which 
endeared him to all hearts. He was 
hopeful, patriotic, magnanimous 
even, while upholding the majesty of 'the law and administering 
the complicated affairs of government. The balances of his 
temperament operated with wonderful delicacy, through all 
the perturbating influences of the rebellion, showing by their 
persistence that he was never for a moment turned aside from 
the great end he had in view; the protection and perpetuation 
of republican liberty. His life exhibited a sublime, moral 
heroism, elements of character which hallow his name, and keep 
it in everlasting remembrance. 
We have treated the brain, not as a mass of organs radiating 
from the medulla oblongata as their real center, but as two 
Fig. 92. 176 
COMMON SENSE MEDICAL ADVISER. 
cerebral masses, each of which is developed around the great 
ventricle. We have freely applied an easy psychical and physio- 
logical nomenclature to the functions of its organs, knowing that 
there is no arbitrary division of them by specific number, for 
the cerebrum, in an anatomical sense, is a single organ. The 
doctrine of cerebral unity is true, and the doctrine of its plural- 
ity of function is true also. Whatever effect an organ produces 
when acting in entire predominance, is regarded as the function 
of that organ and is expressed by that name. Although our 
names and divisions are arbitrary and designed for convenience, 
yet they facilitate our consideration of the psychical, and their 
corresponding physiological functions. Every cerebral manifes- 
tation denotes a psychical organ, and in proportion as these acts 
are transmitted to the body it becomes a physiological organ. 
We have ventured to repeat this proposition for the sake of the 
non-professional reader, that he may be able to distinguish 
between the two results of the manifestation of one organ. 
The transmission of the influence of the brain into the body 
enables the former to act physiologically, whereas, if its action 
were confined within the cranium, it would only be psychical. 
In the language of Prof. J. R. Buchanan, " every organ, there- 
fore, has its mental and corporeal, its psychological and physio- 
logical functions - both usually manifested together - either 
capable of assuming the predominance.n We have already seen 
to what degree the Will operates upon the organism, or how 
" the soul imparts special energy to single organs, so that they 
perform their functions with more than usual efficiency," and 
thus resist the solicitations of morbific agents. Doubtless our 
best thoughts are deeply tinged by the healthful or diseased 
conditions of such organs as the stomach, the lungs, the heart, 
or even the muscular or circulatory systems, and these impres- 
sions, when carried to the sensorium, are reflected by the 
thoughts, for reflex action is the third class of functions, assigned 
to the cerebrum. These reflex actions are either hygienic and 
remedial, or morbid and pernicious. Hence, it is philosophical 
not only to interpret the thoughts as physiological and patholog- 
ical indications, but to consider the cerebrum as exerting real 
hygienic and remedial forces, capable of producing salutary 
reparative, and restorative effects. When a boiler carries more THE HUMAN TEMPERAMENTS. 
177 
steam than can be advantageously employed, it is subjected to 
unnecessary and injurious strain, and is weakened thereby; so, 
when the body is overtasked by excessive pressure of the volitive 
faculties, it is prematurely enfeebled and broken down. There 
are many individuals who need to make use of some sort of 
safety valve to let off the surplus of their inordinate ambition; 
they need some kind of patent brake to slacken their speed of 
living; they should relieve the friction of their functional pow- 
ers by a more frequent lubrication of the vital movements, and 
by stopping, for needed refreshment and rest, at some of the 
many way-stations of life. 
THE ENCEPHALIC TEMPERAMENT. 
The encephalic temperament is distinguished by prominence 
and breadth of the forehead, or by a full forehead associated 
with height and breadth at its coronal junction with the 
parietal bones, and extending toward the volitive region. (See 
Fig. 10, the space between 1 and 2 represents the coronal 
region, 1 indicating the frontal bone, and 2 the parietal). 
Prominence and great breadth of the forehead display ana- 
lytical, i. e., scientific powers applicable to concretes, whereas a 
fair intellect, associated with a preponderating development of 
the coronal region, indicates analogical powers, i. e., faculties 
to perceive the relation and the agreement of principles. The 
former classifies and arranges facts, the latter invests them 
with moral and spiritual import. The one treats of matter, its 
physical properties, and chemical composition, the other of 
thoughts and intentions which involve right and wrong, relating 
to spiritual accountability. The intellect is employed upon an 
observable order of things, while the emotive faculties arrange 
the general laws of being into abstract science. 
Fig. 93, a portrait of Prof. Tholuck, is a remarkable example 
of an encephalic organization. Figs. 72 and 79 fairly indicate 
the effects of undue mental activity, the intellect causing 
vital expenditure resulting in the devitalization of the blood. 
While the intellect displays keen penetration, subtle discrimina- 
tion, and profound discernment, the emotions exhibit intense 
sensitiveness, acute susceptibility, and inspirational impressibility. 178 
COMMON SENSE MEDICAL ADVISER. 
The encephalic temperament is characterized by mental ac- 
tivity, great delicacy of organization, a high and broad fore- 
head, expressive eyes, fine but not very abundant hair, great 
sensitiveness, refined feelings, vividness of conception, and 
intensity of emotion. If the brain is developed on the 
sides, there is manifested Ideality, Modesty, Hope, Sublimity, 
Imagination, and Spirituality. If the brain and forehead pro- 
ject, the Perceptive, Intuitive, and Reasoning faculties pre- 
dominate. If it rises high, and nearly perpendicularly, Liberal- 
ity, Sympathy, Truthfulness, and Sociability are manifested. 
Fig. 93. 
When the emotive faculties are large, Faith, Hope, Love, Philan- 
thropy, Religion, and Devotion characterize the individual. 
It is an artistic, creative, and sesthetic temperament, beautiful 
in conception and grand in expression, yet its sensitiveness is 
enfeebling, and its crowning excellence, when betrayed by 
the propensities, trails in defilement. Its purity is God-like, 
its debauchment, Perdition! 
Fig. 94 is the likeness of Prof. George Bush. His forehead 
is amply developed in the region of Foresight, Liberality, 
Sympathy, Truthfulness, and Benevolence; his mouth expresses 
Amiability and Cheerfulness, and the whole face beams with THE HUMAN TEMPERAMENTS. 
179 
Kindness and Generosity. This philanthropist, who is both 
a preacher and an author, has published several works upon 
Fig. 9If.. 
theology, which distinguish him for great research and origi- 
nality. 
Fig. 95 represents the sanguine-encephalic temperament, the 
two elements being most happily blended. The portrait is 
that of Emmanuel Swedenborg, the great scholar and spiritual 
divine. The reader will observe how high and symmetrical 
is the forehead, and how well balanced appears the entire 
organization. He was remarkable for vivid imagination, great 
scientific acquirements, and all his writings characterize him 
as a subtle reasoner. 
When the encephalic predominates, and the sanguine is 
deficient in its elements, we find conditions favorable to 
waste and expenditure, and adverse to a generous supply and 
reformation of the tissues. A child inheriting this cerebral 
development is already top-heavy, and supports, at an im- 
mense disadvantage, this disproportionate organization. The 
nutritive functions are overbalanced; consequently there is a 180 
COMMON SENSE. MEDICAL ADVISER. 
predisposition to scrofulous diseases and disorders of the blood, 
various degenerating changes taking place in its composition; 
loss of red corpuscles, signified by shortness of breath; morbid 
changes, manifested by cutaneous eruptions; exhaustion from 
lack of nourishment, etc., until, finally, consumption finishes 
the subject. 
Harmony is the support of all institutions, and applies with 
Fig. 95. 
special cogency to the maintenance of health. When the 
mind dwells on one subject to the exclusion of all others, 
we call such a condition monomania. If we have an excessive 
development of mind, and deficient support of body, the 
result is corporeal derangement. It is unfortunate for any 
child to inherit unusually large brain endowments, unless he 
is possessed of a vigorous, robust constitution. Such training TRANSMISSION OF LIFE. 
181 
should be directed to that body as will encourage it to grow 
strong, hearty, and thrifty, and enable it to support the cerebral 
functions. The mental proclivities should be checked and the 
physical organization cultivated, to insure to such a child good 
health. Cut off all unneccessary brain-wastes, attend to muscu- 
lar training and such invigorating games and exercises as 
encourage the circulation of the blood; keep the skin clean 
and its functions active, the body warm and well protected, the 
lungs supplied with pure air, the stomach furnished with whole- 
some food, besides have the child take plenty of sleep to in- 
vigorate the system, and thus, by regular habits, maintain that 
equilibrium which tends to wholesome efficiency and healthful 
endurance. 
TRANSMISSION OF LIFE. 
As has been already stated in the chapter on Biology, repro- 
duction of the species depends upon the union of a sperm-cell 
with a germ-cell, the male furnishing the former and the female 
the latter. It is a well-known fact that the marriage of persons 
having dissimilar temperaments is more likely to be fertile 
than the union of persons of the same temperaments; consan- 
guineous marriages, or the union of persons nearly related by 
blood, diminish fertility and the vigor of the offspring. Upon 
this subject Francis Galton has given some very interesting 
historical illustrations in his well-known work, entitled " He- 
reditary Genius." The half-brother of Alexander the Great, 
Ptolemy I, King of Egypt, had twelve descendants, who suc- 
cessively became kings of that country, and who were also 
called Ptolemy. They were matched in and in, but in nearly 
every case these near marriages were unprolific and the inheri- 
tance generally passed through other wives. Ptolemy II 
married his niece, and afterwards his sister; Ptolemy IV 
married his sister. Ptolemy VI and VII were brothers, and 
they both consecutively married the same sister; Ptolemy VII 
also subsequently married his niece; Ptolemy VIII married two 
of his sisters in succession. Ptolemy XII and XIII were 
brothers, and both consecutively married their sister, Cleopatra. 
Mr. Galton and Sir Jas. Y. Simpson have shown that many 
peerages have become extinct through the evil results of inter- 
marriage. Heiresses are usually only children, the feeble product 182 
COMMON SENSE MEDICAL ADVISER. 
of a run-out stock, and statistics have shown that one-fifth 
of them bear no children, and fully one-third never bear more 
than one child. Sir J. Y. Simpson ascertained that out of 495 
marriages in the British Peerage, 81 were unfruitful, or nearly 
one in every six; while out of 675 marriages among an agricul- 
tural and seafaring population, only 65 were sterile or barren, 
or a little less than one in ten. 
While the marriages of persons closely related, or of similar 
temperaments are frequently unfruitful, we would not have 
the reader understand that sterility, or barrenness, is usually 
the result of such unions. It is most frequently due to some 
deformity or diseased condition of the generative organs of 
the female. In the latter part of this work may be found a 
minute description of the conditions which cause barrenness, 
together with the methods of treatment, which have proved 
most effectual in the extensive practice at the Invalids' Hotel 
and Surgical Institute. 
The temperaments may be compared to a magnet, the like 
poles of which repel, and the unlike poles of which attract each 
other. Thus similarity of temperament results in barrenness 
while dissimilarity makes the vital magnetism all the more pow- 
erful. Marriageable persons moved by some unknown influence, 
have been drawn instinctively toward each other, have taken 
upon themselves the vows and obligations of wedlock, and have 
been fruitful and happy in this relation. Alliances founded 
upon position, money, or purely arbitrary considerations, mere 
contracts of convenience, are very apt to prove unhappy and 
unproductive. 
Men may unconsciously obey strong instinctive impulses with- 
out being conscious of their existence, and by doing so, avoid 
those ills, which otherwise might destroy their connubial happi- 
ness. The philosophy of marriage receives no consideration, 
because the mind is pre-occupied with newly awakened thoughts 
and feelings. Lovers are charmed by certain harmonies, feel 
interior persuasions, respond to a new magnetic influence and are 
lost in an excess of rapture. 
If the parties to a marriage are evenly balanced in organic 
elements, although both of them are vigorous, yet it is physio- 
logically more suitable for them to form a nuptial alliance with TRANSMISSION OF LIFE. 
183 
an unlike combination. The cause of the wretchedness attending 
many marriages may be traced to a too great similarity of 
organization, ideas, taste, education, pursuits, and association, 
which similarity almost invariably terminates in domestic unhap- 
piness. The husband and wife should be as different as the 
positive and negative poles of a magnet. When life is begotten 
under these circumstances we may expect a development bright 
with intelligence. CHAPTER XVI. 
MAL Lt I AG E. 
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 germi- 
nal essence of the human spirit, is the rudimental element of 
the human soul. It is, therefore, a Divine gift, a blessing 
which the Creator did not withdraw from his erring children, 
when they were driven from a paradise of innocence and loveli- 
ness into a world of desolation and strife. He left it as an 
invisible cord by which to draw the human heart ever upward, 
to a brighter home-the heavenly Eden. Love is the very 
essence of Divine law, the source of inspiration, even the 
fountain of life itself. It is spontaneous, generous, infinite. 
To its presence we are indebted for all that is good, true, and 
beautiful in Art and Nature. It endows humanity with count- 
less virtues, and throws a mystic veil over our many faults. 
It is this feeling, this immutable law, which controls the destiny 
of the race. From its influence empires have fallen, scepters 
have been lost. Literature owes to Love its choicest gems. 
184 LOVE. 
185 
The poet's lay is sweeter when Cupid tunes the lyre. The 
artist's brush is truer when guided by Love. Greece was the 
cradle of letters and art. Her daughters were queens of 
beauty, fitted to inspire the Love of her noblest sons. 
The materialism of the nineteenth century has sought to 
degrade Love; to define it as purely physical. The result has 
been a corresponding degradation of art, and even literature 
has lost much of its lofty idealism. Nudity has become a 
synonym of vulgarity; Love, of lust. "Evil 
be to him who evil thinks." True Love 
never seeks to degrade its object; on the 
contrary, it magnifies every virtue, endows 
it with divinest attributes, and guards its 
chastity, or honor, at the sacrifice of its own 
life. It increases benevolence by opening 
the lover's heart to the wants of suffering 
humanity. Ideality is the canvas, and imagi- 
nation the brush with which Love delineates 
the beauties of the adored. Love heightens 
spirituality, awakens hope, strengthens faith, 
and enhances devotion. It quickens the per- 
ceptions, intensifies the sensibilities, and re- 
doubles the memory. It augments muscular 
activity, and imparts grace to every move- 
ment. The desire to love and to be loved 
is innate, and forms as much a part of our 
being as bone or reason. In fact, Love may 
be considered as the very foundation of our 
spiritual existence, as bone and reason are 
the essential bases of our physical and in- 
tellectual being. Every man or woman feels the influence of 
this emotion, sooner or later. It is the Kadesh-barnea of human 
existence; obedience to its intuitions insures the richest bless- 
ings of life, while neglect or perversion enkindles God's wrath, 
even as did the disobedience of the wandering Israelites. 
The one great fact which pervades the universe is action. 
The very existence of Love demands its activity, and, hence, 
the highest happiness is attained by a normal and legitimate 
development of this element of our being. The heart demands 
Fig. 96. 186 
COMMON SENSE MEDICAL ADVISER. 
an object upon which to lavish the largess of its affection. In 
the absence of all others, a star, a flower, or even a bird, will 
receive this homage. -The bird warbles a gay answer to the 
well-known voice, the flower repays the careful cultivator by 
displaying its richest tints, the star twinkles a bright "good 
evening " to the lonely watcher, and yet withal there is an 
unsatisfied longing in the lover's heart, to which neither can 
respond; the desire to be loved! Hence, the perfect peace of 
reciprocated love. If its laws are violated, nature seeks 
revenge in the utter depression or prostration of the vital 
energies. Thus has the Divine Law-giver engraven His com- 
mand on our very being. To love is, therefore, a duty, the 
fulfillment of which should engage our noblest powers. 
This emotion manifests itself in several phases, prominent 
among which is filial affection, the natural harmonizer of society. 
Paternal love includes a new element-protection. Greater than 
either, and second only in fortitude to maternal affection, is 
CONJUGAL LOVE. 
" He is blest in Love alone 
Who loves for years and loves but one."-Hunt. 
With Swedenborg, we may assert, "that there is given love 
truly conjugal, which at this day is so rare, that it is not known 
what it is, and scarce that it is." The same author has defined 
this relation to be a union of Love and Wisdom. The funda- 
mental law of conjugal love is fidelity to one love. God created 
but one Eve, and the essential elements of paternal and ma- 
ternal love pre-suppose and necessitate, for their normal de- 
velopment, the Love of one only. Again, Love is the sun of 
woman's existence. Only under its influence does she unfold 
the noblest powers of her being. Woman's intuitions should 
therefore be taken as the true love-gauge. If she desire a 
plurality of loves, it must be a law of her nature; but is 
communism the desire of our wives and daughters? No! 
Every act which renders woman dear to us, denounces such 
an idea and reveals the exclusive sacredness of her Love. As 
condemning promiscuity in this relation, we may cite the lovers' 
pledges and oaths of fidelity, the self-perpetuity of Love itself, CONJUGAL LOVE. 
187 
the common instincts of mankind, as embodied in public senti- 
ment, and the inherent consciousness that first love should be 
kept inviolable forever. Again, Love is conservative. It clings 
tenaciously to all the memories connected with its first object. 
The scenes consecrated to " Love's young dream " are sacred to 
every heart. The woodland with its winding paths and arbors, 
the streamlet bordered with drooping violets and dreamy 
pimpernel, the clouds, and even "the very tones in which we 
spoke," are indelibly imprinted on the memory. There is also 
the "mine and thine" intuition of love. This sentiment is 
displayed in every thought and act of the lover. Every 
pleasure is insipid unless shared by the beloved; selfish and 
exacting to all others, yet always generous and forgiving to the 
adored. "Mine and thine, dearest," is the language of Con- 
jugal Love. 
The consummation desired by all who experience this affec- 
tion, is the union of souls in a true marriage. Whatever of 
beauty or romance there may be in the lover's dream, is 
enhanced and spiritualized in the intimate communion of mar- 
ried life. The crown of wifehood and maternity is purer, more 
divine, than that of the maiden. Passion is lost; the emotions 
predominate. 
The connubial relation is not an institution; it was born 
of the necessities and desires of our nature. "It is not good 
for man to be alone," was the Divine judgment, and so God 
created for him "an helpmate." Again, "Male and female 
created He them;" therefore, sex is as divine as the soul. It 
is often perverted, but so is reason, aye, so is devotion. 
The consummation of marriage involves the mightiest issues 
of life. It may be the source of infinite happiness or the seal 
of a living death. "Love is blind" is an old saying, verified 
by thousands of ill-assorted unions. Many unhappy marriages 
are traceable to one or both of two sources; Physical Weak- 
nesses and Masquerading. Many are the candidates for mar- 
riage who are rendered unfit therefor from weaknesses of their 
sexual systems, induced by the violation of well-established 
physical laws. 
We cannot too strongly urge upon parents and guardians the 
imperative duty of teaching those youths who look to them for 188 
COMMON SENSE MEDICAL ADVISER. 
instruction, in all matters which pertain to their future well-being 
such lessons as are embraced in the chapter of this book entitled, 
"Hygiene of the Reproductive Organs." By attending to such 
lessons as will give the child a knowledge of the physiology and 
hygiene of his whole system, the errors into which so many of 
the young fall, and much of the misery which is so often the 
dregs of the hymeneal cup, will be avoided. 
Masquerading is a modern accomplishment. Girls wear tight 
shoes, burdensome skirts, and corsets, all of which prove very 
injurious to their health. At the age of seventeen or eighteen, 
our young ladies are sorry specimens of womankind, and " pal- 
pitators," cosmetics, and all the modern paraphernalia of fashion 
are required to make them appear fresh and blooming. Man is 
equally to blame. A devotee to all the absurd devices of fashion, 
he practically asserts that " dress makes the man." But physi- 
cal deformities are of far less importance than moral imperfec- 
tions. Frankness is indispensable in love. Each should know 
the other's faults and virtues. Marriage will certainly disclose 
them; the idol falls and the deceived lover is transformed into 
a cold, unloving husband or wife. By far the greater number 
of unhappy marriages are attributable to this cause. In love 
especially, honesty is policy and truth will triumph. 
HISTORY OF MARRIAGE. 
Polygamy and Monogamy. We propose to give only 
a brief dissertation on the principles and arguments of these 
systems, with special reference to their representatives in the 
nineteenth century. Polygamy has existed in all ages. It is, 
and always has been, the result of moral degradation or wan- 
tonness. The Garden of Eden was no harem. Primeval nature 
knew no community of love. There was only the union of two 
" and the twain were made one flesh." Time passed; "the sons 
of God saw the daughters of men that they were fair; and they 
took them wives of all which they chose." The propensities of 
men were in the ascendant, and " God repented Him that He had 
created man." He directed Noah to take into the ark, two of 
every sort, male and female. But " the imagination of man's 
heart is evil from his youth," and tradition points to Polygamy 
as the generally recognized form of marriage among the ancients. HISTORY OF MARRIAGE. 
189 
The father of the Hebrew nation was unquestionably a polyga- 
mist, and the general history of patriarchal life shows that a 
plurality of wives and concubines were national customs. In the 
earlier part of Egyptian history, Menes is said to have founded 
a system of marriage, ostensibly monogamous, but in reality it 
was polygamous, because it allowed concubinage. As civiliza- 
tion advanced, the latter became unpopular, and "although 
lawful, was uncommon," while polygamy was expressly forbid- 
den. Solomon, according to polygamous principles, with his 
thousand women, should have enjoyed a most felicitous condi- 
tion. Strange that he exclaimed " A woman among all these 
have I not found." According to the distinguished Rabbi, 
Maimonides, polygamy was a Jewish custom as late as the 
thirteenth century. When Cecrops the Egyptian King, came to 
Athens (1550, B. C.) he introduced a new system, which proved 
to be another step toward the recognition of Monogamy. 
Under this code a man was permitted to have one wife and a 
concubine. Here dawned the era of Grecian civilization, the 
glory of which was reflected in the social and political principles 
of Western Europe. During the fourth and fifth centuries 
B. C., concubinage disappeared, but, under the new regime, the 
condition of the wife was degraded. She was regarded as 
simply an instrument of procreation and a mistress of the 
household, while a class of foreign women, who devoted them- 
selves to learning and the fine arts, were the admired, and often 
the beloved companions of the husbands. These were the 
courtesans who played the same r61e in Athenian history, as did 
the chaste matron, in the annals of Rome. When Greece became 
subject to Rome and the national characteristics of these 
nations were blended, marriage became a loose form of monog- 
amy. In Persia, during the reign of Cyrus, about 560 B. C., 
polygamy was sustained by custom, law, and religion. The 
Chinese marriage system' was, and is, practically polygamous, 
for, from their earliest traditions, we learn that although a man 
could have but one wife, he was permitted to have as many 
concubines as he desired. 
In the Christian era, the first religious system which incorpo- 
rated polygamy as a principle was Mohammedanism. This 
system, which is so admirably adapted to the voluptuous 190 
COMMON SENSE MEDICAL ADVISEE. 
character of the Orientals, has penetrated Western Europe, Asia, 
and Africa. Hayward estimated the number of its adherents to 
be one hundred and forty millions. The heaven of the Moham- 
medan is replete with all the luxuries which appeal to the animal 
propensities. Ravishing Houris attend the faithful, who recline 
on downy couches, in pavilions of pearl. On the Western Con- 
tinent a system of promiscuity was practiced by the Mexi- 
cans, Peruvians, Brazilians, and the barbarous tribes of North 
America. 
The Mormon Church was founded by Joseph Smith, and 
professes to be in harmony with the Bible and a special revela- 
tion to its leading Saint. According to the Mormon code, 
"Love is a yearning for a higher state of existence, and the 
passions, properly understood, are feeders of the spiritual life;" 
and again, "nature is dual; to complete his organization a man 
must marry." The leading error of Mormonism is that it mis- 
takes a legal permission for a Divine command. The Mormon 
logic may be premised as follows: the Mosaic law allowed 
polygamy; the Bible records it; therefore, the Bible teaches 
polygamy. 
A Mormon Saint can have not less than three wives but as 
many more as he can conveniently support. The eight funda- 
mental doctrines of the Mormon Church are stated as follows: 
1. God is a person with the flesh and form of a man. 2. Man 
is a part of the substance of God and will himself become a 
god. 3. Man is not created by God but existed from all 
eternity. 4. Man is not born in sin, and is not accountable 
for offenses other than his own. 5. The earth is a colony of 
embodied spirits, one of many such settlements in space. 
6. God is president of the immortals, having under Him four 
orders of beings: (1.) Gods-i. e., immortal beings, possessed 
of a perfect organization of soul and body, being the final state 
of men who have lived on earth in perfect obedience to the law. 
(2.) Angels, immortal beings who have lived on earth in 
imperfect obedience to the law. (3.) Men, immortal beings in 
whom a living soul is united with a human body. (4.) Spirits, 
immortal beings, still waiting to receive their tabernacle of flesh. 
fl. Man, being one of the race of gods, became eligible, by 
means of marriage, for a celestial throne, and his household of HISTORY OF MARRIAGE. 
191 
wives and children are his kingdom, not only on earth but in 
heaven. 8. The kingdom of God has been again founded on 
earth, and the time has now come for the saints to take posses- 
sion of their own; but by virtue, not by violence; by industry, 
not by force. This sect has met with stern and bitter opposi- 
tion. It was successively located in New York, Ohio, Missouri, 
and Illinois, from the last of which it was expelled by force of 
arms, and in 1848 established in Utah. Its adherents number, 
at the present time, more than two hundred thousand. 
Another organization, differing from the Mormons, in many of 
its radical principles, is that of the " Communists," popularly 
termed "Free Lovers." It is located at Lennox, Madison Co., 
N. Y. Its members advocate a system of " complex marriage " 
which they claim is instituted with a conscientious regard for 
the welfare of posterity. They disclaim "promiscuity," and 
assert that the tie which binds them together is as permanent 
and as sacred as that of marriage. Community of property is 
commensurate with freedom of Love. They define love to be 
" social appreciation," and this element in their code of civiliza- 
tion, which they deem Superior to all others, is secondary to 
" bodily support." The principles upon which their social status 
is founded may be briefly summarized as follows: "Man offers 
woman support and love (unconditional). Woman enjoying 
freedom, self-respect, health, personal and mental competency, 
gives herself to man in the boundless sincerity of an unselfish 
union. State-, Communism." In this, as in all forms of polyg- 
amous marriages, love is made synonymous with sexuality, 
and its purely spiritual element is lost. In every instance this 
spiritual element should constitute the basis of marriage, which, 
without it, is nothing more than legal prostitution. Without it, 
the selfish, degrading, animal propensities run rampant, while 
the emotions with all their boundless sweetness lie dormant. 
Woman is regarded as only a plaything to gratify the animal 
caprice. 
That Monogamy is a law of nature is evident from the fact 
that it fulfills the three essential conditions which form the basis 
of true marriage: (1.) The development of the individual. 
(2.) The welfare of society. (3.) The reproduction of the 
species. 192 
COMMON SENSE MEDICAL ADVISER. 
THE DEVELOPMENT OF THE INDIVIDUAL. 
Physically. Reciprocated love produces a general exhila- 
ration of the system. The elasticity of the muscles is increased, 
the circulation is quickened, and every bodily function is stimu- 
lated. The duties of life are performed with a zest and alacrity 
never before experienced. " It is not possible for human beings 
to attain their full stature of humanity, except by loving long 
and perfectly. Behold that venerable man ! He is mature in 
judgment, perfect in every action and expression, and saintly 
in goodness. You almost worship as you behold. What ren- 
dered him thus perfect? What rounded off his natural as- 
perities, and moulded up his virtues? Love mainly. It per- 
meated every pore, so to speak, and seasoned every fiber of his 
being, as could nothing else. Mark that matronly woman. In 
the bosom of her family, she is more than a queen and goddess 
combined. All her looks and actions express the outflowing 
of some or all of the human virtues. To know her is to love 
her. She became thus perfect, not in a day or a year, but by 
a long series of appropriate efforts. , Then by what ? Chiefly 
in and by love, which is specifically adapted thus to develope 
this maturity." But all this occurs only when there is a normal 
exercise of the sexual propensities. Excessive indulgence in 
marital pleasures deadens all the higher faculties, love included, 
and results in an utter prostration of the bodily powers. The 
Creator has endowed man and woman with passions, the sup- 
pression of which leads to pain, their gratification to pleasure, 
their satiety to disgust. Excessive marital indulgence produces 
abnormal conditions of the generative organs and not unfre- 
quently leads to incurable disease. Many cases of uterine dis- 
ease are traceable to this cause. 
Morally and Intellectually. In no country where the 
polygamous system prevails do we find a code of political and 
social ethics which recognizes the rights and claims of the 
individual. The condition of woman is that of the basest slave, 
a slave to the caprice and tyranny of her master. Communism 
raises her from the slough of slavery, but subjects her to the 
level of prostitution. An inevitable sequence of polygamy is 
a decline of literature and science. The natural tendency of THE WELFARE OF SOCIETY. 
193 
each system is to sensualism. The blood is diverted from its 
normal channels and the result is a condition which may be 
appropriately termed mental starvation. Sensualism is in its 
very nature directly opposed to literary attainments or ad- 
vancement. Happily there is a golden mean, an equalization of 
those elements which constitutes the acme of individual en- 
joyment. 
THE WELFARE OF SOCIETY. 
The general law of ethics, that " whatever is beneficial to the 
individual, contributed to the highest good of society and vice 
versa," applies with equal force to the hygienic conditions of 
marriage. Each family, like the ancient Roman household, is 
the prototype of the natural government under which it lives. 
Wherever the marriage relation is regarded as sacred, there 
you will find men of pure hearts and noble lives. Of all 
foreign nations the Germans are celebrated for their sacred 
regard of woman, and the duties of marriage, and all scholars 
from the age of Tacitus to the present day, have concurred in 
attributing the elevation of woman to the pure-minded Teutons. 
In America, the law recognizes only Monogamy; but domestic 
unhappiness is a prominent feature of our national life; there- 
fore, argues the would-be free-lover, monogamy does not accord 
with the best interests of mankind. The fallacy lies in the 
first premise. Legally, our marriage system is monogamous but 
socially and practically it is not! Prostitution is the source 
of this domestic infelicity. The "mistress" sips the sweet 
nectar that is denied to the deceived wife. Legislators have 
battled with intemperance, but have done comparatively little 
to banish from our midst this necessary (?) evil. They recoil 
with disgust from this abyss of iniquity and disease. Within it 
is coiled a hydra-headed monster, which invades our hearth- 
stones, contaminates our social atmosphere, and whose very 
breath is laden with poisonous vapors, the inexhaustible source 
of all evil. 
The perverted appetites of mankind are mistaken for the 
natural desires and necessities of our being; and, accordingly, 
various arguments have been advanced to prove that monogamy 
is not conducive to social developement. It is curious that no 
one of these arguments refers to the health and well-being of 194 
COMMON SENSE MEDICAL ADVISER. 
the individual, thus overlooking, perhaps willfully, the great 
law of social economy. Even a few medical writers sometimes 
advocate the principles of this so-called liberalism. In a re- 
cently published work, there are enumerated only two demerits 
of polygamy and six of monogamy. These six demerits which 
the author is pleased to term a " bombshell," he introduces on 
account of his moral convictions no less than humanitarian 
considerations. The same author terms monogamy a "worm- 
eaten and rotten-rooted tree." The worm that is devastating 
the fairest tree of Eden and draining its richest juices is 
what our contemporary thinks, may be 11 plausibly termed, a 
necessary evil." It is claimed that monogamy begets narrow 
sympathies and leads to selfish idolatry. The fallacy of this 
argument lies in the misapprehension of the term selfishness. 
Self-preservation is literally selfishness, yet who will deny that 
it is a paramount duty of man. If perverted, it may be 
vicious, even criminal; but selfishness, in so far as it is generated 
by monogamy, is one of the chief elements of social economy; 
furthermore, it favors the observance of the laws of sexual 
hygiene. As we have said elsewhere, true love increases 
benevolence, and correspondingly expands and develops the 
sympathies. Selfish idolatry is preferable to social neglect. 
This argument will not bear a critical examination; for it is 
asserted that in a happy union, "love is so exclusive that there 
is hardly a liking for good neighbors, and scarcely any love 
at all for God." If the " good neighbors " were equally blessed, 
they would not suffer from this exclusiveness, and it is prac- 
tically true that there is no higher incentive to love and obey 
our Maker than the blessing of a happy marriage. 
THE PERPETUATION OF THE SPECIES. 
The third essential object of marriage is the perpetuation 
of the species. The desire for offspring is innate in the heart 
of every true man or woman. It is thus a law of our nature, 
and, as such, must have its legitimate sphere. The essential 
features of reproduction proclaim monogamy to be the true 
method of procreation. Promiscuity would render the mother 
unable to designate the father of her children. Among lower 
animals, pairing is an instinctive law whenever the female U THE PERPETUATION OF THE SPECIES. 
195 
incapable of protecting and nourishing her offspring alone. 
During at least fifteen years, the child is dependent for food 
and clothing upon its parents, to say nothing of the requisite 
moral training and loving sympathy, which, in a great measure, 
mould its character. Fidelity to one promotes multiplication. 
It has been argued by the advocates of polygamy that such 
a system interferes with woman's natural right to maternity. 
Of the many marriages celebrated yearly, comparatively few 
are sterile. The statement that many single women are de- 
sirous of having children, would apply only to a very limited 
number, as it is seldom that they would be able to support 
children without the aid and assistance of a father. Pro- 
miscuity diminishes the number and vitiates the quality of the 
human products. "Women of pleasure never give to the 
world sons of genius, or daughters of moral purity." CHAPTER XVII. 
REPRODUCTION. 
Every individual derives existence from a parent, which word 
literally means one who brings forth. We restrict the meaning 
of the term reproduction, ordinarily, to that function by which 
living bodies produce other living bodies similar to themselves. 
Production means to bring forth; reproduction, the producing 
again, or renewing. To protract individual existence, nutrition 
is necessary, because all vital changes are attended by wear 
and waste. Nutrition is always engaged in the work of repar- 
ation. Every organism that starts out upon its career of de- 
velopment depends upon nourishing materials for its growth, 
and upon this renewing process for its development. Nutri- 
tion is all the while necessary to prolong the life of the indi- 
vidual, but at length its vigor wanes, its functions languish, 
and, finally, the light of earthly life goes out. Although the 
single organization decays and passes away, nevertheless the 
species is uninterruptedly continued; the tidal wave of life 
surges higher on the shores of time, for reproduction is as 
constant and stable as the attractive forces of the planetary 
system. 
It is a fact, that many species of the lower order of animals 
which once existed are now extinct. It has been asserted and 
denied, that fossil remains of man have been found, indicating 
that races which once existed have disappeared from the face 
of the earth. The pyramids are unfolding a wonderful history, 
embracing a period of forty-five hundred years, which the 
world of science receives as literally authentic, and admits, 
also, that fifty-four hundred years are probably as correctly 
196 REPRODUCTION. 
197 
accounted for. The extinction of races is not at all improbable. 
At the present time, the aboriginal inhabitants of this continent 
seem to be surely undergoing gradual extinguishment! It, 
therefore, seems to be possible for a weaker race to deteriorate, 
and finally become extinct, unless the causes of their decadence 
can be discovered and remedied. All people are admonished to 
earnestly investigate the essential conditions necessary for their 
continuance, for the rise and fall of nations is in obedience to 
natural principles and operations. Viewed from this standpoint, 
it is possible that a careful study of the human temperaments 
and their relations to reproduction may be of greater moment 
than has hitherto been supposed, and a proper understanding 
of them may tend to avert that individual deterioration, which, 
if suffered to become general, would end in national disaster 
and the extinction of the race. 
Until recently, even naturalists believed that descendants were 
strictly like their parents in form and structure. Now it is 
known that the progeny may differ in both form and structure 
from the parent, and that these may produce others still more 
unlike their ancestry. But all these peculiar and incidental 
deviations finally return to the original form, showing that 
these changes have definite limits, and that the alterations 
observe a specific variableness, which is finally completed by its 
assuming again the original form. (See page 16, Figs. 2 and 3). 
lieproduction may be sexual or non-sexual. In some plants 
and animals it is non-sexual. The propagation of species is 
accomplished by buds. Thus the gardener grafts a new variety 
of fruit upon an old stock. The florist understands how to 
produce new varieties of flowers, and make them radiantly 
beautiful in their bright and glowing colors. The bud person- 
ates the species and produces after its kind. Some of the 
annelldes, a division of articulate animals, characterized by an 
elongated body, formed of numerous rings or annular seg- 
ments, multiply by spontaneous division. A new head is 
formed at intervals in certain segments of the body. (See 
Fig. 97). 
Something similar to this process of budding, we find taking 
place in a low order of animal organization. Divide the fresh 
water polyp into several 'pieces, and each one will grow into 198 
COMMON SENSE MEDICAL ADVISER. 
an entire animal. Each piece represents a polyp, and so each 
parent polyp is really a compound animal, an organized com- 
munity of beings. Just as the buds of a tree, when separated 
and engrafted upon another tree, grow again, each preserving 
its original identity, so do the several parts of this animal, 
when divided, become individual polyps, capable of similar re- 
production. 
The revolving volvox likewise increases by growth until it 
becomes a society of animals, a multiple system of individuals. 
There are apertures from the parent, by which water gains 
a free access to the interior of the whole miniature series. 
This monad was once supposed to be a single animal, but the 
microscope shows it to be a group of animals connected by 
Fig. 97. 
An annelid dividing spontaneously, a new head having been formed toward the 
hinder part of the body of the parent. 
means of six processes, and each little growing volvox exhibits 
his red-eye speck and two long spines, or horns. These animals 
also multiply by dividing, and thus liberate another series, which, 
in their turn, reproduce other groups. 
Generation requires the concurrence of stimuli and suscepti- 
bility, and, to perfect the process, two conditions are also 
necessary. The first is the sperm, which communicates the 
principle of action; the other is the germ, which receives the 
latent life and provides the conditions necessary to organic 
evolution. The vivifying function belongs to the male, that 
of nourishing and cherishing is possessed by the female; and 
these conditions are sexual distinctions. The former represents 
will and understanding ; the latter, vitality and emotion. The 
father directs and controls, the mother fosters and encourages; HERMAPHRODITIC REPRODUCTION. 
199 
the former counsels and admonishes, the latter persuades and 
caresses; and their union in holy matrimony represents one; 
that is, the blending of vitality and energy, of love and wisdom, 
-the elements indispensable to the initiation of life under 
the dual conditions of male and female,-one in the functions 
of reproduction. 
Let us consider the modes of Sexual Reproduction, which 
are hermaphroditic and dioecious. 
HERMAPHRODITIC REPRODUCTION. 
We have said that two kinds of cells represent reproduction, 
namely, sperm and germ-cells. These may be furnished by 
different individuals, or both may be found in one. When 
both are found in the same individual, the parent is said to be a 
natural hermaphrodite. A perfect hermaphrodite possesses the 
attributes of both male and female-uniting both sexes in 
one individual. Natural hermaphroditic reproduction occurs 
only among inferior classes of animals, and naturalists inform 
us that there are a greater number of these than of the more 
perfect varieties. These are found low in the scale of animal 
organization, and one individual is able to propagate the species. 
In the oyster and ascidians no organs can be detected in the 
male, but in the female they are developed. Polyps, sponges, 
and cystic entozoa, may also be included among hermaphrodites. 
It is only very low organisms indeed in which it is a matter 
of indifference whether the united sperm-cells and germ-cells 
are those of the same individual, or those of different indi- 
viduals. In more elaborate structures and highly organized 
beings, the essential thing in fertilization is the union of these 
cells specially endowed by different bodies, the unlikeness of 
derivation in these united reproductive centers being the desid- 
eratum for perpetuating life and power. 
In other classes, as entozoa, there appear to be special pro- 
visions whereby the sperm-cells and germ-cells may be united; 
i. e., the male organs are developed and so disposed as to 
fecundate the ova of the same individual. Sexual and non- 
sexual modes of reproduction are illustrated by that well- 
defined group of marine invertebrate animals, called cirripedia. 
Fig. 98 represents one of this genus. 200 
COMMON SENSE MEDICAL ADVISER. 
Some of these are not only capable of self-impregnation, but 
likewise have what are called complemental males attached to 
some of the hermaphrodites. In the whole 
animal kingdom, it may be doubted if 
there exists another such class of rudi- 
mentary creatures as the parasitic males, 
who possess neither mouth, stomach, 
thorax, nor abdomen. After exerting a 
peculiar sexual influence, they soon die 
and drop off; so that in this class of ani- 
mals may be found the sexual distinctions 
of male, female, and perfect hermaphro- 
dites. 
There is a class of wheel-animalcules termed rotifera, of 
which the revolving volvox is one example. They have ac- 
quired this name on account of the apparent rotation of the 
disc-like organs which surround 
their mouths and are covered with 
cilia., or little hairs. They are 
minute creatures, and can best be 
viewed with a microscope, although 
the larger forms may be seen with- 
out such assistance. They are 
widely diffused on the surface of 
the earth, inhabit lakes as well as 
the ocean, and are found in cold, 
temperate, and tropical climates. 
The rotifera were once supposed 
to be hermaphrodites, but the ex- 
istence of sexes in one species has 
been clearly established. The male, 
however, is much smaller, and far 
less developed than the female. In 
some of these species, germ-cells, 
or eggs, are found, which do not 
require fecundation for reproduc- 
tion or development, so that they belong to the non-sexual class. 
The third variety of hermaphrodites embraces those animals 
in which the male organs are so disposed as not to fecundate 
Fig. 98. 
Pollieipes Mitella. 
Fig. 99. 
Rotifera; Brachionus Urceolaris; 
largely magnified. HERMAPHRODITIC REPRODUCTION. 
201 
the ova of the same body, but require the co-operation of two 
individuals, notwithstanding the co-existence in each of the 
organs of both sexes. Each in turn impregnates the other. 
The common leech, earth-worm, and snail, propagate in this 
manner. 
Unnatural hermaphrodism is characteristic of insects and 
crustaceans, in which the whole body indicates a neutral char- 
acter, tending to exhibit the peculiarities of male or female, in 
proportion to the kind of sexual organs which predominates. 
Half of the body may be occupied by male, the other half by 
female organs, and each half reflects its peculiar sexual charac- 
teristics. Some butterflies are dimidiate hermaphrodites; i. e., 
one side of the body has the form and color of the male, the 
other the form and color of the female. The wings show by 
their color and appearance these sexual distinctions. The stag- 
beetle is also an example. We have accounts of dimidiate 
hermaphrodite lobsters, male in one half and female in the 
other half of the body. 
Among the numerous classes of higher animals, which have 
red blood, we have heard of no well-authenticated instance of 
hermaphrodism, or the complete union of all the reproductive 
organs in one individual. True, the term hermaphrodite is 
often applied to certain persons in whom there is some malform- 
ation, deficiency, or excess, of the genital organs. These con- 
genital deformities consisting of combined increase or defic- 
iency, supernumerary organs, or transposition of them, which 
usually render generation physically impossible, have been 
called bisexual hermaphrodism and classed as monstrosities. 
We have many published accounts of them, hence, further 
reference to them here is unnecessary. We would especially 
refer those readers who may desire to make themselves further 
acquainted with this interesting subject, to the standard physio- 
logical works of Flint, Foster, Carpenter, Bennett, Dalton, and 
others equally eminent in this particular branch of science. 
Certain theories have been advanced concerning conditions 
which may influence the sex of the offspring. One is that the 
right ovary furnishes the germs for males, the left for females; 
that the right testicle furnishes sperm capable of fecundating 
the germs of males, and the left testicle, the germs of the left 202 
COMMON SENSE MEDICAL ADVISER. 
ovary, for females. That fecundation sometimes takes place 
from right to left and thus produces these abnormal variations. 
We merely state the hypothesis, but do not regard it as account- 
ing for the distinction of sex, or as causing monstrosities, 
though it is somewhat plausible as a theory, and is not easily 
disproved. In the lower order of animals, as sheep and swine, 
one of the testicles has been removed, and there resulted after- 
ward both male and female progeny, so that the theory seems 
to lack facts for a foundation. 
We sometimes witness in the child excessive development, 
as five fingers, a large cranium, which results in dropsical 
effusion, or deficient brain, as in idiots; sometimes a hand or 
arm is lacking, or possibly there is a dual connection, as in the 
case of the Siamese twins; or, two heads united on one 
body. It is difficult to give any satisfactory explanation of 
these abnormal developments. From age to age, the type is 
constant, and preserves a race-unity. The crossings of the races 
are only transient deviations, not capable of perpetuation, and 
quickly return again to the original stock. This force is persist- 
ent, for inasmuch as the individual represents the race, so does 
his offspring represent the parental characteristics, in tastes, pro- 
clivities, and morals, as well as in organic resemblances. This 
constancy is unaccountable, and more mysterious than the occa- 
sional malformation of germs in the early period of foetal life. 
If to every deviation from that original form and structure, 
which gives character to the productions of nature, we apply 
the term monster, we shall find but very few, and from this 
whole class there will be a very small number indeed of sexual 
malformations. If the sexes be deprived of the generative 
organs, they approach each other in disposition and appearance. 
All those who are partly male and partly female in their organ- 
ization, unite, to a certain extent, the characteristics of both 
sexes. When the female loses her prolific powers, many of her 
sexual peculiarities and attractions wane. 
DICECIOUS REPRODUCTION. 
Dioecious is a word derived from the Greek, and signifies two 
households', hence, dioecious reproduction is sexual generation 
by male and female individuals. Each is distinguished by sexual DICECIOUS REPRODUCTION. 
203 
characteristics. The male sexual organs are complete in one 
individual, and all the female organs belong to a separate femi- 
nine organization. In some of the vertebrates, impregnation 
does not require sexual congress; in other words, fecundation 
may take place externally. The female fish of some species first 
deposits her ova, and afterwards the male swims to that locality 
and fertilizes them with sperm. 
In higher orders of animals, fecundation occurs internally, the 
conjunction of the sperm and germ cells requiring the conjuga- 
tion of the male'and female sexual organs. The sperm-cells of 
the male furnish the quickening principle, which sets in play all 
the generative energies, while the germ-cell, susceptible to its 
vivifying presence, responds with all the conditions necessary to 
evolution. The special laboratory which furnishes spermatic 
material is the testes, while the stroma of the ovaries contributes 
the germ-cell. Several different modes of reproducing are 
observed when fecundation occurs within the body, which 
vary according to the peculiarities and organization of the 
female. 
Modes of Dioecious Reproduction.-Avery famil- 
iar illustration of one mode is found in the common domestic 
fowl, the egg of which vivified within the ovarium, is afterward 
expelled and hatched by the simple agency of warmth. This 
mode of reproduction is called oviparous generation. 
The ovaries, as well as all their latent germs, are remarkably 
influenced by the first fecundation. It seems to indicate mon- 
ogamy as the rule of higher sexual reproduction. The farmer 
understands that if he wishes to materially improve his cows, 
the first offspring must be begotten by a better, purer breed, 
and all that follow will be essentially benefited, even if not so 
well sired. Neither will the best blood exhibit its most desir- 
able qualities in the calves whose mothers have previously 
carried inferior stock. So that there are sexual ante-natal influ- 
ences which may deteriorate the quality of the progeny. The 
Jews understood this principle, in the raising up of sons and 
daughters unto a deceased brother. The fact that the sexual 
influence of a previous conception is not lost, is illustrated when, 
in a second marriage, the wife bears a son or daughter resem- 
bling bodily or mentally, or in both of these respects, the former 204 
COMMON SENSE MEMCAt AbVtSER. 
husband. This indicates a union for life by natural influences 
which never die out. 
With some species of fish and reptiles, the egg is impregnated 
internally, and the process of laying commences immediately, 
but it proceeds so slowly through the excretory passages, that it 
is hatched and born alive. This is called ovo-viviparous gener- 
ation. 
As we rise in the scale of organization, animals are more 
completely developed, and greater economy is displayed in their 
preservation. The germ passes from the ovary into an organ 
prepared for its reception and growth, to which, after fecunda- 
tion, it becomes attached, and where it remains until sufficiently 
developed to maintain respiratory life. This organ is called the 
womb, or uterus, and is peculiar to most mammalia. This mode 
of reproduction is termed viviparous generation. 
The kangaroo and oppossum are provided with a pouch 
attached to the abdomen, which receives the young born at an 
early stage of development. They remain in contact with the 
mammae, from which they obtain their nourishment, until their 
growth is sufficiently completed to maintain an independent 
existence. This is called marsupial generation. The variety of 
reproduction which is most interesting, is that of the human 
species, and is called viviparous generation. It includes the 
functions of copulation, fecundation, gestation, parturition, and 
lactation. 
For the full and perfect development of mankind, both mental 
and physical chastity is necessary. The health demands absti- 
nence from unlawful intercourse. Therefore children should 
not be allowed to read impure works of fiction, which tend to 
inflame the mind and excite the passions. Only in total absti- 
nence from illicit pleasures is there moral safety and health, 
while integrity, peace, and happiness, are the conscious rewards 
of virtue. Impurity travels downward with intemperance, 
obscenity, and corrupting diseases, to degradation and death. 
A dissolute, licentious, free-and-easy life is filled with the dregs 
of human suffering, iniquity, and despair. The penalties which 
follow a violation of the law of chastity are found to be severe 
and swiftly retributive. 
The union of the sexes in holy matrimony is a law of nature COMPARISON OF MALE AND FEMALE 
205 
Fig. 100. 
Fig. 101. 
Male. 
Female. 206 
COMMON SENSE MEDICAL ADVISER. 
finding sanction in both mbrals and legislation. Even some of 
the lower animals unite in this union for life, and instinctively 
observe the law of conjugal fidelity with a consistency which 
might put to blush other animals more highly endowed. It is 
important to discuss this subject and understand our social evils, 
as well as the unnatural desires of the sexes, which must be 
controlled or they lead to ruin. Sexual propensities are pos- 
Fig. 102. 
Outline of the Female Urinary and 
Generative Organs. 
sessed by all, and they must be held in abeyance, until they 
are exercised for legitimate purposes. Hence parents ought to 
understand the value of mental and physical labor to elevate 
and strengthen the intellectual and moral faculties of their 
children, to develop the muscular system and direct the energies 
of the blood into healthful channels. Vigorous employment DKECIOUS REPRODUCTION. 
207 
of mind and body engrosses the vital energies and diverts them 
from undue excitement of the sexual desires. 
Sexual generation by pairing individuals is the most eco- 
nomical mode of propagating the species. The lower orders 
of animals possess wonderful multiplicative powers and their 
faculty for reproduction is offset by various destructive forces. 
The increased ability for self-maintenance implies diminished 
reproductive energy; hence the necessity for greater economy 
and safety in rearing the young. As certain larvae and insects in- 
Fig. 103. 
Outline of the Male Reproductive Organs. 
crease, the birds which feed upon them become more numerous. 
When this means of support becomes inadequate, these same 
birds diminish in number in proportion to the scarcity of their 
food. Many have remarked that very prolific seasons are 
followed by unusual mortality, just as periods of uncommon 
prosperity precede those of severe disaster. 
The increased mental and moral cultivation of mankind 
imposes upon them the necessity for greater physical culture. 208 
COMMON SENSE MEDICAL ADVISER. 
" Wiser and weaker," is a trite saying, and means that the 
exercise of the higher nature discloses the equivalent necessity 
of culturing the body, in order to support the increasing expen- 
ditures of the former. Mental and moral discipline are essential 
for a proper understanding how to provide for the body, for 
physical training increases the capacity of the individual for 
self-preservation. Constant vigilance is the price of health as 
well as of liberty. 
It is an interesting physiological fact that, while the growth 
and development of the individual are rapidly progressing, 
the reproductive powers remain almost inactive, and that the 
commencement of reproduction not only indicates an arrest 
of growth, but, in a great measure, contributes toward it. 
From infancy to puberty, the body and its individual organs, 
structurally as well as functionally, are in a state of gradual 
and progressive evolution. Men and women generally increase 
in stature until the twenty-fifth year, and it is safe to assume 
that perfection of function is not established until maturity 
of bodily development is completed. Solidity and strength 
are represented in the organization of the male, grace, and 
beauty in that of the female. His broad shoulders represent 
physical power and the right of dominion, while her bosom 
is the symbol of love and nutrition. The father encounters 
hardships, struggles against difficulties, and braves dangers to 
provide for his household; the mother tenderly supplies the 
infant's wants, finding relief and pleasure in imparting nourish- 
ment, and surrounds helpless infancy with an affection which 
is unwearied in its countless ministering attentions. Her ma- 
ternal functions are indicated by greater breadth of the hips. 
Physical differences so influence their mental natures, that, 
" before experience has opened their eyes, the dreams of the 
young man and maiden differ." The development of either 
is in close sympathy with their organs of reproduction. Any 
defect of the latter impairs our fair ideal, and detracts from 
those qualities which impart excellence, and crown the character 
with perfections. Plainly has Nature marked out, in the 
organization, very different offices to be performed by the 
sexes, and has made these distinctions fundamental. 
Likewise, Nature expresses the intention of reproduction, OVULATION. 
209 
by giving to plants and animals distinctive organs for this 
purpose. These are endowed with exquisite sensibility, so that 
their proper exercise produces enjoyment beneficial to both. 
Excessive sexual indulgence not only prostrates the nervous 
system, enfeebles the body, and drains the blood of its vivifying 
elements, but is inconsistent with intellectual activity, morality, 
and spiritual development. The most entrancing delights and 
consummate enjoyments are of the emotive order, ideal, ab- 
stract, and pure, so inspiring that they overpower the grosser 
sensual pleasures and diffuse their own sweet chastity and re- 
fining influence over all the processes of life. 
Hence, the gratification of the sexual instincts should always 
be moderate. It should be regulated by the judgment and 
will, and kept within the bounds of health. No person has a 
moral right to carry this indulgence so far as to produce injur- 
ious consequences to either party, and he who cannot refrain 
from it is in no proper condition to propagate his species. In 
all culture there must be self-control, and the practice of self- 
denial at the command of love and justice is always a virtue. 
Self-government is the polity of our people, and we point with 
pride and laudable exultation to our political maxims, laws, and 
free institutions. The family is the prototype of society. If 
self-restraint be practiced in the marital relation, then the prin- 
ciple of self-control will carry health, strength, and morality 
into all parts of the commonwealth. The leading character- 
istics of any nation are but the reflection of the traits of its 
individual members, and thus the family truly typifies the 
practical morality and enduring character of a people. 
OVULATION. 
The Ovaries are those essential parts of the generative 
system of the human female in which the ova are matured. 
There are two ovaries, one on each side of the uterus, and 
connected with it by the Fallopian tubes ; they are ovoidal 
bodies about an inch in diameter, and furnish the germs or 
ovules. These latter are very minute, seldom measuring of 
an inch in diameter, and frequently are not more than half that 
size. The ovaries develop with the growth of the female, 
so that, finally, at the pubescent period, they ripen and liberate 210 
COMMON SENSE MEDICAL ADVISER. 
an ovum, or genn vesicle, which is carried into the uterine 
cavity through the Fallopian tubes. With the aid of the 
microscope, we find that these ova are composed of granular 
substance, in which is found a miniature yolk surrounded by 
a transparent membrane, called the zona pellucida. This yolk 
contains a germinal vesicle in which can be discovered a 
nucleus, called the germinal spot. The process of the growth 
of the ovaries is very gradual, and their function of ripening 
and discharging an ovum every month into the Fallopian tubes 
and uterus is not developed until between the twelfth and 
fifteenth years. 
This period, wrhich indicates, by the feelings and ideas, the 
desires and will, that the subjects are capable of procreation, is 
called puberty. The mind acquires new and more delicate per- 
ceptions, the person becomes plumper, the mammae enlarge, 
and there is grace and perfection in every movement, a con- 
scious completeness for those relations of life for which this 
function prepares them. The period of puberty is also in- 
dicated by 
MENSTRUATION. 
The catamenial discharge naturally follows the ripening and 
liberation of an ovum, and as the ovaries furnish one of these 
each month, this monthly flow is termed the menses (the plural 
of the Latin word mensis, which signifies a month). The 
menstrual flow continues from three to five days, and is merely 
the exudation of ordinary venous blood through the mucous 
lining of the cavity of the uterus. At this time, the nervous 
system of females is much more sensitive, and from the fact 
that there is greater aptitude to conception immediately before 
and after this period, it is supposed that the sexual feeling is 
then the strongest. When impregnation occurs immediately 
before the appearance of the menses, their duration is generally 
shortened, but not sufficiently to establish the suspicion that 
conception has taken place. The germ is the contribution of 
the female, which provides the conditions which only require 
the vivifying principle of the sperm for the development of 
another being. The period of aptitude for conception ter- 
minates at the time both ovulation and menstruation cease, FECUNDATION. 
211 
which, unless brought about earlier by disease, usually occurs 
about the forty-fifth year of her age. 
FECUNDATION. 
Since in the beginning God created male and female, and 
said unto them, " Be fruitful, and multiply, and replenish the 
earth," it is evident that what was originated by creation must 
be continued by procreation. The process of generation the 
reader will find described on pages 12 and 13. Then com- 
mences a wonderful series of transforming operations, rudi- 
mentary changes preliminary to the formation of tissues, 
structures and functions, which finally qualify the organism 
for independent existence. The ovum, when expelled from the 
ovary, enters the fimbriated, or fringe-like extremity of the 
Fallopian tube, to commence at once its descent to the uterus. 
The process of passing through this minute tube varies in 
different animals. In birds and reptiles, the bulk of the ex- 
pelled ova is so great as to completely fill up the tube, and it 
is assisted in its downward course, partly by its own weight 
and partly by the peristaltic action of the muscular coat of the 
canal. In the human subject, however, the ova are so minute 
that nature has supplied a special agent for their direct trans- 
mission; otherwise they might be retained, and not reach their 
destination. Accordingly, the fimbriated, trumpet-shaped ex- 
tremity of the Fallopian tubes, which is nearest to the ovaries, 
and, consequently from the ovary first receives the ovum when 
expelled ; is provided with a series of small hairs, termed cilia, 
forming the lining or basement membrane of the tubes, and, 
the movements of these cilia being towards the uterus, transmit, 
by their vibrating motion, the ovum from the ovary, through 
the Fallopian tubes, to the uterus. 
The mature ovum, however, is not by itself capable of being 
converted into the embryo. It requires fecundation by the 
spermatic fluid of the male, and this may take place immedi- 
ately on the expulsion of the ovum from the ovary, or during 
its passage through the Fallopian tube, or, according to Bis- 
choff, 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 212 
COMMON SENSE MEDICAL ADVISER. 
expelled by the uterine secretions. It occasionally happens 
that the descent of the impregnated ovum is arrested, and the 
formation of the embryo commences in the ovary. This is 
termed ovarian pregnancy. Or again, the ovum may be 
arrested in its passage through the Fallopian tube, causing 
what is termed tubal pregnancy; or, after it has been expelled 
from the ovary, it may fail to be received by the fimbriated 
extremity, and escape into the cavity of the abdomen, forming 
what has been termed ventral pregnancy. If the microscopic 
germ lodges in some slight interstice of fiber, during its 
passage through the walls of the uterus, it may be detained 
long enough to fix itself there, and when this occurs, it is termed 
interstitial pregnancy. All these instances of extra-uterine 
pregnancy may necessitate the employment of surgical skill, 
in order that they may terminate with safety to the mother. 
Their occurrence, however, is very rare. 
The intense nervous excitement produced by the act of 
coition is immediately followed by a corresponding degree of 
depression, and a too frequent repetition of it is necessarily 
injurious to health. The secretions of the seminal fluid being, 
like other secretions, chiefly under the influence of the nervous 
system, an expenditure of them requires a corresponding 
renewal. This renewal greatly taxes the corporeal powers, 
inducing lassitude, nervousness, and debility. It is a well 
known fact that the highest degree of mental and bodily vigor 
is inconsistent with more than a moderate indulgence in sexual 
intercourse. 
To ensure strength, symmetry, and high intellectual culture 
in the human race, requires considerable care. Consideration 
should be exercised in the choice of a companion for life. Con- 
stitutional as well as hereditary ailments demand our closest 
attention. Age has also its judicious barriers. As before 
stated, when reproduction commences, growth, as a rule, ceases; 
therefore, it is inexpedient that matrimony should be consum- 
mated before the parties have arrived at mature stature. 
PREVENTION OF CONCEPTION. 
Much has been written upon the question whether married 
people have a right to decline the responsibilities of wedlock. PREVENTION OF CONCEPTION. 
213 
The practice of inducing abortion is not only immoral but 
criminal, because it is destructive to both the health of the 
mother and the life of the embryo being. If both the parties 
to a marriage be feeble, or if they be not temperamentally 
adapted to each other, so that their children would be de- 
formed, insane, or idiotic, then to beget offspring would be a 
flagrant wrong. If the mother is already delicate, possessing 
feeble constitutional powers, she is adequate to the duties of 
maternity, and it is not right to lay such burdens upon her. 
Self-preservation is the first law of nature, which all ought to 
respect. The woman may be able to discharge the duties of a 
loving wife and companion, when she cannot fulfil those of 
child-bearing. If the husband love his wife as he ought, he 
will resign all the pleasure necessary to secure her exemption 
from the condition of maternity. It seems to us, that it is a 
great wickedness, unpardonable even, to be so reckless of con- 
sequences, and so devoid of all feeling, as to expose a frail, 
feeble, affectionate woman to those perils which almost insure 
her death. To enforce pregnancy under such circumstances 
is a crime. Every true man, therefore, should rather practice 
self-control and forbearance, than entail on his wife such 
certain misery, if not danger to life. 
Undoubtedly, the trial is great, but if a sacrifice be required, 
let the husband forbear the gratification of passions which 
will assuredly be the means of developing in his delicate wife 
symptoms that may speedily hurry her into a premature grave. 
Before she has recovered from the effects of bearing, nursing, 
and rearing one child, ere she has regained proper tone and 
vigor of body and mind, she is unexpectedly overtaken, sur- 
prised by the manifestation of symptoms which again indicate 
pregnancy. Children thus begotten are not apt to be hardy 
and long-lived. From the love that parents feel for their 
posterity, from their wishes for their success, from their hopes 
that they may be useful from every consideration for their 
future well-being, let them exercise precaution and forbearance, 
until the wife becomes sufficiently healthy and enduring to 
bequeath her own vital stamina to the child she bears. 
From what has been said on this subject, it behooves the 
prudent husband to weigh well the injurious, nay criminal 214 
COMMON SENSE MEDICAL ADVISER. 
results which may follow his lust. Let him not endanger the 
health, and it may be the life, of his loving and confiding 
wife through a lack of self-denial. Let him altogether refrain, 
rather than be the means of untold misery and, perhaps, the 
destruction of the person demanding his most cherished love 
and protection. On so important a subject, we feel we should 
commit an unpardonable wrong were we not to speak thus 
plainly and openly. An opportunity has been afforded us, 
which it would be reprehensible to neglect. We shall indeed 
feel we have been amply rewarded, if these suggestive remarks 
of ours tend in any way to remove or alleviate the sufferings 
of an uncomplaining and loving wife. Our sympathies, always 
susceptible to the conditions of sorrow and suffering, have 
been enlisted to give faithfully, explicitly, and plainly, warnings 
of danger and exhortations to prudence and nothing remains 
for us but to maintain the principles of morality, and leave 
to the disposal of a wise and overruling Providence the 
mystery of all seemingly untoward events. In every condition 
of life, evils arise, and most of those which are encountered are 
avoidable. Humanity should be held accountable for those 
evils which it might, but does not shun. 
By a statute of the national government, prevention of preg- 
nancy is considered a punishable offense; whereas every phy- 
sician is instructed by our standard writers and lecturers on 
this subject, that not only prevention is necessary in many 
instances, but even abortion must sometimes be produced in 
order to save the mother's life. As we view the matter, the 
law of the national government asserts the ruling principle, 
and the exceptions to it must be w'ell established by evidence, 
in order to fully justify such procedure. The family physician 
may, with the concurrence of other medical counselors, be 
justified, in rare cases, in advising means for the prevention 
of conception, but he should exercise this professional duty 
only when the responsibility is shared by other members of 
the profession, and the circumstances fully and clearly warrant 
such a practice. 
After fecundation, the length of time before conception takes 
place is variously estimated. Should impregnation occur at 
the ovary or within the Fallopian tubes, usually about a week UTERINE PREGNANCY. 
215 
elapses before the fertilized germ enters the uterus, so that 
ordinarily the interval between the act of insemination and 
that of conception varies from eight to fourteen days. 
If two germs be evolved simultaneously, each may be im- 
pregnated by spermatozoa, and a twin pregnancy be the result. 
This is by no means a rare occurrence. It is very unusual, 
however, to have one birth followed by another after an 
interval of three or four months, and each babe present the 
evidences of full maturity. Perhaps such occurrences may 
be accounted for on the supposition that the same interval of 
time elapses between the impregnation of the two germs as 
there is difference observed in their birth; that after the act of 
insemination, sperm was carried to each ovary; that one had 
matured a germ ready for fecundation, then impregnation and 
conception immediately followed, and the decidua of the uterus 
hermetically sealed both Fallopian tubes, and thus securely 
retained the sperm within the other Fallopian canal. The stim- 
ulus of the sperm so pent up causes that ovary to mature a 
germ, although it may do so slowly, and after two or three 
months it is perfected, fertilized, and a second conception occurs 
within the uterus. If each embryo observe a regular period 
of growth and each be born at maturity, there must be an 
interval of two or three months between their births. But 
it is far more common for the parturition of the first, dis- 
playing signs of full maturity, to coincide with the birth of a 
second which is immature and which cannot sustain respiratory 
life. The birth of the latter is brought about prematurely, 
by the action of the uterus in expelling the matured child. 
DOUBLE CONCEPTION. 
UTERINE PREGNANCY. 
There are many who manifest a laudable desire to understand 
the physiology of conception, the changes which take place, 
and the order of their natural occurrence. When impregnation 
takes place at the ovaries or within the Fallopian tubes, there 
is exuded upon the inner surface of the womb a peculiar 
nutritious substance. It flows out of the minute porous open- 
ings surrounding the termination of the Fallopian tube within 216 
COMMON SENSE MEDICAL ADVISER. 
the uterine cavity, and, thus, is in readiness to receive the 
germ, and retain it there until it becomes attached. Undoubt- 
edly, the germ imbibes materials from this matter for its 
nurture and growth. This membranous substance is termed the 
decidua, and disappears after conception is insured. Two mem- 
branes form around the embryo; the inner one is called the 
amnion, the outer one the chorion. Both serve for the pro- 
tection of the embryo, and the inner one contains the liquor 
amnii, in which it floats during intra-uterine life. Immediately 
after conception, the small glands in the neck of the uterus 
usually throw out a sticky secretion, filling the canal, or uniting 
its sides, so that nothing can enter or leave the uterine cavity. 
The fertilized ovum rapidly develops. After its conception 
it imbibes nourishment, and there is a disposition in fluids to 
pass into it, through its delicately-organized membranes. If 
this process is not involuntary, it is, at all events, at the con- 
venience and use of the developing germ. After three months 
the embryo is termed the foetus. Its fluids are then so much 
more highly organized, that some of them are tinged with 
sanguine hues, and thenceforward acquire the characteristics of 
red blood. Out of red blood, blood-vessels are formed, and 
from the incipient development of the heart follow faint lines 
of arteries, and the engineers of nutrition survey a circulatory 
system, perfecting the vascular connections by supplementing 
the arteries with a complete net-work of veins and capillaries. 
THE PLACENTA OR AFTERBIRTH. 
Whenever conception occurs, a soft, spongy substance is 
formed between the uterus and the growing ovum, called the 
placenta. It is composed of membrane, cellular tissue, blood- 
vessels, and connecting filaments. The principal use of this 
organ seems to be to decarbonate the blood of the foetus, and 
to supply it with oxygen. It performs the same function for 
the foetus that the lungs do for the organism after birth. It 
allows the blood of the foetus to come into very close contact 
with that of the mother, from which it receives a supply of 
oxygen, and to which it gives up carbonic acid. This inter- 
change of gases takes place in the placenta, or between it 
and the uterus, through the intervening membranes. This QUICKENING. 
217 
decarbonating function requires the agency of the maternal 
lungs, for the purpose of oxygenating the mother's blood. 
The placenta is attached to the uterus by simple adhesion. 
True, in some instances, morbid adhesion takes place, or a 
growing together in consequence of inflammation, but the 
natural junction is one merely of contact, the membranes of 
the placenta spreading out upon the cavity of the uterus, so 
that, finally, the former may be entirely removed without a 
particle of disturbance or injury to the latter. Formerly, it 
was supposed that the placental vessels penetrated into the 
substance of the uterus. We know now there is no such con- 
tinuation of the vessels of the one into the other. The decar- 
bonation of the blood requires the placental and uterine 
membranes to be in contact with each other. 
If the union were vascular, the mother's blood would circu- 
late in the foetal body, and the impulses of the maternal heart 
might prove too strong for the delicate organism of the embryo. 
Besides, the separation of the placenta from the uterus might 
prove fatal to both parent and offspring. The placenta is only 
a temporary organ, and when its functions are no longer re- 
quired, it is easily and safely removed. 
THE UMBILICAL CORD. 
The foetal blood is transmitted to and fro between the body 
of the child and the placenta, by a cord which contains two 
arteries and one vein. This is called the umbilical cord, because 
it enters the body at the middle of the abdominal region, or 
umbilicus. It is composed, also, of its own proper membranous 
sheath, or skin, and cellular tissues, besides the blood-vessels. 
Two months after pregnancy, this cord can be seen, when it 
commences to grow rapidly. 
QUICKENING. 
Not until the mother feels motion is she said to be quick 
with child. That is, the child must be old and strong enough 
to communicate a physical impulse, which the mother can 
distinctly perceive, before it is regarded as having received life. 
This is a fallacy, for the germ has to be endowed with life 
before organization can begin. The act of impregnation 218 
COMMON SENSE MEDICAL ADVISER. 
communicates the vital principle, and from that moment it starts 
upon its career of development. A long period elapses after 
this occurs before it can make the mother feel its motions. 
Before quickening, the attempt to destroy the foetus is not 
considered so grave a crime by our laws, but after this quicken- 
ing takes place, it is deemed a felony. 
THE RIGHT TO TERMINATE PREGNANCY. 
The expediency and the moral right to prematurely terminate 
pregnancy must be admitted when weighty and sufficient 
reasons for it exist. Such a course should never be undertaken, 
however, without the advice and approval of the family phy 
sician, and, whenever it is possible, the counsel of another medi- 
cal practitioner should be obtained. There may be so great a 
malformation of the pelvic bones as to preclude delivery at 
full term, or, as in some instances, the pregnant condition may 
endanger the life of the mother, because she is not able to 
retain nourishment upon the stomach. In such cases only, is 
interference warranted, and even then the advice of some well- 
informed physician should be first obtained, to make sure that 
the life of the mother is endangered before so extreme a 
measure is resorted to. 
Those who are qualified for maternal duties should not under- 
take to defeat the intentions of nature, simply because they 
love ease and dislike responsibility. Such persons may be con- 
sidered genteel ladies, but, practically, they are indifferent to 
the claims of society and posterity. How such selfishness con- 
trasts with the glorious, heroic, Spartan spirit of the young 
woman who consulted us in reference to the acceptance of 
a tempting offer of marriage! She was below medium size and 
delicately organized. She hesitated in her answer, because she 
was uncertain as to her duty to herself, and to her proposed 
husband, and on account of the prospective contingencies of 
matrimony. After she was told that it was doubtful whether 
she could discharge the obligations of maternity with safety 
to herself, and yet that she might prove to her intended hus- 
band a true and valuable wife, she quickly answered, her black 
eyes radiant with the high purpose of her soul: "If I assent 
to this offer, I shall accept the condition and its. consequences THE DURATION OF PREGNANCY. 
219 
also, even if pregnancy be my lot and I know it will cost me 
my life!" She acceded to the proposal, and years found them 
one in happiness; then a daughter was born, but the bearing 
and nursing were too much for her delicate constitution, and 
she continued to sink until she found rest in the grave. Of 
all her beautiful and noble sayings, none reflect more moral 
grandeur of spirit than the one in which she expressed her 
purpose to prove true to posterity. 
THE SIGNS OF PREGNANCY. 
The symptoms which indicate pregnancy are cessation of 
the menses, enlargement of the mammae, nausea, especially in 
the morning, distention of the abdomen, and movement of 
the foetus. A married woman has reason to suspect that she 
may have conceived, when, at the proper time, she fails to 
menstruate, especially when she knows that she is liable to 
become pregnant. A second menstrual failure strengthens 
this suspicion, although there are many other causes which 
might prevent the appearance of the menses, such as disease 
of the uterus, general debility, or taking cold, and all of these 
should be taken into account. In the absence of all apparent 
influences calculated to obstruct the menses, the presumption 
ordinarily is that pregnancy is the cause of their non-appear- 
ance. The evidence is still more conclusive when the mammae 
and abdomen enlarge after experiencing morning sickness. 
Notwithstanding all these symptoms, the audible sound of the 
heart, or the movements of the foetus, are the only infallible 
signs of a pregnant condition. 
THE DURATION OF PREGNANCY. 
The ordinary duration of pregnancy is about forty weeks, or 
280 days. It is difficult to foretell exactly when a pregnancy 
will be completed, for it cannot be known precisely when it 
began. Some gestations are more protracted than others, but 
the average duration is the time we have given. A very 
reasonable way to compute the term, is to reckon three months 
back from the day when the menses ceased and then add 
five days to that time, which will be the date of the expected 
time of confinement. It is customary, also, for women to 220 
COMMON SENSE MEDICAL ADVISER. 
count from the middle of the month after the last appear- 
ance of the menses, and then allow ten lunar months for 
the terra. This computation generally proves correct, except 
in those instances in which conception takes place immediately 
before the last appearance of the catamenia. A few women 
can forecast the time of labor from the occurrence of quicken- 
ing, by allowing eighteen weeks for the time which has elapsed 
since conception, and twenty-two more for the time yet to 
elapse before the confinement. With those in whom quickening 
occurs regularly in a certain week of pregnancy, this calculation 
may prove nearly correct. 
The English law fixes no precise limit for the legitimacy of 
the child. In France a child is regarded as lawfully begotten 
if born within three hundred days after the death or departure 
of the husband. There are a sufficient number of cases on record 
to show that gestation may be prolonged two, and even three, 
weeks beyond the ordinary, or average term. The variation 
of time may be thus accounted for: after insemination, a con- 
siderable interval elapses before fecundation takes place, and 
the passage of the fertilized germ from the ovary to the 
uterus is also liable to be retarded. There are many circum- 
stances and conditions which might serve to diminish its ordi- 
nary rate of progress, and postpone the date of conception. 
This would materially lengthen the apparent time of gestation. 
It is likewise difficult to determine the shortest period at 
which gestation may terminate, and the child be able to survive. 
A child may be born and continue to live for some months, 
after twenty-four or twenty-five weeks of gestation; it was so 
decided, at least, in an ecclesiastical trial. 
We have not the space to describe minutely, or at length, 
the formation and growth of the foetal structures, and trace 
them separately from their origin to their completion at the 
birth of the child. The student of medicine must gain in- 
formation by consulting large works and exhaustive treatises on 
this interesting subject. 
What trifling contingencies defeat vitality! Conception may 
be prevented by acrid secretions, the result of disease of the 
reproductive organs. Leucorrheal matter may destroy the vital- 
izing power of the sperm-cells. There are many ways, even THE DURATION OF PREGNANCY. 
221 
after impregnation, of compromising the existence of the frail 
embryo. Accidents, injuries, falls, blows, acute diseases, insuf- 
ficient nutrition and development, in fact, a great variety of 
occurrences may destroy the life of the embryo, or foetus. 
After birth, numerous diseases menace the child. By what 
constant care must it ever be surrounded, and how often is 
it snatched from the very jaws of death! 
What, then, is man but simply a germ, evolving higher 
powers, and destined for a purer and nobler existence 1 His 
latent life secretly emerges from mysterious obscurity, is in- 
carnated, and borne upon the flowing stream of time to a spirit- 
ual destination-to realms of immortality 1 As he nears those 
ever-blooming shores, the eye of faith, illuminated by the in- 
spired word, dimly discerns the perennial glories. Quickened 
by Faith, Hope, and Love, his spirit is transplanted into the 
garden of paradise, the Eden of happiness, redeemed, perfected, 
and made glorious in the divine image of Him who hath said, 
"I am the Way, the Truth, and the Life." PART II. 
HYGIENE. 
CHAPTER I. 
The object of hygiene is the preservation of health. Hith- 
erto, we have considered, at some length, the science of 
functions, or Physiology, and now, under the head of Hygiene, 
we will give an outline of the means of maintaining the func- 
tional integrity of the system. It is difficult to avoid including 
under this head Preventive Medicine, the special province of 
which is to abate, remove, or destroy the many causes of disease. 
The Greeks bestowed divine honors upon JEsculapius, because 
he remedied the evils of mankind and healed the sick. The 
word hygiene is derived from Hygeia, the name of the Greek 
goddess of health. As male and female are made one in wed- 
lock, so Medicine and Hygiene, restoration and preservation, 
are inseparably united. 
Hygiene inculcates sanitary discipline, medicine, remedial dis- 
cipline; hygiene prescribes healthful agencies, medical theory 
and practice, medicinal agencies ; hygiene ministers with salu- 
brious and salutary agents, medicine assuages with rectifying 
properties and qualities; hygiene upholds and sustains, medical 
practice corrects and heals; the one is preservative and con- 
servative, the other curative and restorative. These discrimi- 
nations are as radical as health and sickness, as distinct as 
physiology and pathology, and to confound them is as unnatural 
as to look for the beauties of health in the chamber of sickness. 
HYGIENE DEFINED.-PITRE AIR. 
222 223 
PURE AIR FOR RESPIRATION-. 
The true physician brings to his aid Physiology, Hygiene, 
and Medicine, and combines the science of the former with 
the art of the latter, that restoration may be made permanent, 
and the health preserved by the aid of hygiene. But when 
any one makes Hygiene exclusively the physician, or deals 
wholly in hygienic regulations with little respect for physiology, 
or lavishly advertises with hygienic prefixes, we may at once 
consider it a display, not of genuine scientific knowledge, 
but only of the ignorance of a quack. Some of the modern 
twaddle about health is a conglomeration of the poorest kind 
of trash, expressing and inculcating more errors and whims 
than it does common sense. Many persons dilate upon these 
subjects with amazing flippancy, their mission seeming to be 
to traduce the profession rather than to act as help-mates and 
assistants. We do not believe that there is any real argument 
going on between the educated members of the medical pro- 
fession but rather that the senseless clamor we occasionally hear 
comes only from the stampede of some routed, demoralized 
company of quacks. 
In the following pages we shall introduce to the reader's 
attention several important hygienic subjects, although there 
are many more that ought to receive special notice. Such 
as we do mention, demand universal attention, because a dis- 
regard of the conditions which W'e shall enumerate, is fraught 
with great danger. Our lives are lengthened or shortened by 
the observance or neglect of the rules of common sense, and 
these do not require any great personal sacrifice, or the prac- 
tice of absurd precautions. 
PURE AIR FOR RESPIRATION. 
Ordinary atmospheric air contains nearly 2,100 parts of 
oxygen and 7,900 of nitrogen, and about three parts of car- 
bonic acid, in 10,000 parts ; expired air contains about 470 
parts of carbonic acid, and only between 1500 and 1600 parts 
of oxygen, while the quantity of nitrogen undergoes little 
or no alteration. Thus air which has been breathed has lost 
about five per cent, of oxygen and has gained nearly five per 
cent, of carbonic acid. In addition the expired air contains 224 
COMMON SENSE MEDICAL ADVISER. 
a greater or less quantity of highly decomposable animal 
matter, and, however dry the atmospheric air may be, the 
expired air is always saturated with watery vapor, and, no 
matter what the temperature of the external air may be, that 
of the exhaled air is always nearly as warm as the blood. 
An adult man on a average breathes about sixteen times in 
a minute and at every inspiration takes in about thirty cubic 
inches of air, and at every expiration exhales about the same 
amount. Hence, it follows that about 16f cubic feet of air are 
passed through the lungs of an adult man every hour, and de- 
prived of oxygen and charged with carbonic acid to the amount 
of nearly five per cent. The more nearly the composition of 
the external air approaches that of the expired air, the slower 
will be the diffusion of carbonic acid outwards and of oxygen 
inwards, and the more charged with carbonic acid and deficient 
in oxygen will the blood in the lungs become. Asphyxia takes 
place whenever the proportion of carbonic acid in the external 
air reaches ten per cent., providing the oxygen is diminished in 
like proportion, and it does not matter whether this condition 
of the external air is produced by shutting out fresh air from 
a room or by increasing the number of persons who are con- 
suming the same air; or by permitting the air to be deprived 
of oxygen by combustion by a fire. A deficiency of oxygen 
and an accumulation of carbonic acid in the atmosphere, pro- 
duce injurious effects, however, long before the asphyxiating 
point is attained. Headache, drowsiness, and uneasiness occur 
when less than one per cent, of the oxygen of the atmosphere 
is replaced by other matters, and the constant breathing of 
such an atmosphere lowers vitality and predisposes to disease. 
Therefore, every human being should be supplied, by proper 
ventilation, with a sufficient supply of fresh air. Every adult 
individual ought to have at least 800 cubic feet of air-space 
to himself, and this space ought to communicate freely with 
the external atmosphere by means of direct or indirect channels. 
Hence, a sleeping-room for one adult person should not be less 
than nine by ten feet in breadth and length and nine feet in 
heighth. What occurred in the Black Hole at Calcutta is an 
excellent illustration of the effect of vitiated air. One hundred 
and forty-six Englishmen were confined in a room eighteen VENTILATION- OF SCHOOL ROOMS. 
225 
feet square, with two small windows on one side to admit air. 
Ten hours after their imprisonment, only twenty-three were 
alive. 
Ventilation of School Rooms. The depression and 
faintness from which many students suffer, after being confined 
in a poorly ventilated school room, is clearly traceable to 
vitiated air, while the evil is often ascribed to excessive mental 
exertion. The effect of ventilation upon the health of students 
is a subject of universal interest to parents and educators, and 
at present is receiving the marked attention of school authori- 
ties. Dr. F. Windsor, of Winchester, Mass., made a few perti- 
nent remarks upon this subject in the annual report of the State 
Board of Health, of Massachusetts, 1874. One of the institu- 
tions, which "was spoken of in the report of 1873, as a model, 
in the warming and ventilation of which much care had been 
bestowed, was visited in December, 1873. He reports as fol- 
lows: "I visited several of the rooms, and found the air in 
all, offensive to the smell, the odor being such as one would 
imagine old boots, dirty clothes, and perspiration would make 
if boiled down together;" again, in the new model school-house 
the hot air enters at two registers in the floor on one side, and 
makes (or is supposed to make) its exit by a ventilator at the 
floor, on the other side of the room." The master said " the air 
was supposed to have some degree of intelligence, and to know 
that the ventilator was its proper exit." Thorough ventilation 
has been neglected by many school officials on account of the 
increased expense it causes. In our climate, during seven months 
at least, pure atmospheric air must be paid for. The construc- 
tion of vertical ducts, the extra amount of fuel, and the 
attendant expenditures are the objections which, in the opin- 
ion of many persons, outweigh the health and happiness of 
the future generation. It is necessary for the proper ventila- 
tion of our school rooms that an adequate supply of fresh air 
should be admitted, which should be warmed before being 
admitted to the room, and which should be discharged as 
contaminated, after its expiration. The proper ventilation of 
the school room consists in the warming and introduction of 
fresh air from without, and the discharge of the expired and 
unwholesome air from within. This may be accomplished by 226 
COMMON SENSE MEDICAL ADVISER. 
means of doors, windows, chimneys, and finally by ventilators 
placed, one near the level of the floor, and the other near the 
ceiling of the room. The ventilators ought to be arranged on 
the opposite sides of the room, in order to insure a current, 
and an abundant supply of air. When trustees and patrons 
realize that pure air is absolutely essential to health, and that 
their children are being slowly poisoned by the foul air of 
school rooms, then they will construct our halls of learning 
with a due regard for the laws of hygiene, and students will 
not droop under their tasks on account of the absence of 
Nature's most bountiful gift, pure air. 
Ventilation of Factories and Workshops. This 
is a subject which demands the immediate attention of manu- 
facturers and employers. The odors of oil, coal gas, and ani- 
mal products, render the air foul and stagnant, and often give 
rise to violent diseases among the operatives. From two to four 
hundred persons are often confined in workshops six hundred 
feet long, with no means of ventilation except windows on one 
side only. The air is breathed and re-breathed, until the oper- 
atives complain of languor and headache, which they attribute 
to overwork. The real cause of the headache is the inhalation 
of foul air at every expansion of the lungs. If the proprietors 
would provide efficient means for ventilating their workshops, 
the cost of construction would be repaid with compound in- 
terest, in the better health of their operatives and the conse- 
quent increase of labor. Our manufacturers must learn and 
practice the great principle of political economy, namely, that 
the interests of the laborer and employer are mutual. 
Ventilation of our dwellings. Not less important 
is the ventilation of our dwellings; each apartment should be 
provided with some channel for the escape of the noxious 
vapors constantly accumulating. Most of the tenements occu- 
pied by the poor of our cities are literally dens of poison. 
Their children inhale disease with their earliest breath. What 
wonder that our streets are filled with squalid, wan-visaged 
children I Charity, indeed, visits these miserable homes, bring- 
ing garments and food to their half-famished inmates; but she 
has been slow to learn that fresh air is just as essential to life 
as food or clothing. Care should be taken by the public SITE FOR HOMES. 
227 
authorities of every city, that its tenement houses do not de- 
generate into foul hovels, like those of the poor English laborer, 
so graphically portrayed by Dickens. But ill-ventilated rooms 
are not found exclusively in the abodes of the poor. True, 
in the homes of luxury, the effect of vitiated air is modified 
by food, etc. Men of wealth give far more attention to the 
architecture and adornment of their houses, to costly decora- 
tions and expensive furniture, than to proper ventilation. 
Farmers, too, are careless in the construction of their cottages. 
Their dwellings are often built, for convenience, in too close 
proximity to the barn. Because they do not construct a suit- 
able sewer or drain, the filth and refuse food is thrown out 
of the back door, where it accumulates and undergoes putre- 
faction; the vitiated air penetrates the interior of the house, 
and, there being no means of ventilation, it remains to be 
breathed by the occupants. The result is, that for the sake 
of saving a few dollars, which ought to be expended in the con- 
struction of necessary flues and sewers, the farmer often sees the 
child he prizes far more than his broad acres gradually decline, 
or suddenly fall a victim to fevers or malignant disease. 
Parents, make your homes healthy, let in the pure, fresh air 
and bright sunlight, so that your conscience may never upbraid 
you with being neglectful of the health and lives of your little 
ones. 
SITE FOR HOMES. 
Malaria. When about to construct our residences, besides 
securing proper ventilation and adequate drainage, we ought 
to select the location for a home on dry soil. Low levels, damp 
surroundings, and marshy localities not only breed malaria 
and fevers, but are a prolific cause of colds, coughs, and 
consumption. Care should be taken not to locate a dwelling 
where the natural currents of air, or high winds, will be likely 
to bring the poison of decayed vegetable matter from low 
lands. Certain brooks, boggy land, ponds, foggy localities, 
too much shade, all these are favorable to the development 
of disease. Then the walls of a building should be so con- 
structed as to admit air between the exterior and interior 
surfaces, otherwise the interior of the house will be damp and 
unwholesome. In the dead of winter, in northern latitudes, 228 
COMMON SENSE MEDICAL ADVISER. 
the house ought to be kept slightly tempered with warmth, 
both night and day, a condition very favorable to the intro- 
duction and change of atmospheric currents. The invigorating 
tendencies of a dry, pure atmosphere are remarkably beneficial, 
while air charged with moisture and decay is exceedingly 
baneful, introducing diseases under various forms. 
Neither should the dwelling be shaded by dense foliage. The 
dampness of the leaves tends to attract malaria. Trees growing 
a little distance from the house, however, obstruct the trans- 
mission of unhealthy vapors arising beyond them. Malaria 
generally lurks near the surface of the earth, and seems to 
be more abundant in the night time. Persons sleeping in the 
upper story of a house may escape its morbid influence, while 
those occupying apartments on the lower floor, become affected. 
DAMP CELLARS. 
Damp cellars, under residences, are a fruitful cause of 
disease. Dr. Sanford B. Hunt, in an article in the Newark 
Daily Advertiser, speaking of the recent epidemic of diphtheria 
in New York City, says: 
"Pestilences that come bodily, like cholera, are faced and 
beaten by sanitary measures. Those which come more subtly 
need for their defeat only a higher detective ability and a closer 
study of causes, many of which are known, but hidden under 
the cellars of our houses, and which at last are only preventable 
by public authority and at public expense in letting out the 
imprisoned dampness which saturates the earth on which our 
dwellings are built. Where wood rots, men decay. This is 
clearly shown in the sanitary map printed in the Times. In 
the great district surrounding Central Park, and which partici- 
pates in its drainage system, there are no cases. On the whole 
line of Fifth Avenue there are none. The exempt districts 
are clearly defined by.the character of the soil, drainage, and 
sewerage, and by the topography, which either has natural 
or artificial drainage, but most of which is so dry that only 
surface-water and house-filth-which does not exist in those 
palaces-can affect the health of the residents. But in the 
tenement houses and on the made lands where running streams 
have been filled in and natural springs choked up by earth DUST AND DISEASE. 
229 
fillings, diphtheria finds a nidus in which to develop itself. 
The sanitary map coincides precisely with the topographic 
map made by Gen. Viele. Where he locates buried springs 
and water-courses, there we find the plague spots of diphtheria 
and in the same places, on previous maps prepared by the 
Board of Health, we find other low types and stealthy diseases, 
such as typhoid and irruptive fevers, and there we shall find 
them again when the summer and autumnal pestilences have 
yielded place to those which belong to the indoor poisoned 
air in the winter. The experience of other cities, notably 
London and Dublin, once plague spots and now as healthy 
as any spot on earth, proves that most of the causations of 
disease are within the control of the competent sanitary en- 
gineer, even in localities crowded beyond American knowledge, 
and houses built upon soil saturated for centuries with the offal 
of successive and uncleanly generations. Wet earth, kept wet 
by the boiling up of imprisoned springs, is a focus of disease. 
Dry earth is one of the most perfect deodorizers, the best of 
oxydizers and absorbents, destroying the germs of disease with 
wonderful certainty. On those two facts rests the theory of 
public hygiene." 
DUST AND DISEASE. 
The air we breathe is heavily loaded with minute particles 
of floating dust, their presence being revealed only by intense 
local illumination. Professor Tyndall says: " solar light, in 
passing through a dark room, reveals its track by illuminating 
the dust floating in the air. 1 The sun,' says Daniel Culverwell, 
'discovers atoms, though they be invisible by candle-light, 
and makes them dance naked in his beams.' " 
After giving the details and results of a series of experiments 
in which he attempted to extract the dust from the air of the 
Royal Institute by passing it through a tube containing frag- 
ments of glass wetted with concentrated sulphuric acid, and 
thence through a second tube containing fragments of marble 
wetted with a strong solution of caustic potash, which experi- 
ments were attended with perfect failure, the Professor con- 
tinues, "I tried to intercept this floating matter in various 
ways; and on the day just mentioned, prior to sending the 230 
COMMON SENSE MEDICAL ADVISER. 
air through the drying apparatus, I carefully permitted it 
to pass over the tip of a spirit-lamp flame. The floating matter 
no longer appeared, having been burnt up by the flame. It 
was, therefore, of organic origin. I was by no means prepared 
for this result; for I had thought that the dust of our air was, 
in great part, inorganic and non-combustile." In a foot note 
he says, " according to an analysis kindly furnished me by Dr. 
Percy, the dust collected from the walls of the British Museum 
contains fully fifty per cent, of inorganic matter. I have every 
confidence in the results of this distinguished chemist; they 
show that the floating dust of our rooms is, as it were, win- 
nowed from the heavier matter." Again he says: "the air of 
our London rooms is loaded with this organic dust, nor is 
the country air free from its presence. However ordinary 
daylight may permit it to disguise itself, a sufficiently powerful 
beam causes dust suspended in air to appear almost as a semi- 
solid. Nobody could, in the first instance, without repugnance, 
place the mouth at the illuminated focus of the electric beam 
and inhale the thickly-massed dust revealed there. Nor is 
the repugnance abolished by the reflection that, although we 
do not see the floating particles, we are taking them into our 
lungs every hour and minute of our lives." " The notion was 
expressed by Kircher and favored by Linnaeus, that epidemic 
diseases are due to germs which float in the atmosphere, enter 
the body, and produce disturbance by the development within 
the body of parasitic life. While it was struggling against 
great odds, this theory found an expounder and a defender 
in the President of this institution. At a time when most 
of his medical brethren considered it a wild dream, Sir Henry 
Holland contended that some form of the germ-theory was 
probably true." Professor Tyndall proposes means by the 
application of which air loaded with noxious particles may 
be freed from them before entering the air passages. The 
following embodies his suggestions on this point: 
COTTON-WOOL RESPIRATOR. 
" I now empty my lungs as perfectly as possible, and placing 
a handful of cotton-wool against my mouth and nostrils, inhale 
through it. There is no difficulty in thus filling the lungs LIGHT AND HEALTH. 
231 
with air. On expiring this air through a glass tube, its freedom 
from floating matter is at once manifest. From the very 
beginning of the act of expiration the beam is pierced by 
a black aperture. The first puff from the lungs abolishes the 
illuminated dust, and puts a patch of darkness in its place; 
and the darkness continues throughout the entire course of 
the expiration. When the tube is placed below the beam and 
moved to and fro, the same smoke-like appearance as that 
obtained with a flame is observed. In shorty the cotton-wool, 
when used in sufficient quantity, and with due care, completely 
intercepts the floating matter on its way to the lungs. 
The application of these experiments is obvious. If a phy- 
sician wishes to hold back from the lungs of his patient, or 
from his own, the germs or virus by which contagious disease 
is propagated, he will employ a cotton-wool respirator. If per- 
fectly filtered, attendants may breathe the air unharmed. In 
all probability the protection of the lungs and mouth will be 
the protection of the entire system. For it is exceedingly 
probable that the germs which lodge in the air-passages, or 
find their way with the saliva into the stomach with its absor- 
bent system, are those which sow in the body epidemic disease. 
If this be so, then disease can be warded off by carefully pre- 
pared filters of cotton-wool. I should be most willing to test 
their efficacy in my own person. But apart from all doubtful 
applications, it is perfectly certain that various noxious trades 
in England may be rendered harmless by the use of such filters. 
I have had conclusive evidence of this from people engaged 
in such trades. A form of respirator devised by Mr. Garrick, 
a hotel proprietor in Glasgow, in which inhalation and ex- 
halation occur through two different valves, the one permitting 
the air to enter through the cotton-wool, and the other per- 
mitting the exit of the air direct into the atmosphere, is well 
adapted for this purpose. But other forms might readily be 
devised." 
LIGHT AND HEALTH. 
Our dwellings ought freely to admit the sunlight. Diseases 
which have baffled the skill of physicians have been known 
to yield when the patients were removed from dark rooms to 
light and cheerful apartments. Lavoisier placed light, as an 232 
COMMON SENSE MEDICAL ADVISER. 
agent of health, even before pure air. Plants which grow in the 
shade are slender and weak, and children brought up in dark 
rooms are pale, sallow, and rickety. It is a bad practice to 
avoid the sunlight through fear of spoiling the complexion, since 
the sun's rays are necessary to give to it the delicate tints of 
beauty and health. Air is necessary for the first inspiration and 
the last expiration of our lives, but the purity and healthfulness 
of the atmosphere depend upon the warming rays of the sun, 
while our bodies require light in order that their functions may 
be properly performed. We know that without solar light, there 
can be no proper vegetable growth, and it is equally necessary 
for the beauty and perfection of animal development. Our 
dwellings should therefore be well lighted and made as 
bright and cheerful as possible. Women who curtain the 
windows, soften the light, and tint the room with some mellow 
shade, may do so in order to hide their own faulty complexions. 
The skin of persons confined in dungeons or in deep mines 
becomes pale or sickly yellow, the blood grows watery, the 
skin blotches, and dropsy often intervenes. On the other hand, 
invalids carried out from darkened chambers into the bright 
sunlight are stimulated, the skin browns, nutrition becomes 
more active, the blood improves, and they become convalescent. 
Light is especially necessary for the healthy growth of children. 
There is nothing more beautiful and exhilarating than the 
glorious sunlight. Let its luminous, warming, and physiological 
forces come freely into our dwellings, enter into the chemistry 
of life, animate the spirits, and pervade our homes and our 
hearts with its joy-inspiring and health-imparting influences. CHAPTER II. 
FOOD. BEVERAGES. AL- 
COHOLIC LIQUORS. 
CLOTHING. 
The human body is continually undergoing changes, which 
commence with the earliest dawn of existence and end only 
with death. The old and worn-out materials are constantly 
being removed to make room for the new. Growth and de- 
velopment, as well as the elimination of worn-out and useless 
matter, continually require new supplies, which are to be de- 
rived from our food. To fulfill these demands it is necessary 
that the nutriment should be of the proper quality, and of 
sufficient variety to furnish all the constituents of the healthy 
body. In order that food may be of utility, like other building 
materials, it must undergo preparation; the crude substance 
must be worked up into proper condition and shape for use, in 
other words, it must be digested. But this does not end the 
process of supply, each different substance must be taken by the 
different bands of workmen, after due preparation in the work- 
shop, to its appropriate locality in the structure, and there 
fitted into its proper place; this is assimilation. In reality it 
becomes a portion of the body, and is advantageous in main- 
taining the symmetry and usefulness of the part to which it is 
assigned; this constitutes the ultimate object of food, nutrition. 
Eating is the process of receiving the food into the mouth, 
i. e., prehension' mastication and insalivation-minutely divid- 
ing and mixing it with the saliva; deglutition-conveying it to 
the stomach. Plenty of time should be taken at meals to 
thoroughly masticate the food and mix it with the saliva, which, 
233 234 
COMMON SENSE MEDICAL ADVISER. 
being one of the natural solvents, favors its farther solution by 
the juices of the stomach; the healthy action of the digestive 
powers is favored by tranquillity of mind, agreeable associ- 
ations, and pleasant conversation while eating. It is proverbial 
of the American people that they bolt their food whole, washing 
it down with various fluids, thus forcing the stomach to perform 
not only its own duties, but also those of the teeth and salivary 
glands. This manner of dispatching food, which should go 
through the natural process above described, is not without its 
baleful consequences, for the Americans are called a nation of 
dyspeptics. 
Eating slowly, masticating the food thoroughly, and drinking 
but moderately during meals, will allow the juices of the 
stomach to fulfill their proper function, and healthy digestion 
and nutrition will result. If the food is swallowed nearly 
whole, not only will a longer time be required for its solution, 
but frequently it will ferment and begin to decay before 
nutritive transformation can be effected, even when the gastric 
juice is undiluted with the fluids which the hurried eater 
imbibes during his meal. 
Regularity of Meals cannot be too strongly insisted 
upon. The stomach, as well as other parts of the body, must 
have intervals of rest or its energies are soon exhausted, its 
functions impaired, and dyspepsia is the result. Nothing of 
the character of food should ever be taken except at regular 
meal times. Some persons are munching cakes, apples, nuts, 
candies, etc., at all hours, and then wonder why they have 
weak stomachs. They take their meals regularly, and neither 
eat rapidly nor too much, and yet they are troubled with in- 
digestion. The truth is they keep their stomachs almost 
constantly at work, and hence tired out, which is the occasion 
of the annoyance and distress they experience. 
Eating too much. It should always be remembered 
that the nutrition of our bodies does not depend upon the 
amount eaten, but upon the amount that is digested. Eating 
too much is nearly as bad as swallowing the food whole. The 
stomach is unable to digest all of it, and it ferments and gives 
rise to unpleasant results. The unnatural distention of the 
stomach with food causes it to press upon the neighboring FEEDING INFANTS. 
235 
organs, interfering with the proper performance of their func- 
tions, and, if frequently repeated, gives rise to serious disease. 
People more frequently eat too much than too little, and to 
omit a meal when the stomach is slightly deranged is frequently 
the best medicine. It is an excellent plan to rise from the table 
before the desire for food is quite satisfied. 
Late Slippers. It is generally conceded that late suppers 
are injurious, and should never be indulged in. Persons who 
dine late have little need of food after their dinner, unless 
they are kept up until a late hour. In such cases a moderate 
meal may be allowed, but it should be eaten two or three hours 
before retiring. Those who dine in the middle of the day 
should have supper, but sufficiently early so that a propel' length 
of time may elapse before going to bed, in order that active 
digestion may not be required during sleep. On the other hand, 
it is not advisable to go wholly without this meal, but the 
food eaten should be light, easily digestible, and moderate 
in quantity. Persons who indulge in hearty suppers at late 
hours, usually experience a poor night's rest, and wake the next 
morning unrefreshed, with a headache and a deranged stomach. 
Occasionally more serious consequences follow; gastric disorders 
result, apoplexy is induced; or, perhaps, the individual never 
wakes. 
Feeding Infants. For at least six or seven months after 
birth, the most appropriate food for an infant is its mother's 
milk, which; when the parent is healthy, is rich in all the 
elements necessary for its growth and support. Next to the 
mother's milk, that of a healthy nurse should be preferred; 
in the absence of both, milk from a cow that has recently 
calved is the most natural substitute, in the proportion of one 
part water to two parts milk, slightly sweetened. The milk 
used should be from but one cow. All .sorts of paps, gruels, 
panadas, cordials, laxatives, etc., should be strictly prohibited, 
for their employment as food cannot be too severely censured. 
Vomiting, diarrhea, colic, green stools, griping, etc., are the 
inevitable results of their continued use. The child should be 
fed at regular intervals, of about two hours, and be limited 
to a proper amount each time, which, during the first month, 
is about two ounces. From 11 p. m. to 5 a. m. the child 236 
COMMON SENSE MEDICAL ADVISER. 
should be nursed but once. As the child grows older the inter- 
vals should be lengthened, and the amount taken at a time grad- 
ually increased. The plan of gorging the infant's stomach with 
food every time it cries, cannot be too emphatically condemned. 
After the sixth or seventh month, in addition to milk, bits of 
bread may be allowed, the quantity being slowly increased, thus 
permitting the diet to change gradually from fluid to solid 
food, so that, when the teeth are sufficiently developed for 
mastication, the child has become accustomed to various kinds 
of nourishment. Over-feeding, and continually dosing the 
child with cordial, soothing syrups, etc., are the most fruitful 
sources of infant mortality, and should receive the condem- 
nation of every mother in the land. 
Preparation of Pood. The production of pure blood 
requires that all the food selected should be rich in nutritious 
elements, and well cooked. To announce a standard by which 
all persons shall be guided in the selection and preparation 
of their food is impossible. Especially is this the case in a 
country the inhabitants of which represent almost every 
nation on the face of the globe. Travelers are aware that 
there is as much diversity in the articles of food and methods 
of cookery, among the various nationalities, as in the erection of 
their dwellings, and in their mental characteristics. In America 
we have a conglomeration of all these peoples; and for a 
native American to lay down rules of cookery for his German, 
French, English, Welsh, and Irish neighbors, or vice versa, is 
useless, for they will seldom read them, and, therefore, cannot 
profit by them. There are, however, certain conditions recog- 
nized by the hygienic writers of every nation. The adequate 
nutrition of the organic tissues demands a plentiful supply of 
pure blood, or the digestive apparatus will become impaired, 
the mental processes .deranged, and the entire bony and mus- 
cular systems will lose their strength and elasticity, and be 
incapacitated for labor. 
Different Kinds of Food Required. The different 
periods and circumstances of life require their appropriate food, 
and the welfare of mankind demands that it should supply both 
the inorganic and organic substances employed in the develop- 
ment of every tissue. The inorganic elements employed in our DIFFERENT KINDS OF FOOD REQUIRED. 
237 
construction, of which Phosphorus, Sulphur, Soda, Iron, Lime, 
and Potpsh are the most important, are not considered as 
aliments, but are found in the organic kingdom, variously ar- 
ranged and combined with organic materials in sufficient quanti- 
ties for ordinary purposes. When, however, from any cause, 
a lack of any of these occurs, so that their relative normal 
proportions are deranged, the system suffers, and restoration to 
a healthy condition can only be accomplished by supplying 
the deficiency; this may be done by selecting the article of 
food richest in the element which is wanting, or by introducing 
it as a medicine. It must be remembered that those substances 
which enter into the construction of the human fabric, are not 
promiscuously employed by nature, but that each and every 
one is destined to fulfill a definite indication. 
Lime enters largely into the formation of bone, either as a 
phosphate or a carbonate, and is required in much greater quan- 
tities in early life, while the bone is undergoing development, 
than afterwards. In childhood the bones are composed largely 
of animal matter, being pliable and easily moulded. For this 
reason the limbs of young children bend under the weight of 
their bodies, and unless care is taken they become bow-legged 
and distorted. Whenever there is a continued deficiency of 
the earthy constituents, disease of the bones ensues. Therefore, 
during childhood, and particularly during the period of denti- 
tion, or teething, the food should be nutritious and at the same 
time contain a due proportion of lime, which is preferable in 
the form of a phosphate. When it cannot be furnished by 
the food, it should be supplied artificially. Delayed, prolonged, 
and tedious dentition generally arises from a deficiency of lime. 
With the advance of age it accumulates, and the bone be- 
comes hard, inelastic, and capable of supporting heavy weights. 
Farther on, as in old age, the animal matter of bone becomes 
diminished, and lime takes its place, so that the bones become 
brittle and are easily broken. Lime exists largely in hard 
water, and to a greater or less extent in milk, and in nearly 
all foods except those of an acid character. 
Phosphorus exists in various combinations in different parts 
of the body, particularly in the brain and nervous system. 
Persons who perform a large amount of mental labor require 238 
COMMON SENSE MEDICAL ADVISER. 
more phosphorus than those engaged in other pursuits. It 
exists largely in the hulls of wheat, in fish, and in eggs. It 
should enter to a considerable extent into the diet of brain 
workers, and the bread consumed by them should be made 
of unbolted flour. 
8ulphury Irony Soda, and Potash are all necessary in the 
various tissues of the body, and deficiency of any one of them, 
for any considerable length of time, results in disease. They 
are all supplied, variously arranged and combined, in both 
animal and vegetable food; in some articles they exist to a 
considerable extent, in others in much smaller quantities. 
Sulphur exists in eggs and in the flesh of animals, and often 
in water. Iron exists in the yolk of eggs, in flesh, and in sev- 
eral vegetables. Soda is supplied in nearly all food, and largely 
in common salt, which is a composition of sodium and hydro- 
chloric acid, the latter entering into the gastric juice. Potash 
exists, in some form or other, in sufficient quantities for health, 
in both vegetable and animal food. 
Classes of Food. All kinds of food substances may be 
divided into four classes: Proteids, Fats, Amyloids, and Min- 
erals. , Proteids are composed of the four elements, carbon, 
hydrogen, oxygen, and nitrogen, sometimes combined with 
sulphur and phosphorus. In this class are included the gluten 
of flour; the albumen, or white of eggs; and the serum of the 
blood; the fibrin of the blood; syntonin, the chief constituent 
of muscle and flesh, and casein, one of the chief constituents 
of cheese, and many other similar, but less frequent substances. 
Fats are composed of carbon, hydrogen, and oxygen only, 
and contain more hydrogen than would be required to form 
water if united with the oxygen which they contain. All 
vegetable and animal oils and fatty matters are included in 
this class. 
Amyloids consist of substances which are also composed 
of carbon, oxygen, and hydrogen only; but they contain just 
enough hydrogen to produce water when combined with their 
oxygen, or two parts of hydrogen to one of oxygen. This 
division includes sugar, starch, dextrine, and gum. The above 
three classes of food-stuffs are only obtained through the 
activity of living organisms, vegetable or animal, and have VARIETY OF FOOD NECESSARY. 
239 
been, therefore, appropriately termed by Prof. Huxley, vital 
food-stuffs. 
The mineral food-stuffs may, as we have seen, be procured 
from either the living or the non-living world. They include 
water and various earthy, metallic, and alkaline salts. 
Variety of Food Necessary. No substance can serve 
permanently for food except it contains a certain quantity of 
proteid matter in the shape of albumen, fibrin, casein, etc., and, 
on the other hand, any substance containing proteid matter in 
a shape in which it can be readily assimilated, may serve as a 
permanent vital food-stuff. Every substance, which is to serve 
as a permanent food, must contain a sufficient quantity, ready- 
made, of this most important and complex constituent of the 
body. In addition, it must also contain a sufficient quantity of 
the mineral ingredients which enter into the composition of the 
body. Its power of supporting life and maintaining the weight 
and composition of the body remains unaltered, whether it con- 
tains fats or amyloids or not. The secretion of urea, and, 
consequently, the loss of nitrogen, goes on continually, and the 
body, therefore, must necessarily waste unless the supply of 
proteid matter is constantly renewed, since this is the only class 
of foods that contains nitrogen in any considerable quantity. 
There can be no absolute necessity for any other food-stuffs 
but those containing the proteid and mineral elements of the 
body. From what has been said, it will readily be seen that 
whether an animal be carnivorous or herbivorous, it begins to 
starve as soon as its vital food-stuffs consist only of amyloids, 
or fats, or both. It suffers from what has been termed nitrogen 
starvation, and if proteid matters are withheld entirely, it 
soon dies. In such a case, and still more in the case of an 
animal which is entirely deprived of vital food, the organism, 
as long as it continues to live, feeds upon itself, the waste pro- 
ducts necessarily being formed at the expense of its own body. 
Although proteid matter is the essential element of food, 
and under certain circumstances may be sufficient of itself to 
support the body, it is a very uneconomical food. The white 
of an egg, which may be taken as a type of the proteids, 
contains about fifteen per cent, of nitrogen, and fifty-three 
per cent, of carbon; therefore, a man feeding upon this, would 240 
COMMON SENSE MEDICAL ADVISER. 
take in about three and a half times as much carbon as nitro- 
gen. It has been proved that a healthy, adult man, taking a 
fair amount of exercise and maintaining his weight and body 
temperature, eliminates about thirteen times as much carbon 
as nitrogen. However, if he is to get his necessary quantity, 
about 4000 grains of carbon, out of albumen, he must eat 7,547 
grains of that substance; but this quantity of albumen contains 
nearly four times as much nitrogen as he requires. In other 
words, it takes about four pounds of lean meat, free from fat, 
to furnish 4,000 grains of carbon, the quantity required, whereas 
one pound yields the requisite quantity of nitrogen. Thus a 
man restricted exclusively to a proteid diet, must take an 
enormous quantity of it. This would involve a large amount 
of unnecessary physiological labor, to comminute, dissolve, and 
absorb the food, and to excrete the superfluous nitrogenous 
matter. Unproductive labor should be avoided as much in 
physiological as in political economy. The universal practice 
of subsisting on a mixed diet, in which proteids are mixed with 
fats or amyloids, is therefore justifiable. 
Fats contain about 80 per cent, of carbon, and amyloids 
about 40 per cent. We have seen that there is sufficient nitro- 
gen in a pound of meat free from fat, to supply a healthy 
adult man for twenty-four hours, but that it contains only 
one-fourth of the quantity of carbon required. About half 
a pound of fat, or one pound of sugar, will supply the quantity 
of carbon necessary. The fat, if properly subdivided, and the 
sugar, by reason of its solubility, pass with great ease into 
the circulation, the physiological labor, consequently, being re- 
duced to a minimum. 
Several common articles of diet contain in themselves all 
the necessary elements. Thus, butchers' meat ordinarily con- 
tains from 30 to 50 per cent, of fat; and bread contains the 
proteid, gluten, and the amyloids, starch and sugar, together 
with minute quantities of fat. However, on account of the 
proportion in which these proteid and other components of 
the body exist in these substances, neither of them, by itself 
is such a physiologically economical food, as it is when combined 
with the other in the proportion of three to eight, or three- 
quarters of a pound of meat to two pounds of bread a day. VALUE OF ANIMAL FOOD. 
241 
It is evident that a variety of food is necessary for health. 
Animals fed exclusively upon one class, or upon a single article 
of diet, droop and die; and in the human family we know that 
the constant use of one kind of diet causes disgust, even when 
not very long continued. Consequently, we infer that the 
welfare of man demands that his food be of sufficient variety 
to supply his body with all of its component parts. If this 
is not done the appetite is deranged, and often craves the 
very article which is necessary to supply the deficiency. 
After the component parts of the organism have assimilated 
the nutritious elements of particular kinds of food for a certain 
length of time, they lose the power of effecting the necessary 
changes for proper nutrition, and a supply of other material 
is imperatively demanded. When the diet has been long re- 
stricted to proteids, consisting largely of salt meats, fresh 
vegetables and fruits containing the organic acids, become in- 
dispensable; otherwise, the scorbutic condition, or scurvy, is 
almost sure to be developed. Fresh vegetables and fruits 
should be eaten in considerable quantities at the proper seasons. 
Vallie of Animal Food. The principal animal food 
used in this country consists of Pork, Mutton, Beef, and Fish. 
Beef and mutton are rich in muscle-producing material. Al- 
though pork is extensively produced in some portions of this 
country, and enters largely into the diet of some classes, yet its 
use, except in winter, is not to be encouraged. The same 
amount of beef would give far greater returns in muscular 
power. 
In addition to the meats mentioned, Wild Game furnishes 
palatable, nutritious, and easily-digested food. Domestic Fowls, 
when young, are excellent, and with the exception of geese and 
ducks, are easily digested. TFz7c? Birds are considered much 
healthier food than those Much are domesticated. All of these 
contain more or less of the elements which enter into the com- 
position of the four classes of foods. 
Vegetable Foods. Wheat is rich in all the elements 
which compose the four classes, and, when the flour is unbolted, 
it is one of the best articles for supplying all the elements. 
Barley stands next to wheat in nourishing qualities, but is 
not so palatable. 242 
COMMON SENSE MEDICAL ADVISER. 
Oats are rich in all the elements necessary for nutrition. 
Oat-meal is a favorite article of diet among the Scotch, and, 
judging from their hardy constitutions, their choice is well 
founded. In consequence of the large proportion of phosphorus 
which they contain, they are capable of furnishing a large 
amount of nourishment for the brain. 
Hye is nutritious, but it is not so rich in tissue-forming 
material. 
Indian Corn is an article well known and extensively used 
throughout the United States, and is a truly valuable one, 
capable of being prepared in a great variety of ways for 
food. It contains more carbon than wheat, and less nitrogen 
and phosphorus, though enough of both to be extremely 
valuable. 
Rice is rather meagre in nutriment; it contains but little 
phosphorous matter, with less carbon than other cereals, and 
is best and most generally employed as a diet in tropical 
countries. 
Beans and Peas are rich in nutritious matter, and furnish 
the manual laborer with a cheap and wholesome diet. 
The Potato is the most valuable of all fresh vegetables 
grown in temperate climates. Its flavor is very agreeable, and 
it contains very important nutritive and medicinal qualities, 
and is eaten almost daily by nearly every family in North 
America. Until very recently it, with the addition of a little 
butter-milk or skim-milk, constituted almost the sole diet of the 
Irish people. The average composition of the potato is stated 
by Dr. Smith to be as follows: Water 75 per cent., nitrogen 
2.1, starch 18.8, sugar 3.2, fat 0.2, salts 0.7. The relative values 
of different potatoes may be ascertained very correctly by 
weighing them in the hand, for the heavier the tuber the more 
starch it contains. • 
Turnip and Cabbage are 92.5 per cent, water, and, conse- 
quently, poor in nutrition, though they are very palatable. The 
solid portions of cabbage, however, are rich in albumen. 
It is evident that the quantity necessary to maintain the 
system in proper condition must be greatly modified by the 
habits of life, the condition of the organism, the age, the sex, 
and the climate. The daily loss of substance which must be DIGESTIBILITY OF FOOD. 
243 
replaced by material from without, as we have seen, is very 
great. In addition to the loss of carbon and nitrogen, about 
four and a half pounds of water are removed from the system 
in twenty-four hours, and it is necessary that about this quan- 
tity should be introduced into the system in some form or other, 
however much it may be adulterated. Professor Dalton states: 
" From experiments performed while living on an exclusive 
diet of bread, fresh meat, and butter, with coffee and water for 
drink, we have found that the entire quantity of food required 
during twenty-four hours by a man in full health and taking 
free exercise in the open air is as follows: 
Meat,16 oz., or 1.03 lb. avoir. 
Bread,19 " 1.19 " " 
Butter or fat, .... 3J£ " 0.22 " " 
Water,52 fluid oz., 3.38 " " 
That is to say, rather less than two and a half pounds of 
solid food, and rather over three pounds of liquid food." 
Climate exerts an important influence on the quantity 
and quality of food required by the system. In northern lati- 
tudes the inhabitants are exposed to extreme cold and require 
an abundant supply of food, and especially that which contains 
a large amount of fat. On this account fat meat is taken in 
large quantities and with a relish. The quantity of food con- 
sumed by the natives of the Arctic zone is almost incredible. 
The Russian Admiral, Saritcheff, relates that one of the Esqui- 
maux in his presence devoured a mass of boiled rice and butter 
which weighed twenty-eight pounds, at a single meal, and Dr. 
Hayes states that usually the daily ration of an Esquimau 
is from twelve to fifteen pounds of meat, one-third of which 
is fat, and on one occasion he saw a man eat ten pounds 
of walrus flesh at a single meal. The intense cold creates a 
constant craving for fatty articles of food, and some members 
of his own party were in the habit of drinking the contents 
of the oil-kettle with great apparent relish. 
Digestibility of* Food. Unless an article of diet can 
be digested it is of no value, no matter how rich it may be 
in nutriment. The quantity of food taken, will influence to a 
considerable extent, the time consumed in its digestion The 244 
COMMON SENSE MEDICAL ADVISEE. 
stomachs of all are not alike in this respect, and the subject 
of time has been a difficult one to determine. The experiments 
of Dr. Beaumont with the Canadian, St. Martin, who acci- 
dentally discharged the contents of a loaded gun into his 
stomach, creating an external opening through which the pro- 
cess of digestion could be observed, have furnished us with 
the following table, which is correct enough to show rela- 
tively, if not absolutely, the time required for the digestion 
of various articles: 
ARTICLES OF DIET. 
Mode of 
e 
Preparation. 
o -H 
K E 
Milk 
Boiled 
2 00 
44 
Raw . .. 
2 15 
Eggs, fresh . 
" 
2 00 
Whipped 
1 30 
4 4 4 4 
Roasted 
2 15 
4 4 44 
Soft boiled 
3 00 
44 44 
Hard boiled.. 
3 30 
44 44 
Fried .. 
3 30 
Custard . . . 
Baked .. 
2 45 
Codfish, cured, dry 
Boiled ... 
2 00 
Trout, salmon, fresh _ 
44 
1 30 
Fried 
1 30 
Bass, striped, " ..... 
Broiled .. 
3 00 
Flounder, " 
Fried ... 
3 30 
Catfish, " 
k4 
3 30 
Salmon, salted .. 
Boiled .. 
4 00 
Oysters, fresh . 
Raw 
2 55 
44 7 44 
Roasted 
3 15 
44 44 
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 ... 
44 
3 36 
44 44 44 44 
Fried 
4 00 
" fresh, lean, rare 
Roasted 
3 00 
Beefsteak 
Broiled ... 
3 00 
Mutton, fresh .. 
44 
3 00 
44 7 44 
Boiled .. 
3 00 
44 44 
Roasted 
3 15 
Veal, fresh .. .. . 
Broiled 
4 00 
44 7 44 
Fried .. 
4 30 
Porksteak _ 
Broiled . 
3 15 
Pork, fat and lean 
Roasted. 
5 15 
" recently salted 
Raw 
3 00 
44 44 44 
Stewed 
3 00 
44 44 44 
Broiled .. 
3 15 DIGESTIBILITY OF FOOD. 
245 
ARTICLES OF DIET. 
Mode of 
Preparation. 
Hours. 
Min. 
1 
Pork, recently salted 
Fried 
4 
15 
Boiled 
4 
30 
Turkey, wild 
Roasted 
2 
18 
" tame 
2 
30 
Boiled 
2 
25 
Goose, wild 
Chickens, full-grown 
Roasted 
2 
30 
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 
Heart, animal 
Broiled 
2 
00 
Fried 
4 
00 
Cartilage 
Boiled 
4 
15 
Tendon 
5 
30 
Hash, meat, and vegetables 
Sausage, fresh 
Warmed 
2 
30 
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 
Turnips, flat 
3 
13 
3 
30 
Beets 
Baked 
3 
45 
Bread, corn 
3 
15 
" wheat, fresh 
3 
30 
Apples, sweet, mellow 
Raw 
1 
30 
" sour, " 
2 
00 
" hard 
2 
50 
Milk is more easily digested than almost any other article 
of food. It is very nutritious, and, on account of the variety 
of the elements which it contains, it is extremely valuable as 246 
COMMON SENSE MEDICAL ADVISEE. 
article of diet, especially when the digestive powers are 
weakened, as in fevers, or during convalescence from any 
acute disease. Eggs are also very nutritious and easily digested. 
Whipped eggs are digested and assimilated with great ease. 
Fish, as a rule, are more speedily digested than is the flesh 
of warm-blooded animals. Oysters, especially when taken raw, 
are very easily digested. We have known dyspeptics who 
were unable to digest any other kind of animal food, to subsist 
for a considerable period upon raw oysters. The flesh of 
mammalia seems to be more easily digested than that of birds. 
Beef, mutton, lamb, and venison are easily digested, while fat 
roast pork and veal are digested with difficulty. According 
to the foregoing table vegetables were digested in about the 
same time as ordinary animal food, but it should be remem- 
bered that a great part of the digestion of these is effected 
in the small intestine. Soups are, as a rule, very quickly 
digested. The time required for the digestion of bread is 
about the same as that required for the digestion of ordinary 
meats. Boiled cabbage is one of the most difficult substances 
to digest. 
Cookery. " Cookery," says Mrs. Owen, " Is the art of 
turning every morsel to the best use; it is the exercise of skill, 
thought, and ingenuity to make every particle of food yield 
the utmost nourishment and pleasure, of which it is capable." 
We are indebted to this practical woman for many valuable 
suggestions in this art; and some of our recommendations 
are drawn from her experience. 
Soups. The nutritious properties, tone, and sweetness of 
soup depend in the first place upon the freshness and quality 
of the meat; secondly on the manner in which it is boiled. 
Soups should be nicely and delicately seasoned, according to 
the taste of the consumer, by using parsley, sage, savory, thyme, 
sweet marjoram, sweet basil, or any of the vegetable condi- 
ments. These may be raised in the garden, or obtained at 
the drug stores, sifted and prepared for use. In extracting 
the juices of meats, in order that soups may be most nutritious, 
it is important that the meat be put into cold water, or that 
which is not so hot as to coagulate the albumen (which would 
prevent it from being extracted), and then, by slow heat and PORK STEAKS. 
247 
a simmering process, the most nutritious properties will be 
brought out. 
Beef Soup may be made of any bone of the beef, by 
putting it into cold water, adding a little salt, and skimming it 
well just before it boils. If a vegetable flavor be desired, 
celery, carrots, onions, turnips, cabbage, or potatoes, may be 
added, in sufficient quantities to suit the taste. 
Mutton Soup may be made from the fore-quarter, in the 
same manner as described above, thickened with pearl-barley 
or rice, and flavored to suit the taste. 
Boiled Fish. Clean the fish nicely, then sprinkle flour on 
a cloth and wrap it around them; salt the water, and, when it 
boils, put in the fish; let them boil half an hour, then carefully 
remove them to a platter, adding egg sauce and parsley. To 
bake fish, prepare by cleaning, scaling, etc., and let them 
remain in salt water for a short time. Make a stuffing of the 
crumbs of light bread, and add to it a little salt, pepper, butter, 
and sweet herbs, and stir with a spoon. Then fill the fish 
with the stuffing and sew it up. Put on butter, salt, pepper, 
and flour, having enough water in the dish to keep it from 
burning, and baste often. A four pound fish will bake in fifty 
or sixty minutes. 
Broiled steak. Sirloin and porter-house steaks should 
be broiled quickly. Preserve them on ice for a day or two and 
their tenderness is much increased. Never broil them until the 
meal is ready to be served. 
Boiled Meat. When meat is to be boiled for eating, 
put it into boiling water, by which its juices are coagulated 
and its richness preserved. The slower it boils, the more 
tender, plump, and white it will be. Meat should be removed 
as soon as done, or it will lose its flavor and become soggy. 
Pork Steaks. The best steaks are cut off the shoulder 
-ham steaks being rather too dry. They should be well fried, 
in order to destroy the little living parasites, called Trichinae, 
which sometimes infest this kind of meat. They are intro- 
duced into the stomach by eating ham, pork, or sausages made 
from the flesh of hogs infested by them. Thorough cooking 
destroys them, and those who will persist in the use of swine's 
flesh, can afford to have it "done brown" 248 
COMMON SENSE MEDICAL ADVISER. 
Baked Mutton. To bake mutton well, a person should 
have a brisk, sharp fire, and keep the meat well basted. It 
requires two hours to bake a leg of mutton, weighing eight 
pounds. 
Bread. The health and happiness of a family depend, 
to a certain extent, on good, well-baked bread. At all events, 
our enjoyment would be greater if it were only better prepared. 
We make the following extract from an article printed by 
the State Board of Health, concerning the food of the people 
of Massachusetts: "As an example of good bread we would 
mention that which is always to be had at the restaurant of 
Parker's Hotel, in Boston. It is not better than is found on 
the continent of Europe on all the great lines of travel, and 
in common use by millions of people in Germany and France; 
but with us, it is a rare example of what bread may be. It 
is made from a mixture of flour, such as is generally sold in 
our markets, water, salt, and yeast-nothing else. The yeast 
is made from malt, potatoes, and hops. The dough is kneaded 
from one and a half to two hours, and is then thoroughly 
baked? The truth seems to be that the kneading, which in 
this country takes the housewife's time and muscle, in Europe 
is done by the help of machinery. So here, in large villages 
and cities, people might furnish themselves with good bread, 
by means of co-operative associations, even at a less cost than 
at present. 
BEVERAGES. 
'Water. The importance of water in the economy of 
nature is obvious to all. It is the most abundant substance of 
which we have knowledge. It composes four-fifths of the 
weight of vegetables, and three-fourths of that of animals. It 
is essential to the continuance of organic life. Water is uni- 
versally present in all of the tissues and fluids of the body. It 
is not only abundant in the blood and secretions, but it is also 
an ingredient of the solids of the body. According to the 
most accurate computations, water is found to constitute from 
two-thirds to three-fourths of the entire weight of the human 
body. The following table, compiled by Robin and Verdeil, 
shows the proportion of water per thousand parts in different 
solids and fluids: MINERAL IMPURITIES. 
249 
Teeth, . . . 100 
Bones, . . . . 130 
Cartilage, . . . 550 
Muscles, .... 750 
Ligaments, . . . 768 
Brain, .... 789 
Blood, .... 795 
Synovial fluid, . . . 805 
QUANTITY OF WATER IN 1,000 PARTS. 
Bile, .... 880 
Milk, . . . .887 
Pancreatic juice, . . 900 
Urine, .... 936 
Lymph, . . . 960 
Gastric juice, . . . 975 
Perspiration, . . 986 
Saliva, .... 995 
The Natural Drink of Man. Water constitutes the 
natural drink of man. No other liquid can supply its place. 
Its presence, however, in the body is not permanent. It is 
.discharged from the body in different ways; by the urine, 
the feces, the breath, and the perspiration. In the first two, 
it is in a liquid form, in the others in a vaporous form. It is 
estimated that about forty-eight per cent, is discharged in the 
liquid, and fifty-two per cent, in the vaporous form; but the 
absolute as well as the relative amount discharged depends 
upon a variety of circumstances. 
Water is never found perfectly pure, since it holds in solution 
more or less of almost every substance with which it comes 
in contact. Rain falling in the country remote from habitations 
is the purest water that nature furnishes, for it is then only 
charged with the natural gases of the atmosphere. In cities 
it absorbs organic and gaseous impurities, as it falls through 
the air, and flowing over roofs of houses carries with it soot 
and dust. Water from melted snow is purer than rain-water, 
since it descends in a solid form, and is therefore incapable 
of absorbing gases. Rain-water is not adapted to drinking 
purposes, unless well filtered. All water, except that which 
has been distilled, contains air, and it is due to this fact, that 
aquatic animals can live in it; for example, put a fish in 
distilled water and it will soon die. 
Mineral Impurities. Rain-water, which has filtered 
through the soil and strata of the earth, dissolves the soluble 
materials, and carries them down to lower levels, until they 
finally collect in the sea. Common well, spring, and mineral 
waters contain from 5 to 60 grains to the gallon; sea-water con- 
tains 2,600 grains; while in some parts of the Dead Sea there are 250 
COMMON SENSE MEDICAL ADVISER. 
20,000 grains to the gallon. The principal mineral impurities 
of well and spring water are lime, magnesia, soda, and oxide 
of iron, combined with carbonic and sulphuric acids, forming 
carbonates, sulphates, and chloride of sodium, or common salt. 
The most general, however, are carbonate and sulphate of lime. 
Mineral w'aters are usually obtained from springs which con- 
tain a considerable amount of saline matter. Those waters 
which abound in salts of iron are called chalybeate or ferru- 
ginous. Those containing salt are termed saline. Those in 
which contain sulphur are termed sulphurous. Water derives 
the quality of hardness from the salts of lime-chiefly the 
sulphates-which it contains. Hard water, being an imper- 
fect solvent, is unsuitable for washing purposes. There are* 
two varieties of hardness, one of which is temporary, being 
due to the presence of carbonic acid gas in the water which 
holds the salts in solution and may be removed by merely 
boiling the water and thus expelling the gas when the salts 
are deposited, while the other is permanent and can only be 
removed by the distillation of the water. It has been ascer- 
tained that twelve pounds of the best hard soap must be added 
to 10,000 gallons of water of one degree of hardness before 
a lather will remain and, consequently, 0.12 lb. to 100 gallons 
of water is a measure of one degree of hardness. Since hard 
water is not so useful in cooking and other domestic purposes, 
as soft water, causing a great waste of labor and material, it 
is often highly desirable to soften it, which is effected by the 
addition of lime in what is known as Clark's process. One 
ounce of quicklime should be added to 1000 gallons of water 
for each degree of hardness. It should be first slacked and 
stirred up in a few gallons and then thoroughly mixed with 
the entire quantity. Then it should be allowed to remain, 
and will become clear in about three hours, but should not 
be drunk for twelve hours. 
The purity of drinking water is a matter of much impor- 
tance. That which contains a minute quantity of lead will 
give rise to all the symptoms of lead poisoning, if the use of it 
be sufficiently prolonged. An account is given of the poison- 
ing of the royal family of France, many of whom suffered 
from this cause when in exile at Claremont. The amount of ORGANIC IMPURITIES. 
251 
lead was only one grain in the gallon. Care should therefore 
be taken to avoid drinking the water which has been contained 
in leaden pipes. It should always be allowed to run a few 
minutes before being used. 
An excess of saline ingredients, which in small quantities 
are harmless, frequently produces marked disorders of the 
digestive organs. A small amount of putrescent matter habitu- 
ally introduced into the system, as in the use of food, is pro- 
ductive of the most serious results, which can be traced to 
the direct action of the poison introduced. A case is recorded 
of a certain locality favorably situated with regard to the 
access of pure air, where an epidemic of fever broke out much 
•to the astonishment of the inhabitants. Upon observation it 
was found that the attacks of fever were limited to those 
families who used water from a neighboring well. The dis- 
agreeable taste of the water which had been observed, was 
subsequently traced to the bursting of a sewer, which had 
discharged a part of its contents into the well. When the 
cause was removed, there was no recurrence of the evil effects. 
Organic Impurities. Water is liable to organic con- 
tamination from a multitude of causes, such as drainage from 
dwellings, dust, insects, the decaying of vegetable and animal 
matter. These impurities may be mechanically suspended or 
held in solution in the water. Although organic impurities, 
which are mechanically suspended in water, are poisonous, 
yet they are generally associated with animalculse, and these 
feed upon, and finally consume them. Good water never con- 
tains animalculae. They are never found in freshly fallen rain- 
water, remote from dwellings, but abound, to a greater or less 
extent in cisterns, marshes, ponds, and rivers. These little 
workers serve a useful purpose since they consume the dead 
organic matter from the water, and, having fulfilled their 
mission, sink to the bottom and die. Water which contains 
organic matter is exceedingly dangerous to health, and its use 
should be carefully avoided. 
In low lands where the current of streams is sluggish, and 
shallow pools abound, the water is apt to be more or less in- 
fected with decaying vegetable substances. Many people living 
in such localities, and wishing to obtain water with as little 252 
COMMON SENSE MEDICAL ADVISER. 
trouble as possible, .dig a hole in the ground, a few feet in 
depth, and allow the stagnant surface water to accumulate. 
This water is used for drinking and cooking. The result is 
that ague prevails in such localities. 
Care should be taken that wells, from which the water is used 
for. household purposes, are located at a distance from barn- 
yards, privies, sinks, vaults, and stagnant pools. 
Purification of Water. There are various methods 
of purifying water. It may be accomplished by distillation, 
which is the most perfect method; by filtration through sand, 
crushed charcoal, and other porous substances, which deprives 
it of suspended impurities and living organisms; by boiling, 
which destroys the vitality of all animal and vegetable matters, 
drives out the gases and precipitates carbonate of lime, which 
composes the crust frequently seen upon the inside of tea- 
kettles or boilers; by the use of chemical agents, which may be 
employed to destroy oi' precipitate the deleterious substances. 
Alum is often used to cleanse roily water, two or three grains 
in solution, being sufficient for a quart. It causes the impurities 
to settle to the bottom, so that the clear water can be poured 
or dipped out for use. One or two grains of the permanganate 
of potassium will render wholesome a gallon of water con- 
taining animal impurities. 
How to Use Water. Very little if any water should 
be taken at meal time, since the salivary glands furnish an 
abundance of watery fluid to assist in mastication. When 
these glands are aided with water to "wash down" the food, 
their functions become feeble and impaired. The gastric juice 
is diluted and digestion is weakened. Large draughts of cold 
water ought never to be indulged in, since they cause derange- 
ment of the stomach. When the body is overheated, the use 
of much water is injurious. It should only be taken in small 
quantities. Thirst may be partially allayed, without injury, 
by holding cold water in the mouth for a short time and then 
spitting it out, taking care to swallow but very little. Travelers 
frequently experience inconvenience from change of water. 
If the means are at hand, let them purify their drinking water, 
if not, they should drink as little as possible. Persons who 
visit the banks of the Ohio, Missouri, or Mississippi rivers and TEA AND COFFEE. 
253 
similar localities, almost invariably suffer from some form of 
gastric or intestinal disease. Water standing in close rooms 
soon becomes unfit to drink and should not be used. A drink 
of cold water taken on going to bed, and another on rising 
are conducive to health, especially in the case of persons 
troubled with constipation. "Drink water " said the celebrated 
Dubois to the young persons who consulted him, " drink water, 
I tell you!" Du Moulin, the great medical authority of his 
time, wrote, just previous to his death, " I leave two great phy- 
sicians behind me-diet and water." 
Tea and Coffee. These substances are almost universally 
used as beverages, and when properly employed, serve a four- 
fold purpose: they quench thirst, excite an agreeable exhilara- 
tion, repress the waste of the system, and supply nourishment. 
In consequence of being generally used at meal times, their 
stimulant properties are employed to promote digestion, and 
consequently they are not so objectionable as they might other- 
wise be. The liquids introduced into the stomach at meal times 
should not be cold. Tea and coffee are drunk warm, while 
water, except in a few instances, is always drunk cold, the 
effects of which have already been shown. That their inordi- 
nate use may be injurious no body can deny, but this is equally 
true of other beverages, even pure, cold water. Scientific 
investigators inform us that the use of these agents as bev- 
erages, when judiciously employed, is not injurious. It has 
been urged that they are poisonous, but if they are, they are 
very slow in their operation. 
When properly prepared, they are very agreeable beverages, 
and as man will drink more or less at meals, they are allowable; 
for if their use were excluded, some other beverage would be 
sought after, and quite likely one of an alcoholic character 
employed, so of two evils, if this be an evil, let us choose the 
least. Unlike alcoholic stimulants, they exhilarate without 
a depressing reaction aftei- their influence has passed off. But 
one cup should be drunk at a meal, and it should be of mod- 
erate strength. The use of large quantities of drink at meals 
retards digestion by diluting the digestive fluids. The exces- 
sive use of large quantities of strong tea or coffee stimulates 
the brain and causes wakefulness, and produces irritability COMMON SENSE MEDICAL ADVISER. 
254 
of the nervous system. When they are productive of such 
effects, their use is injurious, and should be considerably mod- 
erated or wholly discontinued. No criterion can be given by 
which the amount the system will tolerate can be regulated. 
What one person may take with impunity, may be deleterious 
to an other. Individuals differ greatly in this respect. There 
are some who cannot tolerate them at all, either because of 
some peculiarity of constitution, or on account of disease. And 
sometimes when tea is agreeable and beneficial, coffee disagrees 
with the individual and vice versa. Persons of nervous 
habits whether natural or acquired, are apt to find their wake- 
fulness and irritability increased by the use of tea, particularly 
if strong, while coffee will have a tranquilizing effect. Persons 
of a lymphatic or bilious temperament often find that coffee 
disagrees with them, aggravating their troubles and causing 
biliousness, constipation, and headache, while tea proves agree- 
able and beneficial. Whenever they disagree with the system, 
the best rule is to abandon their use. We find many persons 
who do not use either, and yet enjoy health, a fact which proves 
that they are not by any means indispensable, and, no doubt, 
were it customary to go without them, their absence would 
be but slightly missed. 
Tea and coffee are adulterated to a very great extent, and 
persons using them will be greatly imposed upon. This is an 
evil we cannot remedy. If people make use of them, their 
experience in selecting them must be their guide; however, it 
is believed that the Black and Japan varieties of tea are the 
least apt to be adulterated, and coffee, to insure purity, should 
be purchased in the berry, and ground by the purchaser. 
In preparing tea an infusion should be made by adding boil- 
ing water to the leaves, and permitting them to steep for a few 
minutes only, for a concentrated decoction, made by boiling 
for a long time, liberates the astringent and bitter principles 
and drives off the agreeable aroma which resides in a vola- 
tile oil. 
Coffee should be prepared by adding cold water to the 
ground berry, and raising it slowly to the boiling point. Long- 
continued boiling liberates the astringent and bitter principles 
upon which its stimulant effects to a great extent depend, and ALCOHOLIC LIQUORS. 
255 
drives off with the steam the aromatic oil from which the 
agreeable taste is derived. 
ALCOHOLIC LIQUORS. 
These are divided into three classes: malted, fermented, and 
distilled. They all contain more or less alcohol, and their 
effects are, therefore, in some respects similar, and, in the words 
of Dr. B. W. Richardson, the great English authority on 
hygiene: "To say this man only drinks ale, that man only 
drinks wine, while a third drinks spirits, is merely to say, when 
the apology is unclothed, that all drink the same danger. - * * 
Alcohol is a universal intoxicant, and in the higher orders of 
animals is capable of inducing the most systematic phenomena 
of disease. But it is reserved for man himself to exhibit these 
phenomena in their purest form, and to present, through them, 
in the morbid conditions belonging to his age, a distinct pa- 
thology. Bad as this is, it might be worse; for if the evils of 
alcohol were made to extend equally to animals lower than man, 
we should soon have, none that were tameable, none that were 
workable, and none that were eatable." Researches have shown 
that the proportion of half a drachm of alcohol to the pound 
weight of the body, is the quantity which usually produces 
intoxication, and that an increase of this amount to one drachm 
immediately endangers the life of the individual. The first 
symptom which attracts attention, when alcohol commences to 
take effect upon the body, is an increase in the number- of the 
pulsations of the heart. Dr. Parkes and Count Wolowicz con- 
ducted a series of interesting experiments on young adult men. 
They counted the pulsations of the heart, at regular intervals, 
during periods when the subject drank only water; and then 
they counted the beats of the heart in the same individual 
during successive periods in which alcohol was drunk in in- 
creasing quantities. 
The following details are taken from their report: 
" The highest of the daily means of the pulse observed dur- 
ing the first or water period was 77.5 ; but on this day two 
observations were deficient. The next highest daily mean was 
*7-7 beats. 
If instead of the mean of the eight days, or 73.57, we 256 
COMMON SENSE MEDICAL ADVISER. 
compare the mean of this one day, viz., 77 beats per minute, 
with the alcoholic days, so as to be sure not to over-estimate 
the action of the alcohol, we find: 
On the ninth day, with one fluid ounce of alcohol, the heart beat 
430 times more. 
On the tenth day, with two fluid ounces, 1,872 times more. 
On the eleventh day, with four fluid ounces, 12,960 times more. 
On the twelfth day, with six fluid ounces, 30,672 times more. 
On the thirteenth day, with eight fluid ounces, 23.904 times more. 
On the fourteenth day, with eight fluid ounces, 25,488 times more. 
But as there was ephemeral fever on the twelfth day, it is 
right to make a deduction, and to estimate the number of beats 
in that day as midway between the twelfth and twenty-third 
days, or 18,432. Adopting this, the mean daily excess of beats 
during the alcoholic days was 14,492, or an increase of rather 
more than thirteen per cent. 
The first day of alcohol gave an excess of one per cent., and 
the last of twenty-three percent.; and the mean of these two 
gives almost the same percentage of excess as the mean of the 
six days. 
Admitting that each beat of the heart was as strong during 
the alcoholic as in the water period (and it was really more 
powerful), the heart on the last two days of alcohol was doing 
one-fifth more work. 
Adopting the lowest estimate which has been given of the 
daily work done by the heart, viz., as equal to 122 tons lifted 
one foot, the heart, during the alcoholic period, did daily 
work in excess equal to lifting 15.8 tons one foot, and in the 
last two days did extra work to the amount of twenty-four 
tons lifted as far. 
The period of rest for the heart was shortened, though, 
perhaps, not to such an extent as would be inferred from the 
number of beats; for each contraction was sooner over. The 
beat on the fifth and sixth days after alcohol was left off, and 
apparently at the time when the last traces of alcohol were 
eliminated, showed, in the sphygmographic tracing, signs of 
unusual feebleness; and, perhaps, in consequence of this, when 
the brandy quickened the heart again, the tracing showed a 
more rapid contraction of the ventricles, but less power than ALCOHOLIC LIQUORS. 
257 
in the alcoholic period. The brandy acted, in fact, on a heart 
whose nutrition had not been perfectly restored." 
The flush often seen on the cheeks of those who are under 
the influence of alcoholic liquors, and which is produced by 
a relaxed and distended condition of the superficial blood- 
vessels, is erroneously supposed by many to merely extend 
to the parts exposed to view. On this subject, Dr. Richard- 
son says: "If the lungs could be seen, they, too, would be 
found with their vessels injected; if the brain and spinal 
cord could be laid open to view, they would be discovered in 
the same condition; if the stomach, the liver, the spleen, the 
kidneys, or any other vascular organs or parts could be laid open 
to the eye, the vascular engorgement would be equally mani- 
fest. In the lower animals I have been able to witness this 
extreme vascular condition in the lungs, and once I had the 
unusual, though unhappy opportunity of observing the same 
phenomenon in the brain of a man who, in a paroxysm of 
alcoholic delirium, cast himself under the wheels of a railway 
carriage. The brain, instantaneously thrown out from the 
skull by the crash, was before me within three minutes after 
the accident. It exhaled the odor of spirit most distinctly, 
and its membranes and minute structures were vascular in the 
extreme. It looked as if it had been recently injected with 
vermilion injection. The white matter of the cerebrum, 
studded with red points, could scarcely be distinguished when 
it was incised, it was so preternaturally red; and the pia mater, 
or internal vascular membrane covering the brain, resembled 
a delicate web of coagulated red blood, so tensely were its 
fine vessels engorged. This condition extended through both 
the larger and the smaller brain, cerebrum, and cerebellum, but 
was not so marked in the medulla, or commencing portion 
of the spinal cord, as in the other portions. 
In course of time, in persons accustomed to alcohol, the 
vascular changes, temporary only in the novitiate, become con- 
firmed and permanent. The bloom on the nose which charac- 
terizes the genial toper is the established sign of alcoholic 
action on the vascular structure. 
Recently, physiological research has served to explain the 
reason why, under alcohol, the heart at first beats so quickly, 258 
COMMON SENSE MEDICAL ADVISER. 
why the pulse rises, and why the minute blood-vessels become 
so strongly injected. 
At one time it was imagined that alcohol acts immediately 
upon the heart by stimulating it to increased motion; and from 
this idea,-false idea, I should say,-of the primary action of 
alcohol, many erroneous conclusions have been drawn. We 
have now learned that there exist many chemical bodies which 
act in the same manner as alcohol, and that their effect is not 
to stimulate the heart, but to weaken the contractile force 
of the extreme and minute vessels which the heart fills with 
blood at each of its strokes. These bodies produce, in fact, a 
paralysis of the organic nervous supply of the vessels which 
constitute the minute vascular structures. The minute vessels 
when paralysed offer inefficient resistance to the force of the 
heart, and the pulsating organ thus liberated, like the main- 
spring of a clock from which the resistance has been removed, 
quickens in action, dilating the feebly resistant vessels, and 
giving evidence really not of increased, but of wasted power." 
The continued use of alcoholic liquors in any considerable 
quantity produces irritation and inflammation of the stomach, 
and structural disease of the liver. Dr. Hammond has shown 
that alcohol has a special affinity for nervous matter, and is, 
therefore, found in greater quantity in the brain and spinal cord 
than elsewhere in the body. The gray matter of the brain 
undergoes, to a certain extent, a fatty degeneration, and there 
is a shrinking of the whole cerebrum, with impairment of the 
intellectual faculties, muscular tremor, and a shambling gait. 
Large doses of alcohol cause a diminution of the temperature 
of the body, which in fevers is more marked than in the normal 
state. 
In addition to the organic diseases enumerated above, and 
delirium tremens, the following diseases are frequently the 
result of the excessive use of alcoholic liquors: epilepsy, pa- 
ralysis, insanity, diabetes, gravel, and diseases of the heart and 
blood-vessels. 
The physiological deductions of Dr. Richardson are so much 
in accord with our own that we quote them in full: 
" In the first place we gather from the physiological reading 
of the action of alcohol that the agent is narcotic. I have ALCOHOLIC LIQUORS. 
259 
compared it throughout to chloroform, and the comparison is 
good in all respects save one, viz.: that alcohol is less fatal than 
chloroform as an instant destroyer. It kills certainly in its own 
way, but its method of killing is slow, indirect, and by disease. 
The well-proven fact that alcohol, when it is taken into the 
body, reduces the animal temperature, is full of the most 
important suggestions. The fact shows that alcohol does not 
in any sense act as a supplier of vital heat as is commonly 
supposed, and that it does not prevent the loss of heat as those 
imagine ' who take just a drop to keep out the cold? It shows, 
on the contrary, that cold and alcohol, in their effects on the 
body, run closely together, an opinion confirmed by the experi- 
ence of those who live or travel in cold regions of the earth. 
The experiences of the Arctic voyagers, of the leaders of the 
great Napoleonic campaigns in Russia, of the good monks of 
St. Bernard, all testify that death from cold is accelerated by its 
ally alcohol. Experiments with alcohol in extreme cold tell 
the like story, while the chilliness of the body which succeeds 
upon even a moderate excess of alcoholic indulgence leads 
directly to the same indication of truth. 
The conclusive evidence now in our possession that alcohol 
taken into the animal body sets free the heart, so as to cause 
the excess of motion of which the record has been given above, 
is proof that the heart, under the frequent influence of alcohol, 
must undergo deleterious change of structure. It may, indeed, 
be admitted in proper fairness, that when the heart is passing 
through these rapid movements it is working under less pressure 
than when its movements are slow and natural; and this allow- 
ance must needs be made, or the inference would be that the 
organ ought to stop at once, in function, by the excess of strain 
put upon it. At the same time the excess of motion is injurious 
to the heart and to the body at large; it subjects the heart to 
irregularity of supply of blood, it subjects the body in all its 
parts to the same injurious influence; it weakens, and, as a 
necessary sequence, degrades both the heart and the body. 
Speaking honestly, I cannot, by any argument yet presented 
to me, admit the alcohols by any sign that should distinguish 
them from other chemical substances of the paralysing narcotic 
class. When it is physiologically understood that what is called 260 
COMMON SENSE MEDICAL ADVISER. 
stimulation or excitement is, in absolute fact, a relaxation, a 
partial paralysis, of one of the most important mechanisms in 
the animal body, the minute, resisting, compensating circulation, 
we grasp quickly the error in respect to the action of stimulants 
in which we have been educated, and obtain a clear solution of 
the well-known experience that all excitement, all passion, 
leaves, after its departure, lowness of heart, depression of mind, 
sadness of spirit. We learn, then, in respect to alcohol, that 
the temporary excitement it produces is at the expense of the 
animal force, and that the ideas of its being necessary to resort 
to it, that it may lift up the forces of the animal body into true 
and firm and even activity, or that it may add something useful 
to the living tissues, are errors as solemn as they are widely 
disseminated. In the scientific education of the people no fact 
is more deserving of special comment than this fact, that excite- 
ment is wasted force, the running down of the animal mechanism 
before it has served out its time of motion. 
It will be said that alcohol cheers the weary, and that to take 
a little wine for the stomach's sake is one of the lessons that 
comes from the deep recesses of human nature. I am not so 
obstinate as to deny this argument, There are times in the life 
of man when the heart is oppressed, when the resistance to its 
motion is excessive, and when blood flows languidly to the 
centres of life, nervous and muscular. In these moments alcohol 
cheers. It lets loose the heart from its oppression; it lets flow a 
brisker current of blood into the failing organs; it aids nutritive 
changes, and altogether is of temporary service to man. So far, 
alcohol may be good, and if its use could be limited to this one 
action, this one purpose, it would be amongst the most excellent 
of the gifts of science to mankind. Unhappily, the border line 
between this use and the abuse of it, the temptation to extend 
beyond the use, the habit to apply the use when it is not wanted 
as readily as when it is wanted, overbalance, in the multitude 
of men, the temporary value that attaches truly to alcohol as 
a physiological agent. Hence alcohol becomes a dangerous 
instrument even in the hands of the strong and wise, a 
murderous instrument in the hands of the foolish and weak. 
Used too frequently, used too excessively, this agent, which 
in moderation cheers the failing body, relaxes its vessels too ALCOHOLIC LIQUOKS. 
261 
extremely; Bpoils vital organs; makes the force of the circu- 
lation slow, imperfect, irregular; suggests the call for more 
stimulation; tempts to renewal of the evil, and ruins the 
mechanism of the healthy animal before its hour for ruin, by 
natural decay, should be at all near. 
It is assumed by most persons that alcohol gives strength, and 
we hear feeble persons saying daily that they are being ' kept 
up by stimulants? This means actually that they are being 
kept down; but the sensation they derive from the immediate 
action of the stimulant deceives them and leads them to 
attribute passing good to what, in the large majority of cases, 
is persistent evil. The evidence is all-perfect that alcohol gives 
no potential power to brain or muscle. During the first stage 
of action it may enable a wearied or a feeble organism to do 
brisk work for a short time; it may make the mind briefly 
brilliant; it may excite muscle to quick action, but it does 
nothing substantially, and fills up nothing it has destroyed, as 
it leads to destruction. A fire makes a brilliant sight, but 
leaves a desolation. It is the same with alcohol. 
On the muscular force the very slightest excess of alcoholic 
influence is injurious. I find by measuring the power of muscle 
for contraction in the natural state and under alcohol, that so 
soon as there is a distinct indication of muscular disturbance, 
there is also indication of muscular failure, and if I wished 
by scientific experiment to spoil for work the most perfect 
specimen of a working animal, say a horse, without inflicting 
mechanical injury, I could choose no better agent for the 
purpose of the experiment than alcohol. But alas! the readi- 
ness with which strong, well-built men slip into general paralysis 
under the continued influence of this false support, attests how 
unnecessary it would be to subject a lowei' animal to the 
experiment. The experiment is a custom, and man is the 
subject. 
The true place of alcohol is clear; it is an agreeable temporary 
shroud. The savage, with the mansions of his soul unfurnished, 
buries his restless energy under its shadow. The civilized man 
overburdened with mental labor, or with engrossing care, seeks 
the same shade; but it is shade, after all, in which, in exact 
proportion as fie seeks it, the seeker retires from perfect natural 262 
COMMON SENSE MEDICAL ADVISER. 
life. To search for force in alcohol is, to my mind, equivalent 
to the act of seeking for the sun in subterranean gloom until 
all is night. 
It may be urged that men take alcohol, nevertheless, take it 
freely, and yet live; that the adult Swede drinks his average 
cup of twenty-five gallons of alcohol per year and remains on 
the face of the earth. I admit force even in this argument, for 
I know under the persistent use of alcohol there is a limited 
provision for the continuance of life. In the confirmed alcoholic 
the alcohol is, in a certain sense, so disposed of that it fits, as it 
were, the body for a long season, nay, becomes part of it; and 
yet it is silently doing its fatal work. The organs of the body 
may be slowly brought into a state of adaptation to receive it 
and to dispose of it. But in that very preparation they are 
themselves made to undergo physical changes tending to the 
destruction of their function, to perversion of their structure, 
and to all those varied modifications of organic parts which the 
dissector of the human subject learns to recognize,-almost 
without concern, and certainly without anything more than 
commonplace curiosity,-as the devastations incident to alcoholic 
indulgence." 
The statistics collected from the census of the United States 
for 1860, and given by Dr. De Marmon, in the New York 
Medical Journal for December, 1870, must carry conviction 
to all minds of the correctness of the foregoing deductions: 
"For the last ten years the use of spirits has, 1. Imposed on 
the nation a direct expense of 600,000,000 dollars. 2. Has 
caused an indirect expense of 600,000,000 dollars. 3. Has 
destroyed 300,000 lives. 4. Has sent 100,000 children to the 
poorhouses. 5. Has committed at least 150,000 people into 
prisons and workhouses. 6. Has made at least 1,000 insane. 
7. Has determined at least 2,000 suicides. 8. Has caused the 
loss by fire or violence, of at least 10,000,000 dollars' worth 
of property. 9. Has made 200,000 widows and 1,000 orphans." 
If these were the statistics twenty-four years ago, with our 
greatly increased population, what must they be to-day? We 
will let the reader draw his own conclusions. 
Mailed Liquors. Under this head are included all those 
liquors into the composition of which malt enters, such as FERMENTED LIQUORS. 
263 
beer, ale, and porter. The proportion of alcohol in these liq- 
uors varies greatly. In beer, it is from two to five per cent.; 
in Edinburgh ale, it amounts to six per cent.; in porter, it is 
usually from four to six per cent. In addition to alcohol and 
water, the malted liquors contain from five to fourteen per cent, 
of the extract of malt, and from 0.16 to 0.60 per cent, of 
carbonic acid. They possess, according to Pereira, three prop- 
erties: they quench thirst; they stimulate, cheer, and, if taken 
in sufficient quantity, intoxicate; and they nourish or strengthen. 
The first of these qualities is due to the water entering into 
their composition; the second,to the alcohol; the third is attrib- 
uted to the nutritive principles of the malt. 
Objections to their use as Beverages. These ar- 
ticles are either pure or adulterated. In their pure state the 
objection to their use for this purpose lies in the fact that they 
contain alcohol. This, as we have seen, is a poisonous sub- 
stance, which the human system in a state of health does not 
need. Its use, when the body is in a normal condition, is 
uncalled for, and can only be deleterious. Beverages containing 
this poison are more or less deleterious to healthy persons, 
according to the amount of it which they contain. 
These liquors are frequently adulterated, and this increases 
their injurious effects. The ingenuity of man has been taxed 
to increase their intoxicating properties; to heighten the color 
and flavor, to create pungency and thirst; and to revive old 
beer. To increase the intoxicating power, tobacco or the seeds 
of the Cocculus indicus are added; to heighten the color and 
flavor, burnt sugar, liquorice, or treacle, quassia, or strychnine, 
coriander, and caraway seeds are employed; to increase the 
pungency, cayenne pepper or common salt is added; to revive 
old beer, or ale, it is shaken up with green vitriol or sulphate of 
iron, or with alum and common salt. 
Fermented Liquors. These are cider and wine. 
Cider contains alcohol to the amount of from five to ten per 
cent., saccharine matter, lactic acid, and other substances. New 
cider may be drunk in large quantities without inducing intoxi- 
cation, but old cider is quite as intoxicating as ale or porter. 
The composition of wine is very complex, the peculiar 
qualities which characterize the different varieties cannot be 264 
COMMON SENSE MEDICAL ADVISER. 
ascertained by chemical analysis. Wine is a solution of alcohol 
in water, combined with various constituents of the grape. The 
amount of alcohol in wines ranges from six to forty per cent. 
As beverages, these are open to the same objections as those 
manufactured from malt. As a medicine, wine is a useful 
remedy. Concerning its use in this capacity, Prof. Liebig says: 
" Wine is a restorative. As a means of refreshment when 
the powers of life are exhausted-as a means of compensation 
where a misappropriation occurs in nutrition, and as a means 
of protection against transient organic disturbances, it is sur- 
passed by no product of nature or art." That an article is 
useful in medicine, however, is no reason why it should be used 
as a beverage by those in health. It is rather an argument 
against such a practice. For it is generally true that the 
drugs used to restore the diseased system to health, are per- 
nicious or poisonous to it when in a normal condition. 
Distilled Liquors. These are whisky, brandy, and 
the kindred productions of the still. Whisky is a solution 
of alcohol in water, mixed with various other principles which 
impart to it peculiar physical properties. The amount of 
alcohol which it contains varies from forty-eight to fifty-six 
per cent. Old whiskey is more highly prized than the more 
recent product of the still, from the fact that when kept for 
some years certain volatile oils are generated which impart to 
it a mellowness of flavor. 
Brandy is a solution of alcohol in water, together with various 
other substances. It contains from fifty to fifty-six per cent, 
of alcohol. Pure brandy is distilled from wine, 1,000 gallons 
of wine yielding from 100 to 150 gallons of brandy, but a 
very large proportion of the brandy is made with little or 
no wine. It is made artificially from high wines by the addition 
of oil of Cognac, to give it flavor, burnt sugar to give it color, 
and logwood or catechu, to impart astringency and roughness of 
taste. The best brandy is obtained by distillation from the best 
quality of white wines, from the districts of Cognac and Ar- 
magnac. in France. 
THE CLOTHING. 
There is no physical agent which exerts a more constant 
or more powerful influence upon health and life, than the THE CLOTHING. 
265 
atmosphere. The climate in these latitudes is exceedingly vari- 
able, ranging all the way from 110® Fahr, in summer to 40® 
below zero in the winter season. The body of every individual 
should be so protected from cold, that it can maintain a 
mean temperature of 98® Fahr. 
When the body is warm there is a free and equal circulation 
of the blood throughout all the structures. When the surface 
is subjected to cold, the numerous capillaries and minute vessels 
carrying the blood, contract and diminish in size, increasing 
the amount of this fluid in the internal organs, thus causing con- 
gestion. The blood must go somewhere, and if driven from the 
surface, it retreats to the cavities within. Hence this repletion 
of the vital organs causes pain from pressure and fullness of 
the distended blood-vessels, and the organic functions are em- 
barrassed. Besides, cold upon the surface shuts up the pores 
of the skin, which are among the most active and important 
excretory ducts of the system. It is evident, then, that we 
require suitable clothing, not only for comfort, but to maintain 
the temperature and functions essential to health and life. 
The chief object to be attained by dress is the maintenance 
of a uniform temperature of the body. To attain this end, it is 
necessary that the exhalations of the system, which are con- 
tinually escaping through the pores of the skin, should be 
absorbed or conducted away from the person. These exuda- 
tions occur in the form of sensible or insensible perspiration, 
and the clothing, to be healthy, should be so porous as -to allow 
them freely to escape into the air. 
A substance should also be chosen which is known to be a 
poor conductor of heat. That generated by the system will 
thus be retained where it is needed, instead of being dispersed 
into the atmosphere. 
We might add that the better the material for accomplishing 
these purposes, the less will be needed to be worn; for we do 
not wish to wear or carry about with us any more material than 
is necessary. It so happens that all of these qualities are found 
combined in flannel. The value of this article worn next to 
the skin cannot be over-rated, for while it affords protection 
from cold during the winter months, it is equally beneficial 
during the heat of summer, because it imbibes the perspiration, 266 
COMMON SENSE MEDICAL ADVISEE. 
and being very porous, allows it to escape. The skin always 
feels soft, smooth, and pliable, when it is worn; but, when 
cotton takes its place, it soon becomes dry and harsh. Its 
natural adaptability to these purposes, shows that it is equally 
a comfort and a source of health. Where the skin is very 
delicate, flannel sometimes causes irritation. In such cases a 
thin fabric of linen, cotton, or silk, should be worn next the 
skin, with flannel immediately over it. Where there is a uni- 
form and extreme degree of heat, cotton and linen are very 
conducive to comfort. But they are unsuitable in a climate or 
season liable to sudden fluctuations in temperature. 
The value of furs, where people are exposed to extreme cold, 
cannot be overestimated. They are much warmer than wool, 
and are chiefly used as wraps on going outdoors. They are too 
cumbrous and expensive for ordinary wear in this latitude, but 
in places near the poles they constitute the chief clothing of the 
inhabitants. 
The quantity of clothing worn is another important item. 
The least that is necessary to keep the body well protected and 
evenly tempered when employed is the rule of health. Some 
people, instead of wearing flannels next to the body, put on 
other material in greater abundance, thus confining the perspira- 
tion to the skin and making the body chilly. The amount of 
clothing is then increased, until they are so heavily clad that 
they cannot exercise. It is far better to wear one thickness of 
flannel next to the skin, and then cotton, or woolen, for outside 
garments, and be able to exercise, thus allowing the blood to 
circulate and to assist in the warming process. 
One great fault in dress consists in neglecting to properly 
clothe the upper extremities. Some people do not reflect upon 
the necessity, while others are too proud to be directed by plain 
common sense. In the winter season, the feet should be covered 
with woolen stockings. The next matter of importance, is to 
get a thick, broad-soled shoe, so large that it will not prevent 
the free circulation of the blood. Then for walking, and 
especially for riding, when the earth is wet and cold, or when 
there is snow on the ground, wear a flannel-lined rubber or 
"Arctic " over-shoe. Be sure and keep the feet comfortable and 
warm at all times. THE CLOTHING. 
267 
Our next advice is to keep the legs warm. We were called 
not long ago, to see a young lady who had contracted a severe 
cold. She had been to an entertainment where the apartments 
were nicely warmed, and from thence had walked home late 
in the evening. We inquired into the circumstances of the case, 
and ascertained that she wore flannel about her chest, and that 
she also wore rubbers over her shoes, but the other portions of 
the lower extremities were protected by cotton coverings. In 
short, her legs were not kept warm, and she took cold by going 
out from warm rooms into a chilly atmosphere. A good pair of 
woolen leggings might have saved her much suffering. The re- 
sults of insufficient protection of the lower extremities are colds, 
coughs, consumption, headaches, pain in the side, menstrual 
derangements, uterine congestion and disorders, besides disable- 
ment for the ordinary and necessary duties of life. All these 
may be prevented by clothing the legs suitably, and wearing 
comfortable flannels. 
Young people can bear a low temperature of the body better 
than old people, because they possess greater power of endur- 
ance. But that is no reason for unnecessary exposure. 
The amount of clothing should be regulated according to the 
heat-generating power of the individual, and also according to 
the susceptibility to cold. No two persons are exactly alike in 
these respects. But it is never proper for young people to 
reject the counsels of experience, or treat lightly the advice 
to protect themselves thoroughly against the cold. Many a 
parent's heart has ached as he has followed the mortal remains 
of a darling child to the grave, knowing that if good advice had 
been heeded, in all human probability, the life would have been 
prolonged. 
The most deleterious mechanical errors in clothing are those 
which affect the chest and body. Tight lacing still plays too 
important a part in dress. It interferes with the free and 
healthy movements of the body, and effects a pressure which is 
alike injurious to the organs of respiration, circulation, and 
digestion. The great muscle of respiration, the diaphragm, is 
impeded in its motion, and is, therefore, unable to act freely. 
The large blood-vessels are compressed, and when the pressure 
is excessive the heart and lungs are also subjected to restraint 268 
COMMON SENSE MEDICAL ADVISER. 
and thrown out of their proper positions. From the compression 
of the liver and stomach, the functions of digestion are impeded, 
a distaste for solid food, flatulency and pain after eating are the 
unmistakable proofs of the injury which is being inflicted. 
The evil effects of such pressure are not confined to actual 
periods of time during which this pressure is applied. They 
continue after it has been removed and when the chest and 
trunk of the body have thus been subjected to long-continued 
pressure they become permanently deformed. These deformities 
necessarily entail great suffering in child-bearing. 
The evil effects of mechanical pressure on other parts of the 
body are not uncommon. The leg is sometimes so indented by 
a tight garter that the returning flow of blood through the veins 
is prevented, and a varicose condition of these vessels is produced. 
Irregular and excessive pressure on the foot by imperfectly 
fitting shoes or boots produce deformities of the feet and cause 
much suffering. The high heels which are so common on the 
shoes of women and children inflict more than a local injury. 
Every time the body comes down upon the raised heel with its 
full weight a slight shock or vibration is communicated through- 
out the entire extent of the spinal column, and the nervous 
mechanism is thereby injured. Furthermore, displacements of 
the pelvic organs frequently result from these unnatural and 
absurd articles of dress. Women of fashion are subjected to 
much annoyance from wearing long, flowing skirts suspended 
from their waists to trail uselessly on the floor and gather dust. 
It is impossible for the wearers of these ridiculous garments to 
exercise their limbs properly or to breathe naturally. Indiges- 
tion, palpitation, shortness of breath, and physical degeneracy 
are the inevitable consequences of their folly. The skirts 
should always be suspended from the shoulders and not from 
the hips. It is especially important that the clothing of 
children should not fit too tightly. 
It is very important that the clothing should be kept clean. 
That which is worn for a long time becomes saturated with the 
excretions and exhalations of the body, which prevent free 
transpiration from the pores of the skin, and thereby induce 
mental inactivity and depression of the physical powers. Un- 
clean clothing may be the means of conveying disease. Scarlet THE CLOTHING. 
269 
fever has been conveyed frequently by the clothing of a nurse 
into a healthy family. All of the contagious diseases have been 
communicated by clothing contaminated in laundries. 
Certain dyes which are largely used in the coloring of wearing 
apparel are poisonous, and give rise to local disease of the skin, 
accompanied in some instances, with constitutional symptoms. 
The principal poisonous dyes are the red and yellow aniline. A 
case of poisoning from wearing stockings colored with aniline 
dyes, in which there were severe constitutional symptoms, came 
under our observation at the Invalids' Hotel recently. CHAPTER III. 
PHYSICAL EXERCISE. MEN- 
TAL CULTURE. SLEEP. 
CLEANLINESS. 
A well-developed physical organization is essential to perfect 
health. Among the Greeks, beauty ranked next to virtue, 
and an eminent author has said that " the nearer we approach 
Divinity, the more we reflect His eternal beauty." The perfect 
expression of thought requires the physical accompaniments 
of language, gesture, etc. The human form is pliable, and, 
with proper culture, can be made replete with expression, grace 
and beauty. The cultivation of the intellectual powers has 
been allowed to supplant physical training to a great extent. 
The results are abnormally developed brains, delicate forms, 
sensitive nerves and shortened lives. That the physical and 
mental systems should be collaterally developed, is a fact 
generally overlooked by educators. The fullness of a great 
intellect is generally impaired when united with a weak and 
frail body. We have sought perfection in animals and plants. 
To the former we have given all the degree of strength and 
grace requisite to their peculiar duties; to the latter we have 
imparted all the delicate tints and shadings that fancy could 
picture. We have studied the laws of their existence, until 
we are familiar with every phase of their production; yet it 
remains for man to learn those laws of his own being, by a 
knowledge of which he may promote and preserve the beauty 
of the human form, and thus render it, indeed, an image of its 
270 PHYSICAL EXERCISE. 
271 
Maker. When the body is tenanted by a cultivated intellect, 
the result is a unity which is unique, commanding the respect 
of humanity, and insuring a successful life to the possessor. 
Students are as a rule pale and emaciated. Mental application 
is generally the cause assigned when, in reality, it is the result 
of insufficient exercise, impure air, and dietetic errors. An 
intelligent journalist has remarked that " many of our ministers 
weigh too little in the pulpit, because they weigh too little on 
the scales." The Greek Gymnasium and Olympian Games were 
the sure foundations of that education from which arose that 
subtle philosophy, poetry, and military skill which have won 
the admiration of nineteen centuries. The laurel crown of 
the Olympian victor was far more precious to the Grecian youth 
than the gilded prize is to our modern genius. A popular 
lecturer has truly remarked, that " we make brilliant mathema- 
ticians and miserable dyspeptics; fine linguists with bronchial 
throats; good writers with narrow chests and pale complexions; 
smart scholars, but not that union, which the ancients prized, 
of a sound mind in a sound body. The brain becomes the chief 
working muscle of the system. We refine and re-refine the 
intellectual powers down to a diamond point and brilliancy, 
as if they were the sole or reigning faculties, and we had not 
a physical nature binding us to earth, and a spiritual nature 
binding us to the great heavens and the greater God who 
inhabits them. Thus the university becomes a sort of splen- 
did hospital with this difference, that the hospital cures, 
while the university creates disease. Most of them are in- 
dicted at the bar of public opinion for taking the finest 
young brain and blood of the country, and, after working 
upon them for four years, returning them to their homes 
skilled indeed to perform certain linguistic and mathematical 
dexterities, but very much below par in health and endurance, 
and, in short, seriously damaged and physically demoralized." 
We read with reverence the sublime teachings of Aristotle and 
Plato; we mark the grandeur of Homer and the delicate 
beauties of Virgil; but we do not seek to reproduce in our 
modern institutions the gymnasium, which was the real founda- 
tion of their genius. Colleges which are now entering upon 
their career, should make ample provision for those exercises 272 
COMMON SENSE MEDICAL ADVISER. 
which develop the physical man. This lack of bodily training is 
common with all classes, and its effects are written in indelible 
characters on the faces and forms of old and young. Con- 
strained positions in sitting restrict the movements of the 
diaphragm and ribs and often cause diseases of the spine, or 
unnatural curvatures, which prove disastrous to health and 
happiness. The head should be held erect and the shoulders 
thrown backward, so that at each inspiration the lungs may 
be fully expanded. 
Physical exercise should never be too violent or too pro- 
longed. Severe physical labor, and athletic sports, if indulged 
in to an extreme degree, produce undue excitability of the 
heart, and sometimes cause it to become enlarged. There 
is a form of heart disease induced by undue exertion which 
may be called a wearing out or wasting away of that organ. 
It is common in those persons whose occupations expose them 
to excessive physical labor for too many hours together. This 
feebleness of heart is felt but little by vigorous persons under 
forty years of age, but in those who have passed this age it 
becomes manifest. However, when any person so affected is 
attacked by any acute disease, the heart is more liable to fail, 
and thus cause a fatal termination. 
Aneurism of the aorta or the large arteries branching off 
from it, which is a dilatation of the walls of these vessels, 
caused by the rupture of one or two of their coats, is generally 
induced by excessive physical strain, such as lifting heavy 
weights, or carrying weights up long flights of stairs, violent 
horse-back exercise, or hurrying to catch a train or street car. 
All Erect Carriage is not only essential to health, 
but adds grace and beauty to every movement. Although' man 
was made to stand erect, thus indicating his superiority over 
all other animals, yet custom has done much to curve that 
magnificent central column, upon the summit of which rests 
the "grand dome of thought." Many young persons uncon- 
sciously acquire the habit of throwing the shoulders forward. 
The spinal column is weakened by this unnatural posture, its 
vertebrae become so sensitive and distorted that they cannot 
easily support the weight of the body or sustain its equilibrium. 
It is generally believed that persons of sedentary habits are BASE BALL, ETC. 
273 
more liable to become round-shouldered than any other class 
of individuals. Observation shows, on the contrary, that the 
manual laborer, or even the idler, often acquires this stooping 
posture. It can be remedied, not by artificial braces, but by 
habitually throwing the shoulders backwards. Deformed trunks 
and crooked spines, although sometimes the effects 
of disease are more frequently the results of care- 
lessness. Jacques has remarked that "one's stand- 
ing among his fellow-men is quite as important a 
matter in a physiological, as in a social sense." 
Walking is one of the most efficient means of physi- 
cal culture, as it calls all the muscles into action and 
produces the amount of tension requisite for their 
tonicity. Long walks or protracted physical exercise 
of any kind should never be undertaken immediately 
after meals. The first essential to a healthful walk 
is a pleasurable object. Beautiful scenery, rambles 
in meadows rich with fragrant grasses, or along the 
flowery banks of water-courses, affords an agreeable 
stimulus, which sends the blood through the vital 
channels with unwonted force, and imparts to the 
cheeks the ruddy glow of health. Our poets acknowledge the 
silent influence of nature. Wordsworth has expressed this 
thought in his own sublime way: 
Fig. 101/.. 
"The floating clouds their state shall lend 
To her: for her the willow bend; 
Nor shall she fail to see, 
E'en in the motions of the storm 
Grace that shall mould the maiden's form 
By silent sympathy. 
The stars of midnight shall be dear 
To her: and she shall lean her ear 
In many a secret place, 
Where rivulets dance their wayward round, 
And beauty, born of murmuring sound, 
Shall pass into her face." 
Base Ball, Cricket, Boxing, and Fencing, are 
all manly exercises when practiced solely with a view to their 
hygienic advantages, and as such have our approval. 274 
COMMON SENSE MEDICAL ADVISER. 
The Art Of Swimming was regarded by the Greeks 
as an important accomplishment. As a hygienic agency, it 
occupies a high place in physical culture. The varied move- 
Jfy/Ol. 
Fig 108 
IVo'lOG 
^70/ 
Figl/OO. 
ments impart strength and elasticity to the muscles. It is as 
charming a recreation for women and girls as for men and 
boys. Furthermore, it is not only a means of physical culture, 
but is often essential for self-preservation. Figs. 105 to 108 
Fig.110, SKATING AND ROWING. 
275 
represent the successive positions assumed in swimming. Figs. 
109 and 110 represent exercises in the water and a safe and 
easy method of learning to swim. 
The Exercises of the Gymnasium are especially 
productive of health and longevity. The most important of 
these are balancing, leaping, climbing, wrestling, and throwing, 
all of which are especially 
adapted to the develop- 
ment of the muscles. In 
conclusion, we offer the 
following suggestions, viz: 
all gymnastic exercises 
should be practiced in the 
morning, and in the open 
air; extremes should be 
avoided; and it should be 
always borne in mind, 
that their chief object is 
to combine, in a proper 
proportion, mental and 
physical development. In 
every relation of life we 
should cultivate all those faculties which pertain to our physical, 
moral, and mental natures, subdue our passions, and nature will 
bestow upon us her richest rewards of health, beauty, and 
happiness. 
Skating' and Rowing are exercises which develop the 
muscles of the arms and legs. The former should not be too 
prolonged, and the clothing should always be warm and ap- 
propriate. College regattas are rapidly becoming more popu- 
lar in this country, notwithstanding many severe criticisms 
from the press. As an exercise for the health and develop- 
ment of our students, rowing should be universally recom- 
mended, but over-exertion should be carefully avoided in this 
as in other athletic sports. It expands the lungs and strengthens 
the muscles of the arms and chest. Every college should be 
located near some body of water, and a boat-house erected and 
provided with the necessary equipments. Exercise is just as 
essential to the student as a library or a laboratory. 
Fig. 111. 
The Gymnast's Arm. 276 
COMMON SENSE MEDICAL ADVISER. 
Riding on Horseback is a fine exercise for both sexes. 
It promotes digestion, improves the circulation, and expands 
and develops the respiratory organs. The pure, 
fresh air, pleasant scenery, and pleasurable excite- 
ment, impart renewed vigor to the equestrian. In 
the Southern States it is a universal accomplish- 
ment, and children are taught to ride as well as 
to walk. 
Dancing. Notwithstanding the fact that 
dancing has been perverted to the basest pur- 
poses, has been made the fruitful source of dissipa- 
tion, and has often laid the foundation for disease, 
it is yet capable of being made to minister to 
health and happiness. As a means of physical 
culture, it favors the development of the muscular 
system, and promotes health and cheerfulness. 
When practiced for this purpose, Jacques terms 
it " the best of all in-door exercises, as it brings to bear upon 
the physical system a great number of energizing and har- 
monious influences." 
Fig. 112. 
MENTAL CULTURE. 
The brain, like all other organs of the body, requires alternate 
exercise and repose; and, in physical endurance, it is subject 
to general physiological laws. When exercised with modera- 
tion it acquires strength, vigor, and an accelerated activity. 
Excessive mental exertion is liable to result in softening of the 
brain, and various nervous diseases, sometimes culminating in 
insanity, and in many instances proving fatal to life. The mere 
votaries of pleasure who avoid all effort of the mind, fall into 
the opposite error. In all cases of intellectual activity, the 
exertions should be directed to some subject interesting to the 
student. In this manner duty will become a pleasure, which in 
turn will re-invigorate the mental functions. 
When the mind is confined to one subject for any consider- 
able length of time together, it becomes fatigued, and requires 
relaxation, recreation, rest. This may be obtained by directing 
the attention to some other subject, either study or amusement, 
the latter of which is preferable. The amusement, however, MENTAL CULTURE DURING CHILDHOOD. 
277 
may be of an intellectual or physical character, or both 
combined, and will, if properly conducted, restore vigor to both 
mind and body. 
Prominent among physical phenomena is the mutual relation 
between the brain and the organs of nutrition. Mental exertion 
should be avoided for at least one hour after a hearty meal, 
and all mental labor which requires concentration of thought 
ought to be accomplished in the earlier portion of the day, when 
the brain is refreshed and repaired by the night's repose. 
Mental, like physical endurance, is modified by age, health, and 
development. A person accustomed to concentration of thought, 
can endure a longer mental strain than one inured to manual 
labor only. One of the most injurious customs, is the cultiva- 
tion of the intellect at the expense of the physical powers. 
Mental Culture During Childhood. One of the 
greatest mistakes which people make in the management of 
their children, is to overtask their mental faculties. Although 
it is exceedingly gratifying to see children acquire knowl- 
edge, and manifest an understanding far beyond their years, 
this gratification is often purchased too dearly, for precocious 
children are apt to die young. The tissue of the brain and 
nerves of children is very delicate; they have not yet acquired 
the powers of endurance which older persons possess. The 
greater portion of the nutriment assimilated, is required for 
growth and organic development, and they can ill afford its ex- 
penditure for mental manifestations. They receive impressions 
easier and learn much more readily than in after life, but it is at 
the expense of the physical organization. Their mental faculties 
continue to be developed by the expenditure of brain nutriment, 
while physical growth and the powers of endurance are arrested. 
It is much better to give physical development the precedence 
in order that the mental organism may be well supported and 
its operations carried into effect; for it must be apparent to all 
that an ordinary intellect in a healthy body, is capable of 
accomplishing infinitely more than a strong mind in a weak 
body. Regularity should be observed in exercising the mental 
functions. For this reason a fixed order in the pursuit of any 
literary occupation is very essential. The pursuit of the most 
abstruse studies will thus become habitual and comparatively 278 
COMMON SENSE MEDICAL ADVISER. 
easy, a consequence of systematic application. Mental labor 
should always cease when the train of thought becomes 
confused, and there is the slightest sensation of depression. 
All distracting influences should be absent from the mind, in 
order to facilitate intense study, for the intellect cannot attend 
perfectly to two subjects at the same time. Painful sensations 
always have a tendency to paralyze mental exertion. Great 
care should be taken that the head is not subjected to injury 
of any kind, as it is almost invariably accompanied by some 
nervous derangement. Exposure to extreme heat should be 
carefully avoided. An attack of sun-stroke although it may not 
be immediately fatal, may occasion tumors in the brain, or some 
organic disease. 
SLEEP. 
For all animated beings sleep is an imperious necessity, as 
indispensable as food. The welfare of man requires alternate 
periods of activity and repose. It is a well-established physio- 
logical f&ct, that during the wakeful hours the vital energies 
are being expended, the powers of life diminished, and, if 
wakefulness is continued beyond a certain limit, the system 
becomes enfeebled and death is the result. During sleep there 
is a temporary cessation of vital expenditures, and a recuperation 
of all the forces. Under the influence of sleep " the blood is 
refreshed, the brain recruited, physical sufferings are extin- 
guished, mental troubles are removed, the organism is relieved, 
and hope returns to the heart." 
The severest punishment which can be inflicted upon a 
person, is to entirely deprive him of sleep. In China, a few 
years since, three criminals were sentenced to be kept awake 
until they should die. To do this it was necessary to keep 
a guard over them. The sentinels were armed with sharp- 
pointed instruments, with which to goad the victims and thus 
prevent them from sleeping. Life soon became a burden, and, 
although they were well fed during the time, death occurred 
sooner than it would have done had starvation been the pun- 
ishment. 
Sleeping Rooms. The sleeping room should be large 
and well ventilated, and the air kept moderately cool. The 
necessity for a fire may be determined by the health of the HOW TO PUT CHILDREN TO BED. 
279 
occupant. Besides maintaining a proper temperature in the 
room, a little fire is useful, especially if in a grate, for the 
purpose of securing good ventilation. The windows should 
not be so arranged as to allow a draught upon the body during 
the night, but yet so adjusted that the inmate may obtain 
plenty of fresh air. 
The Bed should not be tgo soft, but rather hard. Feathers 
give off animal emanations of an injurious character, and 
impart a feeling of lassitude and debility fo those sleeping on 
them. No more coverings should be used than are actually 
necessary for the comfort of the individual. Cotton sheets 
are warmer than linen, and answer equally as well. 
Sleeping Alone. Certain effluvia are thrown off from 
our persons, and when two individuals sleep together each 
inhales from the other more or less of these emanations. There 
is little doubt that consumption, and many other diseases, 
not usually considered contagious, are sometimes communicated 
in this manner. When it is not practicable for individuals 
to occupy separate beds, the persons sleeping together should 
be of about the same age, and in good health. Numerous cases 
have occurred in which healthy, robust children have gradually 
declined and died within a few months, from the evil effects 
of sleeping with old people. Again, those in feeble health 
have been greatly benefited, and even restored, by sleeping 
with others who were young and healthy. 
Time for Sleep. Night is the proper time for sleep. 
When day is substituted for night, the sleep obtained does not 
fully restore the exhausted energies of the system. Nature 
does not allow her laws to be broken with impunity. 
Children require more sleep than old persons. They are 
sometimes stupefied with " soothing syrups," and prepara- 
tions of opium, in order to get them temporarily out of the 
way. Such narcotics are very injurious and dangerous. We 
have known a young child to be killed by a single drop of 
laudanum. This practice, therefore, cannot be too emphatically 
condemned. 
How to Put Children to Bed. The following char- 
acteristic lines are from the pen of Fanny Fern, and contain 
such good advice that we cannot refrain from quoting them: 280 
COMMON SENSE MEDICAL ADVISER. 
"Not with a reproof for any of the day's sins of omission 
or commission. Take any other time than bed-time for that. 
If you ever heard a little creature sighing or sobbing in its 
sleep, you could never do this. Seal their closing eyelids with 
a kiss and a blessing. The time will come, all too soon, when 
they will lay their heads upon their pillows lacking both. Let 
them at least have this sweet qjemory of happy childhood, 
of which no future sorrow or trouble can rob them. Give 
them their rosy youth. Nor need this involve wild license. 
The judicious parent will not so mistake my meaning. If you 
ever met the man or the woman, whose eyes have suddenly filled 
when a little child has crept trustingly to its mother's breast, 
you may have seen one in whose childhood's home 'dignity', 
and 'severity' stood where love and pity should have been. 
Too much indulgence has ruined thousands of children; too 
much love not one." 
Position ill Sleep. The proper position in sleep is 
upon the right side. The orifice leading from the stomach 
to the bowels being on this side, this position favors the passage 
of the contents into the duodenum. Lying on the back is 
injurious, since by so doing the spine becomes heated, especially 
if the person sleeps on feathers, the circulation is obstructed 
and local congestions are encouraged. The face should never 
be covered during sleep, since it necessitates the breathing of 
the same air over again, together with the emanations from the 
body. 
The Amount of Sleep. The amount of sleep required 
varies with the age, habits, condition, and peculiarities of the 
individual. No definite rule can be given for the guidance 
of all. The average amount required, however, is eight or 
nine hours out of the twenty-four. Some persons need more 
than this, while others can do with less. Since both body and 
mind are recuperated by sleep, the more they are exhausted 
the more sleep is required. A person employed at mental labor 
should have more than one who is merely expending muscular 
strength. Six hours of unbrokefl sleep do more to refresh and 
revive than ten when frequently interrupted. If it is too pro- 
longed it weakens and stupefies both body and mind. If an 
insufficient amount is taken the flagging energies are not CLEANLINESS, 
281 
restored. Persons who eat much or use stimulants generally 
require more than others. In sleep regularity is desirable. If 
a person goes to bed at a certain hour for several nights in 
succession, it will soon become a habit. The same holds true 
with regard to rising. If children are put to sleep at a 
stated hour for several days in succession, it will soon become 
a habit with them. 
CLEANLINESS. 
" Cleanliness is next to godliness," and is essential to the 
•health and vigor of the system. Its importance cannot be 
overestimated, and it should be inculcated early on the minds 
of the young. "Even from the body's purity, the mind 
receives a secret sympathetic aid." 
When we consider the functions of the skin, with its myriads 
of minute glands, innumerable little tubes, employed in re- 
moving the worn-out, useless matter from the system, we cannot 
fail to appreciate the utility of frequent bathing with soap and 
water. Unless these excretions are removed, the glands become 
obstructed, their functions are arrested, and unpleasant odors 
arise. Many persons think because they daily bathe the face, 
neck, and hands, dress the hair becomingly and remove the dirt 
from their clothing that the height of cleanliness has been 
reached. From a hygienic point of view, bathing the entire 
body is of much greater importance. 
Notwithstanding the necessity for cleanliness of the body, 
we occasionally meet with persons who, although particular 
about their personal appearance, permit their bodies to be for 
weeks and even months without a bath. Such neglect should 
never exceed one week. Plenty of sunlight and at least one 
or two general baths every week are essential to perfect health. 
Cleanliness is necessary to health, beauty, attractiveness, and 
a cheerful disposition. CHAPTER IV. 
HYGIENE OF THE REPRO- 
DUCTIVE ORGANS. 
The structure and functions of organized bodies are subject 
to continual alteration. The changes of nutrition and growth, 
which are constantly taking place in the tissues render them at 
the same time, the seat of repair and waste, of renovation and 
decomposition, of life and death. The plant germinates and 
blossoms, then withers and decays; animal life, in like manner, 
comes into being, grows to maturity, fades, and dies. It is, 
therefore, essential to the perpetuation of life, that new organ- 
isms be provided to take the place of those which are passing 
out of existence. There is no physiological process which 
presents more interesting phenomena than that of reproduction, 
which includes the formation, as well as the development of 
new beings. 
Since self-preservation is Nature's first law, the desire for food 
is a most powerful instinct in all living animals. Not inferior 
to this law is that for the perpetuation of the race; and for this 
purpose, throughout the animal and vegetable kingdoms, we 
find the Biblical statement literally illustrated: "Male and 
female created He them." 
Health is the gauge by which the prosperity of a people may 
be measured. Were we to trace the history of nations,-their 
rise and fall,- we would find that much of the barbarism and 
crime, degradation and vice, as well as their decline and final 
extinction, was due to licentiousness and sexual excesses. Since 
there is an intimate relation between mind and body, when 
the body is enfeebled the mind becomes enervated. Morbid 
282 PHYSICAL LABOR MODIFIES THE PASSIONS. 
283 
conditions of the body prevent the highest mental development, 
and, on the other hand, when the mind is debilitated, general 
depravity, physical as well as mental, is the result. The highest 
development of the body results from the equal and harmonious 
cultivation of all the mental powers. The perfect development 
and health of the physical organs is therefore essential to the 
happiness of mankind. But, before health can be insured the 
nature and general functions of the physical system must be 
understood. This being done, the question naturally arises: 
How can health be best maintained and longevity secured? 
Influence of Food. We have previously noticed the 
effects which food, exercise, and other hygienic agencies, have 
upon digestion, circulation, and respiration; and we find that 
they exert a not less potent influence upon the health of the 
generative organs. Excessive stimulation excites the sexual 
passions. For this reason, children should not be immoderately 
indulged in highly seasoned foods. Those persons who have 
great muscular vigor are endowed with violent passions, and 
unless restrained by moral considerations, are very likely to be 
overcome by their animal propensities. 
Alcoholic stimulants have a debasing influence upon the whole 
system, and especially upon the sexual organs; they excite the 
animal and debase the moral nature; they exhaust the vitality, 
and, after the excitement, which they temporarily induce, has 
passed away, the body is left in a prostrated condition. 
Physical Labor modifies the Passions. Labor 
consumes the surplus vitality which a person may possess, and 
no better protective can be found against the gratification of 
the passions, unless it be high moral training, than daily toil 
extended to such a degree as to produce fatigue. Labor 
determines the blood to the surface and to other parts of the 
body, and prevents excitement and congestion of the sexual 
centers. If, by education or association, the passions of children 
be excited, they will be increased. If, on the contrary, they 
be taught to avoid these social or solitary evils, they will be 
abated. Let them be educated to work and the intellectual 
faculties will assert their sway, the moral powers will be 
strengthened, and the body better developed, for purity of mind 
is the result of the perfect development of man. 284 
COMMON SENSE MEDICAL ADVISER. 
Influences of' Climate. Individuals possess distin- 
guishing peculiarities characteristic of the nation to which they 
belong. Climate exerts a powerful influence upon mankind. In 
tropical regions the inhabitants are enervated, effeminate, and 
sensual. The rich live in luxury and ease, vice is unrestrained 
and license unbridled. When the animal propensities are 
allowed to predominate, the mental faculties are kept in 
subjection. Hence races that inhabit those latitudes rarely 
produce scholars or philosophers. A warm climate hastens the 
development of the reproductive organs. Men and women 
become mature at a much earlier age in those regions, than in 
countries where the temperature is lower. In like manner there 
is a tendency to premature enfeeblcment, for the earlier the 
system matures, the sooner it deteriorates. 
Mail is a Social Being;. History demonstrates that 
when man is deprived of the society of woman, he becomes 
reckless, vicious, depraved, and even barbarous in his habits, 
thus illustrating the maxim: "It is not good for man to be 
alone." Social intercourse promotes mental and physical de- 
velopment. The development of the individual implies the 
unfolding of every power, both physical and mental. Nothing 
so regulates and restrains passion as a healthy condition of the 
organs through which it finds expression. And every organ 
of the body is powerful in proportion to its soundness. The 
propensities play a prominent part in the education of the child. 
When properly disciplined and held in subordination to the 
higher faculties, they constitute an important factor in the 
economy of man. Boys are more liable to be morbidly excited 
when secluded from the society of girls, and vice versa. 
Again, when the sexes are accustomed to associate, the passions 
are not apt to be aroused, because of the natural antagonistic 
constitutional elements. The influence of the one refines, and 
ennobles the other. Let children be taught to understand their 
natures, and knowing them, they will learn self-government. 
"As man rises in education and moral feeling he propor- 
tionately rises in the power of self-restraint; and consequently 
as he becomes deprived of this wholesome law of discipline 
he sinks into self-indulgence and the brutality of savage life. 
The passions may be aroused by the language, appearance, OBSCENE LITERATURE. 
285 
or dress of the opposite sex. A word spoken without any 
impure intent is often construed in a very different sense by 
one whose passions color the thought, and is made to convey 
an impression entirely unlike that which was intended by the 
speaker. Also, the dress may be of such a character as to 
excite the sexual passion. The manner in which the apparel 
is worn is often so conspicuous as to become bawdy, thereby 
appealing to the libidinous desires, rather than awakening an 
admiration for the mental qualities. 
ObscdlC Literature. Literature is a powerful agent 
either for good or evil. If we would improve the morals, 
choice literature must be selected, whether it be that which 
realizes the ideal, or idealizes the real. Obscene literature, or 
books written for the express purpose of exciting or intensifying 
sexual desires in the young, goads to an illicit gratification of 
the passions, and ruins the moral and physical nature. 
It not unfrequently happens that a child is born with a vig- 
orous, mental organism which promises a brilliant future, but 
manhood finds him incompetent, debilitated, and totally inca- 
pacitated for mental or manual labor. This may be the result 
of youthful indiscretion, ignorantly committed, but not unfre- 
quently it is the effect of a pernicious literature which inflames 
the imagination, tramples upon reason, and describes to the 
youth a realm where the passions are the ruling deities. 
Many persons are born into the world with disordered organi- 
zations for which they are not themselves responsible. Such 
individuals are entitled to the sympathy of humanity. Dyspep- 
sia, scrofula, consumption, and a thousand ills to which man- 
kind is heir, are inherited from parents, the results of ill-assorted 
marriages. Intoxicated parents often produce offspring utterly 
demented. Children of healthy parents, with good constitu- 
tions, are usually healthy and intelligent. There are marked 
varieties of character in children of the same parents. One 
manifests great precocity, another is below the average in 
mental attainments; one is amiable, another irritable in disposi- 
tion; indeed, there are often as great differences between 
children of the same, as of different families. This is due to 
the physical and mental conditions of the parents, more 
especially the mother, not only at the time of the impregnation 286 
COMMON SENSE MEDICAL ADVISEB. 
but also during the period intervening between conception and 
the birth of the offspring. The ancients regarded courage 
as the principal virtue. By us, purity is so estimated. Moral 
purity is an essential requisite to the growth and perfection 
of the character. 
Self-Abuse. Untold miseries arise from the pollution of 
the body. Self-pollution, or onanism, is one of the most pro- 
lific sources of evil, since it leads both to the degradation of 
body and mind. It is practiced more or less by members of 
both sexes, and the habit once established, is overcome with 
the greatest difficulty. It is the source of numerous diseases 
which derange the functional activity of the organs involved, 
and eventually impair the constitution. This vicious habit is 
often practiced by those who are ignorant of its dangerous 
results. Statistics show that insanity is frequently caused by 
masturbation. 
Immoderate indulgence in any practice is deleterious to the 
individual. Emphatically true is this with regard to sexual 
excesses. Not unfrequently does the marriage rite " cover a 
multitude of sins." The abuse of the Conjugal relation pro- 
duces the most serious results to both parties, and is a prolific 
source of some of the gravest forms of disease. Prostatorrhea, 
spermatorrhea, impotency, hypochondria, and general debility 
of the generative organs, arise from sexual excesses. 
The health of the reproductive organs can only be maintained 
by leading a temperate life. The food should be nourishing 
but not stimulating. Lascivious thoughts should be banished 
from the mind, and a taste cultivated for that literature which 
is elevating in its nature, and the associations should be refining 
and ennobling. Let these conditions and the rules of hygiene 
be observed, and virtue will reward her subjects with a fine 
physique and a noble character. 
Woman, from the nature of her organization, has less strength 
and endurance than man. Much, however, of the suffering 
and misery which she experiences arises from insufficient atten- 
tention to the sexual organs. The menstrual function is gen- 
erally established between the ages of twelve and fourteen. 
For want of proper instruction, many a girl through ignorance 
has caused derangements which have enfeebled her womanhood SELF-ABUSE. 
287 
or terminated her life. At this critical period the mother 
cannot be too considerate of her daughter's health. Preceding 
the first appearance of the menses, girls usually feel an aching 
in the back, pains in the limbs, chilliness, and general languor. 
The establishment of this function relieves these symptoms. 
Every precaution should be taken during the period to keep 
the feet dry and warm, to freely maintain a general circulation 
of the blood, to avoid exertion, and to refrain from standing 
or walking too much. Menstrual derangements should never 
be neglected, for they predispose to affections of the brain, 
liver, heart, and stomach, induce consumption and frequently 
end in death. Young women should, therefore, properly pro- 
tect themselves, and avoid extremes of heat and cold. CHAPTER V. 
PRACTICAL SUMMARY 
OF HYGIENE. 
1. The first step which should be taken for the prevention 
of disease, is to make provision for the health of the un- 
born child. Greater care should be exercised with women 
who are in a way to become mothers. Those who are sur- 
rounded by all the luxuries which health can bestow, indulge 
too much in rich food, and take too little exercise; while the 
poor get too little nourishment, and work too hard and too long. 
A woman in this condition should avoid overexertion, and all 
scenes which excite the passions or powerful emotions. She 
should take moderate exercise in the open air; eat moderately 
of wholesome food, and of meat not oftener than twice a day; 
take tea or coffee in limited quantities, and avoid the use of 
all alcoholic liquors; she should go to bed early and take not 
less than nine hours sleep; her clothing should be loose, light 
in weight, and warm. She should take every precaution against 
exposure to contagious or infectious diseases. 
2. There is no better method for preventing the spread 
of contagious diseases than perfect isolation of the infected, 
and thorough disinfection of all articles of clothing or bedding 
which have been in contact with the infected. Many persons 
erroneously believe that every child must necessarily have the 
measles, and other contagious diseases, and they, therefore, take 
no precautions against the exposure of their children. The 
liability to infection diminishes as age advances, and those 
individuals are, as a rule, the strongest and best developed who 
288 PRACTICAL SUMMARY OF HYGIENE. 
289 
have never suffered from any of the contagious diseases. Al- 
though vaccination is the great safeguard against-pox, yet it 
should never prevent the immediate isolation of those who are 
suffering from this disease. 
3. To avoid the injurious effects of impure air, the fol- 
lowing rules, should be carefully observed. The admission of 
air which contains anything that emits an unpleasant odor into 
closed rooms should be avoided. The temperature of every 
apartment should be kept as near 70° Fahr, as possible, and 
the air should not be overcharged with watery vapor. Pro- 
visions should be made for the free admission into and escape 
of air from the room at all times. When an apartment is not 
in use, it should be thoroughly ventilated by opening the win- 
dows. Those who are compelled to remain in an atmosphere 
filled with dust, should wear a cotton-wool respirator. 
4. To insure a healthy condition of the body, the diet of 
man ought to be varied, and all excesses should be avoided. 
The total amount of solid food taken in the twenty-four hours 
should not exceed two and a half pounds, and not more than 
one-third of this quantity should consist of animal food. Many 
persons do not require more than one pound and a half of 
mixed food. To avoid parasitic diseases, meat should not be 
eaten rare, especially pork. The amount of drink taken should 
not be more than three pints in the twenty-four hours. The ex- 
cessive use of tea and coffee should be avoided. Pickles, boiled 
cabbage, and other indigestible articles should never be eaten. 
5. To avoid the evil effects of alcoholic liquors, perfect ab- 
stinence is the only safe course to pursue. Although one may 
use spirituous liquors in moderation for a long period of time 
and, possibly, remain healthy, yet such an indulgence is unneces- 
sary and exceedingly dangerous. A person who abstains en- 
tirely from their use is safe from their pernicious influence; a 
person who indulges ever so moderately is in danger; a person 
who relies on such stimulants for support in the hour of need 
is lost. 
6. While the use of tobacco is less pernicious than al- 
cohol in its effects, yet it exerts a profound disturbing influ- 
ence upon the nervous system, and gives rise to various func- 
tional and organic diseases. This is the verdict of those who 290 
COMMON SENSE MEDICAL ADVISER. 
have given the subject the most study, and who have had the 
best opportunities for extensive observation. Suddenly fatal 
results have followed excesses in the use of tobacco. Therefore, 
the habit should be avoided, or if already acquired, it should be 
immediately abandoned. 
7. The clothing should be light and porous, adapted in 
warmth to the season. It is especially important that per- 
sons in advanced life should be well protected against vicissi- 
tudes of heat and cold. Exposure is the cause of almost all 
those inflammatory diseases which occur during winter, and 
take off the feeble and the aged. The under-garments should 
be kept scrupulously clean by frequent changes. Corsets or 
bands which impede the flow of blood, compress the organs of 
the chest or abdomen, or restrict the movements of the body, 
are very injurious, and should not be worn. Articles of dress 
which are colored with irritating dye-stuffs, should be carefully 
avoided. 
8. It matters not how varied a person's vocation may be, 
change, recreation, and rest are required. It is an error to 
suppose that more work can be done by omitting these. No 
single occupation which requires special mental or physical 
work, should be followed for more than eight hours out of the 
twenty-four. The physical organism is not constructed to run 
its full cycle of years and labor under a heavier burden than 
this. Physical and mental exercise is conducive to health and 
longevity, if not carried too far. It is erroneous to suppose 
that excessive physical exertion promotes health. Man was 
never intended to be a running or a jumping machine. In 
mental work, variety should be introduced. New work calls 
into play fresh portions of the brain, and secures repose for 
those parts which have become exhausted. Idleness should be 
avoided by all. Men should never retire from business as long 
as they enjoy a fair degree of health. Idleness and inactivity 
are opposed to nature. 
9. The average length of time which a person ought to 
sleep is eight hours out of the twenty-four, and, as a rule, those 
who take this amount enjoy the best health. The most favor- 
able time for sleep is between the hours of 10 p. m. and 6 a. m. 
All excitement, the use of stimulants, and excessive fatigue PRACTICAL SUMMARY OF HYGIENE. 
291 
tend to prevent sleep. Sleeping rooms should be well ven- 
tilated, and the air maintained at a equable temperature of as 
near 60° Fahr, as possible. An inability to sleep at the proper 
time, or a regular inclination to sleep at other than the natural 
hours for it, is a certain indication of errors of habit, or of 
nervous derangement. 
10. Prominent among all other measures for the mainte- 
nance of Health, is personal cleanliness. Activity in the func- 
tions of the skin is essential to perfect health, and this can only 
be secured by thoroughly bathing the entire body. Strictly, a 
person should bathe once every twenty-four or forty-eight hours. 
The body should be habituated to contact with cold water at 
all seasons of the year, so that warm water may not become 
a necessity. The simplest and most convenient bath, is the 
ordinary sponge-bath. An occasional hot-air, or Turkish bath, 
exerts a very beneficial influence. It cleans out the pores of 
the skin and increases its activity. 
11. The emotions and the passions exert a powerful in- 
fluence over the physical organism. It is important, therefore, 
that they be held under restraint by the reasoning faculties. 
This rule applies equally to joy, fear, and grief; to avarice, 
anger, and hatred; and, above all, to the sexual passion. They 
are a prolific source of disease of the nervous system, and have 
caused the dethronement of some of the most gifted intellects. PART III. 
RATIONAL MEDICINE. 
CHAPTER I. 
During the last half century a great change has taken place 
in the treatment of disease. Medicine has advanced with rapid 
strides, from the narrow limits of mere empiricism, to the 
broader realm of rationalism, until to day it comprehends all 
the elements of an art and a science. Scientific researches and 
investigations have added many valuable truths to the general 
fund of medical learning, but much more has been effected by 
observation and empirical discovery. It is of little or no interest 
to the invalid to know whether the prescribed remedy is organic 
or inorganic, simple, compound, or complex. In his anxiety and 
distress of body, he seeks solely for relief, without regard to the 
character of the remedial agents employed. But this indiffer- 
ence on the part of the patient does not obviate the necessity 
for a thorough, scientific education on the part of the 
practitioner. Notwithstanding all the laws enacted to raise 
the standard of medicine, and thus protect the public from 
quackery, there yet exists a disposition among many to cling to 
all that savors of the miraculous, or supernatural. To insure 
the future advancement of the healing art, physicians must 
instruct mankind in Physiology, Hygiene, and Medicine. When 
the people understand the nature of diseases, their causes, meth- 
ods of prevention and cure, they will not be easily deceived, and 
practitioners will be obliged to qualify themselves better for 
their labors. The practice of medicine is every year becoming 
THE PROGRESS OF MEDICINE. 
292 THE ALLOPATHIC SCHOOL. 
293 
more successful. New and improved methods of treating 
disease are being discovered and developed, and the conscientious 
physician will avail himself of all the means, by a knowledge of 
which he may benefit his fellow-men. The medical profession 
is divided into three principal schools, or sects. 
THE ALLOPATHIC, REGULAR, OR OLD SCHOOL 
OF MEDICINE. 
This is the oldest existing branch of the profession. To it 
is due the credit of collecting and arranging the facts and 
discoveries which form the foundation of the healing art. It 
has done, and is doing, much to place the science of medicine 
on a firm basis. To the text-books of this school, every student 
who would qualify himself for medical practice must resort, to 
gain that knowledge upon which depends his future success. 
The early practice of this branch of the profession was nec- 
essarily crude and empirical. Conservative in its character, it 
has ever been slow to recognize new theories and methods of 
practice, and has failed to adopt them until they have been 
incontrovertibly established. This conservatism was manifested 
in the opposition to Harvey when he propounded the theory of 
the circulation of the blood, and to Jenner when he discovered 
and demonstrated the beneficial effects of vaccination. Thus has 
it ever defended its established opinions against innovation; yet 
out of this very conservatism has grown much real good, for, 
although it has wasted no time or energy in the investigation of 
theories, yet it has accepted them when established. In this 
manner it has added to its fund of knowledge only those truths 
which are of real and intrinsic value. 
The history of medicine may be divided into three eras. In 
the first, the practice of medicine was merely empiricism. Igno- 
rant priests or astrologers administered drugs, concerning the 
properties of which they had no knowledge, to appease the wrath 
of mythological deities. In the second or heroic era, the lancet, 
mercury, antimony, opium, and the blister were employed 
indiscriminately as the sine qua non of medical practice. The 
present, with all its scientific knowledge of the human structure 
and functions, and its vast resources for remedying disease, may 
be aptly termed the liberal era of medicine. The allopathic 294 
COMMON SENSE MEDICAL ADVISER. 
differs from the other schools, mainly in the application of 
remedies. In its ranks are found men, indefatigable in their 
labors, delving deep into the mysteries of nature, and who, for 
their scientific attainments and humane principles are justly 
considered ornaments to society and to their profession. 
HOMOEOPATHY. 
Although this school is of comparatively recent origin, yet it 
has gained a powerful hold upon the public favor, and numbers 
among its patrons very many intelligent citizens. This fact 
alone would seem to indicate that it possesses some merit. The 
homoeopathic differs from the allopathic school principally in its 
"la/io of curef which, according to Hahnemann, its founder, 
was the doctrine of " similia similibus curanturf or " like cures 
like." Its method of treatment is founded upon the assumption 
that if a drug be given to a healthy person, symptoms will 
occur which, if transpiring in disease, would be mitigated by 
the same drug. While it may be exceedingly difficult for a 
member of another school to accept this doctrine and compre- 
hend the method founded upon it, yet no one can deny that it 
contains some elements of truth. 
Imbued with the spirit of progress, many of its most intelli- 
gent and successful practitioners have resorted to the use of 
appreciable quantities of medicine. This school associates hy- 
dropathy with its practice, and usually inculcates rigid dietetic 
and hygienic regulations. Many homoeopathic remedies are 
thoroughly triturated with sugar of milk, which renders them 
more palatable and efficacious. Whether we attribute their 
cures to the infinitesimal doses which many homoeopathists em- 
ploy, to their " law of cure," to good nursing, or to the power 
of nature, it is nevertheless true that their practice is measur- 
ably successful. No doubt the homoeopathic practice has modi- 
fied that of the other schools, by proving that diseases may be 
alleviated by smaller quantities of medicine than were formerly 
employed. 
THE ECLECTIC SCHOOL. 
This school, founded by Wooster Beach, instituted the most 
strenuous opposition to the employment of mercury, antimony, 
the blister, and the lancet. The members of this new school THE LIBERAL AND INDEPENDENT PHYSICIAN. 
295 
proclaimed that the action of heroic and noxious medicines 
was opposed to the operation of the vital forces, and proposed 
to substitute in their place safer and more efficacious agents, 
derived exclusively from the vegetable kingdom. The eclectics 
have investigated the properties of indigenous plants and have 
discovered many valuable remedies, which a kind and bounteous 
nature has so generously supplied for the healing of her 
children. Marked success attended the employment of these 
agents. In 1852, a committee on "Indigenous Medical Botany," 
appointed by the "American Medical Association," acknow- 
ledged that the practitioners of the regular school had been ex- 
tremely ignorant of the medical virtues of plants, even of those 
of their own neighborhoods. The employment of podophyllin 
and leptandrin as substitutes for mercurials has been so success- 
ful that they are now used by practitioners of all schools. Al- 
though claiming to have been founded upon liberal principles, 
it may be questioned whether its adherents have not been quite 
as exclusive and dogmatic as those whom they have opposed. 
It cannot be denied, however, that the eclectics have added 
many important remedies to the Materia Medica. Their writ- 
ings are important and useful contributions to the physician's 
library. 
THE LIBERAL AND INDEPENDENT PHYSICIAN. 
After this brief review of the various medical sects, the 
reader may be curious to learn to what shot the physicians of 
the Invalids' Hotel and Surgical Institute belong. Among them 
are to be found graduates from the colleges of all the different 
schools. They are not restricted by the tenets of any one sect, 
but claim the right and privilege, nay, consider it a duty, to 
select from all, such remedies as careful investigation, scientific 
research, and an extensive experience, have proved valuable. 
They resort to any and every agent which has been proved 
efficacious, whether it be vegetable or mineral. 
And here arises a distinction between sanative remedial agents 
and those which are noxious. Many practitioners deplore 
the use of poisons, and advocate innocuous medicines which 
produce only curative results.* We agree with them in one 
proposition, namely, that improper medicines not only poison, 296 
COMMON SENSE MEDICAL ADVISER. 
but frequently utterly destroy the health and body of the 
patient. Every physician should keep steadily in view the final 
effects, as well as present relief, and never employ any agent 
without regard to its ulterior consequences. However, an agent 
which is noxious in health, may prove a valuable remedy in 
disease. When morbid changes have taken place in the blood 
and tissues, when a general diseased condition of the bodily or- 
gans has occurred, then an agent, which is poisonous in health, 
may prove curative. For instance it is admitted that alcohol is 
a poison; that it prevents healthful assimilation, solidifies 
pepsin, begets a morbid appetite; that it produces intoxication, 
and that its habitual use destroys the body. It is, therefore, 
neither a hygienic nor a sanative agent, but strictly a noxious 
one; yet, its very distinct antiseptic properties render it valuable 
for remedial purposes, since these qualities promptly arrest that 
fatal form of decomposition of the animal fluids which is occa- 
sioned by snake-venom, which produces its deadly effects in 
the same manner as a drop of yeast ferments the largest mash. 
Alcohol checks this poisonous and deadly process and neutralizes 
its effects. Thus, alcohol, although a noxious agent, possesses a 
special curative influence in a morbid state of the human 
system; but its general remedial effects do not entitle it to the 
rank of a hygienic agent. We believe that medicine is under- 
going a gradual change from the darkness of the past, with its 
ignorance, superstition, and barbarism, to the light of a glorious 
future. At each successive step in the path of progress, medi- 
cine approaches one degree nearer the realm of an exact science. 
The common object of the practitioners of all medical schools 
is the alleviation of human suffering. The only difference 
between the schools is in the remedies employed, the size of 
dose administered, and the results attained. These are in- 
sufficient grounds for bitter sectarianism. We are all fellow 
laborers in the same field. Before us lies a boundless expanse for 
exploration. There are new conditions of disease to be learned, 
new remedies to be discovered, and new properties of old ones 
to be examined. 
We do not deplore the fact, that there are different schools 
in medicine, for this science has not reached perfection, and 
they tend to stimulate investigation. The remarks of Herbert THE LIBERAL OR INDEPENDENT PHYSICIAN. 
297 
Spencer on the "Multiplication of Schemes of Juvenile Cul- 
ture," may be pertinently applied to the different schools in 
medicine with increased force. He says: "It is clear that 
dissent in education results in facilitating inquiry by the 
division in labor. Were we in possession of the true method, 
divergence from it would, of course, be prejudicial; but the 
true method having to be found, the efforts of numerous inde- 
pendent seekers carrying out their researches in different direc- 
tions, constitute a better agency for finding it than any that 
could be devised. Each of them struck by some new thought 
which probably contains more or less of basis in facts-each 
of them zealous on behalf of his plan, fertile in expedients to 
test its correctness, and untiring in its efforts to make known its 
success-each of them merciless in its criticism on the rest- 
there cannot fail, by composition of forces, to be a gradual 
approximation of all towards the right course. Whatever 
portion of the normal method any one of them has discovered, 
must, by the constant exhibition of its results, force itself into 
adoption; whatever wrong practices he has joined with it must, 
by repeated experiment and failure, be exploded. And by this 
aggregation of truths and elimination of errors, there must 
eventually be developed a correct and complete body of 
doctrine. Of the three phases through which human opinion 
passes-the unanimity of the ignorant, the disagreement of the 
inquiring, and the unanimity of the wise-it is manifest that 
the second is the parent of the third." 
We believe the time is coming when those maladies which are 
now considered fatal will be readily cured-when disease will 
be disarmed of its terrors. To be successful, a physician must 
be independent, free from all bigotry, having no narrow preju- 
dice against his fellow-men, liberal, accepting new truths from 
whatever source they come, free from the restrictions of socie- 
ties, and an earnest laborer in the interests of the Great 
Physician. CHAPTER II. 
REMEDIES FOR DISEASE. 
It will be our aim, throughout this book, to prescribe such 
remedies as are within the easy reach of all, and which may be 
safely employed. Many of those of the vegetable class are 
indigenous to this country, and may be procured in their 
strength and purity, at the proper season, by those residing in 
the localities where they grow, while all others advised may be 
obtained at any good drug-store. We shall endeavor to recom- 
mend such as can be procured and prepared with the least 
trouble and expense to the patient, when it is believed that 
they will be equally as efficacious as more expensive medicines. 
PROPRIETARY MEDICINES. 
Having the invalid's best interests in view, it will often 
happen that we cannot prescribe better or cheaper remedies noi* 
those which are more effective or easily obtained, than some 
of our standard preparations, which are sold by all druggists. 
We are aware that there is a popular, and not altogether 
unfounded prejudice against "patent medicines," owing to the 
small amount of merit which many of them possess. The 
term " Patent Medicine " does not apply to Dr. Pierce's reme- 
dies, as no patent has ever been asked or obtained for them, 
nor have they been urged upon the public as " cure alls." They 
are simply favorite prescriptions, which, in a very extensive 
practice, have proved their superior remedial virtues in the cure 
of the diseases for which they are recommended. 
From the time of Hippocrates down to the present day, 
298 PROPRIETARY MEDICINES. 
299 
physicians have classified diseases according to their causes, 
character or symptoms. It has been proved that diseases appar- 
ently different may often be cured by the same remedy. The 
reason for this singular fact is obvious. A single remedy may 
possess a variety of properties. Quinine, among other properties 
has a tonic which suggests its use in cases of debility; an anti- 
periodic, which renders it efficient in ague; and an antifebrile 
property, which renders it efficacious in cases of fever. The 
result produced varies with the quantity given, the time of 
its administration, and the circumstances under which it is 
employed. Every practicing physician has his favorite remedies, 
which he oftenest recommends or uses, because he has the 
greatest confidence in their virtues. The patient does not know 
their composition. Even prescriptions are usually written in 
a language unintelligible to anybody but the druggist. As 
much secrecy is employed as in the preparation of proprietary 
medicines. Does the fact that an article is prepared by a process 
known only to the manufacturer render that article less valuable? 
How many physicians know the elementary composition of the 
remedies which they employ, some of which never have been 
analyzed? Few practitioners know how morphine, quinine, 
podophyllin, leptandrin, pepsin, or chloroform, are made, or 
how nauseous drugs are transformed into palatable elixirs; yet 
they do not hesitate to employ them. Is it not inconsistent to 
use a prescription the composition of which is unknown to us, 
and discard another preparation simply because it is accompa- 
nied by a printed statement of its properties with directions for 
its use? 
Various journals in this country, have at different times 
published absurd formulae purporting to be receipts for the 
preparation of " Dr. Sage's Catarrh Remedy " and Dr. Pierce's 
standard medicines, which, in most instances, have not contained 
a single ingredient which enters into the composition of these 
celebrated remedies. 
In the manufacture of any pharmaceutical preparation, two 
conditions are essential to its perfection, viz: purity and strength 
of the materials, and appropriate machinery. The first is 
insured, by purchasing the materials in large quantities, whereby 
the exercise of greater care in selecting the ingredients can be COMMON SENSE MEDICAL ADVISER. 
300 
afforded; and the second can only be accomplished where the 
business is extensive enough to warrant a large outlay of capital 
in procuring proper chemical apparatus. These facts apply with 
especial force to the manufacture of our medicines, their quality 
having been vastly improved since the demand has become so 
great as to require their manufacture in very large quantities. 
Some persons, while admitting that our medicines are good 
pharmaceutical compounds, object to them on the ground that 
they are too often used with insufficient judgment. We pro- 
pose to obviate that difficulty by enlightening the people as 
to the structure and functions of their bodies, the causes, 
character, and symptoms of disease, and by indicating the 
proper and judicious employment of our medicines, together 
with such auxiliary treatment as may be necessary. Such is one 
of the designs of this volume. 
PROPERTIES OF MEDICINE. 
It is generally conceded that the action of a remedy upon the 
human system depends upon properties peculiar to it. The 
effects produced suggest the naming of these qualities, which 
have been scientifically classified. We shall name the diseases 
from their characteristic symptoms, and then, without com- 
menting upon all the properties of a remedy, recommend its 
employment. Our reference to the qualities of any remedy, 
when we do make a particular allusion to them, we shall 
endeavor to make as easy and familiar as possible. 
Dose. All persons are not equally susceptible to the influence 
of medicines. As a rule, women require smaller doses than men, 
and children less than women. Infants are very susceptible to 
the effects of anodynes, even out of all relative proportion to 
other kinds of medicines. The circumstances and conditions of 
the system increase or diminish the of medicine, so that 
an aperient at one time may act as a cathartic at another, and 
a dose that will simply prove to be an anodyne when the patient 
is suffering great pain will act as a narcotic when he is not. 
This explains why the same dose often affects individuals differ- 
ently. The following table is given to indicate the size of the 
dose, and is graduated to the age: PROPERTIES OF MEDICINE. 
301 
YEARS. DOSE. 
21 . . . . full. 
15 .... 2-3 
12 ... 1-2 
8 .... 1-3 
6 . 1-4 
YEARS. DOSE. 
4 . 1-6 
2 .... 1-8 
1 1-12 
% . . 1-20 to 1-30 
The doses mentioned in the following pages are those for 
adults, except when otherwise specified. 
The Preparation of Medicines. The remedies 
which we shall mention for domestic use are mostly vegetable. 
Infusions and decoctions of these will often be advised on 
account of the fact that they are more available than the 
tinctures, fluid extracts, and concentrated principles, which we 
prefer, and almost invariably employ in our practice. Most of 
these medical extracts are prepared in our chemical laboratory 
under the supervision of a careful and skilled pharmaceutist. 
No one, we presume, would expect, with only a dish of hot 
water and a stew-kettle, to equal in pharmaceutical skill the 
learned chemist with all his ingeniously devised and costly 
apparatus for extracting the active, remedial principles from 
medicinal plants. Yet infusions and decoctions are not without 
their value; and from the inferior quality of many of the fluid 
extracts and other pharmaceutical preparations in the market, 
it may be questioned whether the former are not frequently 
as valuable as the latter. So unreliable are a majority of the 
fluid extracts, tinctures, and concentrated, active principles found 
in the drug-stores, that we long since found it necessary to have 
prepared in our laboratory, most of those which we employ. 
To the reliability of the preparations which we secure in this 
way we largely attribute our great success in the treatment of 
disease. Tinctures and fluid extracts are often prepared from old 
and worthless roots, barks, and herbs which have wholly lost their 
medicinal properties. Yet they are sold at just as high prices 
as those which are good. We manufacture our tinctures, fluid 
extracts, and concentrated, active principles from roots, barks, 
and herbs which are fresh, and selected with the greatest care. 
Many of the crude roots, barks, and herbs found in the market 
are inactive because they have been gathered at the wrong 
season. These, together with those that have been kept on 
hand so long as to have lost all medicinal value, are often sold 302 
COMMON SENSE MEDICAL ADVISER. 
in large quantities, and at reduced prices, to be manufactured 
into fluid extracts and tinctures. Of course, the preparations 
made from such materials are worthless. Whenever the dose 
of fluid extracts, tinctures, and concentrated, active principles, 
is mentioned in this chapter, the quantity advised is based upon 
our experience in the use of these preparations, as they are 
made in our laboratory, and the smallest quantity which will 
produce the desired effect is always given. When using most 
of the preparations found in the drug-stores, the doses have to 
be somewhat increased, and even then they will not always pro- 
duce the desired effect, for reasons already given. 
The List of Medicines which we shall introduce in 
this chapter will be quite limited, as we cannot hope, by making 
it extensive, that the non-professional reader would be able to 
prescribe with good judgment any other than the simpler reme- 
dies. Hence, we prefer, since we have no space in this volume 
to waste, to mention only a few of the most common remedies 
under each head or classification. 
Tinctures. Very uniform and reliable tinctures may be 
made of most indigenous plants, by procuring the part to be 
employed, at the proper season, while it is green and fresh, 
bruising it well, and covering it with good strong whisky, or 
with alcohol diluted with one part of water to three of alcohol, 
corking tightly, and letting it stand about fourteen days, when 
the tincture may be filtered or poured off from the drugs, and 
will be ready for use. Prepared in this imperfect manner, they 
will be found to be much more reliable than any of the fluid 
extracts found in the drug-stores. An excess of the crude drug 
should be used in preparing the tincture to insure a perfect 
saturation of the alcohol with its active principles. 
IIoilMCopathic Tinctures. The tinctures prepared by 
several of the German and French pharmaceutists, and called 
by them " Mother Tinctures," to distinguish them from the 
dilutions made therefrom, we have found to be very reliable, so 
much superior to any similar preparations made in this country 
that we purchase from them all we use of Pulsatilla, Staph- 
isagria, Drosera and several others. They are prepared with 
great care from the green, crude material, and although high in 
price, when compared with other tinctures, yet the greater ALTERATIVES. 
303 
certainty of action which we secure in our prescriptions by 
their employment more than repays for the expense and trouble 
in procuring them, for of what account is expense to the true 
physician when life may depend upon the virtue of the agent he 
employs ? 
Infusions. These are generally made by adding one-half 
ounce of the crude medicine to a pint of water, which should 
be closely covered, kept warm, and used as directed. Flowers, 
leaves, barks, and roots become impaired by age, and it is neces- 
sary to increase or diminish the dose according to the strength 
of the article employed. 
Decoctions. The difference between a decoction and an 
infusion is, that the plant or substance is boiled in the produc- 
tion of the former, in order to obtain its soluble, medicinal 
qualities. Cover the vessel containing the ingredients, thus 
confining the vapor, and shutting out the atmospheric air which 
sometimes impairs the active principles and their medicinal 
qualities. The ordinary mode of preparing a decoction is to 
use one ounce of the plant, root, bark, flower, or substance to a 
pint of water. The dose internally varies from a tablespoonful 
to one ounce. 
ALTERATIVES. 
Alteratives are a class of medicines which in some inexplic- 
able manner, gradually change certain morbid actions of the 
system, and establish a healthy condition instead. They stim- 
ulate the vital processes to renewed activity, and arouse the 
excretory organs to remove matter which ought to be eliminated. 
They facilitate the action of the secretory glands, tone them 
up, and give a new impulse to their operations, so that they 
can more expeditiously rid the system of worn-out and effete 
materials. In this way they alter, correct, and purify the 
fluids, tone up the organs, and re-establish their healthy func- 
tions. Alteratives may possess tonic, laxative, stimulant, or 
diuretic properties all combined in one agent. Or we may com- 
bine several alteratives, each having only one of these properties 
in one remedy. We propose to enumerate only a few altera- 
tives, and give the doses which are usually prescribed; the list 
which we employ in our practice is very extensive, but it can- 
not be made available for domestic use. 304 
COMMON SENSE MEDICAL ADVISER. 
Hlandrake {Podophyllum Peltatum), also called May- 
apple, is a most valuable alterative. The root is the part 
used. Dose - Of decoction, one to two teaspoonfuls; of 
tincture, six to eight drops; of fluid extract, three to five drops; 
of its active principle, Podophyllin, one-twelfth to one-eighth 
of a grain. 
Poke {Phytolacca Decandr a), also called Skoke, Garget, or 
Pigeon-berry, is a valuable alterative. The root is the part 
used. Dose-Of decoction, one to three teaspoonfuls; of fluid 
extract, three to ten drops; of concentrated principle, Phyto- 
laccin, one-fourth to one grain. 
Yellow Dock {Rumen Crispus). The part used is the 
root. Dose-Of the infusion, one to three fluid ounces three 
times daily; of fluid extract, ten to thirty drops; of tincture, 
twenty to forty drops. 
Tag Alder {Alnus Rubra). This is otherwise known as 
the Smooth, Common, or Swamp Alder. The bark is the part 
Fig. US. 
Tag Alder. 
used. It is excellent in scrofula, syphilis, cutaneous and all 
blood diseases. Dose-Of decoction, one or two tablespoonfuls ALTERATIVES. 
305 
from three to five times daily; of tincture, one or two teaspoon- 
fuls; of fluid extract, one-half to one teaspoonful; of concen- 
trated principle, Alnuin, one-half to one grain. 
Black Cohosh (Macrotys or Cimicifuga Racemosa). 
The part used is the root. Its other common names are Black 
Fig. llJf.. 
Black Cohosh. 
Snake-root, or Squaw-root. Black Cohosh is an alterative, 
stimulant, nervine, diaphoretic, tonic, and a cerebro-spinal stimu- 
lant. It is a useful remedy. Dose-Of decoction, one-fourth to 306 
COMMON SENSE MEDICAL ADVISEE. 
one ounce; of tincture, ten to fifteen drops; of fluid extract, five 
to ten drops; of the concentrated principle, Macrotin, one-eighth 
to one-half grain. 
Blood-root (Sanguinaria Canadensis), is also known as 
Red Puccoon. The part used is the root. In minute doses 
Fly. 115. 
Blood-root. 
Blood-root is a valuable alterative, acting upon the biliary 
secretion and improving the circulation and digestion. Dose- 
Of powdered root, one-fourth to one-half grain; of tincture, one ALTERATIVES. 
307 
to two drops; of the fluid extract, one-half to one drop. When 
given in a fluid form it should be well diluted. 
Burdock {Arctium Lappa). The root is the part used. 
Burdock is a valuable alterative in diseases of the blood. Dose 
-Of tincture, from one teaspoonful to a tablespoonful twenty 
minutes before meals; of fluid extract, one to two teaspoonfuls. 
Blue Flag' {Iris Versicolor). The part used is the root. 
Dose-Of the tincture, five to ten drops; of fluid extract, three 
to ten drops; of concentrated principle, Iridin, one-half to two 
grains. 
Sweet Elder {Sambucus Canadensis). Sweet Elder-flow- 
ers are a valuable alterative, diuretic, mucous and glandular 
stimulant, excellent in eruptive, cutaneous, and scrofulous dis- 
eases of children. An infusion, fluid extract, or syrup, may be 
used in connection with the "Golden Medical Discovery." Both 
will be found valuable for cleansing the blood and stimulating 
the functions to a healthy condition. Dose - Of the infusion 
of the flowers, from one-half to one ounce, if freely taken, will 
operate as a laxative; of fluid extract, one-fourth to one-half 
teaspoonful. The flowers, or inner bark of the root, simmered 
in fresh butter, make a good ointment for most cutaneous 
affections. 
Iodine. This agent, in the several forms of Iodide of 
Potassium, Iodide of Ammonium, Iodide of Iron, and Iodide of 
Lime, is largely employed by physicians, and often with most 
happy results. But for domestic use we cannot advise its 
employment, as it is liable to injure the invalid, when its action 
is carried too far, which is apt to be the case, when not admin- 
istered under the supervision of a competent physician. 
lUei'Cliry. The various preparations of mercury have a 
profound, alterative effect upon the system. When taken for 
some time, they change the quality and composition of the 
blood; cause a diminution in the number of red blood-cor- 
puscles, and an increase in the various effete materials. In the 
vast majority of cases we prefer the vegetable alteratives, but 
in rare instances they exert a beneficial influence, in small doses. 
None of the preparations of mercury should be taken internally 
without the advice of a skillful physician, therefore, we shall 
not give their doses. 308 
COMMON SENSE MEDICAL ADVISER. 
THE COMPOUNDING OF ALTERATIVES. 
The efficacy of this class of remedies can be greatly increased 
by properly combining several of them into one compound. 
This requires a knowledge of Pharmaceutical Chemistry; i. e., 
the preparation of compounds founded on the chemical relation 
and action of their several remedial, active principles. Many 
practitioners make combinations of remedies which neutralize 
each other's influence, instead of extending their efficacy and 
curative power. 
Dr. Pierce's u Golden Medical Discovery," or 
Alterative Extract. This compound is a highly nutritive and 
tonic preparation, combining the remedial properties of the 
best vegetable alteratives at present known to the medical 
profession. In perfecting this alterative compound, and likewise 
other standard preparations of medicine, we have made an out- 
lay of many thousand dollars for chemical apparatus, and 
special machinery by the aid of which these remedies have been 
brought to their present perfection. Great pains are taken to 
obtain the materials at the right season of the year, properly 
cured so that none of their remedial qualities may be impaired. 
We, therefore, can with great confidence recommend Dr. Pierce's 
" Golden Medical Discovery " as one of the best preparations of 
the alterative class. Like all others of this type, its action is 
insensible, producing gradual changes, arousing the excretory 
glands to remove morbid materials, and at the same time toning 
the secretory organs. The manufacture of this compound is 
under the special supervision of a competent chemist and phar- 
maceutist, and it is now put up in bottles wrapped with full 
directions for its use. We can confidently recommend this 
compound whenever an alterative is required to cleanse the 
blood, tone the system, increase its nutrition, and establish a 
healthy condition. For these reasons we shall often advise its 
employment. 
Dr. Pierce's Pleasant Purgative Pellets. These 
pellets combine the pure, concentrated, active principles of 
several vegetable alteratives, and the result is, that within the 
small compass of a few grains he has most happily blended and 
chemically condensed these properties, so that their action upon ACIDS. 
309 
the animal economy is sanative and universal. They awaken 
the latent powers, quicken the tardy functions, check morbid 
deposits, dissolve hard concretions, remove obstructions, pro- 
mote depuration, harmonize and restore the functions, equalize* 
the circulation, and encourage the action of the nervous system. 
They stimulate the glands, increase the peristaltic movement of 
the intestines, tone the nutritive processes, while aiding in 
evacuating the bowels. All this they accomplish without cor- 
roding the tissues or vitiating the fluids. Their assistance is 
genial, helping the system to expel worn out materials, which 
would become noxious if retained. Having expended their 
remedial powers upon the various functions of the body, they 
are themselves expelled along with other waste matter, leaving 
behind them no traces of irritation. This cannot be said of 
mercurials, or of other harsh, mineral alteratives. These Pellets 
may be safely employed when the system is feeble, frail, and 
delicate, by giving them in less quantities. Dose-As an alter- 
ative, only one or two Pellets should be taken daily. 
ALKALIES. 
Alkalies. These constitute an important list of remedial 
agents, their administration being frequently indicated. The 
employment of other medicines frequently should be preceded 
by the administration of an agent of this, class, to neutralize 
excessive acidity in the stomach and bowels. Unless this be 
done, many medicines will fail to produce their specific effects. 
Sulphite Of Soda (Sodas Sulphis). This salt, as well as 
the Hyposulphite of Soda, is not only generally preferable for 
administration on account of its unirritating character and the 
smallness of the dose required, but also because it is a valuable 
antiseptic agent. The Sulphite should not be confounded with 
the Sulphate of Soda (Glauber's Salt). Dose-This is from 
three to ten grains. 
Saleratus (Potasses Dicarbonas). This is a favorite 
domestic antacid. Dose-Five to fifteen grains is the amount. 
ACIDS. 
As alkalies are important and often indicated as reme- 
dial agents, so their re-agents, acids, are also frequently 310 
COMMON SENSE MEDICAL ADVISEE. 
necessary to meet opposite conditions of the fluids of the 
system. 
Hydrochloric or Muriatic Acid. This agent may 
"be administered in doses of from five to ten drops, largely 
diluted in water or gruel. 
Aromatic Sulphuric Acid, or Elixir of Vitriol, is the 
most agreeable form of Sulphuric Acid for administration, and 
may be given in doses of from five to fifteen drops, largely 
diluted with water. 
In taking acids, they should be sucked through a straw, and 
not allowed to come in contact with the teeth, as otherwise the 
latter organs will be injured by their effects; or should the acid 
come in contact with the teeth, the mouth should be immedi- 
ately rinsed with a solution of saleratus or soda, to neutralize 
the acid. 
ANODYNES. 
Anodynes are those medicines which relieve pain by blunting 
the sensibility of the nerves, or of the brain, so that it does 
not appreciate the morbid sensation. An anodyne may be a 
stimulant in one dose, and a narcotic in a larger one. The 
properties of different anodyne agents vary, consequently they 
produce unlike effects. The size of the dose required, differs 
according to circumstances and condition. An adult, suffering 
acute pain, requires, a much larger dose to produce an anodyne 
effect than one who is a chronic sufferer. An individual accus- 
tomed to the use of anodynes, requires a much larger dose to 
procure relief than one who is not. Doses may be repeated, 
until their characteristic effects are produced, after an interval 
of thirty or forty minutes. When the stomach is very sensitive 
and will not tolerate their internal administration, one-sixth 
of a grain of Morphia can be inserted beneath the skin, by 
means of a hypodermic syringe. Relief is more quickly ex- 
perienced, and the anodyne effect is much more lasting than 
when taken into the stomach. 
Opium (Papaver Somniferuni). Opium is a stimulant, 
anodyne, or narcotic, according to the size of the dose ad- 
ministered. Pose-Of the dry powder, one-fourth to one 
grain; of tincture (Laudanum), five to fifteen drops; of cam- 
phorated tincture (Paregoric), one-half to one teaspoonful; of ANODYNES. 
311 
Morphine, one-eighth to one-fourth grain; of Dover's Powder, 
three to five grains. 
Hyoscyamns {Hyoscyamus Niger), commonly known as 
Henbane. The herb is used. It is a powerful narcotic, and 
unlike Opium, does not constipate the bowels, but possesses a 
laxative tendency. Therefore, it may be employed as an 
anodyne for' allaying pain, calming the mind, inducing sleep 
and arresting spasms, when opiates are inadmissible. Dose-Of 
alcoholic extract, one-half to two grains; of fiuid extract, five 
to ten drops; of the concentrated principle, Hyoscyamin, one- 
twelfth to one-fourth of a grain. 
Poison Hemlock (Comm Macidatum). The leaves are 
Fig. 116. 
Poison Hemlock. 
the parts used. Poison Parsley, as it is sometimes called, is an 
anodyne, narcotic, and an excellent alterative. Dose-Of fluid 312 
COMMON SENSE MEDICAL ADVISER. 
extract, two to six drops; of solid extract, one-fourth to one-half 
grain. 
Belladonna (Atropa Belladonna) or Deadly Nightshade. 
The herb or leaves are a valuable agent. In overdoses, it is an 
energetic, narcotic poison. In medicinal doses it is anodyne, 
anti-spasmodic, diaphoretic, and diuretic. It is excellent in 
neuralgia, epilepsy, mania, amaurosis, whooping-cough, stric- 
ture, rigidity of the os uteri, and is supposed by some to be 
a prophylactic or preventive of Scarlet Fever. Its influence 
upon the nerve centers is remarkable. It relaxes the blood 
vessels on the surface of the body and induces capillary 
congestion, redness of the eye, scarlet appearance of the face, 
tongue, and body. Dose-Of fluid extract, one-half to one drop; 
of tincture, one to two drops; of concentrated principle, Atropin, 
one-thirtieth to one-sixteenth of a grain; of the Alkaloid, 
Atropia, one-sixtieth of a grain. Even the most skillful chemists 
are very cautious in compounding these latter active principles, 
and the danger of an overdose is great. 
Camphor. This drug is an anodyne, stimulant, and dia- 
phoretic, and, in large doses, a narcotic and an irritant. It is an 
excellent stimulant for liniments. Dose-Of the powder, one 
to five grains; of the tincture, ten to twenty drops, given in 
simple syrup. 
Hops {Humulus Lupulus). This is an excellent remedy in 
wakefulness, and may be used when opium is contra-indicated. 
A bag of the leaves, moistened with whisky and placed as a 
pillow under the head, acts as an anodyne. Dose-Of the 
infusion of the leaves, from one to four ounces; of the fluid 
extract, one-fourth to three - fourths of a teaspoonful; of the 
concentrated principle, Humulin, one to three grains. 
Dr. Pierce's Compound Extract of Smart- 
weed. This anodyne compound is made by uniting several 
of the most valuable agents of this class, and its medicinal 
qualities are rendered still more efficacious by the addition of 
certain stimulating articles. It is free from narcotic properties 
which are liable to produce deleterious results, and has been 
found to be not only harmless in its action, but very genial and 
effectual withal, and most reliable as a stimulant and diaphoretic 
remedy. ANTHELMINTICS. 
313 
Anthelmintic means " against a worm," and is a term em- 
ployed to designate those medicines which destroy or expel 
worms. It means the same as Vermifuge. Little is understood 
concerning the origin of worms. There are five distinct varie- 
ties described by authors as being more common than others. 
There is the long worm, the short, or pin-worm, the thread- 
worm, the tape-worm, and the broad tape-worm peculiar to 
some countries of Europe. Irritation of the alimentary canal, 
from whatever cause, usually produces an abundant secretion 
of mucus, which is thought to be a condition favorable for 
their production. Therefore, those medicines which remove 
the cause of this irritation tend to diminish the number, if 
not to entirely destroy the worms. Some medicines kill the 
worms, others expel them alive. The remedies which success- 
fully remove one kind of worm, have little effect upon another, 
and to meet these different conditions, we have a variety of 
worm-destroying medicines. The pin-worm inhabits the rec- 
tum, and may be destroyed by injecting into it a strong 
solution of salt, or decoction of aloes, and when it is allowed 
to pass away, the rectum should be anointed with vaseline, 
butter, or lard. The eggs of this worm are developed around 
the orifice of the large intestine, and when this latter precaution 
is not practiced every time there is a passage from the bowels, 
they will multiply as rapidly as they can be destroyed. Gen- 
erally, vermifuge remedies should be taken when the stomach 
is empty, and should be followed by the administration of a 
cathartic in two hours after the last dose is administered. 
Santonin. This is decidedly the most reliable anthel- 
mintic known to the medical profession. It is deservedly a 
popular remedy for worms, and when combined with Podo- 
phyllin, is very efficacious in removing the pin-worm. Dose- 
For an adult, two to three grains of the powdered Santonin, 
repeated every three hours until four or five doses are taken, 
when it should be followed by a cathartic. 
Sage (Salvia Officinalis'). Sage is a common and excellent 
domestic remedy for worms. Make an infusion of Sage and 
Senna leaves, and drink freely until it acts as a cathartic. 
ANTHELMINTICS. 314 
COMMON SENSE MEDICAL ADVISER. 
Pink-root (iSpigelia Marilandica). Pink-root is one ot 
the most active and certain anthelmintics for children. It is 
Fig. 117. 
Pink-root. 
indigenous to the United States. When taken in too large 
quantities, it is apt to purge, give rise to vertigo, dimness 
of vision, and even to convulsions; therefore, it should be ANTIPERIODICS. 
315 
combined with some cathartic. Dose-Of the infusion, one 
ounce at night, followed by physic in the morning. 
Common Salt (Chloride of Sodium). Common table 
salt is an anthelmintic, and may be used in an emergency. Salt 
water is a very common domestic remedy for worms. Dose- 
In solution, one-quarter to one-half teaspoonful. 
Balmony (Chelone Glabra). This is also tonic and anthel- 
mintic, and is valuable in debility, dyspepsia, jaundice, and 
hepatic affections. It also is known as Snake-head. Dose- 
Of the infusion, one to two ounces; of the concentrated prin- 
ciple, Chelonin, from half to one grain. 
Male Fern (Aspidium Filix Mas). Male Fern is the an- 
thelmintic which is considered especially effectual in removing 
the tape-worm. Dose-Of the powder, one to two drachms, 
given morning and evening in syrup, followed by a brisk 
cathartic. The dose of the tincture of the buds in ether is 
from eight to thirty drops. 
Poplar (Populus Tremuloides). The White or Aspen 
Poplar is a common tree, and contains active principles 
termed Populin and Salicin, both of 
which are tonic. An infusion of the 
bark is a remedy for worms. Dose- 
Of the tea made from the bark, one 
to four ounces; of Populin, from one- 
half to two grains. 
Fig. 118. 
ANTIPERIODICS. 
It is well understood that malarial 
diseases are characterized by a peri- 
odicity which indicates their nature. 
Antiperiodics prevent the recurrence 
of the periodic manifestations, and 
hence their name. 
Quinine {Sulphate of Quinia}. 
Quinine is a tonic, febrifuge, and antiperiodic. It should 
generally be administered during the intervals between the 
febrile paroxysms. It is beneficial also in all diseases ac- 
companied by debility. The dose varies from one to six 
grains, according to indications. Frequently it is given in much 
Aspen. 316 
COMMON SENSE MEDICAL ADVISEE. 
larger quantities, but we cannot advise such for domes- 
tic use. 
Prussian Blue {Ferri Ferrocyanidum). Ferrocyanide of 
Iron is an excellent tonic and antiperiodic remedy, and often is 
combined with quinine. Dose-From two to five grains. 
Boneset {Eupatoriwm Perfoliatum), or Thoroughwort. This 
is tonic, diaphoretic, aperient, and possesses some antiperiodic 
Fig. 119. 
Boneset. 
properties; the warm infusion is emetic. Dose-Of the infusion, 
one to four ounces; of the fluid extract, from half to one tea- 
spoonful; of the active principle, Eupatorin, one to three grains. 
The uGolden Medical Discovery" has gained an 
enviable reputation in malarial districts for the cure of ague. 
From observing its action in the cure of this and other mias- 
matic diseases, and knowing its composition, we are thoroughly ANTISEPTICS AND DISINFECTANTS. 
317 
satisfied that it contains chemical properties which neutralize 
and destroy the miasmatic or ague poison which is in the 
system, and, at the same time, produces a rapid excretion of the 
neutralized poisons. One strong proof of this is found in the 
fact that persons who are cured with it are not so liable to 
relapse as those in whom the chills are broken with Quinine 
or other agents. No bad effects are experienced after an attack 
of ague which has been cured with the "Golden Medical 
Discovery." This cannot be said of Quinine, Peruvian Bark, 
Arsenic, and Mercurials, which comprise nearly the whole list of 
remedies usually resorted to by physicians for arresting ague. 
The "Golden Medical Discovery" not only has the merit of 
being a certain antidote for miasmatic diseases, but is pleasant 
to the taste, a matter of no small importance, especially when 
administered to children. To break the chills, this medicine 
should be taken in doses of four teaspoonfuls three times a 
day, and if this treatment pursued for three days, does not 
entirely arrest the chills, these doses may be repeated in 
alternation with five-grain doses of quinine for the three 
succeeding days. But in no case should more than this amount 
of the " Golden Medical Discovery " be given. 
ANTISEPTICS AND DISINFECTANTS. 
Antiseptics prevent, while disinfectants arrest putrefaction. 
Oxygen is a natural disinfectant, but a powerful inciter of 
change. Although this element is the cause of animal and 
vegetable decay, yet oxidation is the grand process by which 
the earth, air, and sea are purified. A few substances are 
both antiseptic and disinfectant. Heat up to a temperature 
of 140° Fahr, promotes putrescence, but above that point, is a 
drier or disorganizer, and destroys the source of infection. 
Yeast (Cerevisice Fermentum). Yeast is an antiseptic, and 
is effective in all diseases in which there is threatened putridity. 
Used externally, it is often combined with elm bark and 
charcoal, and applied to ulcers, in which there is a tendency to 
gangrene. Dose-One tablespoonful in wine or porter, once in 
two or three hours. 
Cl'easote. This is a powerful antiseptic. It is used in a 318 
COMMON SENSE MEDICAL ADVISER. 
solution of glycerine, oil, water, or syrup. Dose-One to two 
drops, largely diluted. 
Carbolic Acid is a crystalline substance resembling crea- 
sote in its properties. It is an antiseptic, and is used both 
internally and externally. Dose-One-fourth to one-half drop 
of the melted crystals, very largely diluted. Externally, in 
solution, one to five grains of the crystals to one ounce of the 
solvent. 
White Vitriol (Zinci Sulphas'). White vitriol is a valuable 
disinfectant, as it will arrest mortification. In solution it is 
employed in ulcers and cancers and also as a gargle in putrid 
sore throat. Dose-One-half to two grains in a pill; in solution, 
one to ten grains in an ounce of water. 
Permanganate of Potash (Potassai Permanganas). 
This substance is an energetic deodorizer and disinfectant. A 
solution containing from one to twenty grains in an ounce of 
water is used as a lotion for foul ulcers. Dose-One-eighth to 
one-fourth of a grain. 
Wild Indigo (Baptista Tinctoria). The root is the part 
used. This plant possesses valuable antiseptic properties. It is 
an excellent lotion for ill-conditioned ulcers, malignant sore 
throat, nursing sore-mouth, syphilitic ophthalmia, etc. It is 
sometimes administered in scarlet and typhus fevers, and in all 
diseases in which there is a tendency to putrescence. Dose-Of 
the infusion, one-fourth to one-half ounce; of the fluid extract, 
from three to ten drops, and of the concentrated, active principle 
of the plant, Baptism, from one to two grains. 
ANTISPASMODICS. 
Antispasmodics are a class of remedies which relieve cramps, 
convulsions, and spasms, and are closely allied to nervines. 
Indeed some authors class them together. The following are 
a few of the most important antispasmodics: 
Assafetida (Assafetida Ferula). This is a powerful 
antispasmodic. It is employed in hysteria, hypochondria, 
convulsions, and spasms, when unaccompanied by inflammation. 
Dose-Of the gum or powder, from three to ten grains, usually 
administered in the form of a pill; of the tincture, from one-half 
to one teaspoonful. ANTISPASMODICS. 
319 
Yellow Jessamine (Gelseminum Sempervirens). The 
root is the part used. This is a valuable remedy in various 
Fig. 120. 
diseases when associated with restlessness and a determination 
of the blood to the brain; also in the neuralgia. Dose-Of the 
Yellow Jessamine. 320 
COMMON SENSE MEDICAL ADVISER. 
fluid extract, three to eight drops; of the concentrated prin- 
ciple, Gelsemin, one-fourth to one grain. The use of this drug 
by non-professional persons should be attended with great 
caution. 
Valerian (Valeriana Officinalis). The root is the part 
used. Valerian is an eifective remedy in cases of nervousness 
and restlessness. Dose-Of the infusion, (one-half ounce to a 
pint of water) one-half ounce; of the tincture, one-half to two 
tablespoonfuls; of the ammoniated tincture of valerian, from 
one-half to two teaspoonfuls in sweetened water or milk; of the 
valerianate of ammonia, one-half to three grains. 
Yellow Lady's Slipper (Cypripedium Pubescens). 
The root is the part used. This is a useful remedy in hysteria, 
chorea, and all cases of irritability. Dose-Of the powder, 
fifteen to thirty grains; of the infusion, one ounce; of the fluid 
extract, fifteen to thirty drops; of the concentrated principle, 
Cypripedin, one-half to two grains. 
Wild Yam (Dioscorea Villosa). The root is the part 
used. This is a powerful antispasmodic, and has been success- 
fully used in bilious colic, nausea, and spasm of the bowels. 
Dose-Of the infusion (two ounces to a pint of water), one 
to two ounces; of the fluid extract, five to fifteen drops; of the 
concentrated principle, Dioscorein, one-half to one grain. 
High Cranberry ( Viburnum Opulus.) The bark is the 
part used. It is also known as Cramp Bark. This is a powerful 
antispasmodic, and is effective in relaxing spasms of all kinds. 
It is a valuable agent in threatened abortion. Dose-Of 
the infusion, one-half to one ounce; of the fluid extract, one- 
half to one teaspoonful; of the concentrated principle, Viburnin, 
one-half to two grains. These doses may be increased if 
necessary. 
ASTRINGENTS. 
Astringents are medicines which condense and coagulate the 
tissues, thereby arresting discharges. When taken into the 
mouth, they produce the sensation known as puckering. They 
are used internally and locally. The term styptic is used as a 
synonym of astringent, but is generally employed to designate 
those astringents which arrest hemorrhage, or bleeding. ASTRINGENTS. 
321 
Logwood {Haematoxylon Campechianum). Logwood is 
a mild astringent, well adapted to remedy the relaxed condition 
of the bowels after cholera infantum. Dose,-Of powdered 
extract, five to ten grains; of the decoction, one ounce; of the 
fluid extract, fifteen to thirty drops. 
Blackberry Root [Bubus 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. 
Witch-hazel (Hamamelis Virginica). The parts used 
are the leaves and bark. This is a most valuable astringent 
Fig. 121. 
Witch-hazel. 
and exerts a specific action upon the nervous system. It arrests 
many forms of uterine hemorrhage with great promptness, 
is a valuable agent in the treatment of piles, and is useful in 322 
COMMON SENSE MEDICAL ADVISER. 
many forms of chronic throat and bronchial affections. Dose,- 
Of the infusion, one-fourth to one-half ounce; of the fluid 
extract, eight to fifteen grains; of the concentrated principle, 
Hamamelin, one fourth to one grain. 
Craiiesbill (Geranium Maculatum). The root is used. 
Fig. 122. 
Cranesbill. 
This plant is also known as Crow-foot, and Spotted Geranium. 
It is a pleasant, but powerful astringent. Dose-Of the fluid ASTRINGENTS. 
323 
extract, ten to thirty drops; of the concentrated principle, 
Geranin, one to two grains. 
Hardback {Spirea Tbmentosa), Spirea, or Meadow Sweet. 
The stem and leaves are used. It is a tonic and an astringent, and 
Fig. 123. 
Fig. 124. 
Bugle-weed. 
Hardback. 
is used in diarrhea and cholera-infantum. Dose-Of the infu- 
sion, one-half to one ounce; of the fluid extract, three to six drops. 
Bugle-weed (Zycopus Virginicus). This is variously- 
known as Water-hoarhound and Water-bugle. It is sedative 
and tonic, as well as astringent, and is employed in hemorrhages COMMON SENSE MEDICAL ADVISER. 
324 
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. 
Canada Fleabane (Erigeron Canadense). The leaves 
Fig. 125. 
Canada Fleabane. 
and flowers are used. This plant, sometimes known as Colt's- 
tail, Pride-weed, or Butter-weed, is astringent, and has been carminatives. 
325 
efficiently employed in uterine hemorrhages. Dose-Of the 
infusion (two ounces of the herb to one pint of water), one to 
two ounces; of the oil, five to ten drops on sugar, repeated at 
intervals of from one to four hours. 
Catechu (Acacia Catechu). A tincture of this plant is a 
pure, powerful astringent, and is especially useful in chronic 
diarrhea, chronic catarrh, and chronic dysentery. Dose-Of 
the powder, five to twenty grains; of the tincture, one-half 
to two teaspoonfuls. 
Tannin (Acidum Tannicum). This acid has a wide range 
of application. It is used as an astringent. Dose-One to five 
grains. 
Gallic Acid (Acidum Gallicum). This remedy is used 
chiefly in hemorrhages. Dose-Three to five grains. In severe 
hemorrhages, this quantity should be administered every half 
hour, until the bleeding is checked. 
Carminatives are medicines which allay intestinal pain, arrest 
or prevent griping caused by cathartics and exert a general 
soothing effect. They are aromatic, and to a certain extent, 
stimulant. 
Anise-seed (Pimpinella Anisum). Anise is a pleasant, 
aromatic carminative, and is used in flatulent colic. Dose- 
Of the powdered seed, ten to fifteen grains; of the infusion 
(a teaspoonful of seed to a gill of water), sweetened, may be 
given freely; of the oil, five to ten drops on sugar. 
Fennel-seed (Anethum Foeniculum). This is one of our 
most grateful aromatics, and is sometimes employed to modify 
the action of senna and rhubarb. Dose-Same as that of 
anise-seed. 
Ginger (Zingiber Officinale). The root is the part used. 
This is a grateful stimulant and carminative. Dose-Of the 
powder, ten to twenty grains; of the infusion, one teaspoonful 
in a gill of water; of the tincture, twenty to thirty drops; of 
the essence, ten to fifteen drops; of the syrup, one teaspoonful. 
Win ter green (Gaultheria Procumbens). The leaves are 
used. This plant possesses stimulant, aromatic, and astringent 
properties. The essence of Wintergreen is carminative, and is 
CARMINATIVES. COMMON SENSE MEDICAL ADVISER. 
326 
used in colics. Dose-Of the essence, one-half to one teaspoon- 
ful in sweetened water; of the oil, three to five drops on sugar. 
Peppermint (Mentha Piperita). Peppermint is a power- 
ful stimulant, carminative, and antispasmodic. It is used in 
the treatment of spasms, colic, and hysteria. Dose-The infu- 
sion may be used freely. The essence may be taken in doses 
of fifteen to thirty drops in sweetened warm water; of the oil, 
one to five drops on sugar. 
Spearmint (Mentha Viridis). The carminative properties 
of spearmint are inferior to those of peppermint, and its chief 
employment is for its diuretic and febrifuge virtues. Dose- 
Same as that of peppermint. 
Compound Extract of Smart-weed. Dr. Pierce's 
Extract of Smart-weed is a valuable carminative and aromatic 
stimulant, and has been employed with marked success in all 
diseases in which this class of remedies is required. 
Cathartics, or Purgatives are medicines which act upon the 
bowels and increase the secretions and evacuations. In many 
parts of the country, these agents are known as purges, or 
physics. They have been variously divided and sub-divided, 
usually with reference to the energy of their operations or the 
character of the evacuations produced. 
Laxatives, or Aperients, are mild cathartics. Purgatives act 
with more energy and produce several discharges which are of 
a more liquid character and more copious than the former. 
Drastics are those cathartics which produce numerous evacua- 
tions accompanied by more or less intestinal irritation. 
Hydragogues are those purgatives which produce copious, 
watery dischargees. * 
Cholagogues are those purgatives which act upon the liver, 
stimulating its functions. Cathartics constitute a class of 
remedies which are almost universally employed by families and 
physicians. 
Jalap (Ipomoea Jalapa). The root is used. It is a drastic 
and a hydragogue cathartic. Formerly it was combined with 
equal parts of calomel. From this fact it received the name of 
"ten and ten." Dose-Of the powder, five to twenty grains; 
CATHARTICS. CATHARTICS. 
327 
of the fluid extract, ten to fifteen drops; of the solid extract, 
two to four grains; of the concentrated 
principle, Jalapin, one-half to two 
grains. 
Ramboge {Gambogia). The gum 
is used. Gamboge is a powerful 
drastic, hydragogue cathartic, which is 
apt to produce nausea and vomiting. 
It is employed in dropsy. It should 
never be given alone, but combined 
with milder cathartics. It accelerates 
their action while they moderate its 
violence. Dose,-Of the powder, one- 
half to two grains. This substance 
combined with aloes and sometimes 
with scammony, constitutes the basis 
of the numerous varieties of large, 
cathartic pills found in the market. 
Ctllvcr's-root. {Leptandra Vir- 
ginica). The root is used. This plant, 
known undei- the various names of Cul- 
ver's Physic, Black-root, Tall Speedwell, 
and Indian Physic, is a certain chola- 
gogue, laxative, and cathartic. Dose- 
Of decoction, one to two fluid ounces; 
of fluid extract, ten to twenty drops; of 
tincture, twenty to thirty drops; of the 
concentrated, active principle, Leptan- 
drin, which is but feebly cathartic, as a 
laxative, two to five grains. 
Rhubarb {Rheum Palmatum). 
This is much used as a domestic 
remedy, and by the profession, for its 
laxative, tonic, and astringent effects. 
It is employed in bowel complaints. 
Dose-Of the powder, ten to thirty 
grains; of the tincture, one-half to two 
teaspoonfuls; of the fluid extract, ten to thirty drops; of the 
solid extract, three to five grains; of the syrup, and aromatic 
Fig. 126. 
Culver's-root. 328 
COMMON SENSE MEDICAL ADVISER. 
syrup, an excellent remedy for children, one-half to one 
teaspoonful. 
Cascara Sagl'ada (Rhamnus Purshiana), is a very effi- 
cient remedy in chronic constipation. Dose - Of the fluid 
extract, from ten to twenty drops taken in a tablespoonful 
of water. The unpleasant taste may be disguised with the 
extract of liquorice. 
Castor Oil (Oleum Ricini). Dose-From one to four 
teaspoonfuls. It may be disguised by rubbing it with an equal 
quantity of glycerine and adding one or two drops of oil of 
anise, cinnamon, or Wintergreen. 
Butternut (Jugldns Ginerea). The bark is the part used. 
Butternut is a mild cathartic, which resembles rhubarb in its 
property of evacuating the bowels without irritating the 
alimentary canal. Dose-Of the extract, as a cathartic, five to 
ten grains; of the fluid extract, one-half to one tea-spoonful; 
of the concentrated principle, Juglandin, one to three grains. 
As a laxative, one-half of these quantities is sufficient. 
Aloes (AZoe). The gum is used. This cathartic acts upon 
the lower part of the bowels and sometimes causes piles; 
though some late authors claim that in small doses it is a valu- 
able remedy for piles. Dose-In powder or pill, three to ten 
grains; as a laxative, one to three grains. 
Epsom Salts (Magnesia Sulphas). Its common name 
is " Salts." Much used in domestic practice. Dose-One- 
fourth to one-half ounce. 
Dr. Pierce's Pleasant Purgative Pellets are 
so compounded from concentrated, active principles, extracted 
from cathartic roots and herbs, as to combine in a small granule, 
scarcely larger than a mustard seed, as much cathartic power 
as is embodied in any larger pill found for sale in the drug 
stores. They are not only pleasant to take, but their operation 
is easy, producing no griping pain or other unpleasant effect. 
From their wonderful cathartic power in proportion to their 
size, people who have not tried them are apt to suppose that 
they are harsh or drastic in effect, but such is not at all the 
case; the different active, medicinal principles of which they are 
composed are so modified by one another, as to produce a most 
searching and thorough, yet gently operating cathartic. CATHARTICS. 
329 
We have offered a standing reward to any chemist who, upon 
analysis, will find in them any calomel or other form of 
mercury, or any other mineral poison or injurious drug. 
Unlike other cathartics, they do not, after their operation, 
have a secondary tendency to render the bowels more costive. 
This is an important improvement. Every one who has ever 
taken pills or other cathartics for the purpose of overcoming 
constipation, knows that the secondary effect of all such medi- 
cines has been " to render a bad matter worse." These Pellets, 
unlike every other cathartic, produce such a secondary tonic 
effect upon the bowels as to bring about a permanently healthy 
action and increase their peristaltic motions. Hence their great 
value, perseveringly taken in small doses daily, in habitual con- 
stipation and in piles, attended and caused, as they generally 
are, by torpor of the liver and costiveness. They act power- 
fully in arousing all the secretions, especially those of the 
liver, in relieving congestion or inflammation, and in producing 
upon that organ, as well as upon the bowels, a secondary tonic, 
and, hence, a permanently beneficial effect. Being entirely vege- 
table, no particular care is required while using them. They 
operate without disturbance to the constitution, diet, or occu- 
pation. Age does not damage them, as they are so prepared 
as to readily dissolve in the stomach, and, being sugar-coated 
and inclosed in glass bottles, their virtues are preserved for 
any length of time in any climate, so that they are always 
fresh and reliable. This is not the case with the pills found 
in the drug-stores, put up in wooden or paste-board boxes which 
allow them to dry and harden until they are nearly, if not 
quite insoluble in the stomach, or else have lost most of their 
virtues from long exposure to the atmosphere. No pains or 
expense will ever be spared to make the Pellets perfect, and 
to keep up their high standard of excellence. 
Dose-For a thorough cathartic, take from four to six, regu- 
lating size of dose, or number of pellets, according to the suscep- 
tibility of the system to the influence of cathartic medicines. 
If for a child, administer from one to three or four, according 
to age. Evening is the best time for taking them, as they 
do not operate by irritating the stomach and bowels, thus 
rushing through at railroad speed, but take twelve, and, in rare 330 
COMMON SENSE MEDICAL ADVISER. 
cases, twenty-four hours to move the bowels, which they 
accomplish in a physiological manner. They are dissolved 
in the stomach and absorbed directly into the blood. They 
stimulate the flow of bile from the liver, and arouse all the 
glandular secretions, which, being poured into the bowels, 
increase their peristaltic action. In this way, the blood itself, 
as well as the stomach and bowels, is purged and cleansed of its 
impurities. Cathartics which operate speedily produce an irrita- 
tion of the stomach and bowels, causing a flow of serum and 
mucus into them, which runs off from the bowels in watery 
discharges. They never enter the circulation, never act upon 
the liver, do not arouse the secretions, or purify the blood, but 
tend only to shock, and thus debilitate the system, and the 
patient soon finds the function of the bowels destroyed, and 
constipation resulting as the secondary effect of the irritation 
thus produced. Hence, jalap and senna, aloes, scammony, castor 
oil, croton oil, gamboge, elaterium, or Epsom salts, should not 
be taken with the idea that any good effect is going to be 
produced upon the blood, liver, or other glands, as their mode 
of operating precludes such an effect. 
Dr. Pierce's Pleasant Purgative Pellets, on the other hand, 
act upon the bowels, only by taking time to enter the blood, 
and arouse the secretions. Hence, when the bowels are moved 
after a dose of Pellets, we know positively that the liver and 
other glands have been aroused to increased action; and this 
belief is confirmed by the laxative effect of the secretions 
after the operation of the cathartic, which can be best appre- 
ciated by those who suffer from constipation or piles, and 
who have been accustomed to taking other cathartics. 
After taking a cathartic dose of Pellets, if it is desired to 
increase their purgative action, common salt should be eaten 
plentifully. Salt is also a good remedy for the slight nausea, 
griping, or other disagreeable symptoms, which are sometimes, 
though very rarely, produced by the acrid and irritating 
matters dislodged by the Pellets. No such disagreeable symp- 
toms arise after taking the Pellets, unless the system is very 
foul, torpid, and obstructed, as they are so compounded as to 
guard against all such unpleasant effects. 
The greatest benefit is derived in all bilious derangements, COUNTER-IRRITANTS. 
331 
not by strong cathartic doses, but by small alterative doses, 
continued for several days, say one to three Pellets a day, 
or just enough to keep the bowels slightly relaxed. 
As a promoter of digestion, take one or two after dinner. 
In all chronic or lingering diseases, it is of the utmost im- 
portance to keep the bowels regular, yet severe purgation 
should be avoided, as it tends to debilitate the system by the 
shock which is thus produced. 
Small laxative doses, by their mild but continuous tonic and 
alterative effect, taken daily and continued for a long time, is 
the course which we would recommend as calculated to pro- 
duce the best results. 
CAUSTICS. 
Caustics are substances which have the power of destroying 
or disorganizing animal structures. By their action they destroy 
the tissue to which they are applied, and form a crust, which is 
thrown off by a separation from the parts beneath. Their 
caustic property may be destroyed by dilution with other 
substances, to such an extent that they will only irritate or 
stimulate, and not destroy. Much care is necessary in their 
employment, and it is not expected that the unprofessional 
reader will have much to do with them; hence, we have deemed 
it best not to give a list of these agents. 
COUNTER-IRRITANTS. 
Counter-irritants are substances which produce irritation of 
the part to which they are applied, varying in degree from a 
slight redness to a blister or pustule. They are applied to the 
surface with a view of producing an irritation to relieve irri- 
tation or inflammation in some other or deeper seated part. 
They are a class of agents which we very seldom employ, and, 
hence, we shall notice only a couple of the most simple. 
mustard {Sinapis). The flour of mustard, which is best 
adapted for domestic use, is employed in the form of a paste 
spread on cloth. It takes effect in a few moments; the length 
of time it remains in contact with the skin and the strength of 
the mustard determine the effect produced. 
Horse-radish (Cochlearia Armoracia). The leaves are 332 
COMMON SENSE MEDICAL ADVISER. 
the parts used. Let them wilt and bind them on the part 
affected. They act nearly as energetically as mustard. 
DIAPHORETICS. 
Diaphoretics are medicines which increase perspiration. Those 
which occasion profuse sweating are termed Sudorifics. The 
two terms indicate different degrees of the same operation. 
They constitute an important element in domestic practice, on 
account of the salutary effects which generally follow their 
action. Their operation is favored by warmth externally, and 
warm drinks, when they are not given in hot infusion. 
Pleurisy-root (Asclepias Tuberosa), is also known as 
Fig. 121. 
Pleurisy-root. 
White-root, and Butterfly-weed. It is a valuable remedy, well 
adapted to break up inflammations and diseases of the chest. DIAPHORETICS. 
333 
Dose-Of infusion, one to two ounces; of fluid extract, one- 
fourth to one-half teaspoonful; of the concentrated principle, 
Asclepin, one to three grains. 
Saffron (CVoeus Sativus). Golden Saffron. Dose - Of 
infusion (one drachm to a pint of water), one to two ounces. 
Sage (Salvia Officinalis'). The warm infusion drunk freely 
is a valuable, domestic diaphoretic. 
Virginia Snake-root (Aristolochia Serpentaria), is an 
Fig. 128. 
Virginia Snake-root. 
efficient agent. Dose-Of infusion, one to two ounces; of 
tincture, one-fourth to one teaspoonful; of fluid extract, one- 
fourth to one-half teaspoonful. 334 
COMMON SENSE MEDICAL ADVISER. 
Jaborandi (Pilocarpus Pinnatus). Jaborandi increases 
the flow of saliva, causes profuse perspiration, and lowers the 
temperature of the body. In doses of from twenty to sixty 
drops of the fluid extract, administered in a cup of warm water 
or herb-tea on going to bed, we have found it very effectual for 
breaking up recent colds. We have also found it valuable in 
whooping-cough, in doses of from three to ten drops, according 
to the age of the child, given three or four times a day. The 
fluid extract may be obtained at almost any drug-store. 
May-weed (UParuta Cotula), is also known as Wild 
Fig. 129. 
Chamomile, and Dog-fennel. It is not much used, though it 
is a powerful diaphoretic. Dose-Of infusion, one to two 
ounces. 
Catnip (Nepeta Cataria). A deservedly popular, domestic 
May-flower. DILUENTS. 
335 
remedy, always acceptable, and certain in its action. The warm 
infusion is the best form for its administration. It may be 
drunk freely. 
Ginger {Zingiber Officinale). The hot infusion may be 
sweetened and drunk as freely as the stomach will bear. 
Dr. Pierce's Compound extract of Smart- 
weed. This is unsurpassed as a diaphoretic agent, and 
is much more certain in its operation than any simple dia- 
phoretic. 
DILUENTS. 
Any fluid which thins the blood or holds medicine in solution 
is called a diluent. Pure water is the principal agent of this 
class. It constitutes about four-fifths of the weight of the 
blood, and is the most abundant constituent of the bodily tis- 
sues. Water is necessary, not only for digestion, nutrition, 
and all functional processes of life, but it is indispensable as 
a menstruum for medicinal substances. It is a necessary agent 
in depuration, or the process of purifying the animal economy, 
for it dissolves and holds in solution deleterious matter, which 
in this state may be expelled from the body. In fevers, water 
is necessary to quench the thirst, promote absorption, and in- 
cite the skin and kidneys to action. Its temperature may be 
varied according to requirements. Diluents are the vehicles 
for introducing medicine into the system. We shall briefly 
mention some which prove to be very grateful to the sick. 
Various vegetable acids and jellies may be 
dissolved in water, as apple, currant, quince, grape, or cran- 
berry. 
The juice of lemons, oranges, pine-apples, 
and tamarinds, is also found to be refreshing to fever 
patients. 
Sassafras-pith, slippery-elm bark, flax-seed, 
and gum arabic make good mucilaginous drinks for 
soothing irritation of the bowels and other parts. 
Brewers' yeast mixed with water in the proportion of 
from one-eighth to one-fourth is a stimulant and antiseptic. 
The white ashes of hickory or maple wood 
dissolved in water make an excellent alkaline drink in fevers, 
or whenever the system seems surcharged with acidity. 336 
COMMON SENSE MEDICAL ADVISER. 
DIURETICS. 
Diuretics are medicines which, by their action on the kidneys, 
increase the flow of urine. 
Marsh-mallow {Althea Officinalis), is used in irritable 
Fig. ISO. 
Marsh-mallow. 
conditions of the urinary organs. The infusion may be drunk 
freely. 
Gravel-plant {Epigea JRepens), is also known as Water- 
pink, Trailing-arbutus, or Gravel-root. Dose-Of decoction of DIURETICS. 
337 
the plant, one to three ounces; of fluid extract, one-fourth to 
one-half teaspoonful. 
Stone-root {Collinsonia Canadensis}, is also known as 
Knot-root, Horse-balm, Rich-weed, or Ox-balm. This is a mild 
diuretic, slow in action, yet effective in allaying irritation of the 
Fig. 131. 
Stone-root. 
bladder. The root is the part used. Dose-Of infusion, one to 
two ounces; of fluid extract, five to ten drops; of the concen- 
trated principle, Collinsonin, one-half to one grain. 
Foxglove {Digitalis purpurea} slows the action of the 338 
COMMON SENSE MEDICAL ADVISER. 
heart, lowers the temperature, and acts indirectly as a diuretic. 
It is especially valuable in the treatment of scarlet fever and 
in dropsy. Dose-Of infusion, one-half drachm to one-half 
ounce; of the fluid extract or strong tincture, from two to 
ten drops. It should be used with caution. A poultice made 
of the leaves and placed over the kidneys is an effectual method 
of employing the drug. 
Queen of the Meadow (Eupatorium is 
also known as Gravel-weed, Gravel-root, or Trumpet-weed. This 
is a most valuable diuretic. Dose-Of the infusion, one to 
three ounces; of fluid extract, one-fourth to one-half teaspoon- 
ful; of the concentrated principle, Eupatorin one-half 
to two grains. 
Blichll (Barosma Crenata). The leaves are used. This 
agent has been extensively employed, generally in compounds. 
Dose-Of infusion, (steeped for two hours or more) one to 
two ounces; of fluid extract, the same; of the concentrated 
principle, Barosmin, one to three grains. 
Pipsissewa {Chimaphila Umbellata), or Prince's Pine. 
This is a tonic to the kidneys, as well as a diuretic and altera- 
tive, and is a mild, but very efficient remedy. Dose-Of de- 
coction, one ounce from four to six times a day; of fluid extract, 
one-fourth to one-half teaspoonful; of the concentrated prin- 
ciple, Chimaphilin, one to two grains. 
Water-melon Seeds (Cucwrbita Citrullus). Dose-Of 
infusion, the patient may drink freely until the desired effect is 
secured. 
Pumpkin Seeds (Cucurbita Pepo). They are mild, 
unirritating, yet effective diuretics. An infusion of these may 
be drunk freely. 
Sweet Spirit of Nitre (Spiritus EEtheris Nitros), 
is diuretic and anodyne. Dose-One-fourth to one-half tea- 
spoonful, diluted in water, every two or three hours. 
Saltpetre (Potassw Nitras). Dose-Powdered, five to 
ten grains. 
Acetate of Potash (Potassve Acetas). Dose-Ten to 
fifteen grains, largely diluted in water. It is more frequently 
used for this purpose than the nitrate. It is a most valuable 
diuretic. EMETICS. 
339 
EMETICS. 
These are medicines which cause vomiting and evacuation of 
the stomach. Some of the agents of this class, termed irritant 
emetics, produce vomiting by a local action on the stomach, and 
do not affect this organ when introduced elsewhere. Others, 
which may be termed systemic emetics, produce their effects 
through the nervous system, and, therefore, must be absorbed 
into the circulation before they can produce vomiting. In cases 
of poisoning, it is desirable to empty the stomach as quickly as 
possible, hence irritant emetics should be employed, for they act 
more speedily. Draughts of warm water favor the action of 
emetics. 
Mustard (Sinapis) acts promptly and efficiently as an 
emetic, and may be employed in poisoning. Dose-From one 
to two teaspoonfuls of powdered mustard, stirred up in a glass 
of tepid water. It should be quickly swallowed and diluents 
freely administered. 
Sulphate of Copper {Cuprl Sulphas') is a prompt, 
irritant emetic. It should be given in doses of ten grains 
dissolved in half a glass of water, and its action assisted by the 
free use of diluents. 
Sulphate Of* Zinc (Zinci Sulphas') is similar in its 
effects to sulphate of copper, but less powerful, and may be 
taken in the same manner, and the dose repeated if necessary in 
fifteen minutes. 
Yellow Subsulphate of Mercury (Hydrargyri 
Sulphas flan a), commonly known as Turpeth Mineral, is an 
efficient and most desirable emetic in membranous croup. It is 
an active poison, but, as it is quickly thrown up with the con- 
tents of the stomach, there is no danger from its administration. 
Dose-It should be given to a child in doses of from three to five 
grains, in the form of powder, rubbed up with sugar of milk. 
Ipecac (flJephadis Ipecacuanha). In large doses Ipecac is 
a systemic emetic. In small doses, it exerts a specific influence 
upon the mucous membranes, relieves nausea and irritation, and 
subdues inflammation. In cholera infantum it is an invaluable 
remedy, if given in very small doses. By allaying irritation of 
the stomach and restoring tone and functional activity to it and 340 
COMMON SENSE MEDICAL ADVISER. 
the bowels, it gradually checks the discharges and brings about 
a healthy condition. It is also valuable in dysentery, and is 
borne in large doses. As an emetic the dose is, of powder, five 
to ten grains in warm water; of fluid extract, ten to twenty 
drops. 
Lobelia {Lobelia Injiata'), sometimes known as Indian 
Fig. 132. 
Lobelia. 
Tobacco, or Emetic-weed. The herb and seeds are used. This 
is a powerful, systemic emetic but very depressing. Dose-Of EMMENAGOGUES. 
341 
the powdered leaves, fifteen to twenty grains; of the infusion, 
one to three ounces; of the fluid extract, ten to fifteen drops. 
Boneset (JEupatorium, Perfoliatum). Dose-Of the warm 
infusion or decoction, two to three ounces; of the fluid extract, 
one teaspoonful in hot water; of the concentrated principle, 
Eupatorin, two to five grains. 
EMMENAGOGUES. 
Emmenagogue is a terin applied to a class of medicines which 
have the power of favoring the discharge of the menses. We 
shall mention only a few of those which are best adapted to 
domestic use. 
Pennyroyal (Hedeoma Pulegioides). Pennyroyal, used 
freely in the form of a warm infusion, promotes perspiration 
and excites the menstrual discharge when 
recently checked. A large draught of 
the infusion should be taken at bed-time. 
The feet should be bathed in warm water 
previous to taking the infusion. 
Black Cohosh (Cimicifuga llace- 
mosa). Black Cohosh, known also as 
Black Snake-root, is an effective remedy 
in uterine difficulties. Dose-Of the 
tincture, twenty drops; of the fluid ex- 
tract, ten drops. 
Tansy (Tanacetum Vulgare). Tansy 
is beneficial in suppressed menstruation. 
Dose-Of the infusion, from one to four 
fluid ounces. 
Ergot (Secale Cormitum) in very 
small doses acts as an emmenagogue, and 
in large doses it checks hemorrhage. The 
dose as an emmenagogue, of the fluid 
extract, is from two to five drops, and 
to arrest hemorrhage, from half a drachm to two drachms, 
repeated in from one to three hours. 
Life-root (Senecio Gracilis.) Life-root exerts a peculiar 
influence upon the female reproductive organs, and for this 
reason has received the name of Female Regulator. It is very 
Fig. 1SS. 
Pennyroyal. 342 
COMMON SENSE MEDICAL ADVISER. 
efficacious in promoting the menstrual flow, and is a valuable 
agent in the treatment of uterine diseases. Dose-Of the 
decoction, four fluid ounces three or four times a day; of the 
fluid extract, from one-fourth to one-half teaspoonful. 
Motherwort (Leonurus Cardiaca). Motherwort is 
usually given in warm infusion, in suppression of the menses 
from cold. Dose-Of the decoction, from two to three fluid 
ounces every one or two hours. 
Dr. Pierce's Favorite Prescription is an effi- 
cient remedy in cases requiring a medicine to regulate the 
menstrual function. Full directions accompany every bottle. 
Dr. Pierce's Compound Extract of Smart- 
weed is an excellent emmenagogue. Dr. Eberle, a very 
celebrated medical writer, and author of a work on medicine 
which is very popular with the profession, says that he has used 
the "Extract of Smart-weed" in twenty cases of amenorrhea 
(suppressed menstruation), and affirms "with no other remedy 
or mode of treatment have I been so successful as with this." 
Full directions accompany every bottle. It is sold by all 
druggists. 
EXPECTORANTS. 
Expectorants are medicines which modify the character of the 
secretions of the bronchial tubes, and promote their discharge. 
Most of the agents of this class are depressing in their influence 
and thus interfere with digestion and healthy nutrition. Their 
application is very limited, hence we shall dismiss them without 
further consideration. 
Liniments are medicines designed for external application. 
The benefits arising from their use depend upon their derivative 
power, as well as upon the anodyne properties which many of 
them possess, rendering them efficacious for soothing pain. We 
cannot mention a more valuable agent of this class than 
Dr. Pierce's Compound Extract of Smart- 
weed. As an external application this preparation subdues 
inflammation and relieves pain. For all wounds, bruises, sprains, 
bee-stings, insect and snake-bites, frost-bites, chilblains, caked 
breast, swollen glands, rheumatism, and, in short, for any and 
LINIMENTS. NARCOTICS. 
343 
all ailments, whether afflicting man or beast, requiring a direct 
external application, either to allay inflammation or soothe pain, 
the Extract of Smart-weed cannot be excelled. 
NARCOTICS. 
A narcotic is a remedy which, in medicinal doses, allays 
morbid sensibility, relieves pain, and produces sleep; but which, 
in overdoses, produces coma, convulsions, and death. The quan- 
tity necessary to produce these results varies in different individ- 
uals. We shall mention a few of those most frequently employed. 
Henbane (Hyoscyamus Niger). The leaves and seeds are 
Fig. 13J>. 
Henbane. 
used. Henbane, in large doses, is a powerful narcotic and 
dangerously poisonous. In medicinal doses, it is anodyne and 
antispasmodic; it allays pain, induces sleep, and arrests spasms. 344 
COMMON SENSE MEDICAL ADVISEE. 
Dose-Of the fluid extract, five to ten drops; of the solid extract, 
from one-half to one grain; of the concentrated principle, 
Hyoscyamin, from one-twelfth to one-fourth of a grain. 
Indian Hemp {Cannabis Indica). An East Indian 
plant. Dose-Of the extract, from one-fourth to one-half grain; 
of the tincture, from three to eight drops; of the fluid extract, 
from two to five drops. The plant known as Indian Hemp, 
growing in this country, possesses very different qualities. 
Stramonium {Datura Stramonium). Stramonium, also 
Fig, 135. 
Stramonium. 
known as Thorn-apple, in large doses is a powerful narcotic 
poison. In medicinal doses it acts as an anodyne and antispas- 
modic. Dose-Of extract of the leaves, from one-half to one 
grain; of the fluid extract, from three to six drops. NERVINES. 
345 
NERVINES. 
These are medicines which act on the nervous system, sooth- 
ing excitement and quieting the condition known as " nerv- 
ousness." 
Hops (Humulus Lupulus). Dose-Of infusion, one to 
three ounces; of the fluid extract, one-fourth to one-half teaspoon- 
ful of the concentrated principle, Humulin, two to three grains. 
Scull-cap (Scutellaria Lateriolid). The herb is used. 
Fig. 136. 
Scull-cap. 
It is also known as Mad-dog Weed. This is a valuable 
remedy. Dose-Of infusion, one to two ounces t of the fluid 
extract, ten to twenty drops; of the concentrated principle, 
one to two grains. 
Lady's Slipper (Cypripedlum Pubescens). The root is 346 
COMMON SENSE MEDICAL ADVISER. 
used. Dose-Of the infusion, one-half to one-ounce; of the 
fluid extract, one-fourth to one-half teaspoonful; of the con- 
centrated principle, Cypripedin, one to two grains. 
Pulsatilla {Pulsatilla Nigricans). We employ the German 
tincture, prepared from the green herb. In many of the dis- 
tressing nervous complications to which both males and females 
are subject in certain diseases of the generative organs, we 
have found it very effectual. The dose is from two to eight drops. 
Dr. Pierce's Favorite Prescription. This is a 
tonic nervine of unsurpassed efficacy, combined in such a 
manner, that, while it quiets nervous irritation, it strengthens the 
enfeebled nervous system, restoring it to healthful vigor. In 
all diseases involving the female reproductive organs, with 
which there is usually associated an irritable condition of the 
nervous system, it is unsurpassed as a remedy. It is also a 
uterine and genera] tonic of great excellence. It is sold by all 
druggists. 
SEDATIVES. 
Sedatives are a class of agents which control excitation of the 
circulation, and diminish irritability of the nervous system. 
Aconite {Aconitum Napellus). The parts used are the root 
and leaves. Aconite slows the pulse, diminishes arterial tension, 
and lowers the temperature of the body in fevers. It is an 
effectual remedy in acute inflammation of the tonsils and 
throat, in acute bronchitis, in inflammation of the lungs, and 
pleurisy, in the hot stage of intermittent and remittent fevers, 
in the eruptive fevers, in fever arising from a cold, and in some 
forms of neuralgia. Acute suppression of the menses from a 
cold, may be relieved by the tincture of aconite in drop doses 
every hour. Dose-Of the tincture of the root, from one-half 
of a drop to two drops, in a spoonful of water. Tn acute 
fevers and inflammations, from one-half drop to one drop 
should be administered every half hour or hour, according to 
the severity of the symptoms. 
Peach Tree (Amygdalus Persica). Peach tree leaves 
and bark are slightly sedative, but the chief use which 
we have found for these articles is to control nausea and 
vomiting arising from irritability of the stomach. It also 
possesses mild, tonic properties. Dose-Of infusion of the SEDATIVES. 
347 
bark of the small twigs or of the leaves, from two to six 
teaspoonfuls. 
American Hellebore ( Veratrum Viride) is also known as 
Fig. 137. 
American Hellebore. 
White Hellebore, Indian Poke, or Swamp Hellebore. The root 
is the part used. It is a most valuable agent with which to 348 
COMMON SENSE MEDICAL ADVISER. 
control the frequent, strong, bounding pulse common to many 
febrile and inflammatory diseases. When the pulse is hard, in- 
compressible, and bounding, this remedy is more effectual than 
aconite. Dose-Of the tincture and fluid extract, from one 
to two drops, repeated every half hour to two hours, according 
to the severity of the symptoms. This remedy should be given 
in very small doses, frequently repeated, if we would secure 
its best effects. Our favorite mode of administering both 
veratrum and aconite is to add ten drops of the tincture to ten 
or fifteen teaspoonfuls of water, of which one teaspoonful may 
be administered every hour. 
Yellow Jessamine (Gelseminum Sempervirens). The 
root is the part used. Through its controlling effect over 
the sympathetic nervous system, this agent exerts a marked 
influence in controlling morbid excitability of the circulatory 
organs. It allays irritation, and determination of blood to 
the brain, indicated by flushed face, contracted pupils, irrita- 
bility, and restlessness, a frequent condition in diseases incident 
to childhood. Its concentrated principle, Gelsemin, is an effi- 
cient remedy in bloody-flux or dysentery. It should be admin- 
istered in very small doses to secure the best results. Only 
one-sixteenth to one-eighth of a grain is required, repeated 
every two hours. It should be triturated with sugar of milk 
or with common white sugar, in the proportion of one grain to 
ten of sugar. Dose-Of tincture, from five to fifteen drops; 
of fluid extract, three to six drops; of Gelsemin, as a sedative, 
one-fourth to one-half grain. 
STIMULANTS. 
Stimulants are medicines which have the power of increasing 
the vital activity of the body. Some have a very transient 
action, while others are more permanent in effect. 
Cayenne Pepper (Capsicum Annuum). Cayenne Pepper 
is a powerful stimulant. Dose-Of the powder, from one to 
six grains, administered in milk; of the tincture, from five to 
ten drops, largely diluted in milk or water. 
Black Pepper {Piper Nigrum). Black Pepper is a 
warm, carminative stimulant. Dose-From five to fifteen 
grains; of the fluid extract, from ten to fifteen drops. STIMULANTS. 
349 
Prickly-asll (Xanthoxylum Fraxineum). Prickly-ash 
bark is a stimulant and tonic. The parts used are the bark 
and leaves. Dose-Of the fluid 
extract, from five to fifteen 
drops; of the tincture, ten to 
twenty drops; of the active 
principle, Xanthoxylin, one to 
two grains. 
Alcohol is a powerful 
stimulant. It is never used in 
its pure state in medicine, but 
when diluted forms a useful 
remedy in many diseases. It 
is generally employed in the 
form of whisky, gin, rum, 
brandy, and wine. 
Ammonia is an excel- 
lent stimulant. Dose-Of the 
carbonate, from three to five 
grains; of the sesquicarbonate, 
from five to ten grains; this is 
the same as the carbonate, 
which has been exposed to the 
air and slacked (powdered 
hartshorn); of the aromatic 
spirit, from one-half to one tea- 
spoonful. The Aqua Ammonia 
and Liquor Ammonia are of 
such variable strength that they 
are seldom employed internally, 
but may be applied externally 
and taken by inhalation. 
Dr. Pierce's Compound Extract of Smart- 
weed. This quickly diffusible stimulant and genial anodyne 
we have spoken of under the head of Anodynes. But its 
medicinal properties equally entitle it to a place and mention 
under the class of stimulants. As a stimulant it spurs the 
nervous system and arouses the circulatory forces. Congestion 
of the lungs, liver, bowels, or uterus, embarrasses the functions 
Fig. 138. 
Prickly-ash. 350 
COMMON SENSE MEDICAL ADVISEE. 
of these organs. Frequently this congestive difficulty may be 
entirely obviated, and the circulation of the blood restored to 
the surface of the body, by the administration of a few doses 
of this pleasant remedy. Thus it often acts like magic in 
giving relief, promoting the circulation, and restoring the organs 
to their accustomed functional activity. Full directions accom- 
pany every bottle. 
TONICS. 
Tonics are remedies which moderately exalt the energies of 
all parts of the body, without causing any deviation of healthy 
function. While stimulants are transient in their influence, 
tonics are comparatively permanent. 
IVliile Poplar (JAriodendron Tulipfera), called also 
American Poplar, or White Wood. The 
part used is the inner bark. This is a 
mild but valuable tonic for domestic use. 
Dose-Of the infusion, from one-half to 
one ounce; of tincture, from one to two 
teaspoonfuls. 
Chamomile (Anthemis Nobilis). 
The part used is the flowers. This 
is a mild, unirritating tonic. Dose-Of 
infusion (one-fourth ounce of flowers 
to a pint of water) one-half to one 
ounce. 
Gentian (Gentiana Dutea). The 
root is the part used. This is a favorite 
domestic tonic in many localities. Dose 
-Of powdered root, five to ten grains; 
of the tincture, ten to twenty drops; of 
the fluid extract, five to ten drops, four or five times a day. 
Nil! Vomica {Strychnos Nux Vomica), or Dog Button. 
This is a powerful tonic. It increases innervation and is 
particularly valuable in cases marked by feeble circulation and 
general impairment of muscular power. In overdoses it is 
poisonous, and hence must be employed with much caution. 
Dose-Of the tincture, three to five drops; of the fluid extract, 
one to three drops. 
Fig. 139. 
White Poplar. TONICS, 
351 
Willow (Salix Alba). Willow is a tonic and an astrin- 
gent. Dose-Of the decoction, from one to two fluid ounces; 
of the concentrated principle, Salicin, from two to four 
grains. 
Dogwood (Cornus Florida). Dogwood, also known as 
Boxwood, is tonic, astringent, and slightly stimulant. Dose- 
Fig. Ufl. 
Dogwood. 
Of the solid extract, from three to five grains; of the infusion, 
from one to two ounces; of the fluid extract, from ten to twenty 
drops. 
Wafer-ash (Ptelea Trifoliata), also called Swamp Dog- 
wood. The bark is used. This is a pure, unirritating tonic. 
Dose-Of tincture, one-half to one teaspoonful; of fluid extract 
ten to twenty drops; of the infusion, one to two fluid ounces. 352 
COMMON SENSE MEDICAL ADVISER. 
Golden Seal (Hydrastis Canadensis). Golden Seal is a 
powerful and most valuable tonic. It is a valuable local remedy 
when used as a general injection in leucorrhea. Dose-Of the 
Fig. lJfl. 
Golden Seal. 
powder, from ten to thirty grains; of the tincture, from one- 
half to one fluid drachm; of the fluid extract, from ten to 
twenty drops; of the concentrated principle, Hydrastin, from 
two to three grains; of the muriate of hydrastia, from one-half 
to one grain. TONICS. 
353 
American Colombo (Frasera Carolinensis). American 
Colombo is a simple tonic. Dose-Of the powdered root, from 
Fig. lift. 
American Colombo. 
ten to fifteen grains; of the infusion one-half to one fluid 
ounce, three or four times a day; of the active principle, 
Fraserin, one to three grains. 354 
COMMON SENSE MEDICAL ADVISER. 
Gold Thread (Coptis Trifolia). Gold Thread is a pure 
and powerful, bitter tonic, and is also efficacious as a wash for 
sore mouth or as a gargle. Dose-Of the decoction, from two 
Fig. IJ/S. 
Gold Thread. 
to six fluid drachms; of the tincture, from one-half to two 
teaspoonfuls; of fluid extract, from ten to twenty drops. 
Iron {Ferrum). Different preparations of iron are fre- 
quently prescribed by physicians. They are particularly 
valuable in anaemic conditions of the system. The following 
are a few of the preparations of this metal most generally 
used: 
Iron by Hydrogen {Ferri Redactum). Dose-One to 
two grains. 
Carbonate of* Iron {Ferri Carbonas). Dose - One to 
three grains. 
Citrate of Iron {Ferri Citras). Dose - One to three 
grains. 
Pyrophosphate of Iron {Ferri Pyrophosphas). Dose 
■-One to three grains. TONICS. 
355 
Tincture of muriate of Iron {Tinctura Ferri 
Chloridi). Dose-Three to twenty drops. 
Dr. Pierce's Favorite Prescription. The Fa- 
vorite Prescription, in addition to those properties already 
described, likewise combines tonic properties. In consequence 
of the never ceasing activities of the bodily organs, the system 
requires support, something to permanently exalt its actions. In 
all cases of debility, the Favorite Prescription tranquilizes the 
nerves, tones up the organs and increases their vigor, and 
strengthens the system. Directions for use accompany every 
bottle. 
Dr. Pierce's Golden Medical Discovery. In 
addition to the alterative properties combined in this com- 
pound, it possesses important tonic qualities. While the Fa- 
vorite Prescription exerts a tonic influence upon the digestive 
and nutritive functions, the Golden Medical Discovery acts 
upon the excretory glands. Besides, it tends to retard unusual 
waste and expenditure. This latter remedy tones, sustains, and, 
at the same time regulates the functions. While increasing 
the discharge of noxious elements accumulated in the system, it 
promptly arrests the wastes arising from debility, and the 
unusual breaking down of the cells incident to quick decline. 
It stimulates the liver to secrete, changes the sallow complexion, 
and transforms the listless invalid into a vigorous and healthy 
being. At the same time, it checks the rapid disorganization of 
the tissues and their putrescent change, while it sustains the 
vital processes. It is, therefore, an indispensable remedy in the 
treatment of many diseases. CHAPTER III. 
BATHS AND MOTION AS RE- 
MEDIAL AGENTS. 
The remedial effects of bathing are generally underrated. 
This want of appreciation is more often due to the improper 
manner in which it is performed than to an insufficiency of 
curative virtues. The term bathing not only implies a clean- 
ing of the body or certain portions of it, but also the applica- 
tion of water in such a manner as to influence the nervous 
system, and regulate the functions of the secretory organs. 
Cleanliness, while it preserves health and promotes recovery, 
has reference only to the hygienic influences of water and not 
to its curative effects. There are several kinds of baths, the 
names of which indicate their character, manner of application, 
or the part of the body to which they are applied. Among 
others, we have Cold, Cool, Temperate, Tepid, Warm, Hot, 
Hot Air, Russian, Turkish, Vapor, Electric, Sea, Shower, Sponge, 
Douche, Foot, Sitz, Head, Medicated, Alkaline, Acid, Iodine, 
and Sulphur Baths. Temperature influences the properties 
of any bath; thus the sponge, sitz, and alkaline baths may be 
employed warm or cold, according to the effect desired. 
The Cold Bath, used at a temperature of from 30© to 
60© Fahr., is powerfully sedative, and is employed for its tonic 
effects. If the vital powers are low, or the individual remains 
in it too long (two or three minutes should be the limit), the 
reaction is slow and its effects injurious. While it is highly 
invigorating to robust persons, those who have a low standard 
of vitality should be cautious in its employment. A local bath 
356 BATHS 
357 
may be followed by beneficial results, when a general bath 
would be inadmissible. For these reasons we advise the general 
use of the 
Cool Bath, at a temperature of from 60® to 75® Fahr. 
If, in any instance, the reaction is slow, we recommend the 
Temperate Bath, at a temperature of from 75® to 
80® Fahr. The time of remaining in the bath should be regu- 
lated by the strength of the invalid. As a rule, it should not 
exceed three minutes, and the colder the water the less time 
should the patient be immersed. Immediately after emerging 
from any bath, the body should be thoroughly dried and rubbed 
with a moderately coarse towel until a glow is experienced and 
reaction is fully established. The attempt to toughen children 
by exposing them to low temperatures of either air or water, 
cannot be too emphatically condemned. This caution, however, 
does not apply to the employment of moderately cool water 
for ablutions. The cold or cool bath should be taken in the 
early part of the day, but never during digestion. Whenever 
reaction does not follow bathing, artificial means must be 
resorted to, as stimulating drinks, dry warmth, or exercise. 
The Tepid Bath, the temperature of which is from 
85® to 92® Fahr., is generally used for cleansing the body. It 
is prescribed in fevers and inflammatory affections for its cool- 
ing effects. It is usually medicated with some acid or alkali. 
The latter unites with the oily secretion of the skin and forms 
a soapy compound easily removed by the water. The tempera- 
ture should be regulated according to the vitality of the patient, 
and the bath may be repeated two or three times a day. It 
removes superfluous heat, and keeps the skin in a condition 
favorable for excretion. 
The Warm Bath, at a temperature varying from 92® to 
98® Fahr., is always agreeable and refreshing. It equalizes the 
circulation and softens the skin, by removing all impurities. 
It moderates pain and soothes the whole system. It does not 
weaken or debilitate the person, but is in every way beneficial. 
It is an efficient, remedial agent in many chronic diseases, con- 
vulsions, spasmodic affections of the bowels, rupture, rheu- 
matism, and derangement of the urino-genital organs. It 
should be employed immediately before going to bed unless COMMON SENSE MEDICAL ADVISER. 
358 
urgent symptoms demand it at other times. It may be medi- 
cated or not, as circumstances require, but should always be 
taken in a warm room. 
The Hot Bath at a temperature of from 98® to 110® Fahr, 
is a powerful stimulant. It excites the nerves, and through 
them the entire system. It causes a sense of heat and a con- 
striction of the secretory organs; but perspiration, languor, 
and torpor soon follow. In the sudden retrocession of cuta- 
neous diseases, it restores the eruptions to the surface and gives 
speedy relief. The hot bath may be applied locally when cir- 
cumstances require. 
The Russian Bath consists in the application of hot 
vapor, at a temperature varying from 112® to 200® Fahr. 
The patient is first subjected to a moderately warm temper- 
ature, which is gradually increased as he becomes inured to it, 
the head being surrounded with cloths wet in cold water. 
Upon emerging from it, the bather is plunged into cold water 
or receives a cool, shower bath. In rheumatic and cutaneous 
diseases, chronic inflammations, and nervous affections, the 
Russian bath is an effective remedy. 
The Turkish Bath is a dry, hot-air bath. The 
bather passes from one apartment to another, each one being of 
a higher temperature than the preceding. He undergoes a 
thorough shampooing, and, although the person may be scru- 
pulously clean, he will be astonished at the amount of effete 
matter removed by this process. The bather then returns 
through the various apartments, and, upon emerging from that 
of the lowest temperature, he experiences a delightful sensation 
of vigor and elasticity. 
As a hygienic agent, the hot-air bath has been constantly 
growing in favor. Its value is now recognized by all physicians 
throughout the world. The judicious use of the Turkish bath 
serves to secure perfect equalization of the circulation. Gland- 
ular activity is increased, elasticity and power given to the 
muscles, and a permanent, stimulating and tonic influence 
imparted to the system, a condition at once conducive to the 
enjoyment and prolongation of life. Dr. Erasmus Wilson, of 
England, says, in a paper read before the London Medical 
Association: "The inhabitant of a large city would live as BATHS, 
359 
healthy, immured within city walls, as amid the fields and 
meadows of the country. His bath would be to him in the 
place of a country house or horse - it would give him air, 
exercise, freshness, health, and life." 
"The bath that cleanses the inward as well as the outward 
man; that is applicable to every age; that is adapted to make 
health healthier, and alleviate disease, whatever its stage or 
severity, deserves to be adopted as a national institution, and 
merits the advocacy of all medical men; of those whose especial 
duty it is to teach how health may be preserved, and how 
disease may be averted." 
The hot, dry atmosphere of the Turkish bath promotes rapid 
evaporation from the surface of the body, and it is well known 
that rapid evaporation from the surface is a cooling process. A 
person's finger may be frozen in one minute's time, by throwing 
upon it a constant, fine spray of rhigolene or sulphuric ether. 
The rapid evaporation of the light fluid congeals the liquids of 
the tissues and a film of ice is rapidly formed upon the part. 
In a less intense degree the same cooling process is carried on 
over the whole surface of a person, when in the hot room, or 
of the Turkish bath. The evaporation from the 
surface is so rapid that one can hardly appreciate the profuseness 
of the perspiration going on. The evaporation from the surface 
so rapidly carries off the heat from the body that one finds 
himself able, with little or no inconvenience, to remain in a room 
heated to from 180® to 200® or even 220® Fahr. 
As a hygienic measure to be regularly or occasionally 
employed by persons in fair health, the Turkish or hot dry-air 
bath is far superior to the Russian or vapor-bath. (1.) It 
produces more profuse perspiration, and is therefore more depur- 
ating, or cleansing, in its effects. (2.) It does not relax the 
system, but rather produces a tonic effect, and fewer precautions 
are, therefore, necessary to guard against taking cold after 
employing it. (3.) The Turkish bath can be better ventilated 
than the Russian. While the air is heated to a high tempera- 
ture, it can be readily kept pure by constant changes. In the 
Turkish hot-rooms, or sudatorium, of the Invalids' Hotel and 
Surgical Institute, provision is made for bringing underneath the 
floors a current of fresh air from without. This column of 360 
COMMON SENSE MEDICAL ADVISER. 
fresh air is carried under the centre of each room where it 
escapes from the conductor, is warmed, and rises into the room, 
from which extraction of air is constantly going on through 
registers opening into tubes, communicating with large ventilated 
shafts which are kept hot, summer and winter, to insure a 
draught through them. In this manner, thorough ventilation of 
our Turkish hot-rooms is insured. 
The Turkish bath not only combines a most agreeable luxury 
with a decidedly invigorating and tonic influence, but also, by 
its stimulating power, induces proper glandular and cellular 
activity, producing a healthy condition. 
Sallowness, tan, and freckles, the result of local or general 
increase of the pigment granules of the skin, soon disappear 
under the stimulating influence and regular use of the Turk- 
ish bath, which causes rapid development of new and trans- 
parent cells. The colored granules are thus gradually re- 
placed and the skin assumes a beautiful clearness and purity 
of appearance, which transcends immeasurably the unhealthy 
hue that follows the frequent employment of the various cos- 
metics. 
The value of an agent which thus improves the general 
health, insures immunity from coughs, colds, and other diseases, 
and at the same time produces a healthy and permanent beauty 
of complexion, is at once apparent. The purity of person, per- 
fect circulation, increase of healthy nutrition and glandular 
activity produced by the Turkish bath, serve to make it of 
the most lasting utility. 
The eminent Dr. Madden has said, and his experience is 
confirmed by every regular patron of the bath, that, " Wherever 
the Turkish bath was a national institution the hair of the 
women was peculiarly luxurious and beautiful. I can vouch 
for it that the use of the bath rendered the complexion more 
delicate and brilliant; that the eyes became clearer and 
brighter; all the personal charms were enhanced. I can recom- 
mend no hygienic measure more beneficial or effectual in pre- 
serving the health and an attractive personal appearance." 
Pimples, blotches, eruptions, and other disfigurations of the 
skin are removed by the frequent use of the Turkish bath, 
leaving the integument smooth and soft. BATHS. 
361 
How the Turkish Hath is Administered at the 
Invalid's Hotel and Surgical Institute. The hot- 
rooms, of which there 
are two, are exactly 
similar in every 
respect except as re- 
gards temperature. 
The first room has a 
temperature of from 
110° to 1200 Fahr. 
The bather is sup- 
plied by the attend- 
ant every few minutes 
with copious draughts 
of cool water. Grad- 
ually the relaxing in- 
fluence of the elevated 
temperature manifests 
itself. The capillaries slowly dilate, the veins enlarge under its 
gentle stimulus, and small points of perspiration appear upon 
the surface, which assumes a slight, 
rosy blush. A delightful calm, a feel- 
ing of perfect rest and luxurious ease 
is imparted to the senses. From this 
room, after an appropriate interval, the 
bather enters the second room, in which 
the atmosphere is higher by from 20° 
to 30°, and it may be made still 
higher, its regulation requiring but an 
instant. 
A thorough sweating occurs while 
the subject remains in these rooms, 
during a period of from ten to forty 
minutes. The secretions of the skin, 
at first impure and loaded with the 
d'ebris of dead cells and extraneous 
matter, gradually become purer, and clearer, until, finally, all 
trace of color disappears and the pearly drops of sweat come 
full and free. Soon the attendant appears and leads the 
Fig. 144. 
First Hotxroom of the Turkish Bath. 
Fig. IJfi. 
One of the Shampooing- 
rooms. 362 
COMMON SENSE MEDICAL ADVISER. 
way to the shampooing-room, where, lying upon a warm marble 
slab, massage is applied most thoroughly to every portion of 
the body. 
By the massage, shampooing, or rubbing, the superficial veins 
are thoroughly emptied of their contents, the muscles are given 
elasticity and tone, and glandular activity is promoted. In- 
numerable dead epithelial cells, together with other impurities, 
are rolled off in flakes under the skillful manipulation of the 
attendant. 
After a thorough shampooing, the shower bath is applied, 
to secure a contraction of the capillaries and a diminution of 
the perspiration. 
The Spirit Vapor-bath is very effective when em- 
ployed in the earlier stages of acute, febrile, inflammatory, and 
painful diseases. In many forms of chronic diseases the admin- 
istration of a spirit vapor-bath once in from three to fifteen 
days, is a valuable adjunct to the treatment of these affections. 
It exerts an exceedingly beneficial influence upon the entire 
system, and, when habitually employed, may ward off disease. 
The body should be moistened with an alkaline solution before 
the administration of a spirit vapor-bath. After the perspir- 
ation which it occasions has subsided, which will usually be in 
from three to four hours, sponge the body with a mixture of 
the following ingredients: water, three gills; alcohol, one gill; 
salt, one teaspoonful. By this method the patient experiences 
none of the unpleasant effects which generally follow the em- 
ployment of diaphoretics. Various kinds of apparatus have 
been devised to facilitate the application of the spirit vapor- 
baths. Most of them are cumbersome and expensive, and, 
consequently, are seldom used except in hospitals or sanitariums. 
The following method described by Dr. J. King, may be 
advantageously employed. 
" The patient is undressed, ready for getting into bed, having 
removed the clothing worn through the day and put on a night 
shirt or other clothing to be worn while sweating, and during 
the night, if the bath is taken at bed-time. He is then seated 
on a high Windsor or wooden-bottomed chair, or instead 
thereof, a bench or board may be placed on a common open- 
bottomed chair, care being taken that the bottom is so covered BATHS. 
363 
that the flame will not burn him. Aftei' seating himself, a large 
coverlet or blanket is thrown around him from behind, covering 
the back of his head and body, as well as the chair, and another 
must be passed around him in front, which last is to be pinned 
at the neck, loosely, so that he can raise it and cover his face, or 
remove it down from the face from time to time as occasion 
demands during the operation of the bath. The blankets must 
reach down to the floor, and cover each other at the side, so as 
to retain the vapor. This having been done, a saucer or tin 
vessel, into which is put one or two tablespoonfuls of whisky, 
brandy, alcohol, or any liquor that will burn, is then placed upon 
the floor, directly under the centre of the bottom of the chair, 
raising a part of the blanket from behind to'place it there; 
then light a piece of paper, apply the flame to the liquor, and 
as soon as it kindles let down the part of the blanket which has 
been raised, and allow the liquor to burn until it is consumed, 
watching it from time to time to see that the blankets are not 
burned. As soon as consumed, put more liquor into the saucer, 
about as much as before, and again set it on fire, being careful 
to put no liquor into the saucer while the flame exists, as there 
would be danger of setting fire to the blanket, and producing 
injury to the patient. Continue this until the patient perspires 
freely, which, in a majority of cases, will be in five or ten 
minutes." 
" If, during the operation, the patient feels faint or thirsty, 
cold water must be sprinkled or dashed in his face, or he may 
drink one or two swallows of it,-and in some cases the head 
may be bathed with cold water. As soon as free perspiration is 
produced, wrap the blankets around him, place him in bed, and 
cover him up warm, giving him about a pint of either some 
good store tea, ginger, or some diaphoretic herb tea to drink, 
as warm as he can take it. After two or three hours, remove 
the covering, piece by piece, at intervals of twenty or twenty- 
five minutes each, that he may gradually cease perspiring." 
The above method may be improved by using an ordinary 
hoop skirt, ten to twelve inches below the bottom of which is 
suspended a larger and stronger hoop. The upper and smaller 
hoops should rest upon the patient's shoulders. A woolen 
blanket, large enough to reach and rest upon the floor, and 364 
COMMON SENSE MEDICAL ADVISER. 
envelop the whole person, is thrown over the hoops. Unless the 
bath is employed to diminish the quantity of fluids in the body 
(as in dropsy), the patient may drink some simple, diaphoretic 
infusion, to hasten or facilitate perspiration. When he perspires 
freely, small quantities of cold water may be frequently given. 
" There is little or no danger of taking cold after this process, if 
ordinary precaution is observed, and it is easy, agreeable, safe, 
and effectual." 
" Occasionally we will meet with patients, upon whom it is 
almost impossible to produce the slightest moisture, much less 
perspiration. The skin of such persons is generally dry and 
harsh, communicating an unpleasant sensation to the touch. In 
most instances the skin may be restored to its normal condition, 
by adopting the following course: 1st. Anoint the whole 
surface of the body and limbs with olive oil every night upon 
retiring to bed. 2nd. Every morning wash the whole surface 
with a warm, weak, alkaline solution, employing considerable 
friction while drying. 3rd. Every two weeks administer a 
spirit vapor-bath. A perseverance in this course for a few 
months will accomplish the desired result." 
Frequent reference to spirit vapor-baths will be made by the 
author of this work, in speaking of those diseases in which its 
employment will prove beneficial. 
Sea Ratliillg' is an excellent, remedial agent in chronic 
disorders, particularly in those of an atonic character, such as 
nervous prostration, dyspepsia, and general debility. 
Much of the benefit attributed to this mode of bathing is 
undoubtedly due to other influences, such as pure air, exercise, 
change of scenery, diet, and associations which surround the 
patient during his sojourn at the sea-shore. 
At first, the duration of a sea-bath should not exceed three or 
five minutes, but it may be gradually prolonged to fifteen or 
twenty minutes. If the patient is very feeble, one or two baths 
a week are sufficient, and the most robust person should never 
take more than one a day. They should always be taken in the 
earlier portion of the day, before breakfast if possible, and 
never during digestion. 
Before entering this bath, a moderate degree of exercise 
should always be taken, enough to arouse the vital energies, but BATHS. 
365 
not to produce fatigue. Suitably dressed, the patient plunges 
into the water, in which he remains during the prescribed time. 
Immediately after emerging from the bath, the patient should 
be thoroughly dried and dressed and then moderate exercise 
should be taken to induce reaction. If the reaction is slow, a 
mild stimulant may be taken and the duration of the bath must 
be diminished the next time. When sea-bathing is beneficial 
improvement is soon manifested. The blood becomes richer, the 
whole system is strengthened and the functions are performed 
with more regularity. To the rich, sea-bathing is a luxury, but 
it is a remedy beyond the reach of the poorer classes unless 
they live near the sea-shore. 
The Shower Bath produces a shock to the nervous 
system by suddenly coming in contact with the skin. Numerous 
streams of cold water fall upon the neck, shoulders, and body of 
the patient who stands beneath the hose or reservoir. When the 
patient is plethoric, feeble, or nervous, or when some internal 
organ is diseased, the cold, shower bath should rcotf be employed. 
In simple debility unaccompanied by inflammation or symptoms 
of internal congestion, its use proves advantageous. By moder- 
ating the force of the shower, and substituting tepid water, the 
most delicate persons can endure it and profit thereby. The 
usual means for inducing a good reaction, friction, and exercise, 
should be employed. 
The Douche Bath consists of a stream of water, dashed 
or thrown upon the patient from a moderate heighth or distance, 
with considerable force. The size, temperature, and force of 
the stream may be modified to suit the exigencies of the case. 
It is locally employed as a remedy for sprains, weak or stiff 
joints, old swellings, etc. The cold, douche bath is more power- 
ful than the shower bath and should be given with the same 
precautions which govern the application of the latter. 
The Sponge Bath admits of extensive employment 
in both acute and chronic diseases, and its simplicity renders it 
of untold value. It consists in a general or local application of 
water (medicated or not) at any desired temperature. The 
quantity may be great or small to suit the requirements of the 
case. If it is applied in acute diseases at a temperature agree- 
able to the patient, it is exceedingly grateful and may be 366 
COMMON SENSE MEDICAL ADVISER. 
repeated as often as necessary. It may be rendered alkaline by 
the addition of some compound of soda, in the proportion of a 
teaspoonful to a quart of water. A portion of the body may 
be bathed at a time, and quickly dried, thus avoiding any ex- 
posure to cold. It removes excessive animal heat, relaxes the 
capillaries, equalizes the circulation, and produces comfort, tran- 
quility, and sleep. 
Nothing is more conducive to the health and comfort of 
laboring men in summer than a daily bath, and it is a matter of 
regret that there are so few conveniences for the purpose in 
most homes, especially those in the country. Farmers in par- 
ticular need bathing facilities, and yet in most cases they are 
almost entirely without them. For their benefit we will de- 
scribe a device which we can recommend to all who want a 
cheap, convenient, and easily managed apparatus for sponge 
bathing in the bed-room. 
The articles required are a piece of rubber-cloth a yard and a 
quarter square, four slats, two inches wide and three feet long, 
notched at the ends so as to lock together in the form of a 
square, 'and a large sponge. The slats are placed upon the floor 
and the rubber cloth is spread over them (there is no need of 
fastening it to the slats), forming a shallow square vessel a yard 
wide. In this the bather stands and applies the water with a 
sponge from a basin or bowl on a stand placed conveniently 
near. There need be no danger of wetting the carpet, or spoil- 
ing the furniture. 
When the bath is finished, gather three corners of the rubber 
cloth in the left hand, take the fourth corner in the right in 
such a way as to form a spout when lifted or held over the slop- 
jar or bucket. The water may be poured out in a moment, 
when the cloth should be spread over the back of a chair to dry, 
and the slats unlocked and set away in a closet. 
The Foot Bath is frequently employed, as a means of 
causing diaphoresis, in colds, attacks of acute diseases, and also 
to draw the blood from the head or some internal organ. It is 
a powerful auxiliary in the treatment of those chronic diseases 
in which inflammation, congestion, and a feeble circulation are 
prominent symptoms. The water should be as hot as it can be 
borne, and the temperature kept up by additions of hot water. BATHS. 
367 
It may be made stimulating by the addition of salt, mustard, 
ginger, or cayenne pepper. 
The Sitz Bath. A tub is so arranged that the patient 
can sit down in it while bathing. In this manner the lower 
part of the abdomen, hips, and upper part of the thighs, 
are immersed in whatever fluid the bath is composed of. It 
is applicable in diseases of the pelvic organs, and may be hot, 
warm, cool, cold, or medicated, according to the effect desired. 
The bath tub should be large enough to permit a thorough 
rubbing and kneading of the diseased parts, and the patient 
may remain in it from ten to thirty minutes. The clothing may 
be wholly or partially removed, as agreeable to the individual. 
A warm, sitz bath is an effective, remedial adjunct in menstrual 
suppression and in painful menstruation, gravel, spasmodic and 
acute inflammatory affections generally. The cold, sitz bath is 
used as a tonic in cases of relaxed tissues of the pelvis, in de- 
bility of the urino-genital organs, in piles, prolapsus of the 
rectum, and in constipation. 
The Head Bath. A shallow basin contains the fluid for 
the bath; and the patient, assuming a recumbent position, 
immerses a portion of the head, generally the back part. The 
temperature may be warm, cool, or cold, as desired. 
Hedicated Baths are infusions of vegetable or other 
substances in water. They are sometimes applied with the 
sponge, though generally the patient is immersed. The temper- 
ature at which they are usually employed is that of the tepid 
bath. The nature and strength of the medication depends upon 
the character of the disease for which it is employed. 
The Alkaline Bath is prepared by dissolving half a 
pound of carbonate of soda in sixty gallons of water. It is 
useful in those diseases in which the fluids of the body are 
abnormally acid, as in rheumatism. 
The Acid Bath is prepared by adding two pounds of 
muriatic or hydrochloric acid to sixty gallons of water. A 
much smaller quantity of the acid is sometimes used, and in 
some instances vinegar is substituted. 
Scott's Acid Bath is composed of nitro-muriatic acid (aqua 
regia) and water. It should be prepared in a wooden tub, and 
a sufficient quantity of acid used to give the water a sour taste. 368 
COMMON SENSE MEDICAL ADVISER. 
It is extensively used in India as a remedy for disorders of the 
liver. 
The Iodine Bath is composed of the following ingre- 
dients: tincture of iodine, two drachms; iodide of potassium, 
four drachms; water, forty gallons. It should be prepared in 
a wooden tub. It reddens the skin. For children, a much 
weaker solution must be employed. Its use is generally re- 
stricted to scrofulous and tubercular affections. 
The Sulphur Bath is prepared by dissolving eight 
ounces of sulphuret of potassium and two ounces of dilute sul- 
phuric acid in sixty gallons of water. The acid may be omitted. 
A Sulphur Vapor-bath is often employed in cities 
where the necessary apparatus can be procured. It may be 
improvised by placing sulphur on a shovel over hot coals. The 
patient should be prepared as in the spirit vapor-bath, and 
burning sulphur substituted for the liquor. The patient is then 
enveloped in the fumes of sulphurous oxide. Heating a mixture 
of sulphur and sulphuric acid, produces the same result. If the 
gas is inhaled in large quantities it causes irritation of the 
respiratory passages, and suffocation. It is therefore necessary 
that the coverings should be securely fastened at the neck, and 
that the room be one which can be quickly filled with pure air 
This bath is used in cutaneous, rheumatic, and syphilitic dis- 
orders. 
Fomentations consist of the general or local application 
of woolen cloths wrung out of hot water. They should not 
be so light as to be ineffectual, nor so heavy as to be burden- 
some. They should not be wet enough to drip, nor applied 
so as to expose the body to the surrounding air. A fresh cloth 
should be ready for application before the first one is re- 
moved, and the change quickly effected. Fomentations are 
effectual in relieving congestion and inflammation. 
The Wet Sheet Pack. As this remedial appliance will 
be frequently recommended in the pages following, its mode of 
application is here described. Take a pail half filled with cold 
water, gather together one end of a common cotton sheet, and 
immerse it, allowing it to remain while preparing the bed, 
which may be done as follows: remove all the bed-clothes 
except a coverlet and the pillows, then spread upon it, in MOTION AS A REMEDIAL AGENT. 
369 
the following order, two ordinary comforters, one woolen 
blanket, one woolen sheet, (or two woolen sheets if a woolen 
blanket is not at hand); then wring out one-half or two-thirds 
of the water from the wet sheet, spread it smoothly upon the 
blanket, and the patient being undressed, places himself on 
the sheet, with his arms extended, while an assistant wraps him 
closely and tightly with it, as quickly as possible. Each arm 
may be thus covered by the wet sheet, or may lie outside of 
it, and be covered by wet towels, prepared in the same manner 
as the sheet. Then quickly and tightly cover with the blankets 
and comforters, tucking snugly from head to foot. The head 
should also be covered with a wet towel, and a bottle of warm 
water placed to the feet, or near enough to keep them warm. 
After the first shock of the chill is over, the pack is very 
pleasant and refreshing, and the patient should go to sleep, 
if possible. The ordinary time for a patient to remain in a 
pack is about sixty minutes. Thirty or forty minutes is suffi- 
cient, if he is in a feeble condition. Never wring the sheet 
out of warm water, for one of its principal benefits comes from 
the vigorous reaction induced by its cold temperature. After 
remaining in the pack from thirty to sixty minutes, allow the 
patient to stand on his feet, if he is able, and have the whole 
surface of his body bathed. Rub briskly, and dry with towels, 
or by throwing over the body a dry sheet and then rubbing 
him. The dry sheet retains the hodily warmth and is more 
comfortable, but interferes with the completeness and vigor 
of the rubbing of the body. Be sure and establish full 
reaction, which may be known by the warmth of the surface. 
Frequently, when the patient is released from the pack, and is 
being bathed, rolls of scales, scurf, and skin-debris come off, 
thus giving palpable evidence of the utility of the pack in 
freeing the myriads of pores of the skin of effete matter. It 
is efficient in fevers, and for breaking up colds, and is a very 
valuable, remedial agent in most chronic diseases, assisting in 
removing causes which depress the bodily functions. 
MOTION AS A REMEDIAL AGENT. 
The stability of the planetary system depends upon the con- 
certed motion of its parts. So in the human system, motion 370 
COMMON SENSE MEDICAL ADVISER. 
is a fundamental principle which underlies every vital process. 
Health consists in normal, functional activity. The human 
system is the arena of various kinds of motions, both of 
fluids and of solids, and life and health depend upon these 
physiological movements. There are the movements incident 
to respiration, the expansion and contraction of the walls of 
the chest, bringing the oxygen of the air into contact with the 
blood as it circulates through the lungs. Corresponding with 
the movements of the chest are the motions of the abdominal 
walls, which promote the functions of the organs of the abdom- 
inal cavity. 
There are motions of the heart and arteries, which urge the 
blood out to the extremities and diffuse it through every part 
of the system, and also motion of the blood in the capillaries, 
by which the blood is circulated through the tissues, that the 
latter may be built up from its nutritive constituents. Then 
there is the motion of the vital current in the veins returning 
towards the heart, and urged forward by the muscular and 
pump-like action of the chest and abdominal walls. The 
peristaltic motions of the stomach and bowels urge onward 
digesting materials, exposing them successively to different 
solvents and aiding the absorption of nutritive matter. No less 
essential to life and health are numerous other minute operations 
or motions, on which vital power in all its manifestations of 
muscular and nervous energy depends. Many other motions 
are consequent upon decay, growth, and repair. Oxygen, 
carbonic acid, watery vapors, and other gaseous matter are 
constantly being exchanged between the system and atmos- 
phere. Then, the human system being a complex, chemical 
laboratory, there are motions consequent upon chemical action, 
constantly going on within it. 
Muscular motion, under the direction of the will, is also 
absolutely necessary for the maintenance of good health. 
Animal heat and muscular and nervous power are dependent 
upon motions of the minutest particles composing the body. 
The body is composed of fluid and semi-fluid matter, permitting 
great freedom of motion. Health requires that there shall be 
a constant change of place, an active transmission of material 
to and from vital organs and parts, through the medium of MOTION AS A REMEDIAL AGENT. 
371 
blood-vessels, as well as outside such vessels; that is, motion of 
interstitial fluids. 
Nature's Mode of Sustaining Health. The act 
of transforming latent, non-vital force which exists pent-up in 
food, as heat is in coal, into vital energy, requires the simul- 
taneous elimination from the system of a like amount of 
worn-out matter. Assimilation of nutritive materials is impos- 
sible, unless a like amount of matter be eliminated from the 
system. Muscular and nervous energy are dependent upon 
activities which cause waste. Not only is this true in a general 
way, but it is also true that the energy produced by the 
operations of the vital system has a strict relation to the wasting 
products-that full energy is only attained by perfected waste. 
Use, waste, and power, then, sustain definite and dependent or 
corresponding relations, since waste is as essential to health as 
is supply. 
Without waste, disturbance is at once produced in the system 
similar to that resulting from the introduction of foreign matter. 
These disturbances constitute disease. The more obvious effects 
of lack of waste and elimination are mechanical. The circula- 
tion is loaded with effete and useless matter, the vessels being 
thereby weakened and distended, and the circulation retarded. 
The capillaries become clogged and vital action is diminished. 
Local congestions, inflammations, effusions, morbid growths, and 
other pathological results follow. 
Deranged or suppressed action characterizes, and, indeed, 
constitutes all departures from health which we call disease. 
Suffering indicates action, but action which is perverted into 
wrong channels, or action in one part at the expense of motion 
in other parts, constituting a disturbance in the equilibrium of 
forces, from which the system suffers. 
Value oF Mechanical Movements and Manipu- 
lations for the Treatment of Chronic Diseases. 
To correct and restore deranged movements, thereby producing 
normal, functional activity of every organ and part of the sys- 
tem, must therefore be the chief object of the physician. All 
remedies, of whatever school or nature, imply motion, and 
depend for their efficacy upon their ability to excite motion in 
some one or more elements, organs, or parts of the system. 372 
COMMON SENSE MEDICAL ADVISER. 
While we do not wish to detract from the real merits of 
medicine as a curative agent, yet we must admit that the reme- 
dial power of motion, transmitted either manually or mechani- 
cally, is founded upon rational and physiological principles. All 
systems of medicine, however much they may differ superficially, 
propose, as the chief end to be attained by the administration of 
medicine, or by other treatment, that motions identical with 
physiological activity should be incited or promoted. How best 
to accomplish this result, and with least cost to vitality, is an 
important consideration. Bearing in mind the conservation of 
forces, that energy or power is as indestructible as matter, that 
it may be changed into other forms but never lost, it is plain 
that mechanical force may be applied to the living system and 
transformed into vital energy; that chemical action, animal heat, 
and magnetism may represent in the system the mechanical force 
transmitted to the body. Keeping in view the transformable 
nature of force, and the need that our systems have of auxiliary 
power in different departments, when normal activity is impaired 
by disease, we can readily understand how undoubted, curative 
effects result from either the manual or the mechanical adminis- 
tration of motion. 
Rubbing is a process universally employed by physicians 
of every school for the relief of a great diversity of distressing 
symptoms, is instinctively resorted to by sympathizers and 
attendants upon the sick, and constitutes one of the chief duties 
of the nurse. Uncivilized people resort to this process as their 
principal remedy in all forms of disease. 
The difficulty in administering motion as a remedial agent 
by manual effort, such as rubbing, kneading, oscillating, flexing, 
and extending the limbs, lies in the impossibility of supplying 
the amount, intensity, and variety of movement required to 
make it most effective. The power of the arm and the strength 
of the operator are exhausted before the desired effect is pro- 
duced. Inventive genius has at last overcome the obstacles to 
the successful and perfect administration of motion as a curative 
agent. We have now a series of machines propelled by 
mechanical power, by the use of which we rub, knead, ma- 
nipulate, and apply in succession a great variety of movements 
to all parts of the body. These machines transmit motion to MOTION AS A REMEDIAL AGENT. 
373 
the body from inexhaustible sources, never tire, but are ever 
ready for new, remedial conquests. The movements admin- 
istered by their use, while entirely under the control of the 
patient, are never disagreeable, and are far more rapid and 
intense than can possibly be given by the hands. By the appli- 
cation of short, quick movements of from twelve to fifteen hun- 
dred vibrations a minute, deep-seated organs and parts are 
reached, to which motion is transmitted and in which vital 
energy is thereby generated. The hands have not the power, 
by kneading, manipulating, or rubbing to impress the system 
except in a very mild degree, and deep-seated organs and parts 
are scarcely influenced by the comparatively slow movements 
thus administered. Among the most important, mechanical in- 
ventions devised for administering motion as a remedial agent, 
is one which has received the name of the manipulator. 
The manipulator. With this machine motion can be 
applied to any organ or part of the system, and intensity of the 
application regulated to a nicety. The rapidity of motion 
necessary to produce active exhilaration of any part of the 
body is easily secured by the use of the manipulator, but is far 
beyond the power of the hands. The degree of circulation 
given to the fluids, both inside and outside of the vessels, and 
of energy imparted to the organs and parts operated upon by 
the manipulator, is also unapproachable by the application of 
manual power. 
Effects Upon the Circulation and Nutrition. 
The influence of motion on these functions is as follows: The 
contents of the blood-vessels are moved onward by the pressure 
and motion transmitted by the manipulator, all backward move- 
ment of the blood being prevented by the valves of the veins 
and by the propelling power of the heart and arteries. Fluids 
outside these vessels pass through their walls, to take the place 
of the stagnant blood that has been moved onward. Other 
blood flows into the part, and thus active and healthy circu- 
lation is induced, and nutritive material, capable of affording 
vital support is also brought to refresh the local part. 
We have found mechanical movements especially effectual in 
paralysis, neuralgia, sleeplessness, and other nervous affections; 
in derangements of the liver, constipation, and dyspepsia; in 374 
COMMON SENSE MEDICAL ADVISER. 
displacements of the uterus, and congestion, and inflammation 
of the pelvic organs. 
For a complete description of the mechanical movements 
and the machinery employed in the treatment of diseases at the 
Invalids' Hotel and Surgical Institute, the reader is referred to 
the appendix to this work. CHAPTER IV. 
HYGIENIC TREATMENT OF 
THE SICK. 
There are two essentials requisite to the successful treatment 
of the sick: (1.) Medical skill; (2.) Good nursing. The former 
is necessary in order that the condition of the patient be fully 
understood, and the proper means be employed to effect his 
recovery. The latter is essential, in order that all influences 
favoring the production and development of disease may be 
removed, the tendencies to restoration be promoted by every 
possible means, and the directions of the physician be properly 
observed. 
Success in the treatment of the sick requires good nursing. 
Without it, the most skillful physicians fail to effect a cure; 
with it, the most unqualified may succeed. If certain hygienic 
agencies are essential to the maintenance of health, how much 
more necessary it is that they be employed in sickness 1 If 
certain conditions cause disease, how great the necessity is that 
such conditions be obviated and hygienic ones substituted! 
Notwithstanding the importance of good nursing, in the rural 
districts it is frequently difficult to find a professional nurse, 
or, if one can be obtained, it is often impossible for the 
invalid to procure such services, on account of the expense 
which must necessarily be incurred. Hence, this office usually 
devolves upon some relative who is considered to be the best 
qualified for the position; or, as is often the case, necessity 
demands that the patient be left to a change of nurses. A 
woman is generally selected for this important position. Her 
375 376 
COMMON SENSE MEDICAL ADVISER. 
soft hand and soothing voice, her kindly, sympathetic, and 
provident nature, together with her scrupulous cleanliness, 
render her man's equal, if not his superior, in the capacity of 
nurse. There are circumstances, however, in vhich the ser- 
vices of a man are indispensable; hence the necessity that 
all should be qualified to care for the sick. 
A nurse should be attentive to the requirements of physician 
and patient, for she sustains an intimate relation to both. She 
should observe the directions of the physician, and faithfully 
perform them. She should note all the symptoms of the pa- 
tient, and do everything in her powTer to promote comfort and 
recovery. She should anticipate the wishes, and not cause 
the patient to ask for everything which is desired. So far as 
practicable, let the wishes be gratified. The senses of the 
sick often become morbidly acute, and those things which in 
health would pass unnoticed, in sickness are so magnified as 
to occasion annoyance and vexation. Sick persons are not 
all alike, and the peculiarities of each must be studied separ- 
ately. The nurse must be kind, but firm, and not yield to 
such whims of the patient as may be detrimental to recovery; 
neither must she arouse dislike or anger by opposition, but 
endeavor to win the patient from all delusions. The feelings 
of the patient should never be trifled with, for idealities 
become realities. 
The nurse should possess an inexhaustible store of patience. 
Disease affects the mind of the patient and fills it with strange 
delusions. The sick are often querulous, fretful, and unreason- 
able, and should be treated with kindness, forbearance, and 
sympathy. The nurse should always be cheerful, look on 
the bright side of every circumstance, animate them with 
encouragement, and inspire them with hope. Hope is one 
of the best of tonics. It stimulates the flagging, vital energies, 
and imparts new life to the weak and exhausted forces. 
Gloom, sadness, and despondency depress the vital forces and 
lead to death. We have seen patients rapidly sinking, who 
had given up all hope, and were quietly awaiting the coming 
of death, snatched, as it were, from its grasp, and restored to 
health, by words of cheer and encouragement. 
The nurse should possess moral principles, which alone can THE BED. 
377 
win the confidence of the patient. She should have judgment, 
circumspection, intelligence, forethought, alacrity, carefulness, 
and neatness. In a word she should exercise common sense. 
We deem it but justice to say a word in behalf of the nurse. 
She, too, is a human being, subject to disease, and, unless 
hygienic conditions be observed, will soon be stricken low by 
its presence. She must be relieved occasionally and get rest,' 
or she cannot long withstand the combined influence of fatigue 
and disease. Her office is an arduous one at best, and the long, 
weary hours of night-watching should be compensated by 
exercise in the open air, as well as by sleep during the day. 
Unless this be done, the system will become exhausted, and sleep 
will intrude itself upon her at the time when the greatest 
diligence is required for the welfare of the patient, when the 
vital powers are at their lowest ebb. She should be supplied 
with plenty of suitable food during the night, to sustain her and 
to serve as a safeguard against the. invasion of disease. She 
should be treated with kindness and respect, else her disposition 
may become morose and reflect itself upon the patient, causing 
peevishness and despondency. 
The Sick-rooill should be as comfortable, cheerful, and 
pleasant, as circumstances will allow. Let the room be large 
and airy, and furnished with a stove, or better still, a fireplace. 
All articles of clothing and furniture, not necessary to the com- 
fort of the patient, should be removed from the room, and in 
malignant or contagious diseases the carpets, even, should not 
be permitted to remain. The surroundings beget happiness or 
gloom, in proportion as they are pleasant or disagreeable. A 
tidy attendant, a few flowers and books, wonderfully enhance 
the cheerfulness of the room. Permit no unnecessary accumu- 
lation of bottles, or any thing that can in any way render the 
room unpleasant. Medicines, drink, or nourishment should 
never be left uncovered in the sick-room, since they quickly 
absorb the gaseous emanations from the patient, and become 
unfit for the purpose which they were intended to serve. Their 
presence gives the room an untidy appearance, suggestive of 
filth and slovenliness, and imparts to the patient a feeling of 
loathing and disgust for articles of diet. 
The Bed should not be of feathers, on account of their 378 
COMMON SENSE MEDICAL ADVISER. 
undue warmth, which causes a sensation of languor throughout 
the system. A husk or sea-grass mattress, or even a straw bed, 
covered with a cotton quilt, is far preferable. The bedding 
should be changed frequently. It is better that the bed should 
be away from the wall, so as to admit of greater freedom of 
movement about it. 
Pure Air. The air in the sick-room should be kept as 
pure as possible. That which is so necessary in health, is indis- 
pensable in sickness. The importance, therefore, of a perfect 
and free ventilation of the sick-room cannot be too thoroughly 
impressed; and yet to properly secure this end, may call forth a 
considerable amount of ingenuity on the part of the nurse. A 
window should be open, but the current of air must not be 
allowed to blow directly upon the patient. One window may 
be raised from the bottom and another lowered from the top. 
This will permit the entrance of pure air from without, and the 
exit of the vitiated air from within. The patient, if sufficiently 
covered in bed, is not liable to take cold from a proper ventila- 
tion of the room. Especially is this true, when the bodily 
temperature is raised by febrile or inflammatory affections. 
The temperature of a room is no indication of the purity of 
the air. It is a prevalent, but mistaken notion, that when a 
room is cold, the air must be pure. Cold air is as readily 
contaminated with impurities as warm air, therefore, it is not 
sufficient that the room be kept cool, but the air should be 
frequently changed. During convalescence, great care is nec- 
essary to protect the patient from taking cold. Air which is 
admitted into the sick-room should not be contaminated by 
passing over foul drains, privies, or other sources of infec- 
tion, since, instead of invigorating, it depresses the physical 
forces and generates disease. 
Light is as necessary to health as is pure air. Banish either 
for any continuous period of time, and serious results follow. 
The strong, robust man, when deprived of light, soon degen- 
erates into a feeble, sickly being, and finally dies. 
According to the investigations of the Massachusetts Medical 
Society, it was found that absence of sunlight, together with 
moisture, not only favor the development of tubercular con- 
sumption, but act as an exciting cause. It is well known that WARMTH 
379 
persons living in shaded dwellings often suffer from forms of 
disease which resist all treatment until proper admission of 
light is secured. 
The physician to the Emperor of Russia found upon examin- 
ation that patients confined in w'ell lighted wards, were four 
times as liable to recover as were those in poorly lighted rooms. 
Children reared away from the sunlight are apt to be deformed 
and idiotic, while those partially deformed have been restored 
by being admitted to the light. 
Patients sometimes wish to have their rooms darkened, 
because the light is painful to their weak and sensitive eyes. It 
is far better to shade the eyes and admit the sunlight into the 
room, since its rays cause chemical changes to take place, which 
favor the return of health. Many invalids can ascribe their 
recovery to the influence of a sun bath. There are, however, 
conditions in which the patients should be screened from the 
light. In such cases a little arrangement of the curtains or 
shutters will accomplish all that is to be desired. 
Patients convalescing from acute, or suffering from chronic 
diseases, should receive the influence of light in the open air, 
and be in it several hours every day. Light and pure air 
stimulate a healthful development, induce cheerfulness, hope, 
and recovery, while darkness begets gloom, sadness, despon- 
dency, disease, and ultimately death. 
Warmth is essential to the well-being of the patient, and 
it is necessary that a proper temperature be maintained in the 
room. Except in very warm weather, a little fire should be kept 
in the room, and at the same time fresh air should be admitted 
from without, and a uniform temperature thus preserved. This 
arrangement is especially necessary in localities where great 
variations in temperature are experienced during the day and 
night. 
The normal temperature of the body ranges from 98° to 
99® Fahr. The minimum occurs from 2 to 6 a. m.; the maxi- 
mum, from 1 to 6 p. m. The deviation of a few degrees from 
this standard indicates disease, and the greater the deviation, 
the greater is its severity. During the early stages of acute 
diseases, the animal heat is generally increased, and should be 
allayed by bathing, and cooling or acidulated drinks. In the 380 
COMMON SENSE MEDICAL ADVISER. 
latter stages, the temperature becomes diminished and the con- 
dition of the system is favorable to congestions, which are most 
likely to occur between the hours of 2 and 6 a. m., when the 
vital powers are lowest. The patient then becomes feeble, his 
extremities grow cold, and he has what is termed a " sinking 
spell," and perhaps dies. It is during these hours that ad- 
ditional covering, the application of hot bricks to the feet, and 
bottles of hot water to the limbs and body, friction upon the 
surface, stimulating drinks, and increased vigilance on the part 
of the nurse will often save the patient's life. But, unfortu- 
nately, at these hours the nurse is apt to get sleepy and inat- 
tentive, the demands of the patient go unheeded, and a sacrifice 
of life is the result. 
Persons suffering from chronic diseases, or those in feeble 
health, should preserve their vital energies by dressing warmly, 
by wearing flannels next to the skin, and by carefully protect- 
ing the feet from cold and moisture. 
Cleanliness cannot be too thoroughly impressed upon the 
minds of those who have the care of the sick. Filthiness is 
productive of disease and favorable to its development. Bath- 
ing at least once a day, with pure, soft water and toilet-soap, is 
strongly urged, and as this is designed for cleanliness, the tem- 
perature of the bath should be made agreeable to the patient. 
The Clothing and Bedding of the Patient in 
acute diseases, should be changed frequently and thoroughly 
aired, if not washed. As soon as removed, these articles should 
be taken from the room, replaced by others well aired and 
warmed. The hands and face of the patient should be bathed 
frequently, the hair combed, the teeth brushed, the nails cleaned, 
the lips moistened, and everything about him kept clean and 
tidy. These observances, although in themselves trifling, pro- 
mote comfort and cheerfulness, and contribute largely to the 
recovery of the sick. All excretions from the patient should 
be buried, and not committed to privies to communicate disease 
to those who frequent them. 
The Diet contains a very important relation to health. 
During the process of acute disease, the appetite is generally 
much impaired, if not entirely absent. It should then be the 
study of the nurse to devise such articles of nourishment as will BEEF TEA. 
381 
be acceptable to the patient and suitable to the condition. 
The food should be light, nutritious, and easy of digestion. 
Each individual disease requires a diet adapted to its pecul- 
iarities. Those of an inflammatory character require an un- 
stimulating diet, as gruel, barley-water, toast, etc. An ex- 
hausted or enfeebled condition of the brain, unattended by 
irritability, demands a stimulating diet, as beef, eggs, fish, 
Graham bread, oysters, etc. In wasting diseases, in which the 
temperature of the system is low, beef, fatty substances, rich 
milk, sweet cream, and other carbonaceous articles of diet are 
recommended. In the various forms of chronic ailments, the 
diet must be varied according to the nature of the disease and 
the peculiarities of the patient. Deranged digestion is gen- 
erally an accompaniment of chronic disease. A return to normal 
digestion should be encouraged by selecting appropriate articles 
of food, paying due regard to its quantity and quality, as well 
as to the manner and time of eating. The appearance of food, 
and the manner in which it is offered, have much to do with 
its acceptance, or rejection by the patient. Let the nourishment 
be presented in a nice, clean dish, of a size and shape appro- 
priate to the quantity. More food than can be eaten by the 
patient should not be placed before him at one time, since a 
great quantity excites disgust and loathing. In taking nourish- 
ment, drink, or medicine, the patient, if feeble, should not be 
obliged to change his position. 
Milk is" one of the most important foods in fevers and acute 
diseases attended with great prostration, and in which the 
digestive powers are enfeebled. It contains within itself all 
the elements of nutrition. 
Beef* Tea furnishes an excellent nourishment for the sick, 
but there are, few, even among professional nurses who know 
how to properly prepare it. We give three good recipes. 
One method is to chip up lean beef, put it in a porcelain or 
tin saucepan, cover it with cold water, and bring it up to just 
below the boiling point, at which temperature retain it for ten 
minutes, then season and serve. Another method is similar to 
the foregoing, with this difference, that the juices of th? meat 
are squeezed through a piece of muslin or crash, making the 
tea richer. Another way, which we consider preferable to 382 
COMMON SENSE MEDICAL ADVISER. 
either of the above, is to take lean beef, cut it into fine bits, 
put them in a tightly covered vessel, which is placed in a kettle 
of water kept boiling. Thus the whole strength of the juice 
will be obtained from the meat without losing any of its prop- 
erties. It can be seasoned to the taste, and reduced with water 
to suit the needs of the patient. 
Sleep is "Nature's grand restorer, a balm to all mankind; 
the best comforter of that sad heart whom fortune's spite 
assails." It is necessary in health, and doubly so in sickness. 
During sleep, the vital energies recuperate, the forces are less 
rapidly expended, and the strength increases. It is the great 
source of rest and refreshment. Often a day's rest in bed, free 
from the cares and anxieties of an active life, is sufficient to 
ward off the approach of disease. If quiet and rest are essential 
to recuperation in health, their necessity in disease must be 
apparent. Life frequently depends on tranquility and repose, 
and the least noise or confusion disturbs the sufferer and 
diminishes the chances of recovery. Nothing annoys sick or 
nervous persons more than whispering and the rustling of 
newspapers. If conversation be necessary, let the tones be 
modified, but never whisper. In sickness, when the vital forces 
are low, the more natural rest and sleep the patient obtains, the 
greater is the prospect for recovery. As a rule, a patient should 
never be awakened when sleeping quietly; not even to take 
medicine, unless in extreme cases. If the patient does not sleep, 
the cause should be ascertained and the appropriate 'remedies 
employed; if it arise from rush of blood to the head, cooling 
lotions should be applied, and warmth to the feet; if, from 
restlessness or general irritability, a sponge bath, followed by 
friction should be administered; if the wakefulness is due to 
noise or confusion, quiet is the remedy. When these means 
fail, anodynes, or nervines, should be employed. Lying on the 
side instead of on the back should be practiced. Patients 
afflicted with chronic diseases, on rising, should take a cold 
bath, dry the surface quickly with a coarse towel, followed by 
friction with the hand. Great benefit may be derived by fol- 
lowing these suggestions when the nature of the disease is not 
such as to forbid it. 
Exercise and rest necessarily alternate with each other. VISITING THE SICK. 
383 
Exercise, so necessary to health, in many forms of disease 
greatly contributes to recovery. It sends the sluggish blood 
coursing through the veins and arteries with increased force 
and rapidity, so that it reaches every part of the system, 
supplying it with nourishment. It increases the waste of old 
material and creates a demand for new. 
Convalescing patients, or those suffering from chronic dis- 
eases, whenever the weather will permit, should take exercise 
every day in the open air. This should be done with regu- 
larity. The amount of exercise must be regulated by the 
strength of the patient; never take so much as to produce 
fatigue, but, as the strength increases, the exercise may be 
increased proportionately. Some interesting employment, com- 
mensurate with the patient's strength, should be instituted, 
so that the mind may be agreeably occupied with the body. 
When unable to take active exercise, the invalid, properly 
protected by sufficient clothing, should ride in a carriage or 
boat, and each day a new route should be chosen, so that a 
change of scenery may be observed, thus arousing new trains 
of thought, which will be exhilarating and prove beneficial 
to him. 
Sexual Influences. During the progress of disease or 
convalescence, entire continence must be observed. It is then 
necessary that all of the vital energies should be employed 
in effecting a recovery from disease, without having the addi- 
tional tax imposed of overcoming the debilitating effects of 
sexual expenditure. This holds true with regard to all diseases, 
and especially those of the nervous system and genito-urinary 
organs. 
Visiting the Sick may be productive of good or evil 
results. Mental impressions made upon the sick exert a power- 
ful influence upon the termination of disease. The chances 
of recovery are in proportion to the elevation or depression of 
spirits. Pleasant, cheerful associations animate the patient, 
inspire hope, arouse the vital energies, and aid in his recovery; 
while disagreeable and melancholy associations beget sadness 
and despondency, discourage the patient, depress the vital 
powers, enfeeble the body, and retard recovery. 
Unless persons who visit the sick can carry with them joy, 384 
COMMON SENSE MEDICAL ADVISER. 
hope, mirth, and animation, they had better stay away. This 
applies equally in acute and chronic diseases. It does not 
matter what a visitor may think with regard to the patient's 
recovery, an unfavorable opinion should never find expression 
in the sick-room. Life hangs upon a brittle thread, and often 
that frail support is hope. Cheer the sick by words of 
encouragement, and the hold on life will be strengthened; dis- 
courage, by uttering such expressions as, "How bad you look!" 
"Why, how you have failed since I saw you last!" "I would 
have another doctor; one who knows something!" "You 
can't live long if you don't get help!" etc., and the tie which 
binds them to earth is snapped asunder. The visitor becomes 
& murderer! Let all persons be guided by this rule: Never 
go into the sick-room without carrying with you a few rays 
of sunshine ! 
If the patient is very weak the visitor may injure him by 
staying too long. The length of the visit should be graduated 
according to the strength of the invalid. Never let the sufferer 
be wearied by too frequent or too lengthy visits, nor by having 
too many visitors at once. Above all things, do not confine 
your visitations to Sunday. Many do this and give themselves 
credit for an extra amount of piety on account of it, when, 
if they would scrutinize their motives more carefully, they 
would see that it was but a contemptible resort to save time. 
The sick are often grossly neglected during the week only 
to be visited to death upon Sunday. 
The use of Tobacco and Opium. The recovery of 
the sick is often delayed, sometimes entirely prevented, by 
the habitual use of tobacco or opium. In acute diseases, the 
appetite for tobacco is usually destroyed by the force of the 
disease, and its use is, of necessity, discontinued; but in chronic 
ailments, the appetite remains unchanged, and the patient 
continues his indulgence greatly to the aggravation of the 
malady. 
The use of tobacco is a pernicious habit in whatever form it 
is introduced into the system. Its active principle, Nicotin, 
which is an energetic poison, exerts its specific effect on the 
nervous system, tending to stimulate it to an unnatural degree 
of activity, the final result of which is weakness, or even THE USE OF TOBACCO AND OPIUM. 
385 
paralysis. The horse, under the action of whip and spur, may 
exhibit great spirit and rapid movements, but urge him beyond 
his strength with these agents, and you inflict a lasting injury. 
Withhold the stimulants, and the drooping head and moping 
pace indicate the sad reaction which has taken place. This 
illustrates the evils of habitually exciting the nerves by the 
use of tobacco, opium, narcotic or other drugs. Under then- 
action, the tone of the system is greatly impaired, and it 
responds more feebly to the influence of curative agents. 
Tobacco itself, when its use becomes habitual and excessive, 
gives rise to the most unpleasant and dangerous pathological 
conditions. Oppressive torpor, weakness or loss of intellect, 
softening of the brain, paralysis, nervous debility, dyspepsia, 
functional derangement of the heart, and diseases of the liver 
and kidneys are not uncommon consequences of the excessive 
employment of this plant. A sense of faintness, nausea, gid- 
diness, dryness of the throat, tremblings, feelings of fear, 
disquietude, and general nervous prostration must frequently 
warn persons addicted to this habit that they are sapping the 
very foundation of health. Under the continued operation of 
a poison, inducing such symptoms as these, what chance is 
there for remedies to accomplish their specific action? With 
the system already thoroughly charged with an influence 
antagonistic to their own, and which is sure to neutralize their 
effect, what good can medicine do ? 
Dr. King says, "A patient under treatment should give up 
the use of tobacco, or his physician should assume no responsi- 
bility in his case, further than to do the best he can for him." 
In our own extensive experience in the treatment of chronic 
diseases, we have often found it necessary to resoft to the 
same restriction. 
The opium habit, to which allusion has also been made, is 
open to the same objections, and must be abandoned by all 
who would seek recovery. PART IV. 
DISEASES AND THEIR REME- 
DIAL TREATMENT. 
INTRODUCTION. 
Knowledge which is conducive to self-preservation is of pri- 
mary importance. That great educator, profound thinker, and 
vigorous writer, Herbert Spencer, has pertinently said that, 
"As vigorous health and its accompanying high spirits, are 
larger elements of happiness than any other things whatever, 
the teaching how to maintain them is a teaching that yields to 
no other whatever. And therefore we assert that such a course 
of physiology as is needful for the comprehension of its 
general truths and their bearings on daily conduct is an all- 
essential part of a rational education." 
Believing that the diffusion of knowledge for the prevention 
of disease is quite as noble a work as the alleviation of physical 
suffering by medical skill, we have devoted a large portion of 
this volume to the subjects of physiology and hygiene. These 
we have endeavored to present in as familiar a style as possible, 
that they may be understood by every reader. Freely as we 
have received light upon these subjects have we endeavored to 
reflect it again, in hopes that a popular presentation of these 
matters made plain and easy of comprehension to all people, 
may lead the masses into greater enjoyment of life-the result 
of a better preservation of health. This we do in part as a 
public acknowledgment of our obligations to society, to whom 
every professional man is a debtor. He belongs to it, is a part 
of its common stock, and should give as well as receive 
386 INTRODUCTION. 
387 
advantages, return as well as accept benefits. We know of no 
better way to signify our appreciation of the public confidence 
and patronage, so generously accorded to us, than to offer this 
volume to the people at a price less than the actual cost for an 
edition of ordinary size. This we do as a token of the cordial 
reciprocation of their good will. In giving to the people whole- 
some advice, by which they may be enabled to ward off disease 
and thus preserve the health of multitudes, we believe we shall 
receive their hearty approval, as well as the approbation of our 
own conscience, both of which are certainly munificent rewards. 
We believe that good deeds are always rewarded, and that the 
physician who prevents sickness manifests a genuine and earnest 
devotion to the common interests of humanity. 
We have no respect for the motives of those medical men 
who would withhold that information from the people which 
will direct the masses how to take care of themselves, and 
thereby prevent much sickness and suffering. Nor is the diffu- 
sion of such knowledge antagonistic to the best interests of the 
true and competent physician. The necessity for his invaluable 
services can no more be set aside by popularizing physiological, 
hygienic, and medical truths, than we can dispense with those 
of the minister and lawyer by the inculcation of the principles 
of morality in our public schools. The common schools do not 
lessen the necessity for colleges or universities, but rather 
contribute to their prosperity. Nor are we so presumptuous as 
to anticipate that we could possibly make this volume so 
instructive as to render "every man his own physician." No 
man can with advantage be his own lawyer, carpenter, tailor, 
and printer; much less can he hope to artfully repair his own 
constitution when shattered by grave maladies, which not only 
impair the physical functions, but weaken and derange the 
mental faculties. What physician presumes to prescribe for 
himself, when suddenly prostrated by serious illness? He very 
sensibly submits to the treatment of another, because he realizes 
that sickness impairs his judgment, and morbid sensations 
mislead and unfit him for the exercise of his skill. If this is 
true of the physician, with how much greater force does it 
apply to the unprofessional! If a sick sea-captain is unfit to 
stand at the helm and direct his ship, how utterly incompetent 388 
COMMON SENSE MEDICAL ADVISEE. 
must the raw sailor be when similarly disqualified! Nor is the 
physician as competent to treat those near and dear to him, 
when they are suffering from dangerous illness, as another 
medical man not similarly situated, whose judgment is not 
liable to be misled by intense anxiety and affectionate sym- 
pathy. 
Notwithstanding all these facts, however, a knowledge on 
the part of the unprofessional, of something more than physi- 
ology and hygiene, and appertaining more closely to medicine 
proper, will many times prove valuable. 
In the first stage of many acute affections which, if unheeded, 
gradually assume a threatening aspect, endangering life and 
demanding the services of the most skilled physician to avert 
fatal results, the early administration of some common domestic 
remedy, such as a cathartic, or a diaphoretic herb, associated 
with a warm bath, a spirit vapor-bath, or a hot foot-bath, will 
very often obviate the necessity for calling a family physician, 
and frequently save days and weeks of sickness and suffering. 
So, likewise, are there numerous, acute diseases of a milder 
are easily and unmistakably recognized without 
the possession of great medical knowledge, and which readily 
yield to plain, simple, medical treatment which is within the 
ready reach of all who strive to acquaint themselves with the 
rudiments of medical science. But in sudden and painful 
attacks of acute disease, life may be suddenly and unexpectedly 
jeopardized, and immediate relief prove necessary. While 
under these circumstances the prompt application of such do- 
mestic treatment as good common-sense may dictate, guided by 
a knowledge of those first principles of medical learning which 
we shall hereafter endeavor to make plain, may result in speedy 
and happy relief, yet at the same time there should be no delay 
in summoning a competent physician to the bedside -of the 
sufferer. 
Then, and not the least important, there are the various chronic 
or lingering diseases, from all of which few individuals indeed, 
who pass the meridian of life, entirely escape. In this class of 
ailments there is generally no immediate danger, and, therefore, 
time may be taken by the invalid for studying his disease and 
employing those remedies which are best suited for its removal. INTRODUCTION. 
389 
Or, if of a dangerous or complicated character, and, therefore, 
not so readily understood, he may consult either personally or 
by letter, some learned and well-known physician, who makes 
a specialty of the treatment of such cases, and whose large 
experience enables him to excel therein. 
In consideration, therefore, of the foregoing facts, we deem 
it most profitable for our readers that Part Fourth of this 
volume should be arranged in the following manner: 
The milder forms of uncomplicated, acute diseases, which may 
be readily and unmistakably recognized, and successfully man- 
aged without professional aid, will receive that attention which 
is necessary to give the reader a correct idea of them, and their 
proper remedial treatment. 
We shall devote only such attention to the severe and hazard- 
ous forms of acute diseases as is necessary in order to consider 
their initial stage, with their proper treatment, not attempting 
to trace their numerous complications, or portray the many 
pathological conditions which are liable to be developed. For, 
even by devoting much space to the latter, we could not expect 
to qualify our unprofessional readers for successfully treating 
such obscure and dangerous conditions. 
We shall devote the largest amount of space to a careful 
and thorough consideration of those chronic diseases, which, by 
a little study, may be readily recognized and understood by the 
masses, and for the cure of which we shall suggest such hygi- 
enic treatment and domestic remedies as may be safely em- 
ployed by all who are in quest of relief. In the more dangerous, 
obscure, or complicated forms of chronic diseases, the correct 
diagnosis and successful treatment of which tax all the skill 
possessed by the experienced specialist, the invalid will not be 
misled into the dangerous policy of relying upon his own 
judgment and treatment, but will be counseled not to postpone 
until too late, the employment of a skillful physician. 
The apportionment of space which is made in considering 
the various diseases and their different stages, as well as the 
course which the people are advised to pursue under the differ- 
ent circumstances of affliction, is not always in accordance with 
the plans and recommendations which have been made by others 
who have written works on domestic medicine. Most of these 390 
COMMON SENSE MEDICAL ADVISER. 
authors have attempted, by lengthy disquisitions, to teach 
their readers how to treat themselves without the services of 
a physician, even in the most hazardous forms of disease. In 
such dangerous maladies as typhoid, typhus, yellow, and scarlet 
fevers, typhoid pneumonia, and many others, in which life is 
imminently imperiled, such instruction and advice is decidedly 
reprehensible, as it may lead to the most serious consequences. 
We are confident, therefore, that the manner of disposing of 
the different subjects which are discussed in the succeeding 
chapters, and the course of action which is advised, will com- 
mend themselves to our readers as being such as are calculated 
to promote and subserve their best interests. 
MEDICAL DIAGNOSIS. 
Skill in the art of healing is indicated in three ways: (1.) by 
ascertaining the symptoms, seat, and nature of the disease, 
which is termed diagnosis' (2.) by foretelling the probable 
termination, which is termed prognosis; (3.) by the employ- 
ment of efficacious and appropriate remedies, which is called 
treatment. Of these three requisites to a prosperous issue, 
nothing so distinguishes the expert and accomplished physician 
from the mere pretender as his ready ability to interpret cor- 
rectly, the location, extent, and character of an affection from 
its symptoms. By medical diagnosis, then, is understood the 
discrimination between diseases by certain symptoms which are 
distinguishing signs. Every malady is accompanied by its 
characteristic indications, some of which are diagnostic, i. e., 
they particularize the affection and distinguish it from all others. 
Medical diagnosis is both a science and an art; a science 
when the causes and symptoms of a disease are understood, 
and an art when this knowledge can be applied to determine 
its location and exact nature. Science presents the general 
principles of practice; art detects among the characteristic 
symptoms the differential signs, and applies the remedy. Da 
Costa aptly remarks: "No one aspiring to become a skillful 
observer can trust exclusively to the light reflected from the 
writings of others; he must carry the torch in his own hands, 
and himself look into every recess." 
The critical investigation of symptoms, with the view of MEDICAL DIAGNOSIS. 
391 
ascertaining their signs, is essential to successful practice. 
Without closely observing them, we cannot accurately trace 
out the diagnosis, and a failure to detect the right disease is 
apt to be followed by the use of wrong medicines. 
General diagnosis considers the surroundings of the patient 
as well as the actual manifestations of the disease. It takes 
into account the diathesis, i. e., the predisposition to certain 
diseases in consequence of peculiarities of constitution. We 
recognize constitutional tendencies, which may be indicated 
by the contour of the body, its growth, stature, and tempera- 
ment, since all these facts greatly modify the treatment. 
Likewise the sex, age, climate, habits, occupation, previous 
diseases, as well as the present condition, must be taken into 
account. 
Auscultation, as practiced in detecting disease, consists in 
listening to the sounds which can be heard in the chest. 
Percussion consists in striking upon a part with the view 
of appreciating the sound which results. The part may be 
struck directly with the tips of the fingers, but more generally 
one or more fingers of the other hand are interposed between 
the points of the fingers and the part to be percussed, that 
they, instead of the naked chest, may receive the blow; or, 
instead of the fingers, a flat piece of bone or ivory, called 
a pleximeter, is placed upon the. chest to receive the blow. 
Latterly, improved instruments greatly assist the practitioner 
of medicine in perfecting this art. The microscope assists the 
eye, and helps to reveal the appearance and character of the 
excretions, detecting morbid degenerations; chemistry discloses 
the composition of the urine, which also indicates the morbid 
alterations occurring in the system; by percussion we can de- 
termine, the condition of an internal organ, from the sound given 
when the external surface is percussed; the ear, with the aid 
of the stethoscope, detects the strange murmurs of respiration, the 
fainter, more unnatural pulsations of life, and the obscurer 
workings of disease; with the spirometer we determine the 
breathing capacity of the lungs, and thus ascertain the extent 
of the inroads made by disease; the dynamometer records the 
lifting ability of the patient; the thermometer indicates the mor- 
bid variation in the bodily temperature; various instruments 392 
COMMON SENSE MEDICAL ADVISER. 
inform us of the structural changes causing alterations in 
the specific gravity of fluids, e. g., the urinometer indicates 
those occurring in the urine; and thus, as the facilities for cor- 
rect diagnosis increase, the art of distinguishing and classifying 
diseases becomes more perfect, 
and their treatment more cer- 
tain. While physiology treats 
of all the natural functions, 
pathology treats of lesions and 
altered conditions. 
By the term symptoms we 
mean the evidence of some 
morbid effect or change occur- 
ring in the human body, and 
it requires close observation 
and well-instructed experience 
to convert these symptoms 
into diagnostic signs. Suppose 
"Old Probabilities" (as we 
commonly designate the inval- 
uable Signal Department) hangs out his "warning tokens all 
along our lake borders and ocean coasts; our sailors behold 
the fluttering symbols indicating an approaching storm, but if 
no one understood their meaning, a fearful disaster might fol- 
low. But if these signals are understood, a safe harbor is 
sought and the mariner is protected. So disease may hang 
out all her signals of distress, in order that they may be seen, 
but unless correctly interpreted, and a remedial harbox* is 
sought, these symptoms are of little practical value. 
Undoubtedly the reason why so many symptom-doctors blunder 
is because they prescribe according to the apparent symptoms, 
without any real reference to the nature of the affection. They 
fail to discovei' how far a symptom points out the seat, and also 
the progress of a disease. They do not distinguish the relative 
importance of the different symptoms. The practical purpose 
of all science is to skillfully apply knowledge to salutary and 
profitable uses. The patient himself may carefully note the 
indications, but it is only the expert physician who can tell the 
import of each symptom. 
Fig. llfi. 
Dr. Brown's Spirometer. MEDICAL DIAGNOSIS. 
393 
Symptoms are within every one's observation, but only the 
physician knows the nature and value of signs. We have read 
an anecdote of Galen, who was a distinguished physician in 
his day, which illustrates the distinction between sign and 
symptom. Once, when dangerously ill, he overheard two of 
his friends in attendance upon him recount his symptoms, 
such as "Redness of the face, a dejected, haggard, and in- 
flamed appearance," etc. He cried out to them to adopt every 
necessary measure forthwith, as he was threatened with de- 
lirium. The two friends saw the symptoms well enough; but 
it was only Galen himself, though the patient, who was able to 
deduce the sign of delirium-that is, he alone was able to 
translate those symptoms into signs. To determine the value 
of symptoms, as signs of disease, requires close observation. 
INTERPRETATION OF SYMPTOMS. 
We shall refer to a few symptoms which any unprofessional 
reader may readily observe and understand. 
Position ot* Patient. When a patient is disposed to 
lie upon his back continually during the progress of an acute 
disease, it is a sign of muscular debility. If he manifests no 
desire to change his position, or cannot do so, and becomes 
tremulous at the least effort, it indicates general prostration. 
When this position is assumed, during the progress of continued 
fever, and is accompanied by involuntary twitching of the 
muscles, picking of the bed-clothes, etc., then danger is immi- 
nent and the patient is sinking. Fever, resulting from local 
inflammation, does not produce muscular prostration, and the 
patient seldom or never assumes the supine position. If this 
inflammation is in the extremities, those parts are elevated, in 
order to lessen the pressure of the blood, which a dependent 
position increases. 
For example, let us change the scene, and introduce a patient 
with head and shoulders elevated, who prefers to sit up, and 
who places his hands behind him and leans back, or leans for- 
ward resting his arms and head upon a chair. The next week 
he is worse, and no longer tries to lie in bed, but sits up all the 
time; note the anxious expression of countenance, the difficult 
or hurried breathing, the dry and hacking cough, and observe 394 
COMMON SENSE MEDICAL ADVISER. 
that the least exertion increases the difficulty of respiration and 
causes palpitation of the heart. These plain symptoms signify 
thoracic effusion, the collection of water about the lungs. 
The Countenance displays diagnostic symptoms of 
disease. In simple, acute fevers, the eyes and face are red and 
the respiration is hurried; but in acute, sympathetic fever, these 
signs are wanting. We cannot forget the pale, sharp, con- 
tracted, and pinched features of those patients whose nostrils 
contract and expand alternately with the acts of respiration. 
How hard it was for them to breathe. The contraction and 
expansion of the nostrils indicate active congestion of the 
lungs. 
As a general rule, chronic inflammation of the stomach, 
duodenum, liver, and adjacent organs, imparts a gloomy ex- 
pression to the countenance, at the same time the eye is dull, 
the skin dusky or yellow, and the motions are slow. But in 
lung diseases, the spirits are buoyant, the skin is fair, and the 
cheeks flushed with fever and distinctly circumscribed with 
white, for delicacy and contrast, almost exceed the hues of 
health in beauty. Note, too, the pearly lustre and sparkling 
light of the eye, the quivering motion of the lips and chin, all 
signs of pulmonary disease. 
The Story ol* Sexual Abuse is plainly told by the down- 
cast countenance, the inability to look a person fairly in the 
face, the peculiar lifting of the upper lip and the furtive glance 
of the eye. The state of the mind and of the nervous system 
corroborates this evidence, for there seems to be a desire to 
escape from conversation and to elude society. The mind seems 
engrossed and abstracted, the individual appears absorbed in 
a constant meditation, he is forgetful and loses nearly all 
interest in the ordinary affairs of life. The whole appearance 
of a patient, suffering from spermatorrhea, is perfectly under- 
stood by the experienced physician, for the facial expressions, 
state of mind, and movements of the body, all unconsciously 
betray, and unitedly proclaim his condition. 
Tongue. Much may be learned from the appearance, color, 
and form of the tongue, and the manner of its protrusion. If 
pale, moist, and coated white, it indicates a mild, febrile con- 
dition of the system. If coated in the center, and the sides MEDICAL DIAGNOSIS. 
395 
look raw, it indicates gastric irritation. If red and raw, or dry 
and cracked, it is a sign of inflammation of the mucous mem- 
brane of the stomach. If the inflammation is in the large 
intestine, the tip of the tongue presents a deep red color, while 
the middle is loaded with a dark brown coating. When the 
tongue is elongated and pointed, quickly protruded and with- 
drawn' it indicates irritation of the nerve-centers, as well as of 
the stomach and bowels. If tremulous, it denotes congestion 
and lack of functional ability; this may be observed in conges- 
tive fevers. 
Pulse. Usually the pulse beats four times during one 
respiration, but both in health and disease its frequency may be 
accelerated or retarded. In adults, there are from sixty-five to 
seventy-five beats in a minute, and yet in a few instances we 
have found, in health, only forty pulsations per minute. But 
when the heart beats from one hundred and twenty to one hun- 
dred and forty times a minute, there is reason to apprehend 
danger, and the case should receive the careful attention of a 
physician. 
Irregularity of the pulse may be caused by disease of the 
brain, heart, stomach, or liver; by the disordered condition of 
the nervous system; by lack of muscular nutrition, as in gout, 
rheumatism, or convulsions; by deficiency of the heart's effective 
power, when the piflse-wave does not reach the wrist, or when 
it intermits and then becomes more rapid in consequence of 
septic changes of the blood, as in diphtheria, erysipelas, and 
eruptive fevers. 
Pain. The import of pain depends on its seat, intensity, 
nature, and duration. An acute, intense pain usually indicates 
inflammation of a nerve as well as the adjacent parts. Sharp, 
shooting, lancinating pains occur in inflammation of the serous 
tissues, as in pleurisy. A smarting, stinging pain attends 
inflammation of the mucous membrane. Acute pain is gen- 
erally remittent and not fixed to one spot. Dull, heavy pain is 
more persistent, and is present in congestions, or when the sub- 
stance of an organ is inflamed, and it often precedes hemor- 
rhage. Burning pain characterizes violent inflammations in- 
volving the skin and subjacent cellular tissue, as in case of 
boils and carbuncles. Deep, perforating pain accompanies 396 
COMMON SENSE MEDICAL ADVISER. 
inflammation of the bones, or of their enveloping membranes. 
Gnawing, biting, lancinating pain attends cancers. 
The location of pain is not always at the seat of the disease. 
In hip-disease, the pain is not first felt in the hip, but in the 
knee-joint. In chronic inflammation of the liver, the pain is 
generally most severe in the right shoulder and arm. Disease 
of the kidneys occasionally produces numbness of the thigh and 
drawing up of the testicle, and commonly causes colicky pains. 
Inflammation of the meninges of the brain is often indicated 
by nausea and vomiting before attention is directed to the head. 
These illustrations are sufficient to show that pain often takes 
place in some part remote from the disease. 
In chronic, abdominal affections, rheumatic fevers, gout, and 
syphilis, the entire system is thrown into a morbid state, the 
nervous system is disturbed, and wandering pains manifest 
themselves in different parts of the body. Fixed pain, which 
is increased by pressure, indicates inflammation. If it be 
due only to irritation, pressure will not increase it. Some 
rheumatic affections and neuralgia not only bear pressure, but 
the pain diminishes under it. Permanent pain shows that 
the structures of an organ are inflamed, while intermittent pain 
is a sign of neuralgia, gout, or rheumatism. Absence of pain 
in any disease, where ordinarily it should be present, is an 
unfavorable sign. Internal pain, after a favorable crisis, is a 
bad omen. Or, if pains cease suddenly without the other 
symptoms abating, the import is bad. If, however, pain and 
fever remit simultaneously and the secretions continue, it is a 
favorable sign. 
A dull pain in the head indicates fullness of the blood-vessels 
from weakness, low blood, or general debility. It may be 
caused by taking cold, thus producing passive congestion of the 
brain. It may proceed from gastric disturbance, constipation 
of the bowels, or derangement of the liver. Heaviness of the 
head sometimes precedes inflammation of the brain, or chronic 
disease of its membranes. A dull, oppressive pain in the head 
indicates softening of the brain, and is generally accompanied 
by slowness of the pulse and of the speech. A pulsating pain 
of the head occurs in heart disease, hysteria, and frequently 
accompanies some forms of insanity. MEDICAL DIAGNOSIS. 
397 
The Eye indicates morbid changes and furnishes unmis- 
takable signs of disease. Sinking of the eye indicates waste, as 
in consumption, diarrhea, and cholera. In fevers it is regarded 
as a fatal symptom. A dark or leaden circle around the eye, 
seen after hard work, indicates fatigue and overdoing. If the 
mucous covering of the inner surface of the lids and the ball of 
the eye is congested and inflamed, it exhibits redness, and may 
indicate congestion or even inflammation of the brain. 
A dilated pupil is often observed in catarrhal consumption, 
congestion of the brain, low fevers, and chlorosis. 
The pupil contracts in inflammation of the meninges, ■when 
there is increased sensibility and intolerance of light, also in 
spinal complaints. In some diseases the lustre of the eye 
increases, as in consumption. But if it decreases with the 
attack of violent disease, it indicates great debility and 
prostration. 
Examination of the Urine. All medical authors and 
physicians of education, freely admit and even insist upon the 
importance of critically examining the patient's urine, in all 
cases in which there is reason to suspect disease of the kidneys 
or bladder. In chronic affections it is particularly serviceable, 
especially in derangements of the liver, blood, kidneys, bladder, 
prostate gland, and nervous system. Many scholarly physicians 
have sadly neglected the proper inspection of the urine, because 
they were afraid of being classed with the illiterate "urosco- 
pian " doctors,- or fanatical enthusiasts, who ignorantly pretend 
to diagnose correctly all diseases in this manner, thus subject- 
ing themselves and their claims to ridicule. Nothing should 
deter one from giving to this excretion the attention it deserves. 
The urine which is voided when the system is deranged or 
diseased is altered in its color and composition, showing that its 
ingredients vary greatly. So important an aid do examinations 
of the urine furnish in diagnosing many chronic ailments, that 
at the Invalids' Hotel and Surgical Institute, where many 
thousands of cases are annually treated, a chemical laboratory 
has been fitted up, and a skillful chemist is employed, who makes 
a specialty of examining the urine, both chemically and micro- 
scopically, and reporting the result to the attending physicians. 
His extended experience renders his services invaluable. With 398 
COMMON SENSE MEDICAL ADVISER. 
his assistance, maladies which had hitherto baffled all efforts put 
forth to determine their true character, have frequently been 
quickly and unmistakably disclosed. 
microscopical Examination. This method of 
examination affords a quicker and more correct idea of a deposit 
or deposits than any other method. The expert, by simply 
looking at a specimen, can determine the character of the urine, 
whether blood, mucus, pus, uric acid, etc., are present or not. 
But when no deposit is present, then it is necessary to apply 
chemical tests, and in many cases the quantity of the suspected 
ingredient must be determined by analysis. As a detailed 
account of the various modifications which the urine undergoes 
in different diseases, would be of no practical use to the masses, 
since they could not avail themselves of the advantages which 
it would afford for correct diagnosis, except by the employment 
of a physician who does not ignore this aid in examining his 
patients, we shall omit all further details upon the subject. For 
the same reason we shall not often, in treating of the different 
diseases in which examinations of the urine furnish such 
valuable aid in forming a diagnosis, make mention of the 
changes which are likely to have occurred. 
INFLAMMATION. 
The term Inflammation signifies a state in which the infected 
part is hotter, redder, more congested, and more painful than is 
natural. Inflammation is limited to certain parts, while fever 
influences the system generally. Inflammation gives rise to 
new formations, morbid products, and lesions, or alterations 
of structure. The morbid products of fever, and its modifica- 
tion of fluids are carried away by the secretions and excretions. 
The susceptibility of the body to inflammation may be natural 
or acquired. It is natural when it is constitutional; that is, when 
there is an original tendency of the animal economy to manifest 
itself in some form of inflammation. We may notice that some 
children are far more subject to boils, croups, and erysipelatous 
diseases than others. This susceptibility, when innate, may be 
lessened by careful medication, although it may never be wholly 
eradicated. When acquired, it is the result of the influence of hab- 
its of life, climate, and the state of mind over the constitution. INFLAMMATION. 
399 
Phlegmonous inflammation is the active inflammation of the 
cellular membrane, one illustration of which is a common boil. 
The four principal symptoms are redness, swelling, heat, and pain; 
and. then appears a conical, hard, circumscribed tumor, having 
its seat in the dermoid texture. At the end of an indefinite 
period, it becomes pointed, white or yellow, and discharges pus 
mixed with blood. When it breaks, a small, grayish, fibrous 
mass sometimes appears, which consists of dead, cellular tissue, 
and which is called the core. 
There are certain morbid states of the constitution which lead 
to local inflammation, subsequent upon slight injury; or, in some 
cases, without any such provocation, as in gout, rheumatism, and 
scrofula. One of the first results of the inflammation, in such 
cases, is a weakening of the forces which distribute the blood to 
the surface and extremities of the body. It is generally admit- 
ted that in scrofulous persons the vascular system is weak, the 
vessels are small, and because nutrition is faulty, the blood is 
imperfectly organized. The result is failure in the system, for 
if nutrition fails, there may be lacking earthy matter for the 
bones, or the unctious secretions of the skin; the sebaceous 
secretion is albuminous and liable to become dry, producing 
inflammation of the parts which it ought to protect. 
Disorder of the alimentary canal and other mucous surfaces 
are sometimes reflected upon the skin. We have occasionally 
observed cutaneous eruptions and erysipelas, when evidently they 
were distinct signs of internal disorder. 
Inflammation may be internal as well as external, as inflamma- 
tion of the brain, lungs, or stomach, and it is frequently the 
result of what is called a cold. No matter how the body is 
chilled, the blood retreats from the surface, which becomes pale 
and shrunken, there is also nervous uneasiness, and frequently a 
rigor, accompanied with chattering of the teeth. After the cold 
stage, reaction takes place and fever follows. The sudden change 
from a dry and heated room to a cool and moist atmosphere is 
liable to induce a cold. Riding in a carriage until the body 
is shivering, or sitting in a draft of air when one has been 
previously heated, or breathing a very cold air during the 
night when the body is warm, especially when not accustomed 
to doing so, or exposing the body to a low temperature when 400 
COMMON SENSE MEDICAL ADVISEE. 
insufficiently clothed, are all different ways of producing inflam- 
mation. 
Inflammation may result in consequence of local injury, caused 
by a bruise, or by a sharp, cutting instrument, as a knife or an axe, 
or it may be caused by the puncture of a pin, pen-knife blade or 
a fork-tine, or from a lacerated wound, as from the bite of a dog, 
or from a very minute wound poisoned by the bite of a venomous 
reptile. Local inflammations may arise from scalds, burns, the 
application of caustics, arsenic, corrosive sublimate, canthar- 
ides, powerful acids, abrasions of the surface by injuries, and 
from the occurrence of accidents. 
The swelling of the part may be caused by an increase of the 
quantity of blood in the vessels, the effusion of serum and 
coagulating lymph, and the interruption of absorption by the 
injury, or by the altered condition of the inflamed part. 
The character of the pain depends upon the tissue involved, 
and upon the altered or unnatural state of the nerves. Ordi- 
narily, tendon, ligament, cartilage, and bone are not very 
sensitive, but when inflamed they are exquisitely so. 
The heat of the inflamed part is not so great, when measured 
by the thermometer, as might be supposed from the patient's 
sensations. 
Termination of Inflammation. Inflammation ends 
in one of six different ways. Inflammation may terminate in 
resolution, i. e., spontaneous recovery; by suppuration, in the 
formation of matter; by effusion, as the inflammation caused 
by a blister-plaster terminates by effusion of water; by 
adhesion, the part inflamed forming an attachment to some 
other part; by induration, hardening of the organ; or by 
gangrene, that is, death of the part. 
Thus, inflammation of the lungs may terminate by recovery, 
that is, by resolution, by suppuration and raising of "matter," 
by hardening and solidification of the lung, or by gangrene. 
Inflammation of the endocardium, the lining membrane of the 
heart, may cause a thickening of it, and ossification of the 
valves of the heart, thus impairing its function. Inflammation 
of the pericardium may terminate in effusion, or dropsy, and 
inflammation of the liver may result in hardening and adhesion 
to adjacent parts. FEVER, 
401 
GENERAL PRINCIPLES FOR TREATMENT OF INFLAMMATION. 
Remove the exciting causes as far as practicable. If caused 
by a splinter or any foreign substance, it should be withdrawn, 
and if the injury is merely local, apply cold w'ater to the parts 
to subdue the inflammation. If caused by a rabid animal, the 
wound should be enlarged and cupped, and the parts cleansed 
or destroyed by caustic. The patient should remain quiet and 
not be disturbed. The use of tincture of aconite internally, 
will be found excellent to prevent the rise of inflammation. 
A purgative is also advised, and four or five of Dr. Pierce's 
Pleasant Purgative Pellets will be sufficient to act upon the 
bowels. If there is pain, an anodyne and diaphoretic is proper. 
Dr. Pierce's Compound Extract of Smart-weed will fulfill this 
indication. In local inflammation cold water is a good remedy, 
yet sometimes hot water, or cloths wrung out of it, will be 
found to be the appropriate application. When the inflamma- 
tion is located in an organ within a cavity, as the lungs, hot 
fomentations will be of great service. Bathing the surface 
with alkaline water must not be omitted. Whenever the in- 
flammation is serious the family physician should be early 
summoned. 
In fever all the functions are more or less deranged. In 
every considerable inflammation there is sympathetic fever, 
but in essential fevers there are generally fewer lesions of 
structure than in inflammation. Fever occasions great waste 
of the tissues of the body, and the refuse matter is carried 
away by the organs of secretion and excretion. The heat 
of the body in fever is generally diffused, the pulse is quicker, 
there is dullness, lassitude, chilliness, and disinclination to take 
food. We propose to give only a general outline of fevers, 
enough to indicate the principles which should be observed 
in domestic treatment. 
Most fevers are distinctly marked by four stages: 1st, the 
forming stage; 2d, the cold stage; 3d, the hot stage; 4th, the 
sweating or declining stage. During the first stage the indi- 
vidual is hardly conscious of being ill, for the attack is so slight 
that it is hardly perceptible. True, as it progresses, there is a 
FEVER. 402 
COMMON SENSE MEDICAL ADVISEE. 
feeling of languor, an indisposition to make any bodily or 
mental effort, and also a sense of soreness of the muscles, 
aching of the bones, chilliness, and a disposition to get near 
the fire. There is restlessness, disturbed sleep, bad dreams, 
lowness of spirits, all of which are characteristic of the form- 
ative stage of fever. 
The next is the cold stage, when there is a decided mani- 
festation of the disease, and the patient acknowledges that 
he is really sick. In typhus and typhoid fever the chills are 
slight; in other fevers they are more marked; while in ague 
they are often accompanied by uncontrollable shaking. When 
the chill is not so distinct the nails look blue and the skin 
appears shriveled, the eye is sunken and a dark circle circum- 
scribes it, the lips are blue, and there is pain in the back. The 
pulse is frequent, small, and depressed, the capillary circulation 
feeble, the respiration increased, and there may be nausea and 
vomiting. These symptoms vary in duration from a few min- 
utes to more than an hour. They gradually abate, reaction 
takes place, and the patient begins to throw off the bed-clothes. 
Then follows the hot stage, for with the return of the circu- 
lation of the blood to the surface of the body, there is greater 
warmth, freer breathing, and a more comfortable and quiet 
condition of the system. The veins fill with blood, the counte- 
nance brightens, the cheeks are flushed, the intellect is more 
sprightly, and if the pulse is frequent, it is a good sign; if 
it sinks, it indicates feeble, vital force, and is not a good symp- 
tom. If there is considerable determination of blood to the 
head it becomes hot, the arteries of the neck pulsate strongly, 
and delirium may be expected. During the hot stage, if the 
fever runs high, the patient becomes restless, frequently changes 
his position, is wakeful, uneasy, and complains of pain in his 
limbs. In low grades, the sensibility is blunted, smell, taste, 
and hearing are impaired. 
The patient in the hot stage is generally thirsty, and if he 
is allowed to drink much, it may result in nausea and vomiting. 
Moderate indulgence in water, however, is permissible. There 
.is aversion to food, and if any is eaten, it remains undigested. 
The teeth are sometimes covered'with dark sordes (foul accumu- 
lations) early in the fever, and the appearance of the tongue FEVER, 
403 
varies, sometimes being coated, a yellowish brown, sometimes 
red and dry, at other times thickly coated and white. The 
condition of the bowels varies from constipation to diarrhea, 
although sometimes they are quite regular. The urine is gen- 
erally diminished in quantity, but shows higher color. 
The sweating stage in some fevers is very marked, while in 
others there is very little moisture, but an evident decline of the 
hot stage, the skin becoming more natural and soft. The pulse 
is more compressible and less frequent, the kidneys act freely, 
respiration is natural, the pains subside, although there remains 
languor, lassitude, and weariness, a preternatural sensibility to 
cold, an easily excited pulse, and a pale and sickly aspect of the 
countenance. The appetite has failed and the powTers of diges- 
tion are still impaired. 
Domestic iUaiiag'eiiient of Fevers. It is proper to 
make a thorough study of the early, insidious symptoms of 
fever, in order to understand what ought to be done. If it 
arises in consequence of malaria, the treatment must be suited 
to the case. If from irritation of the bowels and improper 
articles of diet, then a mild cathartic is required. If there is 
much inflammation, a severe chill, and strong reaction, then the 
treatment should be active. If the fever is of the congestive 
variety and the constitution is feeble, the reaction imperfect, a 
small, weak pulse, a tendency to fainting, a pale countenance, 
and great pain in the head, apply heat and administer diaphor- 
etics, and procure the services of a good physician. 
As a general rule, it is proper to administer a cathartic, 
unless in typhoid fever, and for this Dr. Pierce's Purgative 
Pellets answ'er the purpose, given in doses of from four to 
six, according to the state of the bowels. If these are not at 
hand, a tea of sage and senna may be drunk until it produces 
a purgative effect, or a dose of Rochelle salts taken. In nearly 
all fevers we have found that a weak, alkaline tea, made from 
the white ashes of hickory or maple wood, is useful, taken weak, 
three or four times daily, or if there be considerable thirst, 
more frequently. Some patients desire lemon juice, which 
enters the system as an alkali and answers all purposes. 
Diaphoretic medicines are also indicated, and the use of Dr. 
Pierce's Extract of Smart-weed will prove very serviceable. 404 
COMMON SENSE MEDICAL ADVISER. 
Drinking freely of pleurisy-root tea, or of a strong decoction of 
boneset is frequently useful. After free sweating has been 
established, then it is proper to follow by the use of diuretic 
teas, such as that of spearmint and pumpkin seed combined, or 
sweet spirits of nitre, in doses of twenty to thirty drops, added 
to a teaspoonful of the Extract of Smart-weed, diluted with 
sweetened water. 
To lessen the frequency of the pulse, fluid extract or tincture 
of aconite or veratrum may be given in water, every hour. 
During the intermission of symptoms, tonic medicines and a 
sustaining course of treatment should be employed. If the 
tongue is loaded and the evacuations from the bowels are fetid, 
a solution of sulphite of soda is proper; or, take equal parts of 
brewer's yeast and water, mix, and when the yeast settles, give 
a tablespoonful of the water every hour, as an antiseptic. Ad- 
ministering a warm, alkaline hand-bath to a fever patient every 
day, is an excellent febrifuge remedy, being careful not to chill 
or induce fatigue. If there is pain in the head, apply mustard 
to the feet; if it is in the side, apply hot fomentations. 
The symptoms which indicate danger are a tumid and hard 
abdomen, difficult breathing, offensive and profuse diarrhea, 
bloody urine, delirium, or insensibility. Favorable symptoms 
are a natural and soft state of the skin, eruptions on the surface, 
a natural expression of the countenance, moist tongue, free 
action of the kidneys, and regular sleep. If the domestic 
treatment which we have advised does not break the force of 
the disease and mitigate the urgency of the symptoms, it will 
be safer to employ a good physician, who will prescribe such 
a course of treatment as the case specially requires. It is our 
aim to indicate what may be done before the physician is called, 
for frequently his services cannot be obtained when they are 
most needed. Besides, if these attacks are early and properly 
treated with domestic remedies, it will often obviate the 
necessity of calling upon a physician. If, on the other hand, 
fevers are neglected and no treatment instituted, they become 
more serious in character and are more difficult to cure. 
To recapitulate, our treatment recommends evacuation 
through nature's outlets, the skin, kidneys, and bowels, main- 
taining warmth, neutralizing acidity, using antiseptics, tonics, FEVER AND AGUE. 
405 
and the hand-bath, and the fluid extract or tincture of aconite, 
or veratrum to moderate the pulse by controlling the accelerated 
and unequal circulation of the blood. It is a simple treatment, 
but if judiciously followed, it will often abort a fever, or mate- 
rially modify its intensity and shorten its course. 
FEVER AND AGUE. (Intermittent Fever.) 
The description of fever already given applies well to this 
form of it, only the symptoms in the former stage are rather 
more distinct than in the other varieties. Weariness, lassitude, 
yawning, and stretching, a bitter taste in the mouth, nausea, 
loss of appetite, the uneasy state of the stomach and bowels 
are more marked in the premonitory stages of intermittent 
fevers. The cold stage commences with a chilliness of the 
extremities and back, the skin looks pale and shriveled, the 
blood recedes from the surface, respiration is hurried, the urine 
is limpid and pale, sometimes there is nausea and vomiting, 
and towards the conclusion of the stage, the chilly sensations 
are varied with flushes of heat. The hot stage is distinguished 
by the heat and dryness of the surface of the body and the 
redness of the face; there is great thirst, strong, full, and hard 
pulse, free and hurried respiration and increased pain in the 
head and back. The sweating stage commences by perspiration 
appearing upon the forehead, which slowly extends over the 
whole body, and soon there is an evident intermission of all the 
symptoms. In the inflammatory variety of intermittent fever, 
all these symptoms are acute, short, and characterized by strong 
reaction. Gastric fever, the most frequent variety of intermit- 
tent fever, is marked by irritation of the stomach and bowels, 
and a yellow appearance of the white of the eye. 
Causes. The cause of the malarial fevers, intermittent, 
remittent, and congestive, is supposed to be miasm, a poisonous, 
gaseous exhalation from decaying vegetation, which is generally 
most abundant in swamps and marshes, and which is absorbed 
into the system through the lungs. 
Treatment. During the entire paroxysm the patient 
should be kept in bed, and in the cold stage, covered with 
blankets and surrounded with bottles of hot water. The 
Compound Extract of Smart-weed should be administered in 406 
COMMON SENSE MEDICAL ADVISER. 
some diaphoretic herb-tea. During the hot stage, the extra 
clothing and the bottles of hot water should be gradually 
removed and cold drinks taken instead of warm. During the 
sweating stage the patient should be left alone, but as soon as 
the perspiration ceases, from two to four of the Purgative 
Pellets should be administered, as a gentle cathartic. A second 
paroxysm should, if possible, be prevented. To accomplish 
this, during the intermission of symptoms, the Golden Medical 
Discovery should be taken in doses of from two to three 
teaspoonfuls every four hours in alternation with three-grain 
doses of the sulphate of quinine. If the attack is very severe, 
and is not relieved by this treatment, a physician should be 
summoned to attend the case. 
The distinction between intermittent and remittent fever 
does not consist in a difference of origin. In the former disease 
there is a complete intermission of the symptoms, while in the 
latter there is only a remission. 
Treatment. The treatment should consist in the employ- 
ment of those remedial agents advised in intermittent fever, the 
Golden Medical Discovery and quinine being taken during the 
remission of symptoms. During the height of the fever, 
tincture of aconite may be given and an alkaline sponge-bath 
administered with advantage. As in intermittent fever, should 
the course of treatment here advised not promptly arrest the 
disease, the family physician should be summoned. 
REMITTENT FEVER. (Bilious Fever.) 
This is the most severe and dangerous form of malarial fever. 
It may be either intermittent or remittent in character. In some 
instances the first paroxysm is so violent as to destroy life in a 
few hours, while in others it comes on insidiously, the first one 
or two paroxysms being comparatively mild. It is frequently 
characterized by stupor, delirium, a marble-like coldness of the 
surface, vomiting and purging, jaundice, or hemorrhage from the 
nose and bowels. In America this fever is only met with in the 
Mississippi valley, and in other localities where the air contains 
a large quantity of malarial poison. 
CONGESTIVE FEVER. (Pernicious Fever.) TYPHOID FEVER. 
407 
Treatment. This fever is so dangerous that a physician 
should be summoned as soon as the disease is recognized. For 
the benefit of those who are unable to obtain medical attendance, 
we will say that the treatment should be much the same as in 
intermittent fever, but more energetic. Quinine should be taken 
in doses of from five to fifteen grains every two or three hours. 
If it be not retained by the stomach, the following mixture may 
be administered by injection: sulphate of quinine, one-half 
drachm; sulphuric acid, five drops; water, one ounce; dissolve, 
and then add two ounces of tarch water. 
CONTINUED FEVERS. 
The symptoms of these fevers do not intermit and remit, but 
continue without any marked variation for a certain period. 
They are usually characterized by great prostration of the 
system, and are called putrid when they manifest septic changes 
in the fluids, and malignant when they speedily run to a fatal 
termination. Typhoid and typhus fevers belong to this class. 
We shall not advise treatment for these more grave disorders 
which should always, for the safety of the patient, be attended 
by the family physician, except to recommend some simple 
means which may be employed in the initial stage of the dis- 
ease, or when a physician's services cannot be promptly secured. 
TYPHOID FEVER. (Enteric Fever.) 
In typhoid fever there is ulceration of the intestines and mesen- 
teric glands. This diseased condition of the bowels distinguishes 
this fever from all others, and is readily detected by sensitive- 
ness to pressure, especially over the lower part of the abdomen 
on the right side. The early disposition to diarrhea is another 
characteristic symptom of it, and there is also no intermission of 
symptoms as in intermittent fever. The disease comes on insid- 
iously, with loss of appetite, headache, chilliness, and languor. 
It is usually a week or more before the disease becomes fully 
developed. This dangerous fever is clearly marked by all these 
distinguishing symptoms and its treatment should at once be con- 
fided to the family physician. The evacuations from the bowels 
should be thoroughly disinfected with chloride of lime or 
carbolic acid, that they may not convey the disease to others. 408 
COMMON SENSE MEDICAL ADVISER. 
TYPHUS FEVER. 
Typhus fever is an epidemic and contagious disease, and has 
seldom appeared in America, except in seaport towns. It has 
received many different names, such as " ship fever," " hospital 
fever," "jail fever," and "camp fever." In typhus fever the 
invasion is sudden and the disease runs a rapid course. It is 
usually ushered in with a short chill, followed by severe, frontal 
headache, and pain in the back and limbs, with great muscular 
weakness. No pain is experienced in the abdomen except over 
the liver. The bowels are constipated. The face is flushed, the 
eyes suffused, the countenance dull, and, as the disease progresses, 
the cheeks assume a dusky hue. Between the fifth and eighth 
days, dirty, pink-colored spots, slightly elevated, make their ap- 
pearance on the sides of the abdomen, gradually extending all 
over the anterior portion of the body. Delirium is a common 
symptom. If no complication occurs, the fever runs its course 
in about two weeks. We shall not recommend any treatment 
except that indicated under the general management of fevers, 
but advise the early attendance of the family physician. 
THE ERUPTIVE FEVERS. 
The eruptive fevers are characterized by a rash, or a more 
distinct vesicular or pustular eruption, as in chicken-pox or small- 
pox. Each is due to a distinct specific poison, and all are con- 
tagious except those called rose-rash and erysipelas. 
SCARLET FEVER. (Scarlatina.) 
This fever takes its name from the scarlet color of the eruption 
on the surface of the body. Sometimes it is comparatively mild, 
and is then called Scarlatina Simplex; when it is accompanied 
by a sore throat, it is termed Scarlatina Anginosa; and when 
the disease is of a low, putrid type, it is called Scarlatina Ma- 
ligna. This disease has three distinct stages: (1), the stage of 
invasion; (2), the stage of eruption; and (3), the stage of des- 
quamation. In the first stage there is pain in the head, 
increased heat of the skin, redness and soreness of the throat, 
and sometimes nosebleed, diarrhea, or vomiting. The average 
duration of this stage is twenty-four hours. The eruptive stage SCARLET FEVER. 
409 
generally begins on the second day, though sometimes it is de- 
layed longer, and the scarlet rash rapidly diffuses itself over the 
whole body. The redness is vivid and has been compared to 
the appearance of a boiled lobster. The stage of eruption 
reaches its maximum of intensity on the third day, and it is 
important that it does not recede. Redness of the tonsils and 
throat is one of the early symptoms which precedes any cuta- 
neous eruption. The tongue also is finely spotted with numer- 
ous red points which mark its papillae, presenting an appearance 
which has been compared to that of a strawberry. 
The thirst is urgent, there is no appetite, and vomiting and 
mild delirium are common. This stage continues from four to 
six days, and sometimes longer. Desquamation (scaling off of 
the skin) commences at the decline of the eruption, in the form 
of minute, branny scales. The duration of this stage is indefi- 
nite, and may end in five or six or may continue ten or twelve 
days. 
If the inflammation in the throat is very severe, it may ter- 
minate in an abscess, which may also occur in the glands of the 
neck, and sometimes the inflammation extends to the lips, 
cheeks, and eyelids. Gangrene within the throat occurs in rare 
instances. The disease is easily communicated, and usually 
develops in two to five days after exposure. It occurs most fre- 
quently in the third and fourth years of life. There is no other 
disease so simple, and yet so often liable to prove fatal, as scarlet 
fever; and for this reason we shall advise the attendance of the 
family physician. 
Domestic treatment may be given as follows, until a physician 
can be obtained: Catnip, pennyroyal, or pleurisy-root tea, con- 
taining one teaspoonful of the Extract of Smart-weed, may be 
given, to drive the rash to the surface. Cold drinks are suitable 
to allay the thirst, nausea, and fever. The sick-room should be 
kept at a temperature of about 65° Fahr., and fresh air admit- 
ted freely. The patient ought not to be overloaded with bed- 
clothes; and the skin should be sponged over twice daily with 
tepid water, different parts being exposed successively, and 
carefully dried with soft clothes. Soda may be added to the 
water, but no soap should be used. The diet should consist of 
milk, extract of beef, and soups. Injections may be employed 410 
COMMON SENSE MEDICAL ADVISEE. 
to relieve constipation, but purgatives should be avoided. We 
repeat that this disease is one which requires the attendance of 
the family physician, and great care should be exercised during 
recovery, that no bad results may follow. 
SMALL-POX. (Variola,) 
Small-pox is produced by a specific poison, which is repro- 
duced and multiplied during the progress of the disease. It is 
contained in the pustules, and in the excretions and exhalations 
of affected individuals. It is established after a period of incub- 
ation varying from nine to thirteen days after infection. 
There are two varieties of this disease, known as confluent 
and distinct variola; in the former, the vesicles run together, in 
the latter, they are separate. 
This fever has three stages. The first is that of invasion, 
distinctly marked by a chill or a series of chills, which alternate 
with flushes of heat. In this stage the tongue becomes coated, 
there is also nausea and vomiting, pain in the limbs, back, and 
particularly in the loins, the latter symptom being of diagnostic 
importance. This stage continues about two days, and if the 
symptoms are light, it may be expected that the disease will be 
comparatively mild, and of the distinct variety. 
The stage of eruption.' The eruption begins to appear on the 
skin, generally on the third day following the attack, though in 
the throat and mouth may be discovered round, whitish, or ashy 
spots, several hours previous to the appearance of vesicles on 
the surface of the body. These are first seen on the face and 
neck, then on the trunk and upper extremities, and, lastly, on 
the lower extremities. The eruption at first appears in the form 
of small, red or purple spots, which change the texture of the 
skin by becoming more hard, pointed, and elevated. On the 
fifth day of the eruption they attain their full size, being soft- 
ened and depressed in the center, and hence are called unibili- 
cated. 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 quick- 
ens, the skin becomes hotter, and in many cases of the confluent 
variety, swelling of the face, eyelids, and extremities occurs. 
Frequently there is passive delirium in this stage, and if diarrhea VACCINIA. 
411 
sets in, it is an unfavorable sign. The duration of this stage of 
the eruption is four or live days. 
The stage of desication, or of the drying of the pustules, 
commences between the twelfth and fourteenth day of the 
disease. In the confluent variety, patches of scab cover all 
the space occupied by the eruption, and the skin exhales a 
sickening odor. 
The Treatment should have reference to the determina- 
tion of the eruption to the surface. If there is thirst, allow 
cold drinks, ice-water, or lemonade. Bathing the surface with 
cold water, breathing plenty of fresh air, using disinfectants in 
the room, and taking antiseptic medicine internally, are proper. 
Add one part of carbolic acid to six parts of glycerine, mix 
from two to three drops of this with an ounce of water, and of 
this preparation administer teaspoonful doses frequently. A 
few drops of carbolic acid and glycerine may be rubbed up 
with vaseline, and the surface anointed with it to prevent pit- 
ting. The malady is so grave that it should be intrusted to 
the care of the family physician. 
VARIOLOID. (Modified Small-pox.) 
Varioloid is a modified form of small-pox. There is less 
constitutional disturbance, and very little or no pitting of the 
skin. Varioloid generally occurs in persons who have not 
been fully protected, by vaccination. A person suffering from 
this modification of the disease may, by contagion, communi- 
cate to another genuine small-pox. The treatment is the same 
as that recommended, in variola. 
VACCINIA. (Cow-pox.) 
The important discovery of vaccination is due to Dr. Jenner, 
who ascertained that when the cow was affected by this disease 
and it was then communicated to man, the affection was 
rendered very mild and devoid of danger, and at the same 
time it proved a very complete protection against small-pox. 
Like most other valuable discoveries introduced to the world, 
it encountered bitter prejudice and the most unfair opposition. 
Now its inestimable value is generally known and admitted. 
In a few cases, in which the quality of the vaccine virus was 412 
COMMON SENSE MEDICAL ADVISEE. 
deteriorated, its effect is only to slightly modify small-pox, and 
then the disease resembles that caused by inoculation. The 
operation of infecting the blood with the kine virus is called 
vaccination. All that we know is that when the cow becomes 
affected with this disease, and it is then transferred to man, it 
loses its severity and serves as a protection against small-pox. 
In a great majority of cases this protection is absolute, and only 
in a very few does it leave the subject susceptible to small-pox, 
materially modified. The protection it affords against small- 
pox is found to diminish after the lapse of an indefinite number 
of years, and hence it is important to be re-vaccinated once or 
twice, for instance, after an interval of five years. Between 
the second and third months of infancy is the best period for 
vaccination, and the place usually selected is the middle of the 
arm above the elbow-joint. 
CHICKEN-POX. (Varicella.) 
Chicken-pox is an eruptive disease, which affects children, and 
occasionally adults. It is attended with only slight constitu- 
tional disturbance, and is, therefore, neither a distressing nor 
dangerous affection. The eruption first appears on the body, 
afterwards on the neck, the scalp, and lastly on the face. It 
appears on the second or third day after the attack, and is suc- 
ceeded by vesicles containing a transparent fluid. These begin 
to dry on the fifth, sixth, or seventh day. This disease may be 
distinguished from variola and varioloid by the shortness of 
the period of invasion, the mildness of the symptoms, and the 
absence of the deep, funnel-shaped depression of the vesicles, 
so noticeable in variola. 
Treatment. Ordinarily very little treatment is required. 
It is best to use daily an alkaline bath, and, as a drink, the tea 
of pleurisy-root, catnip, or other diaphoretics, to which may be 
added from one-half to one teaspoonful of the Extract of 
Smart-weed. If the fever runs high, a few drops of aconite in 
water will control it. 
MEASLES. (Rubeola.) 
This is generally a disease of less severity and importance 
than the other eruptive fevers, but it is sometimes followed by ERYSIPELAS. 
413 
serious complications. The stage of invasion is marked by 
the symptoms of a common cold, sneezing, watery eyes, a dis- 
charge from the nostrils, a dry cough, chilliness, and headache. 
This stage may last four days. Then follows an eruption of 
red dots or specks, which momentarily disappear on pressure. 
On the fourth day of the eruption the redness of the skin fades, 
the fever diminishes, and the vesicles dry into scales or little 
flakes. The eyes may be inflamed and the bowels may be quite 
lax at this stage. 
Treatment. The great object in the treatment is to 
bring out the eruption. To effect this, sweating teas are 
beneficial. The free use of the Extract of Smart-weed is 
recommended, and the skin should be bathed every day with 
tepid water. Sometimes when warm drinks fail to bring out 
the eruption, drinking freely of cold water and keeping warmly 
covered in bed, will accomplish the desired result. 
False Measles Hash) is an affection of very little 
importance and may be treated similarly to a case of ordinary 
measles. 
ERYSIPELAS. 
There are few adult persons in this country who have not, by 
observation or experience, become somewhat familiar with this 
disease. Its manifestations are both constitutional and local, 
and their intensity varies exceedingly in different cases. The 
constitutional symptoms are usually the first to appear, and are 
of a febrile character. A distinct chill, attended by nausea and 
general derangement of the stomach is experienced, followed by 
febrile symptoms more or less severe. There are wandering 
pains in the body and sometimes a passive delirium exists. 
Simultaneously with these symptoms the local manifestations of 
the disease appear. A red spot develops on the face, the ear, 
or other part of the person. Its boundary is clearly marked 
and the affected portion slightly raised above the surrounding 
surface. It is characterized by a burning pain and is very 
sensitive to the touch. It is not necessary for the benefit of the 
popular reader that we should draw a distinction between the 
different varieties of this malady. The distinctions made are 
founded chiefly upon the depth to which the morbid condition 
extends, and not on any difference in the nature of the affection. 414 
COMMON SENSE MEDICAL ADVISER. 
Suppuration of the tissues involved is common in the severer 
forms. Should the tongue become dark and diarrhea set in, 
attended with great prostration, the case is very serious, and 
energetic means must be employed to save life. A retrocession 
of the inflammation from the surface to a vital organ is an 
extremely dangerous symptom. 
The disease is not regarded as contagious, but has been known 
to become epidemic. 
Treatment. The treatment during the initial stage of 
this disease should correspond with tlm general principles laid 
down for the treatment of fever. The spirit vapor-bath, with 
warm, diaphoretic teas, or the Compound Extract of Smart- 
weed may be given to favor sweating. The whole person 
should be frequently bathed in warm water rendered alkaline 
by the addition of saleratus or soda. The bowels should be 
moved by a full dose of the Purgative Pellets. Fluid extract 
of aconite in small and frequent doses, will best control the 
fever. The specific treatment, which should not be omitted, 
consists in administering doses of ten drops of the tincture of 
the muriate of iron in alternation with teaspoonful doses of the 
Golden Medical Discovery, every three hours. As a local 
application, the inflamed surface may be covered with cloths 
wet in the mucilage of slippery elm. Equal parts of sweet oil 
and spirits of turpentine, mixed and painted over the surface, is 
an application of unsurpassed efficacy. 
DIPHTHERIA. 
This is an exceedingly grave, constitutional disease charac- 
terized by a rapid breaking down of the powers of life, together 
with a peculiar affection of the throat, in which a disposition 
to the formation of false membranes is a prominent feature. 
The formation of these membranes, however, is not limited to 
the throat, but may occur on mucous surfaces elsewhere. In 
this disease the local affection is but the expression of a specific, 
morbid condition of the system, which closely resembles that 
present in the severer forms of scarlet fever. 
Cause. This is an epidemic disease, and, like other epi- 
demics, has its special causes, though precisely what these are, 
has not been determined. It is also considered contagious. diphtheria. 
415 
Symptoms. The symptoms vary in different cases. In 
some the disease comes on gradually, while in others it is 
malignant from the first. The throat feels sore, the neck is 
stiff and a sense of languor, lassitude, and exhaustion pervades 
the system. Sometimes a chill is experienced at the outset. 
Febrile disturbance, generally of a low, typhoid character, soon 
manifests itself. The skin is hot; there is intense thirst; the 
pulse is quick and feeble, ranging from 120 to 150 per minute. 
The tongue is generally loaded with a dirty coat, or it may be 
bright red. The odor of the breath is characteristic, and pecul- 
iarly offensive, and there is difficulty in swallowing and some- 
times in breathing. Vomiting is sometimes persistent. If we 
examine the throat, we find more or less swelling of the tonsils 
and surrounding parts, which are generally bright red, and 
shining, and covered with a profuse, glairy, tenacious secretion. 
Sometimes the parts are of a dusky, livid hue, and, in rare 
instances, pallid. The false membrane, a peculiar tough ex- 
udation, soon appears and may be seen in patches, large or 
small, or covering the entire surface from the gums back as far 
as can be seen, its color varying from a whitish yellow to a gray 
or dark ashen tint. When it is thrown off, it sometimes leaves 
a foul, ulcerating surface beneath. The prostration soon 
becomes extreme, and small, livid spots may appear on the 
surface of the body. There may be delirium, which is, in fatal 
cases, succeeded by stupor, or coma. The extremities become 
cold; diarrhea, and in some cases convulsions, indicate the 
approach of death. Sometimes the patient dies before the 
false membrane forms. 
Treatment. The extremely dangerous character of this 
disease demands that the services of a skillful physician be 
obtained at once; and that his efforts should be aided by the 
most thorough hygienic precautions, good ventilation, bathing, 
and a supporting diet. Prior to the arrival of the physician, 
lose no time in using the spirit vapor-bath and hot foot-bath. 
If the former is impracticable, the latter is not. Get the 
patient into a prespiration, and maintain it. For this purpose, 
small doses of the Compound Extract of Smart-weed may be 
given in some diaphoretic infusion, as pleurisy-root or catnip, 
repeated as often as the case demands. Control the vomiting 416 
COMMON SENSE MEDICAL ADVISER. 
and allay the thirst by allowing the patient to suck small pieces 
of ice every five or ten minutes. Hot fomentations or spirits 
of turpentine should be applied to the throat. If the physician 
does not take charge of the patient by this time, the throat 
should be swabbed out with the following mixture: chlorate 
of potash, four drachms; tincture of muriate of iron, three 
drachms; syrup of orange, two oz.; water sufficient to make 
four oz.; and two teaspoonfuls of it administered every two or 
three hours. No drinks should be allowed the patient for a few 
minutes after each dose, in order that the full local effect may 
be obtained. Inhaling steam from water to which a few drops 
of the oil of peppermint has been added, is often serviceable, 
although some practitioners regard the vapor of alcohol or 
limewater inhalations as preferable. The use of blisters, 
caustics, active purges, mercurials, or bleeding, should be con- 
demned. Throughout the whole course of the disease the 
strength must be supported by the most nourishing diet, as well 
as by tonics and stimulants. Beef tea, milk, milk punch, 
quinine, and brandy should be freely administered. Although 
we have given a very complete course of treatment, and one 
which has proved eminently successful in this disease, yet we 
would not advise any non-professiona> person to rely upon any 
course of treatment not under the observation and direction 
of a competent physician, when one can be had. 
QUINSY. (Tonsillitis.) 
This is an acute inflammation of the tonsils, which generally 
extends to, and involves adjacent structures, and is attended 
with general febrile disturbance. Its duration varies from four 
to twenty days. It sometimes terminates by a gradual return to 
health (resolution); or by the formation of "matter" within the 
gland (suppuration.) When this latter is the case, the swelling 
sometimes becomes so great before it breaks as to require 
lancing. 
Causes. It most frequently results from a cold. In some 
persons there is a predisposition to it, and the individual is 
liable to recurring attacks. Persons of a scrofulous diathesis 
are more liable to it than others. 
Symptoms. Difficulty of swallowing, soreness, and stiffness ENLARGED TONSILS. 
417 
of the throat, are the first monitions of its approach. There 
is fever, quick, full pulse, and dryness of the skin; the tongue 
is furred, and the breath offensive. The tonsils are intensely 
red, swollen, and painful, the pain often extending to the ear. 
Sometimes but one tonsil is affected, though generally both are 
involved. In severe cases the patient cannot lie down, in conse- 
quence of the difficulty of breathing. 
Treatment. In the early stage of the disease, the spirit 
vapor-bath is invaluable. The sweating which it produces 
should be kept up by the use of the Compound Extract of 
Smart-weed in some diaphoretic infusion. Hot wet-packs to 
the throat, covered with dry cloths, are useful. The inhalation 
of the hot vapor of water or vinegar, or peppermint and water, 
is beneficial. A carthartic should be given at night. When 
the disease does not show a disposition to yield to this treat- 
ment, the services of a physician should be obtained. When 
pus, or "matter," is formed in the tonsil, which may be known 
by the increased swelling and the appearance of a yellow- 
ish spot, the services of a physician will be required to 
lance it. 
ENLARGED TONSILS. 
Chronic enlargement of the tonsils, as shown in Fig. 147, 
A A, is an exceedingly common 
affection. It is most common to 
those of a scrofulous habit. It 
rarely makes its appearance after 
the thirtieth year, unless it has 
existed in earlier life, and has been 
imperfectly cured. Both tonsils 
are generally, though unequally 
enlarged. A person affected with 
this disease is extremely liable to 
sore throat, and contracts it on 
the slightest exposure; the con- 
traction of a cold, suppression of 
perspiration, or derangement of 
the digestive apparatus being sufficient to provoke inflam- 
mation. 
Fig. IJfl. 
-4 A.-Enlarged Tonsils. B.-Elon- 
gated Uvula. 418 
COMMON SENSE MEDICAL ADVISER. 
Causes. Repeated attacks of quinsy, scarlet fever, diph- 
theria, or scrofula, and general impairment of the system, 
predispose the individual to this disease. 
Symptoms. The voice is often husky, nasal or guttural, 
and disagreeable. When the patient, sleeps, a low moaning is 
heard, accompanied with snoring and stentorian breathing, and 
the head is thrown back so as to bring the mouth on a line with 
the windpipe, and thus facilitate the ingress of air into the 
lungs. When the affection becomes serious, it interferes with 
breathing and swallowing. The chest is liable to become flat- 
tened in front and arched behind, in consequence of the difficulty 
of respiration, thus predisposing the patient to pulmonary dis- 
ease. On looking into the throat, the enlarged tonsils may be 
seen, as in the figure. Sometimes they are so greatly increased 
in size that they touch each other. 
Treatment. The indications to be carried out in the cure 
of this malady are: 
(1.) To remedy the constitutional derangement. 
(2.) To remove the enlargement of the tonsil glands. * 
The successful fulfillment of the first indication may be readily 
accomplished by attention to hygiene, diet, clothing, and the use 
of the Golden Medical Discovery, together with small daily 
doses of the Pleasant Purgative Pellets. This treatment should 
be persevered in for a considerable length of time after the en- 
largement has disappeared, to prevent a return. 
To fulfill the second indication, astringent gargles may be 
used. Infusions of witch-hazel or cranesbill should be used 
during the day. The following mixture is unsurpassed : iodine, 
one drachm; iodide of potash, four drachms; pure, soft water, 
two ounces. Apply this preparation to the enlarged tonsils 
twice a day, with a probang, or soft swab, being careful to paint 
them each time. A persevering use of these remedies, both 
internal and local, is necessary to reduce and restore the parts 
to a healthy condition. 
Sometimes the enlarged tonsils undergo calcareous degenera- 
tion; in this case, nothing but their removal by a surgical opera- 
tion is effectual. This can be readily accomplished by any 
competent surgeon. We have operated in a large number of 
cases, and have never met with any unfavorable results. ANAEMIA. 
419 
Chronic enlargement or elongation of the uvula, or palate, as 
shown at b, Fig. 147, may arise from the same causes as enlarge- 
ment of the tonsils. It subjects the individual to a great deal 
of annoyance by dropping into and irritating the throat. It 
causes tickling and frequent desire to clear the throat, change, 
weakness, or entire loss of voice, and difficulty of breathing, 
frequently giving rise to the most persistent and aggravating 
cough. 
Treatment. The treatment already laid down for en- 
larged tonsils, with which affection, elongation of the uvula is 
so often associated, is generally effectual. When it has existed 
for a long time and does not yield to this treatment, it may 
be removed by any competent surgeon. 
ELONGATION OF THE UVULA. 
ANAEMIA. 
When the blood contains less than the ordinary number of red 
corpuscles, the condition is known as anosmia, and is char- 
acterized by every sign of debility. A copious hemorrhage, in 
consequence of a cut, or other serious injury, will lessen the 
quantity of blood and may produce anaemia. After sudden 
blood-letting, the volume of the circulation is quickly restored 
by absorption of fluid, but the red corpuscles- cannot be so 
readily replaced, so that the blood is poorer by being more 
watery. This is only one way in which the blood is impover- 
ished. 
The blood may be exhausted by a drain upon the system, in 
consequence of hard and prolonged study. Severe mental em- 
ployment consumes the red corpuscles, leaving the blood thin, 
the skin cool and pale, and the extremities moist and cold. 
Anaemia may arise from lack of exercise, or it may be occa- 
sioned by mental depression, anxiety, disappointment, trouble, 
acute excitement of the emotions or passions, spinal irritation; 
in fact, there are many special relations existing between the 
red corpuscles of the blood and the various states of the mind 
and the nervous system. The latter depends directly upon the 
health and quantity of these red corpuscles for its ability to 
execute its functions. 420 
COMMON SENSE MEDICAL ADVISER 
Anaemia may arise in consequence of low diet, or because the 
alimentary organs do not properly digest the food, or when 
there is not sufficient variety in the diet. No matter how anaemia 
is occasioned, whether by labor and expenditure, by hemor- 
rhages, lead poisoning, prolonged exposure to miasmatic influ- 
ences, deprivation of food, indigestion, imperfect assimilation, 
frequent child-bearing, or lactation, the number of the red cor- 
puscles in the blood is materially diminished. 
The diagnostic symptoms of anaemia are pallor of the face, 
lips, tongue, and general surface, weakness of the vital organs, 
hurried respiration on slight exercise, swelling or puffiness of the 
eyes, and a murmur of the heart, resembling the sound of a 
bellows. 
This disorder of the blood tends to develop low inflammation, 
dropsical effusion, tubercular deposits, Bright's disease, derange- 
ments of the liver, diarrhea, leucorrhea, and is a precursor of 
low, protracted fevers. This condition of the blood predisposes 
to the development of other affections, providing they are in ex- 
istence, and often it is found associated with Bright's disease, 
cancer, and lung difficulties. 
Treatment. (1.) Prevent all unnecessary waste and vital 
expenditure. 
(2.) Place the patient under favorable circumstances for re- 
covery, by regulating the exercise and clothing entertaining the 
mind, and furnishing plenty of pure air. 
(3.) Prescribe such a nutritious diet as will agree with the 
enfeebled condition of the patient. 
(4.) Regular habits should be established in regard to meals, 
exercise, recreation, rest, and sleep. 
(5.) The use of tonics and stimulants, as much as the stomach 
will bear, should be encouraged. Bathe the surface with a solu- 
tion of a drachm of quinine in a pint of whisky. 
(6.) Iron, in some form, is the special internal remedy in 
anaemia. Meantime, it is proper to treat the patient with gentle, 
manual friction, rubbing the surface of the body lightly and 
briskly with the warm, dry hand, which greatly stimulates the 
circulation of the blood. Anaemia occurs more frequently in 
the female than in the male, because her functions and duties 
are more likely to give rise to it. LEUCOCYTHjEMIA. 
421 
APNCEA. 
Apnoea, or short, hurried, difficult respiration, is occasioned by 
certain conditions of the blood. When anything interferes with 
the absorption of oxygen, or the elimination of carbonic acid, 
the blood is not changed from venous to arterial, and becomes 
incapable of sustaining life. This morbid condition is termed 
asphyxia. We often read of persons going into wells where 
there are noxious gases, or remaining in a close room where 
there are live coals generating carbonic acid gas and thus be- 
coming asphyxiated, dying for want of oxygen. 
Deficiency of oxygen is the cause of apnoea, and sometimes 
the red corpuscles themselves are so few, worn out, or destroyed, 
that they cannot carry sufficient oxygen, and the consequence is 
that the patient becomes short of breath, and when a fatal de- 
generation of the corpuscles ensues, he dies of asphyxia. Many 
a child grows thin and wan and continues to waste away, the 
parents little dreaming that the slow consumption of the red 
corpuscles of the blood is the cause which is undermining the 
health. Sometimes this disease is the result of starvation, 
irregular feeding, improper diet, want of care, and, at other 
times, want of fresh air, proper exercise, and sunlight. 
Treatment. The first essential to success in the treat- 
ment of this disease, is the removal of the exciting cause. Exer- 
cise in the outdoor air and sunlight, with good, nutritious food, 
and well-ventilated sleeping apartments, are of the greatest 
importance. The bitter tonics, as hydrastin, with pyrophosphate 
of iron, should be employed to enrich the blood and build up 
the strength. 
LEUCOCYTEDEMIA. 
This term is used to designate a condition in which there is 
an excess of colorless blood-corpuscles. In health, the colorless 
corpuscles should exist only in the proportion of one, to one or 
two hundred of the red corpuscles. These colorless corpuscles 
increase when there is disease of the lymphatic glands, but 
whether this is the cause of their increase or perversion is not 
known. 
They have been found abundant in the blood in diseases of 
the spleen and of the liver. Diarrhea usually attends this 422 
COMMON SENSE MEDICAL ADVISEE., 
complaint, together with difficult breathing, loss of strength, 
gradual decline, fever, diminution of vital forces, and finally 
death. The recovery of a well-marked case of this disease is 
very doubtful. Its average duration is about one year. 
Transudation is the passage of fluid through the tissue of any 
part of the body without changing its liquid state, while exuda- 
tion means, medically, the passage of matter which coagulates 
and gives rise to solid deposits. When transudations are un- 
healthy, they may accumulate in serous cavities or in cellular 
structures, and constitute dropsy. Exudation is the result of 
inflammation, and the product effused coagulates and becomes 
the seat of a new growth of tissue. Exosmosis means the pas- 
sage of fluid from within outward, and is a process constantly 
taking place in health; while transudation takes place because 
the blood is watery and the tissues are feeble and permeable, 
permitting the serum and watery elements of the blood to pass 
into certain cavities, where they accumulate. 
The cause of dropsies may be low diet, insufficient exercise, 
indigestion, hemorrhages, wasting diseases, in fact, any thing 
which impoverishes the blood and increases the relative amount 
of serum. The tardy circulation of blood in the veins, or its 
obstruction in any way, is a condition highly favorable to the 
development of dropsy. 
General dropsy is called anasarca, and is readily distinguished 
by bloating or puffiness of the skin all over the body. This 
condition is also called oedema. The skin is pale, yields under 
the finger without pain, and preserves the impression for some 
time. The oedema usually appears first in the lower extremities, 
next in the face, and from thence extends over the body. 
General dropsy is commonly due to an impoverished condition 
of the blood, and this may be the result of albuminuria, a dis- 
ease of the kidneys. Albuminuria is frequently the sequel of 
scarlatina. Hence, the utmost care should be taken against 
exposure of a patient recovering from scarlatina, and the same 
caution should be exercised during convalescence from measles, 
erysipelas, and rheumatism. Dropsies may be general, as in 
anasarca, or local, as dropsy of the heart, called cardiac dropsy; 
DROPSIES. DROPSIES. 
423 
dropsy of the peritoneum, the serous membrane which lines the 
abdominal cavity, called ascites; dropsy of the chest, called 
hydrothorax; dropsy of the head, called hydrocephalus; dropsy 
of the scrotum, called hydrocele. 
Dropsy is not, therefore, of itself a disease, but only the 
symptom of a morbid condition of the blood, kidneys, liver, 
or heart. Thus disease of the valves of the heart, may obstruct 
the free flow of blood and thus retard its circulution. In con- 
sequence the pulse grows small and weak, and the patient cannot 
exercise or labor as usual, and finally the lower limbs begin 
to swell, then the face and body, the skin looks dusky, the 
appetite is impaired, the kidneys become diseased, there is 
difficulty in breathing, and the patient, it is said, dies of dropsy, 
yet dropsy was the result of a disease of the heart, which 
retarded the circulation and enfeebled the system, and which 
was actually the primary cause of death. 
Treatment. Dropsy being only a symptom of various 
morbid conditions existing in the system, any treatment to be 
radically beneficial must, therefore, have reference to the dis- 
eased conditions upon which the dropsical effusion, in each 
individual case, depends. These are so various, and frequently 
so obscure, as to require the best diagnostic skill possessed by 
the experienced specialist, to detect them. There are, however, 
a few general principles which are applicable to the treatment 
of nearly all cases of dropsy. Nutritious diet, frequent alkaline 
baths to keep the skin in good condition and favor excretion 
through its pores, and a general hygienic regulation of the daily 
habits, are of the greatest importance. There are also a few 
general remedies which may prove more or less beneficial in 
nearly all cases. We refer to diuretics and hydragogue cathar- 
tics. The object sought in the administration of these is the 
evacuation of the accumulated fluids through the kidneys and 
bowels, thus giving relief. Of the diuretics, queen of the 
meadow, buchu, and digitalis generally operate well. As a 
cathartic, the Purgative Pellets accompanied with a teaspoonful 
or two of cream of tartar, will prove serviceable. Beyond 
these general principles of treatment it would be useless for 
us to attempt to advise the invalid suffering from any one of 
the many forms of dropsy. The specialist skilled by large 424 
COMMON SENSE MEDICAL ADVISER. 
experience in detecting the exact morbid condition which causes 
the watery effusion and accumulation, can select his remedies to 
meet the peculiar indications presented by each individual case. 
Sometimes the removal of the watery accumulation by tapping 
becomes necessary, in order to afford relief and give time for 
remedies to act. We have found it necessary to perform this 
operation very frequently in cases of hydrocele, and also quite 
often in cases of abdominal dropsy. The chest has also been 
tapped and considerable quantities of fluids drawn off, and this 
has been followed by prompt improvement and a final cure. 
CASES TREATED. 
Case I. A Canadian gentleman, aged 68, applied at the Invalids' 
Hotel and Surgical Institute, for examination and treatment. He had 
been dropsical for over two years, and had become so badly affected as 
to be unable to lie down at night. His legs were so filled with water 
and enlarged as to render it almost impossible for him to walk, and 
there was a general anasarca. The least exertion was attended with 
the greatest difficulty of breathing. He had been under the treatment 
of several eminent general practitioners of medicine in Canada but 
found no relief. They were unable to discover the real cause of his 
ailment, but to the specialist who has charge of this class of diseases at 
our institution, and who annually examines and treats hundreds of 
such cases, it was at once apparent that the dropsy was caused from a 
weakened condition of the heart, which rendered it unable to perform 
its functions. He was put upon a tonic and alterative course of treat- 
ment, which also embraced the use of such medicines as have been 
found to exert a specific, tonic action upon the ifauscular 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 disap- 
peared, 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 grad- 
ually 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 RHEUM A.TISM. 
425 
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 lie could conceal the deformity 
from general observation. The disease was immediately recognized by 
the attending surgeon as hydrocele. The liquid was promptly drawn 
off 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 wdiich we 
have had to deal with, have been those which had been subjected by 
other physicians to the administration of strong emmenagogues in the 
vain effort to bring on the menses. 
RHEUMATISM. 
Prominent among constitutional diseases is the one known as 
rheumatism. It is characterized by certain local symptoms or 
manifestations in fibrous tissues. This term has been applied 
to neuralgic affections and to gout, but it differs from each in 
several essential particulars. Rheumatism may be divided into 
(1) Acute, (2) Chronic, (3) Muscular. 
Acute Articular Rheumatism. Acute articular 
rheumatism implies an affection of the articulations or joints. 
It usually commences suddenly; sometimes pain or soreness 
in the joints precedes the disclosure of the disease. The 
symptoms are pain in the joints, tenderness, increased heat, 
swelling and redness of the "skin. The pain varies in its 
intensity in different cases, and is increased by the movement of 
the affected parts. Swelling of the joints occurs, especially 
those of the knee, ankle, wrist, elbow, and the smaller joints of 
the hands and feet. The swelling and redness are generally in 426 
COMMON SENSE MEDICAL ADVISER. 
proportion to the acuteness of the attack. Acute articular rheu- 
matism is always accompanied with more or less fever. Sweat- 
ing is generally a prominent symptom, being strongly acid and 
more profuse during the night. The appetite is impaired, the. 
tongue is coated, the bowels are constipated, or there is diarrhea. 
The Duration ot* this Disease. Unlike fevers, its 
course is marked by fluctuations; frequently after a few days 
the pain subsides, the fever disappears, and convalescence js 
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 oc- 
casioned by a suppression of the functions of the skin, and is 
generally attributed to the action of cold upon the surface of 
the body. But this acts only as an exciting cause. It is a 
disease of the blood. This form of rheumatism usually occurs 
between the age of fifteen and thirty, and prevails most exten- 
sively in changeable climates. Acute articular rheumatism 
seldom terminates in the chronic form. 
Chronic Articular Rheumatism. Articular rheu- 
matism, in the subacute or chronic form, is frequently observed 
in medical practice. The symptoms are pain and more or 
less swelling of the joints, although not of as grave a character 
as in acute rheumatism. There is frequently an absence of 
increased heat and redness. As in the acute form, the differ- 
ent joints are liable to be affected successively and irregularly, 
until, after a time, the disease becomes fixed in a single joint, 
and the fibrous tissues entering into the ligaments and tendons 
are liable to be affected. The appetite, digestion, and nutrition 
are often good, and, in mild cases, patients are able to pursue 
their daily vocations. The disease is supposed to be the same 
as in the acute form, but milder, and, strange to say, more per- 
sistent. A diseased condition of the blood is supposed to be 
involved in both instances, but this morbid state is less extended, 
and, at the same time, more obstinate in the chronic than in 
the acute form. Subacute articular rheumatism is not always 
chronic, and may disappear in a shorter time than in the acute 
form. Chronic articular rheumatism is not generally fatal, but 
there is danger of permanent deformities. RHEUMATISM. 
427 
Muscular Rheumatism. This affection is closely 
allied to neuralgia, and may properly be called myalgia. It 
exists under two forms, acute and chronic. In acute muscular 
rheumatism, there is at first a dull pain in the muscles, which 
gradually increases. When the affected muscles are not used 
the pain is slight, and certain positions may be assumed with- 
out inducing it constantly; but in movements which involve 
contraction of the muscles the pain is very violent. In some 
cases, the disease is movable, changing from one muscle to 
another, but usually it remains fixed in the muscle first attacked. 
The appetite and digestion are not often impaired, and there 
is no fever. The duration of this form of rheumatism varies 
from a few hours to a week or more. 
In subacute or chronic muscular rheumatism, pain is excited 
only when the affected muscles are contracted with unusual 
force, and then it is similar to that experienced in the acute 
form. The chronic form is more apt to change its position 
than the acute. The duration of this form is indefinite. In 
both the acute and chronic forms some particular parts of the 
body are more subject to the affection than others. 
The muscles on the posterior part of the neck are subject to 
rheumatic affection. It is termed torticollis or cervical rheuma- 
tism in such cases, and should be distinguished from ordinary 
neuralgia. When the muscles of the loins are affected, it is 
commonly known as lumbago. In case the thoracic muscles 
are affected, it is known as pleurodynia. In coughing, sneezing, 
and the like, the pain produced is not unlike that in pleuritis 
and intercostal neuralgia. 
One of the most marked features of muscular rheumatism, 
is the cramp-like pain, induced by the movements of the 
affected muscles, whereas the pain is slight when those muscles 
are uncontracted. This feature is very serviceable in dis- 
tinguishing muscular rheumatism, or myalgia, from neural- 
gic affections. Another trait which distinguishes muscular 
rheumatism from neuralgia, is that the former is characterized 
by great soreness, while the latter is not. There is also a dis- 
tinction between inflammation of the muscles and muscular 
rheumatism. In the case of the former, there is continued pain, 
swelling of the parts, occasional redness, and the presence of 428 
COMMON SENSE MEDICAL ADVISER, 
more or less fever, which conditions do not exist in the latter. 
Persons subject to rheumatism of the muscles, are apt to suffer 
from an attack, after exposure of the body to a draught of 
air during sleep, or when in a state of perspiration. 
Treatment of Acute Rheumatism. Administer the 
spirit vapor-bath to produce free perspiration, which should be 
maintained by full doses of the Compound Extract of Smart- 
weed. The anodyne properties of the latter also prove very 
valuable in allaying the pain. Tincture or fluid extract of 
aconite root may also be employed, to assist in equalizing the 
circulation, and also to secure its anodyne action. Black co- 
hosh seems to exert a specific and salutary influence in this 
disease, and the tincture or fluid extract of the root of this 
plant may be advantageously combined with the aconite. Take 
fluid extract of aconite-root, thirty drops; fluid extract of black 
cohosh, one drachm; water, fifteen teaspoonfuls; mix. The 
dose is one teaspoonful every hour. The whole person should 
be frequently bathed with warm water, rendered alkaline by 
the addition of saleratus or soda. The painful joints may be 
packed with wool or with cloths wrung from the hot saleratus 
water, and the patient kept warm and quiet in bed. The 
acetate of potash taken in doses of five grains, well diluted 
with water, every three or four hours, is very valuable in acute 
rheumatism. Its alkaline qualities tend to neutralize the acid 
condition of the fluids of the system, and it also possesses diur- 
etic properties which act upon the kidneys, removing the offend- 
ing blood-poison from the system through these organs. If the 
joints are very painful, cloths wet with the Compound Extract 
of Smart-weed and applied to them, and covered with hot 
fomentations, very frequently relieve the suffering. The major- 
ity of cases yield quite promptly to the course of treatment 
already advised, if it is persevered in. The disease, however, 
sometimes proves obstinate and resists for many days the best 
treatment yet known to the medical profession. 
Treatment of Chronic Rheumatism. The gen- 
eral alkaline baths recommended in the acute affection are also 
valuable in the chronic. The spirit vapor-bath, the Turkish, as 
well as the sulphur vapor-bath, are all worthy of a trial in this 
obstinate and painful disease. Alteratives are a very valuable RHEUMATISM. 
429 
class of agents in chronic rheumatism. The following mixture, 
in teaspoonful doses three times a day, in alternation with the 
Golden Medical Discovery, has proved very successful in this 
disease: acetate of potash, one ounce; fluid extract of black 
cohosh, one ounce; fluid extract of poison hemlock, two drachms; 
simple syrup, six ounces. This thorough alterative course, if 
well persevered in, together with the use of alkaline and vapor- 
baths, will generally prove very successful. The specialist, 
however, dealing with chronic diseases exclusively, will occa- 
sionally meet with a case which has been the rounds of the home 
physicians without benefit, that will tax his skill and require the 
exercise of all his perceptive faculties to determine the exact 
condition of the patient's system, upon which the obstinacy of 
the disease depends. When this is ascertained, the remedies 
will naturally suggest themselves, and the malady will generally 
yield to them. But, although the treatment of this disease has 
entered largely into our practice at the Invalid's Hotel, and has 
been attended by the most happy results, yet the cases have 
presented so great a diversity of abnormal features, and have re- 
quired so many variations in the course of treatment, to be 
met successfully, that we frankly acknowledge our inability to 
so instruct the unprofessional reader as to enable him to detect 
the various systemic faults common to this ever-varying dis- 
ease, and adjust remedies to them, so as to make the treatment 
uniformly successful. If the several plans of treatment which 
we have given do not conquer the disease, we can not better 
advise the invalid than to recommend him to employ a physician 
of well-known skill in the treatment of chronic diseases. If 
such a one is not accessible for personal consultation, a careful 
statement of all the prominent symptoms, in writing, may be 
forwarded to a specialist of large experience in this disease, who 
will readily detect the real fault, in which the ailment has its 
foundation. Particularly easy will it be for him to do so, if he 
be an expert in the analysis of urine. A vial of that which is 
first passed in the morning, should be sent with the history of 
the case, as chronic rheumatism effects characteristic changes 
in this excretion, which clearly and unmistakably indicate the 
abnormal condition of the fluids of the body upon which the 
disease depends. COMMON SENSE MEDICAL ADVISEE. 
430 
GOUT. 
Gout is closely allied to rheumatism, and the two, by some 
authors, have been regarded as identical. They, however, show 
distinct points of contrast, and each affection should have a 
separate place in the catalogue of diseases. Rheumatism 
usually affects the larger joints, while gout attacks the smaller 
ones, for example, the toes. The cause of this disease is an im- 
moderate use of stimulating food and drinks. Plethoric persons 
are its most frequent victims. 
The distinguishing characteristic of gout is a morbid deposit 
within and around the joints. When recent, the deposit is a 
semi-solid, cream-colored substance, resembling mortar. By the 
aid of the microscope, needle-shaped crystals are seen to have 
formed around the joint. At length these become hardened 
into masses, assume a chalk-like appearance, and are supposed to 
be salts of soda, which are deposited here instead of being 
naturally expelled from the system through the kidneys. These 
deposits occur in gout, are peculiar to it, and to no other 
disease. Gout may appear in three forms: Acute, Chronic, 
and Retrocedent. 
Acute Gout. This form of the disease is usually sudden, 
occurring in the night, and is of short duration. The attack is 
marked by pain, which is generally in one of the great toes, 
Often the disease is extended from the toe to the heel, ankle, 
and larger joints. Its duration varies from a few days to 
several weeks. 
Chronic Gout. In this form, the pain, heat, and redness, 
which characterize the acute form of the affection, are very 
slight or entirely wanting. The chalky concretions are deposited 
about the joints, and sometimes make their way through the 
skin. In some cases, patients become crippled and deformed. 
Retrocedent Gout. This is a form in which the affection is 
transferred from the external parts to some internal organ, as 
the stomach, intestines, lungs, or brain. It is sometimes, though 
seldom, transferred to the heart. 
Treatment. The purpose of the treatment is to rid the 
blood of uric acid, and to render this acid more soluble, alkaline 
remedies are given. The bicarbonate of potash is one of the SCROFULA. 
431 
best. In place of this, ten grains of phosphate of ammonia, or 
the urate of lithia, in five-grain doses, may be given three times 
a day. In other respects, the treatment of this affection is 
similar to that suggested for rheumatism. Colchicum has been 
largely employed as a remedy for gout, and is frequently fol- 
lowed by good results. It excites the kidneys to action and 
thus removes the blood-poison from the system through these 
excretory organs. The wine of colchicum may be taken in one- 
half teaspoonful doses three times a day. 
SCROFULA. 
It is estimated that about one-fifth of the human family are 
afflicted with scrofula. A disease so prevalent and so destructive 
to life, should enlist universal attention and the best efforts of 
medical men, in devising the most successful treatment for its 
cure. It varies in the intensity of its manifestation, from the 
slightest eruption upon the skin (scrofulous eczema), to that 
most fatal of maladies, pulmonary consumption. 
The Scrofulous Diathesis. The existence of a certain 
disposition or habit of body, designated as the scrofulous or stru- 
mous diathesis, cachexia, or dyscrasia, is generally recognized 
by medical practitioners and writers as a constitutional condition 
predisposing many children to the development of this disease. 
Enlargement of the head and abdomen, fair, soft, and trans- 
parent, or dark, sallow, greasy or waxy-looking skin, and preco- 
cious intellect are supposed to indicate this diathesis. 
The characteristic feature of this disease, in all the multi- 
farious forms that it assumes, is the formation of tubercle, 
which, when the malady is fully developed, is an ever-present 
and distinguishing* element. 
Tuberculous is therefore almost synonymous with scrofulous, 
and to facilitate an acquaintance with a large list of very preva- 
lent maladies, we may generalize, and classify them all under this 
generic term. As tubercle will frequently be spoken of, playing, 
as it does, a conspicuous part in an important list of diseases, 
which will hereafter be considered, the reader will naturally be 
led to inquire: 
What is Tubercle ? As employed in pathology, the 
term is usually applied.to " a species of degeneration, or morbid 432 
COMMON SENSE MEDICAL ADVISER. 
development of an opaque matter of a pale yellow color, hav- 
ing, in its crude condition, a consistence analogous to that of 
concrete albumen." The physical properties of tubercle are not 
uniform, however. They vary with age and other circum- 
stances. Some are hard and calcareous, while others are soft 
and pus-like. The color varies from a light yellow, or almost 
white, to a dark gray. 
It is almost wholly composed of albumen united with a small 
amount of earthy salts, as phosphate and carbonate of lime, with 
a trace of the soluble salts of soda. 
The existence of tubercular deposits in the tissues of the body, 
which characterizes scrofula, when fully developed, must not, 
however, be regarded as the primary affection. Its formation is 
the result of disordered nutrition. The products of digestion 
are not fully elaborated, and pass into the blood imperfected, 
in which condition they are unable to fulfill their normal destiny 
-the repair of the bodily tissues. Imperfectly formed album- 
inous matter oozes out from the blood and infiltrates the tissues, 
but it has little tendency to take on cell-forms, or undergo the 
vital transformation essential to becoming a part of the tissues. 
Instead of nutritive energy, which by assimilation produces 
perfect bodily textures, this function, in the scrofulous diathesis, 
is deranged by debility, and there is left in the tissues an imper- 
fectly organized particle, incapable of undergoing a complete 
vital change, around which cluster other particles of tubercular 
matter, forming little grains, like millet seed, or growing, by 
new accretions of like particles, to masses of more extensive 
size. As tubercle is but a semi-organized substance, of deficient 
vitality, it is very prone to disintegration and suppuration. 
Being foreign to the tissues in which it is embedded, like a thorn 
in the flesh, it excites a passive form of inflammation, and from 
lack of inherent vital energy it is apt to decompose and cause 
the formation of pus. Hence, infiltration of the muscles, glands, 
or other soft parts with tuberculous matter, when inflammation 
is aroused by its presence, and by an exciting cause, give rise to 
abscesses, as in lumbar or psoas abscesses. When occurring in 
the joints, tubercles may give rise to chronic suppurative inflam- 
mation, as in white s'wellings and hip-joint disease. Various 
skin diseases are regarded as local expressions of, or as being SCROFULA. 
433 
materially modified by, the scrofulous diathesis, as eczema, im- 
petigo, and lupus. The disease popularly known as "fever-sore " 
is another form of scrofulous manifestation, affecting the shafts 
of the bones, and causing disorganization and decay of their 
structure. Discharges from the ear, bronchitis, chronic inflam- 
mation of the intestinal mucous membrane, and chronic diarrhea 
are frequently due to scrofula, while pulmonary consumption is 
unanimously regarded as a purely scrofulous affection. Scrofula 
shows a strong disposition to manifest itself in the lymphatic 
glands, particularly in the superficial ones of the neck. The 
most distinguishing feature of this form of the disease is the 
appearance of little kernels or tumors about the neck. These 
often remain about the same size, neither increasing nor dimin- 
ishing, until finally, without having caused much inconvenience, 
they disappear. After a time these glands may again enlarge, 
with more or less pain accompanying the process. As the dis- 
ease progresses, the pain increases, and the parts become hot and 
swollen. At length the " matter " which has been forming be- 
neath, finds its way to the surface and is discharged in the form 
of thin pus, frequently containing little particles or flakes of 
tubercular matter. During the inflammatory process there may 
be more or less febrile movement, paleness of the surface, lan- 
guor, impaired appetite, night sweats, and general feebleness of 
the system. The resulting open ulcers show little disposition to 
heal. 
Symptoms. There is a train of symptoms characteristic 
of all scrofulous diseases. The appetite may be altogether lost 
or feeble, or in extreme cases voracious. In some instances 
there is an unusual disposition to eat fatty substances. The 
general derangement of the alimentary functions is indicated by 
a red, glazed, or furrowed appearance of the tongue, flatulent 
condition of the stomach, and bloated state of the bowels, 
followed by diarrhea or manifesting obstinate constipation. 
Thirst and frequent acid eructations accompany the imperfect 
digestion. The foul breath, early decay of the teeth, the slimy, 
glairy stools, having the appearance of the white of eggs, and 
an intolerable fetor, all are indicative of the scrofulous tenden- 
cies of the system. 
Causes. Scrofula may be attributed to various causes. 434 
COMMON SENSE MEDICAL ADVISER. 
Observation has shown that ill-assorted marriages, are a prolific 
source of scrofula. Both parents may be not only healthy, 
and free from all hereditary taints, but robust, well-formed 
physically, perfectly developed, and yet not one of then- 
children be free from this dire disease. It may present itself in 
the form of hip-disease, white swelling, "fever-sore," suppurat- 
ing glands, curvature of the spine, rickets, ulcers, pulmonary 
consumption, or some skin disease, in every case showing the 
original perversion of the constitution and functions. Scrofula 
is hereditary when the disease, or the diathesis which predisposes 
to its development, is transmitted from one or both parents who 
are affected by it, or who are deficient in constitutional energy, 
showing feeble nutrition, lack of circulatory force, and a 
diminished vitality. All these conditions indicate that a few 
exposures and severe colds are often sufficient to produce a 
train of symptoms, which terminate in pulmonary or other 
strumous affections. Whatever deranges the function of nutri- 
tion is favorable to the development of scrofula, therefore, 
irregularities and various excesses tend to inaugurate it. Deple- 
tion of the blood by drastic and poisonous medicines, such as 
antimony and mercurials, hemorrhages and blood-letting, 
syphilis, excessive mental or physical labor, as well as a too 
early use and abuse of the sexual organs, all tend to waste the 
blood, reduce the tone of the system, and develop scrofula. 
Scrofula may be the consequence of insufficient nourishment, 
resulting from subsisting upon poor food, or a too exclusively 
vegetable diet, with little or no animal food. 
Want of exercise and uncleanliness contribute to its produc- 
tion. It is much more prevalent in temperate latitudes, where 
the climate is variable, than in tropical or frigid regions. The 
season of the year also greatly influences this disease, for it 
frequently commences in the winter and spring, and disappears 
again in the summer and autumn months. 
Treatment. The skin should be kept clean by means of 
frequent baths. These assist the functional changes which must 
take place on the surface of the body, permit the stimulating 
influence of the light and air, and facilitate the aeration of 
the blood, as well as the transpiration of fluids through 
the innumerable pores of the skin. All exposure to a low SCROFULA. 
435 
temperature, especially in damp weather, and the wearing of 
an insufficient amount of clothing should be avoided. Then 
the food should be generous and of the most nourishing and 
digestible character. Steady habits and regular hours for eating 
and sleep must be observed, if we would restore tone and 
regularity to the functions of nutrition. Moderate exercise in 
the open air is essential, in order that the blood may become 
well oxygenated, that the vital changes may take place. It is 
no doubt true that the occasion of the prevalence of scrofula 
among the lower classes may be ascribed to frequent and severe 
climatic exposures, irregular and poor diet, or want of due 
cleanliness. Every well-regulated family can avoid such causes 
and live with a due regard to the conditions of health. The 
proper treatment of scrofula is important, because we meet with 
its symptoms on every side, showing 
its slow action upon different parts of 
the body and its influence upon all 
the organs. After this disease has 
been existing for .an indefinite length 
of time, certain glands enlarge, slowly 
inflame, finally suppurate, and are 
very difficult to heal. These sores 
are very liable to degenerate into 
ulcers. All of these symptoms point 
to a peculiar state of the blood, which 
continually feeds and strengthens this 
morbid outbreak. All authors agree 
that the blood is not rich in fibrinous elements, but tends to 
feebleness and slow inflammation, which ends in maturation. 
Thus we may trace back this low and morbid condition of the 
blood to debility of the nutritive organs, defective digestion, 
which may be induced by irregular habits, a lack of nourishing 
food, or by the acquirement of some venereal taint. 
The matter that is discharged from these glands is not 
healthy, but is thin, serous, and acrid; a whey-like fluid contain- 
ing little fragments of tuberculous matter, which resembles 
curd. The affected glands ulcerate, look blue and indolent, and 
manifest no disposition to heal. We have thus traced this 
disorder back to wreak, perverted, and faulty nutrition, to 
Fig. lJf.8. 
A Scrofulous Tumor. 436 
COMMON SENSE MEDICAL ADVISEE. 
disordered and vitiated blood, the products of which slowly 
inflame the glands, which strain out unhealthy, irritating, 
poisonous matter. The medicines to remedy this perverted 
condition of the blood and fluids must be alteratives which will 
act upon the digestive organs and tone the nutritive functions, 
thus enriching and purifying the blood. As this affection is 
frequently a complication in chronic diseases, it is eminently 
proper for us to refer to a few considerations involved in its 
general treatment. 
An alterative medicine belongs to a class which is considered 
capable of producing a salutary change in a disease, without 
exciting any sensible evacuation. In scrofula, remedies should 
be employed which will improve digestion and also prevent 
certain morbid operations in the blood. 
It is well known to medical men that nearly all medicines 
belonging to the class of alteratives, are capable of solution in 
the gastric and intestinal secretions, and pass without material 
change, by the process of absorption, through the coats of the 
stomach and intestines, as do all liquids, and so gain an entrance 
into the general circulation; that these same alteratives act 
locally to tone and strengthen the mucous surfaces, and thus 
promote and rectify the process of digestion before being 
absorbed; that alterative medicines, when in the blood, must 
permeate the mass of the circulation, and thus reach the remote 
parts of the body and influence every function; that these 
medicines, while in the blood, may combine with it, reconstruct 
it, and arrest its morbid tendencies to decomposition. 
We should use those alteratives which give tone to the 
digestive and nutritive functions, in order to curtail the constant 
propagation of scrofula in the system; which alter and purify 
the blood through the natural functions, thus reconstructing 
it; and which check the septic, disorganizing changes which 
are evinced by the irritating and poisonous matter discharged 
from the ulcers. 
These are the three ways in which medicines operate upon the 
nutritive functions and the blood. 
Thus alteratives may be specifics, in so far as they are 
particularly useful in certain disorders, and the combination 
which has been made in the Golden Medical Discovery, excels SCROFULA. 
437 
all others with which we are acquainted, for scrofulous diseases, 
particularly in fulfilling the foregoing indications. It works out 
peculiar processes in the blood, not like food, by supplying 
merely a natural want, but by strengthening the nutritive func- 
tions and counteracting morbid action, after which operations it 
passes out of the system by excretion. 
From what has been said upon the importance of blood 
medicines and their modes of action, the reader must not infer 
that we account for all diseases by some fault of the humors of 
the body, for we do not. But that scrofula, in its varied forms, 
results from imperfect nutrition and disorders of the blood, is 
now universally conceded. It is for this reason that neither 
time nor pains have been spared in perfecting an alterative, 
tonic, nutritive, restorative and, antiseptic compound, to which 
Dr. Pierce has given the name of Alterative Extract, or Golden 
Medical Discovery. Not only is it an alterative and a nutritive 
restorative, acting upon the secretions, but it opposes putrefac- 
tion and degenerative decay of the fluids and solids. Hence its 
universal indication in all scrofulous diseases. It will inter- 
cept those thin, watery discharges which are the result of 
weakness, degeneration, and putrescent decay of the blood, 
perpetuated by a low grade of scrofulous inflammation. By 
an adult it can be taken in doses of from one to two teaspoon- 
fuls three or four times per day. 
The bowels should be properly regulated. When constipation 
exists one or two Purgative Pellets taken daily, will fulfill the 
indication. A tea made of equal parts of the bark of tag elder, 
sassafras, and prickly-ash, is a common domestic remedy and 
is supposed to purify the blood. While it can do no harm, it 
will not be found very efficient. A tincture made by putting 
fresh burdock and yellow dock roots into whisky, the dose of 
which is a teaspoonful once a day, in the morning shortly after 
rising, may sometimes be beneficial, yet it cannot always be 
relied upon. The patient ought not to neglect to carry out all 
the hygienic recommendations heretofore given. The treatment 
of local tumors or running sores is very simple. Cleanse them 
every day with Castile-soap and water, and apply some mild 
ointment, such as one made by adding together one part each, by 
weight, of bees-wax and mutton tallow, and two parts of lard. 438 
COMMON SENSE MEDICAL ADVISER. 
LUMBAR AND PSOAS ABSCESSES. 
Lumbar abscess is a form of scrofula, generally commencing 
in the small of the back near the origin of the psoas muscles. 
It then runs down over the pelvis and generally involves the 
tissue in the region of the groin, near the place where the thigh- 
bone articulates with the hip-bone, and the psoas muscle is 
generally affected. 
The Symptoms of lumbar abscess are dull, heavy pains, 
extending down the outside of the thigh, sometimes to the foot. 
When the patient is in a reclining position, the thighs are 
generally flexed upon the abdomen. The pain finally becomes 
intense, the appetite impaired, the breath foul, and chills are 
experienced, and there are night sweats and symptoms of fever. 
The swelling is caused by a collection of " matter " in the 
cellular tissue. The cyst or bag which contains the " matter " 
is continually enlarging as it increases. When the abscess is 
opened or bursts the surface of the cyst becomes inflamed. The 
discharge consists of flaky, tuberculous matter, mingled with 
pus and sometimes blood. 
Treatment. The principles to be observed in the treat- 
ment of this affection are to preserve the strength of the patient 
by the plentiful use of nutritious articles of diet, to improve the 
digestive functions and to constantly employ the best altera- 
tives. All the best hygienic recommendations which have been 
suggested under the treatment of scrofula, apply to the manage- 
ment of this affection. No depletive or exhausting treatment 
is permissible but the free use of tonic and antiseptic alteratives 
should be persistently followed. The patient should have plenty 
of fresh air, sunlight, and a nourishing diet. 
If these abscesses are opened, it must be done so as not to 
permit the entrance of air to the suppurating surface, for that 
will only intensify the inflammation. And when injections are 
made with a view to change the character of the morbid action 
already set up, they should be introduced so as not to permit 
the entrance of air. These surgical means should not be 
undertaken without weighing all the liabilities and conse- 
quences, for they are often rashly employed by inexperienced 
surgeons. HIP-JOINT DISEASE. 
439 
HIP-JOINT DISEASE. (Coxalgia. 
Hip-joint Disease, also known as Coxalgia, is frequently a 
scrofulous affection of the hip-joint. It usually attacks children, 
but may occur at any period of life. The causes of this affec- 
tion are imperfectly understood, yet all the indications point to 
a scrofulous state of the system. Dampness, cold, improper 
diet, severe injuries from blows or falls are all numbered among 
the exciting causes which are conducive to the establishment of 
this disease. 
The Symptoms are usually developed gradually; at first 
there is severe pain in the knee, but finally it is located in the 
hip-joint. Occasionally it is noticed in the hip and knee at the 
same time. As the disease progresses, the general health 
becomes impaired, there is wasting of the muscles, wakefulness, 
disturbed sleep, high fever, profuse and offensive perspiration, 
the hair falls out, and there is an inability to move the limb 
without producing excruciating pain. Frequently pus will be 
formed and discharged at different points, and the limb will 
become greatly emaciated. Since pain in the knee-joint may 
mislead as to the location of the disease, to determine the seat 
of the affection place the patient in a chair and percuss the 
knee lightly, by giving it a slight blow with the knuckle; if the 
hip be affected, the pain will be readily felt in that joint; if it 
be simply neuralgia of the knee-joint, it will excite no pain 
whatever. If the disease be allowed to progress and dislocation 
of the joint takes place, the affected limb becomes shortened. 
Treatment. The treatment of this disease should consist 
in rest for the hip-joint, cleanliness of the person and plenty of 
fresh air and light, a nutritious diet and the use of tonics and 
sustaining alterative medicines. This class of medicines should 
be persistently employed, in order to obtain their full effects. 
It is a disease which progresses slowly and which is not easily 
turned from its course, and its fatality should warn the afflicted 
to employ the best of treatment. 
Many poor, unfortunate victims know too well, from sad 
experience, that the course of treatment frequently recom- 
mended and employed by physicians and surgeons is ineffectual, 
and cruel; they deplete the system, apply locally liniments, 440 
COMMON SENSE MEDICAL ADVISER. 
lotions, iodine, and hot applications; confine the patient in bed 
and strap his hips down immovably, thus preventing all exer- 
cise; then they attach that cruel instrument of torture, the 
weight and pulley, to the diseased limb. 
After many years of practical experience in the treatment 
of hundreds of cases, we have developed a system of treatment 
for this terrible malady which is based upon common sense. 
Instead of depleting, we, by proper constitutional treatment, 
strengthen and fortify the system. We do not confine the 
patient in bed, but permit him to go around and take all 
necessary exercise. We adjust an ingeniously devised and 
perfectly fitting appliance or apparatus, by which a gentle 
extension of the limb is maintained, thereby relieving the ten- 
sion of the muscles, and preventing the friction and wearing 
of the inflamed surfaces of the joint, which, without the use 
of our new and improved appliance, are a source of constant 
irritation. The appliances required in the successful treatment 
of this disease are numerous and varied in their construction, 
and require skill and experience on the part of the surgical 
mechanic as well as on the part of the surgeon, to take ac- 
curate and proper measurements of the diseased limb, and to 
construct the appliances so that they will be adapted to the 
various requirements of different cases. There are no definite 
rules for taking these measurements, and only a thorough 
examination of the case can indicate to the eye of the experi- 
enced surgeon what measurements are required, and what kind 
of an appliance is suitable for each individual case. At the 
Invalids' Hotel and Surgical Institute these measurements are 
all taken by the surgeon in person, and each appliance is 
constructed under his immediate supervision. It is utterly 
impossible for physicians who have but a limited experience 
in the treatment of such cases to take correct measurements 
and send off for an apparatus which will fulfill the require- 
ments of the case. 
In the light of our vast experience at the Invalids' Hotel and 
Surgical Institute, we feel that we cannot too strongly urge the 
employment of a suitable apparatus for supporting the hip- 
joint, giving it perfect rest, and enabling the patient to exercise 
and get the out-door air. As much of the pain in this disease is HIP-JOINT DISEASE. 
441 
due to the pressure of the head of the femur, or thigh-bone, in 
the acetabulum, or socket, steadily-applied mechanical extension, 
to relieve the inflamed and sensitive joint of the pressure, is of 
the greatest importance. By such application the patient is 
enabled to move about without pain, while the joint is kept 
perfectly at rest-a condition favorable to the reduction of 
inflammation within it. The surgeon specialist of the Invalids' 
Hotel and Surgical Institute is frequently sent for to visit cases 
of this disease hundreds of miles away; and by the employ- 
ment of suitable apparatus, he has been enabled, in scores of 
cases, to relieve the suffering at once. In cases in which the 
head of the thigh bone, or the bony socket of the joint, has 
become so diseased as to cause it to ulcerate and break down, 
all portions of diseased bone should be thoroughly removed by 
a surgical operation. If this be neglected or delayed, a fatal 
termination of the disease may be expected. Parents should 
not put off the employment of a competent specialist in this 
terrible, distressing, and fatal disease. As treated by general 
practitioners, it very often proves fatal; or, after causing intense 
suffering for a series of years, if the active condition of the 
disease subsides, the patient is left with a ruined and broken 
constitution, a result which more prompt and earlier relief 
would have prevented. The following sample cases, selected at 
random from among a large number treated, furnish sufficient 
evidence of the results attained by our method of treatment: 
Case 12,342. A gentleman residing in Chicago sent for our special- 
ist to visit his boy, ten years old, who had been confined to bed 
with hip-joint disease for four mouths. Extension with strong sup- 
port was applied, and the lad was able to move and sit up, with very 
little inconvenience, the first day. Within a week, his father brought 
him to our institution for further treatment, which resulted, in two 
months' time, in his complete recovery. 
Case 11,155. A gentleman of Rochester consulted our specialist 
in the case of his daughter, who had suffered terribly for months, 
and who was greatly emaciated from the effects of hip-joint disease. 
For a long time, the surgeon treating the case mistook the disease 
for sciatica. At the time our surgeon visited the case, two large 
sinuses, or fistulous openings were discharging large quantities of 
pus, together with pieces of bone, showing a breaking down of the 
bony structures entering into the joint. After proper preparatory 
treatment, the joint was cut down upon, and the diseased head of 
the thigh-bone removed. The parts readily healed, and the patient 
made a rapid recovery under the supporting, tonic, and blood-purifying 
effects of the Golden Medical Discovery. 442 
COMMON SENSE MEDICAL ADVISER. 
Case 13,560. The little daughter of a gentleman living at Toronto, 
Ontario, was brought to our institution, suffering from what had been 
erroneously pronounced disease of the knee-joint by several eminent 
general practitioners. The pain in the knee-joint had misled these 
medical gentlemen; for, after careful examination, our specialist dis- 
covered the disease to be in the hip-joint. An extension and supporting 
apparatus was carefully adjusted to the limb, a supporting, tonic, and 
alterative course of medicines ordered, with tonic baths, and out-door 
exercise. This rational course of treatment restored the patient to 
good health in a few weeks. 
The records of practice at the Invalids' Hotel and Surgical 
Institute abound in reports of cases similar to the preceding, 
demonstrating the fact, that by careful and judicious manage- 
ment, hip-joint disease in all its earlier stages, may be promptly 
arrested, and that cures may be effected even when the bony 
structure of the joint is seriously diseased. 
WHITE SWELLING. 
White Swelling, otherwise known as Hydrarthrus, or Syno- 
vitis, more frequently affects the knee-joint than any other 
part. The joints of the elbow, wrist, ankle, or toes, may, how- 
ever, be affected with this disease, but we shall speak of it in 
this connection as affecting only the knee-joint. Synovitis may 
be acute or chronic. The latter form is sometimes induced 
by blows, sprains, falls, etc., or from exposure to cold; more 
frequently it is the result of rheumatism or scrofula. 
The Symptoms of this affection are generally slow in 
their appearance, being sometimes months in manifesting them- 
selves. The joint at first presents only a slight degree of 
swelling, which gradually increases. Pain is soon felt, mild at 
first, but augmenting until it becomes severe. The skin has a 
smooth, glistening appearance, and there is an increased amount 
of heat in the parts. The affected limb becomes wasted, and 
is sometimes permanently flexed. There is more or less fever 
about the body, impairment of the digestive organs, and 
sleeplessness. The pulse is low but quick, and night-sweats 
and diarrhea often appear. Under this irritation, the patient 
is liable to waste away and finally die. 
A post-mortem examination reveals the effects of the disease 
upon the parts attacked. The cartilages of the joint are soft, 
the synovial membrane is thickened, the ligaments are inflamed 
and often destroyed, the synovial fluid is increased in amount, WHITE SWELLING. 
443 
sometimes normal in appearance, at others thick and viscous. 
If the bones be diseased, their articular extremities may be 
distended and fatty matter deposited in them. The con- 
ditions depend upon the form, severity, and duration of the 
disease. 
Synovitis may be considered under three heads; Rheumatic, 
Strumous, and Syphilitic. 
Rheumatic Synovitis may arise from exposure to cold, from 
some injury, or from intemperance in eating. The beginning of 
the disease may be distinctly marked, or it may come on so 
gradually that the time of its commencement cannot be noted. 
The pain is of a dull, steady character, and less severe in the 
night. This form of the disease sometimes terminates favor- 
ably, but in scrofulous systems it is liable to end in the 
destruction of the joint. It is more common in early life, 
rarely occurring after the thirtieth year. 
Strumous Synovitis, or Tuberculosis of the Knee-joint, when 
of a chronic character, shows a wasting of the limb, and the 
swelling is of a pulpy consistence. This form of the disease is 
more liable to occur in children, though occasionally it is met 
with in adults. But little pain accompanies this form, although 
the limb is liable to become permanently affected. In its 
earlier stages, this disease may be checked. 
Syphilitic Synovitis is the result of syphilis. The pain is 
more severe during the night. It, however, generally term- 
inates unfavorably, especially in scrofulous constitutions. 
The Treatment of white swelling should be both consti- 
tutional and local. Alterative medicines are indicated to purify 
the blood. The following preparation will be found very 
useful: blue flag root, prince's-pine, tag alder, burdock, and 
yellow dock root, one ounce each; good whisky, one quart; 
cold water, one quart; white sugar, one pound. The dose is one 
tablespoonful twenty minutes before meals. The Golden Medi- 
cal Discovery is, however, preferable to the above mixture. 
As local treatment, in the active stage of the disease, the 
knee-joint should be steamed, and hot fomentations applied. 
This should be followed by applications over the joint of solid 
extract of stramonium or belladonna, mixed with glycerine. 
The joint should be wrapped in cotton or wool to keep it 444 
COMMON SENSE MEDICAL ADVISER. 
uniformly warm. If there are openings about the joint, dis- 
charging pus, syringe' them out once a day with Castile soap- 
suds, which may be improved by adding a little bicarbonate 
of potash (common saleratus). See that the skin is kept active, 
that the bowels are regular, that the kidneys excrete freely, 
and that the diet is nourishing. Tonic medicines should be 
employed to sustain the patient's strength. 
In order to subdue the inflammation of the joint, it is 
necessary to relieve it from motion, giving the diseased surfaces 
perfect rest. This requires nicely adjusted and carefully con- 
structed apparatus, and judgment in its application. Extension 
is necessary to remove the pressure on the joint, and, at the 
same time, the parts should be thoroughly supported, so that 
the patient can walk about without giving rise to motion in 
the joint. This is the only way to arrest the progress of the 
disease and avert the necessity of sacrificing the limb. 
The following cases illustrate the importance of correct treat- 
ment in this painful malady: 
Case 13,327. The specialist having charge of the treatment of 
diseases of the joints, at the Invalids' Hotel and Surgical Institute, 
was summoned to treat a case of white swelling, the patient being a 
young lady of nineteen, whom he found confined to bed and unable 
to move, except with intense suffering. Extension was being 
applied in a crude way by means of a weight attached to the foot 
and suspended so as to produce tension on the joint. This necessi- 
tated perfect confinement of the patient, which had been so long 
continued that she had lost all appetite for food, and had become 
very nervous and much emaciated. By means of a carefully-fitted 
brace, or extension apparatus, the young lady was enabled to get up 
and exercise without pain, and was, in a few days, able to travel 
three hundred miles to become an inmate of our remedial home, 
where she fully recovered her health. 
Case 14,976. A lad of twelve years. He was taken with pain in 
the right knee, supposed to result from a blow upon the joint received 
from a bat while playing ball. When our specialist visited him he 
had been under treatment for six months, but had gradually grown 
worse, until he had become a great sufferer. Two openings discharged 
unhealthy pus from the joint, which was greatly swollen and very 
sensitive. The surgeon in charge had advised amputation. The case 
was certainly not a promising one, but our specialist resolved to make 
an effort to save the limb. Accordingly, he fitted an extension 
apparatus so as to relieve the joint from pressure, and prevent all 
motion of the parts involved in the diseased action. The parents were 
advised that the joints would, as the result of the extensive, destructive 
inflammation and breaking down of its tissues, necessarily be left 
stiffened, but that the limb in this condition would be far preferable to 
an artificial one. After the apparatus had been worn for a few days, 
the patient was able to undertake a journey of over five hundred miles Pickets. 
445 
which he accomplished, that he might be under the direct care of the 
specialist at the Invalids' Hotel and Surgical Institute. A residence 
of three months at this remedial home restored the boy to perfect 
health, and his stiffened limb, being but slightly flexed, is a very 
serviceable member. 
Case 15,302. This case was very similar to the preceding one, 
being a lad of fourteen, of a very scrofulous diathesis, and when first 
seen by one of the surgical staff of the Invalids' Hotel and Surgical 
Institute, he was in a terrible condition; his knee being swollen so 
that it was larger than his head, and so painful that he could get no 
rest, unless when under the influence of very large doses of morphine. 
A similar course of treatment to that employed in case No. 14,976 
resulted, in due time, in his full recovery. 
Cases like the preceding, which have been treated with uni- 
form success, might be cited to the extent of filling a very 
large number of pages like these, but the foregoing are suffi- 
cient to show that, when treated by a skilled specialist, this 
otherwise formidable and dangerous disease is readily amenable 
to treatment, and that good and serviceable limbs can be 
promised, even in extreme cases, in which amputation is usually 
advised by general practitioners and surgeons, who desire the 
glory that they imagine they will receive by performing a 
capital operation. 
RICKETS. (Rachitis.) 
Rickets is a scrofulous disease, in which there is derangement 
of the entire system, and it finally manifests itself in disease 
of the bones. It is characterized by a softening of the bony 
tissue, due to a deficiency of earthy or calcareous matter in 
their composition. It appears to be a disease incident to cold, 
damp places, ill-lighted and imperfectly-ventilated rooms, and 
it especially attacks those who are uncleanly in their habits. 
The Symptoms of rickets are severe pains in the bones, 
especially during the night, febrile excitement and profuse 
perspiration, paleness of the face, a sallow and wrinkled appear- 
ance of the skin, and derangement of the digestive organs. 
After a time the body becomes emaciated, the face pale, and the 
head unusually large. The bones become soft and unable to 
support the body; various distortions appear; the extremities of 
the long bones are enlarged, while the limbs between the joints 
are very slender. Rickets is a disease peculiar to childhood, 
though it may not be developed until a more advanced period 
of life. It rarely proves fatal, unless the lungs, heart, or other 446 
COMMON SENSE MEDICAL ADVISER. 
vital organs, become involved. In some instances the softening 
and other symptoms continue to increase until every function is 
affected, and death ensues. 
Post mortem examinations of those who have died of rickets 
have disclosed morbid changes in the brain, liver, and lymphatic 
glands. The lungs are often compressed or displaced, and the 
muscles of the body become pale and wasted. Sometimes the 
bones are so soft, on account of the deficiency of the calcareous 
deposit, that they can be easily cut with a knife. 
Treatment. The use of alteratives, iron tonics, and 
preparations rich in phosphate of lime, is indicated in this 
affection. It is a disease usually developed during childhood, 
in consequence of insufficient exercise, deprivation of the 
sunlight, low, innutritions diet, and lack of cleanliness. There- 
fore, it is essential to obviate all known causes, and, at the same 
time supply the patient with food rich in those elements which 
the system seems to demand. The importance of this disease 
requires the employment of some experienced physician. 
Under any plan of treatment the general directions given for 
the hygienic management of scrofula should be followed. We 
might cite many cases that have entirely recovered from this 
disease, under our advice and treatment. We shall merely say, 
for the encouragement of the afflicted, that this form of 
scrofula yields to proper medicines, and it may be very suc- 
cessfully treated by skilled and experienced physicians. 
POSTERIOR SPINAL CURVATURE. 
(Humpback.) 
Posterior curvature of the spine, sometimes known as 
Pott's Disease, occurs most frequently in children, and is 
generally developed before the seventh year. Children of 
a scrofulous diathesis are especially liable to this affec- 
tion. It is generally due to disease of the inter-vertebral 
cartilages and bodies of the vertebrae. It comes on in a 
slow, insidious manner, hence, it often makes serious inroads 
upon the spine and system before its true character is even 
suspected. 
Generally the first point of invasion is the cartilaginous POSTERIOR SPINAL CURVATURE. 
447 
substances between the bodies of the vertebrae, beginning with 
inflammation, and finally resulting in ulceration and a break- 
ing-down of the cartilages. It next invades the vertebrae them- 
selves, producing caries, or death and decay of the bony 
substance, which softens and wastes away, as shown in Fig. 149. 
The vertebrae become softened and broken down, and the weight 
of the body pressing them to- 
gether produces the deformity 
known as "humpback." (See 
Fig. 150 and Fig. 151.) 
Symptoms. Among the 
various symptoms present in the 
earlier stages of the disease, and 
during its progress, we deem it 
necessary to mention only a few 
of the more prominent ones. 
While the patient is yet able to 
go around, the disease manifests 
itself by occasional pain in the 
bowels, stomach, and chest. 
Often there is a hacking cough, 
nervousness, lassitude, and a 
generally enfeebled condition of 
the whole system. The patient 
is easily fatigued; there is ap- 
parent loss of vitality, impaired 
appetite, a feeling of tightness 
across the stomach and chest, 
gradually declining health, and loss of flesh and strength, 
torpidity of the liver, deficient secretions, constipation, and 
morbid excretions from the kidneys. The victim, in passing 
chairs, tables, and other objects, instinctively places his hands 
upon them, and, as the disease progresses, when standing, 
leans upon some support whenever possible. In walking, 
he moves very carefully and cautiously, with elbows thrown 
back and chest forward, to assist the body in keeping its 
equilibrium. The body being kept in an upright position, the 
patient bends the knees rather than the back in stooping, 
as illustrated in Fig. 153, and the body is frequently supported 
Fig. 1J>9. 
The above portion of the spinal col- 
umn shows the manner of the break- 
ing down of the vertebrae from caries, 
and the absorption of their bony struct- 
ure. 448 
COMMON SENSE MEDICAL ADVISER. 
by the hands being placed upon the thighs or knees. Sudden 
movements or shocks cause more or less pain. 
The development of the disease then becomes rapid; suffering 
increases, and pain about the joints and lower extremities and 
muscles of the posterior part of the pelvis is experienced; 
numbness and coldness of the extremities is felt; locomotion 
becomes more difficult, and a slight projection is observed upon 
the back. Even in this somewhat advanced stage of the disease, 
when the symptoms are so apparent, many cases are shamefully 
neglected because an ignorant adviser says it is nothing 
serious and that the patient will outgrow it. The pain and 
Fig. 150. 
Fig. 151. 
tenderness not always being in the back, the inexperienced are 
very often misled as to the true character of the trouble. The 
distortion or deformity of the back now becomes painfully 
prominent; the diseased vertebrae quickly soften and waste away; 
the pressure upon the spinal cord increases, and paralysis of 
the limbs supervenes; the power of locomotion is lost, and, at 
last, the danger is realized and the struggle for life begins. 
Thus, through ignorance, neglect, and improper treatment, 
the poor, helpless victim is doomed to a life of hideous 
deformity and suffering. We would, therefore, urge upon 
parents whose children are afflicted with this terrible disease, 
the great importance of placing them under the care of 
surgeons who have for many years made the treatment of POSTERIOR SPINAL CURVATURE. 
449 
such cases a specialty, and who have every acility and all 
necessary surgical appliances for insuring success in every case 
undertaken. 
Treatment. The great essentials for the successful treat- 
ment of disease and deformities of the spine are first, a 
Fig. 152. 
Fig. 153. 
Appearance of a child suffering from 
Pott's disease of the spine. 
Mode of stooping adopted by a child 
suffering from spinal disease. 
thorough knowledge of the structure and parts involved by 
the disease; secondly, the adjustment of mechanical appliances 
perfectly adapted to the requirements and necessities of each 
individual case, and the proper use of our system of "vitaliza- 
tion," applied to the spinal muscles to strengthen the weaker 
and relieve the undue contraction of the stronger. For many 
years our specialists have experimented, and have given the 
various appliances in common use in these cases most thorough 450 
COMMON SENSE MEDICAL ADVISER. 
and practical tests, and have found them very defective, being 
generally constructed upon wrong principles. The physician 
who sends to a mechanic for an appliance, such as are now 
made in the shops of most instrument makers, and uses the 
same, is doing himself an injustice, and barbarously torturing 
his patient by forcing him to wear an apparatus which is 
heavy, clumsy, and inevitably injurious, instead of being bene- 
ficial in its results. In the treatment of disease and deform- 
ities of the spine, there should be no compromising; the appli- 
ance that fails to give complete support should not be worn. 
In our treatment of these maladies we employ only appliances 
which are constructed under the personal supervision of our 
specialists, upon principles dictated by common sense and the 
actual necessities of the case. We do not confine the body 
in an iron jacket. Our apparatus is light, yet durable, and 
is worn by the most delicate children without pain or incon- 
venience. It gives proper support to all parts, and is so nicely 
adjusted as to produce pressure only upon those points which 
should receive support, leaving the muscles of the spine free- 
dom of action, thereby assisting in their development. In 
many hundreds of cases treated by our specialists, the dis- 
ease has been entirely cured and the deformity removed. After 
seeing the patients and adjusting the appliances, they can gen- 
erally be treated at their homes. 
LATERAL CURVATURE OF THE SPINE. 
(Crooked Back.) 
This deformity appears more frequently in anaemic persons, 
in whom the flexibility and elasticity of the muscles are 
weakened, than in those of a plethoric habit. It is generally 
contracted during youth, between the ages of twelve and 
eighteen. Persons of sedentary and indolent habits are espe- 
cially liable to this deformity, hence, girls are most frequently 
its victims. It is never seen among the natives of tropical 
countries who habitually live in the open air, and seldom among 
the barbarous races of northern latitudes. A distinguishing 
feature of the American Indian is his erect carriage. The 
primary curvature is generally toward the right side, as LATERAL CURVATURE OF THE SPINE. 
451 
represented in Figs. 154 and 155. Figs. 156 and 157 show the 
disease in a more advanced stage. The ribs are thus forced 
into an unnatural position, and the vital organs contained in 
the cavity of the chest are compressed or displaced, thus dis- 
torting the form of the whole upper portion of the body. 
Symptoms. The first indication of lateral curvature of 
the spine is a marked projection of the right scapula, or shoul- 
der-blade. It is sometimes first observed by the dressmaker, 
or, accidentally, while bathing. The right shoulder is slightly 
Fig. 15 If.. 
Fig. 155. 
Lateral curvature of the spine. 
E to F, the primary curve. 
A mild case of lateral cur- 
vature of the spine. 
elevated, while the left hip is depressed and projects upward. 
If not corrected while in its earlier stages, it progresses very 
rapidly, and a second curvature is developed. The symptoms 
vary in different cases, and in the early stages are somewhat 
obscure and undefined, but generally the patient feels a sense 
of uneasiness, languor, stupor, and nervousness, loss of energy 
and ambition, general debility, poor appetite, gradually declining 
health, loss of strength and flesh, and, as the disease progresses, 
a slight elevation of one of the shoulder-blades is noticed, as 
well as the deviation of the spine to one side. The curve, or 452 
COMMON SENSE MEDICAL ADVISER. 
distortion, of the spine increases more rapidly as the body 
becomes heavier, the spine often assuming the shape of the let- 
ter S, and, from compression by torsion of the vertebrae and 
distortion of the ribs, the vital organs are encroached upon, 
causing serious functional derangement of the heart, lungs, 
liver, and stomach, producing, as its inevitable consequence a 
list of maladies fearful to contemplate. 
Causes. In rare instances, the lateral curvature of the 
spine is due to defects of certain bones of the pelvis or limbs. 
Fig. 156. 
Fig. 157. 
Lateral curvature in an 
advanced stage. 
Lateral curvature in an 
advanced stage. 
Cases are recorded in which this deformity was caused by 
diseases of the abdominal organs, but, as we have intimated, it 
is generally due to a lack of tonicity of the muscles, or, as a late 
writer has expressed it, "Want of correspondence in the antag- 
onism of those muscles which control the motions of the spinal 
column." Habitual sitting or standing in a leaning posture, 
or standing upon one foot, thus constantly using one set of 
the muscles of the back, while the other becomes enfeebled 
by the lack of exercise, is a common cause of this deformity. 
The habit which so many school-girls contract of drawing up DEFORMED FEET, HANDS, AND LIMBS. 
453 
one foot under the body while sitting, often produces a lateral 
curvature of the spine. 
Treatment. No disease or deformity of the spine is 
so easily cured and perfectly corrected, if the proper plan 
of treatment is pursued. To correct this deformity, many 
ingenious forms of apparatus have been devised and invented 
by our specialists, which should be carefully adjusted to each 
individual case. In addition to this, our method of treatment 
by " vitalization," and by mechanical movements and manip- 
ulations, is almost indispensable in these cases. It never fails 
to give relief, and, if properly pursued, invariably results in a 
permanent cure. 
There are thousands whose feet, hands, and limbs are almost 
entirely useless, besides having an unsightly appearance. - Their 
condition has been helpless so long, their treatment so varied, 
and their hopes of relief or cure have been so often disap- 
pointed, that few can believe the truth of our statement, 
when we positively assert that we can correct and cure nearly 
all cases of talipes, club, or crooked feet and deformed hands, 
and make them as perfect in appearance, and as useful in 
action, as feet and hands which have never been deformed. 
While this may seem miraculous, or even impossible, to those 
who are unacquainted with the wonderful improvements and 
rapid progress made in this department of surgical science, 
it is attested and verified by living witnesses whose feet and 
hands were once deformed and useless, but which have been 
made perfect by our new and improved method of treat- 
ment. We do not make these statements in a spirit of vain 
boastfulness, but having devoted many years to improving and 
perfecting surgical appliances and apparatus, and having had 
practical experience in the successful treatment of thousands 
of cases, we do say that our manner of treatment is original 
and employed only by us. We entirely ignore the ineffectual 
methods usually employed in such cases. Our treatment causes 
no pain, and little inconvenience, yet the curative results are 
speedy and certain, and a hundredfold more satisfactory than 
those obtained by any other course. 
DEFORMED FEET, HANDS, AND LIMBS. 454 
COMMON SENSE MEDICAL ADVISER. 
We have most thoroughly tested all the best forms of treat- 
ment heretofore devised and employed in this class of diseases, 
Fig. 158. 
Fig. 159. 
and have adopted the best features of all the various methods 
heretofore pursued. We have combined these with our own 
improvements and, as the result, we have perfected a thorough 
Talipes Equinus. 
Talipes Calcaneus. 
Fig. 160. 
Fig. 161. 
Talipes Valgus. 
Double Club-foot. 
and efficient system of treatment, based upon scientific prin- 
ciples. The numerous different mechanical devices, surgical 
appliances, and apparatus required in the treatment of deform- 
ities of the feet and hands, arms and legs, are constructed by DEFORMED FEET, HANDS, AND LIMBS. 
455 
Fig. 162. 
Fig. 163. 
Knock-knees. 
Bow-legs. 
Fig. 166. 
Fig. 167. 
Fig. 16If. 
Fig. 165. 
Fig. 170. 
Fig. 168. 
Fig. 169. 
The above illustrations represent various Deformities cured by our Specialists at 
the Invalids' Hotel and Surgical Institute. 456 
COMMON SENSE MEDICAL ADVISER. 
Fig. 171. 
Fig. 172. 
Fig. 113. 
Fig. 11 If.. 
Fig. 115. 
Fig. 116. 
Fig. Ill 
The above illustrations represent various Deformities of the feet cured by our 
Specialists at the Invalids' Hotel and Surgical Institute. HAKELIP. 
457 
skilled mechanics under the personal supervision of our surgeon 
specialists. Perfect drawings of the deformed limbs of every 
patient are made, from which a nicely fitting apparatus is 
constructed, especially adapted to the requirements of each 
individual case. This course is absolutely necessary to insure 
success since no two cases are precisely alike. 
HARELIP. 
This common deformity is generally congenital, and due to a 
want of development of the tissues forming the upper lip. 
The fissure may be either partial or complete, single or double. 
Fig. 178. 
Fig. 179. 
Double Harelip. 
Simple Harelip. 
It may involve the soft tissues only, or both the bone and soft 
tissues. In bad cases the cleft extends completely through 
the alveolar process (that part of the bony structure which 
contains the sockets for the teeth), and in others it also involves 
the hard palate, or bony roof of the mouth. 
Cleft Palate. When the palate, or roof of the mouth, is 
fissured it constitutes what is known as cleft palate. This 
condition may exist either as a complication of harelip or 
independently. 458 
COMMON SENSE MEDICAL ADVISER. 
Treatment. The earlier in life the harelip is operated 
upon the more perfect is the result. As a general rule, the 
operation should not be delayed beyond the third or fourth 
month; yet our surgeons succeed in getting very satisfactory 
results in cases of much longer standing. No child, however, 
should be operated upon when in feeble health, as the parts will 
not, under such circumstances, heal so readily, and perfect suc- 
cess will not be so certain. When the infant is, by reason of 
the deformity, unable to nurse, it is best to operate very early, 
within five or six days after birth. If any of the teeth project, 
they must be removed previous to the operation. If the harelip 
be complicated with a separation of the palate, the separation 
will generally become less and less after the union of the lips. 
Operation. The edges of the fissure, having been carefully 
pared, are brought well to- 
gether and secured with deli- 
cate pins and sutures, as 
represented in Fig. 180. In 
bad cases, and especially 
when the cleft in the pal- 
ate is very extensive, a 
kind of truss or support, sim- 
ilar to that represented in 
Fig. 180, aids materially in 
holding the parts well to- 
gether until the healing 
process makes a firm union 
and perfectly closes up the 
fissure. 
In cases in which cleft pal- 
ate exists independently of 
hare-lip, and especially when 
the fissure is in the back part 
of the roof of the mouth 
only, it is as well to defer operating upon it until the child is a 
few months old. However, if the opening is so great as to 
interfere very seriously with the taking of food, and permits 
liquids to pass into and out of the nostrils, then an operation 
should be performed early. 
Fig. 180. 
The Cheek Truss, or Compressor. OLD SORES. 
459 
Under this head we may properly consider that class of 
affections known as Fever-sores, Running-sores, Ulcers, etc. 
These sores have common characteristics, yet each possesses 
certain peculiarities, which have led to their division into 
irritable, indolent, and varicose. These peculiarities are not 
constant, one form of ulcer often changing into another. One 
feature common to all, however, is their slowness in healing, 
which has sometimes led to the belief that they are incurable. 
Another popular notion is, that their cure is detrimental to the 
health of the patient. With equal propriety we might say 
that it is dangerous to cure diarrhea, dysentery, consumption, or 
cancer. As a result of these erroneous impressions, many peo- 
ple suffer from chronic ulcers for years, and even for a life-time, 
without attempting to obtain relief. Chronic ulcers usually ap- 
pear upon the lower extremities. The depth and appearance of 
the ulcer depend upon its character and the thickness of the tis- 
sues where it is situated. 
Fig. 181 shows a chronic 
ulcer, or fever-sore, as it 
appears upon the ankle. 
The Irritable 
Ulcer is painful and 
tender, the slightest in- 
jury causing it to bleed. 
It is of a dark purplish 
hue and filled with spongy, 
sensitive granulations. It 
discharges a thin, bloody 
matter, which is some- 
times very fetid and acrid, 
and excoriates the tissues if it come in contact with them. The 
edges of this species of ulcer are shelf-like and ragged, and turn 
inward. The adjacent structures are red and swollen. Very 
often they are attended by severe constitutional disturbances, 
such as chills, fever, and great nervous prostration and irritability. 
In the Indolent Ulcer the edges are not undermined, 
but turned outward, and are rounded, thick, glossy, and regular. 
OLD SORES. (Chronic Ulcers.) 
Fig. 181. 
A Chronic Ulcer. 460 
COMMON SENSE MEDICAL ADVISER. 
The granulations are broad, flat, pale, insensible, and covered 
with a grayish, tenacious matter. The surrounding parts are 
not very sensitive, but the limb on which it is located is apt to 
be swollen. This is the commonest form of ulcer, and often 
remains for years. 
Varicose Ulcer. This species of ulcer occasions a swollen 
or enlarged condition of the neighboring veins, which are very 
much enfeebled. It almost invariably appears below the knee, 
and may be either indolent or irritable. It is generally sensitive 
to the touch, and sometimes excessively painful. Knots of 
superficial veins may often be seen beneath the skin. 
As we have before remarked, these various species of ulcers are 
merely modifications of one form of chronic sore. The patient 
may assert that he enjoys excellent health, but if we question 
him closely, we find that the sore irritates him, and that there is 
sufficient constitutional disturbance to prevent the healing pow- 
ers of nature from effecting a cure. 
Treatment. The cure of these sores is necessarily slow, 
and whoever expects to obtain immediate relief will be disap- 
pointed 
Constitutional treatment is of the utmost importance, and 
should, therefore, be thoroughly and persistently applied. The 
nutritive system, especially the absorbents, should be kept active, 
as these are the channels by which the broken-down tissue sur- 
rounding the sore is replaced by that of a higher grade of 
vitality. For this purpose, the best alteratives are required. If 
secretion and excretion are not normally performed, the blood 
becomes poisoned by the absorption of unhealthy "matter" 
from the sore, and various constitutional disturbances occur. 
If, at any time during treatment, constitutional disturbances be 
manifested by fullness or disagreeable sensations in the head, 
nausea, pain, cough, chills, or fever, a thorough cathartic should 
be given. If the patient be robust, a repetition of the same 
once a week will be very beneficial. Dr. Pierce's Golden Med- 
ical Discovery, and Pellets will be productive of the best re- 
sults. If the urine be scanty or loaded with deposits, add to 
every other bottle of the former remedy one ounce of the acetate 
of potash, and administer according to the directions given. 
The skin is apt to be dry, and requires the daily use of an DISEASE OF THE BONES. 
461 
alkaline bath followed by a thorough rubbing. Give a spirit 
vapor-bath once a week. 
The local treatment should depend upon the character of the 
ulcer. If the sore be irritable, soothing applications, such as 
warm poultices or steaming it in a vapor of bitter herbs, will be 
found highly beneficial. A poultice of powdered slippery-elm 
and lobelia is very soothing, and hence well adapted to this 
purpose. If the ulcer is indolent, a stimulating application is 
necessary. The hardened, callous state of the edges should be 
removed by alkaline applications. A strong solution of saleratus, 
a lye poultice, or even a caustic, prepared by boiling the lye 
from hard-wood ashes to the consistence of syrup, will prove of 
great utility. One or two applications of the latter are gener- 
ally sufficient. 
The sore and surrounding parts may then be stimulated by 
the application of lint saturated in the compound tincture of 
myrrh (which can be obtained at any drug store). If the part 
is flabby and the granulations indolent, the application of 
astringents, after cleansing the ulcer, is often followed by 
excellent results. An application composed of half a drachm 
of carbolic acid and one ounce of glycerine, will greatly hasten 
the healing of indolent ulcers. The sore should be so covered 
as to effectually exclude the light and air, and the dressing need 
not be changed oftener than every other day. A preparation 
known as "Black Salve," the composition of which is given in 
the "American Dispensatory," is both cleansing and healing, 
and one of the best applications that can be made. It is advis- 
able to occasionally replace one application by another, as the 
constant use of one preparation is apt to cause it to lose its 
effects. 
The experience of the specialists at the Invalids' Hotel and 
Surgical Institute, in the treatment of chronic ulcers, is very 
extensive, and their practice has been attended with the most 
successful results. 
DISEASE OF THE BONES. 
The bones are liable to various diseases. We shall, however, 
in this connection, but briefly consider a few of the affections to 
which they are subject. 462 
COMMON SENSE MEDICAL ADVISER. 
Inflammation Of the Bones (Osteitis). The inflam- 
mation of a bone is a disease of very rare occurrence. It 
may be caused by external injuries, or by some constitutional 
taint, as syphilis, scrofula, rheumatism, or gout. 
Symptoms. The patient experiences an excruciating, deep- 
seated, throbbing pain, which is increased by any movement, 
and which is usually more severe at night. The flesh over the 
affected bone is tender, and, as the disease progresses, becomes 
swollen. The constitution sympathizes with the local disease, 
and, consequently, the skin is hot, and the pulse quick. As the 
inflammation approaches suppuration, there are chills, delirium, 
profuse sweating, and all the general indications of hectic fever. 
Treatment. Although the most skillful medical as well 
as surgical aid may be employed, yet a long time is generally 
required to restore a diseased bone to its normal condition. 
The treatment must be prompt and energetic, or the inflam- 
mation will result in suppuration and the destruction of the 
bone. Perfect rest is necessary. Dr. Pierce's Compound Ex- 
tract of Smart-weed may be taken in suitable doses, to pro- 
duce gentle perspiration. Warm fomentations or poultices, 
medicated with the Extract of Smart-weed, should be applied 
to the affected part. 
Although the symptoms are less severe in the chronic form, 
yet they are similar to those in the acute, and therefore require 
similar treatment, together with an alterative course of medicine. 
The Golden Medical Discovery is very effectual in chronic 
cases, and tincture of iodine, locally applied, is often found 
beneficial. If "matter" is formed it must be released, or it will 
burrow and cause an extensive destruction of tissue. All consti- 
tutional taints should be removed, and the general health 
improved. 
FEVER-SORE. (Necrosis.) 
By the term, necrosis we mean mortification, or the state of a 
bone when it is deprived of life. Dunglison says: " This con- 
dition is to the bone what gangrene is to the soft parts." It is 
popularly known as fever-sore, there being no distinction made 
between this species of sore and those ulcers which affect only 
the soft tissues of the body. When any part of a bone becomes FEVER-SORE. 
463 
necrosed, it is treated as a foreign body. Nature makes an effort 
for its removal, and at the same time attempts to replace it with 
new and healthy materials. In consequence of this process, the 
dead portion is often inclosed in a case of new, sound bone, 
Fig. 182. 
termed the involucrum; when this is the case the dead portion 
is termed the sequestrum. If, however, it is superficial, and 
separate from the parts beneath, it is called an exfoliation. This 
healing process, by which the involucrum is formed, cannot be 
Hand drill for boring bone. 
Fig. 183. 
The osteotrite, for enlarging openings and cutting carious bone. 
completed while the dead portion remains. Hence, numerous 
openings are made through the involucrum, to permit the escape 
of the sequestrum. When a surgical operation is performed 
for the removal of the necrosed bone it is called sequestrotomy. 
Fig. 18J+. 
Gouge forceps for excavating bone. 
The instruments which our specialists usually employ for this 
practice are represented in Figs. 182, 183, and 184. 
Causes. Fever-sore may be due to inflammation, injuries, 
working in phosphorus, or from the inordinate and protracted 
use of mercury. 464 
COMMON SENSE MEDICAL ADVISER. 
Symptoms. The pain frequently commences in the night, 
and all the different stages succeed, until, finally, the result is fre- 
quently mortification or death. The entire bone, or only a part of 
it, may be affected; the parts become swollen, "matter" forms, 
and unless it be artificially evacuated, it will in time work its 
way out through a fistulous opening. As the disease progresses, 
the adjacent tissues become thickened and numerous openings 
are formed, which communicate with the bone, and often with 
each other, so that a probe may be passed from 
one to another, as represented in Fig. 185, copied 
from a drawing by Dr. Howe. The discharge 
from fever-sores varies in character, and usually 
has a fetid odor. The surgeon can readily dis- 
tinguish between healthy and unhealthy bone 
by the use of a probe. The pus discharged in 
necrosis contains minute particles of bone, which 
may be felt by rubbing it between the fingers. 
Sometimes large pieces present themselves at 
the openings. The general health is seriously 
impaired, and the patient becomes debilitated, 
anaemic, and hectic. 
Treatment. The process of repair is 
necessarily tedious, and nature should be 
assisted to remove the old bone and promote 
the formation of the new. An alterative course 
of treatment is indicated and must be persist- 
ently followed. Give Dr. Pierce's Golden 
Medical Discovery and Purgative 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 be thoroughly cleansed with injec- 
tions of an alkaline solution, after which band- 
ages, moistened with glycerine, may be applied. 
If they emit a fetid odor, add a few drops of 
carbolic acid to the glycerine. The dead bone 
can be but slowly removed by suppuration, therefore time, and, 
indeed, sometimes life itself, may be saved by removing it 
with surgical instruments. In the operation of sequestrotomy, 
Fig. 185. 
Necrosis of the 
tibia. A common 
probe is passed 
through the sin- 
uses, or openings. WRY NECK. 
465 
the surgeon must exercise great judgment. Carelessness may 
prolong the disease and subsequently necessitate another op- 
eration, or, perhaps, an amputation. 
Usually the dead bone is easily removed by the skilled special- 
ist surgeon, and, when thoroughly taken out, the parts readily 
heal and the patient rapidly recovers. The removal, therefore, 
of the dead bone which is a constant source of irritation, and the 
cause of protracted suffering, should not be delayed, for very 
rarely indeed can it be removed at all without the assistance 
of the surgeon. Besides, delay often results in the loss of 
the limb, and not unfrequently occasions the death of the 
patient. Under the influence of a reliable anesthetic, carefully 
administered, the operation of removing the decayed and 
offensive bone is speedily and painlessly performed. 
WRY NECK. 
This deformity may be either congenital or acquired, and 
may result from various causes. The head is thrown to one 
side and approaches the shoulder, as represented in Fig. 186. 
The inclination of the head may be 
due either to weakness or contraction 
of the muscles. Burns, scrofula, rheu- 
matism, and ulcerated wounds are the 
commonest causes of this deformity. 
In rare cases, it is due to paralysis of 
the muscles of the neck, or malfor- 
mations of the spine. It is often 
caused by contractions of the cervi- 
cal muscles. 
Treatment. This will depend 
upon the cause of the deformity. In 
cases of spasmodic contraction, the de- 
formity is transient, but the natural process of cure may be 
hastened by appropriate surgical and medical treatment. When 
due to muscular paralysis, the "vitalization" treatment, practiced 
at the Invalids' Hotel, is very beneficial. When the contraction 
is permanent, the most effectual method of correcting the de- 
formity is sub-cutaneous division of the contracted muscles or 
tendons. When the contraction is slight, the proper adjustment 
Fig. 186. 
Wry Neck. 466 
COMMON SENSE MEDICAL ADVISER. 
of an ingenious brace of our invention, will correct it. In 
cases due to weakness of the cervical muscles, this appliance 
is very efficient for holding the head in its normal position, 
until the system becomes so strengthened that the muscles re- 
gain their tonicity. 
Again, when the contracted muscles have been separated, 
it is necessary to devise some means of supporting the head 
while nature completes the operation by healing the severed 
tissues, and this brace furnishes the desired support. To 
rectify the deformity by mechanical treatment alone, the 
application of strips of adhesive plaster, or bands, is very effi- 
cient. Whatever the mode of correcting the deformity may 
be, mechanical support should always be employed. This, how- 
ever, can only be successful when carefully adjusted and adapted 
to each individual case by an experienced operator. 
SCURVY. 
Scurvy is a disease which was familiar to the ancients, and 
remarkably destructive to life in their armies and navies. In 
consequence of the improvement in hygienic measures, it is not 
so common at the present day, although it contributed not in- 
considerably to the mortality in our armies during the late 
civil war. Scurvy is undoubtedly due to an impaired condition 
of the blood. This deterioration may be caused by an insuffi- 
ciency of vegetable food. The long-continued use of salted 
meats, unaccompanied with vegetable diet, will induce scurvy. 
Although the diet is one cause of the production of the dis- 
ease, other causes act as powerful aids in establishing this 
affection. Exposure to wet and cold and deficient ventilation 
are favorable to its production. 
The symptoms of scurvy, or scoroutus, are a sallow appear- 
ance of the skin, impaired appetite, feeble and slow pulse, and 
dry skin upon which are patches of ecchymosis (black or yel- 
low spots). The gums become swollen, soft, of a dark purple 
color, and are liable to bleed; the teeth loosen, and the breath 
is offensive. As the disease progresses, the symptoms increase 
in severity. This malady is more apt to occur during the 
winter than in summer. 
The Domestic Treatment of scurvy should be of a CANCER, 
467 
hygienic character. The patient should partake freely of 
fresh, juicy fruit, such as lemons, oranges, grapes, apples, pine- 
apples, etc; also, of onions, radishes, water-cresses, fresh meats, 
etc. In short, his diet should be both generous and nutritious. 
Attention should also be paid to cleanliness, and the patient 
should bathe regularly every day; he should also be in a dry 
atmosphere, and have a constant supply of pure air. Consti- 
pation should be relieved by mild laxatives; or, if suffering 
from diarrhea, the patient should use moderate astringents or 
the Extract of Smart-weed. 
CANCER. 
Cancers are malignant affections manifested by the forma- 
tion of morbid growths, which have a disposition to spread 
and involve contiguous tissues, and at some stage of their 
existence ulcerate and become hideous, open sores. There are 
several varieties of cancers, all' of which possess the above 
characteristics, as well as others peculiar to each separate 
variety. Most prominent among these are scirrhus, encepha- 
loid, epithelial, colloid, melanoid, and osteoid. The three 
latter are sometimes included with some other varieties, under 
one general head-mixed. In common parlance, the different 
kind of cancers are named from a fancied resemblance to some 
object, or to the character of the object, as stone, rose, spider, 
wolf, and black cancers; or from the locality in which they 
appear, as lip, breast, womb, skin, and bone cancers. These 
different varieties may exist separately, or may be combined, 
so that several varieties may appear in a single growth; or, 
according to J. Hughes Bennett, Frank H. Hamilton, and 
others, they are sometimes transformed one into another. In 
consequence, it is sometimes very difficult to distinguish and 
classify them. The cancer-cells present almost every conceiv- 
able shape, as round, oval, caudate, spindle-shaped, heart- 
shaped, oblong, square, etc., and vary greatly in size, being 
from to of an inch in diameter. In some form or 
other, cancers are met with at all stages of human existence, 
from infancy to old age. 
It attacks, by preference, particular structures, though none 
are exempt from its ravages. It occurs more frequently in 468 
COMMON SENSE MEDICAL ADVISER. 
females than in males. The structures of the womb and breast, 
particularly the former, being favorable to its development, 
accounts for the greater frequency of its occurrence in women. 
Causes. Regarding the cause of cancer, but little is known. 
There is no doubt that its development is due to perverted nu- 
trition in the part where it occurs, but the nature or cause of 
this perversion is a mystery. 
Symptoms. Cancers are characterized by the presence 
of morbid growths, which show a decided tendency to spread 
and involve surrounding tissues. The pain experienced, which 
is usually severe and agonizing, is peculiar in its character, 
stinging, biting, sharp, and lancinating, generally occurring in 
paroxysms, and in the advanced stages of the disease is nearly 
continuous, the patient get- 
ting but little rest. In the 
earlier stages, pain is some- 
times absent. After a time, 
the growth ulcerates, and 
gives rise to exhaustive dis- 
charges, and in many cases 
to attacks of profuse hem- 
orrhage. As the disease 
progresses, the countenance 
presents a peculiar appear- 
ance, sallow, sodden, or 
grayish yellow, which is 
called the cancerous ca- 
chexia. The patient be- 
comes despondent, the general health is deranged, and life is 
beset on every side by this unrelenting foe, and he dies worn 
out by the pain and exhaustive discharges, literally fretted and 
stung to death. 
Curability of Cancers. Since writing the first edi- 
tion of this work, we have, from large observation and much 
study, quite changed our views respecting the nature of this 
malady. From believing it to be primarily a constitutional 
affection, manifesting itself secondarily in a local tumor, we have 
come to believe that, up to quite an advanced stage, cancer is a 
purely local affection, and if thoroughly removed is not likely to 
Fig. 187. 
Cancer of the Breast. CANCER. 
469 
reappear. It is a specific, morbid cell-growth, and we are now 
fully satisfied, from observation, that if this cell-growth can be 
fully and completely destroyed before ulceration and sloughing 
occur, at which stage absorption of the cancer-cells into the 
blood commences, the disease may be arrested. The course 
pursued by most surgeons, of removing the cancerous tumor 
with the knife and immediately closing the wound by stitches, 
Fig. 188. 
Fig. 189. 
Appearance of a terrible cancer of 
the breast, measuring over six inches 
in diameter, before treatment. This 
tumor was very painful, had com- 
menced to ulcerate, and was pro- 
nounced incurable by some of the 
best surgeons in New York and 
Buffalo. 
Appearance after treatment. During 
the removal of this enormous tumor 
our patient suffered very little. In 
three months' time the cure was com- 
plete, the parts being entirely healed. 
is almost always a failure. At the Invalids' Hotel and Surgical 
Institute, tumors are now removed by a method which causes 
the patient no pain, and a chemical compound is then applied 
which thoroughly destroys any diseased tissue which may re- 
main. The wound readily heals and fills up by granulation. 
We have effected wonderful results by the use of electroy- 
sis, in conjunction with other remedial agents, the tumors 
undergoing degeneration, and their malignant character being 470 
COMMON SENSE MEDICAL ADVISER. 
destroyed. Even in cases in which there was ulceration and 
great enlargement of the lymphatic glands, the pain was re- 
lieved, and the tumors greatly diminished in size by this 
treatment. 
The following cases illustrate the wonderful success which 
has been attained at the Invalids' Hotel and Surgical Insti- 
tute in the treatment of this dreadful disease. 
Case 7,942. Mrs. J., of Syracuse, N. Y., aged 35, applied to our 
specialist for the cure of a cancer of the left breast, first noticed three 
years before. At the time of consultation, it was very painful, prevent- 
ing her from getting much sleep, and so disturbing her system as to 
cause loss bf appetite and considerable emaciation. The tumor was 
very large, but had not yet broken out in ulceration. She had con- 
sulted several prominent physicians and surgeons, the last of whom 
advised her to visit our institution for treatment. Her case was 
promptly undertaken, and the diseased mass removed. The parts 
healed very promptly, and in six weeks she returned home well. This 
was one of the first cases treated under our new plan, and was a perfect 
success, as the lady has had no symptoms of a return of the disease 
since its removal. • 
Case 8,642. Mrs. W., of Brooklyn, N. Y., consulted the Faculty at 
the Invalids' Hotel for the cure of a cancer of the lip. It was promptly 
removed, and the parts healed completely in six week's time. 
Case 8,972. J., of Baltimore, Md., had cancer of the scirrhus variety, 
involving a great part of the right cheek. In order to thoroughly erad- 
icate every vestige of the disease, it became necessary to remove a part 
of the upper jaw. This having been skillfully accomplished by the 
surgeon in charge of this branch of practice at the Invalids' Hotel, the 
wound healed very readily, and only slight disfigurement remains. A 
thorough course of constitutional treatment was kept up after the dis- 
eased mass had been removed, to cleanse and purify the blood and 
system. 
Case 9,847. Six years ago, Mrs. S., of Pa., applied to the Faculty of 
the Invalids' Hotel and Surgical Institute, for the cure of an immense 
cancerous tumor of the breast, which, after removal, weighed six 
pounds. On examination with the microscope, our diagnosis of cancer, 
previously made, was fully confirmed. There has been no return of 
the disease. 
Case 10,042. In 1875, Mr. K. applied to the Faculty of our Institu- 
tion, for the cure of an immense cancerous tumor located on the scalp. 
The tumor had grown until it had encroached upon, and caused ab- 
sorption of a considerable part of the skull. The tumor was effectually 
removed and the parts healed nicely. A letter from this gentleman, 
five years after treatment, stated that he had experienced no return of 
the disease. 
Case 10,340. Mrs. H. C. L., of Indiana, applied at the Invalids' Ho- 
tel and Surgical Institute for the cure of an immense cancerous tumor 
of the breast. It had already ulcerated, and was discharging very 
offensive pus. In two months' time she was cured, and returned to her 
home a well woman. 
Case 12,003. This was a lady sixty years old, from the State of 
Ohio, afflicted with cancer of the breast, of some six years' growth. CANCER. 
471 
Ulceration had recently set in, and the patient was suffering excruci- 
ating pain. Proper applications were made and the tumor was 
removed without the resort to the knife. Owing to the patient's ad- 
vanced age, the parts were rather slow in healing; but under the influ- 
ence of supporting tonics and a generous diet, she fully recovered, and 
in four months returned home. Only a very slight opening existed 
at that time, which gradually closed, and she enjoyed good health for 
four years, and finally died of another disease. 
Case 12,925. Mr. J. T. had a cancer removed from his nose, several 
years ago, and has experienced no return of the disease. 
Case 12,962. This was a case of cancer affecting the face and in- 
volving the upper jaw. It was thoroughly removed, and, although the 
healing caused considerable contraction and disfigurement, there has 
been no return of the disease, which was treated six years ago. 
Case 13,153. Mrs. A. was cured of a cancer of the breast, of very 
large size, over five years ago, and has felt no symptoms of the disease 
since. 
Case 15,523. This was a case of epithelial cancer of the lip. The 
tumor had ulcerated and commenced to break down when first seen at 
our institution. It was promptly removed. The parts healed perfectly, 
and, although nearly two years have intervened, there has been no re- 
turn of the disease. 
Case 52,607. Cancerous Testicle Complicated with Hydro- 
cele. Weight twelve pounds. Painlessly removed and a 
CURE EFFECTED. 
World's Dispensary Medical Association:-Gentlemen-I take 
great pleasure in testifying to the skillful treatment and great benefit 
that I have received at your hands. 
By a delicate but painless operation, I have been thoroughly and 
permanently cured of an obstinate and dangerous disease from which I 
had suffered for years, and which had baffled the skill of a large number 
of talented physicians. 
The tumor commenced as hydrocele, but finally became of a malig- 
nant nature, gradually assuming greater size, until it was larger than 
a man's head, and weighed nearly twelve pounds. 
After several years of suffering, I visited the Invalids' Hotel and 
consulted the Faculty. A skillful and painless operation was per- 
formed, and the tumor was entirely removed. My health is now 
perfect. I desire to express my sincere thanks to the Faculty of the 
Invalids' Hotel for the care and attention I have received, and I cor- 
dially advise all who need medical or surgical aid to visit the Invalids' 
Hotel, as it is unequaled in America for the elegance of its appoint- 
ments, the care bestowed upon its patients, and the many marvelous 
cures that are accomplished by its Faculty. With best wishes for its 
prosperity, I remain, very gratefully and sincerely yours, 
S. M., Shamburg, Pa. 
Case 55,272. Cancer of the Breast. 
World's Dispensary Medical Association:-I have great pleas- 
ure in testifying to the benefit that I have received, and the marvelous 
cure effected in my case, by one month's treatment at the Invalids' Ho- 
tel and Surgical Institute. For over seven years I had suffered from 
the steady growth of a large tumor in my left breast, for the cure of 
which I had vainly consulted all the physicians in our vicinity, failing 
to receive any benefit from their ministrations, and knowing that I 
must be cured at once, if at all, I visited Buffalo and placed myself 472 
COMMON SENSE MEDICAL ADVISER. 
under the charge of your Faculty. They assured me that my so-called 
incurable disease was readily curable by proper treatment. I submit- 
ted to an operation which was skillfully performed and not at all pain- 
ful. An immense tumor nearly the size of my head was removed, the 
wound rapidly healed, and I am now returning home after four weeks' 
treatment, in perfect health, not a vestige of my disease left. The skill- 
ful surgeons have renewed my life by curing a disease that I had been 
led to believe was incurable. I advise all in need of medical or surgical 
treatment to visit the magnificent Invalids' Hotel, as cases hitherto 
deemed incurable are cured there almost daily. The Hotel itself can 
not be equaled in this country as an Invalids' Home. 
A. McK., Lewiston, Pa. 
Case 56,262. Cancer of the Eyeball. A painless cure. 
World's Dispensary Medical Association -.-Gentlemen-I wish 
to express my thanks for the skillful treatment I have received and the 
remarkable cure effected by you. For several years I suffered from a 
cancerous disease of the left eye, which my physicians were unable to 
remove or relieve. Finding the sight of my other eye commencing to 
fail, I visited the Invalids' Hotel. A painless operation was performed 
and the disease cured. I was enabled to return home cured in one 
week. My physicians cannot understand how I was so speedily cured. 
I am yours truly, J. H. D., Clymer, N. Y. 
After removing the tumor from Mr. D.'s eye, and allowing time for 
the parts to heal, we furnished him with an artificial eye which defies 
detection. 
The records of practice at the Invalids' Hotel and Surgical 
Institute abound in cases like the preceding, and did the 
interests of our readers justify us in occupying more space in 
citing cases, a long chapter could be filled in reporting the 
cures effected by our specialists. A large experience in the 
treatment of this terrible malady convinces us that a thorough 
course of after-treatment should be carried out in these cases. 
We think that the immunity from a return of the disease 
enjoyed by our patients is largely due to the observance of this 
precaution. Under the ordinary method of treating the dis- 
ease, by simply removing the tumor with a knife, and using 
no local applications or after-medication many patients are lost, 
and in nearly all cases the disease soon returns and runs a rapid 
course. 
Tumors supposed to be benign and harmless should not be 
neglected and allowed to grow, for it has, in our experience, 
been frequently observed, and the best authorities on the sub- 
ject agree, that tumors of a benign nature often degenerate 
into malignant or cancerous growths, and, if long neglected, 
prove fatal. No time, therefore, should be lost in consulting 
an expert physician in such cases. THICK NECK. 
473 
Our large observation furnishes abundant evidence that be- 
nign growths are often pronounced cancerous by charlatans, 
who seek through such devices to acquire a reputation for 
curing malignant tumors. This fact should not, however, 
deter persons suffering from even small tumors from making 
early application for good, professional advice. General practi- 
tioners, from their limited opportunities for observation, often 
err in the opposite direction, by pronouncing cancerous tumors 
benign and harmless, thus, from the sense of security imparted 
to the patient's mind, really endangering his or her life. It 
must be seen, therefore, that it is of the utmost importance 
that a man of large, professional experience be consulted in 
all cases in which cancer is even suspected. 
THICK NECK. (Goitre.) 
Thick neck, or goitre, also sometimes called bronchocele, 
consists of an enlargement of the thyroid gland, which lies 
over and on each side of the trachea, or windpipe, between 
the prominence known as "Adam's apple " and the breast bone. 
The tumor gradually increases in front and laterally, until it 
produces great deformity, and often inter- 
feres with respiration and the act of swal- 
lowing. From its pressure on the great 
blood vessels running to and from the head, 
there is a constant liability to engorgement 
of blood in the brain, and to apoplexy, epi- 
lepsy, etc. When the enlargement once makes 
its appearance, it continues to increase in size 
as long as the person lives, unless appropriate 
treatment is resorted to. It never disappears 
spontaneously. These tumors are much larger 
than those not familiar with them would sup- 
pose from their outward appearance, as they extend under and 
are bound down by the muscles on each side of the neck, so 
that they become embedded in the cellular tissues underneath, 
while the sides of the neck retain, to a considerable extent, 
their round and even appearance, whereby the real magnitude 
of the tumor is not apparent. Fig. 190 represents the appear- 
ance of the neck of a person afflicted with this disease. The 
Fig. 190. 474 
COMMON SENSE MEDICAL ADVISER. 
form of the protuberance varies materially with different per- 
sons, that shown in the engraving being the shape which it 
ordinarily assumes. 
The causes of the affection are not well understood. The 
use of snow-water, or water impregnated with some particular 
saline or calcareous matter, has been assigned as a cause.- It 
has also been attributed to the use of water in which there is 
not a trace of iron, iodine, or bromine. A writer in a Swiss 
journal, Feuilles d? Hygiene, states that the disease is often due 
to an impeded circulation in the large veins of the neck, from 
pressure of the clothing, or from the head being bent forward, 
a position which is often seen in school children, when the 
muscles of the back of the neck have become fatigued. 
Treatment. We have obtained wonderful results by a 
new method of treatment, which consists in the employment of 
electrolysis in conjunction with other therapeutic means. There 
is scarcely a case in which this treatment, properly carried out, 
will not effect a radical cure. It is attended with no danger 
whatever. 
Those who are afflicted with this disease and unable to 
avail themselves of special treatment, cannot do better than 
to take Dr. Pierce's Alterative Extract, or Golden Medical Dis- 
covery, and apply to the skin over and around the tumor, night 
and morning, the following solution, which may be prepared at 
any drug-store: iodine, one drachm; iodide of potassium, four 
drachms; dissolve in three ounces of soft water. Apply to the 
tumor twice a day, with a feather or hair pencil. 
This is an inflammation of the parotid glands and generally 
occurs in childhood. It is often epidemic, and is manifestly 
contagious. It usually, though not always, appears on both 
sides of the neck at the same time. 
Symptoms. An external, movable swelling, just below and 
in front of the ear, near the angle of the jaw, is the prominent 
symptom. The enlargement is not circumscribed, but hard and 
painful, and attended with more or less fever, derangement of 
the secretions, and difficulty in swallowing. The swelling 
increases until the fourth and fifth day, when it gradually 
MUMPS. (Parotitis.) BOILS, 
475 
diminishes, and by the eighth or tenth is entirely gone. Some- 
times the disease is accompanied by swelling of the breasts, 
in the female, or of the testicles, in the male. 
Treatment. Usually but little treatment is necessary. 
Exposure to cold should be avoided. If severe or painful, with 
febrile symptoms, a hot foot-bath and small doses of the Com- 
pound Extract of Smart-weed in some diaphoretic infusion, to 
induce sweating, together with small doses of aconite, will, 
produce good results. If swelling of the testicles threatens 
(which seldom happens except on taking cold), resort should be 
had to mild cathartics, the spirit vapor-bath, stimulating lini- 
ments to the neck, and warm fomentations to the part attacked. 
If delirium occurs, a physician should be summoned. 
BOILS. (Furunculus.) 
These annoying affections are hard, prominent, circumscribed, 
inflamed, suppurating tumors, having their seat in the cellular 
tissue beneath the skin. They vary in size from a pea to a 
hen's egg, and may occur on any part of the body. The color 
of a boil varies from deep red to mahogany. It is painful, 
tender, advances rapidly to maturity, becomes conical, and 
finally bursts and discharges bloody "matter." Through the 
opening, and filling the cavity, may be seen a piece of sloughing 
cellular tissue which is called the core. In from four to fifteen 
days it is all expelled and the sore rapidly heals. The causes 
are an impure condition of the blood, which generally arises 
from imperfect action of the liver or kidneys. 
Treatment. Spirits of turpentine applied to a boil in 
its earliest stage will almost always cause it to disappear; but 
when suppuration has commenced it should be favored by the 
application of poultices. Next purify the blood to prevent 
subsequent returns in other parts of the body. For this pur- 
pose take the Golden Medical Discovery. Tincture of bur- 
dock root, made by finely slicing four ounces of the green 
root and covering it with whisky or alcohol, is a reliable 
remedy for boils, and may be taken in teaspoonful doses, alter- 
nately with the Golden Medical Discovery. If the patient is 
anaemic give some of the preparations of iron mentioned under 
the head of tonics in this work, in addition to the foregoing. 476 
COMMON SENSE MEDICAL ADVISER. 
CARBUNCLE. (Anthrax.) 
These are more violent, larger, and more painful than boils, 
which they resemble. They may spring from several small 
pimples which extend deep into the tissues, and on the surface 
frequently several small vesicles appear and break. They may 
discharge, through one or several openings, a thin acrid, bloody, 
or dark-colored fluid. They most frequently occur upon the 
back of the neck, back, back part of the limbs, and under the 
arms. Their presence is evidence of a depressed condition of 
vitality. These tumors vary in size from one-half an inch 
to six inches in diameter, and rapidly proceed to a gangrenous 
condition, a grayish slough being detached from the healthy 
tissue. 
Treatment. Invigorate the system by every possible 
means. The bitter tonics such as Golden Seal, Gentian, or 
Willow, together with quinine and iron should be used. Nutri- 
tious diet, pure air, etc., are necessary. Purify the blood to 
remove the causes of the disease. For this purpose, give the 
Golden Medical Discovery in as large doses as can be borne 
without acting too freely on the bowels. Anodynes may be 
necessary to overcome the pain. Poultices are useful to en- 
courage the separation of the dead from the living tissues. 
Antiseptic dressings are beneficial, of which carbolic acid is to 
be preferred; yeast, however, may be employed. 
Sometimes powerful caustics or free incisions are productive 
of gratifying results, if followed by appropriate dressings, but 
these extreme measures should only be resorted to by the direc- 
tion of a physician. 
For a considerable time after the urgent symptoms have sub- 
sided, the Golden Medical Discovery should be used, to purify 
and enrich the blood, and the bitter tonics and iron may be 
alternated with it, or be used conjointly to good advantage. 
ACUTE CATARRH, OR CORYZA, AND INFLITENZA. 
Acute Catarrh, or Coryza, is an inflammation of the lining 
membrane of the nostrils. The first and most prominent char- 
acteristic symptom is that of " stuffing up of the head." This 
feeling is caused by the swelling of the lining membrane of ACUTE CATARRH, OR CORYZA, AND INFLUENZA. 
477 
the passages, which frequently closes them up. This renders it 
difficult or impossible to breathe through the nose, and affects 
the voice very much. In a day or two the sufferer begins to 
sneeze and the nose discharges copious quantities of clear, hot, 
acrid liquid which often irritates the external orifice, causing it 
to become very sore. In addition to the symptoms already men- 
tioned, there is often " aching of the bones," dryness of the 
skin, and a general derangement of the secretions. It is an 
affection more disagreeable than dangerous. 
Influenza. This is an aggravated form of acute catarrh, 
and is frequently epidemic. When epidemic it is more severe 
than when it occurs sporadically and when complicated with 
other pre-existing disorders it sometimes proves fatal. Suffer- 
ers from consumption, heart disease, or any serious derange- 
ment of a vital organ, are in great danger when attacked by 
influenza. 
Symptoms. This acute affection usually commences with 
chilly sensations alternating with flushes of heat. Sneezing is a 
common symptom; there is pain in the forehead; breathing 
through the nose is difficult; the eyes are red and watery; sore- 
ness of the throat is experienced; there is pain in the back, 
nervous irritation, fever, thirst, hoarseness and general lassitude. 
There is cough, at first dry, afterward attended -with free expec- 
toration. 
Causes. The causes of this epidemic are supposed to be 
certain atmospheric changes, the precise nature of which is not 
known. They may or may not be perceptible to the senses, yet 
their effect is painfully apparent to all. Such causes of disease, 
however, are beyond human control. We may mitigate their 
effects, but cannot stay them in their career. 
Treatment. In the milder forms of acute catarrh, or 
coryza, only simple treatment is required. A hot foot-bath, on 
retiring at night, with a full dose of the Compound Extract of 
Smart-weed, to produce free perspiration, will generally break 
up the attack. However, should the discharge from the nostrils 
continue troublesome, Dr. Sage's Catarrh Remedy should be 
freely snuffed four or five times a day, and if the bowels be 
costipated a mild dose of the Pleasant Purgative Pellets will 
materially assist in overcoming the disease. These means, well 478 
COMMON SENSE MEDICAL ADVISEE. 
applied, together with the avoidance of exposure to cold, and 
restriction to a spare vegetable diet, will prove most efficacious. 
In the more severe attacks of Influenza, the most decisive 
measures should be employed. The spirit vapor-bath should 
be administered, to induce profuse sweating, or, if the means 
for its application be not at hand, the patient should be warmly 
covered up in bed, and jugs or bottles of hot water applied to 
his feet and sides. The Compound Extract of Smart-weed 
should be given freely, together with plenty of warm drinks, 
by which copious perspiration will be kept up, the circulation of 
the blood equalized, and inflammation of the mucous lining of 
the air passages subdued. In very severe attacks, the tincture 
of aconite will aid in establishing perspiration and subduing the 
inflammation. If severe coughing be a troublesome symptom, 
the Golden Medical Discovery should be taken in small and 
frequent doses. 
CHRONIC NASAL CATARRH. (Oz,ena.) 
In consequence of repeated attacks of acute catarrh, or "cold 
in the head," as it is usually termed, the mucous membrane of 
the nose and air-passages of the head become permanently 
thickened, the mucous follicles or glands diseased, and their 
functions either destroyed or very much deranged. Although 
chronic catarrh is most commonly brought on in the manner 
above stated, it sometimes makes its appearance as a sequel and 
result of typhoid fever, scarlet fever, measles or other eruptive 
fevers, or shows itself as a local manifestation of scrofulous or 
syphilitic taints in the system. In the early stages of the dis- 
ease the patient may be annoyed with only a slight " dropping 
in the throat," as many express it, the amount of the discharge 
from the air passages of the head at this stage of the disease 
being only slightly in excess of health. In some cases the dis- 
charge is thick, ropy, and tough, requiring frequent and strong 
efforts in the way of blowing and spitting, to remove it from 
the throat, where it frequently lodges. In other cases, or in 
other stages of the same case, the discharge is thin, watery, 
acrid, irritating, and profuse. The nasal passages may be ob- 
structed by the swollen and thickened condition of the lining 
mucous membrane so as to necessitate breathing through the CHRONIC NASAL CATARRH. 
479 
mouth, giving to the voice a disagreeable nasal twang. From 
the nature of the obstruction in this condition, it is useless for 
the sufferer to endeavor to clear the passage by blowing the 
nose; this only tends to render a bad matter worse, by increas- 
ing the irritation and swelling of the already thickened lining 
membrane. The swelling of the mucous membrane does not in 
all cases become so great as to cause obstruction to respiration 
through the affected passages. In some cases the patient suffers 
from headache a great portion of the time, or may experience a 
dull, heavy, disagreeable fullness or pressure in the head, with a 
confusion of his ideas, which renders him quite unfit for 
business especially such as requires deep thought and mental 
labor. Memory may be more or less affected, and the disposi- 
tion of those who are otherwise amiable, is often rendered 
irritable, or morose and despondent. The mental faculties 
suffer to such an extent in some cases as to result in insanity. 
The sense of smell is in many cases impaired, and sometimes 
entirely lost, and the senses of taste and hearing are not unfre- 
quently more or less affected. 
Ozaena. The ulcerative or more aggravated stage of the 
disease, from the offensive odor which frequently attends it, is 
denominated Ozaena. 
The secretion which is thrown out in the more advanced 
stages of chronic catarrh often becomes so acrid, unhealthy and 
poisonous, that it produces severe irritation and inflammation, 
which are followed by excoriation and ulceration of the deli- 
cate lining membrane of the air-passages in the head. Although 
commencing in the lining membrane, the ulceration gradually 
extends in depth, until it frequently involves all the structures 
of the nose, cartilage, bone, and fibrous tissue. As the ulcera- 
tion extends up among the small bones, the discharge generally 
becomes profuse, and often excessively fetid, requiring the fre- 
quent use of the handkerchief, and rendering the poor sufferer 
disagreeable both to himself and those with whom he associ- 
ates. Thick, tough, brownish incrustations, or hardened lumps, 
are frequently formed in the head, by the evaporation of the 
watery portion of the discharge. These lumps are sometimes 
so large and tough that it is with great difficulty that they can 
be removed. They are usually discharged at intervals of a few 480 
COMMON SENSE MEDICAL ADVISEE. 
days. Portions of cartilage and bone, or even entire bones, 
often slough away and are discharged, either in large flakes or 
blackened, half-decayed, and crumbly pieces, or, as is much 
more commonly the case, in the form of numerous minute par- 
ticles, which escape with the discharge unobserved. It is pain- 
fully unpleasant to witness the ravages of this terrible disease, 
and observe the extent to which it sometimes progresses. Holes 
are eaten through the roof of the mouth, and great cavities ex- 
cavated into the solid bones of the face; in such cases only the 
best and most thorough treatment will check the progress and 
fatal termination of the disease. 
COMPLICATIONS. 
Catarrh, or ozaena, is liable to be complicated not only with 
scrofulous or other taints, as has already been pointed out, but 
also by an extension of the diseased condition to other parts 
beyond the air-passages of the head. 
Disease of the Throat. The acrid, irritating, and 
poisonous discharge which, in some stages of the disease, almost 
constantly runs down over the delicate lining membrane of the 
pharynx is liable to produce in the lining membrane a diseased 
condition similar to that existing in the air-passages of the 
head. The throat may feel dry, husky, and at times slightly 
sore or "raw;" or, from the muco-purulent discharge which 
is almost constantly dropping down over its surface, the patient 
may feel very little inconvenience from the disease of the 
throat until it is far advanced, the moistening and lubricating 
effect of the " matter " which drops on the surface tending to 
blunt the sensibility of the parts. The back of the throat may 
be pale, or of a dark red color. In the advanced stages, its sur- 
face is studded with very small ulcers which, as seen through 
the mouth, look like small pimples or " canker sores," for which 
they are often mistaken. The patient may at times experience 
a tickling sensation in the throat, with perhaps a slight cough. 
The voice may be more or less affected, especially on exposure 
to cold or through over exertion. The tonsils often participate 
in the diseased condition, becoming more or less enlarged from 
the organization of the plastic matter, thrown out from the 
substance of these gland-s by the inflammatory process. CHRONIC NASAL CATARRH. 
481 
Extension of the Disease to the Larynx. The 
larynx is that portion of the air-passages which, in the male, is 
indicated by " Adam's apple." The acrid, poisonous discharge 
which drops into the throat from the head, is not all removed 
by hawking and spitting. More or less of it is, by the act of 
inspiration, drawn into the larynx, or still lower down into the 
trachea, wind-pipe. In this way the disease creeps along the 
continuous mucous surface of the air-passages, the acrid, poison- 
ous discharge arousing in its track the same irritation, inflam- 
mation, thickening, and ulceration of the lining membrane, 
which characterize the disease in other portions of the air-pas- 
sages. When affecting the larynx the case is usually attended 
with more or less of a cough, which is sometimes very severe, 
at other times only a slight hacking. Tenderness in these re- 
gions, more or less hoarseness, and loss or partial suppression of 
voice, are common to this stage of the disease. 
Bronchitis and Consumption. We have already 
detailed the manner in which the throat, larynx, and trachea, 
in succession, become affected from catarrh or oziena. By the 
same process of extension, the bronchial tubes, and lastly the 
parenchyma or substance of the lungs, in their turn, are dis- 
eased, and bronchitis and consumption firmly established, 
Tightness in the chest, with difficulty of breathing, soreness, 
darting, sharp, or dull, heavy pain, or a prickly, distressing sen- 
sation accompanied with more or less cough or expectoration, 
are evidences that the bronchial tubes have become affected, 
and should admonish the sufferer that he is now standing 
upon the stepping-stone to consumption, over which thousands 
annually tread, in their slow yet sure journey to the grave. 
Deafness. By means of a small canal called the eustachian 
tube, an air-passage and communication between the throat and 
middle ear is formed. This passage is lined by a continuation of 
the mucous membrane which covers the throat and nasal pas- 
sages. The 'catarrhal, inflammatory process, by continuity of 
surface, follows the mucous membrane, thickening its structure 
until the eustachian tube is closed, and the beautiful mechanism 
of the internal ear is rendered useless. While the thickening 
of the lining, mucous membrane is going on, and the passage 
is slowly becoming closed, the patient occasionally, while 482 
COMMON SENSE MEDICAL ADVISER. 
blowing the nose, experiences a crackling sound in one or 
both ears, and hearing becomes dull, but returns suddenly, ac- 
companied with a snapping sound. This may be repeated 
several times, until, finally, hearing does not return, but remains 
permanently injured. In other cases, the hearing is lost so 
gradually that a considerable degree of deafness may exist be- 
fore the person is really aware of the fact. Either condition is 
often accompanied with noises in the head, of every conceiv- 
able description, increasing the distress of the sufferer. The 
delicate bones of the ear are sometimes detached from their 
articulations, the drum is ulcerated and perforated, and through 
the orifice thus made, the bones or small spicula, may escape 
with the thick, purulent, and offensive discharge. 
Closure of the Tear Duct. The lachrymo-nasal, or 
tear duct, or passage, which, when in a healthy condition, serves 
to convey the tears from the eye into the nose, may be closed 
by the same inflammatory and thickening process which we 
have already described. This condition is usually attended 
with watery and weak eyes, the tears escaping over the cheeks, 
and sometimes producing irritation and excoriation. The nasal 
branch of the ophthalmic nerve sometimes participates in the 
ulcerative process going on in the head, so that the eyes are 
sympathetically affected. They sometimes become congested or 
inflamed, and sharp pain in the eyeballs may be experienced. 
Symptoms. Dull, heavy headache through the temples 
and above the eyes, indisposition to exercise, difficulty of think- 
ing or reasoning or concentrating the mind upon any subject, 
lassitude, indifference respecting business, lack of energy, ob- 
struction of nasal passages, discharges falling into the throat, 
consisting of profuse, watery, acrid, thick, and tenacious mucus, 
or purulent, muco-purulent, bloody, putrid, offensive matter are 
the most frequent symptoms of catarrh. In the most severe 
cases, a dryness of the nasal passages, dry, watery, weak, or 
inflamed eyes, ringing in the ears, deafness, discharge from the 
ears, hawking and coughing to clear the throat, ulcerations, 
death, and decay of bones, expectoration of putrid matter, 
spicula of bones, scabs from ulcers, a constant desire to clear 
the nose and throat, nasal twang, offensive breath, impairment 
or total deprivation of the sense of smell and taste, dizziness, CHRONIC NASAL CATARRH. 
483 
mental depression, loss of appetite, nausea, indigestion, dyspep- 
sia, enlarged tonsils, raw throat, tickling cough, are all common. 
All the above symptoms, as well as some others which have 
been given previously, and which it is not necessary here to re- 
peat, are common to this disease in its different stages or com- 
plications, yet thousands of cases annually result in consumption 
or chronic bronchitis, and end in the grave, without ever having 
manifested one-half of the symptoms enumerated. 
Varieties. People often suppose that there are a great 
many varieties of catarrh. This is an error. The nature of 
the disease is the same in all cases, the symptoms only varying 
with its different stages, and the various complicated, diseased 
conditions which are liable to arise, and which we have already 
pointed out. 
Causes. Anything which debilitates the system, diminishes 
its powers of evolving animal heat and withstanding cold or 
sudden changes of atmospheric temperature and other disease- 
producing agencies, renders the individual thus enfeebled liable 
to catarrh. Among the most common predisposing influences 
are a scrofulous condition of the system, or other impurities 
of the blood, exhausting fevers and other prostrating acute 
diseases, exhausting, unnatural discharges, intemperance, excess- 
ive study, self-abuse, adversity, grief, want of sleep, syphilitic 
taints of the system, which may have been contracted inno- 
cently, or which may have been inherited, too sudden rest after 
great and fatiguing exercise, and living in poorly-ventilated 
apartments. These are among the most fruitful causes of those 
feeble, deranged, or impure conditions of the system to which 
catarrh so frequently owes it origin. The immediate or excit- 
ing cause is generally repeated attacks of " cold in the head," 
which have been neglected or improperly treated. Some people 
are convinced with difficulty that there exists in their system 
a weakness, impurity, or derangement of any kind which has 
permitted the disease to fasten itself upon them. They may 
not feel any great weakness, may not have any pimples, 
blotches, eruptions, swellings, or ulcers upon any part of then' 
person; in fact, nothing about them which would, except to 
the skilled eye of the experienced physician, indicate that 
their constitution is deranged, and yet such is generally the 484 
COMMON SENSE MEDICAL ADVISER. 
case. As an ulcer upon the leg, or a " fever-sore," or an erup- 
tion upon the skin, may be the only outward sign of a derange- 
ment of the system, so chronic catarrh is frequently the only 
sign by which a bad condition of the system manifests itself 
in a manner which is perceptible to the sufferer himself or 
to the unprofessional observer. The educated physician, whose 
constant practice perfects his perceptive faculties in this direc- 
tion, detects the constitutional fault, as an experienced banker 
detects a finely-executed counterfeit bank-note which the un- 
practiced eye would receive as genuine. 
Treatment. As the predisposing cause of catarrh is, 
in the majority of cases, some weakness, impurity, or otherwise 
faulty condition of the system, our chief aim should be directed 
to the removal of this cause. The more we see of this disease, 
the more do we see the importance of combining, with the 
use of a local, soothing, and healing application, a thorough 
and persistent internal use of alterative and tonic medicines. 
As a local application for healing the diseased condition in 
the head, Dr. Sage's Catarrh Remedy is beyond all comparison 
the best preparation ever discovered. It is mild and pleasant 
to use, producing no smarting or pain, and containing no strong 
irritating or caustic drug or poison. Its ingredients are simple 
and harmless, yet when scientifically and skillfully combined 
in proper proportions, they form a most efficient and valuable 
healing remedy. Like gunpowder, which is formed of a com- 
bination of saltpetre, sulphur, and charcoal, the ingredients are 
simple, but the product of their combination is wonderful in 
its effects. This remedy is a powerful antiseptic, and speedily 
destroys all unpleasant odors, which accompanies so many cases 
of catarrh, thus affording great relief to those who suffer from 
this disease. 
The reader's mind cannot be too strongly impressed with 
the importance of combining thorough constitutional with local 
treatment of this disease. Not only will the cure be thus more 
surely, speedily, and permanently effected, but other forms of 
disease will thereby be prevented from breaking out, as the 
result of constitutional derangement or weakness. 
Tn the treatment of catarrh and all the various affections 
with which it is so frequently complicated, as throat, bronchial, CHRONIC NASAL CATARRH. 
485 
and lung diseases, weak stomach, catarrhal deafness, weak or 
inflamed eyes, impure blood, scrofulous and syphilitic taints, the 
wonderful virtues of the Golden Medical Discovery cannot be 
too highly extolled. It has a specific effect upon the lining 
mucous membranes of the nasal and other air passages, pro- 
moting the natural secretion of their follicles and glands, there- 
by softening and restoring the diseased and thickened mem- 
brane to its natural thin, delicate, moist, healthy condition. As 
a blood purifier, it is unsurpassed. As those affections which 
complicate catarrh are diseases of the lining mucous membranes, 
or of the blood, it will be very clear why this medicine is so 
well adapted to cure them. 
The Golden Medical Discovery is the natural auxiliary of Dr. 
Sage's Catarrh Remedy. It not only cleanses, purifies, regulates, 
and builds up the system to a healthy standard, and conquers 
throat, bronchial, and lung complications, when any exist, but, 
from its specific effects upon the lining membrane of the nasal 
passages, it aids materially in restoring the diseased, thickened, 
or ulcerated membrane to a healthy condition, and thus eradi- 
cates the disease. When a cure is effected in this manner it is 
permanent. The system is so purified, regulated, and strength- 
ened as to be strongly fortified against the encroachments of 
catarrh and other diseases. In taking the Golden Medical 
Discovery the effects upon the system are gradual, and the 
alterative changes of tissue and function generally somewhat 
slow. They are, however, not less complete, radical, and perma- 
nent, and this constitutes its great merit. Under its use, all the 
secretions are stimulated, the blood-poisons carried out of the 
system, the nutrition is promoted, and the patient finds himself 
gradually improving in flesh; his strength is built up, his linger- 
ing ailments disappear, and he soon finds that his whole system 
has been renovated and repaired, and he feels like a new and 
perfect being. 
The Clothing. With most persons suffering from chronic 
nasal catarrh, there is a great disposition to take cold, even slight 
exposure being sufficient to produce an acute attack, which 
greatly aggravates the chronic affection, and tends to render 
it permanent. To obviate the evil effects which are liable to 
result from this predisposition, great attention should be paid to COMMON SENSE MEDICAL ADVISER. 
486 
clothing; it should thoroughly protect the person from sudden 
changes of temperature. For more particular and practical 
suggestions in regard to this matter, the reader is referred to the 
article on clothing in Part Third of this volume. 
The Diet has an important bearing upon this disease, as 
with consumption and many other chronic affections. It should 
be largely composed of those articles which are rich in the car- 
bonaceous elements. Fat meats, rich, sweet cream, good butter, 
and other similar articles of diet should be largely eaten. By 
furnishing the elements for the production of animal heat, they 
counteract the predisposition to take cold, and thus become most 
valuable remedial agents-not less essential than the medical 
treatment which has been advised. A person suffering from 
chronic catarrh should study well the hygienic instructions to be 
found in Part Third of this volume, and govern himself accord- 
ingly. 
Treatment of Complications. There are various 
complications of this disease which require modifications of 
treatment. Yet rules cannot be made which would enable un- 
professional readers to vary the treatment to suit peculiarities of 
the constitution, or complications of the disease. When con- 
sulted, either in person or by letter, we have been able to so 
modify the treatment as to adapt it to peculiar, individual cases 
which had resisted all ordinary treatment, and have thus cured 
hundreds who had otherwise failed to find relief. 
Time Required to Effect a Cure. A person should 
not expect to be speedily cured, especially if the case be one of 
long standing. It is true that strong, irritating, and drying 
preparations frequently suddenly arrest the discharge from the 
nose, but the thickened or ulcerated condition of the lining, 
mucous membrane, which really constitutes the disease, is not 
removed by such treatment, and the discharge soon comes on 
again. Besides, there is danger attending the use of strong, 
irritating, or drying preparations. The disease, by their use, is 
frequently driven to the throat, bronchial tubes, lungs, or brain. 
Not less irrational and unsuccessful is the plan of treating the 
disease with inhalations of "carbolized iodine," and other sim- 
ilar preparations. Such treatment may mask the disease for a 
time; but by reason of its constitutional nature they cannot CHRONIC NASAL CATARRH. 
487 
effect a perfect and permanent cure. Dr. Sage's Catarrh Rem- 
edy, on the other hand, cures the disease upon rational and 
scientific principles, by its mild, soothing, and healing properties, 
to which the disease gradually yields, when the system has been 
put in order by the use of the Golden Medical Discovery. Our 
clinical experience has convinced us that this ie the only per- 
Fig. 191. 
This cut illustrates the manner of using Dr. Pierce's Nasal Douche. 
fectly safe, scientific, and successful mode of acting upon and 
healing it. 
This remedy, when prepared according to the directions which 
accompany each package, may be poured into the hollow of the 
hand, and snuffed up the nostrils, one after the other; but a 
much more effectual method of applying it, is to use Dr. Pierce's 
Nasal Douche in the manner illustrated by Fig. 191. The 
remedy should be thoroughly applied to all the affected parts, 
which can only be accomplished by the douche. 488 
COMMON SENSE MEDICAL ADVISER. 
HAY CATARRH. 
This affection, known also as Hay Asthma, and Hay Fever, 
differs but little in its manifestations, from coryza, save in its 
inciting cause, and in its element of periodicity. In this lati- 
tude there are a few persons who, between the middle and last 
of August, are invariably attacked with acute inflammation of 
all the air-passages, giving rise to sneezing, watery discharges 
from the nose and eyes, difficult respiration, fever, and general 
prostration. These symptoms are supposed to be induced by 
the inhalation of the odor of grasses or flowers, which at that 
time are supposed to give off certain exhalations of an irritating 
character. Unless arrested by medical treatment, the disease 
lasts until cool weather, or the occurrence of a hard frost, 
rids the atmosphere of the irritating perfume. 
Some feather beds give off an odor which excites all the 
aggravated symptoms of this disease. Thus it appears that 
certain emanations have the power of inciting these inflamma- 
tory conditions in certain sensitive constitutions. A case or 
two are on record, in which the odor from the body of a horse 
so induced these symptoms that the individual could never ride 
nor drive him. 
Treatment. This disease may generally be prevented by 
the daily use of Dr. Sage's Catarrh Remedy, which neutralizes 
and washes away the particles which poison the mucous mem- 
brane. The Remedy should, for this purpose, be used with the 
Nasal Injector, or Douche. When the disease already exists, 
and has advanced so far that it is accompanied with asthma, the 
Golden Medical Discovery is required to effect a cure, and 
should be used in conjunction with the Catarrh Remedy. Two 
or three drops of tincture or fluid extract of lobelia, with 
the same quantity of tincture or fluid extract of gelsemi- 
num repeated three or four times daily, will assist in control- 
ling this very disagreeable malady. Generally, by a vigorous 
application of this treatment, the patient will observe that 
the disease is yielding by degrees, and the improvement will 
continue until a complete cure is effected. If the exciting 
cause can be determined, it should, of course, be avoided, if 
possible. NASAL POLYPUS. 
489 
NASAL POLYPUS. 
Nasal Polypi are tumors which grow from the mucous mem- 
brane of the nasal passages, to which they are generally 
attached by a small pedicle, or neck. There are two varieties, 
gelatinoid and fibroid. The former closely resembles an oyster 
in appearance, color, and consistence. This form rarely bleeds. 
The latter is more rare, of a firmer consistence, and more apt 
to bleed than the former, and is of a deep red or purple color. 
In either variety there is usually more than one tumor present, 
and they are frequently found in both nostrils. They often 
attain considerable size, and, by pressure upon and displace- 
ment of the surrounding structures, occasion hideous deformity 
of the face. Polypi are very often complicated with nasal 
catarrh, the successful treatment of which necessitates their 
removal. 
Causes. Nothing is definitely known regarding their causes, 
but they are generally supposed to originate in some constitu- 
tional derangement, impairing the nutrition of the mucous 
membranes. 
Symptoms. These are such as attend stoppage of the 
nose from any cause. There is a sense of obstruction, more or 
less complete, with fullness and weight in one oi* both nostrils, 
which is increased in damp weather. The voice becomes un- 
natural, as when a cold obstructs the nose, and the sleep is fre- 
quently embarrassed by its interference with breathing. The 
nasal discharge is usually increased, and is of a variable char- 
acter. The diagnosis of polypus is not certain unless it can be 
seen or felt. By forcing the breath through the nostril in 
which it is supposed to exist, it will generally, if present, come 
in sight, which decides the matter at once. Polypi sometimes 
grow backward into the throat, obstructing the posterior open- 
ings of the nose. 
Treatment. Either before or after the removal of the 
tumor, the constitutional derangement should be rectified. For 
this purpose the Golden Medical Discovery is unequaled. The 
removal of the polypus may sometimes be accomplished by 
snuffing powdered blood-root. When this fails it may be 
readily removed by any competent surgeon, by torsion or the 490 
COMMON SENSE MEDICAL ADVISER. 
ligature, and the operation is but slightly painful, for as no 
nerves are distributed to these morbid growths, they are not 
sensitive. After their removal the use of Dr. Sage's Catarrh 
Remedy will prevent their return. 
Case I. A gentleman presented himself at the Invalids' Hotel and 
Surgical Institute seeking treatment for what he supposed to be 
catarrh. He complained of a sense of weight, fullness, and obstruction 
of the nostrils, with discharge Examination revealed the existence 
of polypus, and constitutional derangement. 
We removed the polypus, advised attention to diet and bathing, and 
recommended the use of the Golden Medical Discovery internally, with 
Dr. Sage's Catarrh Remedy, to be used with the Nasal Douche. The 
polypus never returned. 
Case II. Several years ago a middle-aged gentleman called at the 
Invalids' Hotel supposing that he was laboring under an aggravated 
form of catarrh. On examination both nasal passages were found to 
be perfectly filled with polypi, which had enlarged until they had 
pressed out the sides of the nose to such an extent as to produce great 
deformity, giving him a hideous look. The tumors were promptly 
removed by the attending surgeon, proper treatment advised, and we 
learned not long since, through a neighbor of the gentleman operated 
upon, that he has experienced no return of the morbid growths. 
Nasal polypi are so frequently mistaken for chronic catarrh, the 
treatment of which enters so largely into our practice, that it has also 
been our fortune to be consulted very frequently by those suffering 
from the former disease, and the two cases cited are but fair samples of 
a large number on the case books of the Invalids' Hotel which have 
been successfully treated. 
CASES TREATED. 
ACUTE LARYNGITIS. 
This is an acute inflammation of the upper portion of the 
windpipe, and is attended with considerable danger. Its causes 
are colds, suppression of perspiration, and such as generally 
give rise to inflammation. 
The Symptoms are those common to inflammation else- 
where. There is soreness or stiffness of the throat, a difficulty 
in swallowing, and a desire to clear the disordered organ. 
There is fever, the sense of constriction in the throat increases, 
the voice is harsh, hoarse, or croaking, and there is frequently a 
hacking cough. The throat is red and swollen, the voice alters 
and becomes shrill or whispering and suppressed, and the breath- 
ing more difficult. If not relieved, delirium and coma come on, 
and the patient dies of suffocation. 
Treatment. This should be prompt and thorough, and 
similar in character to that recommended for inflammations CHRONIC LARYNGITIS. 
491 
elsewhere, viz: the use of the spirit vapor-bath and hot foot- 
bath, to induce sweating, which should be kept up by the 
Compound Extract of Smart-weed. The employment of Dia- 
phoretic infusions and tincture of aconite, with mucilaginous 
drinks, hot packs to the throat, and the inhalation of steam, is 
proper. The affection being very rapid in its course and 
dangerous, if it does not quickly yield to this treatment, no time 
should be lost in securing skillful medical aid. 
CHRONIC LARYNGITIS. 
This is of much more frequent occurrence than the acute 
form, and is often associated with tuber- 
cular affections, and constitutional syphi- 
lis. It is characterized by an inflamma- 
tory condition, ulceration, or hardening 
of the mucous membrane of the larynx, 
most frequently the latter. There is also 
a chronic form known as follicular lar- 
yngitis, or clergymen's sore throat, to 
which public speakers are subject. 
The Causes of chronic laryngitis 
are various, as prolonged use of the vocal 
organs in reading or speaking; using 
them too long on one pitch or key, with- 
out regard to their modulation; improper 
treatment of acute diseases of the throat; 
neglected nasal catarrh; the inordinate 
use of mercury; syphilis; repeated colds 
which directly cause sore throat, injuries, 
etc. It is also frequently due to tuber- 
cular deposits, and in these cases it gen- 
erally terminates in consumption. 
Symptoms. The affection often 
comes on insidiously. There is soreness 
of the throat, noticeable particularly 
when speaking, and immediately there- 
after; a "raw" and constricted feeling, 
leading to frequent attempts to clear the throat, in order to 
relieve the uneasy sensation. The voice becomes altered, hoarse, 
Fig. 192. 
Pocket Inhaler. 492 
COMMOX SENSE MEDICAL ADVISER. 
and husky, and there is a slight, peculiar cough, with but little 
expectoration. At first, the matter expectorated is mucus, but 
as the disease advances, and ulceration progresses, it becomes 
muco-purulent, perhaps lumpy, bloody, or is almost wholly pure 
pus. The voice becomes more and more impaired, and is finally 
lost. In the latter stages, it resembles consumption, being at- 
tended with hectic fever, night-sweats, emaciation, cough, pro- 
fuse expectoration, and sometimes hemorrhage. 
Treatment. Thorough hygiene should be at once insti- 
tuted, and the patient should avoid using his voice. At the 
same time, attention should be paid to the diet, the bathing, 
and the clothing. Every thing should be done that is calculated 
to build up and improve the general health. The Golden Medi- 
cal Discovery is well adapted to remove morbid states of the 
disease, in consequence of its direct action on the mucous mem- 
branes of the air-passages, and its efficacy in allaying irritation 
of the laryngeal, pharyngeal, and pneumogastric nerves. It 
should be perseveringly employed. Iodine inhalations, admin- 
istered with the pocket inhaler, illustrated by Fig. 192, and the 
application of tincture of iodine to the forepart of the neck, 
are efficacious in many cases. Inhalations of chloride of am- 
monia, administered with a steam-atomizer, in the form of spray, 
are frequently of great benefit. Perseverance is necessary, and 
the afflicted are cautioned against discontinuing the treatment 
too soon, for the disease is very liable to return. 
CASES TREATED. 
Case I. A public speaker applied at the Invalids' Hotel for treat- 
ment. He had been a sufferer for years. His voice was reduced to a 
whisper, except an occasional hoarse or croaking sound. There was 
dryness, and a frequent desire to clear the throat; short, frequent, irri- 
tating cough, with expectoration of minute particles of tubercle. 
There was general debility, emaciation, and loss of strength. 
The Golden Medical Discovery was given internally, and local appli- 
cations made to the larynx, where the laryngoscope showed extensive 
ulceration. In three months he had so far improved that local treat- 
ment was discontinued, and he returned home and continued the use of 
the Discovery for six months longer. He was fully restored to health, 
resumed his profession, and, two years after, was perfectly well. 
Case II. The Bev. T. H. F. consulted us by letter, giving his symp- 
toms in detail, which did not differ materially from those of the pre- 
ceding case. 
We directed him to take the Golden Medical Discovery, and faith- 
fully observe the hygienic rules heretofore given. Inhalations were CROUP, MEMBRANOUS AND SPASMODIC. 
493 
also advised. A letter was received a few months subsequently, an- 
nouncing the patient's perfect recovery under the course of treatment 
advised. 
CROUP, MEMBRANOUS AND SPASMODIC. 
Every family should be made acquainted with the symptoms 
and treatment of this disease. Especially is this true in the 
case of those living remote from a phy- 
sician. From the lack of this knowledge 
on the part of parents, many a little one 
has perished before medical assistance could 
be obtained. In some of its forms its pro- 
gress is very rapid, and, unless relief is 
obtained in a few moments, or hours at the 
most, death ensues. 
There are several quite distinct patho- 
logical conditions of the vocal and respira- 
tory organs which have, in popular parlance, 
been designated as croup. But two of these 
are worthy of consideration here. These 
are true or membranous croup, in which a 
false, semi-organized membrane is formed, 
and spasmodic croup. Both may result 
fatally, but the former is much the most 
dangerous. 
Membranous Croup is supposed to 
originate in the trachea, from which, as it 
progresses, it often extends upward to the 
larynx, and downward to the bronchial tubes. It is the result 
of severe inflammation of the mucous membrane, and is char- 
acterized by the formation of a false membrane, which covers 
or lines the inner surface of the true structure (see Fig. 193). 
It is formed of a coagulable, semi-fluid exudation from the 
mucous membrane. On being brought to the surface and into 
contact with the inspired air, this substance grows thick and 
tough, or leathery, as we find it. It is the obstruction in the 
respiratory canal which this foreign matter causes that gives 
rise to the labored breathing, and the ringing, brassy cough, 
together with the crowing or whistling inspiration characteristic 
of croup. Before recovery can take place this membrane must 
Fig. IQS. 
False Membrane in 
Croup. From a speci- 
men in Dr. Gross' cabi- 
net. 494 
COMMON SENSE MEDICAL ADVISER. 
be detached and expelled. The cough is nature's effort to 
accomplish this work. 
The formation of this adventitious membrane in the larynx 
is attended with more danger than when it is confined to the 
trachea. In most cases in which the disease has had a very 
speedily fatal termination, an examination has shown that the 
larynx was its chief seat. 
Symptoms. True croup is generally preceded by what is 
known as " a cold." The child coughs, sneezes, and is hoarse. 
It is the hoarseness and the peculiar character of the cough 
which indicate the tendency to croup. This has been already 
described. In addition, the child is restless, fretful, and fever- 
ish. The disease makes rapid strides. Finally the cough ceases 
to be loud and barking, and is very much suppressed; the voice 
is almost gone; the face is very pale; the head thrown back; 
the nostrils dilated and in perpetual motion, the pulse at the 
wrist very feeble, great exhaustion, more or less delirium, and, 
finally, death comes to the relief of the little sufferer. Convul- 
sions sometimes occur in the last stages, and soon terminate 
fatally. 
Treatment. No time should be lost in commencing treat- 
ment. Hot fomentations should be applied to the throat and 
upper portions of the chest. The free inhalation of steam should 
be employed early. The following treatment has been found 
very effectual in membranous croup, and is recommended by the 
highest authorities: yellow sub-sulphate of mercury, or turpeth 
mineral, three to five grains, depending upon the age of the 
child, for one dose. If it does not cause vomiting in fifteen 
minutes, give a second dose. This, however, is seldom necessary. 
If the turpeth mineral cannot be obtained, sulphate of copper or 
sulphate of zinc may be given instead, as directed under the 
head of Emetics, in Part III, Chapter II. If there be a quick 
pulse, hot skin, a hurried breathing, and an occasional ringing 
cough, the child should be kept in bed, comfortably covered, but 
not overloaded with clothes, and the tincture or fluid extract of 
veratrum viride administered as follows: Take fluid extract of 
veratrum, five drops; sweet spirits of nitre, one teaspoonful; 
pure water, twenty teaspoonfuls; mix, sweeten with white sugar, 
and give a teaspoonful of the mixture every half-hour to two CROUP, MEMBRANOUS AND SPASMODIC. 
495 
hours, according to the age of the child and the severity of the 
case. If there be great prostration, with cold extremities, the 
carbonate of ammonia should be administered, in doses of from 
one to two grains, every second hour, in gum arabic mucilage. 
Quinine is a valuable remedy, and is tolerated in large doses. 
The patient's body should be frequently sponged with warm 
water in which a sufficient quantity of saleratus or ordinary 
baking-soda has been dissolved to render it quite strongly alka- 
line. If the bowels be constipated they should be moved by an 
injection of starch-water. Beef tea and other concentrated, sup- 
porting diet should be freely administered. In those cases in 
which there is a tendency to croup, the Golden Medical Discov- 
ery, together with iron and the bitter tonics, should be given to 
build up the system and counteract such tendency. The treat- 
ment which we have advised has been put to the severest tests 
in the most severe forms of the disease, and has resulted most 
successfully. If, however, in any case it does not give prompt 
relief, our advice is to lose no time in summoning a physician 
who is known to be skilled in the treatment of diseases of 
children. 
Spasmodic Croup. In this affection no false membrane 
is formed. It seems to have a nervous origin. Most frequently 
the child is awakened in the night by a sense of suffocation. He 
may cry out that he is choking. The countenance is livid, the 
breathing is hurried and each respiration is attended by a crow- 
ing sound. The child has fits of coughing or crying, and makes 
vehement struggles to recover his breath. This complaint, un- 
like true croup, is unattended by fever, it being of a purely spas- 
modic character with no inflammation. 
Apply hot fomentations to the throat, and give frequent small 
doses of tincture or fluid extract or syrup of lobelia, to produce 
slight nausea; or, better still, an acetic syrup of blood-root, 
made by adding one teaspoonful of the crushed or powdered 
root to one gill of vinegar and four teaspoonfuls of white 
sugar. Heat this mixture to the boiling point, strain, and ad- 
minister from one-fourth to one teaspoonful every .half-hour 
or hour. Slight nausea should be kept up, but it is unnecessary 
to produce vomiting. This is usually all the treatment that is 
required. 496 
COMMON SENSE MEDICAL ADVISER. 
CONSUMPTION. (Phthisis Pulmonajlis.) 
By this we understand a constitutional affection, characterized 
by a wasting away of the body, attended by the deposition of 
tubercular matter into the lung tissue. Hence the appellations, 
Phthisis Pulmonalis; Pulmonary Tuberculosis; Tubercular Con- 
sumption. Tubercles may form in other organs and result in 
a breaking down of their tissues, but the employment of the term 
Consumption in this article is restricted to the lungs. The gen- 
eral prevalence, the insidious attack, and the distressing fatality 
of this disease, demand the special attention and investigation of 
every thinking person. It preys upon all classes of society. Rich 
and poor alike furnish its victims. 
Some idea of its prevalence may be formed when we consider 
that, of the entire population of the globe, one in every three 
hundred and twenty-three persons annually dies of consumption. 
It may not be definitely known just what proportion of all the 
deaths in this country and Europe occurs from this one disease. 
Those who have gathered statistics differ somewhat, some claim- 
ing one-fourth, while others put the ratio at one-sixth, one- 
seventh, and even as low as one-ninth. A fair estimate, and one 
probably very near the truth, would be one-sixth or one-seventh 
of the whole number. In New York City, for five consecutive 
years, the proportion was three in twenty. In New England, 
about twenty thousand annually succumb to this destroyer, and 
in the State of New York as many more. These figures may 
appear to be exaggerations, but investigations of the subject 
prove them to be the simple truth. Epidemics of cholera, yel- 
low fever, and other diseases of similar character, so terrible in 
their results, occasion wide-spread alarm, and receive the most 
careful considerations for their prevention and cure, while con- 
sumption receives scarce a thought. Yet the number of their 
victims sinks into insignificance when compared with those of 
consumption. Like the thief in the night, it steals upon its vic- 
tim unawares. In a large proportion of cases, its approach is so 
insidious that the early symptoms are almost wholly disregarded; 
indeed, they excite but little, if any, attention, and perhaps for 
a time disappear altogether. Thus the patient's suspicions, if 
they have been aroused, are allayed and appropriate measures CONSUMPTION. 
497 
for his relief are discontinued. This may be the case until 
renewed attacks firmly establish the disease, and before the 
patient is fully aware of the fatal tendency of his malady, he is 
progressing rapidly towards that "bourne from which no trav- 
eler returns." 
As has already been stated, consumption is a constitutional 
disease, manifested by feeble vitality, loss of strength, emacia- 
tion-symptoms which are too often classed under the name of 
general debility, until local symptoms develop, as cough, difficult 
breathing, or hemorrhage, when examination of the chest reveals 
the startling fact that tubercular deposits have been formed in 
the lungs. Invalids are seldom willing to believe that they have 
consumption, until it is so far advanced that all medicine can 
do is to smooth the pathway to the grave. Another character- 
istic of this disease is hope, which remains active until the very 
last, flattering the patient into expectation of recovery. To the 
influence of this emotion, the prolongation of the patient's life 
may often be attributed. 
Nature of the Disease. It is an error to suppose that 
the disease under consideration is confined to the lungs. "Pul- 
monary Consumption," as has been remarked, " is but a frag- 
ment of a great constitutional malady." The lungs are merely 
the stage where it plays its most conspicuous part. Every part 
of the system is more or less involved, every vital operation more 
or less deranged; especially is the nutritive function vitiated and 
imperfect. The circulation is also involved in the general 
morbid condition. Tubercles, which constitute a marked feature 
of the disease, are composed of unorganized matter, deposited 
from the blood in the tissue of the lungs. They are small 
globules of a yellow, opaque, friable substance, of about the con- 
sistency of cheese. After their deposition, they are increased in 
size by the accretion of fresh matter of the same kind. They 
are characteristic of all forms of scrofulous disease. 
The most plausible theory in regard to them is, that they 
are the result of imperfect nutrition. Such a substance cannot 
be produced in the blood when this fluid is perfectly formed. 
It is an unorganized particle of matter, resulting from the 
imperfect elaboration of the products of digestion, which is 
not, therefore, properly fitted for assimilation with the tissues. 498 
COMMON SENSE MEDICAL ADVISER. 
The system being unable to appropriate it, and powerless to 
cast it off through the excretory channels, deposits it in the 
lungs or other parts of the body. There it remains as a 
foreign substance, like a splinter or thorn in the flesh, until 
ejected by suppuration and sloughing of the surrounding parts. 
It might be supposed by some that when the offending 
matter was thus eliminated from the lungs, they would heal 
and the patient recover; but, unfortunately, the deposition of 
tubercular matter does not cease. Owing to the morbid action 
of the vital forces, it is formed and deposited as fast or faster 
than it can be thrown off by expectoration. Hence arises the 
remarkable fatality of pulmonary consumption. 
Causes. The causes of consumption are numerous and 
varied, but may all be classed under two heads, viz: Constitu- 
tional, or predisposing, and local, or exciting. Of just what 
tubercular matter consists, is still a subject of controversy, but 
that its existence depends upon certain conditions, either congen- 
ital or acquired, is generally conceded; and one of these con- 
ditions is impaired vitality. Constitutional predisposition must 
first give rise to conditions which will admit of the formation of 
tubercular matter, before any cause whatever can occasion its 
local deposition. It must first modify the vitality of the whole 
system, when other causes may determine in the system thus 
impaired, the peculiar morbid action of which tubercular matter 
is the product. The general division of causes into predisposing 
and exciting, must ever be more or less arbitrary. Individuals 
subject to predisposing causes may live the natural term of life 
and finally die of other disease. Indeed, when predisposing 
causes are known to exist, they should constitute a warning for 
the avoidance of other causes. Again, among the so-called 
exciting causes, some may operate in such a manner, with some 
individuals, as to predispose them to consumption, and the result 
will be the same as if the disposition had been congenital. The 
causes which in one individual are exciting, under other circum- 
stances and in other individuals, would be predisposing, because 
they act so as to depress the vitality and impair the nutritive 
processes. 
The Predisposing Causes, then, are hereditary pre- 
disposition, scrofula, sexual excesses and debility of the parents, CONSUMPTION. 
499 
climatic influences, sedentary habits, depressing emotions, in 
fact, anything which impairs the vital forces and interferes with 
the perfect elaboration of nutritive material. 
The Exciting- Causes are those which are capable of 
arousing the predisposing ones into activity, and which, in some 
instances, may themselves induce predisposition; as spermator- 
rhea, dyspepsia, nasal catarrh, colds, suppressed menstruation, 
bronchitis, syphilis, retrocession of cutaneous affections, measles, 
scarlatina, malaria, whooping-cough, small-pox, continued fevers, 
pleurisy, pneumonia, long-continued influence of cold, sudden 
prolonged exposure to cold, sudden suspension of long-continued 
discharges, masturbation, excessive venery, wastes from excessive 
mental activity, insufficient diet, both as regards quantity and 
quality, exposure to impure air, atmospheric vicissitudes, dark 
dwellings, dampness, prolonged lactation, depressing mental emo- 
tions, insufficient clothing, improper treatment of other diseases, 
exhaustive discharges, tight lacing, fast life in fashionable soci- 
ety, and impurity and impoverishment of the blood from any 
cause. This list might be greatly extended, but the other causes 
are generally in some manner allied to those already named. 
Symptoms. The symptoms of consumption vary with the 
progress of the disease. Writers generally recognize three 
stages, which so gradually change from one to the other that a 
dividing line cannot be drawn. As the disease progresses, new 
conditions develop, which are manifested by new symptoms. 
Prior to the advent of pulmonary symptoms, is the latent period, 
which may extend over a variable length of time, from a few 
months to several years; and, indeed, may never be developed 
any farther. Until sufficient tubercular matter has been depos- 
ited in the lungs to alter the sounds observed on auscultation 
and percussion, a definite diagnosis of tubercular consumption 
cannot be made, even though there may have been hemorrhage. 
Nevertheless, when we find paleness, emaciation, accelerated and 
difficult breathing, increased frequency of the pulse, an increase 
of temperature, and general debility coming on gradually with- 
out any apparent cause, we have sufficient grounds for grave sus- 
picions. These are increased if tenderness under the collar-bone, 
with a slight, hacking cough is present. These symptoms should 
be sufficient to warn any individual who has the slightest reason 500 
COMMON SENSE MEDICAL ADVISEE. 
to believe that he is disposed to consumption, to lose no time in 
instituting the appropriate hygienic and medical treatment, for 
it is at this stage that remedies will be found most effective. 
Unfortunately, this period is too apt to pass unheeded, or receive 
but trifling attention; the patient finds some trivial excuse for 
his present condition, and believes that he will soon be well. 
But, alas for his anticipations ! The disease goes onward and 
onward, gradually gaining ground, from which it will be with 
great difficulty dislodged. 
The cough now becomes sufficiently harassing to attract atten- 
tion, and is generally worse in the morning. The expectoration 
is slight and frothy; the pulse varies from ninety to one hundred 
and twenty beats in a minute, and sometimes even exceeds this. 
Flushes of heat and a burning sensation on the soles of the feet 
and palms of the hands are experienced. A circumscribed red- 
ness of one or both cheeks is apparent. These symptoms increase 
in the afternoon, and in the evening are followed by a sense of 
chilliness more or less severe. The appetite may be good, even 
voracious; but the patient remarks that his food "does not seem 
to do him any good," and, to use a popular expression, "he is 
going into a decline." As the strength wanes the cough becomes 
more and more severe, as if occasioned by a fresh cold, in which 
way the patient vainly tries to account for it. Expectoration 
increases, becomes more opaque, and, perhaps, yellow, with 
occasionally slight dots or streaks of blood. The fever increases, 
and there is more pain and.oppression of the chest, particularly 
during deep respiration after exercise. Palpitation is more 
severe. There may now be night-sweats, the patient waking in 
the morning to find himself drenched in perspiration, exhausted, 
and haggard. Bleeding from the lungs occurs, and creates alarm 
and astonishment, often coming on suddenly without warning. 
The hemorrhage usually ceases spontaneously, or on the admin- 
istration of proper remedies, and in a few days the patient feels 
better than he has felt for some time previously. The cough is 
less severe, and the breathing less difficult. Indeed, a complete 
remission sometimes occurs, and both patient and friends deceive 
themselves with the belief that the afflicted one is getting well. 
After an indefinite length of time, the symptoms return with 
greater severity. These remissions and aggravations may be CONSUMPTION. 
501 
repeated several times, each successive remission being less per- 
fect, each recurrence more severe, carrying the patient further 
down the road toward the "dark valley." Now the cough in- 
creases, the paroxysms become more severe, the expectoration 
more copious and purulent, as the tubercular deposits soften and 
break down. The voice is hollow and reverberating; the chest 
is flattened, and loses its mobility; the collar-bones are promi- 
nent, with marked depressions above and below. Auscultation 
reveals a bubbling, gurgling sound, as the air passes through the 
matter in the bronchi, with a click to the air cells beyond. Per- 
cussion gives a dull sound, or if there are large cavities, it is 
hollow, and auscultation elicits the amphoric sound, as of blowing 
into a bottle. Hectic fever is now fully established; the eye is 
unusually bright and pearly, with dilated pupils, which gives a 
peculiar expression; the paroxysms of coughing exhaust the 
patient, and he gasps and pants for breath. The tongue now 
becomes furred, the patient thirsty, the bowels constipated, and 
all the functions are irregularly performed. Another remission 
may now occur, and the patient be able to resume light employ- 
ment, for an indefinite length of time, which we have known to 
extend over three or four years, when the symptoms again 
return. 
If the patient is a female, and deranged or suppressed men- 
struation has not marked the accession of pulmonary symptoms, 
the flow now becomes profuse and clotted, or is scanty and color- 
less, sometimes ceasing altogether. In the male, the sexual 
powers diminish, and copulation is followed by excessive and 
long-continued prostration. From this time onward, the progress 
of the disease is more rapid. The liver and kidneys are impli- 
cated. In addition to the pallor, the complexion becomes jaun- 
diced, giving the patient, who is now wasted to a mere skeleton, 
a ghastly look. The urine is generally copious and limpid, 
though occasionally scanty and yellow. The pulse increases to 
one hundred and thirty or one hundred and forty beats in the 
minute, and is feeble and thread-like. The cough harasses the 
patient so that he does not sleep, or his rest is fitful and unre- 
freshing; whenever sleep does occur, the patient wakes to find 
himself drenched with a cold, clammy perspiration. The throat, 
mouth, and tongue now become tender, and occasionally ulcerate. 502 
COMMON SENSE MEDICAL ADVISEE. 
Expectoration is profuse, purulent, and viscid, clinging tena- 
ciously to the throat and mouth, and the patient no longer has 
strength to eject it. The hair now falls off, the nails become 
livid, and the breathing difficult and gasping; the patient has no 
longer strength to move himself in bed and has to be propped 
up with pillows, and suffocates on assuming the recumbent posi- 
tion. Drinks are swallowed with difficulty. Diarrhea takes the 
place of constipation. The extremities are cold, swollen, and 
dropsical; the voice feeble, hollow, grating, husky, the patient 
gasping between each word; the respiration is short and quick. 
A slight remission of these symptoms occurs. The patient is 
more comfortable, lively, cheerful, and perhaps forms plans for 
the future. But it is the last effort of expiring vitality, the last 
flicker of the lamp of life, the candle burns brilliantly for a mo- 
ment, and with one last effort goes out, and death closes the 
scene. 
The duration of the active stage of consumption varies from 
a few weeks to several years, the average time being about 
eighteen months. 
Cough is always a prominent symptom throughout the entire 
course of the disease, varying with its progress. 
Expectoration, at first scanty, then slightly increased, color- 
less, frothy, and mucous, is also a characteristic. After a time 
it becomes opaque, yellow, and more or less watery; then muco- 
purulent and finally purulent, copious, and viscid. When tuber- 
cular matter is freely expectorated, with but little mucus, it 
sinks in water. This symptom continues to the very last. 
Haemoptysis (bleeding from the lungs) may occur at any stage 
of the disease, often being the first pulmonary symptom noticed, 
again being delayed until late; and there are cases in which it 
does not happen at all. It seldom occurs in any other disease. 
Night-sweats may occur at any stage, though they are rarely 
experienced until the disease is pretty well established, and are 
very exhausting. 
Hectic Fever generally occurs soon after the pulmonary symp- 
toms are developed, and increases in intensity with the progress 
of the disease. There are usually two paroxysms in the twenty- 
four hours, one of which occurs towards evening and is fol- 
lowed by night-sweats. CONSUMPTION. 
503 
Dyspnoea (difficult breathing) is at first slight, except after 
exertion, amounting to only a sense of oppression; but it be- 
comes more and more severe as the disease advances, until the 
very last, when it is agonizing in the extreme. 
Aphthae, sometimes extending to the pharynx and larynx, 
generally occurs towards the last. The mouth and throat 
become so very sore and tender that nourishment and medicine 
are taken with difficulty. 
Emaciation and Debility are characteristic of the disease. 
They fluctuate as the disease advances or is retarded, increasing 
to the very last. 
Auscultation and Percussion constitute valuable means of 
diagnosis from the time tubercular matter begins to be deposited 
to the very last, and, when correctly practiced, reveal the 
extent and progress of the disease. As a knowledge of the 
sounds elicited can only be acquired by practical experience, 
with proper instruments, they will not be described here. The 
only diseases with which consumption is likely to be confounded 
are general debility in the early stage, bronchitis, chronic 
pleurisy, chronic pneumonia, and abscess in the lungs, after the 
advent of pulmonary symptoms. 
Curability. Notwithstanding the prevailing opinion that 
consumption is incurable, there exists ample, incontrovertible 
evidence to the contrary. Its curability is established beyond 
the shadow of a doubt. Individuals have recovered in whom 
there was extensive destruction of pulmonary tissue, and, indeed, 
entire destruction of one lung. Numerous instances are on 
record in which persons have suffered from all the symptoms 
of confirmed consumption, and have regained their health and 
subsequently died of other diseases. The case of the late Dr. 
Joseph Parish, of Philadelphia, affords a striking example of 
this kind. In early life, he manifested all the symptoms of 
confirmed consumption, including frequent hemorrhages, yet he 
fully regained his health, a»d, after a very useful life, died at an 
advanced age of another disease. Post-mortem examination 
revealed the existence of cicatrices, or scars, in his lungs where 
tubercular matter had been deposited. Dr. Wood, in his Prac- 
tice of Medicine, mentions another instance of a medical gentle- 
man in Philadelphia, who in early life suffered from consumption 504 
COMMON SENSE MEDICAL ADVISER. 
with haemoptysis, from which he recovered, and afterwards 
died, at an advanced age, of typhoid fever, when the knife 
revealed the presence of cicatrices. Post-mortem examinations 
of individuals who have died of other diseases, have revealed, 
in numerous instances, the presence of consumption at some 
period of their existence. In these cases the lungs were per- 
fectly healed by cicatrization, or by the deposit of a chalky 
material. A French physician made post-mortem examinations 
of one hundred women, all of whom were over sixty years of 
age, and who had died of other diseases, and in fifty of them 
he found evidences of the previous existence of consumption. 
Professor Flint says that consumption sometimes terminates 
in recovery, and that his observations lead him to the conclusion 
that the prospect of recovery is more favorable in cases charac- 
terized by frequent hemorrhages. Drs. Ware and Walshe are 
also led to the same conclusion. 
Professor J. Hughes Bennett, of Edinburgh, has thoroughly 
investigated the subject, and adds his testimony to that of 
others, citing numerous cases that have resulted in perfect 
recovery. If such testimony is not sufficient, we may mention 
the following, whose names are well known and respected in 
professional circles, and all of whom declare that consumption 
is a curable disease. The list includes Laennec, Andral, 
Cruveilhier, Kingstpn, Presat, Rogee, Boudet, and a host of 
others. 
No farther back than 1866, on page 145, of the proceedings 
of the Connecticut Medical Society, we find " observations, 
Ante-mortem and Post-mortem, upon the case of the late Presi- 
dent Day, by Prof. S. G. Hubbard, M. D., New Haven," from 
which we learn that Jeremiah Day, LL. D., who was for twenty- 
nine years President of Yale College, was, while a mere youth, 
a victim of pulmonary consumption. During his infancy and 
boyhood his vitality was feeble. He entered Yale College as a 
student in 1789," but was soon obliged to leave the institution 
on account of pulmonary difficulty, which was doubtless the in- 
cipient stage of the organic disease of the lungs which subse- 
quently developed itself." He remained in feeble health for 
two years, but returned to college, and graduated in 1797. For 
the next six years his lung difficulties were quite severe, and he CONSUMPTION. 
505 
repeatedly bled in large quantities, but he had so far recovered 
in 1803, as to accept a Professorship. He was afterwards 
chosen President of the college, which office he held for many 
years, in the enjoyment of good health. He died from " old 
age," as we are told, in 1867, aged 94 years. 
Statistics show that under the improved methods of treating 
this disease, the mortality, as compared with previous years, has 
been greatly reduced. Clinical observation proves that injuries 
to the lungs are not so fatal as was- once supposed. 
Treatment. The earlier the treatment of this disease is 
undertaken, the greater is the probability of success. The 
reason of this is obvious; at first the disease is general or 
constitutional, but as it advances, by the deposit of tubercular 
matter, it becomes both constitutional and local. Hence the 
treatment must be both general and local. The occurrence of 
certain prominent and distressing symptoms, either from the 
natural progress of the disease, or from complications with 
other affections, often renders it difficult, even for physicians, 
to determine how far their treatment should be general and how 
far local. 
Treating the symptoms instead of the general disease, or 
treating the constitutional disease without regard to the symp- 
toms which arise from it, is an error into which many phy- 
sicians have fallen. The constitutional affection, the local 
manifestations and complications, and the circumstances and 
individual peculiarities of the patient, must all be carefully 
considered; bearing in mind all the while, that tubercular 
matter is the product of a morbid action, which, in every case, 
must exist before its deposition in the lungs, or any other 
tissue, can take place. 
In every case in which curative treatment is to be instituted, 
the hearty and persistent co-operation of both patient and 
friends is absolutely necessary; and the treatment, which is 
both hygienic and medical in character, should have in view 
the following aims: 
(1.) The avoidance of the causes concerned in the produc- 
tion and perpetuation of the disease. 
(2.) The restoration of healthy nutrition, in order to stop 
the formation of tuberculous matter. 506 
COMMON SENSE MEDICAL ADVISER. 
(3.) The arrest of the abnormal breaking down of the 
tissues, and the prevention of emaciation. 
(4.) The relief of local symptoms, and the complications 
arising from other diseases. 
The fulfillment of the first indication, the avoidance of 
causes, is of the utmost importance, for if they have been 
sufficient to produce the disease, their continued operation must 
certainly be sufficient to perpetuate it. A single individual is 
very often subjected to the operation of several of the causes 
already enumerated, some of which, in consequence of circum- 
stances and surroundings, are unavoidable. Of these, the one 
most difficult to overcome is climate; z. e. the frequent varia- 
tions of temperature. 
Upon the subject of climate much has been written. But 
that which is best adapted to the cure of consumption, is that 
which will enable the patient to pass a certain number of hours 
every day in the pure open air, without exposure to sudden 
alterations of temperature. There are very few persons who 
change their place of residence, except as a last resort, when the 
disease is in the last stage. It is then productive of little or no 
good. This is one reason why so many people having consump- 
tion die in Florida, and other warm countries. If a change of 
climate is to be effected at all, it should be made early. 
To avoid danger, and maintain a perfect standard of health, 
the hygienic rules laid down in Part II. of this work should be 
carefully followed. 
The most powerful stimulant to health is well-regulated 
exercise. It assists the performance of every function, and is 
of paramount importance to promote good digestion and proper 
assimilation, conditions essential for recovery. It should not, 
however, be carried beyond the powers of endurance of the 
individual, so as to exhaust or fatigue. Every thing that can 
invigorate should be adopted; every thing that exhausts should 
be shunned. 
To fulfill the second indication, to restore healthy nutrition, 
requires not only a proper diet, both as regards quantity and 
quality, but demands that the integrity of the organs concerned 
in the process of digestion and assimilation, shall be maintained 
at the highest standard of perfection possible. CONSUMPTION. 
507 
That the diet be sufficient in quantity should be obvious to 
all. It is also necessary that it be nutritious, and that it should 
contain carbonaceous elements. Food of a starchy or sacchar- 
ine character is apt to increase acidity, and interfere with the 
assimilation of other elements, therefore, articles, rich in fatty 
matters, should enter largely into the diet. The articles of 
food best adapted to the consumptive invalid are milk, rich 
cream, eggs, bread made from unbolted wheat-flour, and raised 
with yeast, cracked wheat, oatmeal, good butter, beef, game, 
and fowls. These contain the necessary elements for assimila- 
tion. Oily food is of great importance, and the beef eaten 
should contain a good proportion of fat. Plenty of salt should 
always be eaten with the food, and a desire for it is often ex- 
perienced. Over-eating should be avoided, lest the stomach be 
induced to rebel against articles of diet rich in important ele- 
ments. 
Derangement of the process of nutrition requires careful at- 
tention, and, if necessary, correction. For this purpose, nothing 
can excel the Golden Medical Discovery. It increases the appe- 
tite, favors the nutritive transformation of the food, enriches 
the blood, and thus retards the deposition of tubercular mat- 
ter. It is so combined that, while it meets all these indications, 
it relieves or prevents the development of those distressing 
symptoms so common in this disease. 
The Golden Medical Discovery is adapted to fulfill the third 
indication in the management of this disease, which is to check 
the abnormal breaking down and waste of tissues, which consti- 
tute such a prominent feature in this malady. The antiseptic 
properties of the Discovery are unmistakably manifested in pre- 
venting such abnormal decomposition. The emaciation, excess- 
ive expectoration, profuse perspiration, diarrhea, and hectic 
fever, common to consumption, are all due to a too rapid dis- 
integration and waste of the tissues. It is in this condition of 
the system that this medicine, by its powerful antiseptic prop- 
erties, manifests its most wonderful curative ability. When, as 
in this disease, the vital forces of the system have, in a degree, 
lost their restraining influence over the processes of disintegra- 
tion, waste, and decay, which go on so rapidly that nutrition 
cannot compensate for the loss to the system, then it is that the 508 
COMMON SENSE MEDICAL ADVISER. 
Golden Medical Discovery, by its antiseptic influence, checks 
this rapid waste of the tissues, and thus arrests the disease. 
To the lack of employment of such a remedy in the treatment 
of consumption, the unparalleled fatality of the disease is 
largely due. In their anxiety to improve digestion and nutri- 
tion, and thus build up the tissues, physicians often lose sight 
of the no less important indication of restraining the destruc- 
tive waste going on in the system, which overbalances the sup- 
plies furnished by absorption. The gradually increasing emaci- 
ation and loss of strength renders perpetuity of the organism 
impossible. 
The fulfillment of the fourth indication, to relieve local 
symptoms, and the complications with other diseases, is often 
attended with no little difficulty. 
The Cough is a secondary symptom, arising from the irrita- 
tion caused by the tubercular deposits. Medicated inhalations 
may give temporary relief, but cannot cure it. They strike at 
the branches of the disease, while the root is left to flourish 
and develop new branches. 
Expectorants have been employed to a great extent, and the 
theories, which have been advanced in favor of their use, are 
sometimes very ingenious. That they modify the cough, we 
do not attempt to deny; but it is usually at a great expense, 
for they derange the stomach and interfere with digestion and 
assimilation. 
Improvement of the general health is always attended with 
amelioration of the cough. If the patient did not cough at all, 
the lungs would soon fill up with broken-down tissue, and death 
from suffocation would result. Irritation of the nerves supply- 
ing the lungs sometimes occurs, and causes the patient to cough 
immoderately, when it is not necessary for the purpose of ex- 
pectoration. This condition is readily controlled by the Golden 
Medical Discovery, which exerts a decidedly quieting and tonic 
influence upon the pneumogastric nerve, which, with its ramifi- 
cations, is the one involved. An infusion of the common red 
clover, in tablespoonful doses, will also be found a valuable ad- 
junct in overcoming this condition. 
Haemoptysis. Hemorrhage from the lungs is generally sudden 
and unexpected in its attack, though sometimes preceded by CONSUMPTION. 
509 
difficulty of breathing, and a salty taste in the mouth. Although 
it very rarely destroys life, it often occasions alarm. Common 
table salt, given in one-fourth to one-half teaspoonful doses, re- 
peated every ten or fifteen minutes, is generally sufficient to 
control it. Ligatures applied to the thighs and arms, sufficiently 
tight to arrest the circulation of blood in the veins, but not 
tight enough to impede it in the arteries, is a useful proceeding. 
Ergot, in teaspoonful doses of the fluid extract, hamamelis, 
and gallic acid, all are valuable for this purpose. 
Night-sweats can only be regarded as a symptom of weakness, 
and are to be remedied by an improvement of the general 
health. Bathing in salt water is sometimes attended with good 
results. The practice of giving acids for this symptom can 
only be regarded as irrational. It may arrest the sweating, but 
it will do harm in other ways. Belladonna, given at bedtime, 
is an effectual remedy. 
Frequency of the pulse is generally a prominent symptom in 
this disease. It sometimes points to a condition of sufficient 
importance to require a remedy. Although the Discovery is 
combined to meet this condition, its value may be greatly en- 
hanced by adding one-half to one teaspoonful, according to the 
urgency of the case and the frequency of the pulse, of the 
fluid extract of veratrum to each bottle. The benefit of this, 
when persisted in, will be apparent in the amelioration of all 
the symptoms, and in the general improvement. 
Diarrhea is sometimes a troublesome symptom, and particu- 
larly so in the latter stages of the disease. It is generally due 
to acidity of the alimentary canal, to which the treatment must 
be directed. Great care should be taken in the selection of the 
diet to improve the quality and avoid everything which disa- 
grees with the patient. Improve digestion by every possible 
means. Carbonate of soda and rhubarb, in the form of a 
syrup, are sometimes excellent. The Compound Extract of 
Smart-weed, in small doses, will generally diminish the fre- 
quency of the discharges. 
Derangement of the Liver is often a complication requiring 
attention, and the timely relief of which goes very far in amel- 
iorating the general condition of the patient. The Golden Med- 
ical Discovery is generally sufficient to relieve this complication. 510 
COMMON SENSE MEDICAL ADVISER. 
Its influence, however, may be considerably increased in this 
direction by the use of Dr. Pierce's Pleasant Purgative Pellets, 
according to the directions which accompany them. They 
should only be taken in the smallest doses, one or two pellets 
every day. 
Uterine Derangements. In the female, derangement of the 
menstrual function is generally an early complication of con- 
sumption, if indeed it does not occur at the outset. It deserves 
early attention, and, in addition to the remedies already advised, 
Dr. Pierce's Favorite Prescription is so compounded as to 
meet the requirements of this condition, and at the same time 
exert a favorable influence upon the constitutional disease. 
The following cases, taken from the many hundreds on record 
in our books at the Invalids' Hotel and Surgical Institute, illus- 
trate the results obtained by the course of treatment which we 
pursue in this disease. 
REPORT OF CASES TREATED. 
Case I. J. W., aged 28, had been subject to poor health for several 
years, during which time his mother and only sister had died of con- 
sumption. The principal symptoms were a poor appetite, considerable 
emaciation, debility, quick pulse, considerable cough, and expectora- 
tion, with difficulty of breathing, and palpitation on exercise. The 
spirometer showed diminished breathing capacity. Upon examination 
of the chest by auscultation, the respiratory sounds were indistinct, 
with numerous rales, and percussion revealed dullness of sound under 
the collar-bones. 
We advised him to take considerable outdoor exercise, taking care to 
protect himself from the vicissitudes of the weather by wearing plenty 
of flannel clothing next to the skin, and by bathing regularly. A 
diet of eggs, milk, cream, beef, and wheat bread, was ordered'. To 
each bottle of the Golden Medical Discovery we added a drachm of 
fluid extract of veratrum viride, and of this medicine he took a tea- 
spoonful every three hours during the day and evening. In two months 
he wrote, stating that he was improving. We advised him to continue 
the same treatment. He continued to improve, and at the end of 
four months wrote as follows: "I am feeling better than I have for 
ten years; I have gained strength and flesh, and can do a day's work. 
I consider myself well. 1 think my disease is permanently arrested, 
and I shall endeavor to profit by your advice, and change to a more 
favorable climate, to prevent a relapse." 
This is but one among thousands of cases that we might mention, in 
which there was no doubt as to the nature of the disease. The results 
of the treatment speak for themselves. Had the disease run on unin- 
terruptedly, it would soon have become much more formidable, if not 
incurable. 
Case II. Mr. S. W. H.. aged forty, applied to us for advice. He 
had been in a decline for a considerable length of time; debility 
and emaciation were well marked, continued cough with profuse CONSUMPTION. 
511 
expectoration, and shortness of breath, loss of appetite, night-sweats, 
all spoke in unmistakable terms. He also had severe attacks of bleed- 
ing from the lungs. 
The hygienic and dietetic treatment already recommended was 
advised and thoroughly carried out. The Golden Medical Discovery 
was the only medicine prescribed. After taking one dozen bottles, 
he wrote: "I feel like a new man; my improvement is wonderful; 
my friends can scarcely believe the evidence of their senses." He 
continued the treatment for eight months and then wrote that he was 
a well man. 
Case III. Mrs. S. N., aged thirty, mother of two children, applied 
to us for examination and treatment. The principal symptoms were 
emaciation, great debility, rapid pulse, no appetite, pain in the chest, 
a severe cough, and expectoration. The respiratory sounds were 
indistinct and confused, mixed with a bubbling noise as the air passed 
through the mucus in the air passages. Percussion showed a dull 
sound over the upper part of the lungs. In addition, there was 
uterine derangement, in the form of prolapsus, enlargement, and 
ulceration. 
Thorough hygienic precautions and a proper diet were recom- 
mended. The Golden Medical Discovery, with a drachm of fluid 
extract of veratrum viride to each bottle, a teaspoonful four times a 
day, was prescribed. Local applications, to heal the uterine ulcers, 
and to reduce the inflammation of that organ and restore its normal 
function, were advised. We also recommended that the Favorite 
Prescription be taken three times a day. She remained under our 
care five weeks, and left for home considerably improved. The 
journey, however, reduced her somewhat, but in four weeks she had 
regained what she had lost, and was feeling better, with cough 
modified, and strength and appetite slightly increased. We prescribed 
a special tonic, prepared for her individual case, and continued the 
Golden Medical Discovery and veratrum with the Favorite Prescrip- 
tion at night. Eight weeks later she wrote: "I have improved so 
much you would scarcely know me, am gaining strength, and all my 
old troubles are fast disappearing. I have an excellent appetite and 
have gained thirty pounds in weight." After four months' continuation 
of treatment she was pronounced cured. 
This was a confirmed case, and badly complicated, but it is only a fair 
sample of hundreds annually treated at the Invalids' Hotel and Surgi- 
cal Institute. 
Case IV. Mr. E. R., aged twenty-six, a lawyer, consulted us by letter. 
His symptoms were general debility, loss of flesh, and cough of sev- 
eral months' standing, which annoyed him most soon after rising in 
the morning; there were very little expectoration, but quite a profuse 
discharge dropping into the throat from the nasal passages; he took 
cold easily, was troubled with creeping chills running up and down 
the back; his pulse, for four months, averaged one hundred and ten 
beats per minute; he had night-sweats, and had had three attacks of 
bleeding from the lungs. He had been examined by several medical 
men, and his disease had been pronounced consumption by all. 
We prescribed the general hygienic course heretofore recommended, 
with strict orders to eat largely of sweet cream and good butter. We 
directed that Dr. Sage's Catarrh Remedy be used with Dr. Pierce's 
Nasal Douche, and that teaspoonful doses of the Golden Medical Dis- 
covery, with one teaspoonful of fluid extract of veratrum viride added 
to each bottle, be taken five times a day. In two months he wrote 
that he was greatly improved in health; that he had experienced one 512 
COMMON SENSE MEDICAL ADVISER. 
slight hemorrhage since commencing treatment, but had promptly 
arrested it by eating largely of common salt, and by taking fluid ex- 
tract of hamamelis, as we had advised him to do, in case it should 
return. He was advised to continue the same treatment, which he did 
for about six months, when he left off all medicines. He has since 
enjoyed good health, as we have been informed by a letter received 
from him, three years after he was under our treatment. 
Case V. S. F., aged 23, a book-keeper, applied at the Invalids' Hotel 
and Surgical Institute. On examination, the percussion over the upper 
portion of the left lung gave a dull sound, while auscultation revealed 
an unnatural respiratory murmur in the same locality. The pulse beats 
were one hundred a minute; respiration was rather short, hurried, 
and quite feeble. Food distressed him, his bowels were constipated, 
he had frequent nightly emissions of semen, and was gloomy and de- 
spondent. 
This was a well-marked case of consumption, complicated with sper- 
matorrhea, the result of masturbation, which he acknowledged having 
practiced from the time he was fourteen years of age. 
As the digestive organs were weak, he could not take sweet cream 
and other oleaginous diet, so beneficial in the preceding cases, until 
after the digestion was improved by tonics. We therefore advised 
Graham bread, rare-cooked beef, eggs, fish, and oysters; enjoined out- 
door exercise, bathing, and other hygienic treatment, and gave the 
Golden Medical Discovery, with half a teaspoonful of the fluid extract 
of veratrum viride to each bottle. We also prescribed a stomach tonic 
in teaspoonful doses four times a day, to overcome the dyspeptic symp- 
toms and strengthen the stomach. A specific for the nocturnal emis- 
sions was given at bed-time. This treatment operated well, and was 
continued for two months without alteration, except as the stomach be- 
came stronger the diet was changed to one including a liberal quantity 
of sweet cream, rich milk, good butter, and fat beef. At the end of 
three months, all medicines except the Golden Medical Discovery 
were omitted, and its continued use for four months longer resulted in 
a perfect restoration of health. 
Case VI. S. A., of Windermere, Ont., writes: "Dr. Pierce: Dear 
Sir-I had pain in my back and side, with severe cough. Three doctors 
told me they could not cure me. I was reduced to utter weakness, and 
nobody thought I could live. Being recommended to try your Discov- 
ery and Pellets, I sent to Toronto and got two bottles of each, and 
found, to my surprise, they did me more good than all else I had taken.. 
I took eight bottles of each, and I now feel well and strong, and can 
recommend them to all suffering with disease of the lungs." 
Case VII. Mrs. R. E., Jonesboro, Tenn., writes as follows: "Dr- 
Pierce: My father died with consumption and I thought I was going 
the same way. My cough could not be stopped until I took your Dis- 
covery. It stopped the cough and cured me, and I have remained well 
for two years." 
Case VIII. J. P. McG., 50 Wight Street, Chicago, HL, writes us as 
follows: "World's Dispensary Medical Association: Gentlemen- 
For years I have been a great sufferer. My trouble first started with 
terrible ague chills and constipation. I also had a racking cough and 
frequent bleeding from the lungs. I had been continually doctoring, 
consulting physicians without number. From them I received no bene- 
fit or encouragement. The most noted physicians of our city expressed 
their opinions in the brief but hopeless words, 'Take good care of your- 
self the few days you have to live, we cannot help you.' I grew CONSUMPTION. 
513 
steadily worse under their treatment. One day, through reading your 
Memorandum Book, I learned of the Golden Medical Discovery. With 
but little hope of relief, I purchased a bottle and took it. To my sur- 
prise and satisfaction it did me more good than all the drugs I had 
taken before. I am now steadily using it with benefit, and recommend 
it to all to be just what it is advertised to be." 
Case IX. Mrs. R. G., of London, Ont., writes: "R. V. Pierce, M. 
D.: Dear Sir-I write to express my gratitude for the benefits ob- 
tained from your medicines. I was treated for years by several of the 
first physicians of Philadelphia, without benefit. Soon after I com- 
menced taking your Golden Medical Discovery and Pellets, the cough, 
constipation, and racking pains, the bane of my life, left me, and I have 
since been enjoying health." 
Case X. Mrs. E. A. R., of Washington, D. C., writes as follows: 
" Hon. R. V. Pierce: Dear Sir-I hope you will pardon my delay in 
not writing you of the arrival of your priceless Golden Medical Dis- 
covery. I am now on the last bottle you sent me. May Heaven 
bless you for your kindness in sending it when you did. My cough 
has ceased, and I feel like a new woman in every way. I have given 
birth to a little girl since last I wrote, and had it not been for your 
valuable medicine, my children would to-day be motherless. As long 
as I am able to purchase it I shall never be without it. If any one 
doubts the curative qualities contained in the Discovery, if you will 
refer them to me I will give them ample proof in my condition. May 
God ever bless and protect you, and spare you for many, many years 
to come." 
Case XI. Mrs. T. V., of Brighton, Ont., writes as follows: "R. V. 
Pierce, M. D., Buffalo, N. Y.: Dear Sir-I have long felt it my duty 
to acknowledge to you what your Golden Medical Discovery and Pleas- 
ant Purgative Pellets have done for me. These medicines cannot be 
too highly praised. ' They almost raised me from the grave. I had 
three brothers and one sister die of consumption, and I was speedily 
following after them. I had severe cough, pain, copious expectoration, 
and other alarming symptoms, and my friends all thought I had but a 
few months to live. At this time I was persuaded to try your Discov- 
ery, and the first bottle acted like magic. Of course I continued on 
with the medicine, and as a result I gained rapidly in strength. My 
friends were astonished. When I commenced the use of your medi- 
cines, six years ago, I weighed but 120 pounds, and was sinking rapidly; 
I now weigh 135, and my health continues perfect. I have a copy of 
your People's Common Sense Medical Adviser, and neither money 
nor friends could ever induce me to part with it. There is truly a 'drop 
of joy in every word' that it contains. I can but poorly express my 
gratitude to you, but that God may prolong your life and ever bless 
you, is my constant prayer." 
Case XII. T. R., of East Benton, Lackawanna County, Pa., writes: 
" R. V. Pierce, M. D., Buffalo, N.Y.: Dear Sir-Three years ago I was 
a dreadful sufferer from consumption and liver complaint. I exhausted 
the skill of several physicians and was quite discouraged. Doctors and 
friends alike thought that I must die. I had a dreadful cough and 
raised a considerable amount of blood and matter; besides, I was 
very thin and so weak that I could scarcely walk around the house. 
At this time I read in the New York Weekly of the wonderful cures 
performed by your Golden Medical Discovery. I procured the medi- 
cine named and began using it in connection with the Pleasant Purga- 
tive Pellets. Under their influence I recovered my health completely. 514 
COMMON SENSE MEDICAL ADVISER. 
I would also say that your Discovery cured my grandchild of heart 
disease." 
Case XIII. E. U., of Donoho, S. C., writes as follows: "Hon. R. V. 
Piebce: Dear Sir-I wish to inform you that my cough has ceased 
since taking your Golden Medical Discovery in connection with the 
Purgative Pellets. For several years I coughed up matter from my 
lungs three or four times daily, but since using your remedies I am en- 
tirely free from this symptom, and my general health has improved in 
every way." 
Case 31,920. (New Series, as Numbered in the Record Books 
of the Invalids' Hotel and Surgical Institute.) Consump- 
tion. Considered Incurable. 
Mr. S., of New York City, writes as follows: "World's Dispen- 
sary Medical Association: Gentlemen-I give you full credit for 
your success in curing my case after so many had failed. I feel myself 
to be a healthy man again, and am very thankful. The medicines you 
sent me caused a steady improvement in my case. At the end of three 
months I had gained sixteen pounds. I am now fully cured." 
Case 33,943. Hereditary Consumption. Considered Hopeless. 
MissC., of Bath, Me., writes us as follows: "I take great pleasure in 
expressing my gratitude to you for the excellent health I now enjoy. Be- 
fore going to your place, consumption had placed its deadly mark upon 
me, and my friends said, ' She is going just like her two sisters,' who had 
died a short time before. A few months' treatment under your spe- 
cialist at the Invalids' Hotel, and the invigorating climate of Buffalo, 
have restored me to the full vigor of health and strength, and now 1 
have a strong desire to live, whereas before I did not care whether 1 
lived or died. Accept the gratitude of an overflowing heart, and my 
best wishes." 
Case 35,528. Consumption Pronounced Incurable. 
Mr. M., of Syracuse, N. Y., writes us as follows: "In January, 1877, 
I visited the invalids' Hotel and was examined by the council of 
physicians, connected with the Institution. My disease was consump- 
tion. Several physicians had pronounced me incurable. After a care- 
ful examination, you said my case was a bad one, and while you would 
not promise to cure, yet you thought, with my co-operation, a cure 
could be effected. As drowning men grasp at straws, so I quickly 
commenced your treatment. Well, I eannot now recite how, step by 
step, the signs and realities of returning health gradually, but surely, 
developed themselves; suffice it to say that I consider myself saved 
from an early grave, for which I shall ever be grateful to you." 
Case 36,031. Consumption. 
Mr. W., of Lake Amelia, Minn. This gentleman probably inherited 
consumption from his mother, who died of it in spite of the efforts of 
her family physicians. 
When he first wrote us, he was merely able to walk a few steps, 
being extremely weak and emaciated, with a severe racking cough, 
profuse expectoration, night-sweats, and no appetite or digestion. He 
had been unable to work for some time, and had been for several 
weeks confined to his bed. He writes after five months' treatment as 
follows: 
"World's Dispensary Medical Association: Gentlemen-The 
neighbors all say, 'We did not think you would be a live man to-day, 
but you look well again.' " CONSUMPTION. 
515 
Doctors you have done me more real good than all the other physi- 
cians I have ever had. With the first month's treatment, I so far re- 
gained my lost strength that I commenced work, my family being in 
need of support. After five months' treatment, I will say that my 
health and strength is far beyond anything I had expected. I work 
hard without undue fatigue. My bad symptoms are gone, cough and 
all. I am satisfied that I am cured, and feel deeply grateful to you for 
the good you have done me. 
Case 38,614. As numbered on the World's Dispensary Records. 
Severe case of Hereditary Consumption. 
Mr. T., of Kansas City, Mo., writes as follows: "World's Dispen- 
sary Medical Association: Gentlemen-I wish to thank you for the 
remarkable cure you have effected in my case. 
For years I had suffered from that terrible disease, hereditary 
consumption. But a few years since my mother, a brother, and a sister, 
fell victims to its terrible malignancy. Slowly I was following in their 
footsteps. The gradual loss of strength, embarrassed breathing, harass- 
ing, hollow cough, that gave me no rest, night-sweats, and diarrhea, 
all told the story of my condition. My wife and children looked for- 
ward hopelessly to a life of destitution and want. They, as well as 
my friends, saw me drifting toward the grave, unable to stretch forth 
a hand for my relief. I was a doomed man. My means were ex- 
hausted by my long illness and the excessive demands of physicians, 
who, though paid, could not benefit me. I became discouraged my- 
self, and could only look forward to death to relieve me of my cares 
and pain. One day, I was induced by the success of your Favorite 
Prescription, in relieving my wife, to write to you. Need I say your 
slight encouragement made me fearful that I would only again be dis- 
appointed. How different has been the result. With four months' 
treatment I find myself sound and well. I weigh ten pounds more 
than I ever did. The cough and all other symptoms have entirely left 
me, and I find myself in the enjoyment of perfect health and 
strength." 
Case 40,485. Consumption. Considered a Hopeless Case. 
Mr. M., of Hibbert, Ont., writes: "I had uselessly employed many 
physicians, and had fully expected to die with consumption. Having 
heard of your Invalids' Hotel, I made up my mind to visit you. To 
your advice and treatment I owe my life and present good health. 
Hoping that you and your eminent Faculty may be spared many 
years to cure the afflicted, I am, etc." 
Case 41,236. Pulmonary Consumption. Severe Cough, Hectic 
Fever, Uterine Derangement, and Increasing Debility. 
Mrs. H., of Buffalo, w'rites us as follows: "I feel it my duty to give 
my unsolicited testimony as to your skillful treatment of pulmonary 
and uterine diseases, from both of which I was a great sufferer, when 
first placing myself under your treatment. To your skill and your 
valuable medicines I owe the past three years of my life. Where others 
had failed you were successful, and I wish suffering humanity in gen- 
eral, and women in particular, to know of it, that they may also come 
and be healed." 
Case 43,415. Consumption in an Advanced Stage. 
Mr. N., of Buffalo, N. Y., writes as follows: "On the third of last 
November, I hopelessly commenced the treatment prescribed and ad- 
vised by yourself and the Faculty of the Invalids' Hotel and Surgical 516 
COMMON SENSE MEDICAL ADVISER. 
Institute. Under other physicians I had continued to run down. My 
disease was genuine consumption. 1 had frequent and copious hem- 
orrhages; I had lost nearly fifty pounds in weight; my stomach and 
bowels were nearly dead, or useless; I coughed and raised continually; 
my breathing was hurried and difficult. The medicines which you gave 
were productive of the most satisfactory results. I persevered for four 
months, at the end of which time I found not only my disease arrested, 
but my health, flesh, and strength restored. I hope you may live long 
to lengthen out the days of your fellow-men." 
Case 46,552. General Debility and Consumption. 
Mr. B., of Beallsville, Pa., writes us as follows: "World's Dispen- 
sary Medical Association: Gentlemen-With pleasure I testify to 
your skill and successful treatment. For eighteen months I was unable 
to do any thing. I tried doctor after doctor without benefit. 
I am now, after a few weeks' treatment, entirely relieved of my com- 
plicated troubles, and able to work as hard as any one." 
Case 47,277. Consumption. 
Mr. S., of Linlithgo, JST. Y., writes as follows: "World's Dispen- 
sary Medical Association : Gentlemen-For the great good you have 
done me in stopping the bleeding, and the still greater good your med- 
icines have done my general health, I cannot be sufficiently grateful. 
Their effect in my case was wonderful. I used only one month's medi- 
cine, but it has done everything for my health. My family and friends 
are astonished at my improvement. All thought I was going to die of 
consumption. I hope all the sick and afflicted of the land may hear of 
you and feel the virtues of your treatment as I have. Though J 
had been sick and unable to work for a long time, after the first 
month's treatment I labored right along, and now feel as well as ever 
I did." 
Case 49,631. Consumption. 
Mr. H., of Jamestown, N. Y., says: "Your month's treatment cured 
me. I am very grateful to you. I have tried six leading physicians in 
the different places where I have lived. Some did .no good, others re- 
lieved me only for a short time, then I was worse than ever. I will do 
all in my power to help you to relieve disease and suffering by recom- 
mending the sick to come to you." 
Case 50,780. Mr. D., of Fall River, Mass., writes as follows: "In 
reply to yours, I will say that I have fully recovered my health. When 
I went under your treatment, I scarcely weighed 150 pounds; now I 
can tip the scales at 168 pounds. I am what Dr. T., of this city, calls a 
healthy, strapping young man. I thank you for your skill." 
Mr. D. consulted us by letter, and was never seen by any member of 
our Faculty. He had been raising large quantities of blood from the 
lungs for several months, and was, indeed, in a very critical condition 
when we undertook his case. He had been treated by the best local 
physicians without benefit, and was failing rapidly, and would no doubt 
have died within a few months had he not changed physicians. We 
introduce his case as a fair sample of hundreds that we annually cure 
at their homes, without personal examination, after they have been 
unsuccessfully treated for months by their family physicians. While 
we cure consumption in its second stage, yet the afflicted should not 
procrastinate too long before applying to us, for there is a stage, some- 
times rapidly reached, in which no human skill can be successful in 
effecting a cure. 517 
CONSUMPTION. 
Case 52,772. Consumption Complicated with Heart Disease. 
Mr. E., of Renovo, Pa., writes: "World's Dispensary Medical 
Association: Gentlemen-In reply to your letter of the 1st inst., 
I will say I have taken all the medicine you sent me, and I derived 
more benefit from it than I have from all other medecines I have ever 
taken. I have gained seven pounds in weight, and feel better than I 
have for years." 
Case 53,154. Incipient Consumption, the Result of Catarrh. 
Mrs. R., of Port Leyden, N. Y., writes us as follows: "World's 
Dispensary Medical Association: Gentlemen-I have been for years 
a sufferer from catarrh in the worst form. My system became greatly 
debilitated. I was constantly in poor health, and slight exposure or 
overwork would confine me to my bed. Disease of the lungs was 
gradually resulting. I had all the symptoms of incipient consumption. 
Having great faith in you, and receiving but little relief, and no per- 
manent benefit, from a number of physicians, I determined to place 
myself under your care. Against the determined opposition of my 
friends, I came to your hotel, and after a short stay find my condition 
better than it has been for years. Your skillful treatment was wonder- 
fully successful in my case, far beyond any thing I had ever used. I 
take pleasure in saying that your scientific plan of treating chronic dis- 
eases cannot fail to give satisfaction. I thank you most heartily for 
what you have done for me." 
Case 55,779. Consumption. 
Mr. D., of Picken's Hollow, N. Y., writes as follows: "World's 
Dispensary Medical Association: Gentlemen-I have to thank you 
for the great relief I have obtained at your institution. My case 
resisted all treatment but yours. I can earnestly recommend your 
institution as the only one in the country where the patient can obtain 
the most complete, skillful, and perfect treatment known to advanced 
science. The appointments of your Invalids' Hotel are perfect. Every 
convenience and comfort possible is there." 
Case 69,058. Consumption, with Severe Hemorrhages. 
Mr. R. McC., of Enon Valley, Lawrence Co., Penn., writes as fol- 
lows: "World's Dispensary* Medical Association: Gentlemen- 
I consider it my duty to acknowledge the benefit I have received from 
your treatment during my short stay here (at the Invalids' Hotel). 
Through your skillful treatment, my health is very much improved. 
I have gained fifteen pounds, and feel better in every way than I have 
for years." 
Case 110,564. Consumption. 
Mrs. K., of White Rock, Kansas, writes as follows: "World's Dis- 
pensary Medical Association: Gentlemen-I have been greatly 
benefited by your medicines, and my health is better than it has been 
for some time, although I have been obliged to work hard. My food 
does not distress me, and my appetite is generally good. I rest well at 
night, and my bowels have been more regular, My lung is much bet- 
ter, as I can lie on that side now. 
I have had the entire care and management of the in-door work of a 
large farm, besides a great deal of the work to do myself, and with 
such incompetent help as I have had, it has been no trifling task. If I 
had not derived great benefit from your medicine, I could not possibly 
have endured so much. 
I hope you will send me another month's treatment, and I will try 518 
COMMON SENSE MEDICAL ADVISER. 
and follow directions closely. Both my husband and friends are sur- 
prised at the change in my feelings. I had such a languishing feeling 
that life seemed a doubtful blessing, but now I am more anxious to 
live, and do not feel so down-hearted." 
ACUTE BRONCHITIS AND PNEUMONIA. 
Acute bronchitis is a disease of common occurrence, and in 
its milder form is popularly known as a cold on the lungs. 
The Symptoms vary with the intensity of the affection. 
In the milder type there is a sense of tightness and heat in the 
upper portion of the lungs. The air passages often seem 
"raw," sore, or tender. Hoarseness, and a dry, harsh, croupy 
cough, in the early stage, with free expectoration in the more 
advanced stage, are prominent symptoms; those common to 
coryza are also frequently present. If the disease is severe, the 
whole system sympathizes in the derangement. Cold chills run 
over the body, followed by flushes of fever. The pulse is 
rapid and hard, the surface and extremities are cold, the bones 
ache, and there is general prostration. Unless timely aid is 
rendered, a fatal termination may ensue. 
Pneumonia, or Lung Fever. This is an inflamma- 
tion of the substance of the lungs. The symptoms of this 
disease, particularly in its early stage, are so similar to those of 
acute bronchitis, that the unprofessional, who are not supposed 
to be qualified for practicing auscultation and percussion, by 
which alone the two diseases can be distinguished with cer- 
tainty, cannot be expected to discriminate between them; and, 
since the treatment of the two maladies, in the initial stage, 
should be the same, we have classed the symptoms common to 
the two together, and shall pursue the same plan in giving the 
treatment. Bronchitis constantly accompanies inflammation of 
the substance of the lungs, and the disease may also be compli- 
cated with inflammation of the pleura, being then designated 
pleuro-pneumonia. Sharp, lancinating pains in the chest are 
characteristic of this complication. As in pneumonia, a far 
greater amount of tissue is involved in the inflammation than 
in bronchitis, and the attendant symptoms are correspondingly 
more severe. 
Treatment. The course of treatment to be employed in 
the early stages of these diseases does not differ essentially CHRONIC BRONCHITIS. 
519 
from that already given for influenza. The spirit vapor-bath, 
with full doses of the Compound Extract of Smart-weed, hot 
fomentations applied to the chest, and two drop doses of tinct- 
ure or fluid, extract of veratrum viride, repeated every hour, will 
generally break up the disease, if resorted to early. Flaxseed 
poultices, made so as to envelop the entire chest, give relief, and 
exercise a very beneficial influence on the inflammation. Should 
the cough be dry and troublesome, three to five-drop doses of 
tincture or fluid extract of lobelia may be given every two hours, 
with mucilaginous drinks, such as flax-seed or slippery-elm tea. 
If the active inflammation bp arrested by this course of treat- 
ment, and should the cough, at the same time, not fully subside, 
the Golden Medical Discovery should be taken until it is thor- 
oughly subdued; for, if allowed to continue, it is liable to result 
in chronic bronchitis or consumption. Should the disease not 
yield promptly to the treatment which we have advised, the 
family physician should be summoned. In applying poultices or 
fomentations, they should be passed up under the clothing, for 
the slightest exposure in pneumonia is sometimes followed by 
the most serious consequences. 
CHRONIC BRONCHITIS. 
This is a subacute form of inflammation of the mucous mem- 
brane of the bronchial tubes, of a very persistent character and 
variable intensity. It is common to the aged, among whom it 
occurs without any obvious exciting cause, and often continues 
during life. There are few diseases which manifest a greater 
variety of modifications than this. It is met with presenting 
symptoms so mild as to attract little or no attention, from which 
it may progress to the most grave and obstinate form of the dis- 
ease, and, perhaps, terminate in consumption. 
Symptoms. The symptoms of this disease vary greatly 
with its violence and progress. Cough is always present, and is 
very often the first symptom to attract the patient's attention. 
It is usually increased by every slight cold, and with each fresh 
accession becomes more and more severe, and is arrested with 
greater difficulty. The cough is always persistent, sometimes 
short and hacking, at other times deep, prolonged, and harsh. 
Sometimes it is spasmodic and irritating, and particularly so 520 
COMMON SENSE MEDICAL ADVISEE. 
when it is associated with affections of the larynx, or with 
asthma, involving irritation of the branches or the filaments of 
the pneumogastric nerve. 
When the chronic follows the acute form of the disease, or 
follows inflammation of the lungs, the expectoration may be 
profuse from the first, and of a yellowish color and tenacious 
character. When the disease arises from other causes, the ex- 
pectoration is generally slight at first, and the cough dry or 
hacking. This may continue some time before much expectora- 
tion occurs. The expectorated matter is at first whitish, opaque, 
and tenacious, mixed sometimes with a frothy mucus, requiring 
considerable coughing to loosen it and throw it off. As the dis- 
ease progresses, it becomes thicker, more sticky, of a yellowish 
or greenish color, mixed with pus, and sometimes streaked with 
blood. In the latter stages, it becomes profuse and fetid, and 
severe hemorrhage may occur. Sometimes the cough and expec- 
toration disappear when the weather becomes warm, to re-appear 
again with the return of winter, which has gained for it the 
appelation of winter cough. The sufferers feel as if something 
was bound tightly round them, rendering inhalation difficult. 
Soreness throughout the chest is often a persistent symptom, 
especially when the cough is dry and hard. Behind the breast- 
bone there is experienced a sense of uneasiness, in some cases 
amounting to pain, more or less severe. 
As the disease progresses, the loss of strength is more and 
more marked, the patient can no longer follow his usual employ- 
ment, his spirits are depressed, and he gradually sinks, or tuber- 
cular matter is deposited in the lungs, and consumption is de- 
veloped. 
Treatment. Thorough attention to hygiene, with the 
avoidance of the causes concerned in the production and per- 
petuation of the disease, is necessary. The patient must be 
protected from the vicissitudes of the weather by plenty of 
clothing; flannel should be worn next to the skin, with a pad 
of flannel or buckskin over the chest, and the feet should be 
kept warm and dry. Exercise in the open air is essential. 
When the weather is so cold as to excite coughing, something 
should be worn over the mouth, as a thin cloth, handkerchief, 
muffler, or anything which will modify the temperature of the ACUTE PLEURISY. 
521 
atmosphere before it comes into contact with the mucous lining 
of the lungs. Good ventilation of sleeping-rooms is all-impor- 
tant; not that the air should be cold, but that it should be as 
pure as possible. 
The diet must be nutritious, carbonaceous, and of sufficient 
quantity. Beef, milk, rich cream, plenty of good butter, eggs, 
fish, wheat bread from unbolted flour, supply the appropriate 
alimentary substances for perfect nutrition and the maintenance 
of animal heat. 
To overcome the modified form of inflammation in the bron- 
chial tubes, all sources of irritation should be avoided, as the 
inhalation of dust, or excessively cold air. It is in the cure of 
severe and obstinate cases of this disease that the Golden Med- 
ical Discovery has achieved unparalleled success, and won the 
highest praise from those who have used it. Its value will gen- 
erally be enhanced in treating this complaint by adding one-half 
a teaspoonful of the fluid extract of veratrum viride to each 
bottle. Especially should it be thus modified if the pulse be 
accelerated so as to beat ninety or a hundred times in a minute. 
The Golden Medical Discovery should be taken in teaspoonful 
doses, repeated every two hours. When the cough is dry and 
hard, with no expectoration, it arises from irritation of some of 
the branches of the pneumogastric nerve, which this remedy will 
relieve. It may, however, be aided by inhaling the hot vapor of 
vinegar and water, or vapor from a decoction of hops, to which 
vinegar has been added. Although the tightness of the cough 
may sometimes seem to demand expectorants, yet their use is 
almost invariably attended with injury. However, in the aged 
and feeble, when there is little or no fever, the following pre- 
scription administered in connection with the above treatment, 
is very beneficial: carbonate of ammonia, two drachms; infusion 
of senega root, two ounces; syrup of orange-peel, two ounces. 
The dose is one teaspoonful every three or four hours. 
ACUTE PLEURISY. 
It will be seen by reference to Part I., Chapter VII., of this 
work, that the cavity containing the lungs and heart, and 
known as the thorax, is lined with a serous membrane called 
the pleura. This membrane envelops each lung separately, 522 
COMMON SENSE MEDICAL ADVISER. 
forms a partition wall between them (the mediastinum), and is 
thence reflected over the diaphragm. 
Like the lungs themselves, it may become the seat of inflam- 
mation. If this membrane be the only part affected, the dis- 
ease is called simply pleurisy. If the lungs share in the 
inflamed condition, it is called pleuro-pneumonia. 
Acute pleurisy may arise from a variety of causes. A violent 
strain or other injury may induce it. It may occur in conse- 
quence of the retrocession of other diseases, as erysipelas, 
rheumatism, or measles. Most frequently, however, it is the re- 
sult of sudden exposure to cold or dampness, when in a state of 
perspiration. Fortunately for the sufferer, the disorder is usu- 
ally confined to one side. This is not always the case, however, 
and when it becomes general, the suffering is great, and the 
probabilities of a fatal termination are largely increased. The 
severer manifestations are usually ushered in by a well-defined 
chill. Sometimes before, but usually immediately after this, a 
sharp, cutting, or pricking pain is felt in the affected side, with 
every effort at inspiration. The lungs are but partially inflated, 
when a sensation like that caused by a sudden stab causes ex- 
piration of the breath. In the first stage of the disease it is 
impossible to lie on the affected side. There is high fever, the 
pulse being hard, small, and rapid, reaching to 120 or 140 beats 
a minute. As in fevers, not of a sympathetic character, the 
tongue is coated, the skin harsh and dry, and the urine scanty. 
A dry, hacking cough harrasses the victim, but he will suppress 
it as much as possible on account of the pain which attends it. 
A lancinating pain, generally most severe in the side under 
the arm, indicates the location of the affection. After a lapse 
of time, varying in different cases, the inflamed surface secretes 
a watery fluid, similar to that issuing from a blister. This is 
called " effusion." When this occurs, the pain subsides, but the 
oppression and difficulty of breathing remain. The fever is 
diminished, the extremities become cold, the cough is somewhat 
looser, and there is great physical prostration. These are the 
prominent symptoms of the different stages. 
Treatment. Prompt, domestic treatment, in the initial 
stages, will frequently arrest the disease, and when it does not, 
will at least lessen its severity, and render the labors of the WHOOPING-COUGH. 
523 
physician easier, and his success more certain. In all such cases 
there is a determination of blood to the affected part. 
The circulation should, therefore, be equalized. To accom- 
plish this, the spirit vapor-bath is very useful. The Compound 
Extract of Smart-weed is an excellent remedy to apply exter- 
nally to the chest, and also to take internally, as it induces 
sweating, and, by its anodyne properties, allays pain. Hot 
fomentations should also be freely applied to the chest, and 
changed often, to keep them as hot as the patient can bear. 
The administration of tincture of aconite, in doses of two or 
three drops every hour, will, by its powerful sedative and ano- 
dyne properties, aid materially in controlling the inflammation 
and relieving the pain. Laudanum, in doses of from fifteen to 
twenty drops, may be necessary to relieve pain. 
As already indicated, however, too great a reliance must not 
be placed upon domestic treatment. In a severe attack of this 
disease, we would recommend that the family physician be 
called. The course advised will be attended with benefit in 
every case, but still more active remedies may be needed to ac- 
complish a cure. 
WHOOPING-COUGH. (Pertussis.) 
This is primarily a disease of the nervous system, involving 
the respiratory organs through the medium of the pneumogas- 
tric nerve. It is considered a disease of childhood, though we 
have met with it in old age. It is eminently a contagious affec- 
tion, and occurs generally but once during life. 
Symptoms. It is at first manifested by a catarrhal cough, 
gradually developed. After a while it becomes paroxysmal, 
generally worse at night. The cough is severe, and long-con- 
tinued; when a prolonged inspiration occurs, it is accompanied 
by a peculiar shrill sound, the characteristic whoop, which, when 
once heard, is never forgotten. The cough is attended by a 
copious secretion of glairy mucous, which is brought up at the 
latter part of the paroxysm. During, or at the end of the 
paroxysm, vomiting frequently occurs, and sometimes nose- 
bleed. The cough is so severe at times, that the patient turns 
purple, gasps for breath, and presents all the symptoms of suffo- 
cation. Bronchitis sometimes is a troublesome complication. 524 
COMMON SENSE MEDICAL ADVISER. 
Immediately preceding a paroxysm of coughing, a sense of im- 
pending danger appears to seize the child, and it runs to its 
mother, or grasps some support, as if for protection. Until the 
paroxysmal character and peculiar whoop is developed, the dis- 
ease is diagnosed with difficulty. 
Treatment. We have found the Golden Medical Dis- 
covery to modify the disease and cut it short. The philosophy 
of its action can be readily understood by its effect on the 
pneumogastric nerve, as explained under consumption and 
bronchitis. Jaborandi, described under the head of diapho- 
retics, often speedily arrests this disease. The employment 
of an infusion of red clover blossoms, in small doses, is of 
undoubted value in modifying the irritation of the air-passages, 
and may be used to good advantage with, or in alternation 
with, the Golden Medical Discovery. Exposure to cold and 
wet should be avoided. 
Asthma, one of the most distressing ailments with which 
the human family is afflicted, is an affection characterized by 
paroxysms of difficult breathing, recurring at more or less 
well-marked periods, more frequently at night, the difficulty 
being due to a spasmodic contraction of the bronchial tubes, 
which is produced by a variety of causes. All cases of asthma 
may be divided into two classes: idiopathic, or primary, and 
secondary, or symptomatic. The first division is that form 
of the disease which occurs independently of, and not being 
complicated with any other disease. The attacks are period- 
ical, the intervals between them being marked by a perfect 
freedom of breathing; secondary, or symptomatic asthma has 
been subdivided into three varieties: peptic, bronchitic, and 
cardiac. Thus, asthma may be caused by derangement of the 
stomach, by an inflamed condition of the mucous lining of 
the bronchial tubes, and by disease of the heart. 
Symptoms. The symptoms of asthma are not to be 
mistaken. Suddenly and without apparent provocation the 
patient finds the greatest difficulty in breathing. When warn- 
ing is given at all, it usually consists of a sense of fullness in 
the stomach, flatulency, languor, and general nervous irritability. 
ASTHMA. (Phthisic.) ASTHMA. 
525 
The countenance is a picture of anxiety and horror. The 
difficulty of breathing increases, and the struggle for air com- 
mences. Windows and doors are thrown open, fans used, 
and, utterly regardless of consequences, even though the tem- 
perature be below zero, the subject passes the whole night 
in exposure. Fearing suffocation, he dares not lie down, he 
rushes to the window for air, rests his head on a table or 
chair, or upon his hands, with the elbows upon the knees, 
jumps up suddenly and gasps and struggles for air. The eyes 
are prominent, and the veins of the forehead distended with 
blood. Sometimes the bowels are relaxed. The urine is color- 
less, and is passed in copious quantities. This symptom demon- 
strates the excitement of the whole nervous system. The 
voice is hoarse, articulation difficult, breathing limited, noisy, 
and wheezy. The wheezing is pathognomonic of the disease. 
It can only be confounded with croup, and then in the young. 
In croup, there is pain and difficulty in swallowing, fever and 
cough, which are usually absent in asthma. A severe paroxysm 
of asthma is very distressing to witness, and one unused to 
it might well suppose the sufferer to be in his last agonies. 
No definite limit can be assigned for the duration of the attack. 
It may last but a few minutes, may endure for hours, or, with 
slight remission, continue for years. The condition of the 
patient may be for years as changeable as the gyrations of 
the weather-vane. The atmosphere has much to do with the 
disease. With every approaching storm, with every cloud of 
dust, even the dust from sweeping a room, with every foul odor, 
and, in some more sensitive organizations, with even the per- 
fume of flowers, a paroxysm is provoked. 
Treatment. This may be divided into palliative and 
curative. It is termed palliative, when the relief of the par- 
oxysm is the object in view; curative, when both the relief 
of the paroxysm and prevention of its recurrence is sought. 
For the relief of the paroxysm, an emetic dose of lobelia, 
to be followed by nauseous doses of the same, generally furnish 
prompt relief, but do not afford immunity from a recurrence. 
Inhalations of chloroform or ether, are sometimes very efficient 
and prompt, but in other cases they aggravate the paroxysm. 
A teaspoonful of chloroform or ether may be poured upon 526 
COMMON SENSE MEDICAL ADVISER. 
a handkerchief or napkin, which should be held about one inch 
from the nostrils, and the vapor inhaled. Inhalation should 
not be carried so far as to produce insensibility. Hot coffee 
is often effective in relieving the paroxysms. It should be 
taken as strong as it can be made, and without sugar and milk. 
Breathing the fumes of burning saltpetre sometimes gives 
relief. Changing from one locality to another frequently will 
suddenly terminate an attack. 
Curative Treatment. The causes of the disease, when they 
can be ascertained, should be avoided. When due to climatic 
influences, a change of residence is often followed by an entire 
disappearance of the disease. When due to disease of the 
stomach, lungs, heart, or uterus, these complications should, if 
possible, be removed. When this is the case, the Golden 
Medical Discovery, or that remedy combined with small doses 
of quinine, will sometimes be sufficient to effect a cure. 
Several years ago, we made thorough investigations into the 
causes, pathology, and treatment of this affection, consulting 
members of the profession in Europe and South America, as well 
as in our own country, and testing all the different remedies 
which were supposed to have a specific, curative effect. Neither 
time nor expense was spared in these researches, and our efforts 
were richly rewarded. We are now able to effect a radical cure 
in the great majority of cases. Our unparalleled success in the 
treatment of this disease is now well-known, and asthmatics from 
every part of the world are daily consulting us. 
DISEASES OF THE HEART. 
Diseases of the heart are classified as either functional or 
organic. We shall dwell only briefly upon purely functional 
derangements of the heart; as increased, or excited action, de- 
fective, or enfeebled action, and irregular action. 
Increased action of the heart, indicated by palpitation, or in- 
creased number of the beats, may be caused mechanically, as by 
distention of the stomach, which, by preventing the descent of 
the diaphragm, excites the action of this organ. Or it may be 
a sympathetic disturbance produced through the nervous sys- 
tem; thus the emotions and passions may suddenly arouse the 
heart to excessive action; or the presence of worms in the ORGANIC DISEASE OF THE HEART. 
527 
intestines, improper food, and masturbation, may be the cause. 
The use of tea, tobacco, and alcoholic drinks excites the heart. 
We have found that the excessive use of tobacco is very fre- 
quently the cause of functional derangement of this organ. 
Deficiency of the blood, as in anaemia, may be the cause of pal- 
pitation of the heart. 
Functional disturbance of the heart's action is manifested by 
palpitation, irregularity, intermissions, a rolling or tumbling 
movement, and a feeling as if the heart were in the throat. 
These symptoms often give rise to great apprehension, anx- 
iety, fear, and depression of mind. 
Treatment. The curative treatment of functional de- 
rangement of the heart must have reference to the causes pro- 
ducing it. If it is in consequence of indigestion, the appetite 
and digestion should be improved by observing regularity in the 
time of taking the meals, and eating very easily-digested food. 
The use of strong tea, coffee, tobacco, and spirits, should be inter- 
dicted, and regular exercise, rest, and sleep should be enjoined. 
In all cases, the domestic management should include daily 
bathing, exercise in the open air, regular habits, and the avoid- 
ance of all causes which tend to excite the heart's irregularity. 
The remedial treatment of these functional affections ought 
to be confided to some experienced physician, as the remedies are 
not within the ordinary reach of all families, nor if they were, 
would they have sufficient experience and knowledge to select 
and properly administer them. 
ORGANIC DISEASE OF THE HEART. 
By organic disease we mean disease pertaining to the structure 
of the heart itself, in contradistinction to functional disease, 
which has reference merely to the action of the heart. The 
heart is subject to various organic diseases, but we have only 
space to consider, in the briefest manner, those which are the 
most common. It is essential that the reader should have 
some knowledge of the anatomy and functions of the various 
parts of the heart in order that its diseases and their effects 
may be comprehended; therefore the anatomy and physiology 
of this organ, given in Part I, Chapter VII, of this work, should 
be carefully studied. 528 
COMMON SENSE MEDICAL ADVISER. 
It is very evident that any disease which affects the structure 
and function of any part of the heart must, necessarily, give rise 
to certain modifications of the pulse, sounds, etc. It is through 
the observation and study of these modifications and changes 
that we arrive at a correct diagnosis as to the precise location 
and character of the disease. 
Until within comparatively recent years, physicians were very 
much in the dark regarding diseases of the heart. Now, how- 
ever, with a thorough knowledge of the anatomy, physiology, 
and pathology of the heart and the parts surrounding it, and 
with the aid of instru- 
ments which modern in- 
genuity has given us, we 
are enabled to diagnosti- 
cate with precision the 
slightest lesions of any 
part of this important or- 
gan, and, knowing then- 
nature, to map out an ap- 
propriate course of treat- 
ment. With the aid of 
the stethoscope, invented 
by Laennec and improved 
upon by Camman, we are 
able to distinguish the 
slightest deviation from 
the normal sounds, and, by 
noting the character of the 
sound, the time when it 
occurs, the area over 
which it is heard most dis- 
tinctly, and the direction 
in which it is transmitted, 
to locate the lesion which 
produces it. By the aid of the sphygmograph, first invented 
by Herrisson, and afterward improved upon by Ludwig, Vie- 
rordt, Marey, and lastly by Pond, of our own country, the pul- 
sations at the wrist are registered, and thus made perceptible 
to the eye. 
Fig. 194. 
Pond's Sphygmograph. ORGANIC DISEASE OF THE HEART. 
529 
We herewith give a cut, Fig. 194, of Pond's instrument, and 
three tracings made by it. The first is a healthy tracing, the 
second indicates fatigue, and the third enlargement, technically 
called hypertrophy, of the heart. 
Pericarditis, or inflammation of the membranous sac 
which surrounds the heart, may be either acute or chronic. 
The symptoms in acute pericarditis are made up from co-existing 
affections, and are frequently associated with articular rheuma- 
tism, Bright's disease of the kidneys, or pleuritis. The intensity 
of the pain varies in different individuals. The action of the 
heart is increased, the pulse is quick, and vomiting sometimes 
takes place. When this disease is developed in the course of 
rheumatism, it is known as rheumatic pericarditis, and is almost 
always associated with endocarditis. In some cases acute peri- 
carditis is very distressing, in others it is mild. The fatality is 
not due so much to the disease itself, as to co-existing affections. 
When it does not prove fatal, it sometimes becomes chronic. 
In chronic pericarditis, pain is seldom present. The heart is 
generally more or less enlarged, its sounds are feeble, the first 
being weaker than the second. 
Endocarditis, or inflammation of the membrane lining 
the cavities of the heart, is one of the most frequent forms of 
heart disease. It is almost invariably associated with acute 
rheumatism, or some of the eruptive fevers, as small-pox, 
scarlet fever, etc., and is due to the irritation of the unhealthy 
blood passing through the heart. The disease is generally 
attended with little or no pain, and, consequently, if the attend- 
ing physician be not on the alert, it will escape his observation. 
When associated with acute rheumatism, the disease is only in 
rare instances directly fatal, but in the great majority of cases 
it leaves permanent organic changes, which sooner or later 
develop into valvular affections, and these may eventually 
destroy life. When the disease occurs, however, as the result 
of pyaemia (blood-poisoning produced by the absorption of 
decomposing pus or " matter ") or of diphtheria, or when it is 
associated with any other septic conditions, it constitutes a very 
grave element. Collections of matter formed on the membrane 
lining the heart and covering its valves, are liable to be de- 
tached and carried by the circulation to the brain, spleen, or COMMON SENSE MEDICAL ADVISEE. 
530 
liver, where they plug up some artery, and thus cause death 
of the parts which it supplies with blood. 
Chronic endocarditis generally occurs in rheumatic subjects, 
unassociated with any acute disease. It may exist without any 
marked symptoms, except, perhaps, a sense of oppression and 
uneasiness in the chest, with palpitation. It produces a thick- 
ening and hardening of the membrane lining the heart, and 
generally causes a retraction, adhesion, and degeneration of 
some of the valves of the heart, thus bringing on valvular dis- 
ease. 
Valvular Lesions are, as we have seen, very frequently 
the result of endocarditis. They are of two kinds. First, 
those which prevent the valves from flapping back close to the 
walls of the ventricles, or arteries, thus diminishing, to a greater 
or lesser extent, the size of the valvular orifices, and offering an 
obstruction to the free flow of blood through them; and which 
consist of a thick- 
ening and retrac- 
tion, or adhesion 
of the valves, 
chalky deposits, 
morbid growths, 
etc. Secondly, 
those which pre- 
vent complete 
closure of the 
valves, and thus 
permit a return 
of the blood into 
the cavity from which it has just been expelled. These latter 
consist of retractions, perforations, and partial detachments of 
the valves, chalky deposits around the base of the valves and in 
them, and rupture of the chordae tendineae. 
These two forms of lesions are usually co-existent, one gener- 
ally being more extensive than the other. Thus, the regurgita- 
tion may be slight, and the obstruction great, or vice versa. 
The symptoms and disturbance of the circulation are altogether 
dependent upon the location and form of the lesion, or lesions. 
Each valvular lesion has its characteristic sound, or murmur, 
Fig. 195. 
The above is a representation of a tracing of a healthy 
pulse as made with the Sphygmograph. ORGANIC DISEASE OF THE HEART. 
531 
which is heard at a particular period in the cycle of the heart's 
action, and it is, as before stated, from these sounds, from trac- 
ings of the pulse, and from the many other indications, that we 
arrive at a diagnosis. Thus, in obstruction of the orifice at the 
junction of the aorta with the left ventricle, one of the most 
frequent of valvular lesions, a murmur, generally harsh in char- 
acter, is heard with the first sound of the heart, with greatest 
intensity directly over the normal position of the aortic semi- 
lunar valves. This is conveyed along the large arteries, and 
may be heard, less distinctly, over the carotids. In the sphyg- 
mographic tracing, the line of ascent is less abrupt than in the 
normal tracing (Fig. 195), and not nearly so high, and it is 
rounded at the top. In aortic regurgitation, the line of ascent 
is similar to that of the healthy tracing, but the line of descent 
is very sudden. The left side of the heart is almost invariably 
the primary seat of these affections, but in the latter stages of 
their course, the right side also is liable to become involved, 
and, as a consequence, there then exists great disturbance of the 
venous circulation, with a damming back of the blood in the 
veins, and passive congestion of the liver, kidneys and brain, 
followed by dropsy, albumen in the urine, etc. 
Hypertrophy of the Heart consists of a thickening 
of the muscular walls of this organ. It may be confined to one 
portion of the heart, or it may affect the entire organ. The 
affection has been divided into the following three forms: Sim- 
ple hypertrophy, in which there is an increase in the thickness of 
the walls of the heart, without any augmentation in the capacity 
of the cavities, and which is usually the result of chronic 
Bright's disease, or great intemperance; eccentric hypertrophy, 
in which there is an increase in the thickness of the walls of the 
heart, together with increase in the capacity of the cavities, and 
which is generally the result of some valvular lesion; and con- 
centric hypertrophy, in which there is an increase in the thick- 
ness of the walls of the heart, with a decrease in the capacity 
of the cavities. Valvular lesions, obstructions in the large 
arteries, or, in fact, any thing which calls upon the heart to con- 
stantly perform an undue amount of labor must, necessarily, 
produce hypertrophy of its muscular walls, just as the undue 
amount of labor which the blacksmith's arm is called upon to COMMON SENSE MEDICAL ADVISER. 
532 
perform produces hypertrophy of its muscles. With this condi- 
tion, the pulse is hard and incompressible, and the line of ascent 
in the sphygmographic tracing (Fig. 196) is higher than in health. 
Dilatation of the Heart is a condition which is closely 
allied to hypertrophy of the heart, and which consists of an 
increase in the capacity of the cavities of the heart, with dimin- 
ished contractile power. In simple dilatation, there is an 
increase in the capacities of the cavities, without any marked 
change in the walls of the organ. It is usually the result of 
some disease which has produced great muscular prostration, and 
which has interfered materially with nutrition. More frequently, 
however, dilatation is the 
result of valvular lesions, 
and is associated with hy- 
pertrophy, there being an 
increase in the thickness 
of the walls with a dimin- 
ution of the contractile 
power. The hypertrophy 
from valvular lesions goes 
on increasing until it 
reaches a certain stage, when dilatation commences, the two con- 
ditions then being associated. 
Atrophy of the heart is the opposite of hypertrophy, and 
signifies a wasting away of the muscular substance, and a dimi- 
nution in the thickness of the walls of the heart. Its power is 
diminished in proportion to the degree of atrophy. 
Fatty Degeneration of the heart consists in the depo- 
sition of particles of fat within the sarcolenima (the sheath 
which invests the fibrils), which are substituted for the proper 
muscular tissue. If the fatty degeneration exists to any extent 
the muscular walls present a yellowish color, and the heart is 
soft and flabby. This may be confined to one ventricle, or it 
may affect the inner layer of fibres, the outer layer remaining 
unchanged. Degeneration of the left ventricle occasions feeble- 
ness of the pulse. Difficulty in breathing is one symptom of 
this disease, especially when the right ventricle is affected. 
There is pallor, feeble circulation, cold extremities, and fre- 
quently dropsy. Fatty degeneration is more liable to occur in 
Fig. 196. ORGANIC DISEASE OF THE HEART. 
533 
corpulent persons, and between the ages of forty and fifty 
years. 
Angina Pectoris, also termed neuralgia of the heart, 
might be included among the diseases of the nervous system, 
but as it is usually associated with a derangement in the action 
of the heart, it may be properly considered in this connection.- 
The pain varies in intensity, sometimes being very acute, at 
others assuming a milder form. The action of the heart is 
more or less disturbed. The beats are irregular, at times being 
strong, while again they are feeble. A feeling of numbness is 
experienced in those parts to which the pain penetrates. These 
paroxysms usually continue but a few minutes, although they 
sometimes last several hours. Persons suffering from angina 
pectoris are liable to sudden death. It is connected with ossifi- 
cation, or other organic changes of the heart. Usually these 
paroxysms, if the life of the patient continues, become more 
and more frequent. The danger is not to be measured by the 
intensity of the pain, but by the co-existing organic disease. 
Although it is not absolutely certain that organic disease is 
present in all cases of angina pectoris, yet the exceptions are so 
rare that when the signs of organic disease cannot be detected, 
it may be inferred that angina is not the real affection, or that 
the existing lesions escape observation. Those who suffer from 
this disease are, in the great majority of cases, of the male sex, 
and rarely under the age of forty. 
Treatment. In the foregoing consideration of organic 
diseases of the heart, we have omitted to speak of their remedial 
management, for the obvious reason that unprofessional readers 
are unable to correctly distinguish between the various diseases 
of this vital organ; and it would, therefore, be useless for us to 
attempt to instruct them as to the medicinal treatment of the 
different cardiac affections. 
In the vast majority of instances, diseases of the heart are 
not necessarily speedily fatal. Persons have been known to 
live twenty years or more with very extensive organic disease 
of this organ. 
It is very important, however, that a correct diagnosis be 
made in the early stages of these diseases, in order that an 
appropriate course of hygiene and treatment may be adopted, 534 
COMMON SENSE MEDICAL ADVISER. 
which will check their progress. While we cannot cure exten- 
sive organic diseases of the heart, we can check their progress, 
and prolong life, and render the condition of the subject 
comparatively comfortable. Since we are able to diagnosti- 
cate with the utmost precision the various affections of the 
heart, and since the discovery of certain specific medicines which 
exert most beneficial effects, we are enabled to treat this class 
of maladies with the most gratifying results. Thus we have 
seen a case in a very advanced stage of the disease, with the 
breathing so difficult that the subject had been compelled to 
remain almost constantly in the sitting posture, in the greatest 
agony, for so long a time that immense bed sores had formed 
on the seat; in which the dropsy had become so extensive that 
the skin of the legs had burst open; and yet this patient, 
through the influence of a specific course of treatment, was 
speedily relieved, and enabled to live in a comparatively com- 
fortable condition for many months. 
One afflicted with heart disease should abstain from the use 
of all kinds of stimulants, tobacco, and whatever tends to lower 
vitality. His life should be an even one, free from all excite- 
ment of any kind whatsoever. He should avoid severe physical 
exertion, and everything which causes the heart to beat with 
undue frequency. 
There are certain symptoms, the result of chlorosis (the green 
sickness), a deficiency of blood, dyspepsia, uterine disease, and 
certain nervous affections, which may simulate those of real 
organic disease, but the physician of education and experience, 
with a trained ear, is able to detect the difference speedily. 
SORE MOUTH. (Stomatitis.) 
Stomatitis, or inflammation of the mucous membrane of the 
mouth, may include the entire surface of the gums, tongue, 
and cheeks, or appear only in spots. Vesicles are formed, 
having swollen edges and a white or yellow center, which 
finally ulcerate. When mild, the affection is confined to these 
parts. 
If the inflammation is acute, the mouth is dry and parched, 
or, as is more frequently the case, the flow of saliva is abund- 
ant and acrid, and, when swallowed, irritates the stomach and NURSING SORE MOUTH. 
535 
bowels, producing fever, diarrhea, griping pains, and flatulency. 
The tongue is either coated white or red, and is glossy, and 
the sense of taste is considerably impaired. Digestion and 
nutrition are then disturbed, and the patient becomes rapidly 
emaciated. 
Thrush, or Canker, is that form of stomatitis in which 
white ulcers locate on the inner side of the upper lip, the 
tongue, or roof of the mouth; the irritation which they cause 
not only interferes with eating, but produces fever, together 
with the symptoms previously mentioned. 
Apthae, or follicular inflammation, is distinguished by very 
painful little ulcers, single or in clusters, scattered over the sur- 
face of the tongue and lining of the mouth. Sometimes it is 
complicated with little lumps in the tongue. These form ulcers 
and denote scrofulous inflammation. Fissures and cracks in the 
tongue indicate derangement of the stomach. 
The Causes of stomatitis, in nursing infants, are unhealthy 
milk, or effete matter, which, for lack of proper care and clean- 
liness, accumulates upon the nipple. In older children, improper 
diet, irritants, debility of the digestive functions, or hereditary 
syphilitic taint, disorder the blood and induce local inflammation. 
Treatment. Locally, use a wash of golden seal or gold 
thread sweetened with maple-sugar, and rendered slightly alka- 
line 'with borax or saleratus. Also use a very weak, alkaline 
tea, or one of slippery-elm flour, to obviate the acridity of 
the secretions. If the sores do not heal, constitutional treat- 
ment may be required, as the use of the Golden Medical 
Discovery. The family physician should be consulted if the 
sore mouth resists all these remedial measures. 
During the period of nursing, and sometimes in the latter 
months of pregnancy, women are liable to a peculiar variety of 
sore mouth. The soreness is sometimes so great that, although 
the appetite may be ravenous, the patient cannot eat. When 
this condition extends to the stomach and bowels, symptoms of 
a very grave character appear, and the disease, by interfering 
with the process of nutrition, causes emaciation and debility, and 
in extreme cases, death. It is a strange affection, nearly always 
NURSING SORE MOUTH. (Stomatitis Materna.) 536 
COMMON SENSE MEDICAL ADVISER. 
disappearing upon weaning the child, though this course is not 
absolutely necessary. It appears to depend upon a hepatic, or 
gastric derangement, in connection with a vitiated condition of 
the blood, but how this is brought about is unknown. 
Symptoms. The disease sometimes comes on suddenly, 
at others more slowly. The fact that the woman is either preg- 
nant or nursing, is of importance in forming a diagnosis. At 
first there is a severe, scalding sensation of the tongue, mouth, 
and fauces, with pain, which is sometimes intense. The color of 
the tongue is often pink, or a light red, while the mouth is gen- 
erally of a deeper hue. This stinging, biting sensation is accom- 
panied by a profuse, watery discharge from the mouth, which 
seems extremely hot and acrid, causing excoriation whenever it 
comes in contact with the face or chin. The appetite is good, 
sometimes ravenous, but food or drinks, except of the blandest 
character, occasion such intense pain that the patient avoids 
their use. Ulceration occurs after a little time. The bowels are 
generally constipated, but when the disease extends to the stom- 
ach or intestines, diarrhea occurs. There is generally amemia, 
debility, and impairment of the vital powers. 
Treatment. The indications for treatment in this affec- 
tion are to overcome the vitiated condition of the blood, and to 
sustain the vital powers. The remedies for this purpose are 
alteratives, antiseptics, and tonics. Give the Golden Medical 
Discovery, the value of which may be greatly enhanced by 
adding one-half ounce of the fluid extract of baptisia to each 
bottle, in doses of a teaspoonful four times a day. Chlorate of 
potash, half an ounce in a pint of water, used as a wash and 
gargle, is of great value. A teaspoonful of the same may be 
swallowed several times a day. This will not interfere with 
other medicines. As a tonic, the tincture of the muriate of iron, 
in five to ten-drop doses, diluted with water, may be taken three 
or four times daily. Quinine, in one or two-grain doses, should 
be given with the iron if the debility be extreme. When there 
is great acidity of the stomach, which may be known by heart- 
burn, saleratus may be taken in water, to neutralize it, but 
should not be drunk within an hour of the time for taking other 
medicines. If constipation exists, use the Purgative Pellets. 
This course of treatment, thoroughly carried out, will seldom STRUCTURAL DISEASES OE THE STOMACH. 
537 
fail to effect a perfect cure, without weaning the child, yet this 
latter course may sometimes become advisable to promote the 
recovery of the patient. Should the treatment advised not pro- 
duce the desired result, a skillful physician's services should be 
secured, as he may, in individual cases, distinguish other import- 
ant indications which may enable him to modify the treatment 
to advantage. 
DISEASES OF THE STOMACH. 
These affections may be classified either as structural or func- 
tional. There is an intimate connection between the stomach 
and nervous system. Their intimate relation is illustrated by 
the fact that some persons cannot hear of an accident, or of 
any distressing circumstance, without experiencing nausea, or 
vomiting. And it is equally remarkable that an injury of 
the tendons and ligaments, which have little sensibility, gen- 
erally affects the stomach more than an injury of the muscles, 
which possess much greater susceptibility to pain. 
STRUCTURAL DISEASES OF THE STOMACH. 
Those affections which implicate the coats of the stomach 
are designated as structural. The stomach is liable to become 
the seat of a Gastric Ulcer, the symptoms of which are similar 
to those of acute gastritis. If small, it is of a round or oval 
form, and liable to eat through the coats of the stomach, when 
it is known as the perforating ulcer. The pain is of a burning, 
gnawing character, experienced especially after food has been 
taken. Vomiting is a common symptom, and the matter vom- 
ited is tinged with blood. 
Carcinoma. Cancer of the stomach does not occur so 
frequently as gastric ulcer, and may be generally distinguished 
from the lancinating character of the pain, but in some cases 
it is extremely difficult to distinguish between cancer and 
ulceration. Vomiting occurs in both affections, and in the 
latter stage of cancer, blood, partially digested and resembling 
coffee grounds, is thrown up. This is frequently the immediate 
cause of death. It can be distinguished from dyspepsia from 
the fact that in the latter affection there is no vomiting of 
blood or pus, and the emaciation and pallor are not so great. 538 
COMMON SENSE MEDICAL ADVISER. 
Dilatation. Dilatation of the stomach may be caused 
by a closing of the pyloric orifice, on account of the thick- 
ening of its walls, or the intervention of some foreign sub- 
stance. 
Symptoms. Vomiting at intervals, when a great amount 
of imperfectly digested food, which emits a putrescent odor, 
is ejected. The stomach appears full and prominent, and 
pressure upon it causes the liquids to fluctuate and give out a 
splashing sound. Generally the appetite is not impaired. 
Softening. Softening of the mucous coat of the stomach 
is a rare affection, and is not attended by inflammation. It is 
very liable to involve other structures of the stomach, and, when 
it affects children, it gives rise to symptoms of cholera infantum. 
In older persons, death may occur from starvation, because of 
the inability to retain solid food upon the stomach. 
Induration. The walls of the stomach may thicken and 
harden in consequence of a morbid deposit under the mucous 
tissues. This is the result of chronic inflammation, generally 
caused by the use of spirits. It rarely occurs in persons under 
forty years of age, and is an affection difficult to diagnose. The 
danger depends upon the extent of the disease and the severity 
of its symptoms. The cause of death in such cases is indigestion 
and consequent exhaustion. 
Treatment. In gastric ulcer, regulate the diet and eat nu- 
tritive food, such as can be best retained by the stomach. Milk 
and vegetables are adapted for this purpose. A drink of slip- 
pery-elm tea, or of lime-water and milk should be used, and if 
there be great thirst, small pieces of ice may be given. Mutton 
broth is nourishing as well as unirritating, and injections of it 
sustain the strength. The treatment of cancer of the stomach is 
only palliative, and should have reference to the comfort of the 
patient and the prolongation of life. The hygienic management 
consists in furnishing a bland, nutritious diet, keeping the skin 
clean, and using such remedies as relieve pain and gastric irrita- 
bility, as the subnitrate of bismuth and anodynes. In dilatation 
of the stomach, the treatment consists in regulating the diet and 
using tonic remedies. In softening of the stomach, the careful 
adaptation of the food and the use of antiseptics is recom- 
mended. In induration, the treatment must be palliative; Inflammation of the stomach. 
539 
relieve the irritation, abstain from stimulants, and regulate the 
diet. All the above affections may be benefited by the use of 
those agents which increase the digestive powers, as pepsin, 
ptyalin, and those acids which are found in the gastric juice. 
These agents are digestive solvents, and prepare the food for 
absorption. All the minute symptoms of such diseases should be 
reported to the physician that he may be able to 'furnish appro- 
priate remedies and digestive fluids which will relieve the 
patient, prolong life, and sometimes cure the disease. 
INFLAMMATION OF THE STOMACH. (Gastritis.) 
Gastritis is generally defined as an inflammation of the mucous 
membrane of the stomach. However, the cellular, muscular, and 
serous tissues are all liable to be more or less affected. Gastritis 
may be either acute or chronic. Either form is a distinct modi- 
fication of disease, manifesting peculiar symptoms and requiring 
special remedies. 
Acute Gastritis generally occurs as a result or complication of 
other diseases. It is an occasional feature in scarlatina, serious 
cases of bilious fever, and in cutaneous affections of every 
description. The mucous membrane of the stomach is placed 
in intimate communication with all the vital organs, by means 
of the nerves of the solar-plexus, hence the sympathy between 
the stomach and skin, and the morbid condition of the stomach 
occasioned by disease of other organs. 
The Early Symptoms of acute gastris are a turning 
sensation in the stomach, accompanied by nausea and frequent 
vomiting. The respiratory movements are rapid and shallow, 
the pulse is hard and short, and as the disease progresses, be- 
comes small, frequent, and thready. The tongue usually retains 
its natural appearance, but it is sometimes dry and tinged with 
a vivid scarlet at the tip and edges. Intense thirst and hiccough 
are occasional symptoms. The facial expression is haggard, and 
indicative of the most intense suffering. The stomach will not 
retain the mildest liquids. In the early stages of the disease, 
the ejections consist of chyme and mucus, streaked with blood. 
As it progresses, the vomiting becomes a sort of regurgitation, 
the contents of the stomach being ejected without any apparent 
nausea or effort. The ejections then consist of a dark-colored 540 
COMMON SENSE MEDICAL ADVISER. 
granular matter, resembling what is known in yellow fever as 
black-vomit. 
Causes. Formerly it was supposed that this was a very 
common disorder, and the term acute gastritis was applied to 
every development of symptomatic fever. But late clinical and 
pathological investigations clearly indicate that acute gastritis is 
of rare occurrence. It may be caused by the excessive and 
habitual use of alcoholic drinks, especially if taken without 
food, by copious draughts of cold water, or by intense emotions. 
But its general cause is the ingestion of irritating and corrosive 
poisons. 
Where the former causes are known not to exist, the presence 
of poison should always be suspected. As the cause sometimes 
becomes a matter of legal investigation, it is very important 
that the practitioner should be able to determine the real origin. 
If caused by poison, the disease is very suddenly developed, 
the patient complaining of a very intense burning sensation in 
the throat and the lining membrane of the mouth, which will 
generally show the action of the poison. A diarrhea is also 
more apt to accompany the disease. If inorganic or vegetable 
poisons are the known or suspected irritants, the appropriate 
antidotes should be promptly administered. For a list of the 
principal poisons and their antidotes, with practical suggestions 
for treatment, the reader is referred to the article in this 
volume, on Accidents and Emergencies. 
Treatment. The inflammation should be allayed, and a 
tea made of peach-tree leaves is very serviceable. Small pieces 
of ice, swallowed, will generally allay the thirst and vomiting, 
and a mucilage of slippery-elm is very soothing to the in- 
flamed mucous membrane. This is an important disease, and 
its management should be entrusted to a skillful physician. 
CHRONIC INFLAMMATION OF THE STOMACH. 
Chronic Gastritis is sometimes mistaken for dyspepsia or 
gastralgia. It is very necessary to discriminate between these 
diseases, as the appropriate remedies for the latter will often 
only aggravate and augment the former. 
A chronic inflammation of the stomach is a very common 
affection and has many phases, but the term chronic gastritis CHRONIC INFLAMMATION OF THE STOMACH. 
541 
is applied only to that species of inflammation occasioned and 
accompanied by irritation. It is seldom a result of the acute 
form. 
The Symptoms of chronic gastritis are various and 
sometimes vague. Among those which are prominent we may 
mention an irregular appetite. At times it is voracious and the 
patient will consume every available article of diet, while at 
others he will experience nausea and disgust at the sight of 
food. Even when very hungry, one mouthful of food will 
sometimes produce satiety and cause vomiting. The appear- 
ance of the tongue is variable, sometimes natural, at others 
thickly coated. The desire for drink is capricious, varying from 
intense thirst to indifference. Another prominent symptom is a 
sense of heaviness and heat in the epigastric region, after par- 
taking of food. Often a small quantity, as a teaspoonful of 
milk, will produce a sensation of weight, as of a heavy ball 
lying at the pit of the stomach. This symptom is frequently 
accompanied by a frontal headache, and a small and wiry pulse. 
Dull or shooting pains are experienced in the stomach and 
between the shoulders, and the patient becomes weary, melan- 
choly, and emaciated. 
Causes. The general cause of chronic gastritis is excess in 
eating or drinking, and the use of alcoholic liquors. We have 
known it to be produced by drinking hard cider, Great mental 
excitement predisposes the system to this affection. Occa- 
sionally it is a result of febrile diseases, as scarlatina, typhoid 
fever, etc. In some families there is a constitutional tendency 
to its development. 
Treatment. All medicines which tend to irritate the 
stomach, should be studiously avoided. The bowels should be 
kept regular, and the skin clean by frequent bathing. Stimu- 
lants of all kinds must be avoided. As a principle article of 
diet, we would recommend milk and farinaceous articles. If 
these precautions be observed, nature will sometimes effect a 
cure. Lime water and the subnitrate of bismuth, in twenty- 
grain doses three or four times a day, are useful to allay 
irritation. Other suggestions applicable to its domestic man- 
agement, may be found under the hygienic and medicinal 
treatment of dyspepsia, to which we refer the reader. 542 
COMMON SENSE MEDICAL ADVISER. 
NEURALGIA OF THE STOMACH. (Gastralgia. 
Gastralgia is a neuralgic affection of the stomach, unaccom- 
panied by inflammation. It is sometimes mistaken for chronic 
gastritis, although there is a marked difference in the symptoms. 
A Prominent Symptom of Gastralgia is a par- 
oxysmal pain radiating from the epigastric region, to all parts 
of the thoracic cavity. The pain is sometimes lessened by 
walking, lying on the left side, or by gentle pressure, and 
usually abates after eating, but is renewed in a few hours. The 
patient occasionally experiences a sense of heaviness at the pit 
of the stomach, nausea, and frequent salty eructations. The 
tongue is white, the appetite variable, and there is no desire for 
liquids. The sleep is usually refreshing, and when not suffering 
from acute pain, the patient is apparently well. 
The distinguishing symptom of this disease is a feeling of 
intense despondency, and, sometimes, a morbid fear of death. 
An effectual method of distinguishing between gastralgia 
and chronic gastritis is by the administration of an alcoholic 
stimulant. If gastritis be the affection the pain will be aug- 
mented; whereas, if it be gastralgia, it will be relieved. 
Cause. The cause of gastralgia is a local or sympathetic 
irritation of the nerves distributed to the stomach. 
Treatment. The pain of gastralgia is sometimes allayed 
by using half a teaspoonful of subcarbonate of bismuth, and 
repeating the dose, if the attack is not relieved. The following 
is a very effectual remedy: take twenty grains of quinine, 
combined with one drachm of prussiate of iron, and divide it 
into ten powders, and administer a powder every three hours 
until the pain is completely arrested. Temporary relief may 
be given by administering one-quarter of a grain of morphine, 
or ten to twenty drops of chloroform in a teaspoonful of 
glycerine, slightly diluted, taken in one dose. One of the most 
effective remedies for preventing a return of the attacks is that 
invigorating tonic and alterative, the Golden Medical Dis- 
covery. The patient should be careful in diet, aud not eat 
too much food, which should not only be of a nutritious kind, 
but easy of digestion. Cleanliness, suitable clothing, bodily 
warmth, exercise, and rest must not be neglected. Sometimes DYSPEPSIA. 
543 
it is lingering and requires long persistence in hygienic and 
medicinal treatment. Everything tending to promote the tone 
of the digestive organs, and. improve the functions of the 
system generally, may be considered advantageous in this neu- 
ralgic affection. 
DYSPEPSIA. 
It is generally conceded that a multitude of human ailments 
arise from indigestion, and in its various forms it taxes the skill 
of the physician to prescribe the proper remedies. It is un- 
deniable that the closest intimacy exists between happiness 
and good digestion. A healthy digestion aids materially in 
making a cheerful disposition, and the "feast of reason and 
flow of soul" is due as much to the functional integrity of the 
stomach as to a strong and generous mental organization. 
Dr. Johnson severely said: " Every man is a rascal as soon 
as he is sick.'1'' We all know that a morbid condition irritates 
the individual and excites sarcastic and disagreeable remarks. 
And, likewise, an irritable temper and suddenly aroused passions 
may not only turn and disturb the stomach, but even poison 
the secretions. Anxiety, excitability, fear, and irritability fre- 
quently cause the perversion of physiological processes. 
The slightest functional disturbance of the stomach deranges, 
more or less, all the succeeding operations of digestion and 
tends to the vitiation and impairment of the delicate processes 
of nutrition. Dyspepsia may commence and proceed so insidi- 
ously as not to excite the suspicion of friends, although the 
patient generally desires active treatment, such as cathartics, 
emetics, and medicines to act upon the liver. When the 
disease becomes confirmed, it presents some of the following 
symptoms: weight, uneasiness, and fullness in the region of 
the stomach, attended by impatience, irritability, sluggishness, 
anxiety, and melancholy; there is impairment of the appetite 
and taste, also sourness, flatulency, and, perhaps, frequent attacks 
of colic, loss of hope, courage, and energy; apathy, drowsiness, 
and frightful dreams are also symptoms common in the dif- 
ferent stages of this disease. There are, furthermore, the 
accompanying symptoms of a coated tongue, bitter taste in the 
mouth, unpleasant eructations, scalding of the throat from regur- 
gitation, offensive breath, sick headache, giddiness, disturbed 544 
COMMON SENSE MEDICAL ADVISER. 
sleep, sallow countenance, heart-burn, morbid craving after food, 
constant anxiety and apprehension, fancied impotency, and fickle- 
ness. The subjects of dyspepsia frequently imagine that they 
require medicines to act upon the liver, desire active treatment, 
are endlessly experimenting in diet, daily rehearse their symp- 
toms, and are morbidly sensitive. 
Causes. Overtasking the body or mind, overloading the 
stomach, the use of improper food, such as stale vegetables and 
meat, unripe fruits, indigestible articles, improperly prepared 
food, irregular meals, disorderly habits, the use of alcoholic 
stimulants, loss of sleep, masturbation, irritability of temper, 
anxiety, or grief may all give rise to indigestion. If the func- 
tions performed by the skin are embarrassed by cold, tight 
clothing, or lack of cleanliness, the nutritive changes cannot 
properly take place throughout the body, and consequently the 
digestive functions are embarrassed, as the revolutions of a 
water-wheel are impeded by the backset of the water. When 
food is not thoroughly masticated, it is not properly mixed with 
saliva of the glands of the mouth, and is not prepared for 
digestion by the acids of the stomach. 
Whatever diminishes the general strength, impairs the health, 
or encroaches upon the functions of life, also hinders the perfect 
solution of food and disturbs in a measure the function of 
digestion. Whatever diminishes the normal amount of the 
digestive secretions or perverts their quality, deteriorating their 
solvent properties, is a cause of dyspepsia. This should be 
borne in mind in selecting remedies. 
Treatment. The hygienic treatment consists in the regu- 
lation of the daily habits, proper selection and preparation of 
the food, cultivation of cheerfulness, diversion of the mind, and 
cleanliness of person. We cannot give particular directions as to 
the kind of diet, as there are no established rules for guidance. 
Generally, a dyspeptic knows best, from experience, what articles 
of diet can be taken with the least injury. The directions ap- 
plicable to the condition of one patient, are not suited to those of 
another. In dyspepsia, animal food is, as a rule, preferable. 
Foods rich in starchy matter often ferment and give distress. 
Sometimes alkalies may be given with beneficial effect, when 
there seems to be an excess of acid in the gastric secretions. DYSPEPSIA. 
545 
In some cases, the digestive fluids are weak and fermentation 
results, giving rise to flatulency and belching. An antiseptic, 
which may be prepared by mixing a teaspoonful of hydro- 
chloric acid with four ounces of water, of which a teaspoonful 
may be taken after each meal, will prove beneficial to check 
the fermentation and aid digestion. The addition of one or 
two drops of a mixture of one part of carbolic acid and six of 
glycerine, to the above solution of hydrochloric acid improves 
its antiseptic properties. 
Acidity of the stomach and the attendant irritation may be 
allayed by the following mixture: calcined magnesia, one 
drachm; refined sugar, one drachm; subnitrate of bismuth, one- 
half drachm; oil of cajeput, ten drops. The dose is half a tea- 
spoonful an hour after every meal. 
It is frequently difficult to prevent the patient from over- 
distending the stomach, and thus impairing the tone of the 
muscular coats and prolonging the process of digestion. 
In consequence of debility, over-exertion, anxiety, or chronic 
inflammation of the stomach, there is not a proper secretion, 
in quantity or quality, of digestive solvents, and it matters 
not whether it be a deficiency of the fluids of the stomach, or 
of the intestines, or of the pancreas and liver, the result is 
indigestion. The question what important agent is lacking, 
naturally presents itself to the physician. Is it pepsin, the 
active principle of the gastric juice, which converts proteids 
into peptone, that is wanting, or is there a deficiency of pancre- 
If so, the principle which is lacking should be supplied; 
but has the physician the remedial agents properly prepared, 
and ready for prescribing? The specialist, having more cases 
of dyspepsia to treat than the general practitioner, is more 
likely to have the latest and most approved remedies applicable 
to loss of appetite, indigestion, impoverished blood, imperfect 
assimilation, and all diseases arising from faulty nutrition. In 
ordinary practice, the physician's time is .divided in his consider- 
eration of acute, chronic, surgical, and obstetrical cases; in 
fact, much of it is occupied in riding to reach his patients. His 
attention is continually diverted from one class of cases to 
another, effectually preventing investigation in any particular 
direction. His patronage does not warrant him in the outlay 546 
COMMON SENSE MEDICAL ADVISER. 
of time required for the investigation of particular diseases, 
and the expense necessary to obtain the latest and best remedial 
agents for their treatment. In the multiplicity of his cares 
and arduous duties by night and by day, obstinate chronic 
cases become an annoyance to him, and, whenever he can be 
otherwise professionally employed, he avoids them, disliking 
to undertake their treatment. 
With plenty of time for scientific investigation, ample facili- 
ties to meet the demands upon his skill, and each succeeding 
case presenting some new phase, the treatment becomes a 
matter of absorbing interest to the specialist, and each success 
inspires greater confidence. We not only use in the treatment 
of indigestion, solvent remedies, like pepsin, which act only 
upon proteids, but also other remedies of recent discovery, 
which exert a remarkable curative influence in diseases of the 
digestive organs. 
The chemistry of digestion and of life is becoming better 
understood. Any of the free acids may serve to dissolve a 
precipitated phosphate; but it is only the investigating thera- 
peutist and experienced practitioner who understands which 
of them is the most and which is the least efficacious. Alkalies 
may dissolve lithic deposits, but who, unless he be an experi- 
enced physician, can detect the fault of nutrition which leads 
to their formation, or rightly interpret the symptoms indicating 
it? These simple illustrations of the complications which 
attend dyspepsia are mentioned merely to show that they must 
be anticipated and taken into account in the treatment. 
For these and many similar reasons, when simple domestic 
management fails, we are constrained to frankly advise the em- 
ployment of those who are skilled in the treatment of these 
affections, and familiar with all their symptoms and signs, and 
who also possess remedies applicable to all the various phases of 
an affection which is very prevalent. 
The number of cases of dyspeptic invalids treated by the 
staff of the Invalids' Hotel and Surgical Institute within the 
past few years, is so large as scarcely to be credited by those 
unacquainted with the prevalence of this disease. As the re- 
sult, we have taken unusual pains to investigate the causes of 
the disease, and have spared no expense to provide the most DYSPEPSIA. 
547 
approved digestive solvents, and stomachic tonics, which invigor- 
ate the mucous membrane of the stomach, and materially assist 
in reducing the food to a liquid condition. Some of these, with- 
out being purgative, increase the activity of the liver, and 
stimulate the intestinal secretions, two very important indica- 
tions which should be fulfilled by remedies which cause no real 
depression. The recent important discoveries made in obtain- 
ing the active principles from indigenous plants, has opened the 
way to the use of a few of the most important of these remedial 
agents, hitherto almost wholly unknown to the medical profes- 
sion, and the encouraging results attending our practice have 
amply repaid us for the investigation and originality in our 
treatment of this affection. 
A careful chemical and microscopical examination of the 
urine often discloses the actual morbid conditions which perpet- 
uate this functional disease. 
The following cases illustrate the remarkable success of our 
method of treating this common affection. 
Case 61,246. Dyspepsia, Catarrh, and General Debility. 
World's Dispensary Medical Association: Gentlemen-I will 
ever be thankful to you for the good your treatment has done me; it 
has given me a new stomach, as it were, and has benefited my lungs, 
and built up my entire system. No one but myself can begin to appre- 
ciate the great benefit you have done me, for which you have my ever- 
lasting respect, esteem, and gratitude. These words do not fall idly 
from my lips, but well up from the depths of a heart profoundly grate- 
ful. Believe me, truly yours, 
B. M. T., Parkersburg, Chester Co., Va. 
Case 67,281. Dyspepsia. 
World's Dispensary Medical Association : Gentlemen-You 
have entirely cured me <Jf dyspepsia, and my health is better now than 
it has been before for twenty years. Respectfully, 
W. J., Shreve, Wayne Co., Ohio. 
Case 72,160. Dyspepsia, Catarrh, and Piles. 
Worlds Dispensary Medical Association: Gentlemen-Your 
special medicines have worked like a charm with me. I regard my im- 
provement as simply wonderful. Words cannot express my gratitude 
for the great and lasting benefit I have received at your hands. I pray 
to God that you may be spared for many years yet to benefit others as 
you have me. Yours very truly, 
Mrs. F. A. H., Traer, Tama Co., Iowa. 
Case 72,751. Dyspepsia and General Debility. 
World's Dispensary Medical Association: Gentlemen-I am 
very glad to be able to inform you that I have improved in every way 
since coming under your treatment. My appetite and general strength 548 
COMMON SENSE MEDICAL ADVISER. 
have returned to me, while the indigestion, sour risings, and bloating 
have left, I hope, forever. Gratefully yours, 
Mrs. J. B. O., Sing Sing, N. Y. 
Case 73,058. Dyspepsia, General Debility, a Feeble Circula- 
tion, Cold Hands and Feet, etc. 
World's Dispensary Medical Association: Gentlemen-I feel 
stronger and better than I have before for three or four years. I think 
your medicines have done for me what no other medicine could; hence, 
I gladly recommend them to every one whom I lind suffering from 
similar troubles. I shall always remain your firm and steadfast friend, 
and a believer in you and your medicines. 
Hoping that you may live long to continue to do good, I remain, very 
truly yours, Mrs, S. A. McN., Brecksville, Cuyahoga Co., O. 
Case 75,688. Dyspepsia; Irritability op the Stomach; De- 
rangement of the Liver; Colic; Constipation; and Gaseous 
Distension of the Stomach, Producing a Feeling of Suf- 
focation. 
World's Dispensary Medical Association: Gentlemen-I am 
happy to inform you that my dyspeptic symptoms have all vanished, 
as if by magic; my stomach is now strong, my food digests well, I am 
no longer troubled with distension or sour risings, while I sleep soundly, 
and feel stronger in every way. My appetite is splendid, and my relish 
for food is great. Formerly, when I ate my supper, bloating or gase- 
ous distension would come on, and compel me to sit up in bed, or, per- 
haps, walk the floor half the night. I now sleep well in any position, 
being entirely free from that distressing feeling of suffocation which 
so long annoyed me. 
One mouth of your treatment did all this for me, and I am so very, 
very thankful to you. With the deepest gratitude, I remain, 
Mrs. E. W. C., Jenny Lind, Calaveras Co., Cal. 
Case 80,292. Dyspepsia. 
World's Dispensary Medical Association: Gentlemen-I have 
gained in almost every respect, particularly in flesh and strength, since 
beginning the use of your specially-prepared medicines. 
I am thankful that you and your medicines were brought to my 
notice, and henceforth I shall do all in my power to spread a knowledge 
of your success, that others afflicted may obtain that relief which I 
have secured. Most respectfully yours, 
Mrs. 8. E. B., Russellville, Franklin Co., Ala. 
Case 82,660. Dyspepsia, Accompanied with Palpitation of 
the Heart. 
World's Dispensary Medical Association: Gentlemen-The re- 
sults of your medicines in my case have been all that could have been 
desired, as under their influence all my symptoms have one by one 
disappeared. My digestion is now good, my heart is regular, whilst 
my general health and strength have very much improved. By con- 
tinuing to follow your special hygienic rules, I believe that no relapse 
will occur. With many thanks, I remain, your most obedient servant, 
W, W. 8., Callaghan's, Alleghany Co., Va. 
Case 85,902. Dyspepsia. 
World's Dispensary Medical Association: Gentlemen-Previous 
to consulting you, I was afflicted with dyspepsia for one year, and was 
greatly annoyed by the almost constant burning in my stomach and INFLAMMATION OF THE BOWELS. 
549 
throat, which was especially aggravated whenever I partook of fruit. 
Acting under the advice of several of my neighbors, whom you had 
cured, I sent for your special home-treatment. I began to improve at 
once, and in a few weeks every trace of my dyspepsia had disappeared, 
together with the burning in my throat and stomach. I do not be- 
grudge you the little money that I paid to secure a blessing so great. 
I should have stated that while a few months ago it was almost impos- 
sible for me to work, I now labor cheerfully from morning to night. 
Yours truly, 
A. S. F., Sticklerville, Sullivan Co., Mo. 
Case 166,682. Dyspepsia, Constipation, Absence of Appetite, 
and Distress After Eating. 
World's Dispensary Medical Association: Gentlemen-Reply- 
ing to your inquiries, I would say that, since taking your last medi- 
cines, I have never enjoyed better health in my life. 1 have a splendid 
appetite, my bowels are very regular, and I never suffer any more after 
eating; besides, I am always ready for three hearty meals every day. 
I never more experience any of my old headaches, and my urine looks 
perfectly clear and natural. In fact I enjoy perfect health. You told 
me that, as my case was so severe and complicated, it would require 
three months' treatment to effect my cure, but I found that two months' 
treatment was all that was necessary. With many, many thanks for 
your kindness, and wishing that you may always be prosperous, 
I remain, respectfully. 
Mrs. S., La Grange, Texas. 
INFLAMMATION OF THE BOWELS. (Enteritis.) 
Inflammation of the mucous membrane of the small intestine 
is termed enteritis, and the affection sometimes extends to the 
large intestine. It may be either acute or chronic. 
Acute Enteritis occurs more frequently during the infantile 
period of life than afterwards. 
The Symptoms are pain and tenderness of the abdomen, 
diarrhea, vomiting, and fever. There is dull, aching pain re- 
ferred to the umbilical region, and the evacuations caused are 
mucous and gelatinous, or watery and acrid, producing a burn- 
ing sensation. 
The Causes. It is generally caused by exposure to cold, 
fatigue, debility, drastic purgatives, indigestible food, or acrid 
substances. It is sometimes confounded with inflammation of 
the peritoneum, but may be generally distinguished from it by 
the diarrhea, and by the fact that there is less prostration. It 
may be distinguished from colic by pressure, which relieves the 
pain in that affection, while in enteritis it increases it. 
Chronic Enteritis is often a sequel of the acute form, 
and is more limited in its morbid effect upon the mucous surface 550 
COMMON SENSE MEDICAL ADVISER. 
of the intestine, frequently affecting the glands and follicles, 
and, hence, has sometimes been termed glandular or follicular 
enteritis. 
The Symptoms, when the disease has been of long dura- 
tion, are languor and weakness, sallowness and harshness of the 
skin, coldness of the hands and feet, dryness of the lips and 
mouth, irritability, headache, weak pulse, impaired appetite, 
emaciation, and night-sweats. There is also great sensitiveness 
and irritability of the stomach, indicated by nausea and vomit- 
ing, for the patient not only ejects whatever food and drink he 
swallows, but has retchings when the stomach is perfectly empty. 
Causes. Chronic enteritis is produced by the same agencies 
as those which excite the acute form of this disease, and fre- 
quently is the sequel of an acute attack. In a scrofulous dia- 
thesis, in which there is some evidence of eruptive disorder, a 
suppression of the perspiration, and the disappearance of 
cutaneous eruptions may be the occasion of derangement of the 
stomach, resulting in indigestion and irritability, followed by 
chronic inflammation of the small intestine, fetid discharges, 
and emaciation. It may be caused by errors in diet, exposure 
to cold, or insufficient protection of the surface from sudden 
climatic changes. 
When this disease attacks adult persons, it is by no means 
dangerous, unless the subject is weak and scrofulous, in which 
case, it may indicate the existence of tubercular disease. The 
patient then wastes away, the pulse becomes 'feeble, and pros- 
tration and death follow. 
Treatment. In the early stages of the acute form, give 
a mild evacuant, to open the bowels and free them from any 
offending or irritating substances. Dr. Pierce's Pleasant Pur- 
gative Pellets will most admirably fulfill this indication and 
also favorably influence the secretory functions of the liver. 
If these are not at hand, a tea made of two parts of senna, one 
of sage, and three of ginger, may accomplish the purpose. 
Apply fomentations to the abdomen, and relieve the pain in 
the bowels by taking the Extract of Smart-weed. In severe 
cases, the tincture of opium should be administered in doses 
of five to ten drops every three or four hours. The next step 
in the treatment is to regulate the diet, and support the patient PERITONITIS. 
551 
with light and easily-digested food. If the appetite is vora- 
cious, restrict the amount of food, and administer warm water- 
gruel, milk-porridge, and mutton-broth. In the chronic form 
of this disease, the alterative action of the Golden Medical 
Discovery often proves to be the specific needed, when the 
diet is properly regulated and of a nutritious character. The 
application of compresses wet in alcohol will be found to be 
of service. The use of supporting remedies is indicated, and 
all drastic or depleting treatment is contra-indicated. A syrup 
made from rhubarb, blackberry-root, and golden seal, equal 
parts, is excellent as a tonic and astringent for the bowels. 
Subnitrate or subcarbonate of bismuth, in doses of ten to 
twenty grains every four hours, is very beneficial in both the 
acute and chronic forms of the disease. 
PERITONITIS. 
The peritoneum, or serous membrane which lines the abdomi- 
inal cavity and invests the intestines, is liable to become inflamed. 
When this occurs, the affection is termed peritonitis, and may 
be divided into the acute and chronic forms. 
Acute Peritonitis. This form may be circumscribed; 
that is, confined to one spot, or it may extend over the entire 
surface of the peritoneum, when it is known as general. 
Symptoms. There is headache, quick pulse, tongue 
coated white, countenance pallid, features pinched, respiration 
difficult, nausea and vomiting, severe pain in the abdomen, 
which is extremely sensitive to pressure and becomes very much 
distended. There is also pain in the limbs, the bowels are con- 
stipated, and, in exceptional cases, diarrhea is a prominent 
symptom. The urine is deficient in quantity, and there is sleep- 
lessness, chilliness, and great general prostration. Vomiting and 
coughing or sneezing increase the pain. An erect position occa- 
sions intense suffering. The patient is compelled to assume a 
recumbent posture and is inclined to lie on the back, for in 
that position the sufferer experiences the least pressure of the 
vital organs against the peritoneum. There is also an inclin- 
ation to draw up the lower limbs and retain them in a flexed 
position. 
Causes. Prominent among these are injuries which have 552 
COMMON SENSE MEDICAL ADVISER. 
been inflicted upon the intestines, compression of the colon, or 
rectum, perforation of the stomach or bowels, either by violence 
or some pre-existing disease, thus allowing the discharge of 
blood, urine, bile, or fecal matter into the abdominal cavity; 
also abortion, overexertion, and exposure to wet or cold. As 
acute peritonitis is always a grave disease, involving more 
or less danger to life, it is the wisest course to employ a physi- 
cian and trust the case to his management. The same remark is 
equally applicable to the chronic form of the disease. 
Chronic Peritonitis. Like the acute, it may be either 
circumscribed or general. This form is sometimes, though 
rarely, a sequel of the acute. When it appears independently 
of the acute, it is generally associated with some cutaneous 
affection pertaining to the abdominal cavity, and the inflamma- 
tion is induced by the tumor. If chronic peritonitis be con- 
nected with the tubercular diathesis, tubercles may be discovered 
upon the surface of the stomach and alimentary canal, and may 
also be found in the lungs and brain. 
When the affection is not tubercular there will appear in the 
abdominal cavity an effusion of serous fluid of greater or less 
quantity, mingled with blood and pus. When such an effusion 
takes place, the abdomen gradually increases in size, or becomes 
smaller than is natural. There is pain, attended by soreness 
upon pressure, and the patient becomes emaciated. 
Inflammation of the peritoneum is frequently an accompani- 
ment of puerperal fever, which is a disease peculiar to childbirth, 
and which may arise from cold, or be communicated from one 
parturient patient to another by midwives. 
Treatment. In the remedial management of acute peri- 
tonitis, it is obviously necessary to use some agent which will at 
once influence and change the congested state and the inflam- 
matory condition. One of the best agents employed to make a 
decided impression upon the vascular system, subdue inflamma- 
tion, and modify its action, is the fluid extract of veratrum 
viride, administered in full doses, and repeated until the sys- 
tem shows its effects in a decided manner. Warm fomentations 
applied to the abdomen are sometimes very serviceable, and are 
objectionable only because of their liability to dampen the bed- 
clothes. When the abdomen will bear a thick, warm poultice, DIARRHEA, CHOLERA INFANTUM, ETC. 
553 
apply it, and then cover the entire surface with oiled silk. The 
tincture of opium, in doses sufficient to relieve pain and quiet 
the peristaltic action of the intestines, is generally necessary. 
DIARRHEA, CHOLERA INFANTUM, OR SUMMER 
COMPLAINT, AND DYSENTERY. 
These diseases are usually considered separately by medical 
writers, but, as they are closely related, a simple diarrhea not 
unfrequently running into a cholera infantum or a dysentery, we 
shall consider them together. 
Diarrhea is an affection characterized by unnaturally fre- 
quent evacuations from the bowels of a liquid or morbidly soft 
consistency. It may be simple or inflammatory, and acute or 
chronic. 
A diarrhea is said to be bilious when the discharges are com- 
posed principally of serum, highly colored with yellow or green 
bile; catarrhal when they are of a semi-transparent, mucous 
character; serous, when the dejections are thin and watery, 
sometimes mixed with blood, bile, or ingesta. 
The symptoms of the affection are usually at first those of 
indigestion, a fullness of the stomach, flatulency, and colicky 
pains. The pains, which precede each evacuation, are intermit- 
tent in character. There may be an unpleasant sinking sensation 
in the abdomen, and, with the discharge, exhaustion, a feeble 
pulse, and a cool skin. In the inflammatory variety, there is 
more or less fever. 
Cholera Infantum, or summer complaint, is a disease 
peculiar to the warm season, and more prevalent in cities and 
among those children who do not nurse at the breast. It is 
characterized by great irritability of the stomach, and persistent 
vomiting and purging, the discharges from the bowels being 
copious and watery, and sometimes containing specks of curd, 
yellowish-green matter, and mucus. The limbs of the little suf- 
ferer are usually drawn up, indicating pain in the bowels, and 
there is great prostration with cold extremities. The invasion 
may be so sudden, and the disease so violent as to destroy life 
in a few hours. 
Dysentery, also known as l)loody-fl,ux, consists of an in- 
flammation of the mucous membrane of the large intestine, 554 
COMMON SENSE MEDICAL ADVISEE. 
with ulceration of the affected surfaces. The disease is accom- 
panied with much nervous prostration, and is distinguished by 
severe pains in the abdomen of a griping nature, followed by 
frequent scanty and bloody stools, and much straining. Occa- 
sionally the attack is ushered in with a chill and aching pains in 
various parts of the body, with copious fecal dejections. In 
other cases the attack is preceded by loss of appetite, a sense of 
uneasiness with dull pains in the abdomen, and weariness. The 
disease, like diarrhea, may be either acute or chronic. 
The Causes of these affections of the bowels are many and 
varied. They may be brought on by exposure to cold and wet, 
or by improper and indigestible articles of food, such as unripe 
fruits, salads, pastries, and, in fact, anything which interferes 
with the normal operations of the digestive apparatus. One of 
the most fertile sources of diarrhea in infants, and of cholera 
infantum, is the administration of unsuitable food, the ill effects 
of which are greatly increased by exposure to heat or cold. 
Uncleanliness, and the inhalation of impure air, are prolific causes 
of these diseases. Epidemics have been supposed to be due to 
some peculiarity in the condition of the atmosphere, or to some 
impalpable germ of a vegetable or animal nature. 
Treatment. In the treatment of these diseases, one 
should first endeavor to ascertain the cause of the trouble, and 
then, if possible, effect its removal. Attention should be given 
to the hygienic surroundings of the individual afflicted; if he 
reside in a miasmatic district, or in a location in which the at- 
mosphere is contaminated by the decomposition of animal or 
vegetable matter, or filled with noxious gases, his abode should 
be changed. A pure, dry air is most beneficial in these cases. 
Only the least irritating and most easily digestible articles of 
food should be taken. Healthy cow's milk is slightly alkaline, 
but that of cows fed on slops is usually acid, and unfit for in- 
fants. It is, therefore, well to test all milk with blue litmus 
paper before feeding it to young children. If found to be 
strongly acid, that is if it turns the paper red, it should be re- 
jected, but if only slightly so, sufficient lime water may be added 
to render it slightly alkaline. For adults and older children, 
the diet should consist of such starchy foods as arrowroot, sago, 
corn starch, and rice, and of ripe grapes, freed from the skins and DIARRHEA, CHOLERA IJJFANTUM, ETC. 
555 
seeds, peaches, and boiled milk, or milk and lime water. In 
some cases the animal broths are beneficial, especially mutton 
broth. To quench the thirst, crust coffee, rice coffee, and lemon- 
ade, in small quantities, may be taken. 
Rest is important in these diseases. In severe cases, the 
patient should be kept in bed. 
At the onset of an attack of diarrhea or dysentery, if there be 
reason to believe that the intestinal tract contains irritating mat- 
ter, a dose of castor oil, with a few drops of anise oil added to 
render it palatable, should be administered. After all irritating 
ingesta have been removed, Dr. Pierce's Compound Extract of 
Smart-weed should be given in doses proportionate to the age of 
the patient, and the severity of the case. Being composed of 
the extract of smart-weed, or water pepper, Jamaica ginger, 
tincture of camphor, and genuine French grape brandy, it exerts 
a most wonderful effect not only in those diseases but also in 
cholera morbus and intestinal colic. It allays the irritation and 
inflammation of the affected mucous surfaces, and soothes the 
nervous system. In the great majority of cases, the above 
course of treatment will be found sufficient, but in the more 
severe forms of these diseases additional remedies may be re- 
quired. 
In dysentery, accompanied with severe pain and straining, 
injections of starch water and laudanum, from two to four 
ounces of the former to from twenty to fifty drops of the 
latter should be used. 
Hot fomentations applied to the abdomen are often beneficial. 
If the discharges contain much blood, a flannel cloth moistened 
with the spirits of turpentine should be laid over the lower part 
of the abdomen, and kept there until slight irritation is pro- 
duced. 
Lime water, bicarbonate of soda, bicarbonate of potash 
(saleratus), chalk, and the subnitrate of bismuth are valuable 
agents to correct the secretions, and allay irritation of the dis- 
eased mucous surface. The above-named preparations of soda, 
potash, and bismuth may be taken in doses of from five to 
twenty grains every few hours. 
Blackberry root and cranesbill [Geranium Maculatum), in 
the form of the fluid extract or infusion, are beneficial in acute 556 
COMMON SENSE MEDICAL ADVISER. 
cases in which the discharges are profuse and watery, and in the 
chronic forms of these affections. 
In cholera infantum subnitrate of bismuth should be given 
in doses of from five to ten grains at intervals of from two to 
four hours. If the discharges are very profuse, the fluid extract 
of cranesbill may be administered in from two to ten-drop doses 
alternately with the bismuth. The camphorated tincture of 
opium. (paregoric) is required in doses of from two to twenty 
drops, depending upon the age of the child and the severity of 
the case, if there is much pain, but great caution should be ex- 
ercised in administering the preparations of opium to children. 
A single drop of laudanum given to a young infant has caused 
convulsions, coma, and death in more than one instance. To 
check the vomiting of cholera infantum, mild irritation over 
the stomach is sometimes effectual. For this purpose a weak 
mustard plaster, or a cloth moistened with turpentine, may be 
laid over the stomach for a few minutes at a time. If the child 
is old enough to suck pellets of ice, these are beneficial. 
On account of the frequency and importance of this disease 
in its chronic form, we deem it worthy of special consideration. 
It is not unfrequently the sequel of the acute form of the affec- 
tion. The urgent and severe symptoms of acute diarrhea are 
often abated, but the disease is not completely cured. The 
bowels are left in an irritable condition, perhaps in a state of 
chronic ulceration, which perpetuates morbid discharges. 
The most noticeable symptom is the tendency to frequent 
and unhealthy discharges from the intestines. The evacuated 
matter varies much in appearance and character in different 
cases. The precise location of the morbid conditions which 
give rise to the discharges, as well as their extent, modifies 
the color, consistency, and ingredients of the stools. Most 
frequently they are dark colored and of very offensive odor. 
They are of a more liquid character than is natural, except 
when, as is sometimes the case, periods of constipation alternate 
with periods of unnatural looseness. Tormina, or griping, is 
usually present, but not so severe as in the acute affection. 
Tenesmus, or straining, often accompanies it. The appetite is 
CHRONIC DIARRHEA. CHRONIC DIARRHEA. 
557 
impaired, there is general debility, and the patient is nervous 
and irritable. The complexion becomes sallow, the skin dry 
and rough, the tongue dark colored, and the body emaciated. 
The affection may be the sequel of neglected or badly treated 
acute diarrhea, may arise from the injudicious use of powerful 
purgative medicines, may result from dissipation, unwholesome 
food, bad air, absence of light, long continued exposure to 
dampness and cold, overwork, and extreme mental anxiety. 
Sometimes it is associated with other diseases, such as Bright's 
disease of the kidneys, scurvy, or some of the various forms of 
scrofulous disease. 
The more prominent symptoms are so apparent and so char- 
acteristic that the most unskilled may be able to decide whether 
the patient has chronic diarrhea; but to determine in what por- 
tion of the intestinal canal the affection is chiefly seated, to 
decide upon the extent of its ravages, to ascertain what peculiar 
shade or type the affection has taken on, to investigate its com- 
plications and modifications, to ferret out its producing or 
aggravating causes, and, above all, to nicely and skillfully 
adjust remedies to meet the depraved conditions, is by no means 
an easy task, even for the educated and experienced physician. 
It should be born in mind that this is a dangerous malady, and 
one which should not be trifled with or neglected. Its tendency 
is to corrode and destroy the bowels, a process which if un- 
checked, must sooner or latter result in death. There is little 
tendency to spontaneous recovery, nor is a removal of the 
exciting cause often followed by recovery. The disease becomes 
so firmly seated, and the powers of life so debilitated, that 
nature cannot rally. 
Treatment. All the suggestions heretofore made with 
reference to the treatment of acute diarrhea, are equally appli- 
cable to the chronic variety; but as chronic diarrhea is more 
obstinate than the acute, and more frequently complicated with 
grave pathological conditions which must be distinguished, and 
properly met by special treatment, all the skill possessed by the 
most experienced specialist is required for its successful man- 
agement. A warm, salt bath, several times a week, taken at 
bedtime, is beneficial. Flannel should be worn next to the skin, 
and the sleeping-room should be warm and well ventilated. 558 
COMMON SENSE MEDICAL ADVISER. 
CASES TREATED. 
Case I. A gentleman aged 35 years, came to the Invalids' Hotel and 
Surgical Institute for consultation and treatment. He had been suffer- 
ing from chronic diarrhea for over five years, and was reduced almost 
to a skeleton. The disease was contracted while in the army. He had 
dyspepsia, torpid liver, frequent passages from the bowels, which 
varied in color and were very offensive. There was intestinal irrita- 
bility, with soreness, griping pain, restlessness, thirst, morbid appe- 
tite, heavily coated tongue, offensive breath, sallow complexion, cold 
feet and hands, and frequent attacks of headache. There was also 
great irritability of the bladder, with frequent desire to urinate, pain 
in the back, and sexual debility. This being a bad case and of long 
duration, he was told at best it would take a long course of treatment 
to effect a cure; that he must strictly comply with very rigid dietetic 
rules, and pay strict regard to all hygienic instructions given in order to 
recover, and even with all this we could not assure him that he would 
regain his health. He continued under treatment but six months when 
he was discharged, perfectly cured, and able to engage in manual labor. 
This case is mentioned to encourage those similarly afflicted. No one 
suffering from chronic diarrhea should be given up as incurable. When 
the treatment is carefully adapted to the case, the disease gradually 
yields and health is established. 
Case II. We received a letter from a gentleman residing in Pennsyl- 
vania, who described his condition as follows: "I have had diarrhea 
for over six months, and none of our physicians can effect a cure. I 
have from five to six passages everyday, unless I take opium; and 
when I take this drug there will be more bloating of the bowels, and 
the diarrhea is made worse. The passages are of all colors and very 
offensive, I have a good-yes, I may say ravenous-appetite. Some- 
times the food digests and sometimes it passes through me whole. I 
have pain in the small of my back, and an irritable bladder; I do not 
pass enough urine, and what I do void is high colored. My bowels 
feel sore all the time, and I can't lift anything heavy without pain and 
an increase of the passages. My skin is dry and my hands and feet are 
cold most of the time." We promptly replied that he could be greatly 
benefited, and, perhaps, cured. He was sent medicine enough for one 
month, and at the end of that time he wrote that he thought he was 
better, and desired to continue the treatment. The second month he 
was much improved, and, at the end of the third month, he was per- 
fectly cured. 
Case 74,898. (New Series, as Numbered in the Record Books 
of the Invalids' Hotel and Surgical Institute.) Chronic 
Diarrhea, with Pain in the Right Side, in an Elderly 
Lady. 
E. J. R., of Wellborn, Fla., writes: "World's Dispensary Medi- 
cal Association: Gentlemen-I would have written to you before 
this, but thought I would wait a while and see if my health would still 
improve after I stopped taking your medicine. I am happy to say that 
I am still improving. I have no aches or pains as before. I feel like a 
new person. I am thankful that I applied to you for treatment." 
Case 110,278. Chronic Diarrhea of Eleven Years' Standing. 
F. O. G., of San Antonio, Texas, writes: "World's Dispensary 
Medical Association: Gentlemen-I consider it a duty on my part to 
you and my fellow men to make a statement of the successful manage- 
ment of my case by you. EPIDEMIC CHOLERA. 
559 
In 1871 I contracted the diarrhea on the Rio Grande River, with nine 
others, all of whom soon died. 1 gradually got over the attack, but 
was left with the piles, and my bowels became ulcerated. Five differ- 
ent doctors tried to cure me, and two of these told my wife that 1 could 
not live. For two years I suffered dreadfully, having from twenty to 
thirty passages from the bowels per day, which debilitated me greatly. 
It was at this time that I learned, from reading 'The People's Com- 
mon Sense Medical Adviser,' that you had a Sanitarium that was so 
well-equipped as to give you great advantages over ordinary physicians 
practicing in the country, and your words of encouragement gave me 
so much hope that I determined to make one more trial before giving 
up, and I am glad that I did so. for I am now well. Your skillful per- 
sonal treatment, supplemented by a perfect dietary, experienced nurses, 
and similar advantages, have combined to bring about a perfect cure. 
Allow me to return my sincere thanks to you all." 
This gentleman, although blessed with a happy family, was 
unable to enjoy any of the comforts of social life. 
The frequent calls of nature prevented him from going any- 
where, as he had little or no warning of a motion, and was, of 
course, in a constant state of anxiety. Upon examination, our 
specialist found several large ulcers in the rectum, and a weak- 
ened and relaxed state of the mucous membrane. On motion 
of the bowels there was a protrusion, or prolapsus, of the rectum. 
After two weeks' personal treatment, he was able to return 
home cured. 
Hundreds of other cases of chronic diarrhea have been treated 
quite as successfully as those here cited. Few of these have 
been found, which required precisely the same treatment, so 
various have been the morbid conditions present, as recognized 
through the attendant symptoms. The larger number have 
been treated at a distance, without personal consultation, the 
patients making known their symptoms by letter, and advice 
and medicines being sent to them by mail or express. 
EPIDEMIC CHOLERA. 
This is an epidemic disease, supposed to be due to an impal- 
pable specific poison, but as to the exact nature of this poison- 
ous matter nothing definite is known. 
This plague first made its appearance on our continent in 
1834. Owing to its great fatality, it is a disease much to be 
dreaded. 
Symptoms. These are well defined. It is characterized 
in its earlier stages by pain in the stomach and bowels, especially 560 
COMMON SENSE MEDICAL ADVISEE. 
in the umbilical region, nausea, vomiting, and diarrhea; later, 
the purging is excessive, and the matter dejected resembles rice- 
water, and contains white, solid, curd-like matter. The patient 
loses strength, and sinks rapidly. The secretory organs fail to 
perform their functions normally, the skin is sometimes moist, 
but oftener cold and dry; but little if any bile is found in the 
excretions, and the urine voided is very scanty. There is gen- 
eral nervous derangement, as indicated by the spasmodic con- 
traction or cramping of the muscles. This first attacks the 
extremities, but soon affects the entire body, and gives rise to 
excruciating pains. The head is affected by singing, roaring, 
disagreeable noises in the ears, the pulse is feeble but quick, the 
nails are of a bluish color, the tongue is coated white, the eyes 
are sunken, and the patient has a corpse-like appearance; the 
temperature of the body rapidly falls, the surface becomes 
deathly cold, and, unless the disease is promptly arrested in its 
course, speedy dissolution follows. The disease is rarely pro- 
longed beyond twenty-four hours, and sometimes terminates 
within three or four after its first attack. 
Treatment. The kind of medicine required depends 
upon the severity of the attack and stage of the disease. In 
all cholera epidemics, there are premonitory symptoms, such as 
an uneasy sensation at the pit of the stomach, and a rumbling 
of the bowels. This is apt to be followed by a painless diar- 
rhea, which occasions no alarm, and the patient pays but little 
attention to it. Herein is the great and dangerous mistake. 
The patient is already in the stage of invasion, which must be 
promptly arrested, or he will suddenly be precipitated into the 
stage of collapse. The patient should lie down, and have placed 
about him bottles filled with hot water, thereby exciting warmth 
upon the surface of the body. At the same time, administer 
two teaspoonfuls of the Extract of Smart-weed. If the symp- 
toms are urgent, repeat the dose every fifteen minutes. Brandy, 
thickened with sugar, may also be given. In either the stage 
of invasion or collapse, the leading indication is to establish re- 
action by promoting perspiration. Bathe the feet in water as 
hot as can be borne, give the Extract of Smart-weed freely, 
and thus endeavor to excite profuse diaphoresis. No time 
should be lost, for delays are dangerous. When the reaction is EPIDEMIC CHOLERA. 
561 
established, the patient should remain quiet, and not attempt to 
exert himself. 
After reaction has taken place, the sweating should be main- 
tained for twelve hours, and the patient should drink slippery- 
elm tea and toast-water, and partake sparingly of soft toasted 
bread and chicken broth. The food should be fluid and nutri- 
tious, but taken in small quantities. Do not disturb the bowels 
with laxatives until the third day after the patient begins to 
improve, and then they may be moved by an injection of warm 
water. Great care should be taken that the patient does not 
indulge too soon or too freely in the use of food. When a 
skillful physician can be had, no time should be lost in securing 
his services, but since in epidemics of this nature, medical men 
are generally overworked, and not always easily and promptly 
to be had, we have been quite explicit in giving full directions 
for treatment. 
Cholera Hlorbtis, 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 sen- 
sation of uneasiness and colicky pains in the stomach. 
Symptoms. Nausea, vomiting, and purging are the most 
prominent symptoms. The discharge from the bowels is at first 
of a thin, yellow appearance, but finally it becomes almost 
colorless. Sometimes, after the contents proper of the bowels 
have been evacuated, the dejections have a bilious appearance. 
Severe cramps and pain accompany the vomiting. The vomit- 
ing and purging usually occur in paroxysms, but finally become 
less frequent, a reaction takes place, the extremities grow warm, 
and the patient gradually recovers. It may be accompanied by 
intense thirst and a quick pulse, yet the surface may be cool. 
Causes. Cholera morbus is most prevalent in warm cli- 
mates, and especially in malarial districts. It is generally the 
result of eating indigestible articles of food, such as unripe 
fruit or uncooked vegetables. Stimulating drinks, or those 
articles which furnish the elements for fermentation, also favor 
the production of this disease. 
Treatment. If the attack be superinduced by eating 
unripe or stale fruit, it may be proper to give an emetic or a 
cathartic, but ordinarily first give a full dose of the Extract of 562 
COMMON SENSE MEDICAL ADVISEE. 
Smart-weed, and, if the vomited matter is very sour, give the 
patient a weak, alkaline drink, which may be made by dropping 
a few live, hardwood coals into a tumbler of water. This will 
not only assist in neutralizing the acidity of the stomach, but 
will allay the thirst and accompanying fever. If the 
patient throw up the first dose of the Extract of Smart-weed, a 
second should be given. Do not allow the patient to drink cold 
water, and give only tablespoonful doses of the alkaline solution 
every thirty minutes. If the thirst is great, occasionally give a 
tablespoonful of a tea made from scorched Indian meal, which 
not only allays the desire to drink, but also the irritation of the 
stomach. If to be obtained, give a tea of the leaves or bark of 
the peach tree. The patient should be well covered in bed and 
kept warm. Laudanum by the stomach, or by enema, may be 
necessary in severe cases to relieve the pain and check the 
purging. Hot fomentations applied to the bowels are very 
valuable. A mustard plaster applied over the abdomen will 
assist materially in relieving the nausea and vomiting. It 
should not be left on sufficiently long to blister. When the 
affection is promptly treated as we have suggested, the patient 
generally quickly recovers. If, however, it does not yield to 
these measures, the family physician should be called in. 
COLIC. 
Colic is a term applied to griping pains in the abdomen, 
which are sometimes accompanied with nausea and vomiting. 
The derangement is recognized in several forms, some of which 
we shall briefly describe. 
Bilious Colic. This may be the result of a morbid con- 
dition of the liver. 
Symptoms. It is characterized by severe pain occurring 
in paroxysms, which may be relieved by pressure upon the 
bowels. The pulse is quick, the tongue coated, and the skin 
harsh and dry; there is headache, impaired appetite, acrid taste 
in the mouth, thirst, nausea, attended with vomiting and gen- 
eral chilliness, followed by febrile symptoms. 
Causes. It may be induced by exposure to cold, in con- 
sequence of which the circulation is impeded, the pores of the 
skin obstructed, and all of the vitiated matters having to be COLIC 
563 
expelled through the liver, stomach, and intestines. It may also 
be due to malaria in the atmosphere. It most commonly occurs 
during the autumn, after a season of hot weather. 
Flatulent Colic. Flatulent or " wind " colic is one of 
the results of indigestion. 
Symptoms. A sense of fullness in the pit of the stomach, 
attended with pain, which is transferred from one part of the 
bowels to another. There is fever, a quick pulse, nausea, and 
the presence of gas; by the latter feature it may readily be 
detected from the other forms. 
Causes. Cold or atmospheric changes, the eating of unripe 
fruits, uncooked vegetables and those articles of diet which 
ferment easily, are the principle causes. 
Painters' Colic. This form is also known by various 
names, such as colica pictonum, saturnine, or lead colic. Those 
persons who are engaged in the manufacture of lead, and 
painters, are the most frequent victims of this affection. 
Symptoms. Impaired appetite, fetid breath, thickly 
coated tongue, obstinate constipation, a dry skin, scanty urine, 
languor, severe pain in the umbilical region, and general 
derangement of the functions of the system. 
Causes. From the term applied to this form, the cause 
may be inferred. It is induced by the absorption of lead 
through the lungs, stomach, and skin. 
Treatment. The indication to be fulfilled in bilious colic 
is to relieve the intestinal spasm. This may be done by drinking 
freely of a decoction of yam-root, or dioscorea villosa, which is 
an effectual remedy in this affection. If this is not at hand, the 
spasm may be relieved by administering tincture of opium in 
doses of from fifteen to twenty-five drops. If the stomach is 
irritable, a tablespoonful of laudanum and one of tincture of 
lobelia, in four ounces of starch water, administered as an injec- 
tion, is effectual. If simple means do not promptly arrest the 
attack, no time should be lost in summoning the family 
physician. 
In flatulent colic, the treatment should depend upon the 
cause. If it be occasioned by cold, a teaspoonful or two of the 
Extract of Smart-weed, in warm water or catnip tea, repeated a 
few times, will be sufficient. If it result from overloading the COMMON SENSE MEDICAL ADVISER. 
564 
stomach, a dose of the Pleasant Purgative Pellets will answer 
the purpose. If the pain in the abdomen is severe, apply hot 
fomentations. Assist the action of physic by giving an injec- 
tion of senna and catnip tea, or if the stomach is very sour, 
take internally some mild alkali, such as common saleratus. 
In painters'1 colic, the following cathartic mixture is an 
effectual remedy: sulphate of magnesia (epsom salts), twelve 
ounces; nitrate of potassa (saltpetre), half an ounce; sulphuric 
acid, one drachm; boiling water, one quart. Of this remedy 
give a teaspoonful every thirty minutes or every hour, until the 
bowels move. An injection of some diaphoretic tea, or of alum 
water, is a good remedy. Castor oil and molasses, containing a 
teaspoonful of spirits of turpentine, will add to the efficiency of 
an injection. If the colic is not promptly relieved, a physician 
should be employed. To eliminate the lead from the system, 
and thus prevent a return of the colic, or other injurious effects, 
two drachms of iodide of potassium should be added to a bottle 
of the Golden Medical Discovery, and a teaspoonful of this 
taken four times a day. 
OBSTRUCTION OF THE INTESTINAL CANAL 
The intestinal canal is liable to be obstructed and the passage 
of its contents prevented. The different forms of obstruction 
are termed invagination, impacted feces, and compression or 
stricture. 
Invagination, or Intussusception, of the intes- 
tines, signifies the introduction of one part of the intestine, 
into another. It may occur at any point in the intestines, 
although it generally takes place near the termination of the 
ileum. 
When an intestine passes into one below it, the condition is 
termed progressive invagination; when the process is reversed, 
it is termed retrograde invagination. It generally takes place 
from above downward, and the invagination may occur so low 
that the intestine protrudes from the anus. 
Symptoms. Persistent constipation, tenderness in the 
abdominal region, sudden attacks of severe pain, nausea, and 
vomiting, are prevailing symptoms. In rare instances, the 
matter vomited has the odor of the feces, showing that the OBSTRUCTION OF THE INTESTINAL CANAL. 
565 
intestinal contents have been ejected by the mouth. This is, 
however, of unusual occurrence. The pulse is quick and the 
extremities are cold. In some instances, a sausage-like swelling 
can be discovered over the seat of the affection. Post-mortem 
examinations have revealed great inflammation of the mucous 
membrane of the intestines, as indicated by their dark red color, 
and not unfrequently the peritoneal sheath has the appearance 
of being inflamed. 
Impacted Feces are excrementitious substances which 
become lodged in the intestinal canal, thereby obstructing the 
passage and preventing free evacuations. These hardened 
masses may accumulate in any part of the colon or caecum, but 
in aged persons, they most frequently form below the sigmoid 
flexure, in the rectum. It is remarkable to what an extent the 
bowels may become impacted. Cases are recorded in which 
months have elapsed without the subject having an evacuation. 
In other instances, it has been ascertained that when injections 
have been used to obtain a movement of the bowels, the con- 
tents below the obstruction only, have been removed, without 
affording the desired relief. 
Symptoms. There is more or less pain, the skin is harsh 
and dry, the tongue thickly coated, the stomach irritated, there 
is nausea, accompanied by vomiting, symptoms of fever, and a 
feeling of general debility. If the accumulations be great, the 
abdomen will become distended, and sometimes these masses 
can be distinctly felt in the place where they are located. 
Causes. Obstruction from impacted feces generally com- 
mences by the introduction of some foreign substance within 
the intestinal canal, and its lodgment there. This substance 
is often a fish-bone, seeds or stones of fruit, mustard seed, or 
carbonate of iron improperly administered, all of which have 
been known to collect and become indurated upon the intes- 
tines; or a gall-stone may have been lodged in the passage. 
With some one of these materials as a centre, earthy deposits, 
composed of the indigestible constituents of food, have been 
made about it, until the intestinal passage has become ob- 
structed, and the feces, thus denied a free exit from the system, 
have accumulated and hardened. Sedentary habits may also 
induce an accumulation of excrement within the intestinal walls. 566 
COMMON SENSE MEDICAL ADVISER. 
Impacted feces may occasion tumors in the mucous coat of 
the intestines, and prevent the passage of its contents; these 
symptoms should be clearly distinguished. They are located in 
the colon, and do not often occasion pain upon being pressed 
with the finger. The removal of a fecal tumor generally obvi- 
ates the difficulty, and regular evacuations of the bowels are 
again established. 
Compression, or Stricture. Obstruction of the in- 
testines may arise from tumors forming externally, or from 
abnormal growth within the intestinal canal, or from the scarr- 
ing produced by the removal of ulcers. This is liable to take 
place in the rectum, in which case, it can easily be ascertained 
by examination. It may be in the colon; if so, it cannot be so 
readily determined. Again, it may occur in the small intestine; 
if so, the colon is not distended, and evacuation may take place 
from below the obstruction. Distention may induce rupture of 
the intestine. 
Treatment. If the intestine is invaginated, it is wrong 
to attempt to force a passage by the use of purgatives, for they 
only increase the difficulty. The proper course is to relax the 
spasm, and thus secure a passage. This is sometimes accom- 
plished by injecting a large quantity of warm water into the 
bowels. The injection may be improved by adding to it thirty 
drops of the fluid extract of hyoscyamus and a drachm of the 
tincture of assafetida. These affections are so important that 
they ought to be treated by a competent physician, for if any 
portion of the intestine has become adherent, the above treat- 
ment will not be sufficient. 
If the intestine is obstructed by impacted feces, the remedy is 
a free discharge from the bowels. A stimulating purgative in- 
jection of senna tea, castor oil, and salt will generally remove 
the accumulations in the colon; then follow with a dose of four 
or five of the Pleasant Purgative Pellets. The patient ought 
to partake of some boiled cracked wheat at each meal, as it is 
one of the best articles of diet to keep the contents of the 
bowels in a soluble condition. It may be cooked, and served in 
the same manner as boiled rice. 
In the treatment of stricture of the intestine, the diet should 
be nutritious and concentrated, in order that there may be little DISEASES OE THE LIVER. 
567 
fecal matter to pass the bowels. If the stricture be in the 
lower part of the bowels, it may be mechanically distended and 
overcome. Active purgatives are contra-indicated, but the use 
of injections is proper. Colic pains may be relieved by ano- 
dynes. All strictures of the intestines are very serious, and 
therefore we advise the employment of a professional attendant. 
Although for centuries past, the physiology of the liver has 
been the subject of extensive researches, yet there still exist 
differences of opinion with regard to the functions which it 
performs. It is the largest gland in the human body. It is the 
great depurating, or purifying organ of the system. Formerly 
it was regarded as an excretory organ, but latterly it has been 
shown to be an important organ of secretion also, the functions 
of which are to change the composition of the blood, purify it, 
by abstracting certain elements, assist in the production of ani- 
mal heat, and aid digestion. 
The bile, which is secreted in the liver, undergoes a wonderful 
transformation in the digestive fluids, loses its identity, re-enters 
the blood under a new form, assists in nutrition, and is then 
secreted again. Thus it assists in various relations, conditions, 
and combinations, and while some of its elements, such as 
cholesterin and sulphur, are eliminated as excrementitious, yet 
most of its constituents remain in the system, after being sep- 
arated from the blood, to perform various functions. 
After effecting these physiological changes, it would become 
a poisonous agent, were not its elements abstracted from the 
blood by the process termed secretion. Any derangement of 
the secretory function of the liver is apt to result in disease 
of other important organs, as the heart, lungs, kidneys, skin, 
stomach, or brain. 
There are various opinions with regard to the probable 
amount of bile daily secreted. From experiments made upon 
carnivorous animals, Bidder and Schmidt arrived at the con- 
clusion, that in a man weighing one hundred and forty pounds, 
about two and a half pounds of this fluid are secreted in a 
day. If, in consequence of tight clothing or any mechanical 
impediment, congestion, functional torpor, chronic disease, slow 
DISEASES OF THE LIVER. 568 
COMMON SENSE MEDICAL ADVISER. 
inflammation, or hardening result, or if, from any cause, the 
liver is disabled in the performance of its duties, it is obvious 
that the elements of the bile must remain in the blood, irri- 
tating, poisoning, and perverting every vital process. 
It is evident that these elements, in other relations so indis- 
pensable to health and life, if not promptly eliminated from the 
blood, must poison it, and, through it, the entire system. When 
the secretion of bile is impeded the skin, lungs, bowels, and 
kidneys, in addition to their own regular duties, attempt to 
rid the system of these noxious materials usually carried off 
in the bile. These elements, by being removed through the 
skin, cause pimples, blotches, boils, or carbuncles; or produce 
irritation of the lungs, as indicated by cough, asthma, bronchitis, 
or consumption; or functional derangement of the bowels, as 
constipation, piles, diarrhea, or dysentery; or, perhaps, organic 
disease of the kidneys or bladder. Often the brain manifests 
functional derangement, such as dullness, dizziness, headache, 
impaired memory, and hypochondria. The process of nutrition 
is perverted, the functions of the blood-vessels are disordered, 
the circulation is materially disturbed, and all the organs of 
the body are morbidly influenced. 
These in turn react upon the liver, so that the functions of 
this organ become still more deeply involved; the portal vessels 
are congested, inflammation and induration follow, and are suc- 
ceeded by other organic diseases. Hardening of the liver may 
be the cause of abdominal dropsy, affections of the heart, 
derangement of the stomach and bowels, Bright's disease of the 
kidneys, and even pulmonary consumption. 
Causes. Among the causes of "liver complaint," we may 
mention overexertion, unduly heating the body, exposure to 
currents of air, vicissitudes of climate, as extremes of heat and 
cold, sudden variations of temperature, insufficient clothing, 
continued compression of the vital organs, irregular habits, loss 
of sleep, drinking cold water when the body is heated, too 
stimulating diet, excessive use of spirituous liquors, sedentary 
habits, constipation of the bowels, improper medical treatment, 
the use of harsh, heroic medicines, mercurials, excessive use of 
purgatives, blows, injuries, or contusions in the region of the 
liver, irritation from biliary concretions, violent rage, deep DISEASES OF THE LIVER. 
569 
sorrow, and malaria. These are prominent agents in producing 
this disease. Solar heat excites the skin, and malaria the liver, 
to excessive action. The cold night air checks the functions of 
the former, on account of which fever follows, succeeded by 
inflammation of the liver. The sudden changes of the New 
England climate, the malarial influences of the West, and the 
heat of the South, together with the faulty dietetic habits of the 
people, tend to develop diseases of the liver throughout the 
United States. 
We have observed in the dissecting room, and also in making 
post-mortem examinations on the bodies of those who had died 
of various diseases, that in a large proportion of cases, the liver 
has given evidence of having at some time been diseased. This 
affection is equally prevalent in beasts; every butcher knows 
that the livers of cattle, sheep, and swine are much more fre- 
quently diseased than any other organ. 
Acute Inflammation of the Diver. (Acute 
Hepatitis.) This disease is of rare occurrence in the temperate 
zones. The inflammation, being seated in the substance of this 
organ, terminates either by a gradual return to health, termed 
resolution, by the formation of pus, or in chronic inflammation, 
attended sometimes with enlargement. 
Symptoms. There is chilliness, with nausea, and vomit- 
ing of bilious matters, a sense of oppression and constriction in 
the region of the stomach and liver, and intense heat of the 
skin; the tongue is coated yellowish white, the pulse is hard, 
full, and strong, there is severe pain across the temples and 
forehead, attended with dullness and languor, the eyes, skin, and 
urine are tinged with yellow, there is difficulty of respiration, 
a dry cough, pain in the right shoulder, collar-bone, and in the 
region of the liver, which may be dull, or sharp and lancinating. 
There is more or less tenderness on pressure over the liver, the 
patient is inclined to lie on the right side, the appetite is im- 
paired, the thirst great, the bowels are constipated, or the 
opposite condition prevails. The symptoms vary according to 
the severity of the attack, and the extent of the inflammation, 
and if the disease does not end in resolution, it generally 
terminates in suppuration. If the abcess points outwardly, it 
may be opened by incision and the matter liberated. The pus 570 
COMMON SENSE MEDICAL ADVISER. 
is sometimes discharged into the bowels and evacuated, or into 
the lungs and expectorated. Recoveries are rare in the latter 
case, and the disease is always fatal when the " matter " 
is discharged into the abdominal cavity and can find no 
exit. 
Treatment. The general directions under the head of 
inflammation apply to the management of this inflammation. 
If there be nausea and vomiting, a thorough emetic should be 
given at once. If there is fever, hot skin, quick pulse, and 
thirst, give veratrum or aconite with pleurisy-root tea, repeating 
the doses every hour. To promote sweating, give the Com- 
pound Extract of Smart-weed. Hot fomentations may be ap- 
plied over the right side to relieve pain. When the pain is 
softened and sweating is induced, give a cathartic, such as a 
dose of four or five of the Pleasant Purgative Pellets. For 
nausea and irritability of the stomach, make a drink by drop- 
ping a few live hardwood coals into a tumblerful of cold 
water; these will also charge it with carbonic acid, which, in 
these diseases proves very acceptable to the stomach. When 
convalescence is established, give of the Golden Medical Dis- 
covery, a teaspoonful dose from three to six times a day, to 
prevent the disease from assuming a chronic form. If the 
inflammation does not readily yield to this treatment, a phy- 
sician should be called, as dangerous complications are apt to 
arise. 
CHRONIC INFLAMMATION OF THE LIVER. 
(Chronic Hepatitis.) 
This is what is ordinarily termed liver complaint, torpid liver, 
and bilious disorder. 
Under this head may be considered all those chronic affec- 
tions known as congestion, induration, and enlargement of the 
liver, and which result in deficient action, functional derange- 
ment, morbid secretion of bile, and various chronic affections. 
Symptoms. Owing to the liability of other organs to be- 
come diseased during the progress of chronic affections of the 
liver, great precision in diagnosis is required to determine, by 
the symptoms, the organ which is primarily diseased and those 
secondarily affected. This requires not only familiarity with CHRONIC INFLAMMATION OF THE LIVER. 
571 
the signs of a complicated disease, but also thorough anatomical 
knowledge of the diseased organ, of the morbid changes which 
occur in its structure, and their influence on its own functions, 
as well as on those of other organs. 
The symptoms may differ according to the circumstances, tem- 
perament, sex, age, or constitution of the individual, and the 
complications of the disease. The local indications are fullness 
of the right side, thus denoting congestion of the liver; a 
dull, heavy pain, which is increased by pressure or by lying on 
the left side; a sense of fullness, weight, and oppression about 
the stomach; an aching in the right shoulder-blade; a dull, 
disagreeable pain in the shoulder-joint, which may extend down 
the arm, and which is sometimes felt in the wrist and joints of 
the hand. Not unfrequently the complexion becomes pale and 
sallow, and there is puffiness under the eye, headache, a bitter 
taste in the mouth, tongue coated white or covered with a 
brown fur, and the hardness of the gums; there is frequent 
sighing, a hacking cough, fever, restlessness, and loss of sleep; 
sometimes an unnatural, greasy appearance of the skin, at 
others, it is dry and harsh, has scaly or branny eruptions, 
pimples, dark blotches, and troublesome itching. The urine 
is frequently scanty and high-colored, but variable as to 
quantity and appearance; it often produces a scalding sensation 
when voided, and, if allowed to stand, deposits a sediment 
which sometimes contains albumen. The pulse is very slow, 
particularly when the elements of the bile are not eliminated 
from the blood. The pulsations of the heart are easily quick- 
ened, and palpitation is excited if the subject be low and 
anaemic. There is depression of spirits, and a decided tendency 
to be discouraged and despondent. The functional powers of 
the stomach are impaired, there is loss of appetite, or it be- 
comes capricious, uneasiness is felt in the region of the stomach, 
oppression, sometimes nausea and water-brash, or there is indi- 
gestion, flatulency, and acid eructations, the bowels become 
irregular, usually constipated, and occasionally subject to obsti- 
nate diarrhea attended with colicky pains, the stools are of a 
light clay color, sometimes hard and dark, again thin and very 
offensive, and occasionally green or black. As the disease pro- 
gresses, during the day the circulation is sluggish, the feet 572 
COMMON SENSE MEDICAL ADVISER. 
and hands are cold, but at night the pulse is accelerated, and 
a burning sensation is felt in the palms of the hands and the 
soles of the feet. 
The foregoing symptoms are not all present in one case, nor 
are any two cases alike in every respect. They vary according 
to the organs most implicated in the hepatic derangement. 
Thus, when chronic inflammation of the liver is associated with 
heart disease, the subject may have palpitation, excessive or 
defective action of the heart, attended with more or less pain 
and shortness of breath. If the lungs be specially influenced, 
then, in addition to the ordinary hepatic symptoms, there may 
be a dry cough, asthma, hurried respiration, bronchitis, hoarse- 
ness, and pain in the chest. If the stomach is the sympathizing 
organ, the tongue coated white or brown, there is nausea, loss 
of appetite, flatulency, acidity, dyspepsia, fullness, and oppres- 
sion, amounting, sometimes, to pain in the stomach after taking 
food, which ferments and gives rise to eructations and various 
other disordered manifestations. If the bowels are morbidly 
influenced by this affection, there is constipation or diarrhea, 
griping pain, distension of the abdomen, piles, and pain just 
within the points of the hips, thus indicating irritation of the 
colon. If the brain or nervous system sensitively responds, 
there is headache, dizziness, disturbed sleep, depression of 
spirits, peevishness, capriciousness, lack of energy, irritability, 
and congestive symptoms. When the skin is involved the 
surface is dry, harsh, and scaly, displaying dark " moth-spots," 
blotches, or numerous little sores, and the countenance has a 
dull, tawny look. If the kidneys be disturbed by it, there may 
be pain and a sensation of weight in the back, while the urine 
may be scanty and high-colored, or abundant, pale, and limpid, 
frequently charged with sedimentary products of disease, and 
voided with difficulty. If the womb be implicated in this 
chronic affection, the menstrual function may be deranged, and 
result in an excessive or a deficient monthly flow, and be fol- 
lowed by profuse leucorrhea. 
The preceding allusion to the complications of chronic inflam- 
mation of the liver, show the necessity of clearly distinguishing 
between the symptoms of this disorder and those reflected by 
the organs which sympathetically respond. To discriminate CHRONIC INFLAMMATION OF THE LIVER. 
573 
more effectually, and place the correctness of the diagnosis 
beyond doubt, we make a chemical and microscopical examina- 
tion of the urine, and thereby detect the morbid products which 
it contains, and direct our attention to the diseased organs fur- 
nishing them. These examinations together with a complete 
history of the case, enable us to make a correct and definite 
diagnosis of the disease, and the extent to which it has affected 
the other organs. 
Before entering upon the consideration of treatment, let us 
briefly enumerate the functions of the liver, First, it removes 
matter which, if allowed to remain in the blood, would become 
noxious and unfit it for the further support of the body. 
Secondly, by secreting bile, it furnishes to the digestive organs a 
fluid which assists in converting the food into chyle, stimulates 
the intestine to action, and then is itself transformed and 
absorbed with the chylous products, after which it circulates 
with the blood and assists in nutrition until, becoming injurious 
and pernicious, it is re-secreted and re-elaborated to serve again, 
as described. 
For its growth and nourishment, the liver is furnished with 
blood by the hepatic artery; but for the purpose of secretion 
and depuration, it is abundantly supplied with venous blood by 
the portal system, which is made up of veins from the spleen, 
stomach, pancreas, and intestines. This impure, venous blood, 
surcharged with biliary elements, which must be withdrawn 
from it, is freely poured into the minute network of this gland- 
ular organ. In a healthy condition of the liver, the carbon- 
aceous elements of the blood are converted into sugar, and the 
constituents of the bile are liberated by the liver, and set apart 
for further duties. When it fails to eliminate these noxious ele- 
ments from the blood, it is itself thoroughly vitiated by them. 
Treatment. Food must be rich in carbon in order that it 
may build up the tissues and keep the body warm, but carbonic 
acid, the result of the combustion, must be removed from the 
blood, or death will ensue. So bile is necessary to digestion, 
nutrition, and life; yet, if it be not separated from the blood by 
the secreting action of the liver, it will as surely poison the 
system and destroy life as carbonic acid. Although the con- 
stituents of the bile exist in the blood, they must be removed in 574 
COMMON SENSE MEDICAL ADVISER. 
order that the blood may be rendered more fit to support the 
body, while the secreted bile is destined to assist in digestion, 
and the mysterious process of nutrition. Therefore, we should 
induce a secretion of bile, and restore the normal activity of the 
liver. This should be done, not by administering stimulants, 
but by relieving it of all contingent embarassments so far as 
possible. Would any one think of giving to a weak, debilitated 
man large portions of brandy to enable him to work? Does 
not every one know that, when the unnatural stimulus is re- 
moved, he fails? Apply this principle in the treatment of the 
liver. When harsh, unnatural stimulants and " bile-driving " 
medicines are administered for a time and then withheld, the 
liver relapses into a more torpid and debilitated condition than 
before treatment was begun. Is not this true of nine-tenths of 
all who suffer from this malady, and have recourse to this class 
of remedies? 
Then how can we remedially fulfill the preceding indica- 
tions ? We answer in the language of a distinguished author 
and standard medical writer, " by using a class of agents which 
should never be overlooked in the treatment of long-standing 
liver diseases, chiefly addressed to the blood and denominated 
' Alteratives? " 
Alteratives, tonics, and restorative catalytics are required not 
only in diseases of the liver, but in a large number of ailments 
in which the blood becomes charged with morbid materials. 
The active remedial properties of the most efficient agents of 
the above classes of medicine now known, are scientifically com- 
bined in the Golden Medical Discovery, which acts especially 
upon the blood, and hence influences the system generally. It 
is also powerful in eliminating those morbid humors which are 
afterwards subjected to excretion through various organs. 
Its action is radically different from most medicines employed 
in chronic diseases, for the reason, that what is usually pre- 
scribed, is something corrosive. Unless the disease be tempo- 
rary, it may return with increased violence. 
We have been very minute in the description of the remedial 
properties of the Golden Medical Discovery, and have relied 
upon the reason and intelligence of our patrons, believing that 
they can, in a degree, understand why we deem it so applicable CHRONIC INFLAMMATION OF THE LIVER. 
575 
to the system. It does not debilitate the liver by overstimula- 
tion, nor irritate the stomach and bowels by disturbing the deli- 
cate processes of digestion, neither does it act with severity 
upon the blood, but it operates so gently, insensibly, and yet 
with so much certainty, that it excites the surprise and admira- 
tion of the patient. 
From the careful detail of its various properties, there is 
abundant reason for its favorable action upon all of the excre- 
tory organs, which co-operate in the removal of morbid mate- 
rials from the system. If, however, the bowels are unusually 
sluggish or obstinately constipated, it is advisable, in conjunc- 
tion with the Golden Medical Discovery, to use the Pleasant 
Purgative Pellets, which are also powerfully alterative, besides 
being mild and unirritating in their operation. They are the 
natural assistants of the Discovery, working harmoniously to- 
gether. They should be taken in small doses, and their use 
perseveringly followed, until the bowels are properly regulated 
by the use of the Discovery alone. 
It has been customary to resort to powerful drastic cathartics, 
followed by bitters prepared in dilute alcohol. The habit is 
unscientific, for it is well known that alcohol deranges the func- 
tions of the digestive organs and depraves the blood, besides 
creating a morbid appetite. It has been repeatedly demon- 
strated that the use of such bitters has led to a life of drunken- 
ness, with all the woe and untold misery which attend it. 
Medicines to be strictly remedial, should exert a tonic influ- 
ence upon all the vital processes. Those organs which are con- 
tiguous to the liver, or connected by sympathy with it, should 
be assisted in the performance of their functions. Persons who 
are habitually subject to " bilious " attacks are pleased to find 
that the use of the Discovery and Pellets furnishes immunity 
from such onsets, and prevents their usual recurrence. Thus 
these remedies are preventative as well as curative. 
What we have thus far recommended for the treatment of 
this chronic affection is within the reach of every family. 
Patients laboring under this disease, when complicated with 
other affections, require special consideration and treatment, 
and all such are counseled to employ only those physicians 
whose experience and success entitle them to confidence. Health 576 
COMMON SENSE MEDICAL ADVISER. 
is one of the greatest of blessings, and how to restore it when 
lost, is a question of vital importance. 
Having successfully treated thousands of invalids who have 
suffered from this chronic affection, we possess abundant evi- 
dence of the curability of the disease, but we have only space to 
publish a few letters from persons who have been under our care. 
CASES TREATED. 
Case 34,001. Disease of the Liver, and Dyspepsia. 
World's Dispensary Medical Association: Gentlemen-I am 
thankful for your treatment; without it I should not have been here. 
Every one says, " You look so much better that I don't know you." 
My cure was not expected. 
Mrs. J. H., Pierre Point Manor, N. Y. 
Case 39,827. "Liver Complaint" and Dyspepsia. 
World's Dispensary Medical Association: Gentlemen-I visited 
the Invalids' Hotel and Surgical Institute in search of a cure for 
an obstinate case of dyspepsia, liver complaint, and general debility. 
After a careful examination by several of your Faculty, I commenced 
treatment, and in four months'"time I was entirely cured. 
Yours truly, F. L., Mendota, Ill. 
Case 47,573. " Liver Complaint." 
World's Dispensary Medical Association: Gentlemen-Your 
medicines have my greatest praise, as they did me a great deal of good. 
My weight is 140 pounds. I have no pain, no more bloating or dizzi- 
ness; the distress in the stomach has ceased. The appetite and diges- 
tion are good, my sleep is sound and refreshing. I can say with 
pleasure, that your medicines did all that I could wish. 
J. A., Greene, Iowa. 
Case 48,681. "Liver Complaint" and Dyspepsia. 
This subject, a wealthy and very hard-working business man, by 
overtaxing himself mentally and physically, and living in a malarious 
region, was suffering from diseased liver and dyspepsia of several years 
standing. His letter describes his condition and his cure perfectly. 
World's Dispensary Medical Association: Gentlemen-Hav- 
ing suffered severely for several months from an inveterate form of 
dyspepsia, with habitual constipation of the bowels, loss of appetite, 
nervous prostration, inability to rest or sleep more than two or three 
hours in twenty-four, great debility, and emaciation, and feeling con- 
scious that my disease was rapidly making serious inroads upon my 
constitution, and that I was surely and speedily becoming unable and 
incapaciated to attend to my ordinary business affairs, I resolved, after 
deliberate and careful consideration, to place myself under your treat- 
ment at the Invalids' Hotel and Surgical Institute, in Buffalo. With 
much pleasure and gratitude, I can now, after only six weeks treat- 
ment, truthfully say that I am entirely relieved of my disease; my 
appetite is excellent, food is well digested, bowels regular, sleep much 
improved and refreshing, and altogether I feel as if I were restored to 
my former health and strength. I most cheerfully and earnestly 
recommend this institution to all who are afflicted with obstinate, 
chronic, or painful diseases. W. McL, Clarksville, Mo. CHRONIC INFLAMMATION OF THE LIVER. 
577 
Case 49,W0. Liver Disease and Dyspepsia. 
World's Dispensary Medical Association: Gentlemen-My 
complaints, dyspepsia, torpid liver, and attendant troubles, appear to 
be entirely relieved. I have Waited some weeks and find my cure 
perfect and permanent. Please accept my heart-felt thanks. 
Yours truly. 
S. W. K., Brunswick, Ohio. 
Case 56,064. Liver Disease, with Weakness and Debility. 
World's Dispensary Medical Association: Gentlemen-Hav- 
ing suffered many years from indigestion, deranged liver, and 
consequent constipation, and general loss of strength, flesh and 
energy, and having found but little, if any, relief from the large 
number of good physicians under whose treatment I had been almost 
constantly during this long time, I determined to place myself under 
your care. After six weeks' treatment with skillfully selected remedies, 
the Turkish bath, and movement cure, I find myself cured. My stom- 
ach now digests without difficulty a good square meal; the bowels are 
regular, and I feel myself to be a new man. I take this opportunity of 
thanking you most kindly for the good you have done me and for 
the kindness shown. Most thankfully yours, 
O. A. R.., Fremont, Ohio. 
Case 64,613. Liver Disease. 
World's Dispensary Medical Association: Gen tiemen-Living 
in a malarious section and being too actively engaged in mercantile 
pursuits, I became bilious, nervous, and completely broken down. I 
went to your great sanitarium, and in the short space of one month I 
was restored to my usual good health. I now take this opportunity to 
thank you with all my heart for this speedy and happy restoration. 
It does seem to me that Buffalo's invigorating air, and your Turkish, 
and electric baths, vacuum cure, movement cure, etc., would cure 
almost any disease. I would advise anybody who is sick to go to this 
grand and unparalleled institution. 
Very respectfully yours, 
Mrs. J. G., Wilkesbarre, Pa. 
Case 88,995. "Liver Complaint." 
World's Dispensary Medical Association: Gentlemen-About 
eight years ago my brother was very low with the liver complaint, but 
by the use of four bottles of your Golden Medical Discovery, he was 
restored to good health again. Respectfully yours, 
A. A. C., Russell, N. Y. 
Case 112,138. Disease of the Liver. 
World's Dispensary Medical Association: Gentlemen-Pre- 
vious to using Dr. Pierce's Golden Medical Discovery, I was badly 
afflicted with liver and kidney complaints, but I used two bottles of the 
Discovery and now feel like a new man. If necessary, I would will- 
ingly pay twenty dollars a bottle for the Discovery, as previous to 
using it I had spent two hundred dollars without receiving any benefit 
in return. Hoping that you may live long to enjoy the blessing of 
God, I remain your true friend and well-wisher, 
C. L. C., Williston, Vermont. 
Case 166,163. Liver Disease. 
World's Dispensary Medical Association: Gentlemen-I was 
troubled one year with liver complaint, dyspepsia, and sleeplessness, 
but twelve bottles of the Golden Medical Discovery cured me. 
Mrs. T. C., Springfield, Mo. 578 
COMMON SENSE MEDICAL ADVISER. 
Case 167,319. Enlarged Liver, from Ague. 
World's Dispensary Medical Association: Gentlemen-I suf- 
fered terribly from chronic malarial poisoning for a period of thirty- 
nine years, until finally I became reduced to the merest "wreck of 
humanity." My liver was dreadfully enlarged, and I suffered greatly 
from catarrh. But two years ago I used the Golden Medical Discovery 
in connection with the Pellets, and they have done me more good than 
words can express, having benefited me in every way. 
I remain, gratefully yours, Mrs. M. A. F., 
Chilford, Sussex Co., Delaware. 
JAUNDICE. (Icterus.) 
This affection is generally regarded as a symptom of disor- 
dered liver, since it frequently occurs during the progress of 
diseases of that organ. When the disease imparts a greenish 
tinge to the skin, it is termed green jaundice, and, when it im- 
parts a blackish color, it is known as black jaundice. Jaundice 
is undoubtedly due to the presence of biliary elements in the 
blood. 
Causes. In consequence of the varied conditions from 
which it arises, Professor Da Costa has aptly remarked: "With 
the recognition of jaundice, the difficulty in diagnosis may be 
said to begin." He considers the causes of jaundice to be (1) 
diseases of the liver; (2) disease of the bile ducts; (3) diseases 
remote from the liver, or general diseases leading to a disorder 
of that viscus; (4) certain causes acting upon the blood. 
Symptoms. It is characterized by a yellowish color of 
the skin and of the white of the eyes. The skin is usually dry 
and harsh; if it be moist, the linen will be tinged yellow from 
the perspiration. The tongue is coated yellow, the mouth is 
dry, and the appetite impaired; there is headache, nausea, and 
sometimes vomiting; there is pain in the abdomen after eating, 
and in the region of the liver, and it is also felt in the right 
shoulder, and between the shoulder-blades. In severe cases, 
there is fever, accompanied with chills, despondency, and loss 
of flesh. The stools are generally of a light clay color, and 
very offensive; the urine is thick and yellow. When the disease 
terminates fatally, there is delirium followed by stupor. 
Treatment. The first step should be to eliminate from 
the system, as speedily as possible, all noxious materials. For 
this purpose, the spirit vapor-bath should be used. If the urine 
is scanty, or voided with difficulty, take acetate of potash or GALL-STONES. 
579 
queen of the meadow. These may be taken in connection with 
the Golden Medical Discovery and Purgative Pellets, the effi- 
cacy of which has already been described in the treatment of 
chronic inflammation of the liver. They are indeed valuable 
agents in this disease, since they increase the action of all the 
excretory glands, and rapidly remove those matters, which, if 
retained, would poison the system. 
In some cases, acids are of great value; good hard cider or 
hydrochloric acid and the acid bath are frequently valuable 
agents. 
In other cases, the employment, both internally and exter- 
nally, of alkalies in addition to the Golden Medical Discovery 
answers the purpose much better. 
Again, there are persons, who, in addition to alteratives and 
baths, require tonics. In the treatment of this affection, what- 
ever may be the nature of the case, the use of alteratives must 
not be forgotten, for without them, the auxiliary treatment 
with acids, alkalies, and tonics, will not produce the desired 
effect. 
The employment of drastic remedies is sometimes resorted 
to; but, although they may give temporary relief, the patient 
soon relapses into his former condition, while if the treatment 
above given be adopted, the recovery will be permanent. 
GALL-STONES. (Biliary Calculi.) 
These are concretions found in the gall-bladder or bile duct, 
and vary from the size of a pea to that of a hen's egg. There 
may be no indication of their existence in the gall-bladder until 
they begin to pass through the duct. 
Causes. The formation of gall-stones is undoubtedly due 
to an unhealthy condition of the bile. Corpulent persons, and 
those indulging in an over-stimulating diet, or in the habitual 
use of fermented drinks, are most liable to be troubled by them. 
Symptoms. The patient is suddenly seized with excru- 
ciating pain in the right side. After a time it subsides, but is 
again renewed with as great severity as before. There is nau- 
sea, with vomiting, which is often excessive and severe. The 
pulse is sometimes slower than is natural, the extremities are 
cold, there is great exhaustion, together with perspiration and 580 
COMMON SENSE MEDICAL ADVISER. 
spasmodic contraction of the abdominal muscles. As soon as 
one stone has passed through the duct into the intestine, imme- 
diate relief is experienced until another commences to pass, and 
the larger the concretion, the greater is the pain. If the stools 
be washed, the gall-stones may be seen floating on the top of 
the water. 
Treatment. This consists chiefly in relieving the patient 
of pain and vomiting during the passage of the gall-stones. 
Hot fomentations made with stramonium leaves and lobelia, and 
applied over the painful parts, are beneficial. Small doses of 
lobelia may be taken, but not in sufficient quantities to produce 
vomiting. Doses of opium should also be taken; this anodyne 
must, however, be used with care. Gelseminum is often useful. 
Chloroform, ether, or the spirit vapor-bath generally allays the 
pain. Carbonate of soda, dissolved in water, often relieves the 
vomiting. 
These distressing symptoms are apt to recur until the removal 
of all the gall-stones is effected. • To aid in removing them, 
take the Golden Medical Discovery rather freely for a day or 
two, and continue its use with lobelia, in doses sufficiently large 
to produce nausea, but not vomiting. From four to eight 
ounces of sweet oil may be given, and, if' the bowels do not re- 
spond within three hours, repeat the dose, and the gall-stones 
will generally be evacuated. To prevent the formation of these 
concretions take the Golden Medical Discovery, together with 
alkaline drinks made with carbonate of soda. Tone and energy 
will thereby be imparted to the liver, the free flow of bile will 
be insured, and the subsequent formation of gall-stones pre- 
vented. 
INTESTINAL WORMS. 
We have not the space to discuss the numerous theories which 
have been offered, to account for the presence, of these parasites 
in the human body. We shall enumerate the principal species, 
describe the symptoms indicating their presence, and indicate 
the proper remedies. 
There are five species of intestinal worms, sufficiently common 
to merit a description. 
(1.) The round worm, termed by naturalists, ascaris lumbri- 
coides, varies from six inches to a foot in length, and resembles INTESTINAL WORMS. 
581 
the common earth-worm. It infests the small intestine, and 
seldom migrates into the stomach or large bowel. Instances 
are recorded, however, in which it has crept upward in the 
esophagus, larynx, nostrils, and eustachian tube; but their 
presence in these parts is of comparatively rare occurrence, and 
is generally caused by some local irritation which compels their 
migration. The fact that they have been found in the peritoneal 
sac, gave rise to the opinion that they perforate the intestine; 
but careful observations have proved that they can only escape 
through openings made by ulcers. 
This species has been found in adults, but is more common in 
children from three to twelve years of age. The number of 
this species existing in a human body is variable. Sometimes 
only two or three are found. At other times a hundred, and 
even twice that number, are voided in a few days. 
(2.) The ascaris vermicular is, thread, pin, or seat-worm, is 
round, very slender, and about half an inch in length. The 
habitation of this species is the rectum, and they are often 
found matted together in the excrement. They are very active, 
even after ejection, and have been known to cause great local 
irritation by entering the vagina and urethra. Their presence 
is an occasional cause of masturbation. It is impossible to esti- 
mate the number of these parasites that may exist in the 
human rectum. Great numbers, sometimes, are voided at a 
single evacuation. 
(3.) The tricocephalus dispar is a third variety of the round 
worm, and is said to infest the bodies of almost every species 
of mammalia. As its name indicates, the upper portion of its 
body is slender, hair-like, and terminates at the lower extremity 
in a thick, spiral portion. It is from one to two inches in 
length, and is found attached by its head to the mucous mem- 
brane of the caecum, and, in rare instances, in the colon and 
small intestine. They are rarely numerous. 
Tcenice, or tape-worms, are hermaphrodites, of a flat, ribbon- 
like form, and are composed of numerous segments, each of 
which is provided with a complete set of generative organs, and 
contains ova for the production of thousands of individuals. 
Some authors have supposed that each segment, or joint, is a 
distinct individual, but the existence of one head for the whole 582 
COMMON SENSE MEDICAL ADVISER. 
precludes this theory. There are two species of taeniae devel- 
oped in the human intestine; the taenia solium and the taenia 
lata. 
(4.) The taenia solium is the species commonly found in 
America and all the countries of Europe, except France, Russia, 
and Switzerland. In France, both species are found, but the 
taenia lata seems to be indigenous to Russia and Switzerland. 
The taenia solium varies in length from four or five to thirty, 
thirty-five, or even forty feet. The head is hemispherical and 
armed with a double row of twenty or thirty booklets. The 
genital organs are alternate, and placed upon the outer edges of 
each segment. It inhabits the small intestine, and is usually 
solitary. 
(5.) The taenia lata, or broad tape-worm, is distinguished by 
the greater breadth of its segments, and the location of the 
genital organs, which are found in the centre of each segment. 
Its small elongated head is unarmed, and has a longitudinal fis- 
sure on each side. It usually attains a greater length than the 
taenia solium. 
Symptoms. The symptoms which the long worms occa- 
sion, are frequently somewhat obscure. Thirst, irregular appe- 
tite, colicky pains, excessive flow of saliva, enlargement of the 
abdomen, itching of the nose, pallor of the face, offensive 
breath, disturbed sleep, and grinding of the teeth, all are com- 
mon symptoms. Occasionally, convulsions and other nervous 
affections are produced by the presence of the ascaris lumhri- 
coides, but generally they produce less constitutional disturb- 
ance than the other varieties. The passage of this species of 
worms from the bowels, or their ejection from the stomach, is 
the only positive evidence of their presence. The ascaris ver- 
micularis, thread, pin, or seat-worm, gives rise to most of the 
symptoms produced by the long worms, but in addition pro- 
duces intense itching at the anus, and, not unfrequently, an erup- 
tion upon that part. The itching is particularly distressing at 
night. When the little sufferer is well covered, the warmth oc- 
casioned by the bedclothes causes these little parasites to crawl 
out upon the anus, and produce such paroxysms of itching and 
pain as to cause the child to kick the covering off and lie naked. 
The persistent manifestation of a disposition to lie naked, should INTESTINAL WORMS. 
583 
excite the parents' suspicions of seat-worms, and lead them to 
investigate all the symptoms. By examining the child's stools 
the worms may be found adhering to the feces, and they may 
also be seen on the anus. Thousands of children suffer untold 
agony from these little seat-worms, which are left unmolested 
to torment them, because the parents are unfamiliar with the 
meaning of the symptoms manifested, and therefore pay no 
heed to them. We have been thus particular in describing the 
symptoms indicating the presence of these pestiferous parasites, 
in order that they may be readily detected. 
The Symptoms produced by the tape-worm are dizziness, 
ringing in the ears, increased secretion of saliva, indigestion, 
ravenous appetite, sharp abdominal pains, and emaciation. The 
only positive sign of the presence of these parasites, is the pas- 
sage of pieces of them in the feces. The nervous and other 
symptoms produced by the ordinary long worms are also caused 
by the tape-worm. 
Causes. Careful observations have proved that there are 
certain causes which favor the generation or development of 
intestinal worms. Among others, we may mention fatty or 
farinaceous articles of food, gormandizing, constant exposure to 
a moist atmosphere, and sedentary habits. 
It is now generally conceded that the development of tape- 
worms is due to the swallowing of an egg or germ-cell, which 
is contained in many kinds of animal food, and which the 
process of cooking has failed to destroy. People living near 
low marshes, lakes, or the seacoast, are peculiarly liable to 
taeniae. 
Treatment. The expulsion of the ascaris lumbricoides 
may be very easily and pleasantly effected. Santonin is an 
effectual remedy for this variety of worms. For a child three 
years old, take santonin, six grains; podophyllin, one grain; 
white sugar, thirty grains; mix, triturate, and divide into twelve 
powders, and give one every three or four hours, until they act 
upon the bowels; or take santonin, ten grains; white sugar, 
twenty grains; mix, triturate, and divide into ten powders, and 
give one every night at bedtime, and after giving two or three 
in this way, administer a mild cathartic. As santonin is almost 
entirely tasteless, if not combined with other medicines which 584 
COMMON SENSE MEDICAL ADVISEE. 
are unpalatable, no difficulty will be experienced in administer- 
ing it to children. By reference to the article on anthelmintics 
in this volume, other valuable vermifuges may be selected, and 
directions found for their employment. 
In the removal of thread or pin-worms, anthelmintic medicines 
taken into the stomach are of little or no value. An injection of 
a strong solution of salt, is a very efficient remedy. A teaspoon- 
ful of turpentine in half a pint of milk makes a good injection. 
Strong coffee has been recommended as an injection. The anus 
should be well anointed with vaseline, lard, oil, or fresh butter, 
after each movement of the bowels. Whatever injection or 
remedy is used, it should be followed by the application of some 
ointment to the anus, otherwise they will continue to deposit 
their eggs about that orifice and multiply there. 
Various remedies have been used to destroy tape-worms. 
Among others we may mention the old and time-honored rem- 
edy, which consists of two or three ounces of the oil of turpen- 
tine, taken in castor oil or some aromatic tincture. 
A decoction made by boiling two or three ounces of freshly 
powdered pomegranate bark in a pint of water was used by the 
ancients, and is now highly recommended as a remedy. 
Some American physicians have used an emulsion of pumpkin 
seeds with marked success. 
Twenty or thirty grains of the extract of male fern, followed 
by a cathartic, is highly recommended for the destruction and 
removal of taeniae. 
TRICHINA SPIRALIS. 
In 1835, Owen discovered a peculiar parasite, which sometimes 
infests the human body, and is termed the trichina spiralis. 
The presence of these parasites has given rise to morbid con- 
ditions of the system, followed by the most serious results. 
They are developed in the alimentary canal, and then perforate 
its tissues and enter the muscles. Twelve trichinae have been 
found in a section of human muscle only one-twelfth of an inch 
square and one-fifth of an inch in thickness. 
The early symptoms of trichinae are very uncertain, being the 
same as those of some other disease. The patient complains of 
severe pain in the abdomen and is troubled with diarrhea. CONSTIPATION. 
585 
When the trichinae pass into the muscles, they occasion great 
suffering. There are sharp pains in the muscles, the perspira- 
tion is profuse, and the patient becomes exhausted. 
Cause. Nearly every case of trichinae, which has been 
brought to the notice of the profession, has been attributed to 
the eating of raw or improperly cooked pork. The parasites 
can only be detected with a microscope. 
Treatment. The impossibility of removing the trichinae 
after they have passed into the muscles is apparent; and, as 
yet, no special remedy has been recommended to remove them 
from the alimentary canal. The only safety lies in prevention. 
Hence raw or imperfectly cooked pork should never be eaten. 
CONSTIPATION. (Costiveness.) 
Health depends very largely upon the regularity of the 
bowels. There should be proper al vine evacuations every day. 
There are few persons who have not suffered at some period of 
their lives from constipation of the bowels. Inattention to the 
calls of nature, or a neglect to regularly attend to this important 
duty, sooner or later, produces disastrous results. Furthermore, 
it is essential to the comfort of every individual, for, when this 
function is not performed, there is derangement of the mental 
as well as of the bodily organs. 
Constipation, or costiveness, as it is sometimes termed, is a 
functional derangement of the large intestine. This intestine is 
about five feet in length, and consists of the caecum, colon, and 
rectum. It serves as a temporary reservoir for the excrementi- 
tial residue of alimentary matter, and for the effete materials ex- 
creted by the glands contained in its mucous coats. It is dis- 
tinguished as the large intestine, because of its great size. 
Habitual constipation produces many derangements, resulting 
from sympathy, irritation, or mechanical obstruction. By re- 
ferring to Figs. 29 and 34, in Part I of this volume, the reader 
may observe the anatomical relations which the large intestine 
sustains to the other abdominal organs. The ascending colon 
arises in the caecum (Fig. 29), at the lower part of the abdomen, 
and passes over the kidney on the right side, where it begins a 
circuitous route around the abdominal cavity, comes in con- 
tact with the inferior surface of the liver, proceeds behind and 586 
COMMON SENSE MEDICAL ADVISER. 
below the large curvature of the stomach, emerges on the left 
side, and passes downward in front of the left kidney, where it 
dips into the pelvic cavity, and ends in the rectum. 
If fecal matters are retained until they are decomposed, great 
injury follows, since the fluid portions are absorbed, conveyed 
into the blood, and, of necessity, corrupt it with their impurities. 
In this way, constipation may be the source of general derange- 
ment, but such disorder is seldom attributed to the torpid state 
of this intestine. There is little doubt but that it thereby 
imposes a great tax upon the functions of the liver, and, fre- 
quently, the fault is attributed to that organ instead of the large 
intestine. Sometimes the blood becomes so charged with fecal 
matter that its odor can be detected in the breath of the subject. 
An overloaded condition of the-.large intestine may cause 
inflammation of the liver or dropsy of the abdomen. When 
the colon is distended, it becomes a mechanical impediment to 
the free circulation of the blood in other organs, and causes 
congestion of the portal system, predisposing to chronic inflam- 
mation or cirrhosis of the liver. This latter is a structural 
affection, and may, in turn, give rise to abdominal dropsy. In 
a word, the accumulation of feces in the colon irritates both 
the large and small intestines, thus causing congestion of the 
bowels, liver, or stomach. 
The protracted presence of feculent matter deadens the 
sensibility of the intestine, so that great stimulation is required 
to provoke it to action. The contents become dry, solid, 
knotty, and hard, and very difficult to evacuate. If drastic, 
irritating physic is taken, only temporary relief is afforded, and 
it must be repeatedly resorted to, and the dose increased, to 
obtain the desired effect. 
Symptoms. One diagnostic symptom of a loaded state of 
the colon, is an abundant secretion of urine, as limpid as water. 
The direct symptoms relate to the hardness of the feces and 
the great difficulty of voiding them. The influence of consti- 
pation upon the functions of the liver, is indicated by the 
sympathy displayed between that organ and the mind. The 
patient manifests apprehension, mental depression, taciturnity, 
and melancholy, all indicative of hypochondriac dejection, 
induced by constipation. CONSTIPATION. 
587 
We have treated patients, who, from this cause, had renounced 
their bright hopes, lost their buoyant spirits, and, becoming 
subject to superstitious fears, had given themselves up, night 
and day, to devotions and penance. It often happens that the 
victims of this deep dejection and morbid feeling of self- 
abasement, are persons not only of good moral character, but 
of high religious attainments, and their painful exhibitions of 
fear, distrust, and gloom, originate in physical rather than in 
spiritual causes. It is interesting to witness this strange perver- 
sion of the imagination, this morbid debasement of the religious 
faculties, and dejection of mind, due to causes disturbing the 
functions of the liver and other vital organs. 
Young girls, as they approach the age of puberty, seem 
possessed with the idea that the unfrequent action of the bowels 
is a desirable habit. They do not associate with the duty a 
proper regard for health, but consider it as an inelegant and 
repugnant practice. The consequence is, that at this susceptible 
period, constipation, induced by neglect, arouses a latent hepatic 
or pulmonary disease which has been lurking in the system. 
How many girls illustrate the truth of this statement by 
their complaints of giddiness, throbbing pain in the forehead 
and temples, flushing of the face, transient flushes of heat over 
the body, while at the same time the extremities are cold. At 
other times, they manifest the evils of such a course by their 
stupor, drowsiness, and deep sleep, although upon arising in the 
morning, they are still tired and unrefreshed. 
The constipated condition of the bowels, often leads to con- 
gestion of the uterus and leucorrhea, followed by uterine 
debility, prolapsus, excessive menstruation, anteversion or retro- 
version of that organ. The infrequency of the habit, incor- 
rectly supposed to be desirable by a young woman, becomes 
nearly, if not quite disastrous to all her desires and bright 
prospects. Complications arise, and neither the inexperienced 
girl nor her solicitous and afflicted parents know where to look 
for remedial aid. If they seek an asylum from these sufferings, 
they find many private institutions, where flattering expectations 
of speedy recovery are aroused. At such institutions, these 
uterine disorders are generally treated merely as local diseases, 
while the causes are overlooked, and, consequently, a permanent 588 
COMMON SENSE MEDICAL ADVISER. 
cure is not effected. Having spent nearly all the money at her 
command, the patient returns home utterly disheartened. After 
such failures, many of these unfortunate individuals have 
applied to us and received treatment, and by persistently 
following our directions, have in due time been restored to 
health, amid all the comforts of home, and among friends, who 
rejoiced with them in the unexpectedly favorable turn of 
affairs, accomplished at a comparatively trifling expense. 
We have seen infants, and also young children, in whom con- 
stipation was obstinate. It therefore seems that it is often 
hereditary. In some persons, this affection continues from 
childhood, with but little variation, until bleeding pile tumors 
are developed. Habitual constipation of the bowels for a period 
of twenty years, will generate a class of diseases, which are 
often very serious in their results. 
Causes. We have already alluded to a sense of false mod- 
esty which prevents a response to the calls of nature, and we 
may mention other reasons, equally trifling, which deter many 
from fulfilling its demands. Some are in the habit of tempo- 
rarily postponing their visits to the water closet, until, when 
they do go, they find themselves unable to evacuate the bowels. 
Sometimes the closet is a damp, uncomfortable out-house, 
situated at a distance from the dwelling, or the access is too 
public, and, hence, there is an unwillingness to visit it at the 
proper time. Some appear to be too indolent to attend to this 
duty. Others are too energetic, and think they cannot take the 
time, until they have finished some self-imposed task or at- 
tended to a pressing engagement. 
Inactive life and sedentary occupations are also causes of con- 
stipation. Active exercise promotes all the bodily functions, and 
helps to regulate the bowels. Those who are engaged in literary 
pursuits, find that mental occupation determines the blood to the 
brain, thus drawing it from the extremities; the temperature falls 
below the natural standard, and there is almost invariably con- 
gestion of the bowels. The inmates of boarding-schools, factory 
girls, seamstresses, milliners, employes in manufacturing estab- 
lishments, and all who sit and toil almost unremittingly twelve 
hours in the day, do not get sufficient exercise of all the muscles 
of the body, and are often troubled with obstinate constipation. Constipation. 
589 
Food prepared according to the modern modes of cookery, 
is one of the causes which favor the development of this de- 
rangement. People live too exclusively upon bolted wheat flour. 
The branny portion of a kernel of wheat consists of various 
nutritive elements, with more than five times the amount of 
carbonate of lime contained in fine bolted flour. Those who 
daily use boiled cracked wheat are not troubled by constipation. 
There is no dryness or hardness of the feces, and the bowels 
are evacuated without discomfort. 
Treatment. Prevention is always better than cure; hence, 
a few hygienic directions may not be amiss. Do not disregard 
the intimations of nature, but promptly respond to her calls. 
If there is constipation, overcome it by establishing the habit 
of making daily efforts to effect a movement of the bowels. 
Taking regular exercise by walking, and lightly percussing or 
kneading the bowels for five minutes daily, help to increase their 
activity. The habit of early rising favors the natural action of 
the bowels. Drinking a glass of water on rising exerts a bene- 
ficial influence. The food should be such as will excite the 
mucous secretion of the large intestines, and arouse its muscles 
to action. For this purpose, there is no one article that excels 
coarsely-cracked boiled wheat. Graham bread, mush, cakes, 
gems, and all articles of diet made from unbolted wheat flour 
are valuable auxiliaries, and may be prepared to suit the taste. 
Take the meals at stated hours; be punctual in attendance, reg- 
ular in eating, and thoroughly masticate youi' food. Irregular- 
ity in the intervals between eating, disturbs the functions of the 
intestine. The use of ripe fruits, such as apples, pears, grapes, 
figs, and prunes, in proper quantities, is sometimes very benefi- 
cial. Trivial or unimportant as these hygienic suggestions may 
appear, yet were they observed, constipation, as well as most of 
the diseases incident to it, would be obviated. A large propor- 
tion of the cases will yield to the foregoing hygienic treatment 
without the employment of medicines. Should it be necessary, 
however, to employ an aperient to relieve the constipation, the 
Golden Medical Discovery will act most congenially, and will 
be followed by no constipating reaction, which invariably occurs 
when drastic cathartics are employed. Its operation is mild, 
bringing about a healthy action by promoting the biliary and 590 
COMMON SENSE MEDICAL ADVISER. 
other secretions, thus aiding nature in establishing normal func- 
tional activity in the bowels. Recourse should be had to it 
before employing any thing more strongly cathartic. However, 
should it prove too mild in its aperient effects, small doses of 
the Pleasant Purgative Pellets may be employed daily to assist 
it. Unlike other cathartics, they produce a secondary tonic effect 
upon the bowels, which renders their influence more lasting than 
that of other purgatives. We cannot too strongly discourage 
the injurious custom which many people have of frequently 
scouring out their bowels with strong cathartics. It is a bad 
practice, and cannot fail to do injury. The greatest benefit is 
derived, not from cathartic doses, but from taking only one or 
two of the Pellets per day, or enough to keep the bowels regu- 
lar, and continuing their use for several weeks, in connection 
with the Discovery, strictly carrying out the hygienic treatment 
heretofore advised. 
The medical treatment of individual cases sometimes involves 
many considerations relative to the particular circumstances and 
complications presented. The peculiar susceptibility of the 
constitution, as well as the diseases incident to constipation, 
must be taken into account. Symptomatic derangement should 
not be treated as primary, although it is by inexperienced phy- 
sicians. If the patient be afflicted with uterine diseases, piles, 
nervous affections, falling of the lower bowel, or fistula, they 
should be treated in connection with this disease. For these 
reasons, we would advise our readers to submit all complicated 
cases, or those that do not yield to the course heretofore ad- 
vised, to a physician of large experience in the management of 
chronic diseases, and not assume the great responsibility and 
the dire consequences which are very liable to arise from the 
improper treatment of such cases. 
We have been called upon to treat thousands of cases of 
this troublesome affection, and as a result of our vast expe- 
rience, and in consequence of our original and improved 
methods of diagnosis, it is not generally necessary that we 
should see and examine the patient in person. We can almost 
always determine the exact nature of the patient's malady, 
and its stage of advancement, without seeing the subject in 
person. PILES. 
591 
PILES. (Hemorrhoids.) 
There are few maladies more common than this, and few 
which are more annoying. Piles consist of tumors formed 
within the rectum and about the anus, by 
dilatation of the hemorrhoidal veins and 
thickening of their walls. Sometimes, when 
attended by considerable inflammation, or 
when the attacks are very frequent, there is 
thickening of the adjacent cellular and mu- 
cous tissues. 
There are two general forms of this dis- 
ease, the external or blind piles, in which 
the tumors are outside the anus, and the in- 
ternal or bleeding piles, in which the tumors 
are formed within the sphincters, although, 
after their formation, they may protrude. 
The external piles are commonly made up of thick tissues; upon 
one side, the skin forms the covering, while on the inner sur- 
face, is the mucous membrane of the 
bowel. It is this surface which is most 
tender and irritable and liable to inflam- 
mation. In the internal form, the tumors 
are situated from half an inch to two and 
a half inches above the sphincter muscle 
of the anus. The tumors are usually 
round, oval, or cylindrical in form. They 
may be scattered over the surface of the 
bowel, or clustered together. The illus- 
trations (Figs. 197 and 198) show the two 
forms of the disease. The two protrud- 
ing tumors in Fig. 198, illustrate the 
usual form of prolapsing internal piles, 
while the one highest up in the bowel, 
shows the form most commonly met with. 
It is seldom that one pile tumor is found 
alone, there usually being two or three, and sometimes as many 
as five or six, in a cluster. Fig. 199 shows the manner of dis- 
tribution of the veins in the rectal region. The small venous 
Fig. 197. 
Swollen External Piles. 
Fig. 198. 
Internal Piles, two pro- 
truded. 592 
COMMON SENSE MEDICAL ADVISER. 
loops, or bulb-like terminations of the veins H. i., are the points 
at which the piles most frequently occur. 
Causes. Whatever tends to favor an undue accumulation 
of blood in the hemorrhoidal veins predisposes to piles. For 
this reason, the affection is frequently a result of diseases of 
the heart and liver, which cause an obstruction in the circulation 
of the blood through the portal vein. Mechanical pressure 
from tumors in the abdomen, pregnancy, or an enlarged or mis- 
placed uterus, is not unfrequently a cause of the disease, by 
keeping the hemorr- 
hoidal veins over-dis- 
tended. Those dis- 
eases, which provoke 
much straining, such 
as stricture, inflamma- 
tion or enlargement 
of the prostrate gland, 
and stone in the 
bladder, are also ac- 
tive causative agents. 
The most common 
cause of all, however, 
is constipation; and 
persons of indolent, 
sedentary, and luxuri- 
ous habits of life are 
those most frequently 
affected with this de- 
rangement. The following are also prolific causes of piles, viz: 
pelvic tumors, excessive sexual indulgence, masturbation, violent 
horseback exercise, unnatural development of the hemorrhoidal 
vessels, indigestion, pregnancy, habitual use of drastic cathar- 
tics, diarrhea, dysentery, sitting on heated cushions, long-con- 
tinued standing posture, diseases of the liver, worms, the wear- 
ing of tight corsets, eating highly seasoned or indigestible food, 
and the use of alcoholic stimulants. No age is exempt from 
piles, nor is the disease limited to either sex. Aside from the 
serious inconvenience and pain which are experienced with 
most forms of piles, there is a tendency to fistula, and to cancer 
Fig. 199. 
li. i. Internal hemorrhoidal veins. H. m. Middle 
hemorrhoidal veins. H. e. External hemorrhoidal 
veins. S. i. Internal sphinctre muscle. S. e. Ex- 
ternal sphincter muscle. PILES. 
593 
in the rectal region. It is important, therefore, that the disease 
should not be allowed to run on unchecked. 
Symptoms. The most common symptom at first is a 
slight uneasiness, such as a little soreness 01* itching at the verge 
of the anus and at times lancinating pains. These sensations 
are more severe, as a rule, if the bowels are constipated. If 
the piles are external, they frequently become inflamed, swollen, 
and painful, arid in some instances suppuration occurs, which 
usually results in relief. When internal piles have increased to 
any considerable extent, or have become inflamed, they produce 
not only itching at the extremity of the bowel and pain in the 
back, but also a sensation of fullness in the rectum, as though 
some foreign body were present, and, on action of the bowels, 
there is a sensation as though a portion of the feces had not 
been expelled. When the internal piles become large, they fre- 
quently come down with fecal matter from the bowel, as illus- 
trated in Fig. 198, and this prolapsus becomes more and more 
marked with the progress of the disease, until, in many cases, 
the tumors are forced down at each action of the bowels, caus- 
ing excruciating pain until they are properly replaced. Usually, 
in the early stages, they recede spontaneously; however, after 
a time it becomes necessary for the sufferer to press them back, 
but in some instances this is impossible. Frequently, during the 
protrusion, one of the hemorrhoidal veins gives way, and this is 
followed by a free escape of blood, and ulceration sometimes 
ensues. Not unfrequently in this disease, the patient loses 
strength and flesh, and the face becomes pale and puffy, assum- 
ing a waxy appearance. There is frequently nausea, with ver- 
tigo. In consequence of the relaxation, the bowel may descend 
when on the feet, or with some unusual muscular effort, espe- 
cially when stooping. These symptoms may not all be present 
in one person, and, indeed, sometimes are somewhat obscure; 
when such is the case, the true character of the affection can be 
determined by a careful physical examination. 
Treatment. Notwithstanding the well established fact, 
that piles may be readily cured by appropriate treatment, hun- 
dreds of thousands of people suffer untold tortures from them, 
because of the popular impression that they cannot be cured. 
All cases are not, however, amenable to the same form of 594 
COMMON SENSE MEDICAL ADVISER. 
treatment, for various unhealthy conditions of the system are 
often concerned in their production and perpetuation, and must, 
of necessity, be remedied by appropriate treatment, before a cure 
of the piles can be expected. It is, therefore, apparent that the 
avoidance of causes is of paramount importance. Some of these 
causes are external, and wholly under the control of the patient, 
while others depend upon diseases which are curable; it fre- 
quently happens that while other diseases are being remedied, 
the piles disappear without any special attention. 
Diseases of the urinary organs, such as stricture of the urethra, 
enlargement of the prostate gland, and stone in the bladder, 
as well as dysentery, diarrhea, and constipation, may cause piles, 
by the irritation and determination of blood, which they induce; 
these affections must be removed by appropriate treatment. 
The reader is referred to the management recommended under 
their respective chapters. 
Some years since, we ascertained that we were using in our 
practice remedies, which, in addition to their other virtues, pos- 
sessed a direct specific influence upon the vessels concerned in 
the formation of piles. These agents enter into the composition 
of Dr. Pierce's Golden Medical Discovery, which, consequently, 
is exceedingly efficacious in the treatment of this disease. This 
remedy, therefore, in removing the disease upon which the piles 
depend, as a congested or torpid liver or constipation, and in 
exerting a direct curative control over the piles themselves, 
has a two-fold influence. 
It may be aided, when the bowels are badly constipated, by 
the use of Dr. Pierce's Pleasant Purgative Pellets, taken in 
doses of from one to two after dinner or on going to bed, to 
secure a regular and easy evacuation of the bowels each day; 
or, instead of the Pellets, some mild saline or mineral water may 
be taken for this purpose. All stimulating food and alcoholic 
drinks should be abstained from. The cold bath is beneficial in 
these cases, provided that there is no great debility. The af- 
fected parts should be bathed frequently with cold water, and, 
if prolapsus exists, it is well to inject a little cool water into the 
rectum, and allow it to remain a few minutes. It is advisable 
in many cases to add to the water the distilled extract of witch- 
hazel, or hamamelis, in the proportion of one part of the extract PILES. 
595 
to from one to four parts of water. It has a soothing and 
mildly astringent effect. In cases of prolapsus of the bowels, 
before the parts are replaced, they should be thoroughly 
cleansed with cool water, and a little sweet oil, lard, or other 
bland oleaginous substance, should be used to supply the place 
of the natural mucus which has been washed away. The parts 
should then be carefully pressed back. When it is difficult to 
do this in the upright position, it will be found that by lying on 
the left side, with the hips elevated, the prolapsus may be re- 
turned much more easily and with less pain than when the body 
is in any other position. In a large percentage of cases, relief 
will follow this treatment. 
The Radical Cure of Targe Pile Tumors. In 
cases in which the tumors have become indurated and very 
large, it is impossible to effect cures by the foregoing or any 
other medical treatment. Various methods have been in use by 
the profession for the relief of the most severe cases. The most 
common is excision with the knife or scissors. Reference to the 
large vessels, shown in Fig. 199, which are affected in this dis- 
ease, will at once convince the reader of the danger of this 
method. The sudden removal of a tumor, which is connected 
with one or more of the large hemorrhoidal veins, is sure to be 
followed by severe hemorrhage, and frequently by painful ulcer- 
ation, and a fatal result. To avoid this, it has been the practice 
of many physicians to apply caustics or to burn off the base of 
the tumors with a red-hot iron. A more barbarous and painful 
method could not be devised. When it is considered that in 
many cases, this severe and painful treatment is followed by 
ulceration, and occasionally by the development of cancer, the 
matter should be carefully weighed before any such dangerous 
procedure is attempted. Another common method of treatment 
is to crush the base of the pile with a clamp, and then cut off 
the tumors with scissors. After this is done, it is also necessary 
to apply the hot iron to prevent hemorrhage. Formerly, appli- 
cations of nitric acid were in common use by physicians as a 
means of cure, but it was found that, while this treatment would 
give temporary relief, in no severe case would it effect a cure. 
By what we term palliative treatment alone, more cures are 
effected than by the old process of treatment with nitric acid. 596 
COMMON SENSE MEDICAL ADVISEE. 
Still another form of treatment is strangulation of the pile by 
means of a ligature. This operation is often more painful than 
the application of hot irons, inasmuch as in cutting off the 
return flow of blood from the piles, a large tumor is left for 
days fully distended and extremely painful. It does not slough 
off for a considerable time. We have seen the strongest men 
suffer intensely, to whom the use of scissors in removing the 
tumors would have been a positive relief in comparison with 
the torture of the ligature. A method of treatment which has 
been highly recommended by some physicians and condemned 
by others, is injection with carbolic acid. This treatment is 
not very painful, but, unfortunately, it is dangerous. The in- 
jection of the tumors with a fluid which causes coagulation of 
the blood, and which does not completely shut off the return 
current of the circulation through the tumors, has proved fatal 
in a small percentage of cases. The clots which are formed 
by this treatment become detached and are carried into the 
general circulation and conveyed to the liver, lungs, and even 
to the brain, where, by plugging up the vessels of those organs, 
they cause abscesses, which terminate life. Serious inflamma- 
tion of the veins is another accident which often follows the 
injection of carbolic acid. This treatment is, therefore, now 
seldom resorted to, except by physicians who do not appreciate 
its dangers. 
A More Successftll Method. Fortunately for suffer- 
ing humanity, a method of treatment has been perfected and 
thoroughly tested in our institution, in which all such torture 
and danger as described is avoided. This consists in bringing 
down the tumors, cleansing them, and making applications of 
certain chemical preparations, which cause them to shrivel 
up speedily, and in a very short time, in from ten to fourteen 
days, to disappear entirely. As the application causes no 
pain, we have never found it necessary, even in treating timid 
ladies, to administer either chloroform or ether. The remedies 
we employ can only be safely applied by a skillful, professional 
hand, since it is necessary to protect the adjacent parts thor- 
oughly from the effects of the chemicals. 
Having now at our command means so certain in their action 
upon pile tumors, we do not hesitate to say that the very PILES. 
597 
worst cases, no matter of how long standing, can be promptly 
cured, if we can only have the patient for a few days under 
our personal care. Considering the very distressing character 
of pile tumors, the discovery of safe, painless, and certain 
means for curing them, is a great triumph. 
There is no longer an excuse for any person suffering the 
tortures inflicted by pile tumors, if the afflicted one can afford 
the time and moderate expense necessary to secure the treat- 
ment indicated. Piles are not only very painful and annoying, 
but often greatly aggravate and even cause grave affections, 
and should, therefore, not be neglected. When large, they 
never disappear without proper treatment. We have seen 
many cases in which the long train of diverse and distressing 
symptoms caused by piles led the sufferer, and even the family 
physician, to suppose that other diseases existed, but in which, 
all annoying symptoms were speedily removed by the cure of 
the piles. We have no doubt but that neglected piles, fistulas, 
and other morbid conditions of the lower bowels, frequently 
degenerate into cancerous disease. We have the eminent 
authority of J. Hughes Bennett, of Edinburgh, and many other 
close observers, to the effect that benign or ordinary tumors 
often degenerate into real cancerous disease, and our own 
extensive observation convinces us that this is not unfrequently 
a result of neglected rectal disease, as piles, fistulas, and fissures. 
How important it is, then, to give prompt attention and skillful 
treatment to disease of these parts. When the ordinary palli- 
ative treatment, with ointments, and with laxative agents to 
keep the bowels soluble, does not completely and perfectly sub- 
due the affection, lose no time in securing the most skillful 
treatment. We have now treated several thousands of cases 
with success, and our patients write to us expressing the great- 
est degree of satisfaction, and recommending our method most 
highly. 
Reports of a few cases, selected at random from the large 
number which we have cured, are given below to illustrate the 
most common forms of the disease, and our success in curing it. 
Case 57,489. A married lady, aged 23. An ordinary case of internal 
piles of long standing. Two applications effected a complete obliter- 
ation of the tumors, which were three in number. The patient also 
suffered severely from uterine disease which, previous to the removal COMMON SENSE MEDICAL ADVISER. 
598 
of the piles, had proved rebellious to all treatment but which was 
afterwards speedily cured. 
Case 63,085. A widow lady, aged 69. In this case there were two 
external and three internal pile tumors, which had caused the patient 
much annoyance and suffering for many years. Three weeks' treat- 
ment, during which six applications were made, was sufficient to effect 
a cure. Two months after going home she writes as follows: "I am 
much relieved and have been well all the time since leaving you." 
Case 64,697. A woman, aged 37; married. This patient had been 
confined to bed for more than two years with uterine disease, and had 
suffered severely from internal piles, which had caused several profuse 
hemorrhages from the bowels. The tumors, three in number, were 
found to be small but extremely sensitive. One application, attended 
with but trilling pain, was sufficient to cure the trouble. 
Case 65,385. A married woman, aged 62. An examination revealed 
two external and three internal pile tumors, the formation of which 
was evidently caused by disease of the heart, together with congestion 
of the liver, and constipation. On the internal tumors becoming 
prolapsed, intense pain was experienced. Her home physicians and 
friends had strongly urged her not to allow any one to give her treat- 
ment fpr the cure of piles, as they felt convinced that such a course 
would be followed by increased trouble from the liver and heart. 
They, regarded the piles as a safety-valve, and believed that the 
frequent ulceration and rupture, followed by a flow of blood, relieved 
the congestion of the vital organs. After giving our opinion regarding 
the case, and assuring her that with the cure of the piles she would 
experience great relief from her other troubles, she was anxious to be 
treated. She returned home from our sanitarium at the expiration of 
three weeks, completely cured of the piles. A course of treatment to 
be carried out at her home, was prescribed for her other derangements. 
A year afterwards, she writes that her liver and heart affections have 
been entirely relieved by the cure of the piles and the course of 
after-treatment prescribed. 
Case 92.678. A man. aged 48. He had internal piles of ten years' 
standing, which frequently gave him so much trouble that he was en- 
tirely unfitted for business. There was prolapsus of the tumors during 
the latter part of each day. The actions of the bowels w ere extremely 
painful, and the tumors were steadily growing larger and becoming 
more tender. His general health was considerably impaired from the 
pain which he had experienced, but he had a good constitution. As a 
result of the application of this new method of treatment, he was able 
to return home at the expiration of fifteen days feeling perfectly well, 
and he assured us, after a lapse of nine months, that both the piles and 
the prolapsus were permanently cured. 
Case 110,199. A man, 50 years of age. He had been troubled many 
years with internal piles and prolapsus, which frequently occurred after 
straining. The primary cause of the affection was a fall on the stake 
of a sled, which caused a slight stricture of the urethra; the formation 
of piles followed this, being caused, doubtless, by the severe straining 
necessary to evacuate the bladder. The tumors were extremely pain- 
ful and tender, and after each movement of the bowels, the protrusion 
of the rectum was as large as a good-sized peach. At times he was 
entirely unfitted for work. The new method of treatment was carried 
out, and in twelve days he was able to return home in a comfortable 
condition. Two years later he wrrote to us, expressing his satisfaction 
and stating that he was permanently cured. FALLING OF THE LOWER BOWEL. 
599 
Case 122,031. A widow, aged 48. An aggravated case of piles and 
prolapsus of the rectum of several years' standing, which followed 
confinement. There were three tumors, one being very large, and all 
exceedingly red and irritable. Three applications were sufficient to 
effect a complete cure of both the hemorrhoids and prolapsus. 
FALLING OF THE LOWER BOWEL. 
(Prolapsus Ani.) 
This affection consists of a descent and protrusion of the 
mucous membrane of the rectum, and, in many cases, of the 
sub-mucous and muscular coats also. The protrusion generally 
occurs when at stool, and, when not severe, is usually easily 
replaced. If, for any reason, it cannot be returned, violent 
inflammation with great constitutional disturbance and slough- 
ing of the protruded bowel occurs, by which means a cure is 
sometimes brought about, though it occasionally ends in death. 
Prolapsus may occur in either sex and at any period of life, but 
it is much more frequently met with in childhood or old age 
than in adult life. When the protrusion is not very extensive, 
it is frequently mistaken for piles. 
Causes. Various causes are capable of producing prolapse 
of the bowel, among which are chronic diarrhea, dysentery, 
habitual constipation, or constipation alternating with diarrhea, 
piles, ulcers, pin-worms, drastic cathartics, falling of the womb, 
stricture of the urethra, enlargement of the prostate gland, 
stone in the bladder, in fact, anything that obstructs the passage 
of the feces or urine, and thus causes strain- 
ing in defecation or urination. The predis- 
posing causes are a want of tone, feeble con- 
tractility, loss of muscular power, relaxation 
of the sphincters of the anus, relaxation of 
the intestines, or muscular debility, no matter 
how produced. 
Symptoms. A dragging sensation in 
the rectum, extending to the back and loins, 
and a sense of fullness, similar to that experi- 
enced in piles, with protrusion of the bowel while at stool. 
In the incomplete variety, illustrated by Fig, 200, the protrusion 
of the falling bowel usually shows itself in the form of a fold 
of mucous membrane around the anus, forming a soft, spongy 
Fig. 200. 
Incomplete prolapse 
of the rectum. 600 
COMMON SENSE MEDICAL ADVISER. 
tumor, of a florid color, and devoid of tenderness; there may, 
however, be several of these folds or tumors presented at the 
same time; and, if they remain long protruded, they become 
congested, assume a dark-red appearance, and are the seat of 
more or less pain. 
In the complete variety, illustrated in Fig. 201, the protrusion 
is greater, sometimes extending several inches beyond the anus 
and forming a tumor as large as the fist, or even larger, of a 
cylindrical shape, truncated, of a florid color, with a wrinkled 
surface, and tender to the touch. It sometimes comes down 
while urinating, as well as when at stool. By being frequently 
prolapsed, it undergoes 
changes of structure, 
becoming congested 
and inflamed, and 
finally hardened and 
thickened. Hemorr- 
hage sometimes occurs. 
Treatment. In 
treating this affection, 
an avoidance of all ex- 
citing causes should be 
insisted upon, or a cure 
cannot be expected. 
The bowels should be 
regulated, and the general health improved, while every possible 
precaution must be taken on all occasions, to prevent the parts 
from protruding, or the sphincters cannot recover their normal 
power. The invalid should never strain at stool, and, indeed, he 
will be more successful in his efforts to avoid the protrusion, if, 
during the act of defecation, he assumes some different posture 
from that usually taken, and the recumbent position is to be 
preferred. Cold water injected into the rectum and retained 
for a minute or two, immediately prior to defecation, is -worthy 
of a trial, and, after the evacuation, the protruded bowel should 
be carefully sponged with cold water, and, before being re- 
turned, lubricated with some oily substance, as a substitute for 
the natural mucus which has been removed. Careful attention 
to the condition of the stomach, liver, and bowels is always 
Fig. 201. 
Complete prolapse of the rectum. FALLING OF THE LOWER BOWEL. 
601 
necessary, as the causes mentioned under the head of piles, are 
sufficient to produce and perpetuate this disease, and, for the 
reasons there given, the Golden Medical Discovery is of great 
value, relieving the congestion, and, by its specific and tonic 
effect, giving tone to the relaxed sphincters. In addition to 
this, bathing the lower portion of the bowels, back, and loins 
with cold water, several times a day, will be found a valuable 
adjunct; when the whole treatment above recommended is care- 
fully carried out, the most favorable results may be anticipated. 
When, however, from any cause, medical treatment fails to 
cure, in consequence of the structural changes the parts have 
undergone, surgical means are availably and several operations 
have been devised to meet the emergencies ; when performed 
by a competent surgeon, they are attended by the most gratify- 
ing results. The operations performed at the Invalids' Hotel 
and Surgical Institute, variously modified to suit the nature of 
the case, together with strict hygienic and constitutional treat- 
ment, have always proved successful. 
CASES TREATED. 
Case I. W. P., aged 32, consulted us by letter regarding an affec- 
tion of the anus which, from its description, we were satisfied was 
prolapsus. The bowel protruded an inch or more at every evacuation, 
and was usually painful and tender, sometimes bleeding. He stated 
that his general health was ordinarily good, though he was slightly 
sallow, his bowels were somewhat costive, and he was troubled a little 
with dyspepsia. We directed him to follow the above hygienic rules, 
take four doses of the Golden Medical Discovery every day, with a 
single Pellet after dinner, and inject into the rectum, twice a day, a 
strong infusion of witch-hazel bark. He followed this treatment for 
some time, and, though at first, there was but little improvement, yet 
perseverance rewarded him with a complete cure. 
Case II. Mr. J., aged 57, a merchant, wrote us that he was suffering 
from prolapsus of the rectum, which had resisted all forms of treatment 
for several years; that the protruded bowel was thickened, hardened, 
and, when down, formed a tumor larger than his fist. He also said that 
if we thought best he would come to the Invalids' Hotel for treatment. 
We advised him to come, as an operation might be necessary. On his 
arrival, we found his general health greatly impaired by Jong suffering. 
He was thin, pale, dyspeptic, and weak. As he was prepared to 
remain for a time, we at once put him under thorough hygienic and 
constitutional treatment, to relieve his obstructed circulation and re- 
move the congestion of the lower bowel. In three weeks, he had made 
decided improvement, and we performed the necessary surgical opera- 
tion for a radical cure. The constitutional treatment was kept up 
until his general health was fully restored, and. in two months from 
the time he arrived, he returned home perfectly well, a wonder to 
all who knew him. 602 
COMMON SENSE MEDICAL ADVISER. 
ANAL FISTULA. (Fistula in Ano.) 
This affection is more dangerous than piles, though, after 
being once formed, it is not so painful. It sometimes com- 
mences with intense itching about the anus, accompanied with 
a slight discharge; or, the first symptom may be a painful 
abscess, like a boil, which finally breaks. The soreness then in 
a measure subsides, leaving a fistulous opening, with a con- 
tinuous discharge of pus. This unnatural opening, with its 
constant drain upon the system, is certain to ruin the health 
sooner or later, or develop consumption or other maladies, and 
destroy life. • 
Fistula in ano may exist in three forms: first, complete 
fistula, in which, the opening is continuous from the cavity of 
the bowel to the surface of the skin, so that fecal matter and 
gases escape; secondly, internal incomplete fistula, in which, the 
opening extends from the inside of the rectum into the tissues 
surrounding it, but not through the skin; thirdly, external in- 
complete fistula, in which, the opening extends through the skin 
into the tissues around the rectum, but does not enter the 
bowels. The second form may exist, and the sufferer be uncon- 
scious of the nature of the lesion, supposing it to be piles or 
some other affection. 
Other complications, such as pendulous teats, or projections, 
from one-fourth of an inch to one and a half inches in length, 
are attendant upon fistula. Two or more openings may appear 
in the skin, all communicating with the same sinus, or opening 
into the rectum. Sometimes only a small external opening is 
seen, while a large abscess exists internally. But in any case or 
condition, the discharge is not only reducing the system, but it 
is disgusting and offensive. 
Causes. Constitutional predisposition, constipation, piles, 
or the presence of foreign bodies in the rectum, causing an 
abscess or ulcer, are the principal causes. Some authors have 
contended that fistula always originates from an ulcer in the 
rectum, which gradually makes its way through the cellular 
tissues to the surface. Others contend that the cause of this 
disease consists in an abscess, which burrows in the tissues and 
makes its exit into the rectum, or through the skin, or both. No ANAL FISTULA. 
603 
doubt it may originate in both ways. When an internal open- 
ing is once established, the feces which enter into it generally 
sooner or later work their way to the surface, burrowing 
through those parts which offer the least resistance, until a place 
of exit is reached. 
Diagnosis. The disease may be suspected, if there has 
been an abscess in the parts involved, or if the patient has been 
subject to pain in the rectum, and the parts are tender, tumid, 
or indurated. When the fistula opens externally, the linen is 
moistened and soiled with pus, or a bloody fluid, and, when the 
tract is large, fecal matter may pass through it. A careful ex- 
ploration with a probe, passed into the external opening while 
the finger is in the rectum, generally reveals the direction of the 
tract; but, sometimes, in consequence of the tortuous course of 
the canal, the probe cannot be made to follow it. When the 
fistula is incomplete, and opens internally, the probe is passed 
into the rectum and directed outwards, when it may be felt ex- 
ternally. In such cases, a tumor, caused by the contents of the 
fistula, may generally be seen protruding near the anus, and the 
pain is considerably increased during defecation, by the feces 
passing into it and disturbing its walls. The examination 
should be made with the greatest possible care, for it is attended 
with more or less pain. 
Treatment. When' constitutional derangement exists, it 
must be rectified, or any treatment will be liable to result in 
failure. The comfort of the patient may be greatly promoted 
by attention to the bowels, keeping their contents in a soluble 
condition, and the liver active, so as to prevent congestion of 
the rectum and adjacent structures. This can best be done by 
careful attention to the hygiene, and the use of the Golden 
Medical Discovery and Pellets, in sufficient quantities to produce 
the above named effects. 
A radical cure, however, cannot be accomplished except by 
surgical means, such as the use of the knife, ligature, caustic, or 
stimulating injections, according to the necessities of the case. 
These means should never be employed, except by a competent 
surgeon. Constitutional conditions materially influence the 
cure, no matter what procedure is adopted; the greater the con- 
stitutional derangement, and lower the general condition, the 604 
COMMON SENSE MEDICAL ADVISER. 
longer is the cure delayed. The great secret of our success in 
treating this disease is the employment of constitutional treat- 
ment 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 success- 
ful. Indeed, other means will succeed in cases in which the knife 
fails, or is for some reason inapplicable. The great objection 
to the knife is, not the dread which patients entertain of it, but 
the great danger of its use resulting in paralysis of the sphinc- 
ters of the anus, in consequence of which the patient loses con- 
trol over the bowels, besides, the operation sometimes fails 
entirely to effect a cure. By the means which we employ, 
these objections are entirely overcome, and, while the general 
system is being renovated, the fistula is healed without any com- 
plications. 
Fistula is much more common than has generally been sup- 
posed, and is apt to be associated with pulmonary diseases. It 
has been supposed that to heal the fistula during the progress of 
a lung affection, would result in fatal consequences, and the 
patient has been left to suffer and die under the combined influ- 
ence of the two diseases. Observation, based upon an extensive 
experience in the management of such diseases, has proved that 
opinion to be fallacious in every respect. We would urge all 
persons afflicted with fistula to have "it cured, no matter what 
complications may exist. The fact underlying this false theory 
is, that, when grave constitutional troubles have co-existed, the 
use of the knife has resulted in failure, the fistula refusing 
to heal. 
Having had ample facilities for observing the relative merits 
of the various methods of treating this troublesome affection of 
the bowel, at the Invalids' Hotel and Surgical Institute, in hun- 
dreds of cases in our own practice, and in that of others in pri- 
vate practice, we feel justified in saying that the general plan 
which we have adopted has been attended with the most grati- 
fying and complete success. The local treatment which we 
employ depends upon the nature of the fistula; in some in- 
stances we find that the ligature is best, in others caustics or 
injections, while still others require a combination of two or 
more methods, or a modification of them. ANAL FISTULA. 
605 
Case 11,349, as numbered in the records of cases treated at the In- 
valids' Hotel. This case was one of fistula, in a man 44 years of age, 
caused by an abscess produced by a local injury. His constitutional 
condition was good. The employment of the ligature resulted in his 
perfect cure in six weeks' time. 
Case 14,376. H. W. consulted us for the cure of fistula, complicated 
with what his physicians had pronounced to be consumption, but which, 
upon careful examination, we found to be chronic bronchitis. Six 
weeks' treatment with the ligature and injections effected a radical 
cure of the fistula, and the bronchial affection also yielded promptly. 
Case 15,962, was that of a young gentleman, twenty years old, who 
consulted us on account of an affection of the lower bowel, the nature 
of which he did not understand. On examination, we found a double 
fistula. His general health was much run down, on account of extreme 
suffering. Tonic and alterative treatment was prescribed, and the lig- 
ature skilfully inserted through the sinuses. No pain was experienced, 
the patient being able to walk about while under treatment, and in 
thirty days he was completely cured, and returned to his home in In- 
diana. 
Case 17,552. J. C., of Cleveland, O., consulted the specialist at the 
Invalids' Hotel for the cure of fistula in ano. He had suffered from it 
for many years. Surgeons had advised him that, on account of lung 
disease from which he was suffering, it 'would be improper to heal the 
fistula. We commenced the immediate use of a ligature, and in a few 
days the fistula was cured. With the cure of the fistula, the lung dis- 
ease began to yield to treatment, and in due time was cured. 
Case 56,811. Mr. D. consulted us on account of a painful fistula from 
which he had suffered for six years, several sinuses had formed and 
were constantly discharging, the sufferer was incapacitated for busi- 
ness, and life was a burden. Failing to receive any benefit from the 
treatment of physicians, he placed himself under our care, and in two 
weeks from his arrival was pronounced cured. The following com- 
munication was afterwards received from him : 
World's Dispensary Medical Association: Gentlemen:-This is 
to certify that for six years I have been afflicted with " fistula in ano," 
which constantly caused me great pain and suffering, and reduced my 
physical health to such an extent, that I was unable to attend to busi- 
ness; In this painful and afflicted state, I called on the Medical 
Faculty of the Invalids' Hotel, Buffalo, N. Y., for medical examination 
and advice. A surgical operation was performed, and in two weeks I 
was entirely restored to health, and felt as though I was a new man. 
If any of my fellow-mankind are suffering from a similar or other dis- 
ease, I can most heartily recommend the above Faculty. 
Very gratefully yours, W. M. D., 
Reynoldsville, Jefferson Co., Pa. 
Case 113,367. G. S., single, aged 28; merchant. He was forced 
to stand or else lie down, and, in no position, could he get entire 
freedom from pain. On examination, we found a large abscess had 
formed near the anus, and we carefully treated it after our new 
method. The result was most satisfactory, and in ten days' time he 
was able to return home. 
We might cite an almost infinite number of similar cases, 
in which our treatment, by the several methods alluded to in 
the preceding article, has proved uniformly successful. 606 
COMMON SENSE MEDICAL ADVISEE. 
FISSURE OF THE ANUS. (Rhagades Ani.) 
This, as its name implies, is an ulcer or fissure, or in other 
words, a crack of the mucous membrane of the rectum, and, 
though apparently insignificant in itself, it is productive of the 
most intense suffering, and is extremely difficult to heal. It 
is seated just above the verge of the anus, and extends upward 
through the mucous membrane, in the shape of a gutter or 
groove, from a half to one inch, and sometimes even further. 
It is generally very irritable and sensitive to the touch, though 
its edges often become thickened, hardened, and turned out- 
wards. Sometimes it is so small as to be scarcely observable, 
though generally it is larger. It discharges a thin, purulent, 
bloody fluid. Frequently, it is associated with a depraved or 
enfeebled condition of the general health, and, by the patient, 
is often mistaken for piles. 
Causes. It often comes on without any assignable cause, 
but, in a majority of cases, it is probably due to those modifi- 
cations of the constitutional integrity which produce ulcerations 
elsewhere, as venereal, scorbutic, or tubercular affections. It 
may, however, be caused by derangements of the stomach or 
bowels, by piles, straining, laceration of the rectum, or by the 
passage of hardened feces. 
Symptoms. The characteristic symptom of this affection 
is the extreme pain which the patient suffers, especially after 
defecation, and which is generally attended with spasmodic 
contraction of the sphincters of the anus, violent bearing down, 
straining, and soreness in the perineum and thighs. This is 
always aggravated by horseback exercise, walking, sexual inter- 
course, and sitting on a hard seat. As the affection progresses, 
the bladder becomes irritable, intolerant of its contents, and 
there is a frequent desire to urinate, with pain, weight, and a 
dragging sensation in the perineum, the general health fails, 
the countenance becomes sallow and haggard, the appetite and 
strength decrease, and everything denotes terrible suffering. 
The cause of these symptoms is easily determined by an ocular 
examination, during which the patient is directed to force the 
parts down as far as possible, when the lower margin of the 
fissure is brought into view. FISSURE OF THE ANUS. 
607 
Treatment. Various methods of treatment have been 
devised for the cure of this affection. It is very rarely, if 
ever, cured by constitutional treatment alone, though any con- 
stitutional derangement must be rectified by such means as 
the nature of the complication demands. The contents of the 
bowels should be kept in a soluble condition, and the general 
health improved by every possible means. For these purposes, 
we would advise the use of the Golden Medical Discovery and 
Pellets, in appropriate doses, together with thorough hygiene 
especially absolute cleanliness. The comfort of the patient will 
be promoted and the cure hastened, by sponging the anus thor- 
oughly clean with warm water, after each evacuation of the 
bowels, and before making any local application. 
The local treatment consists in the employment of such 
measures as properly come within the domain of surgery, and 
which formerly consisted in the division of the sphincters of 
the anus and in paring the edges of the fissure. Such a pro- 
ceeding is at present seldom resorted to. The use of the knife is 
rarely necessary, and is gradually giving way to other means. 
The application of caustics is supplanting more extreme meas- 
ures, and with better success. Their employment should always 
be made under the direction of a judicious and skillful phy- 
sician, or the affection may return. The fact that it arises from 
constitutional causes in nearly every instance, should not be 
overlooked in the attempt to cure it, but should always be met 
by the treatment which is given under the head of those dis- 
eases which complicate it. 
Even the application of caustics is unnecessary and unjustifi- 
able in many cases. The use of healing preparations of. a stimu- 
lating character, after the cause is removed, is often sufficient to 
effect a cure. The spasmodic contraction of the sphincters, 
and irritable condition of the bladder, should be overcome or 
all treatment will prove ineffectual. For this purpose agents, 
which act specifically on those parts are required. In the ab- 
sence of such agents, the judicious local employment of ano- 
dynes is advisable, and often productive of gratifying results. 
When these milder measures fail to effect a cure, then, and not 
till then, should the application of caustics, or a surgical opera- 
tion be resorted to. 608 
COMMON SENSE MEDICAL ADVISER. 
CONGESTION OF THE BRAIN. 
By this term is meant that condition in which the amount 
of blood in the brain is increased. The affection is of great 
importance, from the fact that it is often the forerunner of some 
of the most serious diseases, such as apoplexy, epileptic fits, 
inflammation of the brain, and insanity; although we can, with 
appropriate remedial measures, prevent their occurrence, if not 
neglected too long. 
There are two forms of congestion; the active and the passive. 
In active congestion, there is a greater amount of blood sent to 
the brain through the arteries than can be readily returned by 
the veins, and there is necessarily an excess of arterial blood in 
the brain. In the passive form, the blood is not properly 
returned by the cerebral veins, and there is consequently an 
excess of venous blood in the brain. 
Wakefulness is one of the most prominent symptoms of 
congestion of the brain. Sleep cannot take place without a 
contraction of the blood-vessels of the brain and a consequent 
diminution of the amount of blood in that organ. Stupor, a 
common symptom in passive congestion, and a condition which 
is brought about by pressure on the brain from intense conges- 
tion, or the circulation of poisoned blood through its substance, 
is often confounded with sleep. In healthy sleep, a person is 
easily awakened, but it is very difficult, and sometimes impos- 
sible, to arouse one from a condition of stupor. 
In addition to wakefulness, there is often pain in the head, 
generally of a dull, aching character. There may be dizziness, 
noises in the ears, specks before the eyes, or bright flashes of 
light, loss of memory, illusions, hallucinations, frightful dreams, 
and irritability of temper. In active congestion, the face is fre- 
quently hot and flushed and there is often hemorrhage from the 
nose; in the passive form, the face may be pale or natural. In 
some cases, the patient is troubled with loss of appetite, indi- 
gestion, constipation of the bowels and the urine is scanty, 
high-colored, and contains an excess of the urates and phos- 
phates. 
Treatment. Congestion of the brain and wakefulness 
depend upon such a variety of causes, and the indications for INFLAMMATION OF THE BRAIN, ETC. 
609 
treatment are, therefore, so widely different, that it is impossi- 
ble to mark out any course that would be applicable in all cases. 
The patient may, however, materially aid the physician in 
effecting a cure, by the methodical employment of hygienic 
measures. He should abstain from all severe mental labor, take 
sufficient physical exercise in the open air, sleep in a well-ven- 
tilated room, with the head high, bathe frequently, and keep the 
bowels regular. Ice applied to the back of the head and neck 
for five minutes, just before retiring, is often of great benefit in 
congestion of the brain and wakefulness. Through its reflex 
effects, it brings about a contraction of the cerebral blood- 
vessels, and thus diminishes the amount of blood in the brain. 
Our success in the treatment of congestion of the brain and 
wakefulness has been most gratifying. By prescribing the 
appropriate means to diminish the caliber of the cerebral blood- 
vessels and regulate the arterial circulation, we feel confident 
that we have prevented a number of severe cases of congestion 
of the brain from resulting in apoplexy or epilepsy, and have 
rescued many from the very brink of insanity. 
INFLAMMATION OF THE BRAIN AND ITS 
MEMBRANES. 
The membranes, as well as the substance of the brain, are 
liable to chronic and acute inflammation, and may be partially 
or generally involved. When the membranes are the seat of 
inflammation, it is called Meningitis. Usually, when the brain 
proper is the seat, the inflammation also involves to a greater or 
less extent the arachnoid, the dura mater, and pia mater. It is 
unnecessary here to describe the inflammation of each mem- 
brane separately. 
Symptoms. The symptoms are pain in the head, restless- 
ness, despondency, and sometimes delirium. Sooner or later, the 
patient experiences a chill, is dizzy, the eyes look red, become 
sensitive to light, the hearing is acute, the face is flushed, and 
there is wakefulness, and also confusion of ideas. The pul- 
sations of the arteries leading from the neck to the head can be 
distinctly seen, the pulse is irregular, the skin hot, there is 
intense thirst, and, generally, nausea and vomiting. Children 
turn their heads from side to side, moan, and sometimes scream 610 
COMMON SENSE MEDICAL ADVISER. 
in their sleep as if frightened, and the thumb is often drawn 
down into the palm of the hand. If the disease is not arrested, 
the patient gradually sinks into a deep stupor and it is with 
difficulty that he can be aroused. The sensibilities to light and 
sound are blunted, the pulse becomes slow, the skin cold and 
moist, and the vital powers gradually succumb to the disease. 
Causes. The causes producing inflammation of the brain 
and its membranes are various. Injuries from blows, contu- 
sions, falls, sudden colds, or excess of mental labor are the most 
common. It may be produced by deposits of tubercular matter, 
by intemperance, loss of sleep, irregular habits, excessive sexual 
indulgence, or masturbation. It occasionally results from trans- 
ference of acute or chronic affections of the skin to the brain. 
Treatment. The treatment should be modified according 
to the condition of the patient. We would advise unprofes- 
sional people not to attempt the treatment of such formidable 
and dangerous diseases, but would suggest the employment of 
a competent physician. 
This disease, sometimes known as spotted fever, consists of an 
inflammation of the meninges of the brain and spinal cord. 
There are two forms of the affection. One is characterized by 
all the symptoms of inflammation, ringing in the ears, pain in 
the head and back, restlessness, and delirium, but sensation 
and motion are not impaired. In the second form, the nerves 
of sensation and motion are paralyzed, and consciousness is 
lost. This disease sometimes prevails as an epidemic in some 
localities, and is most apt to attack young persons. 
Symptoms. The attack is usually sudden, and is mani- 
fested by pain in the head, fever, and acceleration of the pulse, 
which becomes rapid and full. Purple spots often appear on the 
surface, there is thirst, the muscles become rigid, the head is 
drawn back, and the pain in it becomes very violent. The 
patient grows stupid and deaf, is not easily aroused, and unless 
the disease is arrested by medical treatment, coma and death 
supervene. The patient at the commencement of the attack 
sometimes complains of feeling sore all over, he cannot bear the 
slightest touch, and dislikes to change his position in bed. 
CEREBRO-SPINAL MENINGITIS. APOPLEXY. 
611 
Causes. It is not well understood what predisposes the 
membranes of the brain and spinal cord to this inflammation. 
It has been attributed by some to malaria. The exciting causes 
are sudden variations of the temperature, exposure to cold and 
wet, and repression of the secretions, and also, in some instances, 
to an epidemic influence. 
Treatment. The proper course to pursue is to bring the 
blood to the surface and induce free and copious perspiration. 
We would recommend wrapping around the body a woolen 
blanket, wrung out of hot water, and the application of bottles 
of hot water to the feet and sides of the body and limbs. Then 
cover with blankets, so as to retain the heat, and thus sweat the 
patient profusely. 
Some physicians commence the treatment by administering an 
active and thorough cathartic, and then bathe the patient in hot 
lye, medicated with salt, pepper, and mustard. This treatment 
should be followed by rubbing the surface with tincture of pep- 
per or other stimulating rubefacients. 
As soon as the patient sweats, give full doses of the Extract 
of Smart-weed to keep up the perspiration. The bromide of 
potassium and the fluid extract of ergot should be taken in 
alternation, from five to twenty grains of the former, and from 
half a teaspoonful to a teaspoonful of the latter, according to 
the severity of the case and the age of the patient, every two 
hours. If the pain in the head be severe, applications of ice to 
the back of the head an'd neck, or dry cupping over the neck 
and spine, may relieve it. If there is retention of urine, consti- 
pation, involuntary stools, convulsions, or palsy, the attack is 
very severe, and liable to prove fatal. A disease of so danger- 
ous a character should be treated by the family physician. 
APOPLEXY. 
Apoplexy may be defined as a sudden cessation of all the 
vital functions, except those of the lungs and heart. It is 
caused by a sudden effusion of blood or serum into the brain. 
In the former case, the shock is due to a sudden rupture of one 
or more of the cerebral arteries, the coats of which have become 
tender or brittle by age or calcareous deposits. This form of 
apoplexy has also received the name of cerebral hemorrhage. 612 
COMMON SENSE MEDICAL ADVISER. 
Serous apoplexy is due to a collection or effusion of serum be- 
neath the arachnoid membrane. 
There are three modifications of this disease, as regards its 
severity, each characterized by peculiar symptoms. The first 
form which we shall mention is always attended with fatal 
results. Complete coma usually supervenes in a few minutes 
after the attack; there are seldom any premonitory symptoms, 
its victims being stricken down without a warning. 
The second form which we shall notice, frequently results in 
partial recovery. A portion of the body is paralyzed, and the 
intellectual powers are seriously impaired. 
The third modification consists of those sudden and transient 
attacks of apoplexy which are produced by an undue deter- 
mination of blood to the brain, or a retention of venous blood 
in that organ. The attack is usually of short duration, 
although sometimes it is fatal. 
Symptoms. In the first form of apoplexy which we have 
considered, the prominent symptoms are sudden and violent 
pain in the head, faintness, nausea, and sometimes vomiting. 
The face becomes ghastly pale, and the pulse is weak and 
irregular, but these symptoms gradually subside. The pulse 
becomes stronger, the mind clear, and the patient appears to 
be recovering. Presently his face becomes flushed, even livid, 
he rapidly sinks into a profound stupor, or coma, and death 
quickly supervenes. 
The second form is characterized by a sudden paralysis of 
some portion of the body, usually one side, when it is termed 
hemiplegia. The attack is accompanied by a total or partial 
loss of consciousness. The power of sensation, and, in some 
instances, of motion, is gradually regained, and many months, 
or even years, may intervene before the final shock which pro- 
duces the apoplectic coma. In this form the quantity of blood 
effused in the brain is very small. 
The third variety is a result of cerebral congestion, and is 
attended by a cold, clammy sweat, and sudden coma. 
The premonitory symptoms of apoplexy are loss of memory, 
frequent headache, drowsiness, and ringing in the ears. 
Causes. These are various. There may exist a constitu- 
tional predisposition to apoplexy. Age also predisposes the PARALYSIS, OR PALSY. 
613 
system to this disease. All the membranes become less elastic 
and hence more liable to rupture. Excessive mental exertion, 
gluttony, drunkenness, and debauchery, are all prominent causes 
of apoplexy. 
Treatment. Formerly blood-letting was always resorted 
to in apoplexy, but modern research and observation have 
proved that this disease is not due to an excess of blood in the 
system, but to an unequal circulation. The circulation should, 
therefore, be equalized by every means possible. When the 
skin is clammy and cold, stimulants should be applied. The 
patient should be placed in a well ventilated room, ice applied 
to the head, and hot foot-baths used, and followed by friction 
upon the extremities. A brisk cathartic should be adminis- 
tered, and, if swallowing is impossible, a powerful injection 
should be given. With the most skillful and careful treat- 
ment, recovery cannot be insured, as the quantity of blood 
discharged by the ruptured vessel may be so large as by pressure 
to paralyze the nerves, and, indirectly, all of the vital organs. 
No time should be lost in summoning a competent physician in 
an affection fraught with so much danger. 
The term paralysis, or palsy, denotes a partial or complete loss 
of motion or sensibility, or of both, in one or more parts of the 
body. 
All paralytic affections may be divided into two classes. The 
first division includes those in which both motion and sensibility 
are affected; the second, those in which the one or the other 
only is lost or diminished. The former is called perfect and the 
latter imperfect paralysis. Imperfect paralysis is divided into 
paralysis of motion, and paralysis of sensibility. The paralysis 
may be partial, local, or general. In partial paralysis, a limited 
division of the body is affected. The most frequent examples 
of this form of paralysis are hemiplegia and paraplegia. In 
hemiplegia the paralysis is limited to one side, and in paraplegia 
to the two upper or lower extremities, almost invariably the 
latter. A paralysis is called local when only a small part of the 
body is affected, as the face, a limb, or any one of the special 
senses. 
PARALYSIS, OR PALSY. 614 
COMMON SENSE MEDICAL ADVISEE. 
The Causes of Paralysis are very numerous. What- 
ever destroys or impairs the natural structure of nervous matter 
or whatever interferes materially with the conducting power of 
nerve-fibre, or the generating power of the nerve-centres, pro- 
duces paralysis, the extent of which depends upon the amount 
of nervous matter affected. Thus paralysis may be due to dis- 
ease of the brain arising from apoplexy; to abscess, softening, 
syphilitic or other tumors, or epilepsy; to disease of the spinal 
cord, or marrow; to disease of the structures which surround 
the spinal cord, producing pressure upon it; to injury or com- 
pression of a nerve, by which its conducting power is impaired; 
to the effects of diphtheria, hysteria, or rheumatism. It may 
also be due to poisoning of nervous matter with opium, lead, 
arsenic, or mercury; or from the retention of poisonous sub- 
stances which are generated in the living body and which should 
pass off through the excretory organs, as the elements of the 
urine and bile. 
General Paralysis. Complete loss of sensation and mo- 
tion in all parts of the body cannot take place without immedi- 
ately resulting in death; therefore, the term general paralysis 
is only applied to paralysis affecting the four extremities, the 
arms and legs. In this form of paralysis there is generally 
more loss of motion than of sensation, and the mind is usually 
more or less affected. 
Hemiplegia, or paralysis of one side of the body, is the 
most common form of palsy. It is generally spoken of as a 
" stroke of palsy." Sometimes only one extremity, the arm, is 
affected. Only occasionally is the face involved. In the major- 
ity of cases, the mind is affected, the memory being poor, and 
the sufferer becoming melancholy, peevish, and fretful. 
In paralysis of the right side, there is sometimes a curious 
forgetfulness or misplacement of language, the patient being 
unable to think of words to express his thoughts. This condi- 
tion is called aphasia. We have seen a remarkable case of 
this kind, in which the intelligence was little, if at all, affected 
but the memory of words was so utterly gone that the single 
monosyllable, " damn," alone remained as the sole utterance of 
all the patient desired to express, and the meaning depended 
upon the emphasis and inflection which he gave it. Hemiplegia LOCOMOTOR ATAXIA. 
615 
is usually the result of some injury or disease of the brain, almost 
invariably the side of the brain opposite the affected half of the 
body. • In some cases it is due to a wasting or softening of the 
brain substance, on account of insufficient nourishment, a defi- 
cient supply of blood;.whilst in others, it is due to just the 
opposite condition, an excess of blood, producing rupture of 
some blood-vessel, transudations, and pressure. 
Paraplegia, or paralysis of the lower half of the body, is 
the result of some abnormal (unnatural) condition of the spinal 
marrow. The paralysis may occur suddenly, but, in the majority 
of cases, it comes on slowly and insidiously, with weakness and 
numbness of the feet and legs, or with tingling and a sensation 
resembling that produced by ants creeping on the surface of the 
skin. By degrees the weakness increases, until there is complete 
loss of both motion and sensation in the feet and legs. The 
lower bowel and bladder are generally involved, and, as a result, 
the patient suffers from constipation and retention and dribbling 
of urine. Although completely paralyzed, the patient is often 
tormented with involuntary movements and cramps in the 
affected muscles. 
Paraplegia may be caused by various injuries of the spinal 
cord; by congestion, degeneration, or hemorrhage; by pressure 
from thickening of the sheath of the cord, or from tumors, or 
from disease of the bones and cartilages of the spinal column. 
Paraplegia may also be produced through reflex action, by an 
irritation or injury of some organ or part of the body distant 
from the spinal cord; thus, irritation of the skin, or of the 
bowels from the presence of worms, or disease of the bladder or 
of the womb, may produce paraplegia. 
LOCOMOTOR ATAXIA. (Progressive Paralysis.) 
This disease consists of a destruction of nervous matter in the 
posterior columns of the spinal cord. In many cases, the first 
symptoms make their appearance in the form of weak eyes, 
disturbances of vision, strabismus (cross-eyes), sharp, darting 
pains in different parts of the limbs, spermatorrhea, or impo- 
tency. In others, these premonitory symptoms are wanting. 
There is more or less numbness of the feet and legs, and, in the 
later stages, of the hands and arms, and sometimes of the face. 616 
COMMON SENSE MEDICAL ADVISER. 
Sooner or later, the patient discovers that he cannot properly 
maintain his balance; that he totters in walking, like a man 
partially intoxicated; that he cannot walk with the eyes closed, 
or that he cannot guide the movements of the fingers. Still 
later, the voluntary movements become .spasmodic or jerking. 
The neuralgic pains often become very distressing; there is often 
a sense of constriction around the limbs or body, as if they were 
encircled with tight cords. In extreme cases, locomotion 
becomes impossible, the patient is unable to bring the hand to 
the mouth, and the speech may become impaired, articulation 
being difficult and imperfect. In all cases, there is more or less 
loss of sensation in the lower limbs, the patient generally being 
unable to distinguish between two points and one, when the two 
are a considerable distance apart. The inability to feel the 
contact of the ground or floor with the foot occasions the 
difficulty in walking. 
In the majority of cases there is little, if any, motor paralysis, 
or loss of muscular strength. The intellect and memory usually 
remain unaffected, but the general sensibility becomes blunted, 
so that the grave nature of the malady occasions little alarm to 
the patient himself. 
The Causes of this disease are somewhat obscure, but 
unquestionably exposure to cold and dampness, venereal ex- 
cesses, masturbation, drunkenness, and mental overwork, are 
largely instrumental in its production. 
INFANTILE PARALYSIS. 
This form of paralysis is believed to result from disease of the 
spinal cord (marrow), or from spinal congestion. "It attacks 
children indiscriminately, without any regard to sex, between 
the age of six months and three years," more frequently at the 
time of the first dentition (cutting of the teeth) and " it is the 
grand source of shriveled, half-dead limbs, club-feet, and other 
sad deformities." The paralysis is generally partial, single mus- 
cles or groups of muscles being affected. There is no loss of 
sensibility in the affected parts, except it be a slight numbness. 
In some cases, the sensibility is at first even more acute than in 
health. 
The disease generally appears suddenly and without warning. INFANTILE PARALYSIS. 
617 
The child is put to bed well, and, in the morning, the parents or 
attendants find, to their great surprise, when lifting the child, 
that it is paralyzed. Sometimes the paralysis comes on during a 
fever, measles, or whooping-cough. Occasionally it is preceded 
by slight feverishness, drowsiness, or spasms. The paralysis is 
usually quite general at first, but soon becomes more or less 
localized. 
The duration of the affection varies extremely. It may en- 
tirely disappear in a day or two ; but, in the majority of 
cases, the paralysis remains nearly or quite stationary. When 
the disease has existed for a time, the affected muscles become 
soft and flabby, and eventually waste and wither away, and 
even the bone ceases to grow. From imperfect circulation, the 
limb often assumes a livid hue ; the temperature sinks below 
that of the body, and chilblains and ulcers are sometimes formed. 
The deformities produced by this disease are met with most 
frequently in the feet and legs, for the reason that these are the 
parts most frequently affected. The particular kind of de- 
formity varies, of course, according to the muscles involved in 
the paralysis. 
Local Paralysis. There are many varieties of local 
paralysis, but the most frequent forms are facial paralysis 
and writers' paralysis. 
Facial Paralysis, or paralysis of the face, is generally 
the result of pressure on, or injury to, the motor nerve of the 
face. Sensation is not affected, but the muscles on the affected 
side are powerless, and the features are drawn to the healthy 
side. The patient is unable to close the eyelid, to whistle, to 
laugh, or to frown, on the affected side. 
Facial palsy may arise from a great variety of causes, but un- 
doubtedly exposure to cold, and debility from exhausting in- 
fluences, stand first. It is sometimes due to pressure from 
swelling of the parotid gland near the angle of the jaw. 
Writers' Palsy, or Cramp, is characterized by a par- 
tial loss of controlling power, so that the will is unable to longer 
" compel a set of muscles to perform a series of acts to which 
they have so long been habituated that the necessary motions 
had become almost mechanical." The disease is not confined 
to writers, but affects telegraph operators, musicians, artists, 618 
COMMON SENSE MEDICAL ADVISER. 
type-setters, shoemakers, saddlers, seamstresses, and even the 
milk-maid. 
Usually the first symptom noticed is a stiffness of the muscles 
of the arm or fingers; this is soon followed by unnatural move- 
ment, which increases as the disorder progresses. 
WASTING, OR CREEPING PALSY. 
The technical name for this affection is progressive muscular 
atrophy, and it is now thought to be a fatty degeneration of the 
voluntary muscles. According to some authorities, it has its 
starting point in the nervous system, the affection of the muscles 
being secondary. The disease at its commencement is generally 
limited to a certain number of muscles, and, in the majority of 
cases, to the muscles of the hand. The first symptom observed 
is often a wasting of the muscles of the ball of the thumb, with 
pain and weakness. One or both arms or legs may be affected. 
The affection, if left to itself, more or less gradually extends 
over the muscular system. Not only the muscles of the limbs, 
but those of the chest and throat are liable to become affected, 
and death result from suffocation or starvation, because of the in- 
ability to breathe, or swallow food, on account of the emaciated 
and paralyzed condition of the muscles of respiration or degluti- 
tion. Not unfrequently distortions of the limbs, head, or body, 
result from the limitation of the waste to certain muscles, or 
from the progress of the waste being much greater in some 
muscles than in others. Sensation generally remains perfect, 
and the mind is not affected. The causation is obscure. The 
disease spares neither young nor old, male nor female, but males 
are more liable to it than females. Overexertion, cold, and 
blows over the spine, have been assigned as causes. 
LEAD PALSY. 
Lead Palsy is induced by absorption of lead into the system, 
in the form of the salts. The muscles of the back of the 
hand and forearm, are generally the first to become paralyzed. 
When the arms are stretched out, the hands hang down by their 
own weight. Preceding the paralysis and accompanying it, the 
patient often experiences attacks of lead colic. The odor of the 
breath is peculiar, and there is a blue or purple line around the SHAKING PALSY. 
619 
edges of the gums, just where they join the teeth. The feet and 
legs are rarely affected. The quantity of lead necessary to pro- 
duce paralysis varies greatly in different individuals. Some are 
remarkably susceptible to its influence. The pernicious effects 
may be produced by a very small quantity of some of the salts 
of lead, taken by the mouth, especially in children. To show 
the carelessness of some physicians in the use of this agent, we 
will relate the following case: Mrs. S. brought her little daugh- 
ter, four years of age, to the Invalids' Hotel. On examination 
the child was found to be suffering from paralysis of both the 
upper and lower limbs. She could not walk, and the arms were 
so paralyzed that she could not carry the hands to the mouth. 
There was wrist-drop in a marked degree, the characteristic blue 
line on the gums, frequent colicky pains, obstinate constipation, 
loss of appetite, and great emaciation. The mother affirmed 
that the child had not been near paint or lead in any form, but, 
after close questioning, the fact was elicited that during the 
previous summer the child had had a diarrhea, for which a 
doctor prescribed some white powder, which undoubtedly con- 
tained the acetate of lead. We will add further that this des- 
perate case was cured by a proper course of treatment, which 
was continued for only one month. 
SHAKING PALSY. 
Shaking Palsy, or Paralysis Agitans, is an affection which 
involves degenerative changes in the nervous centers. It is 
characterized by a tremulous agitation, or continual shaking, 
beginning in the hands, arms, or head, and gradually extend- 
ing itself over the entire body, by rigidity of the muscles, 
and a tendency to loss of equilibrium when the subject is 
walking. The disease progresses slowly, but, when far ad- 
vanced, the agitation is violent, and the patient swallows 
and masticates food with great difficulty. In an advanced 
stage of the disease, the body becomes bent forward, and 
the chin almost touches the breast-bone. The tremor, which 
early in the disease only occurred during the time the pa- 
tient was awake, now continues during sleep, and not unfre- 
quently the agitation becomes so violent as to waken the 
sufferer. 620 
COMMON SENSE MEDICAL ADVISER. 
GENERAL TREATMENT OF PARALYSIS. 
The indications of treatment for the various forms of paraly- 
sis are to remove the causes, if these can be determined, and 
rouse the functions of the paralyzed parts. Measures should 
be adopted to remedy the morbid conditions upon which this 
affection depends. The main object to be fulfilled, by domestic 
management, is to keep the skin clean and healthy, promote the 
circulation of the blood, especially in the paralyzed limbs, and 
encourage healthy nutrition. These ends may be best attained 
by the daily employment of stimulating baths, frictions upon 
the surface, gently rubbing with the warm hand, the use of 
faradisation with an induction apparatus, or magneto-faradic 
machine, and by taking as much regular exercise as the patient 
can bear without fatigue, in order to favor the preservation of 
the appetite and strength. Care should be taken that the 
bowels are evacuated regularly every day. Next ascertain if 
the kidneys excrete the proper amount of urine. The circula- 
tion through, and consequently the nutrition of, the palsied 
muscles may be aided by having a strong healthy person knead 
and manipulate them. These manual movements upon the sur- 
face of the body will often excite muscular sensibility, similar 
to that awakened by a weak faradic current. The internal med- 
icines should be such as to regulate the general functions of the 
system. The use of these remedies must be directed by the 
skill and experience of those who are professionally qualified to 
administer them. The Turkish bath, when properly employed, 
is of great service in some cases. When a syphilitic taint ex- 
ists, remedies should be administered which will eliminate the 
poison from the system. 
When the patient has been able to be under our personal care 
at the Invalids' Hotel and Surgical Institute, we have found the 
employment of mechanical movements and manipulations, ap- 
plied by means of a variety of machinery employed in this 
institution, together with the use of the equalizer, or large dry- 
cupping apparatus, to be of the greatest benefit. These several 
machines and apparatus furnish a perfect system of physical 
training, thus rendering valuable aid in the cure of many forms 
of obstinate chronic disease. GENERAL TREATMENT OF PARALYSIS. 
621 
MECHANICAL MOVEMENTS IN THE TREATMENT OF PARALYSIS; 
THE MANNER IN WHICH THEY ACT. 
In order to obtain a correct understanding of the principles 
of this mode of treatment, it is necessary that the reader should 
have some knowledge of the physiological anatomy of the parts 
involved in nervous affections; therefore he should read care- 
fully that portion of this work devoted to Anatomy and Physi- 
ology. 
The sensory nerves, the motor nerves, and the great central 
organ, the brain, constitute the greater part of the nervous 
system. The brain is the seat of all sensation and mental 
action, and the primary source of all voluntary muscular con- 
tractions. The brain may be compared to a main telegraph 
office to which all communications are sent and from which all 
despatches are transmitted. 
In paralysis and other nervous affections, certain morbid 
changes take place in the parts to which the affected nerves are 
distributed. In the former condition, the loss of muscular con- 
tractility necessarily produces a stagnation of blood in the 
veins, capillaries, and small arteries, and the affected muscles 
consequently fail to receive their due supply of arterial blood, 
from which they derive their nourishment. Hence they atrophy, 
or wither away; the production of animal heat is diminished, 
and the temperature of the palsied parts is reduced; the car- 
bonaceous and other waste products are not carried off by the 
venous blood, hence there is a tendency to fatty degeneration. 
A paralyzed limb often retains its usual size, but careful 
investigation will show that plumpness is due to the deposition 
of fat between the muscular fibers. 
The small arteries and capillaries shrink, many of them 
become impervious, and some of them disappear; the investing 
membranes of the small bundles of muscular fibers become 
agglutinated, or stuck together, so that the muscles cease to 
readily glide over one another, as they do in health. 
Such facts have a rational bearing upon the treatment of 
paralysis. 
The general practitioner often endeavors to overcome the 
inertia of the nerve-centers and nerves by means of specific 622 
COMMON SENSE MEDICAL ADVISEE. 
irritants, with the view of exciting the power-producing func- 
tion, of compelling the weakened and disabled centers to evolve 
more power. By such stimulation and forcing, he places a 
burden on the weakest parts. The compulsory and ineffectual 
endeavor of the weak parts to act in response to such stimula- 
tion is very liable to make undue drafts upon the capacity to 
act, which only end in exhaustion of the little remaining power 
instead of its re-enforcement. Cases which were previously 
curable by direct and appropriate means, are thus forever 
placed beyond the reach of remedies. No powerful stimulating 
or depressing medicines are indicated in any of the various 
forms of the affection. In paralysis, the aim should be to 
improve local and general nutrition, to relieve local conges- 
tions and inflammations, to produce absorption of deposited 
matters, and to force an abundance of blood through palsied 
muscles, from which they may derive a proper supply of nutri- 
ment, and to which they may give up the products of waste. 
All this can be accomplished by massage, mechanical move- 
ments, regulation of the atmospheric pressure of the body, baths, 
and proper physical culture. 
Now, in paralysis, there is a diminution or total loss, as we 
have seen of the contractile property of the muscles to which 
the affected nerve-fibers are distributed; consequently the capil- 
laries and small veins are not compressed, as in health, and the 
blood is not forced on through them towards the heart, hence 
there is a backing-up of the circulation, passive congestion, and 
all the evils incident to that condition ensue. 
Mechanical movements properly applied to the affected limbs, 
or parts of the body, accomplish the same results as contraction 
of the muscles. They compress the capillaries and veins and 
thus force the blood on through these vessels towards the heart. 
There is a constant pressure in the arteries, hence the flow of 
blood in the capillaries is always towards the veins, and, when 
it gets into the veins, it is prevented from flowing back, as we 
have seen, by the valves of those vessels. 
A proper circulation of the blood through the disordered 
parts is thus effected, and, as the result, they receive an abun- 
dance of nutriment, and their waste products are promptly 
carried away to the excretory organs, by which they are GENERAL TREATMENT OF PARALYSIS. 
623 
separated from the body; the deposits of fatty matter between 
the muscular fibers are absorbed, and the agglutinated fibers are 
separated. 
As proof of these statements, it has been found by experi- 
ment and observation that there is an increase of temperature 
in the part subjected to the action, which must be due mainly 
to an increase in the chemico-vital changes which are superin- 
duced by the nutritious elements of the arterial blood, particu- 
larly that element which is supplied to it by the inspired air, 
oxygen. All the products of waste are increased. The skin 
becomes more soft and moist, showing that the amount of 
matter eliminated by it is increased. The urine becomes more 
abundant, and the relative amount of urea, its most important 
constituent, becomes greatly increased. The amount of carbonic 
acid gas exhaled is increased, and further evidence in the same 
direction is furnished by the very marked increase in the inspir- 
atory acts, necessitated by the increased demands for oxygen. 
The local increase of the circulation incident to properly 
applied mechanical movements, must produce a corresponding 
diminution of blood in other, even in remote, regions of the 
body. Thus this treatment, by its revulsive effect, is capable of 
relieving various affections of the head, chest, digestive organs, 
and pelvis. Nowhere, however, is the effect more satisfactory 
than in affections of the brain, and spinal cord, whether charac- 
terized by loss of power, of sensation, or by neuralgic pain. 
Any portion of these nerve centres suffering from congestion, 
will be promptly relieved by mechanical vibratory movements. 
The Movement cure which we advocate, is not a "Swedish 
Movement Cure," nor any thing akin to it. It is the application 
of remedial forces by complex machines and appliances which 
combine a variety of mechanical powers. The inventions are 
solely American. 
By means of this machinery, which is driven by steam power 
with great velocity, we are able to apply soft, pleasant, rapid 
vibratory movements over the surface of the body, and thereby 
increase the circulation of blood through the parts, raise the 
temperature, and excite pleasant sensations. The movements 
can be applied by our ingeniously-devised machinery to any 
part of the body through the clothing, and without the least 624 
COMMON SENSE MEDICAL ADVISER. 
exposure of the person. They can be administered in a great 
variety of ways, by light, quick percussions, by gentle frictions, 
by rubbing, by oscillations, by kneadings, by circular movements, 
in fact, by an almost endless variety of reciprocating and alter- 
nating motions, which, if described, would convey to the mind 
of the reader but a faint conception of their remedial value. 
Vibratory motion not only establishes activity of the circulation 
through the skin and muscles, but it also affects profoundly the 
circulation in the important and vital organs of the body; it is 
thus capable of overcoming torpidity or congestion of the liver, 
spleen, and other deep-seated organs, without the depressent 
effects which sometimes follow the administration of powerful 
medicines. 
It has not been our purpose to literally explain, in detail, the 
methods of applying vibratory motion in the treatment of par- 
alysis for popular experiment, since, to be successful, one should 
become an expert, not only in this mechanical treatment, but 
also in the diagnosis of the various forms of paralysis, as well as 
familiar with their causes, pathology, and remedial requirements. 
Thus, to be successful in the treatment of paralysis and other 
nervous diseases, by the application of motor forces with our 
ingeniously-contrived machinery, the cost of which is beyond 
the means of most invalids, one must exercise great discretion. 
Not only is vibratory motion as a remedial agent rational 
and philosophical, but our experience has fully demonstrated its 
marvelous effects in the treatment of paralysis in its various 
forms, and also in the cure of other chronic diseases. We have 
cured cases of infantile paralysis which had resisted the skill of 
the most renowned physicians in our country. We have treated 
those who could not stand or bear the weight of the body, but 
who have been so far restored as to be able to walk and run 
without assistance. Writers' and telegraph operators' paralysis, 
or cramp, we have cured in a few weeks' time. Club-feet, spinal 
curvature, and other deformities resulting from paralysis, have 
been successfully treated in our institution. In short, our suc- 
cess has been most flattering in all curable cases of paralysis, and 
it is such experience that induces us to hold out encouragement 
to those who are afflicted with paralysis and other serious 
nervous affections. GENERAL TREATMENT OF PARALYSIS. 
625 
Vibratory motion is a desideratum of priceless value to those 
who are afflicted with diseases of the nervous system, as well as 
to all others who need a gentle stimulus to call forth their latent 
energies and improve their physical condition. 
CASES TREATED AT THE INVALIDS' HOTEL. 
Case 1. The son of Mr. K., of Buffalo, had suffered from paralysis 
of one leg ever since he was eleven months old. For nine years the 
disease had gradually increased. The affected limb was, from arrested 
development, much smaller than the well one, and was dragged along 
with difficulty, the boy walking with crutches. After four months of 
physical training and treatment in the movement-cure department of 
the Invalids' Hotel, his father writes as follows: 
"World's Dispensary Medical Association: Gentlemen-The 
improvement in the condition of my son, who has so long been afflicted 
with paralysis, has been so marked and so constant while under your 
care and treatment, that I wish to express my thanks. He was exam- 
ined by the leading physicians of this city and Philadelphia, and by 
them all pronounced hopeless, and that it would be a waste of time and 
money to do any thing for him. I had been made to believe him 
beyond help so long, that the great improvement in his condition is 
very gratifying. I feel assured that the last traces of his trouble will 
disappear in a short time. I look upon his complete and permanent 
restoration as wonderful." 
Case II. Jennie C., of Albany, N. Y., twelve years old, was 
brought to the Invalids' Hotel suffering from paralysis of the muscles 
on one side of the back, giving rise to lateral spinal curvature. Proper 
medical treatment, to brace up her system, with a four months' course 
of physical training in the movement cure, together with dry cupping 
and electricity, corrected all deformity, and restored the little patient 
to good health. 
Case III. Mr. G., of New York, had been paralyzed on one side 
for eight months. Electric baths, mechanical movements and manipu- 
lations, with cuppings, restored perfect sensation and movement in 
three months' time, without the use of medicine. 
Case VI. Mrs. P., of this city, had suffered from paralysis of the 
right arm for over a year. Four months' treatment, with dry electric- 
ity, dry cuppings, and mechanical movements and manipulations, com- 
pletely restored the use of her arm. 
Case V. Mr. N., of this city, a short-hand reporter, had suffered for 
nearly a year from what is called writers' paralysis of the right hand 
and arm, accompanied with severe pain, which greatly disturbed his 
sleep. Three months' treatment in the movement cure completely 
cured him. 
Case 44,679. (New Series, as Numbered in the Record Books 
of the Invalids' Hotel .and Surgical Institute.) Paraly- 
sis, with Neuralgia. 
World's Dispensary Medical Association: Dear Sirs-Having 
suffered intensely for several years from a complication of chronic dis- 
eases, followed by a severe paralytic attack (paraplegia), or palsy of the 
lower half of the body and lower extremities, including my urinary 
Organs and the lower portion of my bowels to the extent that I could COMMON SENSE MEDICAL ADVISEE. 
626 
but partially control their action and movements, and having consulted 
and been treated by several eminent physicians without deriving any 
permanent benefit, I resolved about two months ago to visit your In- 
valids' Hotel and place myself under treatment at that widely-known 
and popular institution. With infinite pleasure and gratitude, I can 
now truthfully say that I have so far recovered that I have complete 
control over my diseased organs, that I can sleep and rest well at night, 
which I had not done for many months. My lost appetite has returned, 
digestion is very greatly improved, and I am now able to walk about 
and enjoy, to a reasonable extent, the comforts of life. 
R. R. St. J., Natchez, Miss. 
Cases similar to the preceding might be reported almost in- 
definitely, but we trust sufficient have been cited to prove most 
conclusively the marvelous power of mechanical movements and 
manipulations, dry cupping, and electricity, over paralysis. 
EPILEPSY. (Fits.) 
Epilepsy, or falling sickness, is a disease which is character- 
ized by attacks of sudden loss of consciousness, together with 
convulsive movements of the muscles. The paroxysms occur 
at irregular intervals, the periods between them, in some cases, 
being only a few minutes or hours, while in others, several 
months elapse. 
There are fwo forms of the disease, the petit mal and the 
grand mal. In the former, the attacks are light, and often not 
attended with complete loss of consciousness, and there is 
little or no agitation of the muscles. 
Symptoms. In the severe forms of the disease, the sub- 
ject suddenly loses consciousness and falls; there is a rigidity 
of the muscles, which lasts but for a moment, and is followed 
by alternate contraction and relaxation, which causes a twitch- 
ing of the face and limbs; the eyes are turned up, and there 
is foaming at the mouth. In the grand mal, or severe form of 
the disease, the respiration is arrested, while in the milder 
attacks, the breathing is difficult, slow, deep, and snoring. With 
the commencement of the spasm, the tongue is sometimes caught 
between the teeth and severely bitten. During the paroxysm, 
the countenance changes from a livid hue to dark purple. The 
convulsion continues from one to three minutes, and is followed 
by a deep, sighing inspiration; the subject then sinks into a 
deep sleep, which continues for half an hour or longer. When 
consciousness is first regained, the subject appears confused, EPILEPSY. 
627 
stupid, and usually complains of headache. He has no recol- 
lection of what has occurred during the attack, he pronounces 
words indistinctly, and, if he attempts to walk, he staggers 
like a drunken man. Sometimes, several attacks occur so closely 
together that there is no interval of consciousness between them. 
In some cases, there are premonitory symptoms, such as gid- 
diness, drowsiness, headache, and irritability of temper, which 
warn the subject of an approaching paroxysm' Occasionally, 
a wave of cold commencing at the feet and proceeding to the 
head, is experienced. This is called an aura. When it reaches 
the brain, the subject becomes unconscious, falls, and the con- 
vulsion commences. If the disease is allowed to proceed 
unchecked, it almost invariably leads to great impairment of 
mind, insanity, or paralysis. 
Causes. The predisposing causes are a hereditary tendency 
to the disease, and everything which impairs the constitution 
and produces nervous prostration and irritability. Syphilis, 
phimosis, sexual abuses, uterine disease, and the use of alcoholic 
liquors are prominent predisposing causes. We think that we 
can safely say that more than half of all the cases treated by 
us have been brought on by masturbation. 
The exciting causes include everything which disturbs the 
equilibrium of the nervous system. Indigestible articles of 
food, intestinal worms, loss of sleep, great exhaustion, grief, 
anger, constipation of the bowels, piles, and uterine irritation 
may be enumerated among such causes. Convulsions of an 
epileptic character may also be induced by a poisoned condition 
of the blood, from malaria, and disease of the kidneys or liver. 
Treatment. When the time of an expected paroxysm 
approaches, great care should be exercised that the patient is 
not suddenly attacked while carrying a lighted lamp, or that 
he does not fall in some dangerous place, strike upon a heated 
stove, or in some similar way inflict great injury. If there is 
an aura a few minutes before the attack, the subject should 
carry a vial of .the nitrite of amyl in the pocket, and, when 
the premonitory symptom is felt, two or three drops should be 
poured on a handkerchief and held about an inch from the nose 
and inhaled, until flushing is produced, or a burning sensation 
is felt on the face. 628 
COMMON SENSE MEDICAL ADVISER. 
During the paroxysm, the subject should be laid on the back, 
with the head slightly elevated, and the clothing about the neck 
and waist, if tight, should be loosened. If there is sufficient 
warning, a folded napkin, or a soft pine stick covered with a 
handkerchief or cloth, should be placed between the double 
teeth, to prevent the tongue from being bitten. During the fit, 
the head may be bathed with cold water. 
A person who suffers from this disease should avoid every- 
thing which tends to excite the nervous system, or increase to 
any great extent the action of the heart. He should go to bed 
at regular hours, and take at least eight hours sleep. The 
sleeping-room should be large and well ventilated, and he should 
lie with the head elevated. He should avoid all indigestible 
articles, and his diet should consist principally of bread, vege- 
tables, milk, and fruits. He should take meat not more than 
once a day, and then in very small quantities. The use of 
alcoholic liquors and coffee should be avoided, and tea only 
taken in small quantities. The bowels should be regulated 
with the Pleasant Purgative Pellets and injections. A thor- 
ough bath should be taken not less than once a week. If the 
attacks occur at night, the body should be sponged before 
going to bed with tepid water, to which should be added suffi- 
cient tincture or infusion of capsicum, or red-pepper, to render 
it stimulating to the skin. 
The causes, if they can be determined, should be removed, 
and those remedies administered which relieve nervous irrita- 
bility and cerebral congestion. If due to worms, anthelmintics 
should be given; if to phimosis, the subject should be circum- 
cised; if to pressure on the brain, from fracture of the skull, 
trephining should be practiced, and the depressed bone raised. 
There are no specifics for this disease; each individual case must 
be treated according to the condition presented. The nostrums 
advertised extensively over the country as specifics for this 
disease, while they may, in some instances, prevent the at- 
tacks for a short time, irritate the stomach, impair digestion, 
lower vitality, and permanently injure the system, often render- 
ing the disease incurable. They deceive the sufferer, leading 
him to think that his disease is being cured, until it pro- 
gresses so far that he is beyond the reach of any treatment. EPILEPSY. 
629 
As a rule, the longer the disease progresses, the more difficult it 
is to cure. 
Epilepsy has by many physicians been regarded as incurable, 
but our extensive experience has convinced us that by an appro- 
priate course of treatment, the vast majority of cases can be 
cured. We have discovered several new remedies, which un- 
doubtedly exert a powerful curative influence over this disease, 
but it is necessary to vary the treatment so much in different 
cases, that it would be useless to enter further into details in 
this work. The following extracts from our records of cases 
treated, show the marvelous results obtained by the methods of 
treatment practiced at the Invalids' Hotel and Surgical Institute. 
„ . CASES TREATED. 
Case 51,989. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-I thank God for his kindness to me in making your medicines 
and advice the means of curing me. It is now fully two and one-half 
years since I had my last attack, and I think I am cured. Sincerely 
thanking you for the remarkable benefit I have received, I remain 
Yours truly, 
I. F., Stratford, Ont. 
Case 64,311. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-This will certify that your special home-treatment has perma- 
nently cured me of epileptic fits, having seen no signs of these since 
discontinuing your medicines. I am how enjoying most excellent 
health, the result of your skillful treatment. 
Very trulv yours. 
C. B., Walton, Delaware Co., N. Y. 
Case 68,455. 
World's Dispensary Medical Association: Gentlemen-Miss E. 
McG., took your medicine as per directions until last August, at which 
time we considered her entirely cured. The last spasm that she had, 
was one year ago last March, and she has had no symptoms of any 
since, and now weighs one hundred and twenty pounds, having gained 
thirty pounds under your treatment. We will always feel grateful to 
you, as we feel that your treatment of her case has saved her from an 
untimely grave. Respectfully yours, 
G. W. M., Jeffersonville, Wayne Co., Ill. 
Case 73,432. 
World's Dispensary Medical Association: Gentlemen - My 
daughter has not had any fits since she commenced taking your 
medicine. Respectfully, 
S. F., White Run, Ohio Co., Ky. 
Case 120,253. 
World's Dispensary Medical Association: Gentlemen-I take 
pleasure in announcing to you that my boy has now fully recovered his 
health, thanks to your unexampled skill. Since he first commenced 
upon the use of your medicines, more than five months ago, he has not 630 
COMMON SENSE MEDICAL ADVISER. 
experienced the slightest symptom of his disease. Yours is the only 
medicine I have ever known to effect a cure in this particular disease, 
and I am sure that I can never sufficiently repay you for such a 
blessing as the restoration of health to my afflicted son. Believe me, 
sirs, Ever gratefully and truly yours, 
W. M. B., Newburgh, Ohio. 
Case 120,875. 
World's Dispensary Medical Association: Gentlemen-My son 
who was badly afflicted with epilepsy, has improved wonderfully under 
your skillful treatment. We are indeed, under great obligations to 
you for effecting what we hope shall prove to be a permanent cure of 
a really distressing malady. 
Gratefully yours. J. M. G., 
El Moro. Los Animas Co., Colo. 
CATALEPSY. 
This is a disease of the nervous system, characterized by 
attacks during which the subject is powerless, with the muscles 
in a state of rigidity. There is generally also loss of con- 
sciousness. 
In some cases, headache, dizziness, and hiccough precede the 
attack. The onset of the paroxysm is generally sudden. There 
is loss of consciousness and rigidity of the muscular system, 
the limbs remaining in the position in which they happen to be 
at the instant of seizure, as if petrified. The countenance is 
expressionless in most cases. The attacks may last only a few 
seconds, or may continue for several hours. 
The treatment should be similar to that given under the head 
of epilepsy. Electricity, properly applied, is of great benefit in 
these cases. If not arrested, the disease is apt to terminate in 
epilepsy. 
ST. VITUS'S DANCE. (Chorea.) 
St. Vitus's Dance is an affection of the nervous system, 
which is characterized by involuntary contractions of the volun- 
tary muscles. It may affect the entire body, although it is 
usually confined to the left side. 
Symptoms. Twitchings of the muscles of the face are 
the most conspicuous symptoms. They are at first compara- 
tively slight, but, as the disease progresses, these spasmodic 
contractions become more decided, and the face is twisted into 
various shapes and forms. The head, in some cases, is con- 
stantly moving up and down, or from side to side. These 
spasms are succeeded by an idiotic look, afterwards returning ST. VITUS'S DANCE. 
631 
again with as much intensity as before. It is with great diffi- 
culty that the tongue is thrust out of the mouth, and then, with 
a sudden jerk, it is quickly withdrawn. 
These spasms or contortions, affect the extremities in a 
similar manner, the hands and arms cannot be kept quiet, the 
gait is unsteady, and one foot is merely dragged after the other. 
If one limb be forcibly held, to keep it quiet, some other limb 
will involuntarily move. Strange as it may appear, these con- 
tractions, which cannot be controlled by the will during wake- 
fulness, are very much lessened or arrested by sleep. One 
writer has remarked, "It would seem that the stimulus of 
volition is in some degree essential to this disease." If the 
affection is long continued, it is apt to weaken, or even destroy, 
the intellectual powers. The general health of the patient 
becomes impaired, the pulse is feeble, the pupils of the eyes 
dilate, the appetite is poor, the digestion deranged, and the 
urine highly colored. 
Causes. These are not definitely or satisfactorily under- 
stood. It is, by some, thought to be an affection of the brain, 
since the voluntary muscles alone are affected, the intellectual 
faculties are impaired, and there is loss of volition, the will fail- 
ing to control the irregular contractions of the muscles. This 
affection may be due to imperfect nutrition, depression of 
spirits, grief, or fright. Some writers have attributed it to 
rheumatic affections, constipation-, a morbid state of the blood, 
suppression of the menstrual function, uterine difficulties, mas- 
turbation, blows, injuries, or any cause which would give rise 
to nervous debility. Some suppose that it is caused by obstruc- 
tion in the alimentary canal, or by intestinal worms. It rarely 
occurs earlier than the sixth year, and generally between the 
tenth and thirtieth. 
Treatment. It is quite customary to use the phrase, " the 
laws of health," an expression indicating natural ordinances 
which should have the force of a command. In one sense, 
disease may be considered as the penalty attached to a violation 
of the laws of life. To carry out the similitude of this mode 
of speech, we would say that most disorders are retributive in 
their character. We, unconsciously, and frequently knowingly, 
infringe the laws of our being, and disobey the requirements of 632 
COMMON SENSE MEDICAL ADVISER. 
health, until judgment is rendered against us, and our trans- 
gressions are straightway followed by the pains of disease. 
St. Vitus's Dance need not be singled out as specially illustra- 
tive of this idea, but points to this moral, viz: disease is often 
the result of enervating habits. We may neglect to cultivate 
the physical health, to strengthen and invigorate the body; we 
may Indulge in idleness and ease; or those practices which make 
us tender and delicate; but by thus degenerating the vitality 
and vigor of the body, the nervous system is weakened and 
prepared for the manifestation of this disorder. If we would 
obey nature, we must learn her injunctions, a knowledge of 
which we may gain in two ways; by the study of physiology, 
and by seeking after the causes of disease. 
These remarks suggest to us the hygienic management of this 
disease. The disorder is a functional derangement of the nerv- 
ous system, showing weakness, a failure of vital power, and a 
lack of the proper endowments of life. The hygienic treatment 
should be sustaining. Pure air, nutritious diet, and cold baths, 
are all essential auxiliaries. Friction upon the surface of the 
body with the warm hand is also beneficial, and helps to estab- 
lish the general circulation of the blood. After employing 
these manual methods for a week or two, commence taking 
regular walks, one in the middle of the forenoon, and the other 
in the middle of the afternoon, immediately after the bath, and 
gain on each walk from five to ten steps, according to the 
strength. The body should be -well protected and the extremi- 
ties warmly clad. If the bowels are torpid, make use of boiled 
cracked wheat, and those means advised under the head of con- 
stipation. In some cases, we have prescribed blood-restoratives 
and antispasmodic medicines with the most gratifying success. 
This affection, as well as hysteria, is frequently amenable to 
nervines. When caused by derangement of the menstrual func- 
tion, we have generally found the Favorite Prescription suffi- 
cient to effect a cure. We have cured several cases of this 
disease, caused by masturbation, by employing treatment to 
control the spermatorrhea, which was undermining the constitu- 
tion. In other cases, we have had our attention directed by the 
symptoms to a morbid condition of the blood, and, by the ad- 
ministration of proper remedies, have been successful in effecting SPINAL IRRITATION. 
633 
a cure. In others, with every facility for investigation, we could 
discover no cause for the distressing convulsive manifestations. 
In such cases, the treatment has, necessarily, been somewhat 
empirical. 
The Staff of the Invalids' Hotel and Surgical Institute have 
had a large experience in the treatment of this disease, and 
their investigations and experience in its management have led 
to the adoption of remedial means which have proved remark- 
ably successful in its cure, as the following statements conclu- 
sively show. 
CASES TREATED. 
Case I. The little daughter of Mr. B. C., of Indianapolis, was 
brought to the Invalids' Hotel for the cure of St. Vitus's dance. She 
was 12 years old, and had suffered terribly for over a year. A residence 
of one month under the personal care of specialists at the above-men- 
tioned institution, and two months' treatment afterwards at her home, 
completely cured this little girl. Mechanical movements and dry cup- 
ping were employed with great benefit. 
Case II. C. H., a boy of 15, consulted the specialists at the Invalids' 
Hotel, last summer, and, upon examination, was found to have suffered 
from St. Vitus's dance for over a year. As he was unable to remain 
at the institution for treatment, a course of medicine was furnished 
him, and his parents were advised how to manage his case at their 
home. Four months' treatment has completely restored him to good 
health. 
Case III. Chorea, with Hemorrhage from the Mouth. 
World's Dispensary Medical Association: Gentlemen-Last 
winter, during a time of unusual excitement, my daughter Laura was 
stricken with St. Vitus's dance. All efforts to restrain her aggravated 
the trouble. During the attack blood would gush from her mouth. 
She was an object of pity. With one month's treatment, prepared by 
you, she has been entirely cured. She is now healthy and fleshy. 
I write this in behalf of others similarly afflicted, believing it to be my 
duty, and hoping that they may apply to you and be cured. 
Yours respectfully, Mrs. H. E. C., 
Sinnamahoning, Cameron Co., Pa. 
SPINAL IRRITATION. 
Spinal Irritation is characterized by more or less tenderness 
of the spine, although, in many cases, it is so slight as to pass 
unnoticed by the patient until pressure is applied. There is gen- 
erally very acute sensibility of the skin where the tenderness is 
most marked. If the affection is chiefly confined to the upper 
part of the spine, there is often present one or more of the fol- 
lowing symptoms: headache, dizziness, sleeplessness, nausea, 
vomiting, neuralgia of the head or face, shortness of breath, 634 
COMMON SENSE MEDICAL ADVISER. 
palpitation of the heart, or soreness of the arms. If the middle 
portion of the spine is affected, there is often intercostal neural- 
gia, neuralgia of the stomach, and dyspepsia. If the affection 
involves the lower part of the spine, neuralgic pains in the small 
of the back, in the ovaries, abdomen, or along the sciatic nerves, 
are not unfrequently present. In some cases, there is more or 
less numbness of the limbs, formication, sensations of heat, mus- 
cular weakness, and cramps. 
Treatment. The treatment of spinal irritation should 
consist in removing, as far as possible, the causes of the dis- 
order, if these can be determined, and in improving the tone of 
the nervous system. The diet should be substantial and abun- 
dant, but easily digested. Moderate exercise in the open air is 
generally beneficial. The patient should abstain from all emo- 
tional and sexual excitement, and from intellectual labor, as 
these are not unfrequently the causes of the disorder. Warm 
douches to the spinal region often prove beneficial. The moder- 
ate ascending continuous current of electricity may sometimes 
be employed with good results. In our vast experience at the 
Invalid's Hotel, we have found, however, that mechanical move- 
ments, properly applied, and regulation of the atmospheric pres- 
sure on the surface of the body, are far more effectual than any 
of the above-mentioned local measures. By means of these 
agents, together with appropriate constitutional treatment, we 
have been able to cure the most severe cases in a few weeks' 
time. 
Case 162,221. Spinal Irritation and Nervous Exhaustion. 
World's Dispensary Medical Association: Gentlemen-Your 
special treatment for my troubles has about restored me to health. I 
am weighing as much as at any time in twenty years. My appetite 
is good and I sleep well. My memory is now retentive, and I have im- 
proved in every respect. I shall ever feel myself under a debt of grati- 
tude to you for the prompt attention you accorded to my case; and 
I shall always take the deepest pleasure in recommending the afflicted 
to call upon the " World's Dispensary Medical Association," if they 
would recover their health. I have the honor to be, gentlemen, your 
obedient servant. Rev. W. M. P., Edgerly, Pa. 
NEURALGIA. 
This affection is manifested by pain, which may occur without 
inflammation or any appreciable changes in the parts affected. 
Any part of the body supplied with sensitive nerves may be the N'EUKAT.GIA. 
635 
seat of neuralgia. The nerves which supply the face, the mus- 
cles of the chest, the stomach, and the sciatic nerve, are, how- 
ever, those most liable to be involved in this affection. 
Sciatic Neuralgia is often a very grave disorder. The inten- 
sity of the pain varies much in different cases. The suffering is 
so great in many cases, that the patient remains quiet in bed. 
The pain is sometimes of a burning character. 
Some people are more sensitive than others, and are therefore 
more subject to neuralgic pains, which may be distinguished 
from the pain of inflammation by pressure upon the part 
affected. If it be neuralgia, relief will be obtained by thus 
doing. Neuralgic pain is changeable, often increased by sneez- 
ing, or any violent movement of the body, and sometimes con- 
tinues in spite of treatment. 
Causes. The causes are very obscure; this disease will 
often manifest itself when the blood is impoverished and the 
diet is innutritious; as Romberg says, "It seems as if pain 
were the prayer of the nerve for healthy food." It is fre- 
quently induced by the passions or by violent emotions, 
excessive exercise, lead poisoning, and in consequence of mental 
depression. Malaria is also a frequent cause of neuralgia. 
The paroxysms generally occur with such regularity as to indi- 
cate periodicity. 
Symptoms. The distinguishing symptom is sudden, sharp, 
and darting pain in some part; when in the face, it is called 
tic douleureux,; when in the heart, it is termed angina pectoris; 
when in the hip and leg, it is known as sciatica, and when 
between the ribs, it is designated intercostal neuralgia, which is 
liable to be mistaken for pleurisy. The pain of neuralgia is so 
agonizing, shooting, and cutting that the feeling is described as 
that of red-hot wires piercing the part. 
Treatment. The treatment should have reference to the 
general condition of the patient. It should be ascertained 
whether the affection is caused by lead poisoning, malaria, or in 
consequence of general debility. The selection of remedies 
should depend upon the causes. If evidence of the influence of 
malaria is discovered, then tonics and antiperiodics are indi- 
cated. If the result of lead poisoning the treatment described 
under the head of painters' colic should be adopted. If the 636 
COMMON SENSE MEDICAL ADVISER. 
pain is local, as in sciatic neuralgia, wet a cloth in a rubefacient 
mixture of equal parts of spirits of ammonia, tincture of aconite 
root, and chloroform, and hold it for a few moments upon the 
region of pain. If it is located in the neck or back, dry cupping 
of the parts may afford relief. In facial neuralgia, when excited 
by derangement of the stomach or bowels, a cathartic will at 
once relieve the pain. Electricity will, at times, mitigate the 
suffering, while at others, a spirit vapor-bath will allay the dis- 
tress. If an anodyne is required, use freely of the fluid Extract 
of Smart-weed. In most cases, the general health will be 
improved by taking freely of the Golden Medical Discovery. 
CASES TREATED. 
Case 43,709. Neuralgia, with Asthma. 
World's Dispensary Medical Association: Gentlemen-For ten 
years I suffered with asthma and neuralgia. No physician that I could 
find (and I consulted nearly all in this city), could give me the least 
relief. No remedy that I could obtain, ever benefited me in the least. 
I was confined to my bed at one time for one year and four months. 
I consulted you at the Invalids' Hotel and Surgical Institute, and com- 
menced your special treatment. Before I had completed the first course, 
I commenced working at my trade, which I had not done for over ten 
years. After a little perseverance an entire cure was effected, and I 
have remained perfectly sound and well ever since. 
J. P. G., 449 Sherman Street, Buffalo, N. Y. 
Case 46,084. Neuralgia from Overwork and Exposure. 
World's Dispensary Medical Association: Gentlemen - My 
language is inadequate to express to you the grateful sentiments of 
my heart. The treatment I received of you at the Invalids' Hotel 
effected mv entire cure, and that after the best physicians in Rochester, 
N. Y., had failed. My disease was a complicated nervous affection of 
the chest and side. I did not expect to live. I was reduced in flesh, 
and broken in spirit. I commenced your treatment in doubt-I had 
been so often disappointed. From almost the first dose I began to im- 
prove, and continued to do so until I was restored, a perfectly sound 
and healthy man. Most gratefully yours, 
F. S. P., Buffalo, N. Y. 
Case 64,293. Neuralgia. 
World's Dispensary Medical Association: Gentlemen-I hope 
you will pardon me for not writing before, but I now tender you my 
hearty thanks for the medicine you have sent me, which has been 
blessed to my good. I feel quite well now, and do not think I 'will 
need any more medicine. I remain, your obedient servant, 
♦ G. H. K., Huron, Ont. 
Case 89,106. Neuralgia Affecting the Chest. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-Permit me to say that I think I have recovered fully, and that 
I do not require any further treatment. Of course, I owe much to your 
noble medicines, but I think a respectable share of the credit is due to HEADACHE. 
637 
your truly excellent rules for invalids laid down in your " People's 
Common Sense Medical Adviser," which I have followed closely, 
Respectfully, 
M. M., Pine Glen, Center Co., Pa. 
HEADACHE. (Cephalalgia.) 
Headache is not, properly speaking, a disease, but it is a prom- 
inent symptom of very many maladies, and so large a proportion 
of mankind are afflicted with it that it deserves a separate con- 
sideration. It assumes various forms and these should, there- 
fore, be treated under separate and distinct heads. 
Organic Headache. It is frequently difficult to deter- 
mine to which class the various headaches should be assigned. 
This form, which is due to disease of the brain, is not easy to 
explain. 
Symptoms. The pain in this kind of headache, is located 
in one place, is continued, deep-seated, severe and increased either 
by motion of the head, close mental application, any kind of 
excitement, or by the use of stimulants. Nausea, accompanied 
by vomiting, sometimes occurs, but it fails to relieve the pain. 
The memory is often impaired, the hearing, as well as the vision, 
temporarily fails, and paralysis or even idiocy may result. 
Causes. Brain disease, the cause of this headache, may be 
hereditary, and a person may be predisposed to it, or it may be 
occasioned by injuries upon the head from blows or contusions. 
In advanced age, the pain is persistent, doubtless in consequence 
of morbid changes occurring in the structures of the brain. 
One author has remarked: "At this period of life, the energy of 
the nervous system is diminished, the stomach and bowels are 
less sensitive, the muscular tissue is no longer renovated with 
the ceaseless activity of adult life, and thickenings, indurations 
of, and morbid deposits in, blood-vessels and other tissues, are 
common." 
Aei'VOUS Headache is common to persons possessing an 
encephalic temperament, for they are usually very sensitive. 
Symptoms. There is severe throbbing pain in the top of 
the head and a swimming or dizzy sensation, dullness of mind 
and consequent loss of memory; the eyes are sunken, the sight 
dim, the pulse low, the cheeks pale and the bowels constipated; 
the patient is low-spirited, has cold hands and feet, and suffers 638 
COMMON SENSE MEDICAL ADVISER. 
from general debility. Sometimes the attacks are sudden, the 
vision is impaired, and the headache increased by keeping an 
erect position, while a recumbent posture diminishes the violence 
of the pain. 
Causes. This form of headache may be due to excessive 
exercise, improper diet, exposure to cold, variations of temper- 
ature, an impure atmosphere, loss of sleep, debilitating dis- 
charges, and self-abuse. It is also incident to persons of seden- 
tary habits, or those who closely devote themselves to mental 
pursuits. It may be the result of taking opium, alcohol, or 
strychnia. 
Bilious Headache may arise from an excessive amount 
of bile in the blood, or from an immoderate secretion of bile. 
Symptoms. There is pain in the head, especially in the 
forehead and over the eyes; the skin is of a jaundiced hue; the 
tongue is coated with a yellow fur and the taste is bitter. 
There is nausea with vomiting, which partially relieves the 
patient, on account of a portion of the bile being ejected from 
the stomach. 
Causes. This kind of headache is doubtless due to a 
morbidly active condition of the liver. Those who are intem- 
perate in the use of food or drink, or who are habitually 
careless of their health, are liable to suffer from this kind of 
headache. 
Sick Headache is another form of this affection, to which 
nervous persons and those of sedentary habits are subject. 
Symptoms. There is a feeling of dizziness, pain in the 
forehead and temples, at first comparatively slight, but which 
at length becomes very severe, the vision is blurred, there is 
nausea, followed by vomiting, after which, the patient is inclined 
to sleep. Upon waking, he finds that his headache has disap- 
peared, leaving a soreness in the affected part of the head. 
The breath is foul, the tongue is coated yellowish white, and 
there is a general chilliness of the body. 
Causes. The causes are immoderate indulgence in the use 
of spirituous liquors, indigestible articles of food, insufficient 
sleep, sedentary habits, constipation, mental anxiety, excitement 
of any kind, insufficient exercise, or, if plenty of exercise is 
taken, eating too soon thereafter. Headache may arise from a HEADACHE. 
639 
plethoric condition of the system, in which case, there is severe 
pain in the temples and forehead, or in the back part of the 
head, attended with dizziness and dullness of vision; the respi- 
ration is difficult, the action of the heart unnatural, the pulse 
full and quick, the tongue coated white, the appetite good, but 
the bowels are constipated, and the urine is highly colored. 
Some of the elements which enter into the composition of the 
urine may be in excess, or even deficient, and the action of 
the urinary organs may be abnormal, thus producing another 
form of headache. This is dull and heavy, the appetite is good, 
the bowels are in a healthy condition, the pulse is quick and low, 
but there is a feeling of general languor and indisposition. 
Those persons who are suffering from syphilis and have taken 
mercurials, are sometimes affected with headache, due to the 
action of these medicines. The pain is intense in the top and 
sides of the head, and sometimes the skin over the painful part 
becomes raised. There is also more or less tenderness in the 
roof of the nose, sore throat, and pain in the legs. Headache 
not unfrequently attacks those who have rhexcmatism. In this 
form, the pain is dull, and located in the temples and back of 
the head; there is sometimes giddiness, drowsiness, and sore- 
ness, as well as tenderness of the painful parts. 
Treatment. Concerning the management of all of these 
headaches, we may say that it is important to keep the bowels 
open, the skin clean, the kidneys active, and the circulation of 
the blood well determined to the surface and extremities of 
the body. It is also necessary, in order to secure these import- 
ant results, that the kind and amount of clothing be suitable, 
the daily habits regulated, and all excesses avoided. The diet 
should be moderate and easy of digestion; the patient should 
refrain from indulging in rich gravies, late suppers, or stimu- 
lating beverages. In organic headache, not much can be sug- 
gested, except the hygienic recommendations above given. In 
nervous headaches, caused by overwork, rest is necessary to 
recuperation. If produced by debilitating discharges, then a 
tonic course of treatment is indicated. If it be incident to a 
sedentary occupation, causing costiveness, exercise more, eat 
boiled cracked wheat once a day, and regulate the bowels 
with the Pleasant Purgative Pellets. The habits should be 640 
COMMON SENSE MEDICAL ADVISER. 
carefully regulated and temperance observed in all things. In 
bilious headache, the bowels should be acted upon by the 
Pellets, followed by the Golden Medical Discovery. Sick 
headache may result from some indiscretion in eating, anxiety, 
or loss of sleep, and may be relieved by taking an alkali, a 
Sedlitz Powder, a Pellet, or a stimulant. In a plethoric condi- 
tion of the body, great care should be taken to control the 
appetite. Medicines will furnish only temporary relief, and, 
unless the desire for food is restrained, it is useless to resort to 
medical treatment. Likewise, the amount of urine daily ex- 
creted should be estimated, for headache often results from a 
retention of some of the urinary elements in the blood. If the 
amount excreted be small, this circumstance should lead to a 
consultation with some physician; or, if syphilitic poison is 
lurking in the blood, then the use of the Golden Medical Dis- 
covery and Pleasant Purgative Pellets is proper. If these do 
not bring relief, the case should then receive a more critical 
examination by some competent physician. If the sufferer do 
not obtain relief from the pains of headache by a strict observ- 
ance of the hygienic rules which we have given, a skillful 
physician should be consulted. 
The eye is subject to numerous diseases which, although 
rarely fatal, yet occasion great inconvenience and suffering, and 
require skillful treatment. 
The term Ophthalmia may be applied to all inflammations of 
the eye, but is usually restricted to inflammation of the conjunc- 
the membrane which covers the external surface of the eye- 
ball and the inner surface of the lids. 
We desire to impress upon the mind of the reader the impor- 
fact, that these maladies are not merely local departures from 
health, but are generally associated with constitutional disease. 
The prevailing notion that they are strictly local derangements 
and require only local applications, is altogether incorrect, and 
the neglect of constitutional treatment will result in a failure to 
cure these affections. The use of eye-waters, eye-salves, and 
kindred preparations, without reference to constitutional treat- 
ment, will generally prove to be of no benefit whatever. 
DISEASES OF THE EYE DISEASES OE THE EYE. 
641 
SIMPLE INFLAMMATION OF THE EYE. 
(Catarrhal Conjunctivitis.) 
This disease, also called Catarrhal Ophthalmia, is the most 
simple form of inflammation to which the eye is subject. 
Causes. It is usually the result of cold, suppressed per- 
spiration, sudden changes in the temperature, heat, smoke, 
intensity of light, extension of the inflammation of the mucous 
membrane of the nose, and irritation from dirt or foreign bodies. 
Some persons are predisposed to these attacks at certain seasons 
of the year, without any apparent cause. By using the same 
towel, it may be communicated from one person to another. 
Symptoms. At first, there is a sensation of dryness and 
smarting, as though dirt were in the eye. Soon that organ 
becomes swollen and is more or less painful; there is headache, 
intolerance of light, a profuse lachrymal secretion, and, if the 
inflammation continues, it terminates in a muco-purulent dis- 
charge. On separating the lids the eye appears swollen, red, 
and angry. In severe cases, there is more or less fever. When 
this inflammation is neglected, or improperly treated, it is apt to 
result in some form of chronic disease. If small blisters appear 
on the eye, the disease is termed Phlyctenular Conjunctivitis, if 
there are ulcers, it is called Pustular Conjunctivitis. 
Treatment. It should be remembered that this disease 
involves constitutional derangement, and should be treated by 
attention to the general as well as the local disturbance. First, 
give a brisk cathartic, after which the spirit vapor-bath and 
mustard foot-bath should be employed. The sweating which 
they produce should be continued with diaphoretics and small 
doses of aconite or veratrum. Give one of the Purgative Pellets 
three or four times a day. If the patient be feeble, the consti- 
tution badly broken down and the powers of life reduced, then 
such tonics as iron and quinine rather than sedatives should be 
used. As soon as the active symptoms begin to subside, alter- 
atives should be given, in which case, the Golden Medical Dis- 
covery will be found very efficacious. 
Keep the eye well cleansed with tepid water, or milk and 
water, exclude all light, and drop into it every three hours the 
following lotion: fluid extract of aconite leaves, one drachm; 642 
COMMON SENSE MEDICAL ADVISER. 
fluid extract of belladonna, one-half drachm; water, one ounce; 
mix. After a few days, mild, astringent lotions may be 
employed, for which purpose, a weak infusion of hydrastis or 
witch-hazel, or one grain of sulphate of zinc in two ounces of 
pure water, are among the most useful. A lotion prepared by 
adding two or three grains of the sulphate or the muriate of 
hydrastia to two ounces of water is excellent, not only in this 
form of the disease, but in purulent and gonorrheal conjunc- 
tivitis. 
In the phlyctenular or pustular form, there is always a 
depravation of the general system, which requires alteratives 
and tonics. Dr. Pierce's Discovery and Pellets should be 
administered, and may be alternated with quinine and iron. 
The same local remedies recommended in the treatment of 
simple inflammation, may be used in this case; also a so- 
lution of one grain of nitrate of silver in one ounce of rose 
water, applied to the eye three times a day, will be found 
beneficial. 
PURULENT INFLAMMATION OF THE EYE. 
(Purulent Conjunctivitis.) 
This disease, also frequently called Egyptian or Military 
Ophthalmia, progresses with great rapidity. The inflammation 
is intense, and all the symptoms of the simple form are greatly 
aggravated. The active stage is short, the swelling of the eye 
is extensive, and pus is produced in great abundance. The 
cornea is liable to be penetrated by ulceration, or it may become 
opaque, and the sight be greatly impaired or entirely lost. 
There are two other forms of this disease, known as Gonorrheal 
Ophthalmia and Ophthalmia Infantium Purulenta. 
Causes. Purulent conjunctivitis may occur spontaneously 
in the adult, or the simple form may become purulent from 
neglect or improper treatment, or it may arise from local 
irritation. It is usually caused by contagion, since it is com- 
municated by wiping on the same towel, or in any way by 
which a particle of matter can be conveyed from the eye 
of one person to that of another. It sometimes occurs as an 
epidemic. 
Diagnosis. The symptoms are similar to those of the DISEASES OF THE EYE. 
643 
simple form of conjunctivitis, though much more intense, and 
there is more constitutional disturbance. The eye is enormously 
swollen and "matter" freely flows from between the lids, as illus- 
trated by Fig. 202. If the lids 
be separated, the eye will be 
seen to be full of pus, and if 
wiped or washed away, the 
membranes will appear in- 
tensely red, the blood-vessels 
very much swollen, and perhaps 
numerous small points of ulcer- 
ation will be seen. The chief 
danger lies in the liability of 
the cornea to be destroyed. 
Treatment. This should 
be active from the outset, and 
well persisted in, or the eye will 
be destroyed. Confine the 
patient in a well-ventilated but darkened room. Make his 
surroundings hygienically as perfect as possible. Bathe the eye 
frequently with tepid water, or milk and water, and cover it 
lightly with cloths in the same, changing them often. Never 
bind anything heavy over an inflamed eye so as to keep it warm, 
as all such applications aggravate the inflammation, and, in this 
disease, favor suppuration. If only one eye be involved, care 
should be taken to protect the other, as well as the eyes of the 
attendants. Give a brisk cathartic, and, if the tongue continues 
foul, repeat it as often as necessary, and throughout the disease 
give one of the Purgative Pellets every four or six hours, 
unless they move the bowels too frequently when the interval 
should be extended. Use the spirit vapor-bath, and, if the pulse 
is quick, full, and hard, symptoms indicative of high inflamma- 
tion, give such sedatives as aconite, or veratrum, in appropriate 
doses. The diet should not be stimulating. If the general 
health of the patient is impaired, alteratives and tonics should 
be used, and a more nutritious and generous diet allowed. 
locally, use the tepid water bath often, keeping the eye well 
cleansed. Various washes have been advised, such as two grains 
of sulphate of zinc in one ounce of pure water, or nitrate of 
Jtyg. 202. 
Purulent Conjunctivitis. 644 
COMMON SENSE MEDICAL ADVISEE. 
silver in the same proportion, to be used two or three times a 
day, until the virulent character of the disease is overcome. 
Antiseptic lotions are of great value. Permanganate of potash, 
three grains to an ounce of pure water, applied freely several 
times a day, is unsurpassed in the early stage. A solution of 
one grain of the sulphate of atropia in one ounce of rose-water, 
should be used, two or three drops being applied twice a day to 
keep the pupil dilated. Always cleanse the eye with tepid 
water before making any application. The services of a skillful 
oculist should be secured, if the disease does not quickly yield 
to the above treatment. 
Gonorrheal Ophthalmia. This is caused by the introduction 
of gonorrheal "matter" into the eye. It is the most violent, 
rapid, and destructive form of ophthalmia known, and often 
ruins the eye. The symptoms are similar to those of the pre- 
ceding form, though much more rapid in their development and 
more destructive in their tendency. If the patient has gonor- 
rhea, the diagnosis is simplified. 
Treatment. The treatment does not materially differ 
from that advised for simple purulent conjunctivitis, but it 
should be more active. Astringent lotions of nitrate of silver 
or sulphate of zinc, may be used as heretofore recommended, or 
antiseptics may be employed with advantage, such as the per- 
manganate of potash, five grains to one ounce of water. No 
time should be lost in securing the services of a physician of 
large experience in treating this disease. 
PURULENT OPHTHALMIA OF NEWBORN CHILDREN. 
(Ophthalmia Infantium Purulenta.) 
This affection usually occurs soon after birth, and may be 
caused by an acrid condition of the vaginal secretions of the 
mother, harsh washings with soap, sponge, or cloths, by careless 
nurses, or exposure to strong light or cold; or it may be com- 
municated from one child to another. Overcrowded tenements, 
poor ventilation, insufficient nourishment, and scrofula are pre- 
disposing causes. 
Although this is classed with the purulent variety it is gener- 
ally very mild in its character. It can usually be recognized by DISEASES OF THE EYE. 
645 
the swelling of the eyes, intolerance of light, and purulent 
discharges. 
Treatment. This should consist in cleanliness, ventilation, 
good nourishment, washing the eyes with tepid milk and water, 
and applying light, wet cloths to them. Mild astringent lotions 
should also be dropped into the eyes, such as a weak infusion of 
witch-hazel, or hydrastis. Simple rose-water is often sufficient, 
or one ounce of sulphate of zinc, added to four ounces of rose- 
water may be employed. One grain of sulphate or muriate of 
hydrastia added to two ounces of pure water, is excellent. 
With this treatment, the disease generally terminates favorably 
in from two to six weeks. 
SCROFULOUS INFLAMMATION. 
(Scrofulous Conjunctivitis.) 
The course of this disease is usually slow, and recovery post- 
poned, on account of the enfeebled condition of the constitu- 
tion. It may affect all parts of the eye, and, under the old 
fashioned treatment, was rendered exceedingly intractable, but 
it can now be controlled as well as other forms of inflam- 
mation. 
The immediate cause of scrofulous conjunctivitis may be any- 
thing which is capable of exciting inflammation. The scrofu- 
lous diathesis is a predisposing cause. 
Symptoms. Ordinarily these do not differ materially 
from those of the acute form of simple conjunctivitis, though 
they are less severe. The lachrymal secretions are excessive and 
run over the cheek. There is intolerance of light, the eyes are 
spasmodically closed, the brows depressed, the cheeks drawn up, 
and the child involuntarily covers his eyes with his hands, since 
the light cannot be endured. On separating the lids, which 
offer considerable resistance, the tears escape. The inside of 
the lid, as well as the eye, is red and swollen, with here and 
there pinkish colored blood-vessels running toward the center. 
The membrane covering the eye is frequently thickened, and 
ulcers are apt to be found on the cornea, which may become 
hazy and opaque. 
Treatment. Heretofore the treatment of scrofulous oph- 
thalmania has been difficult and unsatisfactory, partly from the 646 
COMMON SENSE MEDICAL ADVISER. 
opposition which the child offers to an examination or the 
application of remedies locally, and partly from the fact that 
the local disease depends upon a constitutional affection which 
has been difficult to overcome. Under these circumstances, the 
cure has necessarily been delayed, if not entirely prevented. 
Although immediate benefit may not be received from the 
treatment, yet the remedies should be continued. The treat- 
ment should be general as well as local, or it will fail; for, no 
matter how skillful or scientific the local treatment may be, un- 
less the constitutional condition is improved, the local affection 
will return. The general hygienic directions advised under the 
head of scrofula will be appropriate, together with the persistent 
use of the Golden Medical Discovery in proper doses. If the 
constitution is anaemic or broken down, some of the bitter 
tonics, as gentian, dogwood, hydrastis, or wafer-ash, with iron 
alternated with the Discovery, will give the best results. This 
method of treatment has cured hundreds of cases in which the 
old method of relying entirely upon the local application of 
strong lotions, had failed. 
Locally, the treatment should be of an astringent character. 
Make a tea of the bark of the root of soft maple, or a strong in- 
fusion of hydrastis and witch-hazel leaves, two parts of the 
former to one of the latter. When dropped into the eye, five 
or six times a day, this will produce good results. Cleanliness 
is absolutely necessary, and the forehead and eyes should be 
bathed frequently with cold water. Dr. Sage's Catarrh Remedy 
used weak is an excellent eye-lotion. Nitrate of silver is recom- 
mended by some, but it must be used with caution, and the 
strength should not be more than that of one grain in three 
ounces of water. Blisters, applied to the temples or to the back 
part of the neck, are often employed in this affection. In mak- 
ing local applications, the lotion should be put into the eye and 
not on the face, even if the child has to be forcibly held. 
When the disease shows no sign of improvement under this 
treatment, there is evidently some fault which has been over- 
looked, and professional advice should be obtained. In consult- 
ing a physician, one should be selected who makes diseases of 
the eye a specialty, for the eye is too delicate an organ to be 
'experimented upon. DISEASES OE THE EYE. 
647 
Case I. This case, a fair sample of hundreds of similar ones treated 
at the Invalids' Hotel and Surgical Institute, serves to illustrate the 
success of mild means in overcoming this disease. R. B., aged six 
years, a scrofulous subject, was brought to the Hotel for treatment. 
She had been troubled with sore eyes nearly all her life. When we 
first saw her, she could not open her eyes, so great was the spasmodic 
contraction of the lids, and her hands instinctively covered them from 
the light. She was feeble and delicate, though usually bright and in- 
telligent. On attempting to separate the lids, there was a profuse dis- 
charge of hot tears; the eye was red, swollen, and ulcerated at several 
points. 
A liberal, nourishing diet, outdoor air, exercise, bathing, and other 
hygienic treatment was advised. The eyes were kept well cleansed 
with tepid water, and several times each day astringent lotions were 
applied to them, varied in composition as the eyes improved. We 
directed that she should wear a colored shade, in order to modify the 
intensity of the light, and take the Golden Medical Discovery, with 
such tonics as her condition demanded. In two months, she was so 
much improved that her mother returned home with her. Her eyes 
continued weak for some time, but by persevering in the same treat- 
ment, with the use of the compound lotion of golden seal and witch- 
hazel, she was restored to perfect health. 
CASES TREATED. 
CHRONIC INFLAMMATION OF THE EYES. 
Whenever any form of acute inflammation of the eye passes 
into a chronic condition, certain morbid changes occur in its 
external membranes. It is most frequently met with in persons 
who are debilitated, or who suffer from constitutional taint, and 
whose recuperative powers are low. The disease is sometimes, 
however, produced by overtaxing the sight by reading fine 
print, or by other work which strains the eyes, or by employing 
them closely by a strong or insufficient light. In this form, the 
disease may be sub-acute or chronic from the commencement, 
may come on slowly, or advance and recede alternately. 
Symptoms. The eye presents a vermilion red, or blood- 
shot appearance. The blood-vessels become enlarged, or tortu- 
ous, and may be seen to form a net-work, the color of which is 
deepest near the circumference, and spots of extravasated blood 
may be seen in the membrane covering the eye. There is a 
sensation as if sand were in the eye, there is intolerance of 
light, the lids are swollen, tears are discharged, a drop of matter 
may be seen in the corners, which varies from a mucous to a 
muco-purulent secretion. These symptoms may continue for 
(Chronic Conjunctivitis.) 648 
COMMON SENSE MEDICAL ADVISEE. 
months, or even years, according to the circumstances of the 
patient. 
Treatment. Formerly, the treatment of this affection 
was very unsatisfactory, simply because the eye was considered 
the only diseased part of the system, and, consequently, it was 
tortured, while the true nature of the disease was imperfectly 
understood, and wholly overlooked in the treatment. 
Correct treatment consists in improving the general health by 
every possible means. Any faulty condition of the system 
which may be present, such as syphilis, debility, rheumatism, 
anaemia, or scrofula, must receive special attention and proper 
treatment. Strict attention to ventilation, exercise, bathing, and 
diet, is also of great importance. Keep the absorbents, as well 
as the secretions, active, by giving the Golden Medical Discovery 
and Purgative Pellets, and, if the patient be robust, these reme- 
dies should be given in doses sufficient to produce a free action 
of the bowels. If, on the other hand, the patient is weak, feeble, 
or debilitated, give the same remedies, but in less quantities, 
and alternate with tonics. If constitutional taints, such as 
scrofula or syphilis exist, use such treatment as we have advised 
for those diseases. 
Keep the eyes well cleansed by bathing them with Dr. Sage's 
Catarrh Remedy, and use the astringent lotion of golden seal 
and witch-hazel, as advised under the head of scrofulous con- 
junctivitis. If half a drachm of borax be added to four ounces 
of this lotion, it will be rendered more efficacious. Two grains 
of sulphate of zinc and one grain of morphine to an ounce of 
rose-water, make a good lotion for the eye in this chronic affec- 
tion. A solution of one grain of nitrate of silver and one grain 
of morphine, in one ounce of water, is also a proper application. 
Let it be remembered that whenever there is any ulceration, 
sugar of lead, as a local application, should never be used, for it 
will very likely produce opacity, by adhering to the parts and 
becoming oxidized. The lotions already advised are almost the 
only ones that are safe in unprofessional hands, but, under the 
direction of the qualified physician, others may be employed to 
good advantage, to meet such conditions as are present in indi- 
vidual cases. Discrimination is essential to success in the treat- 
ment of this chronic malady, and can only be acquired by long DISEASES OF THE EYE. 
649 
study and wide experience. Hence, the specialist very often 
succeeds in curing cases which prove intractable in the hands of 
the general practitioner; for although the latter may have an 
extensive general practice, he may not have as many cases of 
this disease in a whole year as the specialist has in a single day. 
CASES TREATED. 
Case I. D. W., aged 40, came to the Invalids' Hotel and Surgical In- 
stitution for treatment. He was suffering from chronic conjunctivitis 
which for several years had resisted all treatment received from his 
home physician. Examination revealed increased redness of the con- 
junctiva, and the blood-vessels were enlarged and tortuous. Several 
ulcers existed, there was considerable muco-purulent discharge, and 
his general health was very much impaired. 
We directed him to thoroughly observe the rules of hygiene, and 
gave him suitable alteratives and tonics. The eyes were kept well 
cleansed, a mild tonic and astringent lotion was applied to them, and 
the ulcers touched once a week with a pencil of sulphate of copper. At 
the end of one month, he had so greatly improved that he was allowed 
to return to his home in Pennsylvania, and a continuance of the consti- 
tutional treatment for a month longer, effected a perfect cure. This is 
but a fair representative of the numerous cases recorded in the Eye 
Department of the Invalids' Hotel and Surgical Institute. 
Although this affection is usually spoken of as granular lids, 
yet it generally extends to that part of the conjunctival mem- 
brane which covers the globe of the eye, as may be seen by 
reference to Fig. 203. It cannot strictly be considered a dis- 
tinct form of conjunctivitis, as it is generally either a result or 
a concomitant of other forms, and is apt to occur if they are 
long-continued. The granulations consist of enlarged papillae 
projecting from the conjunctiva, and, in the milder cases, give to 
the inner surface of the lids a velvety appearance, but in the 
more aggravated form, a wrinkled, seamed, or warty appearance. 
The disease generally attacks those of broken-down or anaemic 
constitutions, or those whose systems are depraved by previous 
disease. It prevails to a great extent among the poor, or those 
subject to many privations, although it is not confined to this 
class. Granular lids are apt to be accompanied with a profuse 
secretion of tears and sometimes pus, which not unfrequently 
leads to ulceration and opacity of the cornea, as shown in 
Fig. 203. 
Treatment. Considerable time is frequently necessary to 
GRANULAR LIDS. (Granular Conjunctivitis.) 650 
COMMON SENSE MEDICAL ADVISER. 
effect a cure, and all measures fail unless the general health is 
restored, the bodily functions are improved, and healthy mater- 
ials elaborated to replace the diseased and worn-out tissues. 
Consequently, all complications should be carefully considered, 
and that constitutional treatment adopted which the nature of 
the case demands. 
The thickened condition of the conjunctiva must be removed 
by absorption, and to this end the process of waste and nutrition 
should be kept active. This can be accomplished by the employ- 
ment of the Golden Medical Discovery and Purgative Pellets, 
which may be combined or 
alternated with those reme- 
dies which may be indicated. 
Tonics are also generally re- 
quired, together with a per- 
fect observance of hygienic 
rules. If the patient be 
scrofulous, syphilitic, rheu- 
matic, or anaemic, the treat- 
ment recommended else- 
where in this volume for 
each of those affections will 
be appropriate in this case. 
The necessary local appli- 
cations cannot be well made 
except by the specialist who 
is prepared with proper in- 
struments required in treat- 
ing diseases of the eye. 
Caustics are sometimes necessary, and, by some, the knife is 
used to cut or scrape away the granulations. Stimulating lo- 
tions may be made by the patient, but great difficulty in select- 
ing the proper ones suited to the case will be experienced. The 
knowledge and judgment necessary for such discrimination, can 
only be acquired by experience in the treatment of this disease. 
Fig. 203. 
Granular Conjunctivitis. 
Case I. E. P., aged 38, applied for treatment at the Invalids' Hotel 
and Surgical Institute. He was first attacked with conjunctivitis which 
terminated in granulated lids. His constitution was feeble, and his gen- 
eral health not very good. The Golden Medical Discovery and special 
CASES TREATED. DISEASES OF THE EYE. 
651 
tonics were prescribed. We applied the solid sulphate of copper by 
penciling the lids every third day for two weeks, after which, we used 
it but once a week. At the end of the second month he returned home. 
His eyes, though weak, were free from inflammation, and his general 
health was better than it had been for many years. He was directed 
to employ a weak infusion of witch-hazel or golden seal once a day, 
also to continue the use of the Discovery. A perfect cure was the re- 
sult. 
Case II. N. T., aged 34, came to the Invalids' Hotel and Surgical 
Institute to be treated for granular conjunctivitis. Being of a scrofu- 
lous diathesis, the constitutional treatment directed for scrofula was 
adopted, and stimulating astringent applications were made to the eye- 
lids every third day. For some time the disease resisted this local 
treatment, but as her general health improved the disease abated. 
This continued until the cure was perfected. The treatment was con- 
tinued, however, until the scrofulous manifestations subsided, and the 
functions of the body were all well established. 
INFLAMMATION OF THE CORNEA. 
(Corneitis. Keratitis.) 
Inflammation of the cornea may be either acute or chronic, 
generally the latter. The cornea is commonly involved to some 
extent during the progress of inflammation of other structures 
of the eye, but we propose here to speak of uncomplicated 
corneitis. This affection is usually of long duration, sometimes 
continuing for months or even years, and is liable to result in 
ulceration, opacity, abscess, or staphyloma. Sometimes both 
eyes are involved at the same time, and it frequently happens 
that when but one is attacked, as that begins to improve, the 
other becomes involved. Young children, and especially per- 
sons from ten to twenty years of age, are more liable to it, 
particularly those of a strumous habit; and also females at the 
age of puberty. As the disease progresses, the whole cornea 
becomes red and vascular, resembling light-red cloth with a 
white spot in the centre, a condition which has been termed 
pannus; deposits of lymph also occur between the layers of the 
cornea, and the vision becomes obscured. The disease is apt to 
involve the iris, and, if unsuspected or neglected, closure of the 
pupil is liable to occur. 
Causes. Constitutional derangements, such as scrofula, 
syphilis, and rheumatism, predispose to inflammation of the 
cornea; while the exciting causes are exposure to cold and wet, 
over-straining of the eyes, badly-ventilated dwellings, insufficient 
food, injuries, irritating substances, and corrosive eye-lotions. 652 
COMMON SENSE MEDICAL ADVISER. 
Symptoms. There is more or less pain in the eye, neural- 
gia of the orbit, increase of tears, intolerance of light, which 
symptoms are very intense in the acute form. The cornea be- 
comes hazy, vascular, and red. In the sclerotic coat, a belt of 
minute blood-vessels may be seen surrounding the cornea, which 
is an important diagnostic mark; in the edge of the cornea, a 
similar circle, or part of one, may be seen, composed of exceed- 
ingly minute vessels, while in the conjunctiva, the vessels are 
large and tortuous. 
Treatment. As the disease is prone to occur in persons of 
broken-down constitutions, and scrofulous or syphilitic subjects, 
treatment appropriate to the constitutional condition must be 
instituted, and the most thorough regulation of the patient's 
habits established. If the patient be plethoric, give a brisk 
cathartic Sedatives, such as aconite, with a diaphoretic, such as 
asclepias, will be beneficial, together with the spirit vapor-bath. 
Generally, all through the course of treatment, tonics, as well as 
alteratives are demanded, and the spirit vapor-bath or the Turk- 
ish or Russian baths should be employed to keep the skin in 
good condition. We must improve the general health by every 
proper means, and, to this end, the Golden Medical Discovery 
and Pellets are advisable, in doses appropriate to the age of the 
patient. In some cases, the value of the Discovery may be 
enhanced by the addition of half an ounce of iodide of potas- 
sium or muriate of ammonia, to each bottle. This should be 
alternated with the bitter vegetable tonics and iron. Quinine 
and iron, in the form of pill or powder, should be used in prefer- 
ence to other tonics. 
The eye needs rest, and should be protected from the light; in- 
deed, the lids should not be separated, except for the purpose of 
making applications to it. The eye may be lightly covered by 
cloths wet in tepid water. The applications should be of a 
soothing or slightly stimulating character. Tincture or fluid ex- 
tract of aconite leaves, one drachm to an ounce of water, is a 
valuable lotion to allay the inflammation, and may be dropped 
into the eye every two or three hours. After the first or more 
active part of the disease, a weak solution of nitrate of silver or 
sulphate of zinc, one grain to an ounce of water; rose-water 
with ten grains of borax to the ounce; a weak infusion of DISEASES OF THE EYE. 
653 
golden seal, or the infusion of golden seal with a little borax 
added, are all valuable eye-lotions. One or two drops of a 
solution of atropia, two grains to the ounce, either separate or 
combined with one of the above mentioned lotions, should not 
be omitted. This will obviate the danger of permanent closure 
of the pupil in consequence of the adhesion of the iris to the 
cornea, a result quite likely to occur if such precaution is not 
taken. The disease is one which requires great skill for its suc- 
cessful management, and no unprofessional person should at- 
tempt its treatment. Indeed, few physicians will be likely to 
assume its management, unless they are ignorant of the deplor- 
able results (hereafter mentioned) which are liable to follow 
its improper treatment. 
OPACITIES OF THE CORNEA. 
Opacities of the cornea result from inflammation of the con- 
junctiva, or cornea, or in consequence of injuries to the cornea. 
These opacities, more or less obscure the vision, according to 
their situation, extent, and thickness. They are divided accord- 
ing to their situation in the layers of the cornea, into superficial, 
central, and deep. When they are moderate in size, quite super- 
ficial, and thin, looking like a faint grayish-blue cloud, they are 
called nebul(je\ when the opacity is greater, denser, pearly white, 
and situated deeper in the substance of the cornea they arc 
termed when there is a corneal or corneo-conjunctival 
scar or cicatrix extending deep within the structure of the 
cornea, resulting from a loss of substance, and its edge well de- 
fined, it is termed Zewcoma. The nebulous variety is apt to 
result from inflammation of the conjunctiva, and is much more 
easily managed than the other varieties which generally result 
from inflammation or injuries. Formerly, when lotions of sugar 
of lead were more frequently used than at present, these opaci- 
ties were much more common, as a direct result of the oxidation 
of the lead and its deposition in, and adhesion to, the coats of 
the cornea. 
Treatment. The younger the patient, the more readily 
the opacity yields to treatment. It is sometimes astonishing 
with what rapidity the part affected is restored in children. 
The form termed leucoma is the most persistent of any, and it 654 
COMMON SENSE MEDICAL ADVISEE. 
may be doubted if medical treatment ever does effect a perfect 
cure, though time and appropriate medicines may greatly narrow 
the extent of the opacity. The treatment mostly relied upon 
at the Invalids' Hotel and Surgical Institute consists in enjoin- 
ing a thorough observance of hygienic regulations and the 
administration of those internal remedies which the condition 
of the constitution demands. Prominent among the remedies 
we prescribe are alteratives and tonics; we also recommend a 
good and nourishing diet. The absorbents should be kept con- 
tinually active by the use of the Golden Medical Discovery. 
To each bottle add one-half ounce of iodide of potassium. Dr. 
Pierce's Purgative Pellets should be used to keep the contents 
of the bowels in a soluble condition. 
Locally, all kinds of stimulating lotions have been employed 
by experimentalists, and nearly every known irritant has been 
tried, not even omitting cotton-oil and mercurial ointment. To 
use such agents is unphilosophical and hazardous in the extreme. 
Pure sweet-oil, or melted lard, is a far superior agent. Various 
ointments are useful, such as fifteen grains of powdered borax 
in an ounce of lard; or five grains of iodide of potassium in an 
ounce of lard or fresh butter. The cautious application of 
diluted tincture of cayenne pepper with a camel's hair pencil, 
is often useful. More powerful irritants than those already 
advised, should never be used except by a skillful oculist, for, 
instead of removing the opacity, they may cause destructive 
inflammation. A lotion of one grain of atropia to an ounce of 
water, applied twice a day, should not be omitted. When all 
medicines fail, which is sometimes the case in leucoma, or if 
chalky deposits take place in the cornea, an operation for 
providing an artificial pupil, illustrated in Fig. 205, may be 
skillfully performed, and at once restore the vision. 
ULCERATION OF THE CORNEA. 
Ulceration of the cornea may be caused by purulent or scrof- 
ulous inflammation, injuries, disease of the nerves which supply 
the cornea, great debility of the general system, or by anything 
which results in defective nutrition of the eye. Corneal ulcers 
may be superficial or deep-seated, the latter being most trouble- 
some and dangerous, and, when located at the centre of the biSEASES OF THE EYE. 
655 
cornea, are more liable to interfere with vision than when situ- 
ated near its circumference. There may be one or several, or 
one may follow another. They may sometimes be so small as 
scarcely to be seen, but are nevertheless dangerous. They are 
generally accompanied with more or less inflammation, which 
varies according to the character of the ulcer, of which there 
are several varieties. They may perforate the cornea and thus 
destroy the vision. 
Symptoms. There is a sensation as if there were dirt or 
grains of sand in the eye, accompanied by more or less redness, 
and straggling conjunctival blood-vessels may be observed 
running toward the cornea; there is increased secretion of tears 
and intolerance of light, and a careful examination of the eye 
will reveal a little depression on the surface of the cornea. 
Treatment. The treatment of ulcers should always be 
regulated by the cause which gave rise to them. Attention to 
the general health is necessary, since, in the majority of cases, it 
is considerably impaired, and the vitality so much lowered that 
the natural reparative processes cannot go on. Tonics with al- 
teratives are required, good diet and rest are also necessary. 
Give the Golden Medical Discovery, in medium doses, with iron 
and hydrastin. If there is syphilis, employ the treatment sug- 
gested under that head. If inflammation exists, it should be 
overcome. Apply, locally, an astringent lotion, such as the in- 
fusion of gold thread, or the golden seal and witch-hazel decoc- 
tion already alluded to; or ten grains of borax in an ounce of 
an infusion of golden seal, or one grain of nitrate of silver in 
an ounce of rose-water. If the disease does not promptly yield, 
a competent oculist should be consulted. 
STAPHYLOMA. 
Staphyloma is an affection of the eyeball, which is character- 
ized by the protuberance of the cornea, which loses its trans- 
parency and becomes a bluish-white, or pearl color, Fig. 204. 
The sclerotic coat is also sometimes involved. In some cases, 
the pain is intense, in others slight. 
Staphyloma may be partial or total. In the first case, the 
projection is comparatively slight, in the second, it is very large, 
frequently rough and uneven, and the sight is wholly destroyed. 656 
COMMON SENSE MEDICAL ADVISER. 
Causes. Ulcers, injuries, abscesses, and sloughing may all 
be causes of this affection. 
Treatment. The treatment must necessarily be chiefly 
local, and consists in a removal of the tumor. If the affection 
is partial, the operation should be per- 
formed as early as possible, for the pur- 
pose of arresting its progress, and thus 
preserving the remaining sight. If it is 
total, the unsightly, morbid growth 
should be removed, or the sound eye 
will be quite liable to become sympa- 
thetically diseased. Numerous cases 
have come to our notice, in which 
staphyloma of one eye, through sympa- 
thy, has produced inflammation in the other, and when the tumor 
was removed from the diseased eye, the other was restored. 
When staphyloma is accompanied by some constitutional af- 
fection, those remedies should be employed which are suited 
to each individual case. 
201 
Staphyloma. 
INFLAMMATION OF THE IRIS. (Iritis.) 
This affection, also known as Internal Ophthalmia, may be 
considered under two forms, acute and chronic. 
The acute form does not occur so frequently as the chronic, is 
more rapid in its course, and, when improperly treated, often 
results in other diseases of the eye, or the chronic form of this 
affection. 
Symptoms. There is at first dimness of vision, and the 
color of the eye is changed; if naturally hazel, it becomes a 
dark red; if blue or gray, it is changed to a greenish color. 
The lining membrane of the eyeball and lids has a pinkish 
appearance. There is a burning, stinging pain, a profusion 
of tears, and it is with the greatest difficulty that the patient 
can open his eye. The pain is paroxysmal, and generally occurs 
in the night-time. This affection is usually attended with con- 
siderable fever, the tongue is coated, the skin dry, the pulse 
quick and hard, the bowels are constipated, there is headache, 
thirst, restlessness, and, as the disease progresses, the eye has a 
hazy appearance. DISEASES OE THE EYE. 
657 
Causes. It may be produced by wounds or injuries of any 
kind, and is then termed traumatic, or it may be the result of 
cold, or improper use of the eye, when it is known as rheumatic 
inflammation. 
Treatment. An emetic should be taken, after which a 
spirit vapor-bath may be used. As a revulsive measure, a hot 
mustard foot-bath is recommended. Small doses of the Com- 
pound Extract of Smart-weed, in some diaphoretic infusion, 
should always be given. To keep the bowels regular, an active 
cathartic should be administered as often as the case requires. 
The circulation may be controlled by veratrum viride. If, how- 
ever, the patient be debilitated or anaemic, this treatment should 
be materially modified. As soon as there is a remission of the 
symptoms, two or three grains of quinine, with one of the 
Purgative Pellets, should be given every three or four hours. 
The Golden Medical Discovery, taken internally, by its alter- 
ative properties, will favor the absorption of any lymph that 
may have been deposited in the eye during the progress of the 
inflammation. 
If the disease is of the rheumatic form, in addition to the 
above treatment, an alkaline diuretic, such as acetate of potash 
or saltpetre, is advised. If the pain be very severe, some 
anodyne, such as hyoscyamus, may be used. 
The light should be excluded from the eye, and it should be 
frequently bathed with warm soft water. A solution of atropia, 
two grains to an ounce of water, dropped into the eye two or 
three times a day, is of great benefit. A lotion of the tincture 
of aconite leaves, may also be used several times a day. Should 
the above treatment fail in effecting a cure, a skillful physician 
should at once be called. 
Chronic Inflammation of the iris more frequently occurs 
than the acute form, and may be severe at first, or its approach 
may be so gradual that it is unnoticed until indistinctness of 
vision indicates the diseased condition of the eye. 
Symptoms. These are essentially the same as in the acute 
form, although much milder in character. There is dull pain in 
the eye, attended with a sensation of weakness. The pupil is 
smaller than natural and contracts and dilates slowly. The 
brightness of the eye is faded, and a belt of blood-vessels may 658 
COMMON SENSE MEDICAL ADVISEE. 
be seen around the cornea; the vision gradually becomes indis- 
tinct and is finally entirely lost. 
Causes. It may be the result of the acute form, or of 
prolonged inflammation of some other part of the eye. It may 
also be caused by other diseases. Scrofula frequently induces 
this inflammation, in which case yellowish spots, occasioned by 
the effusion of lymph, may be seen here and there upon the iris, 
and the cornea is sometimes mottled and opaque. It may also 
follow from venereal disease, -when it is known as syphilitic 
inflammation of the iris, a representation of which may be seen 
in Fig. 31, Colored Plate V. 
Treatment. In this form, the treatment should be ener- 
getic. Hygienic conditions should be observed, and every 
third or fourth day a spirit vapor-bath should be employed. 
The Pleasant Purgative Pellets, alternated -with tonics, such as 
iron, quinine, hydrastin, dogwood, or nux vomica, should be 
taken in sufficient doses to keep the bowels regular. Warm 
poultices should never be applied to the eye, since they favor 
suppuration and are liable to destroy the sight. The atropia 
lotion, advised in the treatment of the acute form, should be 
used in this. The local treatment for the scrofulous form 
should be similar, but the constitutional treatment should be 
adapted to the condition of the system. The same is true of 
the syphilitic form. A green shade for the eyes is of service. 
Other parts of the eye are liable to be implicated in this inflam- 
mation, hence the ophthalmoscope should be employed to detect 
the first approach of disease. 
CASES TREATED. 
Case I. R. P., of Canada, aged 26. applied at the Invalids' Hotel 
and Surgical Institute, for the relief of chronic iritis. He had suffered 
about three months, and his general health was considerably affected. 
The iris was contracted, of a muddy color, and effusions of lymph were 
visible upon it. We advised a nourishing diet, gave him alteratives 
suited to his case, made local applications to produce dilation of the 
pupil and allay the inflammation, and protected the eye from the light 
with a green shade. In two months, his general health was much 
improved, the lymph absorbed, and aside from his eye being a little 
weak, he was fully restored. 
Case II. G. B., aged 20, consulted us. He was suffering from iritis, 
which was rapidly progressing. The iris was of a muddy color, and a 
peculiar angular deformity existed. We learned upon inquiry that 
about eight months before he had contracted syphilis he had been 
treated with mercury and iodine, but without benefit. We at once DISEASES Of THE EYE. 
659 
prescribed constitutional treatment to cure the syphilis. Atropia was 
applied locally, together with fomentations. At the end of a month, 
there was a decided improvement, and, in two months, all traces of 
iritis had vanished, and after further treatment for syphilis, he was 
completely restored to health. 
CLOSURE OF THE PUPIL. (Atresia Pupillaris.) 
Closure of the pupil is characterized by a total loss of sight, 
and is the result of inflammation of the iris. 
Treatment. If there be any constitutional derangement, 
it should be rectified by 
remedies suited to the case. 
In this disease, solutions and 
lotions applied to the eye are 
of no benefit, and surgery 
promises the only relief. If 
the disease does not extend 
behind the iris, the sight 
may be speedily restored by 
the surgical operation 
termed iridectomy. (Fig. 
205.) It is needless to add 
that such a delicate opera- 
tion requires a perfect 
knowledge of the anatomy 
of the eye, as well as famil- 
iarity with the proper in- 
strument with which to perform it. The Eye Department of 
the Invalids' Hotel is furnished with all the surgical instruments 
required for operations upon the eye, and at its head is a com- 
petent surgeon prepared to skillfully treat this class of diseases. 
Fig. 205. 
Iridectomy. 
GLAUCOMA. 
From the earliest history of medicine, great differences of 
opinion have prevailed with regard to the pathology of this dis- 
ease. Formerly, the term glaucoma was indiscriminately applied 
to all diseases affecting that part of the eye behind the pupil. 
Some regarded it as an inflammatory affection of the iris and 
choroid, others thought that it was a disease of the retina, or 
vitreous humor, while others again claimed it to be due to some 660 
COMMON SENSE MEDICAL ADVISER. 
change in the refracting power of the lens. Not until the in- 
vention of the ophthalmoscope was the real nature of the dis- 
ease understood. Mackenzie remarks, " Glaucoma comprehends 
a series of morbid changes, which in general develops itself only 
in the course of years, to involve, at last, all structures of the 
eye." This disease may be either acute or chronic. If the 
acute form is present, it progresses rapidly and generally affects 
both eyes at the same time. The chronic form is most frequent, 
and years may elapse before the structure becomes so involved 
as to destroy the sight. 
Symptoms. The eye presents a greenish appearance, 
varying from a slight discoloration to a light green color. In 
the acute form, the symptoms sometimes appear very rapidly, 
and the vision becomes extinct after a few hours of terrible 
pain. At other times, the disease is gradually developed. There 
is a sensation as if sparks, flames, balls of fire, or bright colors, 
were passing before the eyes. The conjunctiva becomes red 
and the pupil dilated. Pains shoot from the eyes to the fore- 
head and temples, the iris becomes dull, the eyeballs harden, the 
cornea is less prominent, water flows from the eyes, there is 
dimness of vision, and, finally, the sight is altogether lost. 
In the chronic form, there is pain and dimness of vision, which 
occur at intervals, becoming more and more frequent, until these 
symptoms are continually present. Nearly all the symptoms of 
the acute form are present in this, and may continue for months, 
and sometimes years, the sight gradually becoming impaired, 
until it is finally lost. 
Treatment. In the acute form, anodynes should be given, 
to relieve the pain. The bowels, skin, and kidneys, should be 
kept in a healthy condition. The eyes should be kept in a state 
of rest, and a solution of atropia applied to them once or twice 
a day. On account of the rapidity with which this disease pro- 
gresses, a skillful physician should at once be called. 
In the chronic form, the general health should be improved. 
Hygienic treatment should be observed, together with the use 
of alteratives and tonics. The Golden Medical Discovery should 
be taken in large doses. If the pain be severe, anodynes should 
be employed. The spirit vapor-bath once or twice a week is 
also beneficial. In both the acute and chronic forms, a surgical DISEASES OF THE EYE. 
661 
operation is necessary, and should be performed as early as pos- 
sible, before the sight is completely destroyed. If the operation 
is delayed until disorganization of the eye has taken place, treat- 
ment is liable to prove ineffectual; whereas, if it be performed 
in the earlier stages, the disease may be arrested and the sight 
preserved. Iridectomy is the operation usually adopted at the 
Invalids' Hotel, and is the one advised by Von Graefe, the cele- 
brated German oculist, who has given the subject much atten- 
tion. It is also recommended by other eminent oculists. 
The term amaurosis signifies a loss or decay of sight.- This 
impairment of vision is due to some change in the retina, optic 
nerve, or brain, and may be either partial or complete, func- 
tional, or organic. There may be said to be three stages of this 
affection: one in which the eyes are weak, with but little dimi- 
nution of sight; another in which the loss of sight is more 
marked; and, still another, in which the sight is entirely lost. 
Causes. Various causes favor the establishment of amau- 
rosis. It is common among the young as well as the old, and 
most frequently occurs in persons of a nervous temperament. 
It may be due to congestion of the retina, exposure to intense 
light, excessive use of the eyes, or the use of improperly ad- 
justed glasses. It may be the result of an exhausted condition 
of the nervous system, of excessive study, hemorrhages, vene- 
real excesses, masturbation, spermatorrhea, exhaustive diarrhea, 
intemperance, cholera, fevers, hysteria, convulsions, sunstroke, 
derangement of the stomach, suppression of habitual discharges, 
or the use of tobacco. 
Symptoms. The eye is at first weak, which indicates that 
it ought to be shaded; it is red and painful, the pupil is dilated 
and does not readily contract, and there is a mist or blur con- 
tinually before it. The sight becomes impaired, and there is a 
sensation as if minute objects were continually passing before 
the eyes, and one color cannot be distinguished from another. 
The gait becomes uncertain, and the patient gropes his way 
along as if in the dark. As the disease progresses, the vision 
becomes more and more impaired, and total blindness is the 
final result. 
AMAUROSIS. (Impaired Vision.) 662 
COMMON SENSE MEDICAL ADVISER. 
Amaurosis is apt to be confounded with glaucoma or cataract. 
It may be distinguished from glaucoma, which is characterized 
by hardness of the eyeball and a greenish color of the eye. In 
amaurosis, the pupil is of a natural color, whereas in cataract 
an opaque body appears behind it. To the person affected with 
amaurosis, objects appear discolored or perverted in shape, and 
seem to float before the eye; in cataract the vision is clouded but 
objects do not float before the sight. If amaurosis is complete, 
the patient cannot distinguish between light and darkness, while 
in cataract he is sensible of both. By the ophthalmoscope, as 
represented in Fig. 206, amaurosis may be distinguished from 
Fig. 206. 
other affections of the interior of tho eye. This instrument is of 
inestimable value to the specialist in determining the nature of 
the disease, for by understanding the conditions which are made 
apparent, the treatment is much more direct and certain. 
Treatment. In amaurosis, the causes of the affection 
should be well understood, since only constitutional treatment 
can be advised. If the disease be inflammatory, or the patient 
be plethoric and has headache, giddiness, red face, hot skin, full, 
quick pulse, apparent flashes of light, or balls of fire passing 
before the eyes, the treatment should be vigorous. The spirit 
Employment of the Ophthalmoscope. DISEASES OF THE EYE. 
663 
vapor-bath and hot mustard foot-bath should be given daily. 
Aconite and belladonna, together with the Extract of Smart- 
weed, should be taken in suitable doses, and some purgative, 
such as Epsom salts. As soon as there is a remission of the 
symptoms, the Golden Medical Discovery and Purgative Pellets 
may be taken. 
If amaurosis is caused by an enfeebled condition of the 
nervous system, and there is general debility, quick pulse, and 
anaemia, then tonics and nervines are indicated, together with a 
nourishing diet and other hygienic agencies. Small doses of 
Purgative Pellets, to keep the bowels regular, may also be 
given. 
If the blindness be sympathetic and result from some other 
disease, the general system should be toned, and treatment given 
according to the nature of the affection. 
If the affection is organic, tonics, nervines, and other agents 
are advised to suit the case; the Golden Medical Discovery and 
Purgative Pellets are generally found useful in nearly all forms 
of amaurosis. This disease is often improperly treated, on ac- 
count of the causes which produce it and the conditions which 
favor it not being understood. We have restored hundreds in a 
short time by carefully diagnosing every case, and varying the 
treatment so as to adapt it to the individual condition of the 
different subjects, and also to the causes in which the affection 
had its origin. 
CATARACT. 
The term cataract, when applied to the eye, signifies an 
opacity of the crystalline lens, or its capsule, or both; the pas- 
sage of the rays of light being thereby prevented and vision pre- 
cluded. When the opacity is confined to the lens, it is termed 
lenticular; when to the capsule, it is called capsular; when to 
both the lens and capsule, it is known as capsulo-lenticular 
opacity. Cataracts may be divided into hard and soft, and may 
occur at any age, and involve one or both eyes. They make 
their appearance gradually; at first, objects are indistinctly seen, 
as through a mist, and the vision becomes more and more indis- 
tinct as the opacity increases, until the person becomes entirely 
blind. 
Causes. The true cause of this disease is yet a subject 664 
COMMON SENSE MEDICAL ADVISER. 
of discussion among ophthalmologists. Persons of feeble or 
broken-down constitutions are most subject to it, doubtless 
owing to the impairment of the nutritive functions. 
Symptoms. The affection is painless; there is no intoler- 
ance of light or flow of tears, and were it not for the gradual 
loss of sight, the patient would not be aware of the disease. 
There is at first dimness of vision, and a mist or cloud appears 
before the eyes. This condition is more marked in a bright 
day, and objects can be seen more distinctly if placed at one 
side than if directly in front of the eye. Upon examination, an 
opaque body is observed behind the pupil. The pupil itself is 
natural in appearance and dilates or contracts readily when 
exposed to the light. 
Cataract may readily be distinguished from opacities of the 
cornea by remembering that, in the latter affection, the opacities 
are in front of the pupil, -while in cataract, they are behind it. 
It is sometimes confounded with glaucoma and amaurosis, but 
can readily be distinguished from those diseases, for in cataract, 
the sight is best in cloudy weather, or in a subdued light; there 
is no pain in the eye or head, nor is there any constitutional 
disturbance; the sight is seldom entirely obliterated, but the 
patient can distinguish between daylight and darkness, and the 
eyeball preserves its natural consistence. 
Treatment. Until very recently, surgical treatment was 
regarded as the only means by which cataract could be relieved. 
Eminent oculists now entertain the opinion that in some cases, 
medical treatment is beneficial. One author says: "There are 
three conditions presented to the practitioner, viz.: first, the 
cataract may be just commencing; second, it may be almost 
complete or fully matured without serious complications; or, 
third, the cataract may be complete or incomplete with serious 
complications." In the first condition, medical treatment may 
be successful and should consist of a thorough alterative course. 
The Golden Medical Discovery with iodide of potassium or the 
muriate of ammonia, is recommended. In the second and third 
conditions, relief can only be expected by a surgical operation. 
The methods of operating may be classified under three gen- 
eral heads, viz.: division or absorption, depression or displace- 
ment, and extraction. By the first method, a needle is passed DISEASES OF THE EYE. 
665 
through the sclerotic (see Fig. 207) and the opaque lens, and its 
capsule is broken into fragments, which by dexterous manipula- 
tions are pushed forward into the anterior chamber of the eye, 
where they are acted upon by the aqueous humor and dissolved. 
The pupil in the figure, appears fully dilated and larger than the 
cataract, which occupies the centre and is represented by the 
white spot. This operation is most successful in soft cataract, 
and is accom- 
panied with but 
little escape of the 
aqueous humor. 
By the second 
method, the needle 
is passed through 
the coats of the 
eye, pushed care- 
fully forward in 
front of the cata- 
ract (the pupil 
having previously 
been dilated), and 
applied to the up- 
per and front part 
of the lens. It is 
then pressed downward and backward into the vitreous humor. 
The needle is retained for a few moments in the eye, until it is 
ascertained if the lens is disposed to rise; if so, it is again de- 
pressed; if not, the needle is withdrawn. This operation is not 
very successful, as it is liable to be followed by inflammation. 
By the third method, extraction, the lens is entirely removed. 
This operation is more delicate than either of the others, and it 
is also more successful. There are various ways of performing 
this operation. The one known as the linear method of extrac- 
tion is accomplished by making an incision through the cornea, 
near the sclerotic, on the outer side of the eye; upon withdraw- 
ing the knife, the aqueous humor escapes. A curved needle is 
now introduced, and the capsule is cut, when the lens readily 
escapes by pressure upon the opposite side of the eye. It is a 
prevalent opinion that any escape of the aqueous humor will 
Fig. 207. 
Operation for Cataract, bjr Division. 666 
COMMON SENSE MEDICAL ADVISER. 
result in loss of vision. This impression is erroneous, for in 
many operations upon the eye, this fluid is permitted to escape. 
Whenever the aqueous humor is evacuated, it is again produced 
in from twenty to thirty 
hours. 
In the flap operation of 
extraction, as shown in 
Fig. 208, and which is per- 
formed by what is termed 
the lower section, an in- 
cision is made in the cor- 
nea near the sclerotic, as 
represented in the figure, 
and the cornea is divided. 
The capsule is then cut 
and the lens allowed to 
escape. In the figure, the 
lens is represented as es- 
caping from the incision 
made in the cornea. After the operation is completed, the eyes 
are kept closed by strips of adhesive plaster, which should be 
removed every day to ascer- 
tain the condition of the 
eye. The patient should 
be kept in a darkened room 
and in a recumbent posi- 
tion, for some time, and 
care ought to be taken that 
he does not disturb the eye 
during sleep. The wound 
in the cornea speedily heals 
by what is known as first 
intention. 
The modified linear 
method of extraction, rep- 
resented by Fig. 209, is a 
modification of both the 
linear and flap operations, and may be divided into incision, iri- 
dectomy, opening the capsule, and extraction of the lens. In 
Fig. 208. 
Flap operation for Cataract. 
Fig. 209 
Modified linear method of Extraction. DISEASES OE THE EYE. 
667 
Fig. 209, the eye is represented as transfixed with a knife and 
held by fixation forceps. The knife is then moved upward, fol- 
lowing the sclerotic until a complete flap is cut; iridectomy is 
then performed, the capsule is opened, and the lens extracted in 
a manner similar to the preceding operation. 
After any operation for cataract has been performed, the 
patient should have the best of care, for through ignorance, 
carelessness, or neglect, serious consequences may ensue. To 
meet this difficulty, we have made suitable provisions whereby 
every patient upon whom we operate shall have every attention 
after the operation until the cure is complete, and he can with 
safety return to his home. 
The word from a Greek word signifying a wing, 
is applied to a disease of the eye. This affection is character- 
ized by a vascular thickening of a portion of the conjunctiva, 
which is triangular in shape and 
bears a resemblance to the wing 
of an insect. This thickened 
membrane usually occupies the 
nasal side of the eye, its base 
being situated at the inner 
corner, and its apex directed to 
the cornea, thereby obstructing 
the sight, as illustrated by Fig. 
210. Sometimes one of these 
membranes is formed on the 
inner and one on the outer side 
simultaneously, in which cases, 
they may entirely cover the cornea. In the early period of this 
disease, this membrane is thin and light-colored and causes but 
little if any disfigurement, but later it becomes inflamed and 
eventually destroys the sight. 
Causes. These are obscure, but inflammation or continued 
irritation favors the production of this disease; it most fre- 
quently occurs in warm climates. 
Treatment. The absorbents should be kept active by the 
use of the Golden Medical Discovery and Purgative Pellets, 
PTERYGIUM. 
Fig. 210. 
Pterygium. 668 
COMMON SENSE MEDICAL ADVISER. 
which for this purpose are unequaled. Local applications may 
be employed, but with great care. Caustics, or the tincture of 
capsicum, may be applied to the pterygium, but they are very 
painful, and, unless used with caution, may be productive of 
much harm. A solution made from three grains of sulphate of 
copper and one ounce of water, may be applied two or three 
times a day. If the growth is large, or if the means above 
advised fail, it should be removed by a surgical operation. 
Both medical and surgical treatment are employed at the In- 
valids' Hotel, according to the nature of the case, the latter 
only being resorted to when the former fails to perfect a cure. 
FOREIGN BODIES IN THE EYE. 
The eye is liable to injury from the introduction of foreign 
bodies, which occasion suffering and inflammation if allowed to 
remain. These substances may be cinders, glass, scales of iron, 
particles of sand, bits of wood, lime, or mortar, gunpowder, and 
sometimes pieces of percussion caps or insects. When very 
small, they may be "washed away by tears, but they are liable to 
become imbedded in the structures of the eye, or lodged in the 
conjunctiva, where they remain until they produce congestion 
or inflammation, which is very much intensified by rubbing the 
irritated organ. 
Treatment. This consists in removing the particles from 
the eye. Let the patient be placed in a good light, and his lids 
drawn apart by a person standing behind him; if the eye be 
then rolled in every direction, the particles may generally be 
seen, and removed with a pointed instrument. If the substance 
be lodged beneath the upper lid, by turning the lid outward, it 
may be removed by a pencil or probe. If the substance is 
lodged directly in front of the pupil, especially if the eye is 
black, it is very liable to be overlooked, but it can usually be 
discovered by looking across the eye, and is best removed by 
the point of a lancet. If the substance has passed beneath the 
layers of the cornea, it may be removed by making an incision, 
and lifting it out with a pointed instrument. A magnet is often 
efficient in extracting bits of iron from the eye. Lime should 
be removed as quickly as possible, and the eye syringed with a 
weak solution of tepid water and vinegar. Glycerine or pure DISEASES OF THE EYE. 
669 
water may be used, if vinegar is not at hand. If the foreign 
substance be acid, the neutralizing agent should be alkaline, 
and a solution of saleratus or soda is generally beneficial. 
Pitch is best removed with oil. If there be gunpowder in the 
eye, it should be picked out as soon as possible, or the nitre will 
dissolve and give rise to extreme pain, inflammation, and dis- 
coloration of the eye. Pieces of percussion-caps should be 
removed as quickly as possible by a surgeon. After any sub- 
stance has been removed, the eye should be bathed with tepid 
water, milk and water, or rose-water, or a weak decoction of 
tea, after which the eye should be protected from the light. 
CROSS-EYE. (Strabismus.) 
This is an affection in which the axes of the eyes cannot be 
directed the same way, and, therefore, when one eye is turned 
toward, the other is turned away from the object. Strabismus 
may be divided into convergent, when the eye is turned toward 
the nose, divergent, when turned away from the nose, and oblique, 
when it is directed obliquely upward or downward. 
Causes. This affection may be congenital, but it is fre- 
quently induced by some disease of childhood, such as whoop- 
ing-cough, measles, or worms, or by irritation of the stomach, 
constipation, fright, or passion. It may be produced by an 
enfeebled condition of the nervous system, diseases of the 
brain, opacity of the cornea, by using one eye to the entire 
exclusion of the other, or by sportively attempting. to imitate 
cross-eyed people. 
Although it is easy to detect this affliction in a person, it is 
not always easy to determine which eye is turned. " In order 
to ascertain which is the squinting eye, the patient should be 
directed to look steadily at an object (a lighted candle or 
uplifted finger), held in the horizontal median line, at the dis- 
tance of a few feet from the face. Then alternately covering 
each eye with the hand, note whether the uncovered eye remains 
steadily fixed upon the subject or has to change its position 
before it can bring its visual line to bear upon it."-Wells. 
There are various other methods employed to discover which is 
the affected eye. 
Treatment. If strabismus be produced by disease of the 670 
COMMON SENSE MEDICAL ADVISER. 
brain, remedies should be employed which will benefit that 
affection. If due to an enfeebled condition of the nervous 
system, tonics, alteratives, and nervines should be employed. 
If to convulsions, antispas- 
modics and nervines are in- 
dicated. Some exercise of 
the crooked eye may be 
beneficial; for example, shut 
the well eye, and, keeping 
the head in one position, let 
the affected member be di- 
rected toward a glass and 
then suddenly open the 
other. The repetition of 
this experiment has some- 
times been serviceable in 
restoring the affected eye. 
When other means fail, a 
surgical operation will com- 
pletely remedy the affection. 
The operation may be per- 
formed quickly, and with 
very little pain. Fig. 211 
represents an operation performed on convergent cross-eye. It 
consists in making an incision in the sclerotic, and raising the 
contracted muscles with a blunt hook, and passing one blade of 
the scissors beneath the muscles, which are then divided, and 
the eye is made straight. 
Physicians who are in general practice, especially those who 
do not reside in the larger towns or cities, seldom have occasion 
to treat these affections of the eye, and they are, therefore, not 
proficient and skillful in operating, and generally direct the 
patient to some competent surgeon who makes a specialty of 
treating such diseases. Consequently, at the Invalids' Hotel 
and Surgical Institute there are many cases of this character 
treated, and we have devoted special attention to these affec- 
tions, and have provided ourselves with all the instruments and 
accessories necessary to effect the most approved and successful 
operations. 
Fig. 211. 
Operation for Cross-eye. DISEASES OF THE EYE. 
671 
OBSTRUCTION OF THE LACHRYMO-NASAL TUBE, 
OR TEAR-DUCT. 
The lachrymo-nasal tube, the passage which conveys tears 
from the eye to the nose, is liable to be obstructed, and hence 
the tears, deprived of their usual exit, flow outward over the 
cheek. The person is then said to have watery eyes. If the 
passage is entirely closed, the amount of tears will be greater 
than if it is only partially obstructed, and the nostril on the 
affected side will be correspondingly dry. If the duct is 
obstructed, belowr the lachrymal sac, the tears will accumulate 
and produce swelling, inflammation, or an abscess. 
Causes. The obstruction may be due to inflammation of 
the lachrymal sac or adjacent structures, and most frequently 
occurs in persons of a scrofulous diathesis. It may be caused 
by nasal catarrh, which produces a thickening of the mucous 
membrane lining the duct. Again, the tears may not enter the 
sac, in consequence of the small canals which convey them from 
the lids to the lachrymo-nasal tube being obstructed. 
Treatment. If the affection is the result of scrofula, 
corresponding constitutional treatment is advised, if due to 
catarrh, the use of the Golden Medical Discovery, together with 
Dr. Sage's Catarrh Remedy, applied with the Nasal Douche, is 
recommended; if to obliteration of the canaliculi (little canals), 
a surgical operation is necessary. If there be stricture of the 
duct, a probe should be passed through it into the nasal cavity, 
and the operation repeated by changing from a small to a large 
instrument. 
LACHRYMAL FISTULA. 
Whenever there is continued inflammation of the lachrymal 
sac, it produces an abscess or fistula, 
which discharges its contents upon 
the cheek through the skin, a little 
below the inner corner of the eye. 
A representation of the lachrymal 
fistula may be seen in Fig. 212. 
Treatment. This consists in re- 
moving the obstructions of the duct 
by passing through it a long slim knife 
and keeping the passage open by the frequent introduction of 
Fig. 212. 
Lachrymal Fistula. 672 
COMMON SENSE MEDICAL ADVISEE. 
probes, or by the insertion of a little silver instrument called a 
style, which is worn in the passage until all danger of its con- 
tracting and closing again is passed. 
INFLAMMATION OF THE LIDS. (Ophthalmia Tarsi.) 
Inflammation chiefly affects the edges of the eyelids, although 
it may extend to the conjunctiva. It is generally chronic, and 
is liable to cause more or less disfigurement. 
Causes. It may be caused by exposure to the atmosphere, 
dirt, irritating vapors, inflammation of the eye, or uncleanliness, 
or it may be due to catarrhal or purulent conjunctivitis, intem- 
perance, unwholesome food, or excessive use of the eyes by 
artificial light. It is most frequent in persons of a feeble con- 
stitution or scrofulous diathesis; soldiers, farmers, and travelers 
are also subject to this affection. 
Symptoms. The edges of the eyelids are red, swollen, 
and covered with a secretion from the glands of the lids; there 
is an itching, burning sensation, and they adhere to each other 
in the morning. If produced by scrofula, the incrustations or 
scales are thick, and small pustules or ulcers are formed at the 
roots of the eyelashes. If the inflammation is long continued, 
the eyelids become thickened, the eyelashes fall out, the eyes 
are irritated, and their appearance is unsightly. 
Treatment. The constitutional derangements must first 
be corrected by hygienic observances, and, if tonics are neces- 
sary, the Golden Medical Discovery is advised. The eyes should 
frequently be bathed with milk and water, or a weak infusion 
of golden seal, or a lotion made from one or two grains of sul- 
phate of zinc and one ounce of rose-water. Glycerine, either 
pure or medicated, may be applied at night to keep the surface 
moist. After thoroughly cleansing the eyelids, a preparation 
made with fifteen grains of borax, one-half ounce of rose-water, 
and one-half ounce of glycerine, may be applied and will pro- 
duce good results. 
STYE. (Hordeolum.) 
This affection is characterized by a red, hard swelling on the 
edge of the lid and is attended with considerable pain and 
inflammation. It is of the same nature as a boil and when it DISEASES OF THE EYE. 
673 
bursts, thick "matter" is discharged and a small part sloughs 
off, after which the swelling subsides and the lid heals. The 
treatment is the same as that for boils. 
TUMORS OF THE LIDS 
Tumors frequently form upon the lids. These may be 
removed by the knife. Careful discrimination, however, should 
be made between simple and cancerous tumors. 
EXCRESCENCES OF THE LIDS. 
These have essentially the appearance of warts and may be 
removed from the lids by the use of caustics or the knife. The 
same precaution advised in the preceding affection applies 
equally well to this, viz: to distinguish between simple excres- 
cences and those of a cancerous nature. 
WILD HAIRS. (Trichiasis.) 
Wild hairs, or ingrowing of the lashes, is of frequent occur- 
rence. The lashes grow in toward the eye and produce irrita- 
tion and inflammation of that organ. 
Treatment. When but a small part of the eyelid is thus 
affected, pulling out the lashes with a pair of tweezers may 
suffice, but they will grow in a similar manner again. When 
the eye is endangered by the irritation which the lashes produce, 
the treatment should be radical and relief may be effected by 
destroying the hair-bulbs in the margin of the lid. This may 
be done by the use of caustics, care being taken to protect the 
eye by an investment made for that purpose; or a surgical 
operation upon the lid will remove the affection. 
EVERSION OF THE LIDS. (Ectkopium.) 
This disease is characterized by the lid being drawn away 
from the eyeball, which, being deprived of its natural protec- 
tion, is subject to irritation and inflammation, with frequent 
ulceration of the cornea. 
Causes. It generally results from the contraction of parts 
which have been wounded and are beginning to heal, as in 
burns, scalds, or cuts. It may be caused by paralysis of the 
muscle which surrounds the eye. Not long since we had 
29 674 
COMMON SENSE MEDICAL ADVISER. 
occasion to operate upon a case, in which eversion of the lids 
was caused by contraction of a wound in healing. A distin- 
guished surgeon of New York had removed a tumor from the 
cheek of the patient, and in healing, the skin had contracted so 
much as to result in eversion of the lower lid. 
Treatment. If paralysis is the cause of this affection, 
appropriate constitutional treatment is advised. If caused by 
contraction of wounds or burns, a surgical operation is the only 
remedy. The operation consists in removing a part of the 
tissue, as shown by the black lines in Fig. 213, which represent 
the incisions made in operating, and in bringing the edges of 
Fig. 213. 
Fig. 21 f 
Ectropium immediately after op- 
eration, with the sutures 
in position. 
Ectropium before the'- operation. 
the wound together, and holding them in position by means of 
pins and silk thread, applied as represented in Fig. 214. If too 
little of the superabundant tissue be removed, the operation will 
only partly relieve the difficulty. If, on the other hand, too 
much be taken away, inversion of the lids will result. When 
properly performed, the operation is successful, and leaves little 
or no disfiguration. 
INVERSION OF THE LIDS. (Entropium.) 
This disease of the eyelid is exactly the reverse of the pre- 
ceding; the edge of the lid and the lashes are turned toward the 
eye. If this condition be continued, the result will be inflam- 
mation, caused by the irritation of the eyelashes, as described 
under wild hairs. DISEASES OF THE EAR. 
675 
Causes. It may be caused by inflammation or thickening 
of the conjunctiva, or from flaccidity of the adjacent tissue. 
Treatment. Astringents or nitric acid may be applied to 
produce contraction of the skin. If, however, these do not 
afford relief, a surgical operation should at once be performed, 
since prolonged irritation is dangerous to the eye. A portion 
of the lid should be removed, while the margin remains uncut, 
and the edges of the wound brought together to heal. 
ADHESION OF THE LIDS. 
Adhesion may be of two kinds, viz.: when the margins of 
the lid adhere, and the globe of the eye remains free, which is 
caused by burns, wounds, ulcerations, and, sometimes, by inflam- 
mation, and when the conjunctiva, the surface of the eye, and 
one or both lids adhere. This deformity is sometimes con- 
genital. 
Treatment. In either case, the treatment is surgical, and 
consists in separating the adhesion by means of a knife, and 
applying ligatures. Care must be taken lest the structures of 
the eye be wounded. 
DISEASES OF THE EAR. 
The ear is liable to maladies which occasion severe suffering 
and oftentimes result in structural lesions and total deafness. 
EARACHE. (Otalgia.) 
Earache is of frequent occurrence, especially among children. 
Sometimes the pain is neuralgic, again it is inflammatory, and 
is increased by a recumbent posture. 
Causes. Exposure to cold, inflammation of any portion of 
the auditory canal, rheumatism, or derangements of the diges- 
tive apparatus are among the most prominent causes. Earache 
frequently occurs during the progress of measles or scarlet fever 
and is incident to feeble or scrofulous constitutions. When it 
has once occurred, it is apt to return, even when no cause can be 
assigned. 
Symptoms. When the pain is neuralgic, it usually begins 
at night, is severe, lancinating, and darting, but remits toward 
morning and the patient may be comparatively free from it COMMON SENSE MEDICAL ADVISER. 
676 
during the day. If the pain results from inflammation, it comes 
on gradually and does not entirely disappear until the cause is 
arrested. It is attended with noises in the ear, such as singing, 
buzzing, and roaring, and an examination reveals the auditory 
canal red, swollen, and inflamed, or entirely obstructed. The 
pulse is quick, the tongue coated, the skin dry and hot, and 
general symptoms of fever appear. 
Treatment. When constitutional derangement exists, 
remedies should be administered appropriate to the disease. 
When earache is a result of measles or scarlet fever, alteratives 
are recommended. If the pain be neuralgic, quinine and nux 
vomica, alternated with belladonna may be given, after which 
the Golden Medical Discovery and Purgative Pellets will be 
found beneficial. If the pain be indicative of inflammation, a 
spirit vapor-bath should be administered, the ear carefully 
steamed, and the Compound Extract of Smart-weed in some 
diaphoretic infusion, taken in suitable doses. Aconite and bella- 
donna may also be used, and, as soon as the inflammation begins 
to abate, alteratives are indicated. The above treatment may 
not give immediate relief, but is designed to effect a permanent 
cure. 
Palliative treatment, or that which will give present relief, is 
desirable and may be obtained from simple household remedies, 
such as sweet-oil, camphor and oil, glycerine, a roasted onion, or a 
toasted biscuit moistened in hot vinegar and applied to the ear. 
A little tuft of cotton or wool, saturated in a mixture of two 
grains of gelsemin and one of morphine dissolved in a drachm 
of glycerine, and placed in the ear, will rarely fail to give relief. 
PURULENT DISCHARGE FROM THE EAR. 
(Otorrhea.) 
This affection, which is of frequent occurrence, is the result of 
inflammation. The discharge varies in character and quantity. 
Sometimes it is thin and watery, again it is thick, creamy, and 
of a yellow or greenish color and very offensive. 
Causes. The external part of the ear may be inflamed and 
give rise to this discharge, or the tympanum and adjacent parts 
may become diseased and suppuration follow. It may be 
occasioned by injuries, exposure to cold, and vicissitudes of DISEASES OF THE EAR. 
677 
climate, or it may be induced by scrofula and translation of 
eruptions of the skin, or by a polypus of the ear. 
Symptoms. There is severe earache, headache, and swell- 
ing of the glands of the neck, all of which are symptoms of 
inHammation. As soon as the discharge takes place, the inflam- 
Fig. 215. 
Examination of the external ear and tympanum by the speculum and mirror. 
mation subsides. The existence of this disease is very readily 
determined, but there is frequently much difficulty experienced 
in ascertaining its course, and to what extent the tissue has 
become involved. By means of the speculum and mirror, as 
illustrated in Fig. 215, the diseased structure can readily be 
brought to view'. 678 
COMMON SENSE MEDICAL ADVISER. 
Treatment. When the inflammation is. acute and the 
pain severe, a spirit vapor-bath is advised, and the perspiration 
should be kept up with the Compound Extract of Smart-weed 
and small doses of aconite. When the disease is chronic, or 
when it results from eruptive fevers, an alterative and tonic 
course of treatment is recommended, for which the Golden 
Medical Discovery and Purgative Pellets are unequaled; hy- 
drastis, dogwood, and other tonics may also be given. The ear 
should be thoroughly syringed two or three times a day with 
tepid water, and Castile soap. The nasal douche is preferable 
to a syringe, since the force of the current may be regulated by 
elevating or lowering the douche, or by compressing the flex- 
ible tube between the thumb and finger. Dr. Sage's Catarrh 
Remedy is excellent for cleansing the ear, and promoting restor- 
ation of the diseased parts. When the discharge is profuse, 
mild astringents are frequently beneficial, and may be used 
with the douche. If ideers be visible, nitrate of silver or sul- 
phate of zinc may be applied with a fine brush, but should be 
used with great care. When morbid growths produce the dis- 
charge, they should be removed by a skillful surgeon. If hard- 
ened wax be the cause of the discharge, it should be softened, 
and removed with suitable instruments, after which a warm in- 
fusion of hydrastis may be applied with the douche. 
Deafness may arise from obstruction, of the eustachian tube, 
affections of the tympanum, obstruction of the external ear, or 
paralysis of the auditory nerves. 
Obstruction of the Eustachian Tube. By refer- 
ence to Fig. 64, it will be seen that the eustachian tube estab- 
lishes a direct communication between the middle ear and the 
cavity of the pharynx. It is obvious that any obstruction in 
this passage will impair the hearing. 
Causes. These are catarrh and chronic inflammation of the 
lining membrane, which becomes thickened and fills the cavity 
of the tube; also enlargement of the tonsils, which, being in 
close proximity to the orifice of this canal, encroach upon the 
passage and necessarily obstruct it. 
Symptoms. Bubbling, cracking sounds in the ear, and a 
DEAFNESS. DISEASES OF THE EAR. 
679 
disagreeable sensation extending from that organ to the throat. 
In some cases, it is difficult to ascertain the character of the 
sound, and whether or not the noises are produced by air in the 
eustachian tube. By the use of the otoscope and Pontzer's 
air-bag, as illustrated by Fig. 216, the aurist can readily hear 
the sounds and deter- 
mine their nature. 
Treatment. If 
the affection be caused 
by nasal catarrh or en- 
largement of the ton- 
sils, the treatment 
should be similar to that 
prescribed for these dis- 
eases. If the thickening 
of the tube be so far 
from the opening that 
the Catarrh Remedy 
cannot be made to reach 
the diseased parts, the 
eustachian catheter may be used. Alteratives should also be 
taken, and the Golden Medical Discovery is advised. 
Affections of the Tympanum are all liable to result 
in thickening or perforation, which may terminate in complete 
destruction of this organ. 
Causes. These affectiojis arc incident to a scrofulous diath- 
esis, and may result from external violence, such as blows or in- 
juries of any kind. The tympanum is liable to be ruptured by 
foreign substances entering the ear, or by concussions of air, as 
in artillery practice. The perforation is more generally due to 
inflammation or ulceration, the structure giving way to allow 
the escape of matter, while thickening is usually occasioned by 
chronic inflammation of the tympanum. 
Symptoms. These are dullness of hearing, and giddiness, 
hissing, puffing, rattling sounds in the ears. By closing the 
mouth and nostrils, and attempting to expel the air, it will find 
exit through the ear, if there is perforation of the tympanum 
and the eustachian tube is unobstructed. 
Treatment. In a strumous diathesis, alteratives should 
Fig. 216. 
Examination of the Internal Ear and Eusta- 
chian Tube, by the Otoscope and Air-bag. 680 
COMMON SENSE MEDICAL ADVISER. 
be employed. Local applications, such as nitrate of silver, 
iodine, hydrastin, myricin, or sanguinarin, may be used under 
the direction of a competent aurist. Cleanliness is absolutely 
necessary. When there is perforation or destruction of the 
tympanum, the hearing may be greatly improved by the inser- 
tion of an artificial one. Thickening of the tympanum may be 
remedied by alteratives and local applications. 
Obstruction of the External Ear. Any obstruc- 
tion of the external ear prevents sounds from coming in contact 
with the tympanum, and thus produces deafness. 
Causes. It may be caused by morbid growths, such as 
tumors or polypi obstructing the passage, or by foreign bodies, 
such as insects, beans, peas, kernels of corn, cherry-stones, 
slate-pencils, or bits of wood, getting into the ear and clos- 
ing the auditory passage. If from any cause, such as narrow- 
ness of the canal or neglect, wax remains in the ear, it may 
harden and completely obstruct the passage, or destroy the 
tympanum. 
Treatment. If the obstruction be due to tumors or 
polypi, a surgical operation is necessary for their removal, after 
which, constitutional treatment may be adopted. Insects may 
generally be removed by putting a few drops of oil or warm 
water into the ear. When this fails, they should be removed 
with a delicate pair of forceps. When beans, corn, peas, and 
similar substances are lodged in the ear, all efforts to withdraw 
them with such improper instruments as pins or knitting needles, 
are useless, and quite liable to force them still further into the 
ear. Sometimes, however, a loop of fine wire is effectual in 
removing them. Again, by dropping oil or glycerine into the 
ear and lying on the affected side, these foreign substances will 
sometimes work their way out. If these methods fail, a skillful 
surgeon should at once be consulted. It is a common mistake to 
manipulate the ear in vain endeavors to remove foreign sub- 
stances, thereby inducing inflammation. If hardened wax ob- 
structs the passage, warm water, applied with our Nasal Douche, 
may be used to soften it, after which it may be removed with 
forceps and a small scoop, and the ear moistened with glycerine. 
After the removal of the hardened wax, if the ear should 
ulcerate or become inflamed, alteratives may be taken and the DISEASES OK THE EAR. 
681 
ear cleansed with Dr. Sage's Catarrh Remedy. A lotion of 
borax or an infusion of golden seal may be used. 
Dryness of the Ear. Sometimes this occasions deaf- 
ness. Little or no wax is secreted and the tympanum is very 
sensitive and easily ruptured. 
Treatment. Alteratives will arouse the functions of the 
glandular system and the Golden Medical Discovery fulfills the 
indication. Equal parts of glycerine and rose-water should be 
applied to moisten the dry and sensitive parts. 
Paralysis of the Auditory Nerves. There is fre- 
quently considerable difficulty in distinguishing this affection 
from organic diseases of the hearing apparatus. Especially is 
this true of physicians who do not make diseases of the ear a 
specialty. This affection is, properly speaking, an impairment 
of the functional powers of the auditory nerves. It is also a 
symptom of cerebro-spinal meningitis and other diseases affect- 
ing the spinal cord. 
Causes. Doubtless it is often hereditary. Again, it may 
be induced by actual mental emotion,'shocks or concussions, 
fainting, anaemia, the use of hair-dyes, lead-poisoning, narcotics 
or quinine, masturbation, excessive sexual excitement, debauch- 
ery, or old age. 
Symptoms. Paralysis of the nerves sometimes occurs 
suddenly, again it is more gradual and follows severe diseases. 
There is little or no pain, but a feeling of uneasiness, dizziness, 
and sometimes nausea and vomiting. There are ringing, buzz- 
ing sounds in the ear, sometimes musical, again harsh and 
unpleasant, which are doubtless due to the inability of the 
auditory nerves to correctly convey impressions to the sen- 
sorium. 
Treatment. When this affection is due to anaemia or 
depression of the nervous forces, tonics and alteratives are indi- 
cated. Give the Golden Medical Discovery, together with phos- 
phate of iron, dogwood, nux vomica, or hydrastis. Hygienic 
regulations should be observed. Electricity and galvanism are 
beneficial, also the injection of ether through the eustachian 
tube. These agents, however, can only be applied by the pro- 
fessional aurist. We have, in some instances, benefited cases of 
long standing by applying a preparation made from ten drops 682 
COMMON SENSE MEDICAL ADVISEE. 
of nux vomica, ten drops of belladonna, and one ounce of gly- 
cerine, two or three drops of which may be put in the ear three 
times a day. In thus briefly referring to the diseasea common 
to the ear, we have indicated only the treatment which may be 
employed by the family, and incidentally suggested the advan- 
tages that may be derived from instruments which we com- 
monly employ. If we should write more extendedly upon these 
maladies, giving the full details of the treatment, or report 
cases which have been cured under our management, it would 
be of little interest to the general reader. We will therefore 
content ourselves with simply saying that we have given par- 
ticular attention to surgical operations connected with the ear, 
and also have the services of a specialist of great experience 
and skill, who is a regular physician of the Faculty at the In- 
valids' Hotel and Surgical Institute, and devotes his time to the 
treatment of these diseases. 
DISEASES OF THE SKIN. 
Few diseases are less understood by the majority of practi- 
tioners of medicine than those which affect the skin. They are 
situated where they may be readily examined by the sight and 
touch, nevertheless many physicians err in distinguishing these 
different affections, for which they are entirely inexcusable. 
Egregious blunders are constantly committed, even by eminent 
practitioners, and the consequence is inappropriate treatment. 
To facilitate acquiring an accurate knowledge of these dis- 
eases, we shall group them together in classes according to their 
relations in general appearances and symptoms. To still further 
aid the reader in recognizing those various affections, we have 
had prepared, at considerable expense, colored representations 
of some twenty different varieties (see Colored Plates I, II, and 
HI), which, although not representing all the minute sub- 
divisions of these affections, show nearly all the more common 
ones, which are embraced within our large experience in treat- 
ing diseases of the skin. Much confusion prevails among 
medical writers in the classification of these affections. We 
shall follow the classification of that eminent dermatologist, 
Sir Erasmus Wilson, which is as well designed as any to sim- 
plify the study of these diseases. Plate I. 
Fig.2 . 
Fig.l, 
Fig. 3 
Fig. 5 
Fig.4. DISEASES OF THE SKIN. 
683 
ECZEMATOUS AFFECTIONS. 
Eczematous affections constitute a very important class of 
skin diseases, the prominent characteristics of which are erup- 
tion and itching. They are progressive in character, passing 
through all the successive stages of development, from mere 
redness of the skin to desquamation, or thickening of the 
cuticle. The affections belonging to this group are eczema, 
psoriasis, pityriasis, lichen, impetigo, gutta rosacea, and scabies, 
or itch. A careful examination of each of these diseases shows 
it to be a modified form of eczema, and, therefore, they demand 
similar treatment. 
Eczema. Tetter, Salt-rheum, Running Scali, or 
Heat Eruption.') The term eczema is used to designate the 
commonest kind of skin diseases. By the Grecians this disease 
was termed psora, and by the Romans, scabies. 
In this disease, the minute blood-vessels are congested causing 
the skin to be more vascular and redder than in its natural state. 
There is an itching or smarting in the affected parts. The skin 
is raised in the form of little pimples or vesicles, and a wratery 
lymph exudes. Sometimes the skin becomes detached and is 
replaced by a crust of hardened lymph, or it may be partially 
reproduced, forming squamce, or scales. There are three stages 
of this disease; the inflammatory, accompanied by swelling, and 
the formation of pimples or vesicles; that of exudation, which 
is succeeded by incrustation; and that of desquamation, in 
which the skin separates in little scales and sometimes becomes 
thickened. Rarely, if ever, does the disease pass through these 
successive stages, but it is modified by its location and the 
temperament of the patient. 
The many varieties of eczema are designated according to 
their predominating characteristics. Thus, when pimples or 
vesicles are abundant, it is termed, respectively, eczema papu- 
losum and eczema vesiculosum, a fine illustration of which may be 
seen in Colored Plate I, Fig. 1. Again, when characterized by 
the eruption of pustules, it is termed eczema pustulosum, a 
representation of which may be seen in Plate I, Fig. 2; and, 
when the prominent feature is the formation of scales, it is 
termed eczema squamosum. Other varieties are also mentioned, 684 
COMMON SENSE MEDICAL ADVISEE. 
such as eczema erythematosum, in which congestion and inflam- 
mation are the predominant features, and eczema mucosum, so 
named from the mucous fluid exuded. Eczema is also desig- 
nated, according to the situation of the eruption, as eczema 
aurium when it affects the ear, and eczema labiorum when it 
affects the lips. 
Eczema may be general or partial; in other words, the erup- 
tion may appear in patches or be distributed over the entire 
surface of the body. The latter form often appears in infants, 
but rarely occurs in adults. Two or more varieties of the 
eruption may be associated, or one form may gradually develop 
into another. 
Eczema Infantile. Infants and young children are peculiarly 
subject to this disorder, and, if the disease be not promptly 
arrested, it will assume the severest form and eventually become 
chronic. The muscles are soft, the eyes are dull and expres- 
sionless, and the little sufferer experiences the most excruciating 
torments. Frequently the whole body is covered with patches 
of eczema, the secretions are arrested, and, where the scales 
fall off, the skin is left dry and feverish. 
Eczema has no symptoms proper, since the morbid feelings 
are due to constitutional debility, of which eczema is the result. 
The signs of eczema are redness, heat, an itching or smarting 
sensation, the formation of pimples or vesicles, exudation, incrus- 
tation, the separation of the cuticle into scales and a gradual 
thickening of the skin. 
Causes. Three forms of constitutional derangement predis- 
pose the system to eczema; nutritive, assimilative, and nervous 
debility. In the former, there is a diminution of nutritive power, 
so that the patient becomes weak and emaciated. Assimilative 
debility is indicated by an impaired digestion and a consequent 
suppression, or an abnormal state of the secretions. Eczema oc- 
casioned by nervous debility, is accompanied by all the morbid 
conditions incident to irritation and exhaustion of the nervous 
system. Eczema may be excited by a violation of the rules of 
hygiene, as undue exposure, or sudden transition from heat to 
cold, deficient or excessive exercise, impure air, or improper cloth- 
ing. Violent mental and physical excitement may predispose the 
system to this disease. It may be due to a strumous diathesis. DISEASES OF THE SKIN. 
685 
Psoriasis. Psoriasis may be defined as a chronic form 
of eczema. The transition of the last stage of eczema into 
psoriasis is indicated by a tendency of the inflamed, thickened, 
scaly skin to become moist when rubbed. This disorder is never 
general except in cases of congenital eczema. It usually 
appears in patches' on various portions of the body. The skin 
is parched and highly discolored. The hairs are harsh and 
scanty. The patient is constantly tormented by an unbearable 
itching sensation and, if the skin is rubbed, it exudes a viscous 
or sticky fluid. These are the characteristic signs of psoriasis. 
It generally appears on the flexures, folds and crooks of the 
joints, the backs and palms of the hands, the arms, and the 
lower portion of the legs. This disease is liable to be con- 
founded with lepra, or lepra alphos, white leprosy. It may be 
distinguished from lepra, first, by its causes, which are irritation 
and disorder of the nutritive, assimilative, and nervous func- 
tions, while leprosy is an hereditary affection having no depen- 
dence upon health; secondly, by its pruritic, or itching charac- 
ter, which in leprosy is absent; thirdly, by its curability, 
whereas leprosy is essentially incurable. 
Pityriasis. (Branny Tetter, or Dandruff.} This affec- 
tion is a mild form of psoriasis, from which it may be distin- 
guished by a more superficial congestion or inflammation of 
the affected parts, the absence of swelling, and the formation of 
smaller scales, having the form and appearance of fine bran. It 
generally appears on the scalp, sometimes extends over the face, 
and, in rare instances, affects the entire surface of the body. 
The signs peculiar to this disease are slight inflammation, itch- 
ing, and the formation of minute scales. With reference to the 
extent of the affection, it is termed pityriasis localis when it is 
confined to the face, scalp, hands, or feet, pityriasis diffusa, 
when the whole body is covered with patches of yellow scales. 
It is termed pityriasis capitis when confined to the head. This 
form of the eruption is liable to degenerate into favus or scald- 
head. 
Pityriasis Bubra is a general or diffused form of the dis- 
ease, and, in its severest stages, is the most interesting and 
remarkable of eczematous affections. Ilebra noted three cases 
of this disorder in his practice. In each instance, the surface 686 
COMMON SENSE MEDICAL ADVISER. 
was of a bright red tint, but if pressed with the finger, would 
assume a tawny yellow color. It was covered with minute 
branny scales, but there was very little itching and no excoria- 
tion or peeling of the cuticle. 
Pityriasis nigra is an affection peculiar to the natives of 
India. The peculiar characteristics of this disease are inflam- 
mation without exudation, the detachment of scales exposing a 
red, glazed surface, absence of itching or burning sensations, 
indigestion, weakness, and emaciation. The prominent feature 
of the disease, however, is the peculiar appearance of the skin. 
At times, it appears as if covered with a layer of imbricated 
scales, as on a fish. Again, the intensely red surface is traversed 
by white parallel layers of cuticle in the form of plate armor. 
Colored plate II, Fig. 7, is an admirable representation of this 
arrangement of the scales. If the hand is passed downward 
over the skin, the surface feels smooth and soft, if upward., it 
feels rough and a large quantity of scales are detached. 
Causes. Pityriasis is caused by nutritive debility, and is 
often associated with erysipelas, rheumatism, and bronchitis. 
Lichen. (Papular Pashi) Liehen is a term used to desig- 
nate an eruption of minute conical pimples, which are more or 
less transparent, red, and occasion great annoyance. The erup- 
tion is attended with a severe, hot, prickling sensation, as if the 
flesh were punctured with hot needles. The pimples contain no 
pus, but if opened, they exude a small quantity of blood and 
serum. This disease more frequently occurs between the ages 
of twelve and fifty, but occasionally appears during dentition, 
when it is called " tooth rash." The lichen pimples are some- 
times dispersed singly over the skin and gradually subside, 
forming a minute scale, corresponding in position with the 
summit of the pimple. When the pimples appear in clusters, 
there is a diffused redness in the affected part, and, if they are 
irritated, minute scabs will be formed. Lichen generally appears 
on the upper portion of the body, as on the face, arms, hands, 
back, and chest. 
The various forms of lichen are designated according to their 
causes, signs, location, manner of distribution, and the form of 
the pimples. 
lichen simplex is the simplest form of this disorder, and is Plate n. 
Fig. 6. 
Fig-7. 
Fig. 9 
Fig. 8 
Fig. 10. 
Fig.11 
Fig.13 
Fig.12 DISEASES OE THE SKIN. 
687 
indicated by the appearance of minute pimples, which, when the 
distribution is general, are arranged like the blotches of measles. 
Sometimes the eruption is local and bounded by the limits of an 
article of clothing, as at the waist. In eight or ten days, the 
cuticle separates into minute scales, which are detached and 
thrown off; but a new crop of pimples soon appears and runs 
the same course, only to be succeeded by another, and thus the 
affection continues for months and even years. 
In lichen dispersus, as the name implies, the pimples are dis- 
tributed over the entire surface of the body. The pimples are 
hard, and occasion an unbearable sensation of itching. This is 
the most common variety of lichen, and not unfrequently is the 
result of scabies, or itch. 
Lichen circumscriptus is an aggravated form of lichen sim- 
plex, and is characterized by a circular arrangement of the 
pimples. The circumference which marks the limit of the 
patch is sharply defined. This form of lichen usually appears 
on the chest, hips, or limbs, and is not unfrequently mistaken for 
ringworm. 
Lichen strophulosus is a variety peculiar to infants. Derma- 
tologists recognize several subdivisions of this species, but the 
general characteristics are the same in all. The pimples are 
much larger than in the other forms of lichen, of a vivid red 
color and the duration of the eruption is limited to two or three 
weeks. 
Lichen urticatus is also an infantile affection and begins with 
inflammation, which is soon succeeded by the eruption. In a 
few days the pimples shrink, the redness disappears, and the skin 
has a peculiar bleached appearance. The eruption is attended 
by an intense itching sensation and, if the skin is ruptured, a 
small quantity of blood is discharged and a black scab formed. 
This variety of lichen is very obstinate and of long duration. 
Lichen tropicus, popularly known as prickly heat, is an 
affection which attacks Europeans in hot climates. It is char- 
acterized by the appearance of numerous red pimples of an 
irregular form, distributed over those portions of the body 
usually covered by the clothing. It is attended with a fierce, 
burning, itching sensation, which is aggravated by warm drinks, 
friction of the clothing, and the heat of the bed. The eruption 688 
COMMON SENSE MEDICAL ADVISER. 
indicates a healthy condition of the system; its suppression or 
retrocession is an unfavorable symptom, denoting some internal 
affection such as deranged nutrition. 
In lichen planus, as the term indicates, the pimples are flat- 
tened. There is no sensation of itching or formation of scabs. 
The pimples are solitary and have an angular base, and the fresh 
pimples formed appear on the spaces between their former 
eruptions. This affection usually attacks some particular region, 
such as the abdomen, hips, or chest. Instances are recorded 
in which it has appeared on the tongue and the lining membrane 
of the mouth. Sometimes it appears in patches, but even then, 
the margin of each pimple can be discerned. 
Lichen pilaris and Hvidus are modifications of lichen sim- 
plex, the former being so named to describe the location of the 
pimples, i. e., surrounding the minute hairs which cover the 
body, especially the lower limbs. The term lichen lividus in- 
dicates the dark purplish hue caused by a torpid circulation 
and the consequent change of arterial into venous blood before 
leaving the pimples. Lichen circinatus is a modified form of 
lichen circumspectus. The pimples in the center of the circu- 
lar patch subside and a ring is formed which gradually increases 
in size. When the rings become broken or extend in regular 
forms, the affection is termed lichen gyratus. 
Causes. Constitutional debility predisposes the system to 
this eruption. The exciting causes are irritation of the skin, 
strumous diathesis, dentition, and any violation of hygienic 
rules. Although lichen is not a fatal disease, yet it tends to 
reduce the vitality of the system. 
Impetigo. (Crusted Tetter or Scali.) Impetigo is a term 
applied to an inflammation of the skin, more severe and ener- 
getic in its character than the preceding affection. We have 
found the predominating characteristics of eczema and lichen 
to be the presence of exudation in the former, and the absence 
of it in the latter. 
Impetigo is marked by the formation of yellow pus, which 
raises the cuticle into pustules. There is a slight swelling, red- 
ness, and the pus gradually dries up, forming an amber-colored 
crust, a representation of which is given in Colored Plate I, 
Fig. 5. It soon falls, leaving the skin slightly inflamed, but DISEASES OF THE SKIN. 
689 
with no scar. The pustules are sometimes surrounded by a 
cluster of smaller ones. 
The varieties of impetigo are designated according to the dis- 
tribution of the pustules. Impetigo figurata, is characterized 
by the appearance of large clusters upon ah inflamed and 
swollen surface, generally upon the face, but sometimes upon 
the scalp. This form is represented in Colored Plate I, Fig. 4. 
In impetigo sparsa the pustules are scattered over the whole 
body. 
The only affections for which impetigo is liable to be mis- 
taken are erythema and variola, from either of which it may be 
distinguished by the superficial inflammation incident to the 
former, while in the latter it is intense. 
Causes. The predisposing cause of impetigo is nutritive 
debility, and the exciting causes are irritation, impure air, and 
errors of diet. 
Gutta Rosacea. (Rosy Drop.} This affection is usually 
described by dermatologists under the name of acne rosacea, 
but Sir E. Wilson has made an admirable distinction between 
these diseases. In his own words, "Gutta Rosacea is the red 
and pimply face of the mid-period of life; a disease of inflam- 
matory congestion and depending upon constitutional causes: 
Acne is a disorder of secretion, of nutrition, of growth, and the 
development of the cutaneous tissues." 
It is a progressive disease, and its successive stages of develop- 
ment mark the several varieties, such as gutta rosacea, ery- 
thematosa, papulosa, tuberculosa, pustulosa, according as they 
are characterized by redness, pimples, tubercles, or pustules. 
This affection is attended with heat, itching, and throbbing. 
The pustules contain serous lymph, which exudes if the cuticle 
is broken, and forms a crust at the summit of the pustule. 
This eruption often appears on the face of persons addicted to 
intemperate habits, and has thus received the name of "rum 
blossom." 
Cause. It is essentially a chronic affection, and depends 
upon constitutional causes. 
Scabies. (Zi'cA.) This disease is characterized by a pro- 
fuse scaliness of the skin, by an eruption of pimples, vesicles, 
and, in rare instances, of pustules. Its prominent feature is an 690 
COMMON SENSE MEDICAL ADVISER. 
intense itching, so aggravating that, in many instances, the skin 
is torn by the nails. Unlike other diseases of the skin, it is 
not due to inflammation, but is caused by animalculae, or little 
parasites, termed by naturalists the acari scabiei. This minute 
animal burrows in the skin, irritating it, and thus producing the 
scaliness and itching. The vesicles are comparatively few in 
number, and contain a transparent fluid. The pustules are only 
present in the severest forms or when the skin is very thin and 
tender. It is then termed pustular itch. 
The parts usually affected are the hands, flexures of the joints, 
and the genital organs. Cases are recorded, in which the scabies 
appeared upon the face and head, but they are of rare occur- 
rence. The activity of the animalculae, is modified by the 
vitality of the victim. In persons of a vigorous constitution, 
they will rapidly multiply, and, in a few days after their first 
appearance, will be found in almost every part of the body. 
The scabies norwegica boeckii, so named because first noticed 
in Norway by the eminent European physician Boeck, is charac- 
terized by the formation of a thick, hard crust, containing vast 
numbers of dead animalculae, their ova and fecal matter. 
Scabies is not confined to any age or sex, but'chiefly affects 
persons of filthy habits. This disease can only be communi- 
cated by contact, or by articles of clothing worn by an infected 
person. There are certain indications which predispose the 
system to infection, such as robust health, a hot climate, and 
uncleanliness. 
Treatment. In all the varieties of eczematous affections, 
except scabies, the treatment of which will hereafter be separ- 
ately considered, remedies employed with a view to the removal 
of the constitutional fault are of the greatest importance. The 
eruption upon the skin is but a local manifestation of a func- 
tional fault, which must be overcome by alterative remedies. 
All the excretory organs should be kept active. To open the 
bowels, administer a full cathartic dose of the Pleasant Pur- 
gative Pellets. Afterwards they should be used in broken 
doses of one or two daily, in order to obtain their peculiar 
alterative effects. The use of the Golden Medical Discovery is 
also necessary to secure its constitutional remedial benefits. As 
a local corrective to relieve the itching and disagreeable dryness DISEASES OF THE SKIN. 
691 
of the skin, add half an ounce of blood-root to half a pint of 
vinegar, steep moderately for two hours, strain and paint the 
affected parts once or twice daily with the liquid. Every night 
before retiring, apply glycerine freely to all the affected parts, 
or dissolve one drachm of oxalic acid in four ounces of glycerine 
and anoint the skin freely. The white precipitate ointment is 
an excellent application in most forms of eczema. Vaseline is 
preferable to lard in making up this preparation. An infusion 
of black walnut leaves applied as a lotion to the affected parts, 
has also proved beneficial. The surface of the body should be 
kept clean by frequently bathing it, and thus stimulating its 
capillary vessels to healthy activity. All varieties of eczema- 
tous affections, except scabies, are only temporarily relieved 
by external applications, while the radical cure depends upon a 
protracted use of alterative medicines. Therefore, we would 
again remind the reader of the necessity of keeping the bowels 
active, and removing all morbid taints of the blood and faults 
of the secretory organs by the use of the Golden Medical 
Discovery. 
The successful treatment of scabies generally requires only 
local applications, for the object to be obtained is simply the 
destruction of the little insects which cause the eruption. Hap- 
pily, we possess an unfailing specific for this purpose. Numer- 
ous agents have been employed with success, but sulphur enjoys 
the greatest reputation for efficacy, and, since it is perfectly 
harmless, we advise it for this class of diseases. Take a quan- 
tity of the flowers of sulphur and mix with sufficient vaseline 
or lard to form an ointment. Having first divested the body of 
clothing, anoint it all over freely, and rub the ointment thor- 
oughly into the pores of the skin while standing before a hot 
fire. The application should be made at night before retiring, 
and the patient should wear woolen night-clothes or lie between 
woolen blankets. In the morning after the application, the 
patient should take a warm bath, washing the skin thoroughly 
and using plenty of soap. This treatment should be repeated 
two or three times to be certain of a perfect eradication of the 
disease. After this course of treatment, the wearing apparel 
well as the bed-clothes should be thoroughly cleansed, as a pre- 
caution against a return of the disease. 692 
COMMON SENSE MEDICAL ADVISER. 
ERYTHEMATOUS AFFECTIONS. 
Many writers have classified the eruptive fevers, such as 
scarlatina and rubeola, with the slight flushing of the face 
known as rash. There is an obvious distinction between them, 
hence, we have treated the former in the chapter on fevers, and 
shall consider in this connection erythematous affections proper. 
The prominent features, eruption, and itching of eczematous 
affections are purely local. Erythematous affections are how- 
ever, remarkable for their symptoms of constitutional disorder. 
Each of these affections is preceded by intense febrile excite- 
ment and nervous debility. In brief, the local manifestations 
are simply signs of general internal disorders; hence, the treat- 
ment should be directed to the restoration of the general health 
of the system. This group includes erythema, erysipelas, and 
urticaria. As erysipelas has been considered with the eruptive 
fevers in a preceding part of this volume it will be omitted 
here. 
Erythema. A vivid and partial flushing of the face is 
produced by a superficial inflammation of the skin, termed 
erythema. There are many stages of this disease, from the 
instantaneous transient flush caused by emotional excitement, to 
the protracted inflammation and swelling of erythema nodosum. 
The affection is characterized by a flush which is at first a 
bright vivid scarlet but which changes to a deep purplish tint. 
There is a slight elevation of the skin, sometimes accompanied 
by itching. In the second stage of development, the flush 
subsides, the skin has a yellowish or bruised appearance, and a 
few minute scales are formed. In erythema papulosum, a fine 
representation of which is given in Colored Plate III, Fig. 18, 
there is an eruption of red pimples or pustules. The prominent 
feature of erythema nodosum, a variety of erythema which 
affects those portions of the skin exposed to the sun, is the 
appearance of a large swelling, usually lasting four or five days 
and attended by constitutional symptoms, such as nausea, fever, 
languor, and despondency. The disease is associated with the 
symptoms incident to a disordered nervous system and some- 
times results fatally, in other cases, it terminates in melancholy 
and mania. Plate m 
Fig. 14, 
Fig.15 
Fig. 16 
Fig.*20 
Fig. 17. 
Fig 18 
Fig 19. DISEASES OE THE SKIN. 
693 
Causes. The predisposing causes of erythema are constitu- 
tional debility, changes of climate and temperature, and irritat- 
ing food or medicines. Locally, it may be produced by friction 
and the heat of the sun. 
Urticaria. {Hives, or Nettle-Rash.} This word is de- 
rived from urtica, signifying a nettle; it is a transient affection 
of the skin, indicated by a fierce, burning, itching sensation and 
a development of pustules, or white blotches of various forms. 
A representation of this eruption is given in Colored Plate III, 
Fig. 17. It is appropriately named nettle-rash, from its resem- 
blance to the irritation caused by the sting of a nettle. There 
is the same sharp, tingling sensation and a similar white wheal 
or blotch, caused by the muscular spasm of the corium, a layer 
of the skin. 
Urticaria may be either acute or chronic. Acute urticaria is 
always preceded by febrile symptoms and the attack is indicated 
by a sudden congestion of the skin, followed by a slight swell- 
ing oi' elevation of the affected part. When the congestion 
subsides, the skin has a bruised appearance. In chronic urti- 
caria, the febrile symptoms are absent. 
Causes. The exciting causes of urticaria are gastric dis- 
order, irritation of the mucous membrane, or a sudden nervous 
shock. The predisposing causes are conceded to be assimilative 
and nervous debility. Hence, it frequently accompanies purpura 
or land scurvy and rheumatism. The skin in some persons is 
so susceptible to irritation that urticaria can be kindled at any 
moment by excitement, as an animated conversation, or by the 
simple pressure of the hand. 
Treatment. The proper treatment for simple erythema 
consists in applying to the affected parts a little lime-water and 
sweet-oil, or glycerine, with the use of warm baths and mild 
cathartics. This is generally sufficient to effect a cure, but 
should it fail, the Golden Medical Discovery, taken three times 
a day for a little while, will overcome the disorder. 
For urticaria, the Pleasant Purgative Pellets should be ad- 
ministered in sufficient doses to move the bowels, the skin 
bathed with warm water rendered alkaline by the addition of 
common baking soda or saleratus, and, if there be any febrile 
symptoms, a little aconite or veratrum may be administered. In COMMON SENSE MEDICAL ADVISER. 
694 
the chronic form of the disease, the diet should be light, unstim- 
ulating, and easily digested, the skin kept clean by frequent 
bathing, and fresh air and outdoor exercises freely taken. The 
somewhat protracted use of the Golden Medical Discovery will 
result in the greatest benefit in this form of disease. 
BULLOUS AFFECTIONS. 
The distinguishing feature of this group of cutaneous affec- 
tions is the formation of bullae, or blebs, which are defined by 
Galen as "eminences of the cuticle, containing a fluid." Of the 
three affections frequently classified under this group, only one, 
pemphigus, properly belongs to the order. Herpes and miliaria 
are vesicular, yet the vesicles often attain the size of a bulla, and 
the remote and immediate causes are the same in all; hence, the 
propriety of this classification to facilitate the suggestion of ap- 
propriate treatment common to all. 
Herpes is an inflammation of the skin in which the eruption 
appears in patches of a circular form. On the second day, 
minute, transparent vesicles appear and gradually develop, be- 
coming opalescent. On the succeeding days, they shrink and 
produce reddish brown scabs, which soon become hard and fall 
off, leaving deep, purplish pits. In adults, these vesicles some- 
times terminate in painful ulcers, caused by an irritation of the 
eruption. By some practitioners, herpes is regarded as a purely 
nervous disorder, from the fact that it is frequently accompanied 
by severe neuralgic pains. These pains are not constant, but 
occasional, and do not appear at any definite stage of the dis- 
ease. Sometimes they precede and accompany the eruption. 
Other instances are recorded in which they remained many 
years after the disease had disappeared. The local and constant 
pain of herpes is a severe burning, prickling, itching sensation, 
which still remains after the scabs fall. 
The three general forms of this disease are herpes zoster, 
phlyctoenodes, and circinatus. 
In herpes zoster, or shingles, the clusters of vesicles encircle 
one-half of the body, frequently at the waist; hence, it has 
received the name of zona cr girdle. The vesicles often develop 
into bullae, and sometimes ulcerate. In herpes phlyctoenodes, the 
vesicles are small, round, and irregularly distributed over the DISEASES OF THE SKIN. 
695 
face, neck, arms, and breast. This form is accompanied by 
febrile symptoms and offensive excretions. 
In herpes circinatus, or ringworm, the vesicles appear in cir- 
cular patches, or rings. This is the mildest form of herpes, and 
is not attended by symptoms of constitutional disorder. The va- 
rious forms of herpes are represented in Colored Plate I, Fig. 3. 
Causes. Herpes is not contagious. It is caused by vicissi- 
tudes of heat and cold, violent emotion, excessive exertion, irri- 
tation of the skin, and a general atony of the system. 
Miliaria is the name given to an eruption of vesicles which 
are larger than those of eczema, but smaller than the bullae of 
herpes. At first, the serum contained in the vesicles is perfectly 
transparent, and reflects the red tint of the underlying skin, 
hence, the name miliaria rubra. But gradually it becomes 
milky and opalescent, hence, the term miliaria alba. The vesi- 
cles of miliaria are generally solitary, and appear on those por- 
tions of the body most liable to become heated and to perspire. 
The eruption is preceded by chills, languor, slight fever, intense 
thirst, a sharp prickling sensation of the skin, and profuse per- 
spiration. The vesicles soon desiccate and are replaced by a 
new crop. 
Causes. Miliaria is almost universally an accompaniment 
of febrile disease, and all disorders in which there occurs a pro- 
fuse perspiration. The causes to which it may be traced in 
each instance are improper diet, impure air, burdensome cloth- 
ing, or strong emotions. 
Pemphigus is a peculiar eruption which appears upon the 
limbs and abdomen. The affected part is of a bright red color, 
and, in a few hours, small vesicles appear containing a trans- 
parent fluid. The vesicles soon develop into bullae, entirely 
covering the inflamed portion. The fluid becomes opaque and 
in a few hours escapes. The patch is then covered with a 
yellow scab. Pemphigus may be either acute or chronic. The 
acute form is subdivided according to the degree of inflam- 
mation, as pemphigus pompholyx in which it is severe, and 
pemphigus benignus, when it is mild. The bullae of pemphigus 
are illustrated in Colored Plate III, Fig. 19. 
Cause. Pemphigus is always caused by a vitiated state of 
the system. 696 
COMMON SENSE MEDICAL ADVISER. 
Rupia is indicated by an eruption as large as a chestnut 
containing a watery fluid, which desiccates into a yellowish- 
brown crust. A fine representation of rupia vesicles in both 
stages of development, is given in Colored Plate II, Fig. 13. 
Treatment. In all forms of herpes, the administration 
of a small dose of the Pleasant Purgative Pellets, with the use 
of the Golden Medical Discovery in teaspoonful doses three 
times a day, will be followed by the happiest results. The skin 
should be kept clean by the use of the sponge-bath, rendered 
alkaline by the addition of common baking soda or saleratus. 
The portion of the body covered by the eruption, should be 
bathed with a solution of sulphate of zinc, one ounce to a pint 
of water. 
Miliaria is generally associated with certain febrile diseases 
and its proper treatment consists in overcoming the febrile and 
other constitutional symptoms which accompany the disease. A 
hot foot-bath and small doses of aconite will suffice to remove 
the fever. If the stomach and bowels are in a vitiated condi- 
tion, as they are apt to be, a mild cathartic may be adminis- 
tered. 
The treatment of pemphigus should consist in frequent alka- 
line sponge-baths, and in covering the affected parts with poul- 
tices of slippery elm, which should be kept moist with vinegar. 
The constitutional treatment should embrace the persistent use 
of the Golden Medical Discovery. When the disease occurs in 
children, it is most generally dependent upon deficient nutrition, 
and special attention should be given to the diet of the patient, 
which should be nutritious. Fresh air and outdoor exercise 
ought not to be neglected. 
The proper treatment of rupia does not differ from that sug- 
gested for pemphigus. 
NERVOUS AFFECTIONS OF THE SKIN. 
In nervous affections of the skin, the natural sensibility may 
be increased, diminished, or perverted. These morbid impres- 
sions arise from the nervous system. Although there are sev- 
eral varieties of these affections, yet, being of minor importance, 
we shall omit their consideration and only speak of one of them 
in this work. DISEASES OF THE SKIN. 
697 
Prurigo affects the entire surface of the body and im- 
parts to the skin a parched, yellowish appearance. It is charac- 
terized by pimples, and an intense burning, itching sensation. 
Rubbing and scratching only irritate the skin, which becomes 
covered with thin black scabs. A good representation of pru- 
rigo may be seen in Colored Plate II, Fig. 6. The itching sen- 
sations are sometimes caused by chilling the body, by violent 
exercise, and heat; allowing the mind to dwell upon the affec- 
tion aggravates it. Prurigo is recognized under two forms; 
vulgaris, which is a mild form, and senilis, which chiefly occurs 
in old age, and is more severe. The external genital parts of 
females are frequently affected with this disease, and it is ag- 
gravated by menstruation and uncleanliness. 
This affection may be due to a vitiated condition of the 
blood, and is common among those who are greatly debilitated. 
It is frequently occasioned by uncleanliness, intemperance, the 
use of unwholesome food, or by an impure atmosphere. 
Treatment. To allay the itching, take glycerine, one 
ounce, add to it one drachm of sulphite of soda, and one ounce 
of rose-water, and apply this to the affected parts. A solution 
made with borax, two drachms, and morphine, five grains, dis- 
solved in six ounces of rose-water, makes an excellent lotion to 
allay the itching. If the disease is severe, it will be necessary 
to correct the vitiated condition of the blood by a protracted 
use of the Golden Medical Discovery, and to aid its effects, give 
one Purgative Pellet every day, not to operate* as a cathartic, 
but only to exert an alterative influence. 
Differences of opinion exist with regard to the proper classi- 
fication of these affections. We shall briefly consider alphos, 
which is sometimes confounded with lepra. 
Alphos, which from its Greek derivation signifies white, is 
characterized by circular, slightly raised white spots. These 
eruptions vary in size from one line to two inches in diameter, 
and may be scattered over the entire surface of the body, al- 
though they most frequently appear upon the elbows and knees. 
Alphos may consist of a single tubercle, or of large clusters 
constituting patches. The scales vary in color and thickness. 
ALPHOUS AFFECTIONS. (Scaly Skin Diseases.) 698 
COMMON SENSE MEDICAL ADVISER. 
In Colored Plate III, Figs. 14 and 15, are fine illustrations of 
alphos. When a person begins to recover from this affection, 
the scales fall off, leaving a smooth, red surface, which gradually 
returns to its natural color. 
This affection may be classified under three forms; alphos cir- 
cinatus, which appears in circular patches upon the limbs and 
fleshy parts of the body; alphos guttatus, which occurs in 
groups; and alphos diffusus, which is scattered over the entire 
body, sometimes occurring upon the face, head, elbows, or knees, 
and again upon the hands. It has no tendency to preserve the 
rounded form of the circinatus variety. 
This disease is more liable to occur in winter than in summer, 
although in some cases the reverse holds true. It may disappear 
for a time, only to return again with renewed vigor. It is not 
regarded as contagious. 
Treatment. Thorough and protracted constitutional 
treatment is required to overcome this disease. The Golden 
Medical Discovery should be taken internally and also applied 
locally to the affected parts. To every other bottle of the Dis- 
covery which is taken, one-half ounce of the iodide of potash 
may be added. One or two of the Pellets taken daily will 
prove a useful adjunct to the Discovery. 
Locally, we have sometimes applied a lotion made of oxide of 
zinc, one-half drachm; benzoic acid, two drachms; morphine, five 
grains; glycerine, two ounces. Tincture of the chloride of 
iron, one drachm in one ounce of glycerine, makes an excel- 
lent local application. Whatever the local treatment may be, 
however, we chiefly rely upon the persistent use of the best 
alteratives. 
AFFECTIONS OF THE HAIR-FOLLICLES. 
Favus {Scald Head) is a disease peculiar to the hair- 
follicles, and is indicated by the formation of small yellow 
crusts, having the form of an inverted cup. The eruption has a 
very offensive odor. When it appears in isolated cups, it is 
termed favus dispersus, but it often occurs in large clusters, as 
represented in Colored Plate II, Fig. 12, and is then termed 
favus confertus. It generally affects the scalp, but sometimes 
extends to the face and neck. DISEASES OF THE SKIN. 
699 
Cause. Favus is caused by nutritive debility, which results 
in a perverted cell-growth. 
Sycosis (Barber's Itch) is an inflammatory affection of 
the hair follicles of the face. The prominent features of the 
disease are redness and the formation of scales. It is peculiar 
to males. It has received various names, according to its pre- 
dominating characteristics, such as sycosis papulosa, tuberculosa, 
and fungulosa. Colored Plate II, Fig. 10, is a tine illustration 
of sycosis as it appears on -the cheek. 
Causes. Various causes induce the appearance of sycosis. 
The general causes are nutritive debility, vicissitudes of heat 
and cold, and an exhausted state of the nervous system. It may 
also result from various chronic diseases, such as syphilis and 
dyspepsia. 
Comedones, or grubs, are due to a retention of the seba- 
ceous matter in the follicles. The sebaceous substance under- 
goes a change, becoming granular and somewhat hardened. It 
gradually extends to the mouth of the follicle, where it comes in 
contact with the atmosphere, and assumes a dark color, as 
represented in Plate II, Fig. 8. This fact, together with its 
peculiar form when squeezed out of the skin, has caused it to be 
termed grub. They often appear in great numbers on the face 
of persons whose circulation is not active, or those who are of a 
particularly nervous temperament. Stimulating baths and fric- 
tion will prove very efficacious in removing these cylinders of 
sebaceous matter. If they are allowed to remain, they will 
produce an irritation of the skin causing an inflammatory dis- 
ease known as acne, or stone-pock. 
Acne or Stone-pock. In the earliest stage of conges- 
tion, acne is characterized by minute hardened elevations of the 
skin, as shown in Plate II, Fig. 9, and is termed acne punctata. 
As the affection progresses, a bright red pimple, Plate II, Fig. 
11, appears, having a conical form, hence the name acne coni- 
formis. The pimple develops into a pustule containing yellow 
"matter," and is then known as acne pustulosa. This is fol- 
lowed by a thickening of the tissues, termed acne tuberculata. 
When the thicker skin is removed, it leaves a deep scar, hence 
the term acne indurata. 
Causes. The remote cause of acne is nutritive debility. COMMON SENSE MEDICAL ADVISER. 
700 
The immediate causes are rapid growth, anaemia, improper 
food, errors of hygiene, mental exhaustion, and various chronic 
diseases. 
Treatment. The treatment of favus or scald-head should 
be commenced by shaving the hair off close to the scalp and 
washing the head thoroughly with soap and water. In some 
severe cases, it may be necessary to soften the incrustations with 
poultices, following these with a free use of soap and water. 
Having thus exposed the scalp and thoroughly divested it of 
incrustations, apply to it the ointment of iodide of sulphur, 
which may be procured at any good drug store. It should 
be gently rubbed over the parts night and morning. The scalp 
ought to be kept perfectly clean throughout the treatment. In- 
stead of the foregoing, the following may be applied: take ox- 
alic acid, ten grains; creosote, twenty drops; water, two ounces; 
mix. Half an hour after using this lotion, anoint the head freely 
with butter or lard. If a few drops only of muriatic acid be 
thoroughly incorporated with the butter or lard, it will add 
greatly to the efficacy of the treatment. But while local appli- 
cations will relieve many skin diseases and mitigate suffering, 
we cannot too strongly impress upon the minds of our readers 
the importance, in this as in all other chronic diseases of the 
skin, of perseverance in the use of the best alteratives. In 
this class of agents, the Golden Medical Discovery stands pre- 
eminent. Its efficacy may be increased in this disease by adding 
to each bottle one ounce of the acetate of potash, and, when 
thus modified, it may be administered in the same manner as if 
no addition had been made to it. 
The Treatment of Sycosis should be essentially the same as 
that suggested for favus, and it will result in prompt relief and 
a permanent cure. 
Treatment of Acne. In the treatment of this, as in that of 
other diseases, we should seek to ascertain the cause, and, when 
possible, remove it. Outdoor exercise, a spare unstimulating 
diet, and perfect cleanliness are of the first importance. The 
affected parts should be bathed with warm water and Castile, 
or, what is better, carbolic soap. Washing the face in cold 
water generally aggravates the disease. As a local application 
to the pustules, we have used with good results the following DISEASES OE THE SKIN. 
701 
lotion: oxide of zinc, twenty grains; morphine, five grains; 
glycerine, two ounces; mix. First having washed the affected 
parts thoroughly, apply this compound. Our chief reliance, 
however, as in the preceding diseases, should be upon the per- 
sistent use of alteratives and mild cathartics or laxatives. 
FURUNCULAR AFFECTIONS. (Boil-like Affections.) 
Under this head properly belong boils, carbuncles, and styes, 
which have been considered in preceding portions of this vol- 
ume and which will therefore be omitted here. With these 
affections, Sir Erasmus Wilson has grouped ecthyma. 
Ecthyma. This is a pustular disease, partaking somewhat 
of the characteristics of boils. The essential points of differ- 
ence between ecthyma and boils are the free suppuration of the 
former throughout the whole pustule, and the presence of a core 
of cellular tissue in the latter. 
A fine illustration of the large pustules of ecthyma is given 
in Colored Plate III, Fig. 20. These pustules may be dispersed 
more or less extensively over the body and limbs, but most 
commonly are confined to the lower extremities. They are 
hardened and inflamed at their base, distended with deep yellow 
pus, and distinctly circumscribed. The pustule commences as a 
small itching, tingling pimple, represented in Colored Plate III, 
at letter H, which increases in size until a little pus is formed on 
its summit, as seen at I. The pustule discharges in about three 
days, and dries up into a yellowish gray or brown scab5 as seen 
at K, if this is detached too soon, a small ulcer is left, which 
dries up into a larger secondary scab, as seen at L. When this 
scab is separated, the ulcerated condition of the skin is brought 
into view, as represented at M. This in turn becomes covered 
with a thick scab, which, when removed or allowed to drop off, 
leaves a pit still deeper than that left by its predecessors. At 
O, in Colored Plate III, Fig. 20, may be seen a representation 
of a cluster of pustules in their crusted state. 
Causes. These pustules arise in consequence of constitu- 
tional debility and perversion of the nutritive functions. 
Treatment. This must be both local and constitutional. 
The local applications should be such as to moderately stimulate 
the skin. Thorough washing of the affected parts night and 702 
COMMON SENSE MEDICAL ADVISEE. 
morning with carbolic or juniper-tar soap and tepid water, fol- 
lowed with a dressing of resin ointment, which may be procured 
of the apothecary, is a suitable local treatment. The proper 
constitutional treatment does not differ from that suggested for 
boils. The prominent indication is to cleanse the blood, which 
is the great fountain of life, and a good digestion, a fair skin, 
buoyant spirits, vital strength and soundness of constitution, 
will all be established. 
These excrescences appear most frequently upon the hands. 
Their causes are very obscure. If cut or punctured, they exude 
a watery or bloody serum which, when applied to the skin, is 
apt to produce others of the same kind. 
They may be removed by applying to them a drop of chromic 
acid, which is much superior to the remedies usually recom- 
mended. 
WARTS. 
CORNS. 
Corns are abnormal protuberances upon the feet or toes, 
caused by the pressure of tightly-fitting boots or shoes. Corns 
may vary much in size, and be either hard or soft. Those 
formed between the foot and the boot are almost always hard ; 
those formed between the toes, caused by the pressure one 
upon another, are nearly always soft. When subjected to only 
the ordinary amount of pressure, they may be painless, and 
occasion no great annoyance. But if from any cause the pres- 
sure is increased, the surrounding parts become actively inflamed 
and give rise to much suffering and lameness. 
Treatment. The first thing to be done is to remove the 
cause. Substitute a more comfortable boot or shoe, or make a 
hole in the leather over the corn to give it room. Do not, how- 
ever, go from one extreme to another, and select a boot so large 
that it will allow the foot to move about and chafe the already 
irritated part. 
Never attempt to extirpate a corn while there is active inflam- 
mation or great soreness in the surrounding tissues. This con- 
dition will usually disappear after the provoking cause is re- 
moved. If it does not, then apply to the part some soothing 
cerate or ointment. Having thus subdued the swelling and 
tenderness, soak the foot in warm water to soften the corn, and INGROWING TOE-NAILS. 
703 
pare it down well with a sharp knife. Then have ready some 
nitro-muriatic acid, and with a camel-hair pencil, or a sharp- 
pointed pine stick, apply a small drop to the corn. The sur- 
rounding parts should be protected with a thin layer of soda or 
saleratus, or with a thin piece of leather, having a hole cut 
through it large enough to expose the corn. After using the 
acid, in the manner described, apply an adhesive plaster over 
the parts, and, on removing it a few hours later, the corn will 
usually come away with it. If it does not, apply a little more 
of the acid from time to time, until it can thus be removed. 
INGROWING TOE-NAILS. (Onyxis.) 
A person who has never experienced the suffering arising 
from an inversion of the toe-nail may think that the subject is 
unworthy of notice in this work, yet this affection sometimes 
assumes formidable proportions, giving rise to great suffering 
and requiring weeks and even months of treatment for its cure. 
This malformation consists of a curling down of the sides of 
the nail of the great toe, which grows into the flesh and gives 
rise to inflammation, swelling and suppuration. The part 
becomes extremely tender and irritable, so that a boot or shoe 
cannot be worn. In extreme cases the toe swells and fungous 
flesh developes to such an extent that all trace of the original 
form of the member is lost, and it becomes a large, unsightly 
tumor. A case is on record, in which it became as large as a 
goose-egg and the whole foot and leg were involved in the 
inflammation. Pus was discharged from several openings and 
the part was so sensitive and tender that the patient could not 
endure the weight of a fly upon it. 
The affection is liable to reach a serious condition similar to 
the one referred to, as the result of the savage and irrational 
treatment to which it is sometimes subjected by unskillful prac- 
titioners, such as slitting the nail and pulling out the offending 
part with the forceps, or cutting it out with the knife, and 
treating the wound with acetate of lead or mercury. The 
result is that the nail grows inverted again, and is worse than it 
was previous to such treatment. 
Treatment. In the incipient stage, relief may be given by 
softening the nail in hot water or weak lye, and then with a 704 
COMMON SENSE MEDICAL ADVISER. 
sharp knife cutting out a narrow furrow in the middle of it, 
running lengthwise from the front edge to the root. This cut 
should not be deep enough to give pain. Nature immediately 
makes an effort to fill the furrow that has been made, the nail 
grows toward the centre and draws away from the edges, thus 
giving the desired relief. 
In advanced and serious cases, like the one referred to, resort 
ought to be had to more extended and efficacious treatment. 
In the first place, the swelling, soreness, and inflammation 
should be reduced so that the part can be handled. To accom- 
plish this, soak the toe an hour or two every day in warm, weak 
lye, and, during the interval, poultice it with slippery elm. It 
may require three or four days to reduce the inflammation. 
Then, wherever the nail is softened and most easily detached, 
press under it with a probe little pledgets of cotton to raise it. 
Also, press pledgets down at the sides and between the nail and 
the flesh which has risen up over it. Dress with some simple 
ointment to keep down the inflammation, bandage, and keep the 
part moist with warm water. Twice a day the part should be 
soaked in weak lye and the toe should be thus dressed. Con- 
tinue to push the pledgets under as the flesh cleaves from the 
nail, and cut away portions of it as fast as they become loose. 
In this manner, the offending portion may be removed, the 
ulcers healed and there will be no return of the trouble. Should 
excessive granulation, or " proud-flesh," occur and prove obsti- 
nate, dust it with powdered blood-root or burnt alum. 
This is a phlegmonous inflammation, which affects either the 
fingers or toes. Its usual location is near the end of the finger, 
where the nerves of sensation are very numerous. The palm of 
the hand is occasionally the seat of its manifestation. The 
nerves of sensation here are not so numerous, but the number 
of tendons and ligaments involved, increases the severity of 
the local disease. 
Medical men recognize three or four varieties of felon, distin- 
guished from one another chiefly by the different tissues in 
which they originate. They may find their starting point 
between the periosteum and the bone, or any where between that 
FELON. (Whitlow.) FELON. 
705 
part and the skin. These nice distinctions, however, are not of 
any service to those for whom this work is written, and are 
therefore omitted with this mere allusion to them. 
Causes. In a majority of cases, the cause is not apparent. 
It may be produced by some local injury, as a strain, a bruise or 
a puncture, especially if the latter is made with a poisoned 
instrument. 
Symptoms. The first sensation experienced is a pricking 
or stinging pain, which might result from a wound inflicted by a 
splinter or briar. • So close is this resemblance that the person is 
frequently deceived, and searches with a needle or penknife for 
the supposed " thorn in the flesh," but fails to find it. Mean- 
while the pain continues at intervals, and sometimes almost con- 
stantly, for two or three days, when the part becomes inflamed, 
begins to swell, and suppuration takes place. This occurs in 
from four to ten days, according to the distance the pus has to 
travel, and the nature of the obstructions it has to overcome, 
before reaching the surface. If it is deeply seated, pieces of the 
bone may be discharged. In very severe cases, a portion of the 
finger or toe may be lost. When it occurs in the palm of the 
hand, it has been known to occasion such extensive destruc- 
tion among the bones and tendons as to permanently impair the 
use of the member. 
Treatment. This deserves special consideration, not only 
on account of the painful nature of the affection, but also 
because of the serious consequences which so often result 
from it. 
In the incipient stage, the further development of a felon is 
easily arrested. Many different applications are recommended 
for this purpose. Success depends very much upon mechanical 
compression, more than upon the medicinal properties of any 
poultice or liniment that can be applied; hence, whatever is used 
as an application should be bound on tightly. 
One of the best preparations that can be used is finely pulver- 
ized salt wet with spirits of turpentine, bound tightly upon the 
affected part and allowed to remain one or two days. It should 
be moistened from time to time with the turpentine, which can 
be done without removing the bandage. 
Poke-root bruised and applied as a poultice is useful in the 706 
COMMON SENSE MEDICAL ADVISER. 
incipient stages. Soaking the finger for a long time in lye or 
lime-water, as strong and as hot as can be borne, is highly rec- 
ommended. However, we place more confidence in the first 
remedy than in any and all others. 
Much suffering will be avoided by lancing it as soon as the 
throbbing pain indicates that pus has formed. When this oper- 
ation is postponed, the pus burrows and extends under the 
strong fibrous sheath of the bone and causes far greater destruc- 
tion of tissue than when it is early released. The point selected 
for this operation should be as near as possible to the place 
where the swelling would naturally break. A common thumb- 
lancet or sharp-pointed bistoury is the instrument usually 
selected to make the incision, and it should be made to cut com- 
pletely down to the bone, in order to lay open the fibrous sheath 
surrounding it, under which the pus usually forms. The parts 
should be laid open by a deep, free incision. Relief from the 
pain will be instantaneous, if the operation is thoroughly per- 
formed. We have frequently produced local anaesthesia of the 
finger to be operated upon, by throwing upon it a spray of 
sulphuric ether or rhigolene. This produces a momentary freez- 
ing, during which the felon may be lanced without pain to the 
patient, after which the parts suddenly thaw and the circulation 
and sensibility are restored. After the operation, the wound 
may be treated with warm poultices ointments, or salves. 
An imaginative poet avers that woman is the link connecting 
heaven and earth. True it is, we see in her the embodiment of 
purity and holiness, heavenly graces, the most perfect combina- 
tion of modesty, devotion, patience, affection, gratitude, and 
loveliness, and the perfection of physical beauty, blending grace 
in outline with delicacy and compactness of texture. We watch 
with deep interest the steady and gradual development from 
girlhood to womanhood, when the whole person improves in 
grace and elegance, the voice becomes more sonorous and mel- 
odious, and the angles and curvatures of her contour become 
more rounded and amplified, preparatory for her high and holy 
trust. ' 
The uterus and ovaries, with which her whole system is in 
WOMAN AND HER DISEASES. MENSTRUATION AND ITS DISORDERS. 
707 
intimate sympathy, render her doubly susceptible to injurious 
influences and a series of diseases from which the other sex is 
entirely exempt. By their sympathetic connections, they wield 
a modifying influence over all the other functions of the system, 
they mould her character, beautify and perfect her form. When, 
therefore, this organism so wondrously endowed, so delicately 
constructed, is attacked by disease, the most efficient aid should 
be extended, in order that the normal equilibrium may be 
regained, her health restored, and that her divine mission, on 
which human welfare so largely depends, may be fulfilled. Its 
importance should elicit the best efforts of the highest type of 
mind, the ripe development of genius, and the most studied 
manipulation of the choicest, rarest, and purest medicinal ele- 
ments in the whole range of nature. 
As the remedial management of those diseases peculiar to 
women has entered very largely into our practice at the Invalids' 
Hotel and Surgical Institute, involving the treatment of thou- 
sands of cases annually, we have been afforded great experience 
in selecting remedies for their cure, enabling us to meet their 
requirements with greatly increased certainty and exactness. 
As the diamond and other most precious stones are hidden away 
in nature's secret recesses, requiring patient toil and diligence to 
unearth them, so by the same unceasing toil, we have secured 
the most precious and valuable remedial agents designed for 
woman's use, from recesses in vegetable life heretofore unex- 
plored, with which to enrich the world of medicine. 
MENSTRUATION AND ITS DISORDERS. 
The function of the ovaries is to furnish ova or germs, and 
the functions of the uterus or womb are to secrete mucus; to 
exude the menses; to secrete the decidua; to contain and nourish 
the foetus and to effect its expulsion. 
Menstruation, or the menses, monthly visitation, catamenia, 
menstrual flow, courses, or periods, usually makes its appearance 
in the female between the twelfth and fifteenth years, at which 
time the reproductive system undergoes remarkable changes. 
A marked characteristic of menstruation is its regular return 
about every twenty-eight days. The menstrual flow usually 
continues from three to six days, and the discharge seems 708 
COMMON SENSE MEDICAL ADVISER. 
to be ordinary blood, which, during its vaginal passage, be- 
comes mixed with mucus, and is thereby deprived of the power 
of coagulation. The quantity exuded varies from two to eight 
ounces, but the amount consistent with the health of one person, 
may be excessive and weakening in another. This function is 
regarded as being regular when its effect upon the system 
is favorable, for whatever organic process directly contributes 
to the health should be considered as normal. It occurs 
at regular intervals for about thirty years, when menstruation 
and the aptitude for conception simultaneously cease. 
The departures from healthy menstruation are numerous. 
The most important of these are amenorrhea, dysmenorrhea, 
and menorrhagia. 
AMENORRHEA. 
The term amenorrhea signifies the absence bf menstruation 
when it should occur. It may be considered under two general 
heads: when it fails to be established at the proper age, and 
when,after having made its appearance, it ceases to return at 
the usual periods. The term retention has been applied to the 
first, and that of suppression to the latter. Menstruation may 
fail to be established in consequence of organic defects, or from 
some abnormal condition of the blood and nervous system. 
Malformation of the Vagina. Retention of the 
menses may result from malformation of the vaginal canal, 
which sometimes terminates before it reaches the womb, being 
simply a short, closed sac. If the uterus and ovaries are per- 
fect, all the feminine characteristics are manifest, and a vaginal 
exploration discloses the nature of the difficulty. If, however, 
the sides of this passage adhere in consequence of previous 
inflammation, they may be carefully separated by a surgical 
operation, and this function restored. 
Absence or Malformation of the Womb. The 
uterus may be deformed or entirely absent, and yet there be an 
inclination, or symptoms indicative of an effort, to establish this 
function. The individual may be delicate in organization, 
graceful in bearing, refined and attractive in all feminine ways, 
and yet this organ may be so defective as to preclude the estab- 
lishment of the menstrual function. Sometimes there is merely AMENORRHEA. 
709 
an occlusion of the mouth of the uterus, the perforation of 
which removes all difficulty. In others, the neck of the womb is 
filled with a morbid growth, or the walls of its canal are adher- 
ent, as the result of inflammation, and may be separated by a 
small silver or ivory probe, and the menses thus liberated. 
Imperforate Hymen. The hymen is a circular, or 
semilunar membrane, which imperfectly closes the outer orifice 
of the vagina in the virgin. When of a semilunar shape, it 
usually occupies the lower or posterior portion of the canal, 
leaving an opening in the upper or anterior portion, varying 
from the size of a quill to that of a thimble, through which the 
menstrual fluid exudes. This membrane is usually ruptured and 
destroyed by the first sexual intercourse, and, hence, its presence 
has been considered evidence of virginity. Its absence, how- 
ever, must not be considered a conclusive evidence of sexual 
intercourse, for, as Dr. Dunglison says, " many circumstances of 
an innocent character may occasion a rupture or destruction of 
this membrane. It is often absent in children soon after birth; 
while it may remain entire after copulation. Hence, the pres- 
ence of the hymen does not absolutely prove virginity; noi' does 
its absence prove incontinence, although its presence would be 
prima facie evidence of continence." 
Sometimes this membrane, when not imperforate, is so thick 
and strong as to render sexual intercourse impossible, and re- 
quires a cutting operation to open the vagina. Several such 
cases have been operated upon at the Invalids' Hotel and 
Surgical Institute. 
It occasionally happens that the hymen is entire, or imperfor- 
ate, at birth. This may not be discovered before puberty. But 
when this period arrives and the menstrual discharge takes place 
into the vagina, the female will suffer from the retention and 
accumulation of this secretion, and ultimately a tumor or a pro- 
trusion of the membrane which closes the vagina will occur, 
giving rise to severe pain and other serious symptoms. The 
retained menstrual fluid, increasing in quantity at every monthly 
period, dilates the womb as well as the vagina, and even the 
Fallopian tubes become distended, presenting at length an ur- 
gent necessity for relief. 
Treatment. This condition admits of relief only by COMMON SENSE MEDICAL ADVISER. 
710 
operative surgery. The operation consists in dividing the 
hymen by a crucial incision, thus allowing the accumulated fluid 
to be discharged, after which the vagina is cleansed by syring- 
ing it with warm water. 
Absence of the Ovaries. Let us suppose the case of a 
young woman who has fully reached the period of puberty 
without having menstruated. All the organs which we have 
described, are manifestly developed, she is healthy, vigorous, 
robust, and able to exercise freely or to engage in laborious oc- 
cupations. But we notice that her voice is not sweetly femi- 
nine, nor is her presence timid, tender, and winning; there is 
wanting that diffident sexual consciousness, which gently woos, 
and, at the same time, modestly repels, and tends to awaken in- 
terest, curiosity, and desire. Considering also that she has never 
manifested any inclination to menstruate, we are irresistibly led 
to the conclusion that the ovaries are wanting; the delicate mus- 
tache upon the upper lip, the undeveloped breasts, the coarse 
features, and her taste for masculine pursuits, all concur in this 
diagnosis. Thus we account for the harshness of the voice, fitted 
for command rather than to express the mellow, persuasive ca- 
dences of love. Such a malformation cannot be remedied. 
Retention and Suppression from morbid 
Conditions of the Rlood. Non-appearance, as well as 
suppression of the menses, may result from an abnormal state of 
the blood. The first condition which demands our attention 
under this head is plethora. In robust, plethoric females the 
menses are sometimes very tardy in their appearance, and every 
month the attempt to establish this function is attended with 
pain in the head, loins, and back, chilliness, nausea, and bloating 
of the abdomen. Sometimes there is intolerance of light or 
sound, and cerebral congestion amounting almost to apoplectic 
symptoms. The pulse is full and strong, the blood abundant 
and surcharged with red corpuscles. Such persons may be 
accustomed to luxurious living, and there is evidently a predis- 
position to abnormal activity of the alimentary functions. 
Treatment. We may briefly suggest that such subjects 
should engage in laborious physical exercise in order to expend 
the surplus of vitality, and should lessen the daily amount of 
food taken, and use that which is light and unstimulating. We AMENORRHEA. 
711 
should also prevent the determination of blood to the head, by- 
keeping it cool and the feet warm, and by increasing the flow of 
blood to the extremities. The volume of the circulation may 
be diminished by acting upon the natural outlets, such as the 
skin, kidneys, and bowels. The proper means and appliances 
for quickening the circulation of the blood are indicated, and 
friction upon the surface, bathing, the daily use of such cathar- 
tics as the Purgative Pellets, and, finally, the use of some gen- 
eral uterine stimulant, such as the Favorite Prescription, will 
generally prove successful in cases of amenorrhea resulting 
from plethora. 
Retention and Suppression from Anaemia. To 
describe the condition of the patient whose blood is low and 
deprived of the richness, warmth, and bloom, it once possessed 
when it kindled admiration and enthusiasm in others, is but to 
give a picture of a numerous class of female invalids. It is sad 
to see beauty fading, vigor waning, and Bright's disease or 
consumption slowly wasting the blood and consuming the vital 
cells, until the spirit can no longer dwell in its earthly abode 
and death claims the skeleton for dust. 
Chronic decline, with its attendant ansemia, may be induced 
by bad habits, destitution, or constitutional depravity. Sickly 
forms, wrecks of health, address our senses on every side. All 
these subjects evidently once had a capital in life, sufficient, if 
properly and carefully husbanded, to comfortably afford them 
vital stamina and length of days. Alas ! they have squandered 
their estate, perchance in idleness and luxurious living, or have 
wasted it in vanities or misdirected ambition. Having become 
bankrupts in health, there is necessarily a failure of the men- 
strual function, and then follows a panic. All the blame of the 
insolvency and general derangement, is unjustly attributed to the 
non-performance of the duties of the uterus. Thus, this organ 
is altogether dependent upon the general health for its func- 
tional ability, yet frequently treatment is instituted to compel 
menstruation, regardless of the condition of the system. Thus 
the enfeebled uterus is wrongfully held responsible for general 
disorder, because it ceases to act, when by acting it would 
further deplete the blood and thus materially contribute to the 
already existing chronic decline. 712 
COMMON SENSE MEDICAL ADVISER. 
No matter what are the causes of this decline, whether they 
are the follies of fashion, the effect of indolence, debility in con- 
sequence of insufficient food, perversion of nutrition by irregular 
habits, lack of exercise, or the taking of drastic medicines, the 
result is anaemia and amenorrhea. 
Treatment. We wTould suggest in such cases a nutritious 
diet, increased exercise, cleanliness, regular habits, hard beds, 
and useful enployment. The diet may be improved by animal 
broths, roasted meats, fresh beef, mutton, chicken, or eggs, and 
the dress should be comfortable, warm, and permit freedom of 
motion. The patient should indulge in amusing exercises, walk- 
ing, swinging, riding, games of croquet, traveling, ringing, per- 
cussing the expanded chest, or engage in healthful calisthenic 
exercises. The hygienic treatment of this form of amenorrhea, 
then, consists in physical culture, regular bathing, and the regu- 
lation of the bowels, if constipated, as suggested in this volume 
under the head of constipation. 
The medical treatment should be directed to enriching the 
blood, improving nutrition, toning up the generative organs, and 
the health of the whole system. This requires the employment 
of uterine and general tonics, and the Favorite Prescription, 
which is sold by druggists, happily combines the properties 
required. It improves digestion, enriches the blood, exercises a 
tonic and gently stimulating effect upon the uterus and ovaries, 
and thus promotes the function of menstruation. It is not a 
strong emmenagogue, but operates slowly, yet surely, and in 
accordance with physiological laws, being eminently congenial 
in its effects upon the female system, and, hence, not liable to do 
harm. There is danger in employing active driving medicines, 
besides, no emmenagogue, however powerful, can establish the 
menstrual function so long as the system is in a debilitated con- 
dition and the blood reduced. The restorative effects of the 
Favorite Prescription should be secured by administering it 
regularly, in from one to two teaspoonful doses, three or four 
times a day, for several weeks, and as the system is built up and 
those symptoms appear which indicate a return of the menses, 
their visitation may be encouraged by the use of hot foot and 
sitz-baths, and free doses of the Compound Extract of Smart- 
weed. But the latter should only be used when symptoms of AMENORRHEA. 
713 
approaching menstruation are manifested. By following out 
this course of treatment, a soft flush will gradually take the 
place of the pallor of the cheeks, the appetite will return and 
the health will be restored. 
Acute Suppression of the Menses may be caused 
by strong emotions, as excessive joy, or by violent excitement of 
the as intense anger, sudden fright, fear, or anxi- 
ety. Suppression may result from sudden exposure to cold, 
immersion of the hands and feet in cold water, drinking cold 
water when the body is heated, sitting on the cold ground or 
damp grass, or from a burn or wound. It is not uncommon for 
women to labor in the heated wash-room, pounding, rubbing, 
and wringing soiled linen, thereby overtaxing the delicate phy- 
sical system. While feeling tired and jaded, all reeking in 
perspiration, they rinse and wring the clothes out of cold water 
and hang them upon the line with arms bare, when the atmos- 
phere is so freezing that the garments stiffen before they finish 
this part of the task. Is it any wonder that acute suppressions 
occur or that inflammations set in? 
The symptoms which naturally follow are a quick pulse, hot 
skin, thirst, fever, headache, and dizziness, and the inflammation 
may locate in the ovaries, uterus, lungs, bowels, brain, or other 
parts. No mattei' what organs are attacked, the menses are 
suppressed. The suppression can generally be attributed to an 
adequate cause, resulting in constitutional disturbance. The 
severity and duration of the attack and the power of the consti- 
tution to resist it, must determine the gravity of the conse- 
quences. 
Treatment. As acute suppression of the menses is due to 
derangement of the circulation of the blood, caused by taking 
cold, by violent excitement of the propensities or excessively 
strong emotional experience, the prominent indication is to se- 
cure its speedy equalization. Give a hot foot, a warm sitz, or 
the spirit vapor-bath and administer full doses of Dr. Pierce's 
Compound Extract of Smart-weed, to produce free prespira- 
tion. Dr. Eberle, a very celebrated medical author, says that 
he used the Extract of Smart-weed in twenty cases of amenor- 
rhea, and affirms, " with no other remedy or mode of treatment 
have I been so successful as with this." Our experience in the 714 
COMMON SENSE MEDICAL ADVISER. 
use of the Extract has been equally satisfactory. Should this 
treatment not establish the function, Dr. Pierce's Favorite Pre- 
scription should be given three times a day until the system is 
invigorated, say for twenty-eight days, when the above course 
may be repeated, and generally with success. Should the case 
be complicated with inflammation of the lungs, brain, or other 
vital organs, manifesting alarming symptoms, the family physi- 
cian should be called. The treatment should be active and 
suited to the indications of each particular case. When the 
disease becomes chronic, the active stage of symptoms having 
passed, and it continues to linger without making the desired 
improvement, all the means suggested for the treatment of 
suppression from anaemia should be employed. Their use will 
be followed by the most gratifying results. It should be borne 
in mind, however, that when we have suggested any treatment 
in this volume, it is generally such as the family may institute 
and apply, and does not, by any means, represent the variety 
or extent of the remedial resources which we employ when con- 
sulted in person or by letter. We refer our readers to only a 
few of the safe and reliable remedies which we have prepared 
and placed within their reach, and give them just such hygienic 
advice as we think will best serve their interests. 
CASES TREATED. 
Case 89,25". Suppression of the Menses. 
World's Dispensary Medical Association: Dear Sirs-lfry 
daughter has been regular ever since she used the medicine, and has 
improved wonderfully, so much so that she thinks she does not need 
anything more. She is able to do all the work for the family now. 
We are obliged to you for your kindness, and hope that you maybe 
blest in your labors for the benefit of the sick. 
L. M. P., Des Moines, Iowa. 
This was a case of amenorrhea of three months' standing, 
the result of malarial poisoning and uterine disease. There was 
great pain in the head and back, with twitching of the muscles 
of the abdomen and limbs, and constipation. 
Case 120,855. Non-appearance of the Menses. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-Since she returned from your Invalids' Hotel, my daughter has 
continued steadily to improve, and she is better at this writing than we 
ever expected her to be. Last year when, after having secured with- 
out regard to expense the best medical advice obtainable, and having 
been told that I "need not flatter myself that my daughter would get DYSMENORRHEA. 
715 
better," I little expected that she would be alive at this date. I was 
advised at that time to allow her whatever she fancied, as " no doctor 
in the world could cure her." 1 was also told at the same time and by 
the same authorities, that she "might live one month or go any day." 
But your treatment has succeeded in establishing her menses, which 
now appear with the utmost regularity, and her other troubles have 
been almost entirely removed. 
We are entirely satisfied with you and your system of treatment. 
Yours truly, 
W. N., Waubaushene, Ont. 
This patient was twenty years of age, and had never men- 
struated. When she came to the Invalids' Hotel and Surgical 
Institute, she was suffering from palpitation of the heart, general 
dropsy, and retention of the urine, and was pale and anaemic. 
She remained in our Institution only one month. 
DYSMENORRHEA. (Painful Menstruation.) 
Dysmenorrhea, from its Greek derivation, signifies a difficult 
monthly flow, and is applied to menstruation when that function 
becomes painful and difficult. Menstruation, like other healthy 
operations of the body, should be painless, but too frequently it 
is the case, that discomfort and distress commence twenty-four 
hours before the flow appears, and continue with increasing 
pain, sickness at the stomach, and vomiting, until the patient 
has to take to the bed. When the discharge does occur, speedy 
relief is sometimes obtained, and the patient suffers no more 
during that menstrual period. With others, the commencement 
of the function is painless, but from six to twenty-four hours 
after, the flow is arrested and the patient then experiences acute 
suffering. Pain may be felt in the back, loins, and down the 
thighs. Sometimes it is of a lancinating, neuralgic kind, at 
others, it is more like colic. Frequently the distress causes 
lassitude, fever, general uneasiness, and a sense of lethargy. 
There are those who suffer more or less during the entire period 
of the flow, while the distress of others terminates at the time 
when a membranous cast is expelled. For convenience of de- 
scription, 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 sensi- 
bility of the ovaries and uterine nerves, which sympathetically 716 
COMMON SENSE MEDICAL ADVISER. 
respond, especially to cutaneous, biliary, and sexual irritation, 
and when ovarian or uterine irritation is communicated to dis- 
tant nerve-centres. In the first class, usually comprising lean 
persons of an encephalic temperament, whatever disorders the 
functions of the general system, instantaneously reflects upon the 
ovaries and uterine nerves, and the menstrual function is corre- 
spondingly disturbed, and, instead of being painless, the flow be- 
comes spasmodic, with paroxysms of distress. In the second 
class, which includes those persons who are plethoric, the ovarian 
and uterine nerves seem to be the origin and centre of irritation, 
which is sometimes so severe as to cause indescribable pain. 
We have known women who affirmed that the severity of labor 
pains was not so great as that from this cause. In one instance, 
the subject suffered thus for eleven years, and then became a 
mother, and has ever asserted that her periodic suffering was far 
more intense than the pain experienced during her confinement. 
These neuralgic pains fly along the tracks of nerves to different 
organs, and capriciously dart from point to point with mar- 
velous celerity, producing nausea, headache, and sometimes 
delirium. 
Ill the congestive variety of dysmenorrhea, the men- 
strual period may be ushered in without pain; after a few 
hours, the pulse becomes stronger and more rapid, the skin 
grows hot and dry, the menses stop, there is uneasiness, rest- 
lessness, and severe pelvic pains. Evidently, the mucous mem- 
branes of the Fallopian tubes and uterus have become con- 
gested, and the pain results from the arrest of the functional 
process, the exudation of blood. 
The causes are plethora, exposure to cold, excitement of 
the emotions or passions, and a morbid condition of the blood. 
Sometimes congestion arises in consequence of a displacement 
of the uterus. 
Ill the inflammatory variety, the mucous membrane 
of the uterus is the seat of irritation. The blood flows into the 
capillary vessels in greater abundance than is natural, and those 
vessels become overdilated and enfeebled and so altered in their 
sensibility as to produce local excitement and pain. It may be 
associated with inflammation of the ovaries, peritoneum, or blad- 
der. Upon the return of the menses, there is a dull, heavy, fixed DYSMENORBHEA. 
717 
pain in the pelvis, which continues until the period is completed. 
There is generally tenderness of the uterus, and also leucorrhea 
during the intervals between each monthly flow. 
In the membranous variety of dysmenorrhea, the 
entire mucous membrane which tines the cavity of the uterus, 
in consequence of some morbid process, is gradually detached 
and expelled at the menstrual period. 
Symptoms. There are steady pains at the commencement 
of the menstrual flow, and they increase in violence and become 
decidedly expulsive. The mouth of the uterus gradually dilates, 
and, finally, the membrane is forced out of the uterus, attended 
with a slight flow of blood and an entire subsidence of the 
pain. 
The treatment, in all the preceding varieties of dysmen- 
orrhea, should consist of measures to determine the circulation 
of the blood to the surface, and increase the perspiratory func- 
tions. Congestion and inflammation of the internal organs are 
generally induced by exposure to cold or from insufficient cloth- 
ing. Sometimes they follow from neglect of the skin, which is 
not kept clean and its excretory function encouraged by warm 
clothing. The domestic treatment at the monthly crisis should 
be commenced by the administration of hot foot, and sitz-baths, 
after which the patient should be warmly covered in bed, and 
bottles of hot water applied to the extremities, back, and thighs. 
Dr. Pierce's Compound Extract of Smart-weed should be given 
in full doses, frequently repeated, to secure its diaphoretic, em- 
menagogue, and anodyne effects, which, for this painful affec- 
tion, are unsurpassed. For the radical cure of this disease, 
whether of a congestive, inflammatory, or neuralgic character, 
the Favorite Prescription, which is sold by druggists, is a pleas- 
ant and specific remedy, which will most speedily correct the ab- 
normal condition that produces the trouble, and thereby obviate 
the necessity of passing this terrible ordeal at every monthly 
period. The patient should take two teaspoonfuls of the medi- 
cine three times a day, and keep up its use in these doses for 
Weeks. Frequently, one month will suffice to cure, but in most 
cases, a longer season is required. In the end, the suffering 
patient will not be disappointed, but will become a new being, 
ready for the enjoyments and duties of life. The bowels should COMMON SENSE MEDICAL ADVISER. 
718 
be kept regular throughout the treatment by the use of the 
Purgative Pellets, if necessary. A hand or sponge-bath should 
be used daily to keep the skin active, and be followed by a brisk 
rubbing of the surface with a rough towel or flesh-brush. A 
wet sheet pack will cleanse the pores of the skin and invite the 
blood into the minute capillaries of the surface, and thus prove 
of great benefit. It should be repeated after an interval of 
seven days, but ought to be omitted if near the approach of 
a menstrual period. The clothing should be warm, to protect 
the system against changes of temperature; especially should 
every precaution be taken to keep the feet dry and warm. The 
patient should walk in the open air, and the distance should be 
regularly lengthened at each succeeding walk. If the course of 
treatment which we have suggested be faithfully pursued, a per- 
manent cure will be effected. 
In the obstructive variety of dysmenorrhea, some 
organic impediment hinders the exit of the menstrual blood 
from the uterus, which, consequently, becomes distended and 
painful. The pain may be constant, but is most acute when the 
uterus makes spasmodic efforts to discharge the menstrual blood. 
If these efforts prove successful, there is an interval of relief. 
Flexion or version of the womb may produce partial occlusion 
of the canal of the neck of the uterus, thus preventing the free 
flow of the menstrual fluid through it. Tumors located in the 
body or neck of the uterus often cause obstruction to the free 
discharge of the menses. Imperforate hymen and vaginal stric- 
ture also sometimes cause obstruction and give rise to painful 
menstruation. As these several abnormal conditions and dis- 
eases will be treated of elsewhere in this volume, we omit their 
further consideration here. 
Partial adhesion of the walls of the neck of the womb may 
result from inflammation of the mucous lining, and prevent a 
free and easy exit of the menstrual fluid. In many cases, the 
contracted and narrowed condition of the canal of the cervix 
seems to be a congenital deformity, for we can trace it to no 
perceptible cause. It is also true that contraction and partial, 
or even complete stricture of the cervix, or neck of the womb, 
often results from the improper application of strong caustics 
to this passage by incompetent and ignorant surgeons. Every DYSMENORRHEA. 
719 
Fig. 217. 
person has observed the contraction of tissue 
caused by a severe burn, which often produces 
such a distortion of the injured part as to dis- 
figure the body for life. A similar result is pro- 
duced when the neck of the womb is burned 
with strong caustics. The tissues are destroyed, 
and, as the parts heal, the deeper-seated tissues 
firmly contract, forming a hard, unyielding cica- 
trix, thus constricting the neck of the womb, 
through which the menses pass into the vagina. 
Treatment. From the nature of this mal- 
ady, it will readily be seen that no medical treat- 
ment can effect a radical cure. We must there- 
fore resort to surgery. In a small proportion of 
cases, the stricture may be cured by repeated 
dilations of the constricted part of the cervical 
canal. This may be accomplished by using a 
very smooth probe which is fine at the point, 
but increases in size, so that its introduction will 
widen and expand the orifice and canal. The 
stricture may be overcome in many cases by 
using different sized probes. In some instances, 
we have employed the uterine dilator, repre- 
sented by Fig. 217. We have also introduced 
sea-tangle and sponge tents into the neck of the 
womb, and allowed them to remain until they 
expanded by absorbing moisture from the sur- 
rounding tissues. The latter process is simple, 
and in many cases preferable. By means of a 
speculum (see Figs. 225 and 226), the mouth of 
the womb is brought into view, and the surgeon 
seizes a small tent with a pair of forceps and 
gently presses it into the neck of the womb, 
where it is left to expand and thus dilate the 
passage. If there seem to be a persistent dis- 
position of the circular fibers of the cervix to 
contract, and thus close the canal, a surgical 
operation will be necessary to insure permanent 
relief. In performing this operation, we use a 
THE UTERINE DI- 
LATOR. 
This instrument is 
introduced into the 
canal of the uterine 
neck with its blades 
closed. By means 
of the thumb-screw 
the blades are then 
separated, as shown 
in this illustration, 
the cervical canal 
being thereby dilat- 
ed to the required 
extent. COMMON SENSE MEDICAL ADVISER. 
720 
cutting instrument called the hysterotome (see Figs. 218 and 
219). By the use of this instrument, the cervical canal is en- 
larged by an incision on either side. The operation is but 
slightly painful, and, in the hands of a competent surgeon, is 
perfectly safe. We have operated in a very large number of 
Fig. 218. 
WHITE'S HYSTEROTOME. 
In operating, this instrument is introduced into the canal of the neck of the 
womb, when a thumb screw in the end of the handle is turned, by which a small 
blade is thrown out from each side, and as the instrument is withdrawn from the 
canal an incision is made on each side, thus enlarging the passage. The upper 
figure illustrates the instrument closed, ready for introduction; the lower one, 
with the blades projected for cutting. 
cases and have never known any alarming or dangerous symp- 
toms to result. After the incision, a small roll of cotton, 
thoroughly saturated with glycerine, is applied to the incised 
parts, and a larger roll is introduced into the vagina. The 
Fig. 219. 
STOHLMAN'S HYSTEROTOME. 
This instrument has two cutting blades which shut past each other, as seen in the 
lower figure, so as not to cut when introduced into the canal of the uterine neck. 
After introduction, the cutting blades are separated, as shown in the upper figure, 
the extent of the incision being regulated by the thumb-screw attached to the 
handles, as represented in the lower figure. 
second day after the operation, the cotton is removed, the edges 
of the wound separated by a uterine sound or probe, and a cot- 
ton tent introduced into the cervix, and allowed to remain, so 
that it will expand and thus open the wound to its full extent. 
This treatment must be thoroughly applied, and repeated every 
alternate day, until the incised parts are perfectly healed. DYSMENORRHEA. 
721 
Case I. Miss B., a teacher, aged twenty-live, applied at the Invalids' 
Hotel and Surgical Institute for relief from dysmenorrhea, from which 
she had suffered at every menstrual period for several years. The pain 
was so severe that she had been accustomed to have large quantities of 
morphine injected into her arm. By this means, she had obtained a 
slight but temporary relief. An examination proved that the cause of 
her disease was a severe stricture of the neck of the womb. We per- 
formed the operation referred to above, and applied the proper after- 
treatment for three weeks, at the end of which time she menstruated 
freely and without suffering the least pain. 
Case II. Mrs. D., aged thirty-eight, had suffered severely from dys- 
menorrhea for seventeen years. There was extreme tenderness over 
the region of the womb, and an intense irritability of the vagina and 
uterus. She had been treated by many physicians, but had obtained 
no relief. We instituted a careful examination, and found that the 
normal discharge of the menses was obstructed by a marked stricture 
of the cervix. We performed the operation indicated, and pursued the 
requisite course of after-treatment. At the end of three weeks, she 
menstruated freely, but experienced considerable pain, owing to the 
excessive morbid sensibility of the uterus, caused by the, long-contin- 
ued obstruction. A course of appropriate constitutional treatment 
rendered the cure complete. 
Case III. Mrs. G., aged twenty-nine, applied to us for relief from 
dysmenorrhea. She had been treated by her family physician, but 
received no relief. She had been married eight years and was sterile, 
yet both her husband and herself desired offspring. We discovered 
the cause of painfid menstruation to be a stricture of the cervix, and 
expressed the opinion that if this abnormal condition were remedied, 
she could conceive and bear children. The treatment above indicated 
was successfully applied, and, in due time, our prediction in regard to 
pregnancy was fulfilled. 
Case 53,873. (New Series, as Numbered in the Record Books 
of the Invalids' Hotel and Surgical Institute.) Dysmen- 
orrhea from Uterine Stricture. 
This case was bad indeed. She suffered terribly from dysmenorrhea, 
the result of a stricture of the neck of the uterus, and her health was 
broken down generally. After her return home, she wrote as follows: 
Dear Doctors-The wonderful and speedy cure accomplished in my 
case, induces me to write for the benefit of females who are suffering 
from nervousness and nearly all the ailments our sex is heir to. I had 
been treated by eight different physicians; some of them ordered 
opiates, nervines, and different kinds of liquors. Only one of them 
seemed to understand my case, and his treatment did me very little 
good, lasting only for a short time. Soon after, I saw your advertise- 
ments in Harper's Weekly, and told my husband I was going to write 
and see what you would say concerning such a case. I also ordered a 
"Common Sense Medical Adviser," and commenced taking the reme- 
dies therein recommended. I improved very much, but was satisfied 
that there had got to be other means employed before I could get well; 
accordingly I went as soon as convenient to Buffalo. I was there only 
four weeks; visited my parents in New York; was absent only four 
months, and,when I returned home, some of my old friends said I 
looked ten years younger than when I left, and I told them I felt 
twenty years younger. My advice to all who are afflicted is, if you 
CASES TREATED. 722 
COMMON SENSE MEDICAL ADVISEE. 
wish to get well, go where they make such diseases a specialty, and do 
not employ one who does not know as much about treating you as you 
do yourself, for through the ignorance of a physician, one is liable to be 
an invalid for life. In a place like the Invalids' Hotel, they employ 
none but the most skillful and experienced physicians and surgeons. I 
hope that many others may be as much benefited as I have been. 
Mrs. C., Boulder City, Colorado. 
Case 66,332. Painful Menstruation with Chronic Inflam- 
mation of the Womb. 
This lady suffered from painful menstruation, with inflammation of 
the womb, for twenty years, in consequence of which her blood had 
become greatly impoverished, and her general health greatly impaired 
Chronic inflammation of the kidneys and bladder was also present, 
together with spinal irritation. During later years, her liver became 
deranged, while her bowels utterly refused to act without artificial 
means. She was under the care, at different times, of thirteen good 
physicians, but the amelioration of her symptoms was never more than 
temporary or partial. Her condition after having taken our special 
home-treatment for three months, is described in the following letter: 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-My health is better now than it has been before for several 
years, thanks to you and your specialists. I have not taken a dose of 
cathartic medicine since last August. My urine is now natural. My 
appetite is good, and every thing I eat agrees with me. I have done 
all my own housework for the last three months. My health is im- 
proved in every way, and I am so thankful to you for it. Since coming 
under your care I have taken no other treatment than yours. The 
little money that I have spent has been positively nothing in com- 
parison to the benefit I have received in return. 
I remain your devoted friend, 
Mrs. A. E. A., 
Norrisonville, Christian Co.. Ill. 
Case 71,944. Painful and Irregular Menstruation. 
We prescribed a course of treatment for this lady which was fol- 
lowed uninterruptedly for three months. Eight months afterwards 
she wrote as follows: 
World's Dispensary Medical Association: Dear Sirs-For years 
I had been a great sufferer from general declining health, female weak- 
ness, and heart disease, and had despaired of ever getting well. Physi- 
cians afforded me only temporary relief. It was not until I commenced 
doctoring with Dr. R. V. Pierce that I experienced any decided bene- 
fit. My health has gradually improved until now I feel like a new 
being. Language fails to express my gratitude for this cure, which is 
due wholly to your life-saving and life-giving medicine. 
Mrs. B., West Line, Cass Co., Mo. 
Case 96,801. Painful, Profuse, and Frequent Menstruation, 
with Prolapsus and Ulceration. a 
World's Dispensary Medical Association: Gentlemen-The re- 
sult of the first course of medicine has been so satisfactory that I was in 
doubt as to more being needed. Some two weeks have passed since the 
medicine was taken and I am able to attend to my household duties 
without suffering any pain. The monthly periods are thoroughly reg- 
ulated. The pain is less than formerly and the time of continuance 
shorter. I have regained my usual amount of flesh and am feeling 
very well. Mrs. E. E. W., Louisville, Ky. MENORRHAGIA. 
723 
We might, from the records of the Invalids' Hotel and Surgi- 
cal Institute, add to the list of cases almost indefinitely, but we 
have cited enough to illustrate the treatment of such cases. 
MENORRHAGIA. (Profuse Menstruation.) 
The word Menorrhagia, which is of Greek derivation, liter- 
ally means monthly breaking away, and is employed to desig- 
nate profuse menstruation. This disorder must not be con- 
founded with those hemorrhages which are not periodical, and 
which are due to other causes. The term menorrhagia is 
restricted to an immoderate monthly flow. The menstrual flow 
may occur too often, continue too long, or be too profuse. It 
induces a feeble pulse, cold extremities, weak respiration, general 
debility, and may occur in opposite states of the system, i. e., in 
women who have a plethoric and robust habit, or in those of 
flaccid muscles and bloodless features. When the menstrual dis- 
charge is natural, it is so gradual that by mixing with the vag- 
inal secretions it is prevented from coagulating, while in this 
disease, clots are often formed. 
Symptoms. In women of a plethoric habit, it is ushered 
in by itching and heat in the vagina, pain and a feeling of 
weight in the loins and lower part of the abdomen, and, at 
times, the breasts become hot and painful. There is consider- 
able thirst, headache, and giddiness. At last, the blood appears 
and flows profusely, and all the violent symptoms at once sub- 
side. The rest of the period is marked by an inordinate flow, 
leaving the system weak from the loss of blood. It oftener 
occurs, however, in persons who are naturally weak and delicate, 
in which case the periods are more frequent and continue longer 
and after a time they are renewed by any bodily exertion or 
mental emotion, so that a constant drain exists. If the flow of 
blood is not continuous, leucorrhea intervenes. The patient 
gradually loses strength and becomes languid, her face is pale 
and usually bloated, livid circles appear around the eyes, the 
appetite is impaired, the bowels are constipated, and the feet and 
ankles swollen. Lack of blood in the brain is indicated by 
headache, ringing in the ears, and dizziness. The patient is 
nervous and irritable, being disturbed by the slightest noise, and 
the heart palpitates after the least exertion. 724 
COMMON SENSE MEDICAL ADVISER. 
Causes. The first form is caused by eating too much rich and 
highly-seasoned food, drinking wine, porter, ale, or beer, want of 
exercise, in brief, whatever induces plethora; the second results 
from an insufficient or poor diet, leucorrhea, frequent abortions, 
want of ventilation, inherent feebleness, and whatever depresses 
the vital powers. Either form may be due to syphilitic taints, 
excessive sexual indulgence, accidents of pregnancy, or organic 
diseases of the womb. The morbid affections of the womb 
most likely to induce menorrhagia, are granular ulceration of its 
mouth and neck, fungous degeneration of its lining membrane, 
and tumors within that organ. As these subjects will be sev- 
erally considered hereafter, we shall here dismiss them with 
this brief notice. 
Profuse menstruation is very prone to occur in young women 
of a lymphatic temperament, whose organs are sleazy in texture. 
Treatment. To control the excessive flow, the patient 
should remain in her bed, and assume the recumbent position 
until the period is passed. If circumstances prevent strict com- 
pliance with this rule, it should be observed as nearly as possible. 
Warmth should be applied to the feet, and cold cloths, which 
ought to be removed as soon as they become warm by the heat 
of the body, should be repeatedly placed upon the back and 
abdomen. A strong tea made from cinnamon bark, or witch- 
hazel leaves or bark, taken freely, will prove very efficacious in 
checking the flow. The fluid extract of ergot, in doses of from 
half a teaspoonful to a teaspoonful, in a little water or cinna- 
mon tea, is one of the most effectual remedies in this affection. 
Another valuable remedy for arresting menorrhagia is an in- 
fusion of Canada fleabane; or the oil of this plant may be 
administered in doses of from five to ten drops on sugar. 
Gallic acid is also a good styptic to employ in these cases. If 
there is febrile excitement, a hard pulse, frequent and throb- 
bing, and if there is headache, thirst, parched lips, hot and dry 
skin, as is sometimes the case, then menorrhagia is due to an 
augmented action of the heart and arteries, and the indication 
of treatment is to diminish vascular action. This may be tem- 
porarily accomplished by the use of veratrum viride, which 
should be continued until the flow is sufficiently diminished. 
The means already suggested will generally prove effective MENORRHAGIA. 
725 
in controlling the inordinate flow at the time. Treatment that 
will produce permanent relief should then be adopted. The 
condition of the skin, kidneys, and bowels, requires attention 
for noxious elements should not be retained in the system. To 
give tone to the weakened pelvic organs we know of nothing 
more specific in its effects than Dr. Pierce's Favorite Prescrip- 
tion, which is sold by druggists. It should be taken continu- 
ously for weeks, in order to fully correct the extremely 
weakened condition of that organ. It also aids nutrition, and 
thus tones up the general system, so that in the form of profuse 
menstruation, resulting from debility, the patient is strength- 
ened, her blood enriched, and her nervousness quieted, which 
constitutes the necessary treatment to make the cure permanent. 
As women approach the critical age, and menstruation ceases, 
if they are antemic, their condition is pitiable. This period is 
popularly denominated the turn of life. Under favorable cir- 
cumstances, the vitality is decidedly enhanced, and the decline 
of this function is attended with a revival of the bodily powers. 
But when this crisis has been preceded by excessive labor, when 
intemperance or excesses of any kind have deranged the bodily 
functions and perverted nutrition, when the mind has been long 
and deeply depressed, or when the insidious progress of disease 
of the heart, liver, or other important organs, occurs in conse- 
quence of irregularities of living, then there is danger of con- 
gestion of the uterus and a protracted and profuse menstrual 
flow, which favors a decline. 
The treatment of this form of menorrhagia does not differ 
from that already suggested. The diet should be light and 
nourishing, and daily exercise, such as walking, riding, change 
of air and scenery, all will contribute to restoration. Especial 
attention should be directed to the condition of the bowels and 
liver. If the latter be deranged, Dr. Pierce's Golden Medical 
Discovery will be a most efficacious remedy. When there is a 
diminution of vital force, resulting in impaired nutrition and 
disorders of the blood, an alterative is required which will 
insensibly and gradually restore activity by removing the causes 
of derangement. Impairment of nutrition is very frequently 
associated with functional or organic disease of the liver, and 
curative measures consist of the use of alteratives, friction 726 
COMMON SENSE MEDICAL ADVISEE. 
baths, exercise, nutritive diet, and diversion of the mind. 
Whenever innutrition depends upon depravation of the blood or 
torpor of any of the secretory organs, the Golden Medical Dis- 
covery will prove to be an invaluable remedial agent, for it is 
an alterative and at the same time a blood restorative. The 
Favorite Prescription regulates the menstrual function by ton- 
ing up the tissues of the uterus and restraining the escape of 
the menses from the orifices of the blood-vessels. While the 
diet should be nourishing, consisting of wild game, mutton, 
chicken, and wine, the patient ought not to debilitate the 
stomach by the use of strong tea or coffee. The circulation of 
the blood should be quickened by riding, walking, exposure to 
sunlight, and fresh air. The patient ought to engage in some 
light occupation, in which the mind will be constantly as well as 
agreeably employed, but not overtaxed. By pursuing this 
course of treatment, invalids suffering from menorrhagia may 
be permanently restored to health. 
CASES TREATED. 
Case 70,613. Excessive Flowing, with General Uterine De- 
rangement. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-After using your medicines two weeks, I began steadily to im- 
prove, and the frequent and excessive flowing that has so long deranged 
my health has, I am happy to inform you. now ceased entirely. 
Very respectfully, 
Mrs. H. M. F., Allegan, Mich. 
Case 74,069. Excessive Flowing, with Dyspepsia. 
World's Dispensary Medical Association: Gentlemen-I deem 
it my duty to express to you my deep and heartfelt gratitude for hav- 
ing been the means, under Providence, of restoring me to health. One 
year ago I was wholly unable to walk or talk. I was helpless. My 
troubles were all caused by excessive flowing at the menstrual periods 
and by dyspepsia, as the result of which my entire system broke down. 
I had relinquished the last hope of ever being restored to health, when 
I first consulted you. Now every thing is changed. My improvement 
has been wonderful, and I go about doing my own work and taking 
great comfort in every way. I forward you this testimonial cheerfully 
and unsolicited, together with my most heart-felt thanks for the great 
interest you have manifested in my case. May God ever remember and 
bless you. Yours with gratitude that will die not, 
A. V. O., Ridgeway, Ont. 
Case 83,979. Menorrhagia, with Prolapsus, Leucorrhea, 
Palpitation, Headache, Constipation, Piles, and Extreme 
Nervousness. 
World's Dispensary Medical Association: Gentlemen -I can 
say that I feel entirely cured except a few distresses, and I think by the MENORRHAGIA. 
727 
time I have used all your medicine I will feel entirely cured, for which 
I extend my sincere thanks for the kindness and benefit I have re- 
ceived from you. I also inclose within the remittance fee for medi- 
cine received. Miss C. R. A., Montrose, Mo. 
Case 84,041. Menorrhagia, Menses every three weeks, 
Pruritus Numbness, and Sleeplessness. 
World's Dispensary Medical Association: Dear Sirs-I cannot 
express my many thanks for the benefit I have received from your 
medicine in one month's treatment. I have gained eleven pounds since 
I took your medicine, have gained in strength, and generally have a 
good appetite. The troubles have disappeared. 
Mrs. C. B., Kincardine, Ont. 
Case 84,490. Excessive Flowing, with Impoverishment of 
the Blood and General Debility. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-Now that I have used your medicines, I suppose you would 
like to hear of any improvement received. I believe that in my case a 
perfect cure has been effected, at least I feel like a different person 
from what I was before commencing your treatment. Everybody 
notices my improved appearance, and I take great pleasure in explain- 
ing to them the cause. Several of my afflicted lady friends have already 
expressed to me their intention of applying to you for relief. I feel 
like thanking you a thousand times for what you have done for me, 
and for the uniform kindness which you have extended me through- 
out. Wishing you great success, I remain 
Very truly yours, 
Mrs. G. S. O., 
Edison, Furnas Co., Nebraska. 
Case 92,530. Profuse Menstruation, Sterility, Leucorrhea, 
and Prolapsus. 
World's Dispensary Medical Association: Gentlemen - The 
short period I have been under your treatment has improved me won- 
derfully. Your medicine is doing every thing for me that I wished, I 
am gaining in strength every day. I have more color in my face, and 
do not sutler with cold feet and hands. The cure is a deep satisfaction. 
Mrs. E. P., New York City. 
Case 92,567. Excessive Flowing, with General Uterine De- 
rangement. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-Your medicines have benefited me greatly. When I com- 
menced upon your special treatment, I was in bed most of the time; 
now I am able to be around and do most of the housework. I return 
to you my hearty thanks for the result of your skill. 
Very truly yours. 
Mrs. J. J. R., 
Shiloh, Callaway Co., Kentucky. 
Case 93,075. Menorrhagia, with General Uterine Derange- 
ment. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-I took your medicine and treatment as directed, and derived 
the greatest benefit therefrom; they did me a world of good. I shall 
always speak a good word for you and your system of treatment. 
I remain, yours respectfully, 
Mrs. F. A. H., Cape Elizabeth, Maine. 728 
COMMON SENSE MEDICAL ADVISEE. 
THE TURN OF LIFE. (Cessation of the Menses.) 
Menstruation commonly occurs at regular monthly intervals, 
during a period of about thirty years. The time for its cessa- 
tion depends somewhat upon the date of its first appearance. 
In the temperate zones, it commences at about the fifteenth 
year, and, consequently, should terminate at the forty-fifth 
year. Instances are common, however, in which it has been 
prolonged until the fiftieth and even to the fifty-fifth year. 
In warm climates, it commences and terminates at an earlier 
age. 
As women approach the critical period of life, if the general 
health and habits be good, the discharge may gradually diminish 
and, at length, totally disappear, without producing any particu- 
lar inconvenience, but this seldom happens. More frequently, 
the discharge is entirely absent for six or seven weeks, and 
when it does return, it is more copious than usual. In some 
cases, the flow is not only too profuse, but too frequent. Many 
months may elapse before the menses return, and, even then, 
they are apt to be very pale and deficient in quantity. 
The fluctuations of this function occasion irregularities and 
disturbances of the general health. When the flow of blood is 
diverted from the uterus, it is liable to be directed to the head 
or some other part of the body. In fact, there appears to be 
constitutional agitation, and disorders of all the organs. Per- 
haps one reason for calling this a critical period is, that if there 
is a morbid tendency in the system, a disposition to develop 
tumors of the breast or uterus, these are very liable to make 
rapid progress at this time, since they are not relieved by the 
customary local exudation of blood. It is a time favorable to 
the awakening of latent disorder and morbid growths, for, at 
the decline of the menstrual function, the uterus is not so capa- 
ble of resisting vitiating influences. 
There is greater liability to irritation of the bladder and rec- 
tum, and the menstrual flow may be superseded by a white, 
acrid discharge, caused by an inflammation of the mucous mem- 
brane of the vagina. Even if the system be not enfeebled by 
excessive losses of blood, debility may result from a continued 
irritation of the uterine organs, and cause the morbid discharge. THE TURN OF LIFE. 
729 
The nervous system sympathetically responds, becoming exceed- 
ingly irritable, and thus implicating in this derangement every 
bodily organ. In some constitutions, the change of any habit 
is almost impossible, particularly if it is improperly acquired, or 
detrimental to health; and so we have sometimes thought re- 
specting this function, that the more it has been abused and 
perverted during the time of its natural activity, the greater is 
the disturbance occasioned when it ceases. 
Treatment. There should be regularity in all the habits 
of life. Women are too apt to approach this important period 
without due care and consideration. When the physical system 
is about to suspend a function, it is folly to endeavor to per- 
form the labor or assume the responsibilities which were per- 
missible when the constitution was more robust. 
How the duties of each day and hour weigh upon the ener- 
gies of the mother ! What intense solicitude and yearning she 
experiences ! How unselfish is that mother who each day works 
steadily and faithfully for others, and who is conscious of the 
hidden dangers that lurk around her pathway! With confiding 
faith and love, she commends the interests of her children to 
Him who doeth all things well. She anticipates the wants of 
her family and strives to supply the desired comforts, thus wast- 
ing her strength in the labors prompted by her loving nature. 
Would it not be a greater comfort to those children to have 
the counsel of their dear mother in later years, than to have 
the bitter reflection that she sacrificed her health and life for 
their gratification? 
Unconsciously, perhaps, but none the less certainly, do women 
enter upon this period regardless of the care they ought to 
bestow upon themselves. Without sufficient forethought or an 
understanding of the functional changes taking place, they over- 
tax their strength, until, by continuous exertion, they break down 
under those labors which, to persons of their age, are excessive 
and injurious. Is it strange, when woman has thus exhausted 
her energies, when her body trembles with fatigue and her mind 
is agitated with responsibilities, that the menses capriciously 
return, or the uterus is unable to withstand congestion, and 
capillary hemorrhage becomes excessive? If the physical sys- 
tem had not been thus exhausted, it would have exercised its 730 
COMMON SENSE MEDICAL ADVISER. 
powers for the conservation of health and strength. It is better 
to be forewarned of the ills to which we are liable, and fortify 
ourselves against them, rather than squander the strength 
intended for personal preservation. Let every woman, and 
especially every mother, consider her situation and properly pre- 
pare for that grand climacteric, which so materially influences 
her future health and life. 
The general health should be carefully preserved by those 
exercises which will equalize the circulation of the blood, and 
the regular action of the bowels should be promoted by the use 
of those articles of diet which contribute to this end. Relieve 
the mind of responsibility, keep the skin clean, and enrich the 
blood with tonics and alteratives. For the latter purpose, use Dr. 
Pierce's Favorite Prescription and Golden Medical Discovery. 
If these remedies fail, seek professional advice. A careful regu- 
lation of the habits, strict attention to the requirements of the 
system, and the use of tonic medicines, will very frequently 
render the employment of a physician entirely unnecessary. 
LEUCORRHEA. (Whites.) 
Leucorrhea is the symptomatic manifestation of some uterine 
or vaginal affection, vulgarly called " whites." We say symp- 
tomatic, for the white or yellowish discharge, which we term 
leucorrhea, is not a disease, but a symptom of some uterine 
or vaginal disorder. We call it a white discharge to distin- 
guish it from the menses and uterine hemorrhages. It varies, 
however, in color and consistency from a white, glairy mucus 
to a yellow or greenish, purulent, fetid matter. Sometimes it 
has a curdled appearance, at others, it is of the consistency of 
cream. Leucorrhea is the most common symptom of uterine 
derangement and there are few females who are not affected by 
it at some period of life. It may originate either in the vagina 
or uterus, and it is accordingly termed either vaginal or uterine 
leucorrhea. The nature of leucorrhea is analogous to that of 
nasal catarrh. In a healthy state, the lining membrane of the 
genital organs secretes sufficient mucus to moisten them; but, 
if the mucous membrane is temporarily congested or inflamed, 
the secretion becomes profuse, irritating, and offensive. Vaginal 
and uterine leucorrhea are essentially different in character, the LEUCORRHEA. 
731 
former being an acid, and the latter an alkaline secretion, and, 
while the first is a creamy, purulent fluid, the latter is thick and 
ropy, like the white of an egg. In fact, the latter discharge is 
rich in albuminous matter and blood-corpuscles, hence, its great 
debilitating effect upon the system, and, if not promptly ar- 
rested, it is likely to produce vaginitis, pruritus vulvce, or 
vulvitis. ' 
Vaginitis is indicated by intense inflammation of the 
mucous membrane of the vagina. When this affection is 
present the patient experiences a sense of burning heat, aching 
and weight in the region of the vagina, violent and throbbing 
pains in the pelvis, and the discharge is profuse and very offen- 
sive. There is also a frequent desire to urinate, and the pas- 
sage of the urine causes a sensation of scalding. 
Pruritus Vtllvae. The discharge irritates the nerves of 
the external genital parts, thus producing an almost unendur- 
able itching. Scratching or rubbing the parts only aggravates 
the affection. The patient is tormented night and day, is de- 
prived of sleep, and naturally becomes despondent. Pruritus 
vulvas, in its severest forms, is often developed when the dis- 
charge is scarcely noticeable. It is the most common result or 
accompaniment of leucorrhea. 
Vulvitis. This term indicates an inflammation of the lin- 
ing membrane of the external genital parts. Sometimes the 
inflammation extends to the deeper tissues, causing great pain, 
and even suppuration, resulting in the formation of an abscess. 
The attack is indicated by redness, swelling, and a feverish 
state of the affected parts, which is quickly followed by a pro- 
fuse flow of yellow pus, and, in some instances, small ulcers are 
formed on the affected parts. 
Symptoms. The sufferer from leucorrhea becomes pale 
and emaciated, the eyes dull and heavy, the functions of the 
skin, stomach and bowels, become deranged, more or less pain in 
the head is experienced, sometimes accompanied with dizziness, 
palpitation is common, and, as the disease progresses, the blood 
becomes impoverished, the feet and ankles are swollen, the 
mind is apprehensive and melancholy, and very frequently the 
function of generation is injured, resulting in complete sterility. 
Exercise produces pain in the small of the back and the lower 732 
COMMON SENSE MEDICAL ADVISER. 
portion of the spine, and, owing to a relaxation of the vaginal 
walls, the womb falls far below its natural position, or turns 
in various directions, according to the manner in which the 
weight above rests upon it. Ulcers are apt to appear upon the 
mouth of the womb, the matter from which tinges the dis- 
charge and stains the linen. Hysteria is often an attendant of 
this disease. ' 
Causes. The immediate cause of leucorrhea is either con- 
gestion or inflammation of the mucous membrane of the vagina 
or womb, or both. The exciting causes are numerous. Among 
others, deranged menstruation, prolonged nursing of children, 
pregnancy, abortions, excessive indulgence in sexual intercourse, 
uncleanliness, piles, uterine ulcers, and displacement of the 
womb, are the most common. In brief, it usually accompanies 
every uterine disorder which vitiates and reduces the system. 
During childhood, particularly in scrofulous children, discharges 
from the vagina are not unfrequent, owing to worms or other 
intestinal irritation. 
Among the organic causes of leucorrhea, are ulceration of the 
mouth or neck of the womb and tumors. These will be consid- 
ered hereafter. 
Treatment. We have dwelt upon leucorrhea because of 
its prevalence, and in order to exhibit the various forms it may 
assume. These reasons long ago prompted us to investigate it; 
and, ascertaining the derangement to consist in a relaxation of 
the walls of the vagina, attendant upon depressed vitality, for 
many years we experimented with various medicines to find 
those that would exercise specific properties in restoring the 
tissues involved to a natural condition, thereby arresting the 
abnormal discharge. Our efforts in that direction have been 
very successful, and our expectations more than realized. The 
treatment which we shall recommend is rational, based upon 
the pathological conditions of the disease, and has been attended 
with the greatest success. 
It embraces the use of those general restoratives and specific 
uterine tonics, so harmoniously combined in Dr. Pierce's Fa- 
vorite Prescription, a remedy which has achieved unparalleled 
success in the cure of this affection and won the highest praise 
from thousands of grateful women. In many cases, it is well LEUCORRHEA. 
733 
to accompany its use with alterative treatment, for which the 
Golden Medical Discovery will be found especially effective. 
It is an absurd practice to arrest the discharge with astringent 
injections alone. The weak and lax walls of the vagina, as 
well as the other tissues of the system, require strength, and 
this can be gained only by the use of general and special tonics. 
Appropriate injections as auxiliary treatment will very much 
assist in the cure. The Favorite Prescription is a special tonic 
for the affected parts, and the Golden Medical Discovery is the 
best general alterative of which we have any knowledge. They 
may be taken in alternate doses every day. If the patient is 
very pale and anaemic, one drachm of the carbonate, or two 
drachms of the citrate or pyrophosphate of iron, may be advan- 
tageously added to each bottle of the Favorite Prescription. 
If the carbonate is employed, as it is insoluble, the bottle 
should be well shaken every time before using. The functions 
of the skin should be kept active by frequent baths, and the 
patient, if able, should walk or ride in the open air, and freely 
expose herself to the sunshine. If the invalid is too weak to 
exercise much, she should go out in warm weather and sit in 
the open air. Sunshine is no less important in maintaining 
animal, than in supporting vegetable growth and health. The 
human being, like the plant, sickens and grows pale, weak, and 
tender, if secluded from the sunlight. The apartments occu- 
pied should be thoroughly ventilated. Many women are sickly 
and feeble because they live in badly ventilated rooms. 
We cannot too strongly urge in this, as in all other chronic 
diseases peculiar to women, that the bowels be kept regular. 
Frequent, but small doses of the Pleasant Purgative Pellets will 
prove most beneficial. If the vaginal passage is tender and 
irritable, an infusion, or tea of slippery-elm bark is very sooth- 
ing, and may be used freely with a vaginal syringe. Whatever 
injection is employed, should be preceded by the free use of 
Castile soap and warm water, to thoroughly cleanse the parts. 
One part of glycerine to six parts of water is a soothing lotion 
when there is much tenderness, heat, and pain in the vagina. If 
there be no great tenderness in the vagina, or if the acute, inflam- 
matory symptoms have yielded to the lotions already suggested, 
then a mere tonic and astringent injection should be employed. 734 
COMMON SENSE MEDICAL ADVISEE. 
An infusion of Peruvian bark, witch-hazel leaves or bark, or 
either of these combined with golden-seal root, make a very- 
valuable lotion to be employed. A teaspoonful of tartaric acid 
in a pint of warm-water is a specific, in some cases acting like 
magic. Dr. Sage's Catarrh Remedy is as perfect a specific in 
some cases of leucorrhea as it is for nasal catarrh. To render 
it more astringent, a gill or two of oak bark tea, or of the 
infusion of Peruvian bark or witch-hazel, may be added to each 
pint of the liquid. This will improve its efficacy in cases in 
which the discharge is very profuse and resists the simpler 
lotions. Whatever lotion is employed, always use it warm. 
If pruritus be also a symptom, the itching will readily yield 
if the parts be cleansed with Castile or other fine soap and 
warm water, followed by the application of a compound com- 
posed of two ounces of glycerine, one ounce of rose-water, and 
one drachm of sulphite of soda; or, for the sulphite of soda, 
two drachms of borax may be substituted. The following 
lotion is a good one to relieve pruritus: sugar of lead, two 
drachms; carbolic acid, half a drachm; laudanum, four ounces; 
glycerine, four ounces; water, four pints; mix. TJiis may be 
applied to the itching parts, and also injected into the vagina. 
How to use Vaginal Injections. The effect of 
vaginal injections depends very much upon the manner in which 
they are applied. A soft rubber bulb syringe is preferable to 
most other kinds, because the patient can use it conveniently 
without an assistant, and the required amount of fluid can be 
injected without having to remove and re-insert it. After intro- 
ducing the syringe, which should be pressed up as far as possi- 
ble without causing pain, so as to bring the end of the tube into 
contact with the os uteri (see Fig. 102), warm water should be 
freely injected to cleanse the parts of all acrid, irritating, and 
offensive secretions, previous to using the medicated fluids. 
The medicated lotion, which should not be less than two ounces, 
should then be injected. 
STERILITY. (Barrenness.) 
Real sentiment and interest center in fecundity, since the 
desires and happiness of mankind are consummated in mar- 
riage and procreation. How dreary would life be without love, STERILITY. 
735 
companionship, and the family! How precious are the ties that 
bind our hearts to father, mother, daughter, and son! The love 
of children is innate in the heart of every true man and woman. 
Each child born supplements the lives of its parents with new 
interest, awakens tender concern, and unites their sympathies 
with its young life. 
How dreary is the thought that one may attain a ripe old age 
with neither son nor daughter to smooth the decline of life, or 
sorrow for his or her departure! How many 
women desire a first-born of love, the idol of 
their waiting hearts, a soul, which shall be 
begotten within, clothed with their own na- 
ture, and yet immortal! It is a natural in- 
stinct, this yearning of the heart for offspring; 
and yet little is said upon this subject, in which 
so much is experienced. All that is beautiful 
and lovely in woman, finds its climax in 
motherhood. What earthly being do we love so devotedly as 
our mother? 
Men and women exhibit but little concern, mere idle curiosity, 
perhaps, on this subject, unless, perchance, there is no evidence 
of their own reproductive powers. If, however, these appear to 
be deficient, then few topics are more deeply interesting or 
investigated with greater personal solicitude. Such persons will 
seldom submit their condition to the family physician, for it is a 
delicate subject involving personal considerations, and, therefore, 
they prefer to consult with one who cannot connect their unfor- 
tunate situation with any of the incidents which enter into the 
history of their lives. This is very natural, and sometimes is the 
only way to keep private matters profoundly secret. Being 
widely known as specialists devoting our undivided attention to 
chronic affections, and having unusual facilities for the investi- 
gation and management of such cases, we have been applied to 
in innumerable instances, to ascertain the causes of barrenness 
and effect their removal. 
It is admitted that the question of a woman's sterility is 
practically decided in the first three years of married life, for 
statistics show that less than ten out of a hundred women who 
do not indicate their fertility in the first three years of wedlock 
Fig. 736 
COMMON SENSE MEDICAL ADVISER. 
ever bear children. We have treated many who gave no evi- 
dence of fertility for a much longer period of married life, and 
who afterwards gave birth to children. We are unable to state 
the proper ratio of the number of the married who are childless; 
much less have we the right to assume that all who decline the 
responsibilities of motherhood are necessarily barren. 
Causes. The causes of barrenness may be obliteration of 
the canal of the neck of the womb, sealing up of its mouth, or 
inflammation resulting in adhesion of the walls of the vagina, 
thus obstructing the passage to the uterus. In the latter case, 
the vagina forms a short, closed sac. In some instances, the 
vaginal passage cannot be entered in consequence of an imper- 
forate hymen. Again, the cause of barrenness may either be a 
diseased condition of the ovaries, preventing them from matur- 
ing healthy germs, or chronic inflammation of the mucous mem- 
brane of the neck of the uterus, which does not render concep- 
tion impossible, but improbable. It is one of the most common 
causes of unfruitfulness, because the female seldom, if ever, 
recovers from it spontaneously. It has been known to exist for 
twenty or thirty years. 
Chronic inflammation of the vagina also gives rise to acrid 
secretions, which destroy the vitality of the spermatozoa. Sup- 
pression of the menses, or any disorder of the uterine functions, 
may disqualify the female for reproduction. Flexions of the 
uterus, displacements, congestions, and local debility, may like- 
wise prevent fertility. Sterility may result from impaired ova- 
rian innervation or undue excitement of the nerves, either of 
which deranges the process of ovulation. Even too frequent 
indulgence in marital pleasures sometimes defeats conception. 
Prostitutes who indulge in excessive and promiscuous sexual 
intercourse, seldom become pregnant. Any thing that enfeebles 
the functional powers of the system is liable to disqualify the 
female for reproduction. 
Treatment. An extensive observation and experience in 
the treatment of sterility, convinces us that, in the majority of 
cases, barrenness is due to some form of disease which can be 
easily remedied. If the passages through the neck of the uterus 
be closed or contracted, and this is the most frequent cause of 
sterility, a very delicate surgical operation, which causes little STERILITY. 
737 
if any pain or inconvenience to the patient, will remove the 
impediment to fertility. In many of these cases, we have suc- 
ceeded in removing the contraction and stricture of the neck of 
the womb by dilatation. When the vaginal walls are so firmly 
united as to prevent copulation, a surgical operation may be 
necessary to overcome their adhesion. When the hymen ob- 
structs the vaginal orifice, a similar operation may be necessary 
to divide it. Vaginismus, which will be treated elsewhere, 
sometimes causes sterility. 
It is proper that we should suggest to the barren, that if 
sexual intercourse be indulged in only very abstemiously, con- 
ception will be more likely to occur than if moderation be not 
exercised. We may also very properly allude to the fact that 
there is greater aptitude to fecundation immediately before and 
soon after the menstrual periods than at other times. In fact, 
many medical men believe that it is impossible for conception to 
occur from the twelfth day following menstruation up to 
within two or three days of the return of the menses. 
Elongation of the Neck of the Womb. An elon- 
gated condition of the neck of the womb, illustrated by Fig. 
221, is frequently a cause of sterility. If 
this part is elongated, slim, and pointed, 
as shown in the illustration, it is apt to 
curve or bend upon itself, thus constricting 
the passage through it and preventing the 
transit of seminal fluid into the womb. An 
eminent author says, " Even a slight de- 
gree of elongation, in which the cervix, or 
neck, has a conical shape, has been ob- 
served to be frequently followed by that 
condition [sterility]." Our own observa- 
tions, embracing the examination of hun- 
dreds of sterile women annually, lead us to 
believe that this condition is among the common causes of bar- 
renness. But, fortunately, it is one of those most easily over- 
come. 
Treatment. If the neck is only slightly elongated, this 
consists in dividing the slim projecting part, by the use of the 
hysterotome. If it be a more aggravated case, a portion of the 
Fig. W. 
Conoid Neck. 738 
COMMON SENSE MEDICAL ADVISER. 
womb must be removed. This operation is perfectly safe and 
simple, and, strange as it may seem to those who are not famil- 
iar with operations upon the womb, is not painful. We have 
never seen any bad results follow it, but have known it to be 
the means of rendering numerous barren women fruitful. 
Flexions and Versions of the Womb. Flexion of 
the uterus, in which it is bent upon itself, as illustrated in Fig. 
221, produces a bending of the cervical canal, constricting or 
obliterating it, and thus preventing the passage of spermatozoa 
through it. Version of the uterus, in which its top, or fundus, 
falls either forward against the bladder (anteversion), as illus- 
trated in Fig. 222, or backward against the rectum (retrover- 
Fig. 222. 
Fig. 223. 
Flexion, u, Uterus, b. Bladder. 
Version, u, Uterus, B, Bladder. 
eion), may close the mouth of the uterus by firmly pressing 
it against the wall of the vaginal canal, and thus prevent the 
passage of spermatozoa into the womb. The treatment of these 
several displacements will be considered hereafter. We may 
here remark, however, that they can be remedied *by proper 
treatment. Our mechanical movements, manipulations, and 
kneadings are invaluable aids in correcting these displacements. 
Disease of the Ovaries. Sterility may be due to dis- 
ease of the ovaries. Chronic inflammation of the ovaries may 
result from uterine disorders or peritonitis, and is commonly 
attended with a sense of fullness and tenderness, and pain in 
the ovarian region. These symptoms are more apparent upon 
slight pressure, or during menstruation. This disease is curable, 
although it may require considerable time to perfectly restore STERILITY. 
739 
the health. When this chronic affection is the result of other 
derangements, the indications are to restore health in the con- 
tiguous organs, and to relieve excessive congestion and nervous 
excitement in the ovaries. The patient should be very quiet 
during the menstrual period and avoid severe exercise or fa- 
tiguing occupations, not only at those periods, but during the 
intervals. All measures calculated to improve the general 
health should be adopted. Use injections of warm water, 
medicated with borax, soda, and glycerine, in the vagina every 
night and morning. The surface of the body should be kept 
clean by the daily employment of hand-baths, followed by 
brisk friction. The bowels, if constipated, should be regulated 
as suggested for constipation. The system should be strength- 
ened by the Favorite Prescription, and, if the blood be disor- 
dered, no better alterative can be found for domestic use than 
the Golden Medical Discovery. If the patient does not in a few 
months improve under this treatment, the case should be placed 
under the immediate care of some physician well qualified by 
education and experience to critically examine and successfully 
treat this affection. 
Chronic Inflammation and Ulceration of the 
Uterus, a Cause of Sterility. When enumerating the 
causes of barrenness we mentioned that chronic inflammation 
of the mucous membrane of the mouth and neck of the womb 
was the most common affection that defeats conception. Of 
all diseases of female organs, this is, without doubt, the 
most common, and, since it does not at first produce great 
inconvenience or immediately endanger life, it does not excite 
the attention which its importance demands. It is overlooked, 
and, when the attention is directed to the existence of this long- 
neglected disease, it appears so trivial that it is not regarded as 
being the real cause of infertility in the patient. 
When this disease has existed for a long time, the very struc- 
ture of the parts involved becomes changed. The glands of the 
cervical membrane secrete a glairy mucus, resembling the white, 
or albuminous part of an egg. The secretion is thick and ropy, 
and fills the entire mouth and neck of the uterus, thus prevent- 
ing the entrance of the spermatozoa. The mucous membrane 
becomes thickened, the inflammation extends to the deeper 740 
COMMON SENSE MEDICAX. ADVISER. 
structures, and, on examination through the speculum, we find 
the mouth of the uterus inflamed, hardened, and enlarged, as 
represented in Fig. 22, Colored -Plate IV, or in Fig. 23 of same 
plate. Fig. 25, Plate IV, shows the mucous follicles just as they 
are found all along the neck of the womb, in a state of inflam- 
mation and enlargement, and filled with a fluid resembling 
honey, giving rise to ulceration and a thick discharge, as illus- 
trated in Fig. 23, Colored Plate IV. 
Feebleness of the constitution, impoverishment of the blood, a 
scrofulous diathesis, want of exercise, uncleanliness, tight lacing, 
disappointment, excessive excitement of the passions, the use of 
pessaries for displacement of the uterus, overwork, and taking 
cold, all predispose the cervical membrane to chronic ulceration. 
The inflammation may be so mild, and the discharge so 
trifling in quantity, as scarcely to attract attention. But after 
it obtains a firmer hold, and, in most cases, it is aggravated by 
exposure or neglect, the patient experiences dragging sensa- 
sensations about the pelvis, and pain in the back and loins, 
accompanied with a bearing-down sensation and numbness or 
pain extending to the thighs. 
The discharge is thick, starch-like, and generally irritating. 
The patient becomes irascible, capricious, querulous, and some- 
times moody and hysterical. She is easily discouraged, her 
appetite and digestion become impaired, and she grows thin and 
does not look or act as when in health. 
Treatment. In offering a few hints for the domestic 
management of these abnormal conditions, we would at the 
same time remark, that, while health may be regained by skillful 
treatment, recovery will be gradual. We especially wish to 
guard the patient against entertaining too strong expectations 
of a speedy recovery. Although she may employ the best treat- 
ment known, yet from three to five months may elapse before a 
perfect cure can be effected. In persons of a scrofulous diathe- 
sis, in whom the recuperative forces are weakened, it is very dif- 
ficult to effect a radical cure. It is equally true, however, that 
under domestic management alone, thousands have been restored 
to perfect health and fruitfulness. 
Hygienic management consists in toning the functions of the 
skin by daily bathing the surface of the body, and quickening STERILITY. 
741 
the circulation by brisk friction. The patient should rise early 
in the morning, and exercise in the fresh and invigorating air. 
Those who sleep in warm rooms, or spend much of their time in 
bed, will continue to have congestion of the uterus, and habitual 
discharges from this enfeebled organ. The patient should take 
daily walks, increasing the length of the excursion from time to 
time, but not to the extent of producing fatigue. The bowels, 
if constipated, should be regulated. Strengthen the system by 
using the Favorite Prescription, to each bottle of which add two 
drachms of citrate or pyrophosphate of iron. The mouth and 
neck of the uterus should be thoroughly cleansed by the use of 
the syringe, as suggested for the treatment of leucorrhea. The 
use of some one of the lotions there advised will also be bene- 
ficial, if thoroughly applied. 
A most valuable course of local treatment, which may be 
adopted by any intelligent lady without the aid of a physician, 
and one that will result in the greatest benefit when there is 
morbid sensibility, congestion, inflammation, or ulceration about 
the mouth or neck of the womb, consists in applying to those 
parts a roll of medicated cotton or soft sponge, allowing it to 
remain there for twelve hours at a time. A piece of fine soft, 
compressible sponge, as large as a hen's egg, or a roll of cotton 
batting of the same size, thoroughly saturated with pure gly- 
cerine, or the following preparation: powdered alum, half a tea- 
spoonful; carbolic acid, ten drops; pure glycerine, four ounces, 
should have securely fastened to it a stout cord a few inches 
long. The vagina and affected parts having been thoroughly 
cleansed with warm water and Castile soap, as advised in the 
treatment of leucorrhea, the sponge or cotton should be passed 
up the vagina with the finger, and pressed rather firmly against 
the mouth and neck of the womb, which, being enlarged, and, 
consequently, falling below its natural position, will generally 
be low down in the vagina, and so hardened as to be unmis- 
takably distinguished from the surrounding parts by the sense 
of touch. The glycerine, having a very strong affinity for 
water, will absorb Targe quantities of the serum, which has been 
effused into the affected tissues in consequence of their conges- 
tion and inflammation, and thus reduce the inflammation and 
enlargement. This is the cause of the profuse, watery discharge COMMON SENSE MEDICAL ADVISER. 
742 
which follows the application. In twelve hours after the sponge 
or cotton has been applied, it should be removed by means of 
the attached thread, one end of which has been purposely left 
hanging out of the vagina. Then thoroughly cleanse the vagina 
with warm water, use one of the lotions suggested for the treat- 
ment of leucorrhea, and repeat the glycerine application the 
following day or every other day. 
If there is no irritation or tenderness of the vagina, add one 
drachm of tincture of iodine to each ounce of the glycerine, 
alternating the use of this with that of the pure glycerine; or, 
the iodine and glycerine may be used every third day, and the 
glycerine alone on the two intervening days. As the iodine will 
color the finger somewhat, it is well to know that this unpleas- 
ant effect may be almost or entirely avoided by coating that 
member wTith lard, sweet oil, or vaseline. The stain may be 
readily removed with a solution of iodide of potassium. If the 
discharge be very fetid, three grains or drops of carbolic acid 
should be added to each ounce of the glycerine. The car- 
bolic acid is very beneficial when there is ulceration of the 
mouth of the womb, as represented in Figs. 22 and 23, Colored 
Plate IV. 
It is well to alternate the Golden Medical Discovery -with the 
Favorite Prescription, taking of each three times a day. By 
persevering in this course of treatment, nine-tenths of those 
who are thus afflicted will improve and be fully restored to 
health, fruitfulness, and happiness. If barrenness continue, the 
case should be unreservedly submitted, either in person or by 
letter, to a physician skilled in the diagnosis and treatment of 
these affections. 
From the foregoing remarks, the reader will perceive that 
there are a variety of diseased conditions, any one of which 
may produce sterility. It is equally true that nearly all these 
conditions may be easily cured by proper medical or surgical 
treatment. A frequent cause of barrenness is stricture of the 
neck of the uterus. No medicine that a woman can take or 
have applied will remove this unnatural Condition. Fortu- 
nately, however, the means to be employed cause no pain, are 
perfectly safe, and the time required to effect a cure is short, 
rarely over twenty or thirty days. STERILITY. 
743 
We subjoin a few of the many hundreds of cases in which 
we have been instrumental in removing the cause of sterility. 
CASES TREATED. 
Case I. Mrs. W. P., Buffalo, N. Y., had been married seven years 
and never had been pregnant. She suffered from painful menstruation, 
nervousness, and headache, and had a poor appetite, cold feet and hands, 
with symptoms of. hysteria. An examination revealed the fact that all 
her ailments arose from stricture of the neck of the uterus. An oper- 
ation with the hysterotome removed the stricture and the use of a tonic 
completed the cure. In about five months from the date of her de- 
parture from the Hotel, she happily found herself pregnant, and in due 
time gave birth to a fine healthy child. 
Case II. Mrs. B. C. H., of Buffalo, had been married ten years and 
had never been pregnant. Her health was generally good. She had a 
fine physique, and the appearance of excellent health; in fact, she con- 
sidered herself perfectly well. Mrs. H. consulted us relative to her 
barrenness, a subject to her of great solicitude, and desired our opinion. 
After a thorough investigation of her case, she was informed that there 
was a slight stricture, and inflammation of the neck of the uterus. 
This slight affection was sufficient to keep her barren. After a full ex- 
planation to herself and her husband, she submitted to a painless opera- 
tion, and in a short time the cause of her barrenness was entirely 
removed. In less than twelve months after the cure, Mrs. H. and her 
husband were made exceedingly happy by the appearance in their 
family of a healthy girl baby. 
Case III. Mrs. K. applied to us for treatment for sterility. She was 
thirty years of age and had been married ten years, but was sterile. 
By examination, we found the cervical membrane highly inflamed, a 
condition termed in professional works cervical endometritis. The dis- 
eased glands of the cervical membrane secreted a thick, glutinous 
matter, which effectually obstructed the canal, and thus prevented the 
passage of the spermatozoa into the uterus. By the aid of the spec- 
ulum, we introduced sponge tents to dilate the cervix, or neck of the 
womb, and applied specific remedies to the diseased parts. These appli- 
cations were made twice every week for six weeks, after which the con- 
stitutional treatment was continued for a few weeks longer. Within 
three months thereafter the lady became pregnant, and in due time 
gave birth to a son. 
Case IV. Mrs. H. G., aged thirty-five, had been married seventeen 
years, but had never been pregnant. We found the neck of the womb 
strictured, and a painless surgical operation was necessary. The oper- 
ation was successfully performed, and in four weeks she recovered and 
was discharged. She became pregnant soon after, and, to the joy of 
both husband and wife, a son was born to them, after years of patient 
waiting. 
Case V. Mrs. H. C., aged twenty-seven, had been married seven 
years, when she consulted us. Menstruation had been regular, but 
accompanied with severe pain. She was sterile, but desired offspring. 
We made a thorough examination and found the cause of sterility to be 
a stricture of the cervical canal. The operation indicated was per- 
formed, and the appropriate constitutional treatment continued during 
a period of five weeks. At the end of this time she menstruated freely 
and without pain. Within four months after her recovery, she became 
pregnant. 744 
COMMON SENSE MEDICAL ADVISER. 
Case VI. Mrs. H. applied to us for treatment for barrenness. She 
had been married ten years but had never been pregnant. The diag- 
nosis was simple. She was suffering from uterine leucorrhea. The 
discharge was gelatinous and slightly tinged with blood and was the 
result of endometritis, or uterine catarrh. The proper treatment for 
that affection was instituted aud the cause of the patient's sterility 
removed. By following the prescribed course of constitutional treat- 
ment, she fully regained her health. She became pregnant and gave 
birth to a healthy child. 
Case 93,577. (New Series, as Numbered in the Record Books 
of the Invalids' Hotel and Surgical Institute.) Sterility, 
with Womb Disease. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-I write to you to say that your medicines have cured me, and 
that a fine little girl has been born to me. I am so thankful that my 
health has been restored. I thank the great God of us all who gave 
you such skill and wisdom. Very truly, 
Mrs. L. S. M., Mayersville, Miss. 
Case 164,517. Barrenness from Uterine Disease. 
World's Dispensary Medical Association: Gentlemen-Thanks 
to your skill aud medicines, I am the mother of a line and healthy babe. 
I cannot forget to whom I owe my preseut health, strength, and good 
fortune. I am most grateful to you. 
Mrs. M. E. W., Wellston, O. 
We might add hundreds to the few cases here cited, in which 
our Faculty at the Invalids' Hotel have been successful in re- 
moving the cause of sterility, or barrenness, by instituting the 
proper medical or surgical treatment, but it is not necessary to 
occupy more space with them. 
MASTURBATION A CAUSE OF DISEASE IN WOMEN. 
It is a law of nature, that any habit becomes stronger by being 
indulged. This is also true of the venereal propensity. In- 
dulgence makes it a powerful and controlling passion. Respon- 
sibility begins with life, and every organ in the body has its 
function. How easily can we pervert the sensibilities and func- 
tions, and render them morbidly active and domineering! The 
responsibilities of such perversion does not rest altogether upon 
the growing child or promising maiden, but it belongs also to 
parents and teachers, who should warn and instruct them con- 
cerning the danger of arousing the propensities. We have 
known young women of lovely disposition, whose health was 
undermined and their careers ended before attaining their 
twenty-third year, in consequence of the practice of masturba- 
tion, begun before they were eight years old. MASTURBATION. 
745 
Nymphomania. The diseased condition resulting from 
masturbation, when occurring in the female, is usually desig- 
nated by the term nymphomania, which has been defined as " a 
disease in females, attended with an uncontrollable and insati- 
able desire for sexual intercourse." As, however, this desire is 
only one of many morbid manifestations resulting from self- 
gratification of the sexual passions, or from excessive venery, 
and, in fact, is frequently absent, the term is not sufficiently 
comprehensive to embrace the numerous derangements of the 
system consequent upon such abuses and excesses. Instead of 
an inordinate desire for venery, there is, in many cases, a dis- 
position of coldness and indifference toward the opposite sex, a 
lack of sexual passion. 
As the semen or sperm of the male is a vital secretion, and 
its excessive loss is followed by debilitating results, so the dis- 
charge occurring during the sexual orgasm of the female pro- 
duces a depression of energy. It has long been our opinion, 
however, that the general debility resulting from masturbation, 
in both male and female, is more due to the unnatural shock 
produced upon the sympathetic nerves distributed to the sexual 
organs, than to the attendant loss of vital secretions. The 
moderate and natural gratification of the sexual propensity is 
conceded by all physiologists to be healthful, but the unnatural 
gratification sought in the practice of onanism or masturbation, 
although perhaps attended with no greater seminal loss at the 
time, is always injurious to the system. A blow in the region of 
the stomach, or upon the testicles, produces such a powerful 
shock upon the sympathetic nerves, which are freely distributed 
to those parts, as to instantly annihilate strength, and render an 
adult as weak as a child. So the unnatural impression produced 
upon the sexual organs by masturbation, although it does not so 
powerfully and suddenly deprive the system of its strength, yet 
it accomplishes the same result gradually, eventually producing 
a chronic weakness. 
In a letter addressed to us, the writer, a lady twenty-foui* 
years of age, says that she commenced the habit of self-indul- 
gence when but fifteen years old, without suspecting that she 
was doing wrong, and had continued it nearly to the time when 
she wrote us the letter. Her health began to fail, but -she did 746 
COMMON SENSE MEDICAL ADVISER. 
not suspect the cause of its decline, until by chance she learned 
that this habit is injurious, and then she firmly resolved to 
abandon the practice; but it had become so fixed, and the pas- 
sion was so strong and overpowering, that she was unable to 
restrain herself, even while realizing the terrible mischief that it 
was producing. Catarrh had attacked her in its worst form, the 
eyes were bloodshot, swollen, and watery, the sight obscured, 
she grew deaf and had to converse by signs. Iler strength 
failed, her memory was greatly impaired, and she had partially 
lost her faculties of thought. Finally, leucorrhea was added to 
her troubles, and she became emaciated and utterly discouraged. 
She was well educated, and, before becoming prostrated by this 
habit, she possessed excellent physical endowments and her 
future was bright and promising. But now all her hopes were 
blighted, the fine physique had become a miserable wreck, and 
she made touching appeals to us for relief. We could illustrate 
the prevalence of this habit and its dire consequences by hun- 
dreds of letters, but we will not draw upon our professional 
records to further substantiate our statements. 
When this morbid passion gets control of a person, it is as 
though an unclean spirit had entered, subdued the will, weak- 
ened the moral forces, enfeebled the intellectual faculties, less- 
ened the power to resist temptation, and overcome every obstacle 
opposed to its gratification. Even while the intellect is still 
clear, and the sense of wrong keen, the individual is a slave 
to this morbid impulse. 
The practice of masturbation leaves an indelible impress upon 
the nervous system. The patient manifests a love of solitude 
She becomes despondent and loses her natural vivacity. Her 
complexion loses its delicate blush, the eye its lustre, and the 
voice its melody; her breasts lose their rotundity and become 
flabby or are not developed. The general debility of her sys- 
tem renders her extremely susceptible to every disease. The 
menses are disturbed, and leucorrhea, falling of the womb, hys- 
teria, sterility, chronic uterine or ovarian congestion, epilepsy, 
and other nervous diseases are common results. 
Some young women who practice masturbation experience an 
indescribable feeling of illness throughout the whole body. 
They complain of a general trembling of the limbs, chilliness, MASTURBATION. 
747 
painful drawing or dragging sensations in the abdomen, and 
relaxation of all the muscles, sometimes accompanied with 
strange illusions, hysteria, or convulsions. The skin is sallow 
and dry, the breath fetid, the abdomen painful, the pulse weak, 
and there are often violent pains in the head and uterus. In 
some cases, the disease assumes a violent mental form, in which 
even the most refined women frequently talk in an indecent 
manner, and place themselves in the most improper situations 
and attitudes. 
Women of highly excitable temperaments so intensify their 
sexual ardor by this habit that they are apt to betray their 
longings to their male companions, and frequently give way to 
temptation, and are initiated into lives of prostitution. Some 
are actually convulsed by their ungovernable emotions. 
Sterility is often a result of self-abuse. It sometimes blunts 
the sensibility of the parts, so that the wife cannot enjoy sexual 
intercourse, and the husband calls her cold and passionless. 
Frequently, coition is exceedingly painful to her, and she avoids 
it in every possible way. 
Treatment. The habit must be absolutely relinquished. 
The animal forces should be expended in mental or physical 
employments. The subject ought to rise early and walk or 
engage in some kind of labor. The sensibility and irritability 
of the sexual organs should be diminished by using cold baths. 
The patient should live abstemiously, and the bowels should be 
kept regular, and thus free from the congestion and irritation 
attendant upon constipation. She should avoid the reading of 
books which will excite the passions, and associate only with 
those persons who are rigidly chaste in their ideas and conver- 
sation. It is very important to take daily and prolonged exer- 
cise in the open air, in order that at night the fatigue of the 
body may divert the sexual feelings. It is equally necessary to 
take daily baths, one upon rising in the morning, and, if the 
subject has sufficient vitality, another in the middle of the after- 
noon, each bath to be followed by brisk friction. 
These cases should be entrusted to the care of an experienced 
physician. To give to the unprofessional reader a full list of 
the remedies which are adapted to the different temperaments 
and constitutions, with full directions for their use, would fill 748 
COMMON SENSE MEDICAL ADVISER. 
the pages of a small volume, and serve to confuse and perplex, 
rather than enlighten and benefit. It would lead only to experi- 
ments, failures, and loss of faith in. medicine, while if these 
remedial agents are skillfully prescribed, the result is generally 
salutary and satisfactory. In this connection, we will remark 
that the depreciation of the profession and the undervaluation 
of drugs, not only in this, but in all other diseases, originate 
with those who are uneducated, inexperienced, and, therefore, 
unqualified for the practice of medicine. There is no such 
thing as infallibility in any art, the perfection of which depends 
upon the exercise of human faculties. Occasional failures in 
the profession furnish no good grounds for those sweeping 
detractions which often fill the pages of journals edited by self 
styled reformers. 
Persons afflicted with this disease should rigidly observe the 
sanitary regulations which we have prescribed, and persevere in 
the use of remedies adapted to their cases. They will require 
all the aid that can be obtained from both domestic and pro- 
fessional treatment, to overcome this habit and regain that com- 
plete self-control which is the indispensable basis of recovery. 
ABORTION. (Miscarriage.) 
The term abortion is used to denote the premature expulsion 
of the foetus. If the expulsion takes place within four months 
after impregnation, it is termed abortion; if between the fourth 
and the seventh month, miscarriage ; if after the seventh month, 
but before the completion of the full period of gestation, pze- 
mature labor. 
Abortion may be due to those agents which act directly upon 
the uterus and cause the expulsion of the foetus; to those which 
occasion the death of the foetus, thereby effecting its ejection; 
and it may be criminal, that is produced intentionally by direct 
agencies intended for that purpose. 
Symptoms. The premonitory symptoms are pain in the 
loins and lower part of the back, a dull pain in the abdomen 
and thighs, nausea, chills, and palpitation. The membranes and 
blood-vessels of the uterus become lacerated, .causing profuse 
hemorrhage. The discharge of blood from the vagina is some- 
times attended with excessive pain. ABORTION. 
749 
The Causes which act directly upon the uterus to pro- 
duce abortion may be violent exercise, lifting, accidents, or 
injuries from blows or falls. Nervous susceptibilities, a plethoric 
condition of the system, anaemia, exhaustive discharges, use of 
improper food, uterine displacements, congestion caused by ex- 
cessive sexual excitement, general debility or muscular irrita- 
bility, which is sometimes so great as to produce contractility 
of the uterus before the term of pregnancy is completed, 
inflammation of the cervix, ulcerations of the uterus, or any 
previously existing disease may produce abortion. When it 
has once taken place, it is apt to recur at about the same time 
in subsequent pregnancies. 
The death of the foetus may be occasioned by a diseased con- 
dition of the embryo, amnion, or placenta, and also by convul- 
sions or peritoneal inflammation. 
Criminal Abortion is secretly practiced by women who 
desire to rid themselves of the evidence of immorality, and by 
those in wedlock who wish to avoid the care and responsibility 
of rearing offspring. Statistics show that it is very prevalent, 
undermining the health of women and corrupting the morals 
of society. We cannot pass over this subject in silence. Those 
who frustrate the processes of nature by violating the laws 
of life incur just penalties. All the functions of life and body 
are vitally concerned in reproduction. Any infraction of the 
Divine law, "Thou shalt not kill." is inevitably followed by 
punishment. The obligations to nature cannot be evaded with- 
out inevitable penal effects. Furthermore, all such transgressors 
carry with them the consciousness of guilt and the feeling of 
secret woe. 
" O God! that horrid, horrid dream 
Besets me now awake! 
Again, again, with dizzy brain, 
The human life I take, 
And my red right hand grows raging hot, 
Like Cranmer's at the stake."-Hood. 
What shall we say concerning abortionists, men and women 
who are willing to engage in the murder of innocents for pay ? 
True, there may be circumstances in which it is not right to 
continue in the pregnant condition, such as when the children of 750 
COMMON SENSE MEDICAL ADVISER. 
an unfortunate marriage are idiots, or the pelvis of the woman is 
so deformed that she cannot bear a living child. All such cases 
should be submitted to the family physician, who ought to be 
made acquainted with all the circumstances and facts relating 
to the case, when he can summon other physicians for counsel, 
and their deliberations may determine the propriety or necessity 
of bringing on an abortion. 
Parties have written to us and others have made personal 
application under circumstances when it might have been right 
for their family physician to have induced abortion. We wish 
to have it distinctly understood that we will not under any cir- 
cumstances prescribe medicines or perform any operation to 
relieve women of pregnancy. 
Mechanical means are resorted to by abortionists, and many 
women produce abortion upon themselves. It always terminates 
in lasting injury and sometimes in speedy death. Certain medi- 
cines will sometimes produce abortion but they are very unsafe. 
An opinion is very prevalent that if abortion is produced be- 
fore the movements of the foetus are felt, there is no crime 
committed. It should be remembered that life begins with 
conception, and, at whatever period of pregnancy abortion is 
committed, life is destroyed. Whoever disobeys the Divine 
injunction cannot escape his own consciousness of the deed, and 
the anguish and bitter remorse which ever after disturb the soul. 
Treatment. In threatened abortion, there is pain in the 
back or lower part of the abdomen, and later some flow of blood. 
The first object is to obtain perfect rest and quiet, and assume 
the recumbent position. By lying down, the blood will be 
more easily diverted to the surface of the body. Gallic acid, 
in doses of five grains every two or three hours, is often a 
valuable agent to arrest the hemorrhage, but opium in some 
form should be relied upon principally. A Dover's powder, 
ten grains, may be administered, to assist in determining the 
blood to the surface and extremities of the body and to allay 
irritation. The room should be cool, the patient should lie on a 
hard bed, and all company should be avoided, for excitement 
favors abortion. If the flow of blood equals a gill in amount, 
there is little hope of preventing abortion, and the treatment of 
the case should be entrusted to the family physician. DISPLACEMENTS OF THE WOMB. 
751 
DISPLACEMENTS OF THE WOMB. 
The relative positions of the womb and surrounding organs, 
when in a state of health, are well illustrated by Fig. 102, page 
106. The womb is supported in its place by resting upon the 
vaginal walls, and by a broad ligament on either side, as well as 
by other connective tissues. By general debility of the system, 
the supports of the womb, like the other tissues of the body, 
become weakened and inadequate to perfectly perform their 
duty, thus permitting various displacements of that organ. 
Prolapsus, or Falling of the Uterus, is a common 
form of displacement. It has been erroneously regarded as a 
local uterine disease, requiring only local treatment instead of 
being considered as a symptom of general derangement, and, 
therefore, requiring constitutional treatment. Hence, variously 
devised supporters have been invented to retain the womb in 
position after its replacement. It is a law of physiology, that the 
muscular system is strengthened by use, and that want of exer- 
cise weakens it. The blacksmith's arm is strengthened and 
developed by daily exercise. Support his arm in a sling, and 
the muscles will be greatly weakened and wasted. So when 
artificial supports are used to retain the womb in position, there- 
by relieving the supporting ligaments and tissues of their nor- 
mal function, the natural supports of the uterus are still further 
weakened, and the prolapsus will be worse than before when 
the artificial support is removed. Besides, all these mechanical 
contrivances are irritating to the tissues of the womb and 
vagina, and frequently produce congestion, inflammation, and 
even ulceration, thus rendering the patient's condition much 
worse than before their employment. These worse than useless 
appliances should never be resorted to for the temporary relief 
which they sometimes afford. Constitutional treatment to- 
gether with appropriate applications is the only effectual method 
of remedying this morbid condition. 
Symptoms. When the displacement is sufficient to cause 
any serious disturbance, the prominent symptoms are a sensa- 
tion of dragging and weight in the region of the womb, pain in 
the back and loins, inability to lift weights, great fatigue from 
walking, leucorrhea, a frequent desire to urinate, irritation of the 752 
COMMON SENSE MEDICAL ADVISER. 
lower bowel, and derangement of the stomach. The womb 
may protrude from the vaginal orifice; in very rare cases, it 
wholly protrudes, and may be inverted. 
Causes. - As we have already stated, general debility favors 
prolapsus of the womb, but various general and local circum- 
stances and conditions also favor its occurrence. Wearing 
heavy garments supported only by the hips, compressing the 
waist and abdomen with tight clothing, thus forcing the abdom- 
inal organs down upon the womb, are fruitful causes of this 
affection. Excesses in sexual intercourse give rise to leucorrhea 
producing a relaxed condition of the vagina, upon which the 
womb rests, and, in this way, one of its supports is weakened. 
Enlargement of the uterus from congestion, and inflammation 
or tumors also favor prolapsus. Abortion may leave the womb 
enlarged, its supports weakened, and result in this displacement. 
Flexions and Versions. Instead of sliding down into 
the vagina, as in prolapsus, the uterus is liable to fall or be 
forced into other unnatural positions. When the uterus is bent 
upon itself, it is called flexion. If the bending is backward, it 
is called retroflexion ; if forward, anteflexion. Fig. 221 repre- 
sents the former condition, the uterus being flexed backward so 
that the fundus, or upper part of the womb, is pressed against 
the rectum, while the neck of the uterus remains- in its natural 
position. This is a common form of displacement, and gener- 
ally occurs between the ages of fourteen and fifty. 
Symptoms. The prominent symptoms of retroflexion of 
the uterus are a sense of weight in the region of the rectum, 
difficulty in evacuating the bowels, and, sometimes, a retention 
of the feces. There may also be suppression of the urine, and 
the menses may be diminished in quantity. If retroflexion is 
due to a chronic enlargement of the uterus, caused by abortion 
or parturition, the patient suffers from an immoderate menstrual 
flow. 
Causes. The principal causes of retroflexion are conges- 
tion, enlargement, and tumors of the uterus. Congestion is 
liable to occur in women possessing an extremely active tem- 
perament, as well as in those of sedentary and indolent habits. 
Retroflexion is a common displacement in both married and un- 
married women; it is a secondary affection, and, when it is DISPLACEMENTS OF THE WOMB. 
753 
caused by congestion, the menses are painful and reduced 
in quantity, and there is pain in the back and a sense of 
weight in the region of the rectum. In some instances, there 
is a reflex irritation of the mammary glands, and a conse- 
quent secretion of milk. There may also be nausea and vom- 
iting, which often lead to the erroneous opinion that the 
patient is pregnant. 
Anteflexion of the uterus denotes a bending forward of the 
body and fundus of the uterus, while the neck remains in its 
natural position. 
In versions of the uterus, neither the body nor the neck of the 
womb is bent upon itself, but the whole organ is completely 
turned backward or forward. 
Retroversion of the uterus, illustrated by Fig. 222, signifies a 
change in the position of the womb, so that the upper, or fundal 
portion of the organ drops back toward the concavity of the 
sacrum, while the neck preserves a straight line in the opposite 
direction. The fundus presses forcibly against the rectum, 
while the upper part of the vagina bends abruptly and forms, an 
acute angle near the mouth' of the uterus. 
Symptoms. Retroversion is indicated by bearing-down 
pains in the loins and difficulty in evacuating the bowels. The 
feces may accumulate in the rec- 
tum, because they cannot pass this 
obstruction. 
Causes. Jumping, falling, or 
undue pressure from the contents 
of the abdomen, may suddenly 
cause retroversion of the uterus. 
Sometimes retroversion results 
from obstinate constipation. 
Anteversion. This term desig- 
nates another unnatural position of 
the uterus, in which the fundus, or 
upper part of the organ, falls for- 
ward, as illustrated by Fig. 224, 
while the neck points towards the hollow of the sacrum. This 
position of the womb is the reverse of that of retroversion. In 
its natural position, the fundus of the uterus is slightly inclined 
Fig. 224. 
Anteversion, v, Uterus, b, Bladder. COMMON SENSE MEDICAL ADVISEE. 
754 
forward, and any pressure, or forward traction, is liable to cause 
it to fall still further in that direction. 
Symptoms. One of the most common symptoms of ante- 
version is a frequent desire to urinate, in consequence of the 
pressure of the uterus upon the bladder. The free flow of the 
menses is sometimes obstructed. 
Causes. The causes are tight lacing, prolapse of the abdom- 
inal organs, weakness of the supporting ligaments, and enervat- 
ing habits. 
Treatment. In treating all the various displacements of 
the uterus, the prominent indication is to tone up the general 
system, for by so doing we also strengthen the uterine supports. 
Digestion should be improved, the blood enriched, and nutri- 
tion increased, so that the muscles and ligaments which retain 
the womb in position may become firm and strong. The womb 
will thus be gradually drawn into position by their normal 
action and firmly supported. It is a great mistake, made by 
physicians as well as patients, to consider a displacement of the 
uterus a local disease, requiring only local treatment. A res- 
toration of the general health will result in the cure of these 
displacements, the uterus will regain its tone and muscular 
power, and the local derangement, with its attendant pain and 
morbid symptoms, will disappear. 
It is true that displacements of the womb may be associated 
with inflammation and ulcers, which require local treatment, as 
elsewhere suggested; but simple displacement of the uterus may 
be remedied by pursuing the following course of sanitary and 
medical treatment. Sleep on a hard bed, rise early, bathe, and 
take a short walk before breakfast. Dress the body warmly 
and allow sufficient space for the easy and full expansion of the 
lungs. Eat moderately three meals a day, of those articles 
which are nutritious and readily digested. Keep the bowels 
regular by the use of proper food. If they are constipated, 
employ the treatment elsewhere suggested for that condition. 
Avoid retaining the standing position too long at a time, 
especially when the symptoms are aggravated by it. Many 
energetic women disregard their increasing pains, and keep upon 
their feet as long as possible. Such a course is extremely 
injurious and should be avoided. DISPLACEMENTS OF THE WOMB. 
755 
As a general restorative and uterine tonic, nothing surpasses 
the Favorite Prescription, which is sold by druggists and accom- 
panied with full directions for use. If leucorrhea is an attend- 
ant symptom, the treatment suggested for that condition should 
be employed. A soft sponge or roll of cotton saturated with 
the following preparation: powdered alum, one-half drachm; 
carbolic acid, ten drops; pure glycerine, four ounces; intro- 
duced into the vagina and pressed up against the womb, on 
going to bed, and allowed to remain for twenty-four hours, 
often exerts a very beneficial influence, especially if there is 
much inflammation or congestion of the uterus. 
By persevering in the rational treatment which we have sug- 
gested for the various displacements of the womb, nearly all 
who suffer from such derangements may be fully restored to 
health. The patient should not expect speedy relief. Consider- 
able time will be necessary to bring the general system up to a 
perfect standard of health, and, until this is accomplished, no 
great improvement in the distressing symptoms can be expected. 
Mechanical movements are especially effective in this class of 
cases. We have successfully treated many obstinate cases in 
which the displacements were very serious. 
Case 4,916. Displacement of the Uterus. 
World's Dispensary Medical Association: Gentlemen - It is 
through neglect that I have not written sooner to you. The remedies 
sent me did me more good than all I have taken in my life, and I have 
been almost constantly under the care of a physician. I can most 
earnestly recommend your medicines to all sufferers with falling of the 
womb. Mrs. D., Sparta, Marrow Co., Ohio. 
Case 47,624. Displacement of the Uterus. 
World's Dispensary Medical Association: Gentlemen-Having 
suffered a long time with retroversion and nervousness, and finding no 
relief, I placed myself under the care of your specialists, and, after 
thirty days' treatment, find myself well. Mrs. S., Clymer, N. Y. 
Case 53,790. Prolapsus of the Uterus. 
World's Dispensary Medical Association: Gentlemen - It 
affords ihe great satisfaction to be able to add my grateful testimony 
to that of the many who have been restored to health through your 
skillful treatment. Having suffered for years from prolapsus, antever- 
sion and enlargement of the uterus, and obtaining no relief from home 
physicians, I determined to go to your hotel for treatment. After a 
two months' course of treatment in your institution, I find myself 
cured, and am exceedingly grateful for the happy relief obtained. 
Your kind and courteous attentions and skillful treatment, with the 
CASES TREATED. 756 
COMMON SENSE MEDICAL ADVISER. 
many luxurious and perfect baths and movement cure, will cure any 
case, no matter what the disease is. I now thank you most kindly for 
the happy relief I received, and shall make an effort to influence others 
similarly afflicted to go to you. Mrs. A., Greeley, Colo. 
Case 77,235. Falling of the Womb, Dyspepsia, Cramps, etc. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-All my symptoms have undergone such a general improvement 
under your attentions, that I think no further treatment will be 
required at present. I feel highly pleased with the results of your 
skillful treatment, inasmuch as 1 had previously employed different 
members of the best medical faculty in this part of the country without 
any permanent relief. Believe me truly yours, 
O. L., Fair Grove, Tuscola Co., Mich. 
Case 90,151. Displacement of the Womb, with Resulting In- 
flammation of the Bladder, Whites, Dyspepsia, etc. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-When I first commenced your treatment I was suffering badly 
from female weakness of a very complicated nature; the desire to 
urinate was most distressing and constant, and I was compelled to rise 
five or six times during the night for this purpose; there was a profuse 
discharge from the womb; dyspepsia, with spasms and bloating, was 
present, whilst I was so weak as to scarcely be able to walk across the 
floor. In one day after beginning your treatment, the whitish dis- 
charge was arrested, and in a reasonable time the urinary difficulty 
was wholly overcome. I would add that my dyspepsia and other symp- 
toms are perfectly and permanently relieved. 
I am, very respectfully yours, 
Mrs. M. A. B., Abbeville, 8. C. 
ULCERATION OF THE UTERUS. 
Ulceration is the process by which ulcers, or sores, are pro- 
duced. It is characterized by the secretion of pus or some fetid 
discharge, and is continued as a local disease through the opera- 
tion of constitutional causes. 
Ulcers may form in the mouth or neck of the uterus, and, 
omitting cancerous ulcers and those of a syphilitic character, 
which are considered elsewhere, may be classified as granular 
and follicular. 
Granular Ulcer. This variety of ulcerative degenera- 
tion is the most frequent and may exist for some time without 
exciting any suspicion in the mind of the patient that she is 
afflicted with any such morbid condition. There is local inflam- 
mation, and the mouth of the uterus is uneven, rough, and 
granular. If an examination is made with the speculum, the 
mouth of the uterus is often found in the condition represented 
in Fig. 22, Colored Plate IV. Plate IV. 
Fig.22 
Fig. 21 
Fig. 24 
Fig. 23 
Fig.25 
Fig. 26 ULCERATION OE THE UTERUS. 
757 
Figs. 225 and 226 represent two different forms of specula. 
The one represented in Fig. 225 consists of a tube of glass 
coated with quicksilver and covered with India rubber, which is 
thoroughly varnished. That represented by Fig. 226 is made of 
Fig. 225. 
The Fergusson Speculum. 
metal and plated. By using one of these instruments, the con- 
dition of the womb can be distinctly seen. 
Follicular Ulcer. When the mucous follicles of the 
neck of the uterus are inflamed, they enlarge and become filled 
with a fluid having the color and consistency of honey, present- 
Fig. 226. 
An Expanding- Uterine Speculum. 
ing the appearance illustrated by Fig. 25, Colored Plate IV. 
This secretion, because of the presence of inflammation, is not 
discharged. The follicles, therefore, continue to enlarge until 
they burst, and then we see in their place the red, elevated, 
angry-looking eminence which is called & follicular ulcer. COMMON SENSE MEDICAL ADVISER. 
758 
Symptoms. The-severity of the symptoms depends upon 
the character of the ulceration. If ulceration be slight and 
local, few symptoms will be present; but if it be associated 
with uterine debility, congestion and inflammation of the mu- 
cous membrane of the uterus, the discharge will be profuse, and 
there will be fixed pain in the back and loins, a bearing-down 
sensation, and great difficulty in walking. The discharge is 
weakening, as it impoverishes the blood and thus reduces the 
strength. 
Causes. Ulceration may be induced by any thing which 
excites inflammation of the lining membrane of the mouth and 
neck of the uterus. The use of pessaries, excessive sexual in- 
dulgence, injuries occasioned by giving birth to children, con- 
gestions, enlargements, and displacements may all operate as 
causes. 
Treatment. For the proper treatment of these ulcers, 
the reader is referred to pages 740 and 741. The course there 
advised has proved very successful. We cannot too strongly 
condemn the practice so popular at the present time, of cauter- 
izing all uterine ulcers with strong caustics, regardless of the 
.condition of the general system. Ulcers of the womb must be 
healed in the same manner as those upon any other part of the 
body. It is an irrational practice to repeatedly apply caustics 
to them, expecting thereby to promote healing, while the sys- 
tem is vitiated and the vitality far below the standard of health. 
Enrich the blood, tone up the system, keep the ulcers cleansed 
as suggested, and they will generally heal. Caustics often ag- 
gravate the irritability and interfere with the healing processes 
of nature. If the treatment which we have suggested be fully 
carried out, other local treatment will rarely be found neces- 
sary. We do not wish to be understood as undervaluing or 
denying the necessity, in rare cases, of examinations of the 
uterus, or as being unappreciative of the aid afforded in such 
investigations by the speculum, and the beneficial effects of 
local applications made directly to the womb through that in- 
strument. What we affirm is, that such examinations and.ap- 
plications are, in the practice of most modern. physicians, made 
unnecessarily frequent, often resulting in lasting injury to the 
patient. VAGINISMUS. 
759 
CASES TREATED. 
Case 85,328. Ulceration of the Uterus and Vagina, with 
Prolapsus, Irregular Menstruation, Piles, and Leucor- 
rhea. 
World's Dispensary Medical Association: Dear Sirs-I have 
experienced ujuch improvement every way, especially in digestion and 
in the absence of night-sweats, and in the palpitation, pain in the 
shoulder, side, back, temple; also in the bloating and congestions. The 
relief is wonderful. Mrs. H. H. M., Cuba, Mo. 
Case 88,114. Ulceration, Inflammation of the Womb, with 
a Bearing-down Sensation, Weak Back, Indigestion, Sour 
Stomach, Palpitation, and Sharp and Severe Pains in the 
Left Side and Abdomen. 
World's Dispensary Medical Association: Dear Sirs-\ have 
received your medicine and have used most of it, and I am happy to 
be able to say that my health is restored. At the time I wrote to you. 
I thought I never would be well again, I was so reduced in flesh and 
strength. I have not had any pain in my side at all, and my appetite 
is very good. Be assured, whenever I have it in my power, I shall 
recommend your invaluable remedies. 
Mrs. E. W., Clinton, Ont. 
Case 91,416. Uterine Disease of ten years' standing, with 
THE FOLLOWING SYMPTOMS IN AN AGGRAVATED FORM: INFLAM- 
MATION and Ulceration of the Womb, a Bearing-down Sen- 
sation, Headache, Palpitation, and Eruptions upon the 
Surface. She had had one Miscarriage. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-I want to let you know that I am now better than I ever 
expected to be. Your medicine has cured me. I had tried a good 
many other doctors. I shall ever feel thankful to you for your kind- 
ness ami good medicine. May the Lord bless you through all your 
life for the good you do poor sick women. 
Mrs. M. C. T., 
Willowglen, Deer Lodge Co., Montana. 
Case 96,801. Ulceration, with Prolapsus, Painful, Profuse 
and Frequent Menstruation, and Partial Suppression of 
the Urine. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-The result of the first course of medicine has been so satisfac- 
tory that I was in doubt as to whether more would be needed. Some 
two weeks have passed since the medicine was taken, and I am able 
to attend to my household duties without suffering any pain. The 
monthly periods are thoroughly regulated. The pam is less than for- 
merly, and the time of continuance shorter. I have regained my usual 
amount of flesh, and am feeling very well. 
Mrs. E. E. W., Louisville, Ky. 
VAGINISMUS. (Irritable Vagina.) 
Not unfrequently the nerves distributed to the mucous mem- 
brane of the vagina, especially to that portion near the hymen, 760 
COMMON SENSE MEDICAL ADVISER. 
become morbidly sensitive. The slightest irritation will arouse 
this sensibility and produce a spasmodic contraction of the 
vaginal sphincter muscle, thus effectually closing the vagina. 
Roux, Dupuytren, and Burns of Glasgow first noted and de- 
scribed this peculiar nervous affection, and the surgical opera- 
tion which they adopted for its removal is the one now most 
generally approved by the profession. Subsequently, Scanzoni 
and Sir J. Y. Simpson insisted upon the importance of a 
thorough investigation of the causes and nature of this disease, 
and, in 1861, Michon, Debout, and Huguier more accurately 
defined it, and Sims designated it vaginismus. 
Concerning the real cause of this disease, physicians have 
differed in their opinions, and it is remarkable that, while some 
have concentrated their attention upon the morbid condition of 
the pubic nerve, and others have directed their efforts solely to 
relieve the muscular spasm, both classes have been led to adopt 
the same operative procedure. 
Causes. Vaginismus may be either symptomatic, a mani- 
festation of some uterine disorder, or idiopathic. The causes 
which are recorded as having induced this disease are chronic 
inflammation of the cervix and vagina, a hysterical diathesis, 
eruptions on the vulva, fissure of the anus, excavations or 
fissures at the vulva, and carunculae of the meatus. It will be 
observed that the causes enumerated may produce vaginismus 
in two ways, namely, directly, by mechanical irritation, or, in- 
directly, by producing a discharge which inflames the mem- 
brane and thus renders the imbedded nerve-filaments morbidly 
sensitive. 
As Dr. Sims has remarked, there is " no disease capable of 
producing so much unhappiness to both parties of the marriage 
contract, and I am happy to state that I know of no serious 
trouble that can be so easily, safely, and so certainly cured." 
Sterility is a frequent accompaniment of this affection. 
The duration of vaginismus is variable, depending, to a great 
extent, upon its cause. Sometimes it is only a temporary 
symptom of some uterine disorder. Again, it may remain for a 
considerable time, even twenty-five or thirty years, and, in rare 
instances, it becomes a permanent condition unless a surgical 
operation is resorted to. • VAGINISMUS. 
761 
Symptoms. The distinguishing symptom of this affection 
is the excessive pain and nervous apprehension experienced upon 
attempting sexual intercourse. Sometimes there is a tendency 
to spasm of the vaginal sphincter, when the genital fissure is 
washed. When these symptoms are marked and an examination 
is attempted, it is often impossible to explore the vaginal canal 
with the finger unless the patient is under the influence of an 
anaesthetic. But if the finger be forced into the vagina, the 
violent contraction of the sphincter muscle can be distinctly 
felt, and the patient will complain of severe pain and manifest 
intense nervous disturbance. 
Treatment. In the mildest forms of this disorder, sooth- 
ing applications to the affected parts will alone be necessary to 
effect a cure, and, in some instances, a mere change of scene or 
habit, pleasant associations and surroundings, healthful exercise, 
and the use of tonics, will eradicate the disorder without resort- 
ing to local treatment. We can advise no better tonic and 
nervine than Dr. Pierce's Favorite Prescription, which is espe- 
cially beneficial in the peculiar nervous diseases affecting the 
female genital organs. 
For local treatment, use warm water freely as a vaginal injec- 
tion, and follow with a lotion composed of two teaspoonfuls of 
laudanum to four ounces of glycerine and two ounces of water. 
Fifteen grains of acetate of lead may be substituted for the 
laudanum. In cases in which the irritability is more intense, the 
use of Sim's vaginal dilator will frequently render a surgical 
operation unnecessary. The dilator consists simply of a glass 
tube, which is daily introduced into the vagina and left there as 
many hours as possible. It will distend the vagina and grad- 
ually overcome the morbid sensitiveness of the membrane. The 
soothing lotion above advised should be used at least twice 
every day. While the patient is under treatment, she should 
live apart from her husband. We have pursued this course of 
treatment in a large number of cases, and have found it gener- 
ally successful. In fact, in all our experience in treating this 
affection, we have found it necessary to resort to a surgical 
operation in only a few cases. In these, the division of the 
vaginal sphincter muscle, with the removal of the remains of 
the hymen, as proposed by Dr. Sims, followed by the use of 762 
COMMON SENSE MEDICAL ADVISEE. 
the glass dilator and proper lotions, proved successful in curing 
the disease. 
OVARIAN AND UTERINE TUMORS. 
We have only space to give a brief outline of the character- 
istics and treatment of the most frequent classes of tumors 
which affect the ovaries and uterus, with a report of a few illus- 
trative cases, which demonstrate the remarkable effects of a 
comparatively new method of treatment. 
Ovarian Tumors generally consist of one or more cysts 
or sacs, developed within the ovary, and filled with a fluid, 
or semi-fluid matter, which is formed in their interior. The 
cysts vary in size, in some instances being not larger than a pea, 
while in others they are capable of containing many quarts of 
fluid. In one case operated upon at the Invalids' Hotel, thirty- 
five pints of fluid were taken from three cysts. The tumor 
sometimes consists of a single cyst, and is then called an uni- 
locular tumor, but more frequently it is composed of several 
cysts varying greatly in size, and it is then called multilo- 
cular. 
The effect of ovarian tumors on the duration of life is shown 
by the statistics of Stafford Lee. Of 123 cases, nearly a third 
died within a year, more than one-half within two years from 
the first development of reliable symptoms, while only seven- 
teen lived for nine years or upwards. 
Fibroid Tumors of the uterus are composed of fibrous 
tissue, identical in structure with that of the uterine walls. They 
are met with of all sizes, from that of a small shot to that of a 
mass capable of filling the entire cavity of the abdomen. Cases 
are on record in which these tumors have attained the weight 
of seventy pounds. 
They are divided into three classes, namely: sub-peritoneal or 
extra-uterine, those which spring from the peritoneal or external 
surface of the uterus; intramural, or interstitial, those which 
are imbedded in the uterine wall and covered on all sides with 
uterine tissue; and sub-mucous or intra-uterine, those which are 
developed inside the uterus from the tissue just beneath the 
mucous lining. OVARIAN AND UTERINE TUMORS. 
763 
Sometimes cavities or cysts are developed in the substance of 
fibroid tumors, and filled with liquid. They may be small and 
numerous, or of such size as to be mistaken for ovarian tumors, 
unless one makes a very careful examination. 
The manner in which fibroid tumors terminate life is gener- 
ally by prostration and debility produced by pressure on, and, 
consequently, interference with the function of some one or 
more of the organs essential to life; or by anaemia and debility, 
produced by the severe hemorrhages, which the intra-uterine or 
sub-mucous form not infrequently induces. 
Polypi or Polypoid Tumors of the uterus are of 
three kinds, cystic, mucous, and fibrous. They vary greatly in 
size, sometimes being as large as a tea-cup; and their point of 
attachment may be extensive or consist only of a small pedicle. 
The cystic and mucous varieties may spring from any portion of 
the mucous surface of the uterus, but they are more frequently 
met with growing from the mucous membrane lining the cervi- 
cal canal, and pendent from the mouth of the womb, as repre- 
sented in Fig. 23 and in Fig. 26, Colored Plate IV; while the 
fibrous variety generally grows from the sub-mucous tissue at 
or near the fundus, or upper portion, of the uterus. 
The most prominent symptoms of polypoid growths are 
hemorrhage, which is almost invariably present, leucorrhea, 
pain, back-ache, and a sense of weight and dragging in the 
pelvis. 
The best method of treatment, and, in fact, the only effectual 
one, is removal with the teraseur, polypus forceps, galvano-cau- 
tery, or other means. The operation is usually attended with 
little or no pain. 
The course of treatment for ovarian and fibroid tumors laid 
down in most of the works on diseases of women, is simply pal- 
liative, except in the rare instances in which the tumors are so 
situated, and their attachments of such a character, that they 
may be extirpated. Removal with the knife, even in the most 
favorable cases, is a very dangerous operation, the percentage 
of recoveries being only from sixty to seventy in a hundred, 
whereas in the method of treatment which was carried out in 
the cases reported below there is no danger to life, and it is 
adapted to all cases, no matter what their character or location 764 
COMMON SENSE MEDICAL ADVISER. 
may be. It consists of the employment of electrolysis in such 
a manner that the tumor receives the entire current of elec- 
tricity, the surrounding tissues not being affected thereby, and 
of the application, in conjunction with electrolysis, of other 
therapeutic means, the remarkable effects of which were discov- 
ered by us about eight years ago. 
In many cases, this is the only treatment which offers any 
hope of recovery, or even prolongation of life. Every year 
thousands who might be saved by this treatment pass out of 
existence, the victims of these morbid growths. 
The following cases, typical of the various forms of these 
tumors, which we have selected from the records of the Invalids' 
Hotel and Surgical Institute, show the effectiveness of the 
treatment. 
Case I. A married woman, aged 38. She had never given birth to any 
children. About four years before coming under our observation, she 
discovered a small bunch, as she termed it, in the left ovarian region, 
which gradually increased in size until, when she consulted us, it caused 
considerable pain in the region of the liver from pressure, and interfered 
with respiration. Her general health was becoming much impaired. 
She stated that she had consulted a prominent gynecologist in this city, 
who had told her that the attachments of the tumor were so extensive 
that ovariotomy (removal with the knife) was out of the question, and 
that, therefore, he could only give her palliative treatment. This 
unfavorable prognosis only added mental anguish and despair to her 
physical suffering. On 
examination, we found 
a large multilocular cys- 
tic tumor, represented 
by Fig. 227, with very 
thick walls, extending 
from the left ovarian re- 
gion obliquely upwards 
and to the right, so that 
it pressed more upon the 
short ribs on the right 
side than it did upon the 
left, but which filled the 
entire cavity of the abdo- 
men. The attachments, 
as the physician whom 
she had previously con- 
sulted had stated, were 
so extensive that its removal with the knife could not be thought of. 
We were not disposed, however, to give the case up as hopeless. We 
told her that we would do what we could for her, but what the result 
of our treatment would be, we could not definitely say. She placed her 
case in our hands, and we resorted to the treatment'described above. 
She was treated two and three times a week for more than two months, 
at the end of which time, the tumor had decreased in size fully two- 
thirds. It has ever since remained stationary, and has given her no 
Fig. 227. 
The shape and position of the Tumor are shown 
by the dotted line. OVARIAN AND UTERINE TUMORS. 
765 
trouble or inconvenience whatever. It is now seven years since we 
treated her. 
Case II. .A young lady of 23; unmarried. About six months before 
consulting us, she had discovered a tumor of about the size of an egg, in 
the region of the left ovary, 
which had been gradually in- 
creasing in size. On exami- 
nation, we found the morbid 
growth to be about the size 
of a quart bowl, and evidently 
composed of several cysts 
with thick walls. She expe- 
rienced no pain, and but slight 
inconvenience from its pres- 
ence, but she was in great 
mental distress. She was an 
only daughter and her mother 
had died a few years pre- 
viously from the shock and 
hemorrhage resulting from 
an operation for the removal 
of a large ovarian tumor, per- 
formed by the late lamented 
Dr. Peaslee, of New York. 
The same course was pursued 
in this case, and, at the end of six weeks' treatment, the tumor was re- 
duced to the size of an egg, and has remained so ever since, now more 
than three years. 
Case III. A woman 37 years of age: married six years; no children. 
She had suffered for eight years 
from profuse menstruation and dys- 
menorrhea, with a membranous dis- 
charge, and, for several months 
before consulting us, she had experi- 
enced severe pain and a soreness in 
the pelvic organs. Her bowels were 
obstinately constipated, it being next 
to impossible for her to have an 
evacuation, and her countenance was 
pale and careworn. Upon examina- 
tion, we discovered a hard, incom- 
pressible tumor, represented in Fig. 
229, attached to the posterior wall 
of the uterus, which caused antever- 
sion of the womb, and which pressed 
upon the rectum so as to produce 
great obstruction. She was treated 
by means of electrolysis, with injec- 
tions into the substance of the growth, 
for one month, at the end of which 
she returned home, with the tumor 
reduced from the size of a pint bowl 
to the size of an egg, and her health 
greatly improved. After going home 
the tumor continued to grow less, 
until, at the end of a few months, 
her home physicians could detect no 
trace of it, and she has remained well since, for more than five years. 
Fig. 228. 
rr, Uterus, b, Bladder. R, Rectum, t, Tumor. 
Fig. 229. 
it, Uterus, t, Tumor. 766 
COMMON SENSE MEDICAL ADVISER. 
Case IV. A lady aged 36; married 12 years; no children. She 
complained of severe pain in the back and a frequent desire to urinate. 
Menstruation was profuse aud the bowels were constipated. On 
examination, we found an intra-mural 
fibroid tumor, represented in Fig. 229, 
developed in the anterior wall of the 
uterus, and pressing upon the bladder. 
The womb was enlarged, measuring 
three inches in depth, and was slightly 
anteflected. A month's treatment, with 
electrolysis and injections into the 
tumor, arrested the growth and dimin- 
ished the size more than one-half, aud 
caused the unpleasant symptoms to 
disappear. 
Case V. A married lady, 26 years of 
age; had borne no children, but had 
had several abortions, brought about 
intentionally. Six months before con- 
sulting us, a tumor, about the size of 
an egg, was discovered by her home 
physician. It grew steadily from the 
time of its discovery until, when we 
made an examination, it was found to 
be about the 
size of an or- 
dinary tea- 
cup. It was 
developed in 
the posterior 
wall of the 
womb, as rep- 
resented in 
Fig. 230. Three weeks' treatment reduced 
the tumor two-thirds. 
Case VI. A widow lady, aged 52. She 
was examined ten years ago by two of the 
most distinguished physicians of New Haven, 
Conn., who pronounced her sufferings due 
to cancer of the uterus. She was then 
suffering from repeated hemorrhages and 
other symptoms. They gave her palliative 
treatment, and told her that to interfere 
with the morbid growth would only shorten 
her life, and that by leaving it alone she 
might live several years. The hemorrhages 
afterwards ceased and she passed the change 
of life, but she continued to be troubled 
with a sensation of fullness in the pelvis, 
pains in the back, and frequent headaches. 
On examination, we found not a cancer, but 
a large polypus, as represented in Fig. 230, 
which had caused all the trouble. It was 
quickly removed, without pain, and hei- 
health restored. Thus, through an error 
of diagnosis, she was made to suffer physically and mentally for ten 
long years of her life, in constant dread of a horrible death. 
Fig. 230. 
Fig. 231. 
U, Uterus. T, Tumor. 
u, Uterus, p, Polypus. DERANGEMENTS INCIDENT TO PREGNANCY. 
767 
URINARY FISTULA. 
A fistula, or false passage, is sometimes formed between the 
bladder and uterus, between the bladder and vagina, or between 
the urethra and vagina. This passage allows the urine to escape 
into the vagina, and is a source of great annoyance and suffer- 
ing. This affection is most commonly due to sloughing, caused 
by severe and long-continued pressure upon the parts during 
child-birth. It is also sometimes produced by the unskillful 
use of forceps and other instruments employed by midwives. 
Syphilitic and other ulcerations may so destroy the tissues as to 
form a urinary fistula. 
Treatment. The treatment is purely surgical, and con- 
sists in paring the edges of the opening so as to make them raw, 
bringing them together, and holding the parts thus by means of 
stitches until they heal. By the aid of a speculum, properly 
curved scissors, needles with long handles, fine silver wire, and a 
few other instruments and appliances, the skillful surgeon can 
close the urinal fistula with almost as much ease as he can close 
a wound on the surface of the body. 
DERANGEMENTS INCIDENT TO PREGNANCY. 
While some women pass through the whole period of preg- 
nancy without inconvenience, others suffer from various sym- 
pathetic disturbances, such as impaired appetite, dyspepsia, con- 
stipation, diarrhea, headache, fainting, difficult breathing, and 
sometimes convulsions. A strong nervous sympathy exists be- 
tween the uterus and every part of the system, and this sym- 
pathy is greatly intensified by pregnancy, causing many of the 
distressing symptoms above mentioned. 
Treatment. By proper treatment, most of these ills can 
be obviated and the patient made comfortable. By the moder- 
ate use of such a nervine and uterine tonic as the Favorite 
Prescription, this nervous irritability may be controlled or sub- 
dued, and the disagreeable symptoms thus avoided. 
While the female is pregnant, she should avoid all compres- 
sion of the waist and abdomen. For this reason, tight clothing, 
stays, or corsets, must be discarded. She should also care- 
fully regulate her diet, selecting those articles which are most 768 
COMMON SENSE MEDICAL ADVISEE. 
nutritious and easily digested. Sexual intercourse should be 
avoided, for although commonly indulged in, and frequently 
with impunity, yet it is liable to be followed by distressing 
symptoms, as well as by some defect in the mental or physical 
organization of the offspring. 
The nausea which occurs in the morning may generally be 
avoided by partaking of a little light food and a cup of tea or 
coffee before leaving the bed. If vomiting occur, and the 
ejected matter be very acid, carbonate of magnesia, some alkali 
with aromatics, or charcoal will afford relief. If constipation 
or diarrhea be experienced, the treatment suggested when con- 
sidering those subjects in a preceding part of this volume should 
be employed. Want of appetite, headache, or a tendency to 
convulsions can be generally overcome by a persistent use of 
the Favorite Prescription, which should be taken in teaspoon- 
ful doses three or four times every day. Indeed, this valuable 
medicine not only relieves the distressing symptoms which 
frequently attend the pregnant state, but also prepares the sys- 
tem for the ordeal of parturition, or delivery. One or two bottles 
of this nervine and tonic, used previous to confinement, will, in 
many cases, save hours of terrible suffering, besides regulating 
the system, and thus insuring a speedy recovery. We have 
received the heart-felt thanks of hundreds of grateful mothers 
for the inestimable benefit thus conferred. Dr. Pierce's Favor- 
ite Prescription is perfectly safe and harmless to use at all times 
in the doses above prescribed. 
PHYSIOLOGICAL ANATOMY OF THE URINARY 
ORGANS.' 
The urinary organs consist of the kidneys, of which there are 
two, with their corresponding ureters, or ducts, the bladder, or 
reservoir for the urine; and the urethra or urinary canal, 
through which the urine is voided. (See Figs. 53 and 103.) 
The Kidneys. The function of the kidneys is to remove 
certain waste materials from the blood. As fast as excreted by 
the kidneys, the urine passes through the ureters into the 
bladder. The ureters (see Fig. 53) are lined with a continua- 
tion of the mucous membrane, reflected from the bladder up- 
wards, which also extends to the cavities of the kidneys. THE URINARY ORGANS. 
769 
The Bladder. The bladder receives and holds the urine 
as it comes from the kidneys through the ureters. Its walls are 
composed of muscular fiber, with an external peritoneal covering 
and an internal lining of mucous membrane. It is by the con- 
traction of the muscular fibers that the urine is expelled. When 
empty, the bladder shrinks down to a small size, as compared 
with its condition when distended. When filled, it is capable of 
holding about one pint. If it is distended by the retention of 
urine much beyond this capacity, the muscular coats lose their 
power of contraction, and the urine cannot be passed without 
considerable effort. In health,'when the bladder becomes filled 
and distended, there is a desire to empty it. The voiding of the 
urine should not be attended with any pain or disagreeable sen- 
sation, and the desire to pass it should not be frequent. 
The Urethra. The urethra, in the male, is the canal ex- 
tending from the bladder to the end of the penis (see Fig. 103, 
page 207), through which the urine is passed. The direction 
and length of this canal are well shown in the illustration just 
referred to. It will be seen that this canal starts from the base 
of the bladder, passes through the prostate gland, and, entering 
the penis, continues of about uniform size along the under part 
of the penis until it reaches the glans, or head of that organ, 
where it expands somewhat into a bulb-like fossa, or cavity, and 
becomes reduced again at the orifice. At a short distance from 
the bladder it receives the outlets of the seminal ducts. The 
urethra is a most delicate and sensitive canal, and is sur- 
rounded by tissues of great delicacy, and is lined with a mu- 
cous membrane which is highly vascular, and filled with sensitive 
nerves. 
Slight Affections of the Urinary Organs. When 
there is frequent desire to void the urine, or when its passage is 
attended with pain, there is irritation or inflammation in the 
coats of the bladder or in the urethra. This may arise from an 
excessively acid or irritating condition of the urine, as well as 
from various other causes. Gonorrhea, or clap, stricture of the 
urethra, which impedes the free flow of the urine, enlargement 
or inflammation of the prostate gland, gravel, and stone in the 
bladder are all capable of creating a frequent desire to pass 
water. Whatever the unhealthy condition may be which gives 770 
COMMON SENSE MEDICAL ADVISER. 
rise to this troublesome symptom, it cabs for prompt and 
skillful treatment, for the most trivial affections of these organs 
often pass into others which are exceedingly intractable, if not 
incurable. 
The urine should spurt from the urethra in a full, round, 
and regular stream, until the bladder is entirely emptied. If 
the stream is forked, checked, or interrupted in any way 
before the bladder is completely emptied, it is evidence that 
something is wrong. Stricture of the urethra, prostatic dis- 
ease, gravel, or stone in the bladder, which will be described 
further on in this work, are all capable of producing obstruction 
to the free flow of the urine. 
As we have before stated, the mucous membrane lining the 
bladder is reflected upwards into the ureters, lining these canals. 
By reason of this continuity of mucous tissue, persons suffering 
from urethral, prostatic, or bladder affections, often die from 
disease of the kidneys. It must not be supposed that because 
stricture of the urethra does not always co-exist with Bright's 
disease, that the latter may not be caused by obstruction of the 
urethra due to stricture. Pulmonary consumption, for instance, 
often begins in the form of nasal catarrh, but, by the continuity 
of the mucous membrane, it travels, so to speak, into the 
pharynx, from the pharynx into the larynx, and then into the 
lung structure itself. What occurs in the nasal, laryngeal, and 
pulmonary tracts of mucous membrane, happens, also, in the 
urinary tract. A gonorrhea, which is a specific acute inflamma- 
tion of the urethral canal, leaves behind it a slight gleet, or 
chronic inflammation of the mucous membrane of the urethra. 
This may give little inconvenience for a number of years, but 
gradually it culminates in stricture, or, implicating the prostatic 
portion of the urethra, occasions inflammation of the prostate 
gland, and, perhaps, enlargement of that organ. This gradually 
gives rise to cystitis, or inflammation of the bladder. From the 
bladder, the disease travels up the ureters into the kidneys, and 
finally Bright's disease is established in these organs. Thus, 
slight affections of the urinary organs may become dangerous 
diseases. 
Sympathetic Affections of the Urinary Organs. 
The bladder is largely supplied with blood-vessels, lymphatics, DISEASES OE THE URINARY ORGANS. 
771 
and nerves, given off from the same systems that supply the 
rectum or lower bowel and, in females, the uterus, or womb, and 
the ovaries. This accounts, in a great measure, for the symp- 
toms of bladder disease, in those afflicted with piles, or other 
diseases of the lower bowel, or of diseases of the uterus or 
womb in the female. We have frequently been consulted by 
patients who had eroneously supposed themselves to be suffer- 
ing from disease of the bladder or of the prostate gland, but 
whom we found, on examination, to be suffering from hemor- 
rhoids, or piles. In these cases, by removal of the pile tumors, 
the frequent desire to urinate and all pain in the region of the 
bladder, were promptly removed. Sometimes, ulcers located in 
the rectum give very little unpleasant sensation in the bowel, 
but produce pain in the bladder, with frequent desire to urinate. 
Enlargement of the uterus, or womb, or displacements of that 
organ, such as prolapsus or anteversion, are capable of producing 
symptoms of bladder disease. A frequent desire to urinate and 
more or less sharp pain in the region of the bladder are usually 
experienced in these cases. Disease of the bladder, in like 
manner, often produces an apparent disease of other organs 
through sympathy, and, without great care in diagnosticating 
every case, the effect may be taken for the cause, and the patient 
may be treated for a disease which does not really exist. 
DISEASES OF THE URINARY ORGANS. 
Examination of the Urine. In health, the urine 
holds in solution certain substances which have a definite rela- 
tion to one another. In diseases, the proportions are subject to 
numerous changes, some ingredients being diminished and others 
increased. Sometimes the changes are so great that the urine 
can no longer hold the substances in solution and they are pre- 
cipitated, sometimes in the form of gravel. These changes bear 
a well-defined relation to disease, and, when correctly under- 
stood, indicate the true condition of the system more definitely 
than in any other way. To determine the character, extent, 
and indications, of these urinary changes, recourse must be 
had to thorough chemical and microscopical examinations. An 
examination the of urine often affords the only means of 772 
COMMON SENSE MEDICAL ADVISER. 
determining the exact nature and extent of diseases of the 
urinary organs. At the Invalids' Hotel and Surgical Institute, 
urinary examinations form a prominent feature of the methods 
by which we distinguish diseases, and to this fact we attribute 
much of our success in correctly understanding and treating 
urinary affections. 
Diseases of* the Kidneys are generally very slow in 
their inception, coming on gradually, and manifesting no spe- 
cial symptoms of their presence until they have assumed a 
formidable character. For this reason they are the more dan- 
gerous. Simple derangement of the urinary secretion is no 
evidence of disease of those organs, as changes in the color, 
quantity, and specific gravity of the urine are often produced 
by changes of temperature, active or sedentary habits, mental 
emotions, and sometimes by articles of diet or drink, as well as 
by the use of different drugs. 
The existence of disease of the kidneys in the early stages 
can only be positively determined by a microscopical and 
chemical examination of the urine. The microscope informs 
us not only of the presence of disease, but very often of the 
particular portion of the kidney in which it is located, as well 
as the form of the disease. Chemical tests assist in determin- 
ing the presence or absence of albumen, sugar, etc. These 
examinations with the microscope and chemical re-agents, 
should never be neglected by the physician. Without them 
his diagnosis is simply guess-work. With them he is enabled 
to base his treatment upon a definite knowledge of the patient's 
real condition. 
The usual symptoms of chronic disease of the kidneys, which 
vary materially with the age, constitutional peculiarities, and 
temperament, are weakness in the small of the back, pains in 
the region of the loins and groins, numbness of the thigh on 
the side of the affected kidney, high-colored and scalding urine, 
frequently depositing a sediment, white or milky urine, bloody 
urine, a frequent desire to pass the urine, partial impotency, 
pains in the testicles shooting into the loins, suppression or 
inability to pass the urine, dropsy, swelling of the testicles, 
irritability and pain in the' bladder, mucous and sometimes 
seminal discharges oozing from the urethra. ebight's disease. 
773 
ACUTE INFLAMMATION OF THE KIDNEYS. 
(Acute Nephritis.) 
This affection may be caused by injuries, blows upon the 
back, strains, irritation from calculi, suppressed perspiration, or 
by the employment of irritating medicines, such as turpentine 
and cantharides. 
The Symptoms are chills, a hot and dry skin, a quick 
and hard pulse, and a deep-seated throbbing in the region of 
the kidneys. These symptoms soon become very severe. The 
urine is scanty and highly colored, and the bladder irritable; 
the patient is unable to lie on the affected side, and the distress 
is increased upon rising. There is pain extending down into 
the thigh, numbness, and drawing up of the testicles, nausea, 
vomiting, flatulency, and constipation. If the disease termi- 
nates by suppuration, chills are experienced, and the pain in 
the region of the kidneys becomes very severe; there is also 
numbness and weight in the affected side, and pus frequently 
appears in the urine. 
The Treatment should be energetic. Most diuretics are 
harmful and ought not to be used, but poultices of digitalis 
leaves should be applied over the kidneys, and an infusion of 
digitalis leaves should be administered in doses of half an ounce 
every two or three hours until there is a free flow of urine, 
when it may be discontinued and diluent drinks given to keep 
up the effects. The bowels should be regulated and a spirit 
vapor-bath given every day. Wet packs applied to the back 
as hot as can be borne, are also beneficial. As soon as the in- 
flammation yields, pursue an alterative and tonic course of 
treatment. Care should be taken not to induce a relapse by 
undue exposure. When the pain is intense, a powder composed 
of three grains of saltpetre and one-fourth to one grain of 
opium, given every four hours, generally gives relief. 
This affection may appear in either an acute or chronic form. 
Acute Bright's Disease (Acute desquamative nephritis) 
is frequently a complication, or sequel of scarlet fever, diph- 
theria, cholera, typhoid fever, erysipelas, or measles, and is 
BRIGHT'S DISEASE. COMMON SENSE MEDICAL ADVISER. 
774 
frequently developed by intemperance. The acute form of the 
disease is very rapid in its progress, often destroying life by 
uraemic poisoning, the retention of urea in the system. 
The symptoms of the acute form are diminution or suppres- 
sion of urine, a dry skin, chills, thirst, pains in the loins, and a 
general dropsical, puffy condition of the system, especially 
manifesting itself in the earlier stages under the eyes, but grad- 
ually showing itself in cedema, or swelling of the feet and legs. 
Unless promptly relieved, the patient dies of coma, or from 
convulsions. 
Treatment. The treatment given under the head of acute 
inflammation of the kidneys is proper for this affection, but all 
cases should be intrusted to the best medical aid that can be 
procured. 
Chronic Bright's Disease. Chronic Bright's disease 
includes desquamative nephritis and the fatty and amyloid 
forms of degeneration of the kidneys. It is an insidious and 
most fatal form of organic disease, named after Dr. Richard 
Bright, of England, who first accurately described the affection 
in 1827. 
In these days, it has become extremely fashionable to have 
" Bright's disease." A few years ago it was thought to be 
aristocratic to have " hay-fever," and some twenty years before 
" gout" was the fashionable affection of the period. Hence, we 
predict that before many years have elapsed, " Bright's dis- 
ease " will have had its day, and some other new-fangled notion 
will have sprung up to charm and chain the popular fancy. 
Very few of those who imagine they have Bright's disease, ac- 
tually have this affection. 
We find that most of those who suppose that they are afflicted 
with Bright's disease base their diagnosis upon the ever-chang- 
ing condition of the urinary secretion, and especially upon the 
copiousness of the deposit, whereas, in true Bright's disease, 
deposits of any kind are rarely met with. The form of 
deposit most commonly mistaken for an indication of Bright's 
disease, is that known to medical men as the urates. When the 
urates are in excess, they form a heavy pinkish deposit of a 
flocculent nature, within from five to thirty minutes after the 
urine has been passed, that is, after it has been passed sufficiently bright's disease. 
775 
long to cool. To prove that the deposit is composed of urates, 
heat the specimen to the temperature of the blood, and, if 
the deposit in question be composed of urates, it will disap- 
pear. Excess of urates has now been definitely traced, in 
the majority of instances, to slight functional torpidity of the 
liver. 
Another common form of deposit is that in which the re- 
action of the urine, instead of being acid, as in health, is either 
neutral or alkaline, and in which the earthy phosphates are pre- 
cipitated for this reason. The earthy phosphates, when thrown 
down by a neutral or alkaline condition of the urine, appear as a 
heavy white deposit, which, though usually devoid of clinical sig- 
nificance, is certainly calculated to frighten timid patients who 
read about the " terrible ravages of Bright's disease " in adver- 
tisements in various newspapers and pamphlets. To ascertain 
that the precipitate is phosphatic in its nature, add a few drops 
of vinegar and it will disappear. There is only one substance 
known to pathological chemistry that can form a deposit when 
vinegar or nitric acid has been added to the urine and it has 
been brought to the boiling point, and that substance is albu- 
men, which, if present in quantity, is always indicative of seri- 
ous disease. 
We are consulted by persons almost daily in whose cases 
these errors have been made. In reality, true Bright's disease 
is not a common affection, and nine out of ten individuals who 
think that they are suffering from it have some less serious 
disease. In some cases, it is an affection of the liver, which 
forces an excretion of unnatural salts by the kidneys, and thus 
renders the urine acid and irritating, or they may be suffering 
from some other disease, such as deformity or enlargement of 
certain glands, such as the prostate, or from some displace- 
ment of the uterus. It is as common for persons to suffer 
from deformity of the urinary canal as from deformity of the 
limbs, nose, or ears. 
The urinary canal from the bladder outwards, is small and 
formed of delicate tissues. Any disease or injury therein is 
liable to result in gradual contraction, which may be manifested 
several years after the cause has been forgotten or has dis- 
appeared. These affections, to the inexperienced or to the 776 
COMMON SENSE MEDICAL ADVISER. 
physician who is not particularly alert and cautious in his diag- 
nosis, are liable to cause error, and a case is often erroneously 
pronounced Bright's disease, when, in reality, there is some sim- 
ple cause for the irritation of the urinary canal, and the pains in 
the kidneys all of which frequently result from a slight obstruc- 
tion to the flow of urine and the retention in the system of ex- 
crementitious products which should pass off by the kidneys. 
They cannot work under pressure. When, from any cause, the 
flow of urine is checked, and, as it were, dammed up so that 
a slight pressure is put upon the kidneys, their secretion is mate- 
rially interfered with, and the many symptoms which usher in 
disease of the kidneys appear. 
The true and only sure way to relieve these conditions is to 
remove the real cause. The use of any medicine that stimu- 
lates the kidneys to increased action while such an obstruction 
exists, should be avoided, for it only .aggravates the disease by 
increasing the amount of urine which is dammed up. By 
relieving the choked outlet, the flow of urine becomes free, and 
the kidneys are speedily restored to their natural condition. 
This is well illustrated by the following case: 
Case 113,396. 
A farmer, aged 41, married, had for a period of nearly ten years, as 
a result of slight injury, suffered from cloudy and unhealthy looking 
urine, with some burning on passing it. He had a frequent desire to 
urinate, with swelling of the limbs, loss of energy and strength, and 
headache. Gradually there appeared severe pain in the back, 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. He had 
been assured, that without the shadow of a doubt, his symptoms were 
the result of Bright's disease. After consulting many doctors, all of 
whom assured him that they could give him treatment which would 
prolong his life somewhat and make his condition comfortable, but that 
no treatment would effect his cure, he applied to us for treatment. A 
thorough examination of the case was made, which resulted in the 
discovery of two contractions of the urethra, which admitted the 
passage of only the smallest probe, and which, necessarily, prevented 
the free flow of the urine. These strictures 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 disap- 
peared. From a feeble and irritable invalid, in a few weeks he was 
converted into a happy and cheerful man. The symptoms of conges- 
tion and irritability of the kidneys gradually disappeared, and in 
thirty days after visiting us, he wrote that he felt satisfied that he was 
perfectly cured. bright's disease. 
777 
Bright's disease, when fully established, is characterized by 
degeneration of the kidneys. When submitted to examination 
after death by this disease, these organs present various ap- 
pearances. The disease has been classified as desquamative, 
waxy, or fatty degeneration of the kidneys, all of which are 
characterized by the presence of albumen in the urine. The 
particular variety can be determined before death only by a 
careful microscopical examination of the urine. 
As to the causes of kidney disease, it may be said that any 
thing which gives rise to a greater or less degree of congestion 
of the kidneys may induce either a temporary albuminous con- 
dition of the urine or true Bright's disease of the kidneys. Sup- 
pression of perspiration, from exposure to cold and wet, want 
of cleanliness, deficiency of nutritious food, disease of the 
liver, certain poisons in the system, such as that of scarlet fever, 
measles, erysipelas or diphtheria, excessive mental labor or 
worry, may all occasion an albuminous urine and finally result 
in Bright's disease, but of all the causes which produce this 
disease, none is so prominent as intemperance. A scrofulous 
diathesis strongly predisposes to the disease, and chronic disease 
of the kidneys also frequently follows acute rheumatism and 
the practice of masturbation. In some instances, the chronic 
form of Bright's disease follows an acute attack, but it is more 
frequently developed slowly and insidiously. 
The Symptoms of this fatal malady generally appear so 
gradually that they excite but little or no concern until it has 
reached its more advanced and dangerous stages. Frequently, 
a puffy, watery, or flabby condition of the face, particularly 
under the eyes, is the first symptom noticed, and the patient 
may observe that his urine is diminished in quantity. This 
secretion is sometimes abundant, but generally more scanty 
than in health and generally of a low specific gravity. The 
countenance is frequently pale and bloodless, which, taken with 
the dropsical condition of the system, and the constant albu- 
minous condition of the urine, points the expert specialist to 
Bright's disease of the kidneys. Various circumstances and 
conditions may give rise to the temporary presence of albumen 
in the urine, and, although albumen may be temporarily absent 
from the urine even when Bright's disease exists, yet this is not 778 
COMMON SENSE MEDICAL ADVISER. 
common. There are certain indirect symptoms which point 
clearly and almost unmistakably to the presence of this disease. 
These are deep-seated pain or weakness in the back, gradual loss 
of flesh, red, brown, or dingy urine, more or less drowsiness, 
and, as the disease advances, a smothering sensation, or difficulty 
in breathing, with dropsical puffiness or swelling. Occasional 
attacks of nausea and vomiting are common, and pains in the 
limbs and loins, which are often mistaken for rheumatism. Ir- 
regularity of the bowels is also a frequent symptom. The skin 
becomes harsh and dry, not perspiring even under active exer- 
cise. Sometimes these symptoms are years in their develop- 
ment, being very obscure at first, and, in some cases, the disease 
has been known to prove fatal without the patient having 
experienced any extraordinary symptoms. In those whose sys- 
tems are enfeebled by want of food, by intemperance, expos- 
ure, or disease, such as scrofula or syphilis, the first symptoms 
usually observed are a frequent desire to urinate, occasional 
attacks of diarrhea, flatulency, dropsical swelling of the face, 
especially under the eyes, and afterwards of the extremities, 
paleness, and increasing debility. Stupor and convulsions are 
the forerunners of a fatal termination. 
Microscopical and chemical examinations of the urine are the 
only reliable means of diagnosis and should be often repeated. 
As albumen is often present in the urine without the existence 
of Bright's disease, it is impossible, except by the aid of the 
microscope, to distinguish true Bright's disease from other affec- 
tions of the kidneys. In purulent urine, and in that containing 
blood, albumen may be found by the usual tests but in smaller 
quantity than in Bright's disease. Albumen, with disintegrated 
epithelia, hyaline, and large granular casts, as well as waxy casts, 
are peculiar to, and characteristic of this disease. 
Treatment. In chronic Bright's disease, every case re- 
quires special study and a course of treatment in detail peculiar 
to itself, therefore we can only indicate the general principles 
which should be followed. Persons suffering from this disease 
should place their cases in the hands of those physicians who 
have had the most experience in its treatment. Accuracy in 
diagnosis as to the exact state of the kidneys is very important, 
for, without this, a physician is not likely to define the line of bright's disease. 
779 
treatment which is best adapted to the diseased condition. It is 
important that the action of the skin should be promoted, hence 
measures to produce sweating are proper. Jaborandi may be 
given and the warm bath or alcoholic vapor-bath. The dis- 
charge from the bowels should also be promoted, but great 
caution should, be exercised that it does not become excessive 
and pass into permanent diarrhea. The subject should wear 
flannel next to the skin and avoid sudden changes of tempera- 
ture. The food should be light and nutritious, and easy to 
digest, and alcoholic liquors should never be used. The 
principal meal should be taken in the middle of the day. If 
symptoms of convulsions, such as severe headache, extreme 
nervousness and restlessness, occur, hydragogue cathartics, such 
as jalap, should be given, and digitalis should be employed as 
directed under acute inflammation of the kidneys. The jalap 
may be given in doses of twenty or thirty grains, together with 
a teaspoonful of cream of tartar, mixed in two or three table- 
spoonfuls of syrup or molasses. We have indicated the above 
course of treatment for the benefit of those who may be unable 
to procure the services of competent physicians without con- 
siderable delay. The remedies which we have mentioned are 
simple and can be procured at any drug store. 
In the treatment of this malady, the experience of our spe- 
cialists has been very great and attended with marvelous 
success. Of course, after the substance of the kidney has 
degenerated and broken down and has become destroyed to 
any great extent, a cure is impossible. We have the most pos- 
itive evidence in the remarkable success attained, that we now 
possess remedies of great value, and specific power over this 
terrible disease. Most cases that are curable can be managed 
successfully at a distance, the necessary medicines being sent 
either by mail or express. We have cured many in this way 
who were so bloated from dropsical effusion as to weigh from 
twenty-five to fifty pounds more than in health. In our sanita- 
rium, where we have the advantages of Turkish baths and other 
appliances, we have cured some cases in which the removal of 
the dropsical effusion reduced the weight of the patient seventy 
pounds. 
We cannot, in conclusion, too strongly condemn the general 780 
COMMON SENSE MEDICAL ADVISER. 
resort to strong diuretics, so often prescribed by physicians for 
all forms of renal diseases, but which, by over-stimulating the 
already weak and delicate organs, only aggravate and render 
thousands of cases incurable. Not less harmful are the many 
advertised "kidney cures" and kindred preparations. They all 
contain powerful stimulating diuretics, and, while they may 
appear for a short time to do good, they invariably render the 
disease worse. The cases of Bright's disease reported cured by 
these preparations are cases of less dangerous affections. In no 
disease is there greater necessity for treatment properly adapted 
to the exact condition of the diseased organs. Those persons 
who are suffering from any serious affection of the urinary 
organs should send samples of their urine for examination to 
expert specialists, and no other physician than a specialist of 
large experience should be entrusted with the treatment of a 
malady so dangerous in its character as Bright's disease, in 
the diagnosis and treatment of which general practitioners com- 
mit such frequent and often fatal errors. 
CASES TREATED 
Case 48,180. Bright's Disease with General Dropsy. 
Executive Office, Muskogee Nation, 
Okmulgee, 0. N., Ind. Ter. 
World's Dispensary Medical Association: Gentlemen-I con- 
sider myself in duty bound to you and suffering humanity to acknowl- 
edge the benefits I have received from your treatment. I had been 
suffering for a number of years from Bright's disease of the kidneys 
and a generally deranged state of the system. After trying many 
eminent physicians of New York, Philadelphia, and other Eastern 
cities, without receiving any benefit, I was induced, by hearing of your 
many astounding cures, to proceed to Buffalo and enter upon a course 
of treatment, which, I am happy to say, has resulted in a final cure of 
my disease. I have been enjoying splendid health for the past twelve 
months. I have deferred making this statement until fully convinced 
that I am permanently cured. 
I am,' with great respect, yours, etc., 
W. C., Prin. Chief, Muskogee Nation. 
When this case came under our treatment, there was general dropsy 
of the whole system, and the urine was loaded with albumen. The 
case was, however, but a fair sample of scores that have been cured 
by our treatment, after having been pronounced incurable by others. 
Some time afterwards he wrote as follows: 
World's Dispensary Medical Association: Gentlemen-Gen'l 
Porter, Col. Hodge, and myself will call on you about the 2nd or 3rd of 
December. We have been selected by our Chief and National Council 
as delegates to represent our people at Washington during the coming 
session of Congress. We simply call on a friendly visit, they to see bright's disease. 
781 
your Institution and your town, I to again thank you for saving my 
life. To you and your medicine I owe more than I can ever express. 
For years I was only the wreck of a man-until I finally commenced 
to take your medicine, and afterwards came to your institution and 
placed myself under your care. I also desire to renew old associations, 
for I found you to be not only excellent physicians, but kind friends 
and perfect gentlemen. 
Truly your friend, W. C., 
Late Chief of the Muskogee Nation, Ind. Ter. 
Case 50,518. Bright's Disease. 
World's Dispensary Medical Association: Gentlemen-Several 
months have passed since I commenced treatment. I was then in a 
dying condition, and a few weeks would have put me in my grave. 
Other doctors failed to help me in the least. Under your care I am 
steadily regaining my health and strength. I am improved in every 
way, and my kidneys and bladder are all right. God bless you. 
Good bye. T. H. D., Brunswick, Me. 
Case 59,780. Bright's Disease. 
Mr. C. P. H., of Iowa, consulted us, describing a condition which 
led us to suspect Bright's disease. An examination of urine which he 
sent us, disclosed the presence of large quantities of albumen. This 
gentleman stated that his limbs were very much bloated, and he felt a 
smothered sensation constantly, which was especially marked when 
lying down; there was loss of appetite and strength, and he had be- 
come thoroughly convinced that he could not live long unless he could 
soon get relief, an opinion in which his home physicians concurred. 
Without seeing the patient we effected a complete cure in four months, 
and, two years and a half afterwards, there were no symptoms indica- 
ting a return of the disease. 
Case 91,722. Bright's Disease. 
This gentleman when consulting us stated that he was suffering 
severely with pains across the kidneys, frequent sick headaches, a dull, 
dizzy sensation, with great nervous debility, weakness, frequent night- 
sweats, unpleasant dreams and loss of sexual power. His derange- 
ment had been pronounced by many physicians to be Bright's disease. 
His urine was found to be heavily loaded with albumen. Upon advising 
him that his case was curable, which he seemed to doubt, he was in- 
duced to take treatment, with the following result. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-I desire to state that I am perfectly well, and very thankful to 
you for curing me. The medicines, which I used for two months only, 
have effected a perfect cure of my case. I feel that my health is fully 
restored and that the result is permanent, as there has been no tendency 
to a return of the disease. 
Sincerely yours, 
M., Fairfield, Kan. 
Case 93,298. Bright's Disease. 
When this gentleman applied for treatment he wrote: 
"The symptoms of my disease are as follows, as near as I can 
describe them: I think the cause was from drinking a large amount of 
water and working in the heat. I was taken with pains in the back, 
vomiting, and cramps on the inside of the legs, which continued for 
some time. Then my feet and limbs begin to fill with water. The 
pain in my back grew less, but the water in my legs steadily increased, 
and since that I am burdened with the water. Two years ago my legs 782 
COMMON SENSE MEDICAL ADVISER. 
broke, just above the ankle, and ran water for about eight months. 
Since that time I have kept them bandaged and they have healed up so 
that they do not run, but the water is steadily rising on me. I have 
a bad taste in my mouth, my hands and feet get cold very easily, and I 
have very little blood in me. I was tapped about two years ago, and 
since that the water has not got so high. My stomach is weak." 
After taking treatment for three months, during which period he 
steadily improved, we received the following letter: 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-I am getting well fast. The swelling and other symptoms of 
disease have all gone. I will take another lot of your medicine so as 
to be sure that I am all right. I have no pain anywhere now. All 1 
can say is, that I am pretty well, and feel sure that you can do for me 
as you promised. My strength has returned, and l am able to work. 
My flesh is firm and solid. Yours very trulv, 
J. C., 'Hopewell, N. Y. 
DIABETES. (Polyuria and Glycosuria.) 
There are two essentially different varieties of this disease, 
one of which is called diabetes insipidus or polyuria, and the 
other diabetes mellitus, or glycosuria. The first is character- 
ized by an increase in the amount of urine excreted, and yields 
readily to proper treatment. The second is characterized by the 
presence of sugar in the urine, and, under ordinary treatment, 
generally proves fatal. 
The causes are obscure, and therefore not very well under- 
stood by the profession. 
Symptoms. A notable increase of the quantity of urine 
excreted, is the first symptom which attracts the patient's atten- 
tion. Frequently, several quarts, or even gallons of urine are 
daily excreted, and it is paler than natural. The patient experi- 
ences extraordinary thirst, and he has an almost insatiable 
appetite, though at the same time he loses flesh and strength. 
The tongue may be either clammy and furred or unnaturally 
clean and red. The bowels become constipated, and a peculiar 
odor is observed in the patient's breath and is exhaled from his 
body. The skin becomes harsh, dry, and scurfy. There is dizzi- 
ness, headache, dejection, lassitude, and not unfrequently a cata- 
ract is developed in one or both eyes, often producing blindness. 
The intellect is blunted, and, as the disease progresses, the ema- 
ciation and debility increase, and pulmonary diseases develop; 
or, perhaps, an uncontrollable diarrhea sets in, and the patient 
dies from exhaustion. DIABETES. 
783 
Treat incut. Persons suffering from this disease should 
wear flannel next the skin and bathe frequently. The Turkish 
bath is often a valuable auxiliary in the treatment of this dis- 
ease. Great attention should be paid to the diet in these cases. 
It should be highly nutritious, but anything of a sweet or 
starchy nature ought to be avoided. 
The following articles are wholesome and afford sufficient 
variety: of animal food, beefsteak, game, poultry, fish, eggs, 
cheese, cream, butter; of vegetables, spinach, dandelion greens, 
turnip-tops, water-cresses, lettuce, celery, and radishes; of drinks, 
tea, coffee, claret, water, brandy and water, beef-tea, mutton- 
broth, or water acidulated with tartaric, nitric, citric, hydro- 
chloric, or phosphoric acid. The forbidden articles are oysters, 
crabs, lobsters, sugar, wheat, rye, corn or oat-meal cakes, rice, 
potatoes, carrots, beets, peas, beans, pastry, puddings, sweetened 
custards, apples, pears, peaches, strawberries, and currants, also 
beer, sweet wines, port, rum, gin, and cider. It is impossible to 
lay down any course of treatment which would be universally 
applicable as it must be varied to suit the individual in differ- 
ent cases. 
In this disease, as in Bright's disease, we have many medicines 
which produce specific curative effects and enable our specialists 
to treat it with success. The disease is readily diagnosticated 
by a chemical examination of the urine; hence we have been 
enabled to treat this class of cases very successfully at a dis- 
tance, and without personal examinations. 
The following are fair samples of cases of diabetes mellitus 
which our specialists have permanently cured. 
CASES TREATED. 
Case 52,969. 
This gentleman, a German by birth, came under our treatment, after 
suffering for years from the most aggravated form of diabetes. He had 
been unsuccessfully treated by many prominent physicians in Chicago 
and elsewhere in Illinois. He complained of constant thirst. At night 
it was his common custom to place a large wooden pail of water by his 
bedside, which was only sufficient to quench his thirst during the 
night; by morning it was drained. He had little appetite, poor diges- 
tion, was troubled with constipation, vertigo, pain in the back over the 
kidneys and throughout the body, with general lassitude. The skin, 
on examination was found dry and rough, the gums were swollen and 
tender, the tongue was heavily furred, the whites of eyes were yellow, 
and the sight was dim. The amount of urine voided averaged over two 
gallons per day, and, on examination, was found to contain from ten to 784 
COMMON SENSE MEDICAL ADVISER. 
fifteen grains of sugar to the ounce. He was at once placed upon a 
carefully selected diet, and a thorough course of treatment, with Turk- 
ish baths and the application of dry cups was begun. After leaving 
the Invalids' Hotel, he wrote, "I would not take one thousand dollars 
for the comfort I have experienced since I came under your care." 
At the date of writing, he voided but three and one-half to four pints 
of urine per day, containing no sugar, and was in robust health, feeling 
better than he had for years. 
Case 53,483. 
A gentleman consulted us suftering from diabetes. He stated that he 
drank three or four gallons of water daily and urinated as much. Ex- 
amination of his urine disclosed the presence of a large amount of 
sugar. He was told by a celebrated physician of New York that he 
could not live twelve months. This patient remained under our treat- 
ment six months and has been well ever since, for a period of seven 
years. 
Case 56,079. 
Mrs. H. A., of Pa., applied to us by letter sending with her descrip- 
tion of the disease a bottle of her urine. Sugar was found to be present 
in the urine in large quantity. She said her home physicians had pro- 
nounced her case to be diabetes and past all possibility of cure. She 
stated that she was fast failing in strength, and felt that unless some- 
thing could be done to relieve her she must soon die. She was under 
our treatment five weeks, at the end of which she was entirely cured. 
Case 90,553. 
Z. M. W. came to us suffering from the most serious form of dia- 
betes, caused by working in the water. There was great thirst and a 
free flow of urine. He complained of great internal heat, and daily 
grew weaker and more emaciated. The bowels, at first very consti- 
pated, became loose, and there were weakening diarrheal discharges. 
He passed from three to four gallons of water per day, having a spe- 
cific gravity of 1,040°, which was due mainly to the presence of sugar. 
He had been under the treatment of many physicians with no benefit 
whatever. He was steadily growing worse, and had almost lost all 
hope of recovery. After being under treatment for a few months, he 
wrote us as follows: 
" I desire to thank you for the great benefit that has been effected in 
my case. When I came to your institution, it was with the feeling 
that, if I failed to secure relief, my case was hopeless, as I had been 
treated unsuccessfully by so many physicians, and was growing gradu- 
ally weaker and more emaciated. It was apparent to myself, as well as 
to my friends, that I could not long survive this disease, and the great 
percentage of sugar lost, was fast carrying me off. As a result of your 
treatment the amount of water has steadily diminished, my strength is 
restored so that I do a full day's work in my mill. The cramps and 
pains with which I was affected, have left me, and I feel in every way 
like a new man. My improvement has been steady since I placed my- 
self in your care, i feel that my disease has been conquered, and all 
that I require is a little care in order to prolong my life indefinitely. 
The gratitude that I feel toward you cannot be expressed, as I feel 
that I have been rescued from an early grave. My family and chil- 
dren, for whom you have preserved a father, will join me in expressing 
their sincerest gratitude and thanks. I can recommend your institu- 
tion most highly as the best place for those suffering from the disease 
with which I am troubled, to go to secure health." RETENTION OF URINE. 
785 
Case 111,119. 
This gentleman wrote us, stating he was suffering from diabetes and 
that he had been unsuccessfully treated by other physicians. After 
being under our treatment for two months he wrote: 
" I am entirely relieved of the diabetes, and desire to thank you for 
the improvement. I have not taken any medicines for six months, and 
I find the disease has no tendency to return." 
Case 111,537. 
E. B., a tanner by occupation, applied to us after having suffered for 
several years with diabetes of a very severe form. During this time he 
had been constantly under the treatment of physicians, who had as- 
sured him that there was no permanent benefit to be obtained from 
medicines, but that only temporary relief could be expected. After 
being under our treatment for four months at his home he writes as 
follows: 
"The improvement that has followed your treatment is most won- 
derful. Previous to coming under your care I had been sadly hum- 
bugged. Physicians who had promised me relief made my condition 
far worse. From a healthy and robust man, able to do a big day's 
work, I became a feeble invalid, and, my circumstances being limited, 
it was necessary for me to force myself to work in order to support 
my family. To such an extent had I become weakened by the disease 
that frequently, when returning from the tannery to my home, a dis- 
tance of half a mile, I would be forced to sit down under the trees 
four or five times to rest. The kindness of my employer and my fel- 
low-workmen, who relieved me of all hard tasks, only enabled me to 
continue. I am happy to state that, as a result of your treatment, I 
am able to do a hard day's work. I have paid all the expenses of my 
trip, the money for which was raised for me by my friends, and I feel 
satisfied that with reasonable care, my trouble, which has not bothered 
me for three or four months, will remain permanently controlled. My 
thanks and gratitude, as well as those of my family, cannot be ex- 
pressed. I can recommend your institution most highly." 
RETENTION OF URINE. 
Retention of Urine is generally due to some mechanical 
obstruction, such as an enlarged prostate, a tumor, inflamma- 
tion, or stricture of the urethra. It is sometimes caused by an 
impacted calculus, and, in rare instances, by spasm of the mus- 
cles surrounding the urethra. This condition should not be con- 
founded with suppression of the urine, which is the result of 
defective action of the kidneys, and in which the bladder is 
empty, no urine being secreted. 
Treatment. The treatment should consist of measures to 
effect the removal of the obstruction which causes the retention. 
The Compound Extract of Smart-weed may be given in tea- 
spoonful doses to allay spasm and relieve pain. Diuretics should 
not be given, for, by increasing the flow of urine, they aggravate 
the affection. Hot sitz-baths and hot packs placed over the 786 
COMMON SENSE MEDICAL ADVISER. 
bladder often give relief. The tincture of chloride of iron in 
doses of fifteen drops, three or four times a day, is frequently a 
valuable remedy. Free purgation with the Pleasant Purgative 
Pellets often affords great relief. If there be great distention 
of the bladder, a soft rubber catheter of a proper size should be 
carefully introduced into the bladder. 
Catheterisni. The introduction of any instrument into 
this canal is to be undertaken only when absolutely required, 
and when necessary, it should be so skillfully and carefully 
effected that no pain or irritation can result. The slightest 
awkwardness is liable to cause an unnoticeable injury, which 
may result in a false passage, or an effusion of plastic lymph 
around the canal, which, organizing, forms the most troublesome 
kind of organic stricture. By proper and early treatment, all 
danger and pain is avoided, and a cure effected in a very short 
time. In an extensive practice, in which we yearly treat thou- 
sands of cases, we have never yet failed to give perfect and per- 
manent relief in retention of urine, stricture, and disease of the 
prostate gland, without the necessity of using cutting instru- 
ments of any kind, when we have been consulted before injury 
to the urethra had been produced by the improper use of in- 
struments. Having specialists who devote their entire time 
and attention to the study of these diseases, we are able to 
relieve and cure a large number painlessly and speedily, in 
which the awkward manipulations of physicians or surgeons, 
whose hands, untrained by constant and skillful use, not only 
fail to effect any benefit, but cause new, or aggravate existing 
disease. 
Enlargement of the prostate gland and stricture of the ure- 
thra will receive a more full and complete consideration in 
another part of this work. 
INCONTINENCE OF URINE. (Enuresis.) 
Two forms of this annoying disease are observed. In one, 
there is inability to retain the urine, and it escapes when the 
patient is laughing, sneezing, or coughing, or it constantly 
passes away in small quantities. It is generally due to weak- 
ness of the urinary organs, paralysis of the bladder, pressure 
from tumors, falling of the womb, pregnancy, masturbation, INCONTINENCE OF URINE. 
787 
or excessive venery. The other form of the disease more com- 
monly appears in children and in young adults, and is charac- 
terized by nocturnal incontinence, or " wetting the bed." In 
either form, the urine is discharged involuntarily. 
Treatment. If the disease be due to weakness of the 
genito-urinary organs or paralysis of the neck of the bladder, 
those conditions should be remedied; if to tumors, a surgical 
operation may be necessary; if it be caused by falling of the 
womb, the treatment suggested for that affection ought to be 
employed. If it be induced by venereal excesses or masturba- 
tion, the cause should be avoided and proper tonic treatment 
applied to strengthen the debilitated parts. 
When the affection occurs in children, the cause must, if pos- 
sible, be ascertained and removed. If it is due to worms, give 
anthelmintics; if to irritation of the bladder, the treatment 
recommended for that complaint is appropriate; if to spinal 
irritation, bathe the back, loins, and genitals, with cold water 
before going to bed. Establish a habit in the child of waking 
at certain hours to evacuate the bladder, do not allow hearty 
suppers, and compel the use of a hard bed without too much 
covering. Give one of the Purgative Pellets every night. If 
they act too freely on the bowels, give one every other night. 
If the child is pale and weak, administer five drops of the tinc- 
ture of iron three times a day. 
The causes are sometimes so obscure that the services of a 
skillful physician are required, to ascertain them and determine 
the proper treatment. 
A consideration of the many and diverse causes which lead to 
this troublesome affection is sufficient to explain the lack of 
success which follows the usual treatment. Occasionally cases 
are met with in which the sole cause of the incontinence is a 
weakness and irritability of the base and neck of the bladder, 
yet these apparently simple cases resist the best efforts of the 
general practitioner. 
Individuals thus affected frequently grow up from childhood 
to adult life without being relieved of the disease which causes 
them so much annoyance and chagrin. 
By a thorough consideration of the symptoms present, and a 
careful examination of the urine a correct diagnosis of the COMMON SENSE MEDICAL ADVISER. 
788 
disease may be readily arrived at, and a course of treatment 
directed which will remove the affection. 
Two cases illustrating the most common forms of the affec- 
tion and our success in its treatment are here given. 
Case 79,979. 
A farmer, aged 22. He had been afflicted since childhood with incon- 
tinence, which, at intervals, was very troublesome. Unusually sound 
sleep, a soft, warm bed, or a late supper, was certain to induce the 
unconscious discharge of the urine during sleep. When a child, he 
had been severely whipped and ill-treated for what was supposed to 
be laziness. 
After a brief course of proper medical treatment, he was relieved. 
Two years after treatment he visited our office for the purpose of 
thanking us for his permanent cure. 
Case 113,622. 
A retired merchant, aged 58 years. For about two years he bad ex- 
perienced a difficulty in retaining the urine. The calls were frequent 
at times, and unless they were heeded immediately, an involuntary 
escape of the urine would follow. Frequently, this would occur also 
when excited or when coughing or in making any unusual effort. 
Nearly every night, during sleep, he would awake, and find his cloth- 
ing and his bed drenched with urine, and many severe colds had re- 
sulted from sleeping in the wet bedclothes. He had been treated by 
an eminent college professor and by several prominent physicians, 
without relief. He was thoroughly examined by us and a course of 
treatment was prescribed which in three weeks resulted in a perfect 
cure. 
ACUTE INFLAMMATION OF THE BLADDER. 
Inflammation of the bladder seldom appears in the acutq 
form, except in connection with gonorrhea. The portion of th<» 
bladder nearest its neck is most frequently involved. 
Symptoms. There is intense pain in the region of the 
bladder, sensitiveness to pressure, and sometimes pain in the 
perineum, testicles, and loins. There is an almost constant desire 
to urinate, but the act is accompanied with severe pain and a 
bearing-down sensation. During the first stage of the disease, 
the urine is apt to be scanty and highly colored, but afterwards 
becomes red, occasionally bloody, and finally loaded with muco- 
purulent matter. There is generally considerable febrile distur- 
bance, which is at times severe. 
Treatment. Absolute rest is essential. A spirit vapor- 
bath should be given, and the sweating continued by adminis- 
tering the Extract of Smart-weed, which will also relieve the 
(Acute Cystitis.) CHRONIC INFLAMMATION OF THE BLADDER. 
789 
pain. Hot fomentations over the region of the bladder are 
beneficial. As a brisk cathartic, large doses of the Pleasant 
Purgative Pellets should be given during the early stage of the 
disease. The thirst may be allayed by cooling drinks. Give a 
moderately large dose of aconite and gelseminum every hour. 
When the acute symptoms disappear, mild, unirritating diuretics 
may be administered, such as an infusion of stone-root, marsh- 
mallow, water-melon or pumpkin seeds. 
CHRONIC INFLAMMATION OF THE BLADDER. 
This affection, also called catarrh of the bladder, is an inflam- 
mation of the mucous lining of this organ. It may occur at 
any period of life, but it most frequently appears in the aged, 
and is usually associated with some obstruction to the flow of 
urine. 
Causes. It may be due to colds, injuries, irritating diu- 
retics, injections, extension of disease from the kidneys or 
adjacent organs, intemperance, severe exercise on horseback, 
retrocession of cutaneous affections, gout, or rheumatism, but 
it more frequently results from stricture of the urethra, en- 
larged prostate gland, gravel, and gonorrhea. It is also caused 
by a habitual retention of the urine, and sometimes results from 
masturbation, or self-abuse. 
Symptoms. There is an uneasy sensation in the bladder, 
and heaviness and sometimes pain and weakness in the back and 
loins. The urine is scanty, and, although there is a desire to 
void it frequently, it is passed with difficulty. If allowed to 
stand, it deposits more or less mucus, which is sometimes mis- 
taken for semen. As the disease progresses, the quantity of the 
mucus increases. It is very viscid, and adheres to the sides of 
the vessel, so that if an attempt is made to pour it out, it forms 
long tenacious, ropy threads. Sometimes the quantity of 
mucus is so great that on exposure to cold the whole mass 
becomes semi-solid, and resembles the white of an egg. The 
excreted urine is alkaline and acrid, exhaling a strong odor of 
ammonia, and soon becoming exceedingly fetid. Sometimes the 
urine becomes so thick that great difficulty in experienced in ex- 
pelling it from the bladder. Nocturnal emissions, impotency, 
(Chronic Cystitis.) 790 
COMMON SENSE MEDICAL ADVISER. 
and loss of sexual desire are apt to ensue. Occasionally there is 
spasmodic contraction of the bladder, with straining and a 
sensation of scalding in the urethra, and sometimes the patient 
is unable to urinate. 
When ulceration occurs in the progress of the disease, which 
sometimes happens in its advanced stages, blood is occasion- 
ally seen in the urine. In the advanced stages of the disease 
the system becomes greatly debilitated, emaciation occurs, 'with 
hectic fever and nervous irritability, finally ending in death. 
Treatment. A strict observance of the rules of hygiene 
is essential. The cause should be ascertained if possible and 
removed, thus preventing the perpetuation of the disease. The 
various causes and conditions involved in different cases demand 
corresponding modifications of treatment, hence, it is useless for 
us to attempt to instruct the unprofessional how to treat this 
disease. We have succeeded in curing many severe cases with- 
out seeing the patients, being guided in prescribing by indica- 
tions furnished by microscopical and chemical examinations of 
the urine. In fact, nearly all cases can be cured at their homes, 
and without a personal examination being made. In the worst 
forms of the disease, we have found it best to have our patients 
at our institution, where wTe can wash out the bladder with 
soothing, healing lotions, and thus make direct applications to 
the diseased parts. 
CASES TREATED. 
Case 61,375. Chronic Inflammation of the Bladder. 
World's Dispensary Medical Association: Gentlemen-It is 
with pleasure that I can testify to your skillful and successful treat- 
ment of my case. My disease was caused by overwork and exposure, 
and had been years forming. During all my life-time I have been a 
very active worker, and, owing to circumstances, unable to give myself 
the care necessary to preserve perfect health. I suffered f or years with 
constipation and torpidity of the liver, which resulted in irritation of 
the prostate, and, owing to a cold, brought on inflammation of the 
bladder, commencing with burning sensations in the urethra, and feel- 
ings of heat and weight in that region. Gradually these sensations 
kept increasing for months, until I could retain my water but a few 
minutes, and, after voiding it, would suffer from a very painful spasm, 
and often the ejection of as much as a teaspoonful of blood. For a 
year I ran down very rapidly, losing at least thirty pounds in weight. 
My physicians said that I had stone. My bowels became more and 
more constipated and caused me such pain that I was forced to employ 
the strongest purgatives to get relief, and in such doses that I was 
always greatly nauseated for hours after their use. You can compre- 
hend my sufferings, nervousness, and debility, from want of rest and CHRONIC INFLAMMATION OF THE BLADDER. 
791 
comfort. In this condition, I tried a number of physicians without 
benefit, and I became very despondent, but finally determined as a last 
resort, to place myself under your care. My neighbors and friends, as 
well as my medical attendant, tried to dissuade me from it; and when I 
went to your Hotel I received many a parting shake and expression of 
sympathy and fear that I would be brought home dead. After a month 
in your institution, I cannot too gratefully acknowledge the great 
benefit I have received as a result of your skillful treatment, baths, 
movement cure, and diet. My bowels are regular and move easily, 
and I feel that I am cured of the bladder disease, all pain, soreness, 
and discomfort being gone, and I feel myself to be practically a well 
man. From a wreck. I have been made strong and hearty. I hope 
that many sufferers may avail themselves of and receive at your hands 
the benefit that can be so certainly obtained. 
With many thanks, and good will for the success of you and your 
perfect institution, which I believe is unequaled on the continent, I am 
Most gratefully yours, 
A. H. B., Elkland, Tioga Co., Pa. 
Case 62,257. Chronic Inflammation of the Bladder of 
TWENTY YEARS' STANDING. 
World's Dispensary Medical Association: Gentlemen-Allow 
me to express to you my thanks for the attention and benefit received 
at your hands. For twenty years I have been a terrible sufferer from 
inflammation of the bladder and the results of improper treatment. 
My disease was in itself hard enough to bear, but add the pain and 
suffering caused by the ignorant and heroic treatment to which I was 
subjected by physicians that I visited at great expense. No pen can 
describe the constant torment to which I was subjected to every mo- 
ment of my life. With the cares of a large family and being compelled 
to labor, no matter what my condition was, one can in a measure 
appreciate what I was forced to go through daily. In placing myself 
under the personal care of your specialists, it was with great reluctance 
and with the fear that I would be again subjected to the harsh manipu- 
lations that had before rendered my life so great a burden. You can 
imagine my comfort and pleasure at the careful and soothing treat- 
ment given. My pains and nervousness were- calmed at once. I can 
say that during the six weeks I was at your Hotel I felt that I was 
(although before that an entire stranger) treated and regarded as 
kindly and considerately as though I had been a brother. By a 
Southern man, of warm impulses, this was most thoroughly appre- 
ciated. 
The treatment of my affection I can heartily say was the most satis- 
factory that I have ever received. I improved more rapidly than I had 
ever thought possible. I left your place with renewed hope and with 
better health than I had experienced for twenty years. You have my 
heart-felt thanks for what you have done for me. I take the greatest 
pleasure in urging every sufferer to go and try your treatment, believ- 
ing it to be the most skillful and advanced of this period. 
With verv best wishes, 
W. J. W., Darlington C. H., N. C. 
Case 63,028. Chronic Cystitis of eight years' standing. 
World's Dispensary Medical Association: Gentlemen-Having 
been under your personal care for the treatment of chronic inflamma- 
tion of the bladder of many years' standing, I can testify to what I 
know to be a fact from experience with other physicians namely, that 
your mode of treatment is more perfect by far than any other I have 792 
COMMON SENSE MEDICAL ADVISER. 
known. From the time I went under your care my fear of harsh treat- 
ment was overcome. The soothing applications gave me more comfort 
and benefit than I had experienced in years, although I had consulted 
some of the best medical men in the United States. 
J. P., Sioux City, Iowa. 
Case 75,243. Chronic Inflammation of the Bladder. 
World's Dispensary Medical Association: Gentlemen-1 have 
no symptoms of disease of any kind. I have enjoyed better health 
since under your treatment than for three or four years previous to 
that time, and am satisfied that my present health is due to the use of 
your medicine, and to your skill. Gratefully yours, 
A., Parsippany, N. Y. 
Case 81,362. Inflammation of the Bladder, with Seminal 
Emissions. 
World's Dispensary Medical Association: Gentlemen-The first 
week after taking your medicines I felt much improved. I am now 
doing well, my nerves are stronger, and I have increased in weight. 
Respectfully yours, 
J. M., Philadelphia, Pa. 
Case 94,756. Chronic Inflammation of the Bladder, with 
Seminal Debility. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-As a result of a sudden cold, I suffered for many years with 
inflammation of the bladder and urethra. My manly strength was 
apparently lost. As a result of six months' special treatment, I feel 
that I am fully cured. The first month's treatment did not effect 
much benefit, and I was somewhat discouraged; but, feeling certain 
that you fully understood your business, and knowing other sufferers 
who had been cured, I was led to go on with your course, and I am 
now very thankful that I did so. The cure was perfect, and I am now 
fully restored in every way. My urinary organs are in an apparently 
healthy state. You may rest assured that I will take good care of my- 
self, now that I have my health fully restored, and that I will take 
great pleasure in advising other sufferers to apply to you, as I feel cer- 
tain that, had it not been for your advanced' treatment, I would not 
now be alive. Very truly yours, R., Saginaw, Mich. 
Case 98,213. Chronic Inflammation of the Bladder, with the 
PASSAGE OF LARGE QUANTITIES OF PUS AND BLOOD. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-I desire to inform you that my greatest trouble, the urinary 
difficulty, is now entirely cured. I have not experienced the slightest 
feeling of pain in the region of the bladder for the past three weeks, 
not even during the whole of my monthly period. I feel as if the light 
of a new and better day had dawned upon me. Believe me, 
Ever yours truly, Mrs. H., 
Duke Centre, McKean Co., Pa, 
When the solid constituents of the urine are increased to such 
an extent that they cannot be held in solution, or when abnor- 
mal substances are secreted, they are precipitated in small crys- 
tals, which, if minute, are called gravel. Another cause of the 
GRAVEL. GRAVEL. 
793 
precipitation of these salts is a stricture of the urinary canal 
which, by interfering with the free expulsion of all the urine 
from the bladder, results in the retention of a portion, which 
gradually undergoes decomposition. Salts from the urine are 
thus precipitated in the same way that they are thrown down in 
urine which is allowed to stand in a vessel. Any one can illus- 
trate this, by allowing a small quantity of the urinary secretion 
to stand for a few days either in an open or a closed bottle. 
Soon a white, flaky deposit will be observed, which will become 
more and more dense, and finally fine grains will be seen precipi- 
tated at the bottom of the bottle. Similar grains, lodging in 
the folds of the bladder, gradually increase in size, by the pre- 
cipitation of more salts around them, and ultimately become a 
source of much irritation. When of large size, they are termed 
calculi or stones. When these formations occur in the kidneys 
they are termed renal calcxcli; when in the bladder, vesical cal- 
culi. There are several varieties of gravel, each depending upon 
different conditions of the system for its formation. The two 
prominent varieties are the red, containing uric acid, and the 
white, or phosphatic gravel. 
Symptoms. When the deposits are forming in the kid- 
neys, there is generally pain in the back and loins, occasionally 
cutting and severe. Calculi or gravel passing down through the 
delicate and sensitive ureters cause excruciating pain. There is 
severe cutting pain in the loins, and along the ureter, attended 
with considerable fever. A very rough stone such, for instance, 
as a mulberry calculus, passes with considerable difficulty, and 
the patient is often suddenly seized with excruciating agony in 
the loins and in the groin, the pain also shooting down into the 
testicle of the corresponding side, often causing it to retract. 
There is usually, also, sympathetic pain shooting down the 
thigh. We have seen patients roll on the floor in the greatest 
agony, with the cold sweat pouring down the face when thus 
suffering. The patient may also vomit violently through nerv- 
ous sympathy. The urine is generally bloody, and there is a 
constant desire to pass it. When the deposits are in the 
bladder, there is a frequent desire to urinate, with a bearing 
down, straining pain; also a cutting or scratching sensation in 
the urethra during micturition. In the male, intense pain is 
34 794 
COMMON SENSE MEDICAL ADVISER. 
often experienced at the end of the penis. When the urine is 
voided in a vessel and allowed to settle, a gravelly deposit is 
seen, generally of a red or a white color. 
Treatment. These urinary deposits indicate a general 
derangement of the system, as well as a local disease. Nutrition 
is imperfect and some of the excretory organs are not properly 
performing their functions. Very frequently these gravelly for- 
mations are due to a rheumatic or gouty diathesis. It is also a 
well known fact that congestion, or torpidity of the liver throws 
an excessive amount of work on the kidneys. These organs 
then, in part, perform the function of the liver, and hence un- 
natural activity is required of them. The excretion of such 
substances as uric acid, which precipitates readily, gives rise to 
severe irritation of the urinary canal. 
In order to treat these cases successfully, it is first necessary 
to ascertain by microscopical and chemical examinations the 
character of the deposit. By such an examination, the exact 
condition of the system which gives rise to these abnormal 
products may be definitely determined, and the remedies to 
be employed indicated. As the unprofessional are not quali- 
fied to make such examinations, it would be useless for us to 
suggest specific treatment for the various forms of this affec- 
tion. 
The following cases illustrate different varieties of the affec- 
tion and the usual results obtained by a proper course of 
treatment. 
„ , CASES TREATED. 
Case 6,423. 
Mr. T. J., of Toledo, O., consulted us by letter, saying: "I have, oS 
and on, for the past three years, been terribly afflicted, having suffered 
severe cutting pain in the back and loins, at times extending to the 
region of the bladder and to the thighs. These attacks have been fol- 
lowed by frequent desire to urinate and bearing-down or strong pain. 
Sometimes the urine has been quite bloody and at other times I have 
noticed a deposit in the bottom of the vessel, a sample of which I send 
you with a quantity of my urine." Examination of the urine disclosed 
the presence of innumerable hard particles, or gravel, which had caused 
the irritation of the kidneys, bladder, and urinary passages. Proper 
medicines were sent him, the use of which he continued for three 
months, although very speedily relieved from all the distressing symp- 
toms. He wrote us five years afterwards, as follows: "I have never 
experienced any attacks of the gravel since I quit taking your medi- 
cine. I think the thorough course of treatment put my system in such 
perfect condition that I may never suffer further from my old com- 
plaint that gave me such intense suffering." STONE IN THE BLADDER. 
795 
Case 81,414. 
J. L. H., a man aged 24. He had suffered from irritation of the 
urinary organs for two years. He was very sallow, weak, dyspeptic, 
and nervous. After two months'treatment he wrote: "When I had 
nearly completed the use of your medicines there came from me on 
three successive mornings, as much dissolved stone as I could con- 
veniently hold in the palm of my two hands. Your specialist has done 
a splendid favor for me, and I consider that, but for his help, I would 
not have been living to-day." 
Case 111,183. 
W. A. T., a man of middle age. He had been troubled with gravel 
for a period of five years. The symptoms described as common to the 
malady were present, with an unusual irritation at the neck of the blad- 
der and in the urethra, and scalding on urination. After careful ex- 
amination of several small specimens of gravel from the urine, a course 
of treatment was advised, which was followed for five months. At the 
end of this time he wrote: "I have passed a large amount of gravel, 
specimens of which I send you. I feel better than I have before for 
years, and I do not discharge any gravel now. The irritation has en- 
tirely subsided, and I feel as well in those parts as I ever did." The 
specimens alluded to weighed 40 grains. 
We might add an almost unlimited number of reports of sim- 
ilar cases to the preceding, but we have cited a sufficient num- 
ber to indicate the usual course of the disease and the success 
of our method of treating such cases. 
If the gravelly deposits are not expelled with the urine, they 
form a nucleus upon which layer after layer is deposited, thus 
developing stone in the bladder. This disease more frequently 
appears in men than in women, and, in the majority of cases, is 
developed before the thirtieth year. 
Symptoms. There is pain in the region of the bladder, 
which is aggravated by any jolting motion, and which is very 
severe immediately after urinating. In males, there is often very 
acute pain at the end of the penis. In children, the pain and 
uneasiness is often so great that they grasp and pull the penis 
violently. In urinating, the stream is sometimes suddenly 
arrested, when, by a change of position, it again flows freely. 
These symptoms are not to be accepted, however, as conclusive 
evidence of the existence of stone in the bladder. The surgeon, 
by exploring the bladder with a steel sound, detects stone with 
certainty, an audible click being produced when the instrument 
conies in contact with it. 
STONE IN THE BLADDER. (Vesical Calculi.) 796 
COMMON SENSE MEDICAL ADVISEE, 
Close to the neck of the bladder is a triangular space on 
which the mucous membrane is smoother and devoid, of folds, 
or rugae, and which is far more sensitive and vascular than other 
portions of the mucous membrane lining this organ. It is called 
the trigone, v'esical. This trigone is the most depending part of 
the bladder. If there is stone in the bladder, it naturally grav- 
itates and rests on this sensitive space, so that, when the 
bladder is empty, the foreign body occasions inconvenience, 
until the urine, trickling down through the ureters, and inter- 
vening between the mucous membrane and the stone, serves as 
a temporary protection to the mucous surface. Hence the pain 
becomes less as the urine is secreted, until the urine is again 
passed, and the intervening fluid thereby removed, when the 
stone again presses upon and irritates the sensitive trigone, by 
coming into more immediate contact with it. The greater 
ease which patients afflicted with stone experience in a recum- 
bent position in bed or on a sofa, compared with being in an 
erect posture, is easily explained. The foreign body, when 
the patient is standing, walking, or riding, falls by its own 
gravity on this sensitive spot; when in a recumbent position, it 
rolls away from the trigone into the back part of the bladder, 
where the mucous membrane is less sensitive; consequently, 
the patient suffering from stone in the bladder is more easy at 
night, whereas, one suffering from prostatic disease, whether 
it be inflammation of the prostate gland, or enlargement of 
that organ, is usually worse in bed. 
Treat llicilt. In persons subject to this disease, the form- 
ation of stone may be prevented by appropriate treatment, but 
after the stone is once developed, seldom will any treatment but 
a surgical operation prove effectual. A belief that calculi can 
be dissolved in the bladder has been entertained by some dis- 
tinguished practitioners, but their attempts to accomplish this 
have not been successful. 
The surgical means employed to remove calculi are various. 
The cutting operation heretofore required to remove it, is con- 
sidered one of the most dangerous operations that the surgeon 
is ever called upon to perform. 
The death of Napoleon III of France, from an operation for 
the removal of a stone, at the hands of surgeons renowned for STONE IN THE BLADDER. 
797 
their skill, gave new impetus to the efforts of physicians to in- 
vent some method which would be less dangerous than that 
which had been commonly employed. The cutting operations 
have been those most frequently adopted. The operation by 
median section is the safest, and is most commonly employed 
for the removal of stones that are not very large, while the 
lateral operation is used in cases in which the stone is more 
than one inch in its smallest diameter. 
As may be seen by consulting hospital records, the deaths 
in these various operations have been, in adults, from one in 
three to one in every four cases, a percentage sufficient to deter 
any sufferer from undergoing an operation except for the relief 
of a condition which is in itself worse than death. 
Not being satisfied with the results of these operative meas- 
ures, we have endeavored to perfect other means by which these 
foreign bodies can be removed from the bladder without such 
great pain and danger. The operation by crushing and removal 
without cutting, appeared to present the most practicable 
advantages. 
The method of crushing was first invented by a French sur- 
geon many years ago, but, owing to the imperfect character of 
his instruments, and the difficulty that was experienced in ex- 
pelling the fragments, the operation was seldom resorted to 
by surgeons. The improvements in these methods made by 
Bigelow and Sir Henry Thompson, with those which have been 
made by our specialists, enable us to offer those suffering from 
this disease a means of cure which is, we feel confident, the 
most successful known. 
About one hundred and twenty cases have been operated 
upon by the new method by prominent surgeons, all of which 
operations were performed with less perfect instruments than 
those we possess, and there were but four deaths in this number. 
By the advantages gained by the recent improvements of our 
specialists, the rate of mortality has been still further reduced. 
In a moderately healthy subject, one in whom the kidneys are 
not badly diseased, the operation is attended with compara- 
tively little danger. 
The operation consists in crushing the stone into small frag- 
ments, which are washed out through silver catheters attached 798 
COMMON SENSE MEDICAL ADVISER. 
to a suction apparatus, which gently and perfectly removes all 
the pieces. This operation has now been performed in our insti- 
tution in a large number of cases with success, and the cures 
have been effected in from six to eight weeks without a single 
unpleasant symptom arising. By this method, it is not neces- 
sary to remove the entire stone at one operation. By the old 
cutting operation this was necessary, for the bleeding was great, 
and what was to be done had to be done quickly, for other- 
wise the patient would die from the hemorrhage. By the new 
method, a part of a large calculus, or, when several exist, one 
or two may be removed at a time, after which the patient can 
rest and gain strength for a second operation. 
The largest stone removed by us in this way, weighed between 
seven and eight hundred grains, being as large as a hen's egg, 
for which three operations were required. The operation is 
necessarily performed while the patient is under the influence of 
a mild anaesthetic, which prevents suffering and secures perfect 
relaxation of the muscles. In the above case, we feel certain 
that a cure could not possibly have resulted from the cutting 
operation, as the heart was seriously affected, and the physical 
condition of the patient was such, from years of suffering, that 
death would have occurred from the shock of the operation. 
By carefully pursuing the new method, and not prolonging the 
operation for more than a few minutes, every particle of the 
stone was removed. The health of the patient constantly im- 
proved during the intervals between the three operations, which 
occupied a period of seven weeks. 
Small calculi, or particles of gravel, are readily removed in a 
few minutes by the new method, without hemorrhage. Instead 
of a large gaping wound being left after the operation, from 
which secondary hemorrhage may take place, or poisoning 
result from the irritation of decomposing urine, the parts are 
left in a healthy state with the surface unbroken. The stone, 
a constant source of irritation, is removed, and the health is 
speedily restored. 
When it is impossible for the patient to visit us, a careful 
examination of the urine is made, and if gravel have been 
passed, these are carefully examined also. A knowledge of the 
composition of the stone is acquired in this way, and treatment STONE IN THE BLADDER. 
799 
is prescribed to disolve it. Success has commonly followed this 
method of treatment, when the stone has not been very large. 
With the gradual reduction of the size of the stone, the irrita- 
tion subsides, and the general health of the patient improves. 
„ CASES TREATED. 
Case 20,324. 
Although the stone was not of the largest size, it was deemed a 
favorable case for the crushing process, and accordingly it was removed 
in this manner very perfectly, and although five years have since 
elapsed, there have been no symptoms indicating the formation of 
another stone. 
Case 95,564. 
For two years before consulting us, this gentleman had constantly 
suffered severely with the symptoms of stone. There was constant 
pain when urinating, and at times he would pass quantities of blood 
and pus. He had frequently acute pain at the end of the penis, and, 
when urinating, the stream was sometimes suddenly arrested, causing 
great pain. By changing the position, it would again, after a time, 
ow quite freely. On examination a large stone was found. He had 
intended to go to Scotland for an operation, but was induced by one of 
our former patients to place himself under our care. He felt the more 
willing to do this as he was afraid that he would be so much weakened 
during the period which must necessarily elapse before he could be 
operated upon in Scotland, that the operation would probably be fatal. 
The advantages of our new method of operating being explained to 
him, he readily trusted himself in our hands. We subsequently re- 
ceived the following letter: 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-I desire to thank you for the cure that has been performed in 
ray case. I suffered for four years very severely with a very large stone 
in the bladder. My age, 58 years, and the weakness that had followed 
from the suffering I had undergone, made me fear that I would fail to 
recover front the operation. I am thankful to be able to state that 
I had the same removed by a new method in which there was no 
cutting. I have returned home, after remaining seven weeks under 
your care, entirely cured of the trouble. The relief I feel cannot be 
expressed. Please accept my sincere thanks for saving my life. I 
would be happy to correspond with any sufferer who desires further 
information, if he will send me a stamped envelope for reply. 
Sincerely yours, J. T. C., Leamington, Ont. 
After a period of three months, he wrote: " My friends were glad to 
see me looking so well, and I have continued to improve. Two months 
from the time I left your hotel, I weighed 167 pounds, and have been 
able to work. I am steadily gaining in health, weight, and strength." 
Case 113,371. 
This gentleman, aged 40, had suffered severely from painful micturi- 
tion for two years. As a result of injury while the urinary organs were 
in an irritable condition, quantities of blood were passed at times. On 
examination, a mass of fibrinous clots was found in the bladder, con- 
taining phosphatic deposits. He had a constant desire to urinate, with 
an intensely disagreeable, bearing-down pain, or straining. His geh- 
eral health was poor, owing to want of sleep and lack of appetite, 
resulting from the pain and irritation. 800 
COMMON SENSE MEDICAL ADVISEE. 
By our new method of treatment, several large and tough clots were 
evacuated, containing particles of gravel of various sizes, not large 
enough, however, to require crushing for their removal. Immediate 
relief was the result, and his health was soon restored. 
Case 113,447. 
This gentleman, aged 54, consulted us, stating that he had suffered 
from disease of the bladder caused by stone, for four years. He had 
been examined by several physicians, who were unanimous in this opin- 
ion regarding the case. He suffered from a constant, dull pain in the 
bladder, with frequent stoppage in the flow of urine, and an excruciat- 
ing pain in the urethra. He stated that the introduction of instruments 
had several times caused fainting. There was a frequent desire to 
urinate, and it required a great effort to cause the urine to flow. An 
examination revealed the presence of a small stone, which was im- 
mediately removed, without causing any pain or suffering. He recov- 
ered rapidly, and in a few days was able to do entirely without opium, 
which he had taken for months, and he expressed himself as feeling 
like a new man. 
STRICTURE OF THE URETHRA. 
Organic stricture of the urethra generally results from gonor- 
rhea, but may be caused by injuries, sexual excesses, exposure, 
or by the practice of masturbation, or self-abuse. It runs a 
course varying in duration from a few days to many weeks or 
months, during which time the patient is unaware of the real 
cause of his sufferings. 
Generally, attention is first called to a stricture by a slight 
discharge or smarting sensation or the appearance of an undue 
amount of mucous deposits in the urine. Occasionally some 
difficulty in " starting the water " or a diminution* in the size 
and force or a twisting of the stream as it flows, is the first 
symptom. This stage is of variable duration. When skillful 
treatment is instituted at this period of the disease, a speedy 
cure is easily effected without pain or danger. Any exposure, 
improper use of instruments, or irritation, may speedily give 
rise to the alarming symptoms due to closure of the urethra, 
from which fatal consequences sometimes suddenly ensue. 
This condition is illustrated in Fig. 232, which shows the 
hard and tough stricture which surrounds the soft mucous mem- 
brane that lines the urinary canal. When irritated or inflamed, 
from a cold or other cause, the mucous membrane becomes 
swollen and thickened, and, as the stricture will not yield and 
enlarge, the urethra is almost completely closed, and it becomes 
impossible to pass the urine. Great pain is experienced, and a STRICTURE OF THE URETHRA. 
801 
physician has to be called to draw off the urine with a catheter, 
which, in this condition, is at best a very difficult and painful 
operation. 
Treatment. In the earlier stages of the malady, relief is 
given by the skillful use of instruments for dilating the canal, 
or, when this fails, by the operation of urethrotomy, for which 
we employ an improved and ingenious instrument, by which the 
stricture is readily and almost painlessly divided. 
Our surgeons have operated upon many hundreds of bad 
cases by an almost painless method, in which the use of bougies 
in the after-treatment is not required. This saves the patient 
Fig. 232. 
A single Stricture of the Urethra. 
an immense amount of pain and annoyance, and enables him to 
go home almost immediately after the operation. 
The ordinary after-treatment, by dilation with bougies, is 
very tedious, and often more painful than the operation itself, 
so that our original method of treatment has been hailed with 
joy by those familiar with the old and unnecessarily painful sys- 
tems of treatment. Besides, this method has been followed by 
more perfect cures. 
In many of the cases coming under our observation and treat- 
ment, there have been several strictures as illustrated in Fig. 233 
which shows the urethra constricted at three different points, 
besides a congenital contraction at its mouth or meatus. 
Spermatorrhea not unfrequently results from stricture of the 
urethra, even when the affection is quite slight. Our attention 802 
COMMON SENSE MEDICAL ADVISER. 
was first called to this subject by the consideration of the 
numerous cases in which epileptic convulsions and other serious 
diseases of the nervous system have resulted, in children, from 
an unnatural contraction of the prepuce, or foreskin, constitut- 
ing what is termed phimosis. 
Every surgeon of experience has met with many of these cases 
of reflex irritation. It occurred to us, inasmuch as these con- 
tractions of the foreskin give rise to nervous diseases of an 
alarming nature, that an unnatural narrowing of the urethral 
canal, which must have exactly the same effect in retarding the 
Fig. 233. 
Three Strictures of the Urethra, with a congenital contraction at the meatus. 
flow of the urine, may give rise to irritable nervous affections 
in adults. An unnatural irritation and excitement of the sexual 
organs so produced, may cause nocturnal emissions and conse- 
quent nervous and general debility. 
It is a well recognized fact that the urethral canal should bear 
a certain definite and proportionate size to that of the penis, 
just as the length of the arm should naturally bear a certain 
proportion to the length of the body. In the case of some parts 
of the body, disproportionate development of the part may not 
give rise to any thing further than unsightliness, but, when we 
find the small size of the urethra retarding the free passage of STRICTURE OF THE URETHRA. 
803 
the urine, then we may expect, if this condition is long con- 
tinued, to find more or less irritation of the urethra and, per- 
haps, of the bladder also. When there is a contraction of the 
urethra at its external orifice, or any point along its course, un- 
natural pressure is put upon the urinary canal behind the con- 
stricted portion, and these parts must bear an undue strain 
during the passage of the urine. 
It is a well established fact that improper diet, cold, exposure, 
and overwork exert a very powerful modifying influence upon 
the urinary secretion, frequently causing an acrid and irritating 
condition of this fluid. This condition, when associated with a 
contracted urethra, must result in irritation of the mucous mem- 
brane lining this canal behind the stricture, if long continued 
or frequently repeated. For illustration, water can be expelled 
a considerable distance from a hose by using a small nozzle, 
but a great tension is put upon the hose behind this noz- 
zle; if the pressure is greatly increased, the hose bursts; if, 
however, the small nozzle be replaced with a larger one, the pro- 
jection of the stream will be quite as great, all undue tension of 
the pipe will be avoided and the danger of bursting will be 
removed. In an unnaturally contracted urethra, there is a favor- 
able condition for the development of disease in the urinary 
canal and adjacent parts. Irritation is caused in the urethra 
behind the stricture by undue strain in expelling the urine, and 
from the frequent occurrence of acrid urine, as the result of any 
of the causes we have already mentioned, and this irritation 
keeps gradually increasing. It is felt more during the periods 
when the urine is acrid, but may pass unnoticed even then. The 
seminal sacs and the prostate and Cowper's glands communicate 
with the deeper portions of the urethra by means of canals or 
ducts, lined with mucous membrane, which is continuous with 
the urethral mucous membrane. Hence, it is plain that not only 
are those parts debilitated by reflex nervous irritation, through 
the contraction of the urethra, but the affection is apt to extend 
by continuity of the mucous tissue, and thus become more and 
more manifest, through symptoms of disease of the testicles, 
prostate gland, and seminal vesicles. These affections become 
more and more seated the longer the morbid condition of the 
urethra is allowed to continue, until there may be an entire loss 804 
COMMON SENSE MEDICAL ADVISER. 
of the sexual power, occurring at an age when there should be 
the most vigor. To no other cause can we ascribe the common 
prevalence of disease of the deeper portions of the urethral 
canal and the bladder, which are frequently confounded with 
other diseases of the genito-urinary organs. 
The following case of an unmarried gentleman, 32 years of 
age, fully illustrates the above. 
Case 112,289. 
When he applied to us there was entire loss of the sexual function, 
with great nervous prostration, and a thin slimy discharge from the 
urethra, and the usual symptoms of melancholia and debility. 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 physical condition 
would not permit it. On examination, a contraction of the urethra 
was found at the point shown in Fig. 234, which had probably been 
present for years. He stated that he never had been just right in those 
Fig. 2SJf.. 
parts, although he had lived a virtuous life and 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 im- 
mediate improvement in this condition, which became more and more 
rapid, until he quite recovered. At the end of two months after leav- 
ing the Invalids' Hotel and Surgical Institute, he wrote that he felt 
perfectly well, and that he had experienced the most wonderful im- 
provement in every way, for which he was most profoundly grateful. 
Chronic inflammation of the bladder, an affection which has 
been fully considered elsewhere in this book, chronic inflamma- 
tion of the kidneys, and Bright's disease are liable to result from 
strictures of the urethra. Hence, it behooves every one suffer- 
ing from this affection to have it promptly and skillfully 
treated. STRICTURE OF THE URETHRA. 
805 
False Passages. In very rare cases of impassable stric- 
ture, or those in which fistulous openings, or false passages, have 
formed, through which the urine flows or dribbles away, we 
have resorted to the operation of perineal section with the most 
gratifying results. The cases requiring this operation are such 
that death must necessarily result but for the relief afforded by 
the operation. 
Danger in the Use of Instruments. The worst 
cases of stricture which we have seen in an extensive experi- 
ence, were those in which the condition had been made worse 
by the careless or unskillful use of bougies, catheters, or sounds. 
Many physicians and surgeons are recklessly careless or unskill- 
ful in the use of these dangerous instruments, as the many cases 
of false passage or stricture of a painful and dangerous kind, 
caused or aggravated by their ignorant or improper use, sorrow- 
fully testify. 
By proper treatment of stricture in its early stages, all dan- 
ger and pain are avoided, and a cure is effected in a very short 
time. We never fail to effect a cure of stricture without using 
cutting instruments of any kind, when we are consulted before 
injury to the urethra has been produced by the improper use 
of instruments. Having specialists who devote their entire time 
to the study and cure of these diseases, we are thereby enabled 
to attain the highest degree of skill in the management of these 
cases. 
Caution in the Use of Instruments. The urethra 
is, as we have seen, a very delicate canal, surrounded by soft 
tissues. No instrument should ever be introduced into it ex- 
cept when absolutely necessary, and then the operation should 
be so carefully and skillfully performed as to produce no irrita- 
tion or injury. Neglect of this precaution has frequently caused 
false passages and the formation of the most troublesome kind 
of organic strictures. By our improved method of performing 
the operation known as perineal section, a cure of even the 
worst cases of impassable stricture and false passages, or uri- 
nary fistulae, is effected in from thirty to forty days, with very 
little suffering. 
Of the many cases of stricture of the urethra which have 
been successfully treated by the surgical staff of the Invalids' 806 
COMMON SENSE MEDICAL ADVISER. 
Hotel and Surgical Institute, we will cite a few which serve to 
illustrate the various forms of this affection, and the success 
attained by appropriate treatment. 
Case 51,081. A Remarkable case of Stricture of the Ure- 
thra, with an Abscess. 
World's Dispensary Medical Association: Gentlemen - For 
twelve years I suffered from the torments of inflammation of the 
bladder and urethritis, which finally resulted in stricture. My life was 
an unending misery. The urine could only be voided in drops and 
with the most intense agony, which would be followed with chills, and 
sharp, shooting pains, that made my life unendurable. During these 
years, I consulted some of the most eminent Canadian physicians, who 
invariably made my condition worse. Finally, my health become so 
broken down, and the trouble so greatly augmented, that they told me 
that my case was hopeless, and that by no human skill could my life 
be prolonged more than a very few weeks. 
Discouraged, I determined yet to make a last effort, and so came to 
you, feeling that if you offered no encouragement, I would give up. I 
have to thank you for the candid and kind expressions as to my condi- 
tion and chances of a cure. For the painless and skillful operation 
which you performed, and which resulted in perfect and immediate 
relief of the wasting fever and intense agony, I cannot express my 
thanks and heart-felt gratitude, to which are added those of my family, 
which depends upon me for support and protection. After being thirty 
days under your care, I feel myself entirely and permanently restored 
to health. I would urge all invalids to apply to you. Any thing that 
can be done by human skill and perfect judgment you can do. 
Gratefully yours, 
W. G. D., Niagara, Ont. 
Early and proper treatment of this case would have saved 
years of intense suffering. Three weeks further delay would 
have resulted in death. At the time of the operation, his weight 
was but ninety-six pounds, two months after, he weighed one 
hundred and sixty, was able to pass a catheter of the largest 
size without difficulty, and urinate a stream of full size. His 
perfect recovery was speedy and without an untoward symptom. 
Case 52,947. Impassable Stricture of the Urethra. 
J. P., Pine River, Ont. This gentleman came under our charge 
suffering most intensely from the effects of inflammation of the blad- 
der and stricture of the urethra. His money had all been spent in 
fruitless endeavors to be cured. He had consulted the best physicians 
in his country without being improved. Their careless or ignorant use 
of instruments had resulted in a false passage and an aggravation of 
his disease. He passed his urine only with the greatest agony, and 
but one or two drops at a time. By long suffering and loss of appetite, 
he was reduced to a trembling skeleton, unable to stand erect, and 
moving with the greatest reluctance and with terrible suffering. His 
friends raised a purse and placed him under our care as a last resort 
and with little hope of a cure. His weight was less than one hundred 
pounds. The stricture was impassable and the urine was burrowing in 
the tissues under the bladder, and an abscess was gradually forming in STRICTURE OF THE URETHRA. 
807 
that part. By an operation we relieved him, and in three months 
effected a perfect cure. He wrote us one year afterwards as follows: 
"I got along all right after leaving your place. To-day I can chop 
two cords of wood during the day and feel well after it. I weigh two 
hundred and one pounds and feel perfectly well. I am as good as new. 
I am a laboring man and cannot write how well and thankful I feel, 
but my love and thankfulness to you for saving my life shall never 
fail." 
Case 56,287. Fistula, Cured by the Operation of Perineal 
Section. 
World's Dispensary Medical Association: Gentlemen - My 
heart-felt thanks for the kind attention and skillful treatment given 
my case. My life was saved by you. For two years, I had endured the 
most painful torments from disease of the bladder and urethra. Large 
holes had been eaten in my flesh, forming false passages through which 
the urine poured, instead of going through the natural channel, caus- 
ing the most intense pain and misery. My case defied the efforts of 
our best physicians. Seeing that I could not endure my sufferings 
longer, I visited Buffalo, against the desire of my physicians, who con- 
sidered my case incurable, and placed myself under the care of your 
surgeons. By a skillful surgical operation, I was at once freed from 
all pain and distress, and in four weeks enabled to return home per- 
fectly cured and with every prospect of future health and happiness, 
which I had deemed forever lost. I strongly urge all in need of medi- 
cal or surgical aid, to avail themselves of your skillful care and the 
perfect appointments of your magnificent Invalids' Hotel. 
Gratefully yours, 
A. C. D., Etna, Allegheny Co., Pa. 
This patient, a young, hard-working man of steady habits, 
was in an extremely dangerous condition when admitted to our 
institution. His affection was the result of a strain and rupture 
of the urethra from heavy lifting, aggravated by the improper 
use of instruments. The debility and great emaciation, which 
were daily increasing, indicated an extreme degree of suffering, 
and that something radical must be done if his life was to be 
saved. We were enabled, by the performance of our new oper- 
ation, to close the fistulas and effect a perfect cure. 
Case 61,269. Stricture of the Urethra. 
World's Dispensary Medical Association: Gentlemen - The 
operation performed during my visit at your institution, which has 
been the means, combined with medicine received for my complaint, of 
so improving my health that I shall not require any more treatment. 
I consider myself cured, and am very thankful and grateful for the 
valuable services and advice which have contributed to the same, and 
shall always advise any of my suffering friends to pay you a visit, as 
the Invalids' Hotel is the Mecca for the invalid, where, if human skill 
will avail, death and a great amount of suffering can be averted. 
Wishing you every success in your glorious mission, I am 
Yours sincerely, 
R. B., Halifax, N. S. 808 
COMMON SENSE MEDICAL ADVISEE. 
Case 70,054. Stbicture of the Urethra. 
World's Dispensary Medical Association: Gentlemen-I desire 
to add my testimonial to the many received at your Hotel. I was a 
great sufferer from the effects of stricture for over eight years. I have 
been permanently cured by a short course of treatment by your spe- 
cialists. The method is the most skillful and painless known, and, I am 
satisfied, the most perfect. I can most heartily recommend your insti- 
tution and skill, from the immediate, painless, and permanent relief 
that I have experienced. Sincerely yours, 
A. N., Buffalo, N. Y. 
Case 85,235. Stricture, with Bright's Disease as a result. 
World's Dispensary Medical Association: Dear Friends-When 
I visited your Invalids' Hotel, nearly a year ago, I had nearly given up 
all hope of getting well. It was my last effort. 1 had the misfortune 
to contract a private disease, which was improperly treated by one of 
the most prominent physicians in New York city. He was addicted to 
liquor, and must have injured me. A stricture gradually formed near 
the end of the penis, but, as it did not give much trouble, I gave it no 
attention. There was a slight mucous discharge in the morning. I had 
lost my manly strength. A pain in the back, and in the region of the 
bladder, led me to believe that something must be wrong. On examin- 
ation of my urine by a skillful chemist, he stated that 1 was suffering 
from subacute inflammation of the bladder, and the first stage of 
Bright's disease. I tried several doctors, but steadily grew worse. At 
last, by reading the straightforward writings in your pamphlets, I was 
led to visit your institution. The statements of my chemist, and my 
fears of the bad state of my urinary organs, were confirmed by you. 
The operation and cure of the stricture was painless and speedy. It 
gave me great relief. I was able to leave your institution in two 
weeks, feeling greatly improved and encouraged. By taking your 
special treatment for two months, I was perfectly restored to health. 
All my debility left me, I gained steadily in weight, and now feel 
myself, thanks to your skill and care, a sound and well man in every 
way. May God bless you for the cure you have effected. I am travel- 
ing from place to place, and will aid your good work in every way I 
can. Respectfully yours, 
A., Nashville, Tenn. 
Case 87,148. Stricture of the Urethra. Cure -without Oper- 
ation. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-It would be impossible for me to express to you my thanks for 
the frankness displayed by you in the management of my case. It 
would have been an easy matter for you to have advised me to come on 
and undergo a surgical operation at great expense to myself, as many 
others advised me to do; but, as you stated frankly that I could be 
relieved by home-treatment alone, I saw that your interest in my case 
was an unselfish one. The improvement predicted by you has been 
abundantly verified. With gratitude, I remain, 
Very respectfully, 
J. B. B., Herald, Kansas. 
Case 91,333. Stricture of the Urethra, wtith Inflammation 
of the Bladder. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-I desire to testify to the speedy cure that has been effected in 
my case by the treatment you gave me. 1 had suffered from stricture STRICTURE OF THE URETHRA. 
809 
of the urethra, the result of a private disease contracted twelve years 
before. The stricture gradually formed, giving me little or no trouble 
at first, but I soon experienced considerable difficulty in urinating. I 
had to wait some minutes, at times, for the stream to flow, and often 
had to walk the floor back and forth for fifteen or twenty minutes 
before I could get the stream started. It would then fall at my feet, 
having no force. The pain was variable, at times severe, and at others 
I could make water quite easily, but never in a natural manner. Such 
was the trouble experienced, that I consulted a physician who had a 
great reputation for the cure of such cases, and who was considered the 
best man in the district, in which I lived in Massachusetts. He per- 
formed an operation on me which gave me relief for a short time, but 
soon the disease appeared as bad as before. One of your pamphlets fall- 
ing into my hands, and knowing the great success that you had experi- 
enced in the cure of such, 1 determined to consult you, and I am thank- 
ful to say with the most gratifying results. Although it is some months 
since I stopped your treatment, there has been no return of the strict- 
ure, and I feel that my cure is permanent. The kidneys and bladder 
have returned to their natural, healthy condition. I feel that my life 
has been prolonged many years by your treatment. Please accept my 
sincere thanks. Very truly yours, M., Adams, Mass. ' 
Case 97,466. Stricture of the Urethra, with Gleet and Sper- 
matorrhea. 
World's Dispensary Medical Association: Gentlemen-When 
I left your institution, last winter, it was with a thankful heart. From 
the bad treatment of a private disease, contracted five years ago, I had 
a severe stricture form. This was unsuccessfully operated on, and 
made worse by two of our best doctors. Knowing your great reputa- 
tion, I was led to visit your Invalids' Hotel. At that time I suffered 
not only with the stricture, but also from gleet and spermatorrhea. 
My face was constantly breaking out with pimples and blotches. I felt 
weak and languid, dull pain in the back, and smarting in the urethra. 
By the careful treatment of your skillful specialist, all my troubles 
were removed, and by continuing the course at home for two months, I 
have since enjoyed perfect health. With heart-felt gratitude, 
I am, yours truly, W., Sandy Creek, N. Y. 
Case 110,028. Urethral Fistula. 
This gentleman consulted us to obtain relief from a most aggravated 
urinary fistula. There were some eight or ten openings extending into 
the urethra from which issued a fetid discharge. On examining his 
urine, we found evidences of a severe affection of the kidneys of such 
a nature that, on consultation, we deemed it advisable for him to return 
home, and remain there until, by proper treatment, his kidneys could 
be restored to a more healthy state. When this was accomplished, we 
advised him to come on, and allow us to effect a cure by an operation. 
The improvement which took place in his case, is stated in the commun- 
ication given below: 
World's Dispensary Medical Association: Gentlemen-Having 
been under your treatment two weeks for a trouble of a serious nature, 
I desire to express to you my sincere thanks for the kind and skillful 
treatment I have received at your hands. I feel that I have progressed 
further toward my recovery in this time than in the years that I have 
been under the treatment of other physicians, who, though undoubtedly 
doing their best, did not have the skill and experience possessed by the 
physicians of your staff. 810 
COMMON SENSE MEDICAL ADVISER. 
I came to your institution with misgivings, as I had been frequently 
told that you were humbugs, and I must say it has been the greatest 
satisfaction to me to prove the falsity of all the statements which have 
been made against you. 
Thanking you for the kind treatment I have received, I remain, 
Sincerely yours, P., Tunnelton, Pa. 
Case 110,G13. Stricture of the Urethra. 
This gentleman had been treated for gonorrhea by several physicians 
for a number of months with but poor success. The pain in the urethra 
led him to consult a specialist of large experience, but who evidently 
made a mistake in his case. He informed him that there was a stricture 
at the neck of the bladder, for which large-sized sounds should be used. 
He gave him instruments, and instructed him how to employ them. 
The result of their improper use was a severe inflammation of the 
urethra and bladder, and he became very much worse than before 
the treatment was undertaken. He applied to us, much discouraged, 
and fearing that his case was incurable. On examination, we found 
that what had been supposed to be stricture at the neck of the bladder 
was merely an unusual sensitiveness at that place, which caused its 
sudden contraction on the introduction of the sound, which condition 
was kept up by inflammation of the prostate gland. A very severe 
stricture was found near the end of the penis, which was operated upon 
by our painless method, and he was able to return home permanently 
cured. The gleet, painful irritation, and all the symptoms of disease 
in the bladder and urethra were permanently relieved. On going away 
from the Invalids' Hotel, he left the following communication: 
World's Dispensary Medical Association: Gentlemen-I leave 
your institution this evening, after a stay of one week. During the 
time, I have been operated on for a stricture of the urethra and cured. 
The operation was absolutely painless. I desire to testify to the per- 
fection of your institution and the good care and kind attention I have 
received while with you. Very truly yours, B., Bellaire, Ohio. 
PHYSIOLOGICAL ANATOMY OF THE MALE GENER- 
ATIVE ORGANS. 
A general idea of the relative positions of the male reproduc- 
tive organs may be obtained by referring to the illustration, 
Fig. 103, page 207. They consist of the penis, with its 
urethra, or urinary canal, through which the urine is voided; 
the testicles, or glands, which secrete the seminal fluid, contained 
in their bag, or sac, called the scrotum', the seminal vesicles, or 
sacs, which serve as reservoirs for the seminal fluid before it is 
expelled into and through the urethra; the prostate gland, about 
the size of a large chestnut, lying just in front of the outlet or 
base of the bladder, and surrounding the urethra, and Cowper's 
glands, two small organs similar in structure to the prostate 
gland. 
In Fig. 103 the course of one of the seminal ducts may be MALE GENERATIVE ORGANS. 
811 
seen as it passes over the bladder from the testicle, and enters 
the corresponding seminal sac or vesicle, which lies under and 
behind the base of the bladder, and forms one of the recep- 
tacles in which the seminal fluid is stored. 
The Penis. The penis consists principally of a sponge-like 
structure, which admits of a sudden influx of blood, causing its 
distension and erection, as well as of its sudden evacuation, caus- 
ing collapse of the organ. This is influenced by the will and 
the emotions. The integument or skin covering the penis rests 
upon loose, cellular tissue, which permits it to move backward 
and forward over the organ very freely. That portion covering 
the glans, or head of the penis, is called the prepxice, or fore- 
skin. This during erection should slip back, leaving the glans 
completely uncovered. There are, unfortunately, many instances 
of deformity of the penis, generally existing from birth, in 
which the foreskin cannot be drawn back at all, from being too 
contracted close in front of the glans, or head of the penis. 
This condition is called phimosis. When present it constitutes 
a serious impediment to sexual intercourse. Thousands of per- 
sons sufleering from this deformity are sorely distressed in mind 
through ignorance of the fact that a very simple operation will 
remove all difficulty. This subject will, however, be considered 
more fully under its proper head. Minute follicles, or glands, 
around the neck of the penis, secrete a peculiar white substance, 
which, if allowed to accumulate under the foreskin, often gives 
rise to unpleasant symptoms, and, in some cases, to actual dis- 
ease. It is exceedingly important, therefore, even in early 
youth, that the prepuce, or foreskin, should be frequently drawn 
back for the purpose of washing away this offensive and irritat- 
ing secretion. 
The Testicles. The testicles, or testes, are two small 
glandular organs, situated in the scrotum, or sac of skin, hang- 
ing beneath the root of the penis. Each testicle is of an oval 
form, and suspended by a vascular, nervous structure, called the 
spermatic cord. The function of the testicles is to secrete the 
sperm, or semen, a vital, quickening fluid, of a whitish color and 
of a peculiar odor. 
Development of the Testicles. The testicles at an 
early period of intra-uterine life, are in the abdomen of the 812 
COMMON SENSE MEDICAL ADVISEE. 
foetus, directly beneath the kidneys. In the fifth or sixth 
month of pregnancy, they pass downward to the lower part of 
the abdomen, and each testicle from its lower part sends forth 
a cord, which is composed of cellular tissue and ligamentous 
fibers and called the gubernaculum testis. Each cord passes 
through the inguinal canal, which is only two inches in length, 
proceeds obliquely downward, inward, and forward, out of the 
lower part of the ab- 
domen, and termi- 
nates in the bottom 
of the scrotum. In 
the eighth month of 
pregnancy, the tes- 
ticles pass through 
the abdominal canals 
and reach the base of 
the scrotum, two or 
three weeks before 
birth. Occasionally, 
one or both are re- 
tained in the body 
until the fifteenth or 
seventeenth year, but 
they seldom perma- 
nently remain there. 
This circumstance, 
however, does not al- 
ways prevent procre- 
ation. 
Structure of' 
the Testicle. Fig. 
235 is an excellent 
illustration of the internal structure of the human testicle, when 
its several parts are made distinct by being injected with mer- 
cury, and then so dissected as to be exposed to view. The nu- 
merals, 1, 2, 2, refer to a bundle of seminal tubes, each of which 
is about seventeen feet long, and of an inch in diameter. 
As represented in the figure, each tube is remarkably convo- 
luted, having the appearance of a miniature intestine, and they 
Fig. 235. 
A representation of the internal structure of a 
Testicle partially unraveled. MALE GENERATIVE ORGANS. 
813 
all converge at 3, as represented by the dotted lines; each bun- 
dle forms a single straight tube, which is called the vasum rec- 
tum. The vasa recta are twice the diameter of the seminiferous 
tubes, and are so woven together as to form a complete plexus, 
called the rete testis, which signifies a network of interlacing 
vessels. The body which is thus formed, represented at 4, is an 
oblong eminence called the corpus Highmori. The tubes which 
compose this part unite to form the vasa efferentia, which, at 5, 
constitute little vascular cones, uniting to form a single tube, as 
seen at 6. This vessel remains single for a short distance, but 
soon becomes convoluted, having the appearance of an arched 
structure in the back part of the testicle, and is termed the 
epididymis. The vas deferens, represented at 7 and 8, is the 
excretory canal of the testicle. It arises from the epididymis, 
and, as will be seen at 8, becomes less twisted in its course, 
and, at 9, is straight, and parallel to 10 and 11, the spermatic 
artery and cord. The vas deferens in this part of its course 
is a firm, white duct, about one-eight of an inch in diameter, 
but its caliber is only the size of a fine bristle. The spermatic 
cord consists of spermatic arteries, veins, nerves, and absorbents, 
besides its own proper coverings. 
The testicles are small in childhood, but begin to increase in 
size from the thirteenth to the fifteenth year, at which time the 
penis also gradually enlarges, and there is greater tendency to 
erection. The lower part of the abdomen, about the root of 
the penis, previously bare, now becomes covered with short hair; 
the voice becomes deeper in pitch, and more sonorous; the form 
becomes more developed and perfect, and, in fact, the period 
between childhood and manhood, that of youth, has been 
reached. 
This is the period in life during which every lad should be 
guarded by the watchful care of an intelligent parent. Perni- 
cious habits are at this period easily acquired, and, when once 
formed, almost invariably end in ruin to health and strength. 
The Prostate Gland. The prostate is a gland of about 
the size and shape of a large chestnut, lying just in front of the 
bladder and surrounding the urethra. The size of the prostate 
gland varies considerably with the age of the individual. In 
early life, it weighs but a few grains. As puberty approaches, 814 
COMMON SENSE MEDICAL ADVISEE. 
it becomes larger, and, in the adult, weighs from half an ounce 
to an ounce. The prostate gland secretes a whitish, bland fluid, 
which empties into the urethra through its duct, and more par- 
ticularly during coition. This fluid is supposed to be more for 
the purpose of diluting the semen to facilitate its flow, rather 
than to impart to it any peculiar or vital power. Hypertrophy, 
or enlargement, of the prostate gland, is not unfrequent in the 
adult or middle-aged, and in old age it enlarges considerably. 
Being in close contact with the bladder, when it enlarges, it 
encroaches on this organ, pressing on it and interfering with the 
function of urination. Enlargement, or hypertrophy, of the 
prostate gland is often confounded with stricture, gravel, and 
stone in the bladder by inexperienced physicians, and treated 
accordingly. The condition of this gland may be readily deter- 
mined by an examination through the rectum or lower bowel, 
the finger of the expert surgeon being able to determine at once 
whether it is enlarged or not. 
Cowper's Glands, situated behind the bulb of the 
urethra, just in front of the prostate, are two minute organs, 
similar in structure, which secrete a similar fluid, that is also 
discharged into the urethra. 
AFFECTIONS OF THE MALE GENERATIVE ORGANS. 
Masturbation, also termed solitary indulgence, self-abuse, 
onanism, self-pollution, venereal debouchment, or voluntary pol- 
lution, is the production of the sexual orgasm by unnatural 
means. 
Our object in preparing and publishing this article is to im- 
part correct information upon a subject which is of the greatest 
importance to mankind, but which, from false modesty and a 
mistaken sense of duty, has been quite generally ignored both 
by parents and by the medical profession. To this prudery or 
false modesty, is due an immeasurable amount of suffering, and 
great injury to the human race. We have only to look about 
us with a practiced eye, to see abundant evidence of the truth 
of this assertion. We cannot enter a church or a theatre or 
walk the streets, without being painfully conscious of the ter- 
rible consequences of this ruinous habit, which is largely the re- 
sult of ignorance on the part of the victims. The statements AFFECTIONS OF THE MALE GENERATIVE ORGANS. 
815 
which we have received both by letter and in person, from 
many thousands of these unfortunates, prove conclusively that 
this habit is often formed in ignorance of the terrible evils 
which follow the abuse of the generative organs. 
Speaking of the general prevalence of spermatorrhea as a 
consequence of masturbation, or self-abuse, Dr. J. L. Milton, 
senior surgeon to St. John's Hospital, says, " That the disease 
exists to a very great extent, far greater than is generally 
thought, that it yearly reduces hundreds, if not thousands, to 
impotence and all its attendant ills, hypochondria, weariness of 
life, insanity and so on; that not only every town but every 
village could show victims of this neglected malady, are facts 
which I feel assured will not be disputed by those who have 
looked into the subject." 
Dr. John P. Gray, the distinguished superintendent of the 
State Insane Asylum at Utica, N. Y., speaking of the influence 
of masturbation, in the production of insanity, says, " The 
records of this institution show 521 cases admitted directly 
attributable to this vice, and I am well convinced that the num- 
ber is greatly understated." 
Dr. H. Fournier, one of the most distinguished physicians of 
Paris, says, in speaking of masturbation, "En effet, il n'est 
point de vice plus funeste a la conservation des hommes que 
1'onanisme," (indeed, there is not a vice more fatal to the conser- 
vation of man than masturbation). 
That such a terrible state of things should, from feelings of 
false delicacy, be permitted at this period of the world's history 
is simply monstrous; that medical men should be averse to af- 
fording instructive and sound information upon this important 
subject is equally discreditable. Every one should know that in 
the marvelous and most perfect work of God, no one set of 
organs is more sacred, private, or worthy than others of the 
system, and that there is nothing improper or indelicate in the 
naked truth concerning their functions, whether in health or in 
disease. 
From the period of puberty or maturity to old age, the gen- 
erative organs exercise a more potent influence ovei- the health 
of both men and women than any other organs, and they are 
more abused. This is due to the fact that the youth of the 816 
COMMON SENSE MEDICAL ADVISER. 
land are kept in total ignorance concerning the ruinous effects 
of self-abuse, or masturbation. 
They fall easily into this pernicious practice, which saps the 
vigor, undermines and ruins the constitution, and, if the vic- 
tim marries and has not by such indulgences rendered himself 
entirely impotent, he becomes the father of puny offspring; or, 
more frequently, being entirely impotent, it renders both his 
own life and that of his companion most wretched. 
We are fully conscious of the delicate nature of the subject 
which we are about to discuss, and of the peculiar difficulties 
attending its consideration in a book intended for popular read- 
ing, but we shall endeavor to present it in a style which cannot 
offend the modesty of the most chaste and fastidious, and we 
beg our readers to peruse this chapter in the same spirit in 
which we have written it, not with a view of exciting impure 
feelings, but to arrive at the truth, for the benefit of mankind, 
always bearing in mind that, "To the pure all things are pure.* 
We sincerely hope that the widespread circulation of this 
book may be the means of rescuing thousands from the inevit- 
able consequences of this habit, by inducing those who practice 
it to abandon the error of their ways before it is too late, and 
by preventing the acquisition of such pernicious habits by 
others. Every sentence is written in the cause of true morality 
and physical improvement. 
We are ever thankful for the support of those truly good peo- 
ple who can appreciate our honest efforts in behalf of suffering 
humanity, while we have only contempt for those whose mental 
vision is so distorted that they can only impute impure motives 
where all are pure, and dishonesty of thought and action wdiere 
all is honest. 
To those acquainted with our institutions, it is hardly neces- 
sary to say that the Invalids' Hotel and Surgical Institute, and 
the branch establishment located at No. 3 New Oxford Street, 
London, England, have for many years enjoyed the distinction 
of being the most largely patronized and widely celebrated 
institutions in the world for the treatment and cure of those 
affections which arise from abuse of the generative organs. 
Many years ago, we established a special department for the 
treatment of these diseases, under the management of some of AFFECTIONS OF THE MALE GENERATIVE ORGANS. 
817 
the most skillful physicians and surgeons on our staff, that all 
cases of spermatorrhea, seminal debility, impotency, varicocele, 
hydrocele, strictures, and kindred affections, applying to us for 
treatment might receive all the advantages of a full council of 
the most experienced medical men. This we have been able to 
do only at very great expense, as large inducements were 
necessary in order to secure skillful and experienced physicians, 
many of whom left lucrative private practices, and some of 
them hospital positions, to join our staff. 
We offer no apology for devoting so much attention to this 
neglected class of diseases, believing that no condition of hu- 
manity is too wretched to merit the sympathy and best services 
of the profession to which we belong. Many who suffer from 
the terrible diseases depicted in this work, contract them inno- 
cently. Why any medical man intent on doing good and al- 
leviating suffering, should shun such cases, we cannot imagine. 
Why anyone should consider it otherwise than most honorable 
to cure diseases resulting from this habit, we cannot understand. 
Of all the maladies that afflict mankind, there is probably not 
one about which physicians in general practice know so little. 
Dr. Milton, of St. John's Hospital, whom we have already 
quoted, says: "Indeed, ever since there was such a thing as 
opinion on this subject, it appears, so far as we can learn from 
reading, to have vibrated in the profession between something 
very like intolerance and neglect on the one hand, and an 
amount of ignorance on the other, which only afforded too great 
facilities for quackery, about the growth of which those who 
have done so much to foster it, were among the first to com- 
plain." 
"We read now with horror how the leper was chased forth 
from society, how the maniac and reputed witch were dealt 
with, how the venereal were driven from Paris under the threat 
of being thrown into the river if they did not leave, and of 
being hanged if they ventured to return. We can scarcely 
understand physicians refusing to treat phagedenic affections 
because they were seated on the genitals, or the authorities of a 
city burning a man alive for practicing midwifery.* But in 
* " In the sixteenth century. Dr. Werth was burnt alive at Hamburg, because ho 
attended a woman in her confinement."-Edinburgh Med. Journal, vol. xviii, p. 845. 818 
COMMON SENSE MEDICAL ADVISER. 
point of fact this kind of barbarity, which was always confined 
to the fanatical part of the community, has rather changed its 
outward semblance than lost its vitality. The man who has an 
attack of virtuous horror whenever the subject of spermatorrhea 
is mentioned, or profess to be ignorant of its nature or even its 
existence, who will ostracise alike the patient suffering from this 
complaint, and the medical man who so far forgets the dignity 
of his profession as to prescribe for it, is in all essentials the 
same person as the magistrate, who, in by-gone days, enforced 
his orders with the whip and halter, and the physician who 
refused the aid of his art to the patient with sloughing ulcer of 
the genitals." 
We fully agree with Dr. Bartholow, who says, "I think it a 
reproach to our profession that this subject has been permitted, 
in a measure by oui- own indifference, to pass into the hands of 
the unscrupulous pretenders, whose suggestive publications are 
amongst the crying evils of the time. Because the subject is 
disagreeable, and to a certain extent disreputable, competent 
physicians are loth to be concerned with it. The same unneces- 
sary fastidiousness causes the treatment of this malady to be 
avoided in private practice; and the unfortunate patients, thus 
precluded from obtaining intelligent advice, fall into the hands 
of those who excite their worst apprehensions for a mercenary 
purpose." 
We shall, therefore, continue, as heretofore, to treat with our 
best consideration, sympathy, and skill, all applicants suffering 
from any of the diseases resulting from self-abuse or sexual 
excesses. 
Causes of the Formation of the Habit. It is a 
deplorable fact that this vice is sometimes acquired by boys 
before their sixth year. In some instances, the habit may be 
attributed to foolish or vicious nurses, who quiet children when 
they cry by tickling their sexual organs. These witless persons 
may not know how dangerous such a practice is to health and 
morals, or how easily the child is overcome by its own propen- 
sities. It is wrong to commit these important trusts to the keep- 
ing of those who may easily transform a naturally healthy desire 
into a pernicious, morbid sensibility which will eventually ripen 
into a degrading animal lust. AFFECTIONS OF THE MALE GENERATIVE ORGANS. 
819 
Dr. Barth olow, late of the Good Samaritan Hospital, says: 
" The growth of the sexual apparatus at the period of puberty 
is accompanied by abundant secretion of the seminal fluid, which 
accumulates in the reservoirs. The sexual instinct, then fully 
developed, exerts a powerful influence over the mind, whilst the 
reason is not in a sufficiently matured state to correct the 
mirages of the imagination. An accidental friction of the erect 
organ in these moments of delirium makes the unfortunate youth 
acquainted with a new and voluptuous sensation. Ignorant of 
the dreadful consequences which must ensue from the repeated 
perpetration of this act, the youth perseveres in his secret pleas- 
ures until arrested by realizing some of the sad effects upon the 
mind and body which follow." 
Masturbation may arise from premature and unnatural devel- 
opment of the sexual organs, as in a case related by the distin- 
guished surgeon, Mr. South, who reports the case of a child as 
follows: "When he was about four months old, the hair on the 
pubes began to grow very thickly and black, at which time the 
penis increased in size, particularly the glans, so that it gradually 
extended beyond the prepuce, till about fifteen months, when it 
was entirely exposed; the pubes were then completely covered 
with black, curling hair. * * * Soon after this, she 
[his mother] noticed that his linen was stained two or three 
times in the week. * * * She a]g0 states that since 
he has been in town (six weeks) the emissions have been more 
frequent than for some time previously." * 
Mr. South states that the length of the penis of this extraor- 
dinary child, when pendent, was three inches; when erect, six 
inches. This, to be sure, was a rare and curious case. That 
premature and inordinate development of the sexual organs, 
does, however, occasionally give rise to self-abuse, is undeniable. 
Dr. Heckford says: "I believe it is not generally known that 
this vice is practiced not only by adults, but also by young 
children, and even by infants in the cradle. Dr. Hughlings 
Jackson gives the following narrative: "A woman came into 
the hospital for epilepsy and paralysis, on account of fits. She 
took the opportunity of asking my advice about her child. 
* Medico-Chirurgical Transactions, vol. xii, p. 76. 820 
COMMON SENSE MEDICAL ADVISER. 
The boy was fifteen months old; he was delicate, and had 
never been able to stand; but the special circumstance about 
which the mother wished to hear my opinion was the pe- 
culiar position of his legs. The right leg was almost always 
placed high up over the other, and he kept it moving in a 
sawing way towards the pelvis. The penis was in the way of 
friction, and was quite stiff when I examined it. He was much 
annoyed at my interference with the movements of his leg, 
making resistance and crying. * * * The j]aj 
congenital phimosis, but he did not cry when he made water. 
Mr. Hutchinson was kind enough, at my request, to circumcise 
him. * * * After this the habit ceased, for a time, 
at least, and the child much improved in health." * 
Dr. Bartholow, to whom we have already referred, says: "I 
have had lately under observation a case, a boy four years of 
age, who had practised the habit for two years. He exposed 
the penis to friction between the thigh and abdomen. His 
mother informed me that he was much excited during the act, 
and at its termination passed into a nervous state, preceded by a 
shudder. He had frequent epileptic convulsions. Circumcision, 
although it interrupted, did not cure the habit, for the boy re- 
sumed it again after the wound healed. Threats, punishment, 
and restraint were alike unavailing to prevent the perpetration 
of the act." 
Some boys seem to regard the practice of this vice, like the 
vile habits of smoking and chewing tobacco, as a manly accom- 
plishment. A boy may inherit a predisposition to this prac- 
tice, or his sexual feelings may be awakened at an early age 
and his bad example be imitated by many others. In this way, 
the habit is early acquired, and, when the sexual propensities are 
habitually indulged to the exclusion of the cultivation of higher 
and nobler pleasures, if not rendered impotent by these abuses, 
such a person may transmit the same propensity to his offspring, 
so that it becomes irresistible. 
Indications Of the Vice. The indications of this vice 
in boys are irritability, impatience, and restlessness, loss of flesh, 
pallor, and a timid, downcast look. There is loss of memory 
♦London Hospital Reports, vol. ii, p. 58. AFFECTIONS OF THE MALE GENERATIVE ORGANS. 
821 
and the intellect becomes enfeebled. They are melancholy, 
easily discouraged, and prefer solitude. They do not remem- 
ber what they learn, the nervous system shows serious im- 
pairment, and the general health fails. The symptoms are too 
significant to deceive the experienced eye. The short, irritable 
replies of the boy, and his general sensitiveness and nervous- 
ness are indicative of the loss of nerve-power, occasioned by 
this habit. 
Preventive Measures. This evil can only be prevented 
by knowing the habits of children and regulating them in early 
life. As soon as this practice is acquired, the child should be 
forewarned of its destructive tendency and informed that such a 
practice results in calamities which will embitter the whole life. 
Parents hesitate to talk to their boys, because they fear putting 
impure ideas into innocent minds. Their hopes are strong that 
th&ir sons will never indulge in so degrading a practice. It is 
a false modesty which restrains them from fulfilling this duty. 
If they do not attend to their children's interest, who will? 
The child's confidence should be gained through the manifesta- 
tion of a tender personal concern. Diffidence and suspicion on 
the part of the parent destroys confidence in the child. Parents 
should divest themselves of all false modesty, and by their 
frankness establish an understanding which will result in mutual 
confidence. The physician compassionately meets his patient, 
is pitiful, tender, and kind. When parents are actuated by the 
same feelings, they can win the confidence, guard the health, 
and preserve the morals of their children. 
We cannot too earnestly urge upon parents the necessity of 
forewarning their children against yielding to this pernicious 
desire. Boys ought to know that they may be thrown into the 
company of older lads who practice masturbation, and who may 
solicit them to acquire the same vile habit. They should be 
taught to resist these solicitations and exercise self-control, or 
they will be carried by the swift current of licentiousness to 
utter moral and physical ruin. 
If the lad be instructed that this unnatural sexual enjoyment 
is a degrading pollution, a low practice, in which no right- 
minded boy will indulge, the gratification will be followed by 
an instinctive sense of disgust and self-condemnation. He will 822 
COMMON SENSE MEDICAL ADVISER. 
then realize that restraint is far more manly, and that self-con- 
trol is a higher test of maturity than the degrading indulgence 
of his passions. Nature requires her own time to nourish the 
body, complete the physical frame-work, and bring every mem- 
ber and organ to perfect maturity. The muscular exertion re- 
quired in sports and plays, the athletic exercises of youth, tends 
to develop physical energy, self-reliance, and heroism. Let boys 
compete with one another in these manly exercises; let them 
emulate one another in all that is worthy and just. Such a 
strife will bring out the highest qualities, those crowning ex- 
cellencies of character which distinguish and honor manhood. 
How to Break up the Habit. Excitement of the 
reproductive organs with the hand or other unnatural means 
is called masturbation, or self-abuse, even when no semen is lost. 
The practice inflicts injury on the nervous system, causing great 
loss of nervous power. The habit being once formed, the desire 
for such indulgence increases, until the boy becomes, in later 
years, if not impotent, a victim of sexual intemperance. His 
love of sexual pleasure grows upon him until he becomes a 
monomaniac on this subject. While "it is never too late to 
mend," yet a perfect redemption from this habit, as from drunk- 
enness, is difficult, and can be achieved only by a determined 
and persistent effort, which will frequently require the aid of 
medicine, to allay the unnatural sexual excitement. 
If the habit has been formed, the child should be required to 
rise early, and take cold baths and exercise freely, that the blood 
may be diverted into the muscles. Let the thoughts be directed 
into proper channels and the taste for manly sports cultivated. 
Let him be encouraged in such amusements as croquet, ball- 
playing, quoits, walking, hunting, rowing, foot-ball, and all the 
invigorating exercises of the gymnasium; or let him become 
interested in the cultivation of flowers, in agriculture, or in the 
care of animals in which he has a pecuniary interest, and in 
these healthful ways the mind will be diverted from sexual 
objects. If these hygienic means be not sufficient to overcome 
the morbid sexual excitement, then a skillful physician should 
be consulted, that the proper remedies may be applied in time to 
save the child from becoming, in later life, a victim of sper. 
matorrhea and impotency. SPERMATORRHEA AND IMPOTENCY. 
823 
Spermatorrhea, or the involuntary emission of semen 
without copulation, is generally induced by the early habit of 
masturbation. It is one of the evidences that passion, instead of 
prudence, has held sway. Passion may aptly be termed the 
voice of the body, by which, if we listen, we are enchanted and 
led astray. Conscience is the voice of the soul, which remon- 
strates, and, if we obey it, we shall be guided aright. We can- 
not reconcile these conflicting voices, and, if we indulge the 
passions when conscience forbids gratification, the remembrance 
of the wrong remains forever, and constant fear is an everlast- 
ing punishment. 
Man possesses few powers which are more highly prized than 
those of virility, which is the very essence of manhood. "He 
is but the counterfeit of a man, who hath not the life of a 
man." 
The semen is the most important secretion of the animal 
economy. It is a milky fluid of the consistency of mucus, 
and, when perfectly elaborated, contains no albumen in its com- 
position. It is intermixed with the fluids secreted by the vesi- 
culie seminales and the prostate and Cowper's glands. Its fer- 
tilizing property depends upon the presence of minute bodies, 
termed spermatozoa. These consist of small animalcula, hav- 
ing large heads and long filaments or tails. Under the micro- 
scope, these little bodies are seen to describe movements not 
unlike polliwigs, or tadpoles. 
The Debilitating Effects of Involuntary Semi- 
nal Emissions. The seminal fluid consists largely of the 
most important elements in the human body. It not only assists 
in maintaining the life of the individual, but communicates the 
essential, transforming principle which generates another mortal. 
Its waste is a wanton expenditure, which robs the blood of its 
richness and deprives the body of its animating influence. Its 
loss enfeebles the constitution, and often results in impotency, 
premature decay, consumption, St. Vitus's dance, epilepsy, paral- 
ysis, softening of the brain, and insanity. Conscience and fear 
become tormenting inquisitors, and the symptoms are changed 
into imaginary spectres of stealthily approaching disease. 
SPERMATORRHEA AND IMPOTENCY. 824 
COMMON SENSE MEDICAL ADVISER. 
"There is no future pang 
Can deal that justice on the self-condemned 
He deals on his own soul." 
Semen represents the forces of life, and may be compared to a 
spring having vital tension. The watch runs with regularity by 
means of the tension of its elastic spring. If that power is 
weakened, the friction and resistance of the wheels cause the 
watch to stop. So it is with man. Expend the semen, and the 
vital force is exhausted, for all the functions are obedient to its 
energy. There is nothing left to propel the delicate machinery 
of the functions, which, from sheer exhaustion, comes to rest. 
The practice of onanism squanders the vitality and bankrupts 
the constitution. Indigestion, innutrition, emaciation, shortness 
of breath, palpitation, nervous debility are all symptoms of ex- 
haustion. Subsequently, the skin becomes yellow and reveals 
the bones, the sunken eyes are surrounded by leaden circles, the 
imagination becomes dull, the mind loses its activity, in short, 
the spring having lost its tension, every function wanes in con- 
sequence. Excessive lustful practices produce feebleness, which 
finally terminates in disease and impotency. 
Spermatorrhea, or seminal weakness, may be the result of 
marital excesses. A proper sexual gratification contributes to 
the health and happiness of both parties. On the other hand, 
intemperate indulgence not only prevents fruitfulness but ulti- 
mately renders the husband entirely impotent, and undermines 
and destroys the constitution of the wife. Spermatorrhea may 
be induced by spinal irritation, intestinal worms, or piles. It 
may also result from inherited, as well as acquired constitutional 
weakness. 
Involuntary emissions of semen most frequently occur during 
amorous dreams at night and are, therefore, termed nocturnal 
emissions. Although they are at first occasioned by lascivious 
dreams, attended by erections and pleasurable sensations, yet, 
as the disease progresses, the erections become less perfect and 
the losses are only revealed by the depression of spirits experi- 
enced the following morning, and by the stiffened and stained 
spots on the linen. At first, these emissions may occur but once 
in two or three weeks, unless the patient is excited by company, 
stimulating food, drinks, or other causes; but, at a later stage SPERMATORRHEA AND IMPOTENCY. 
825 
of the disease, they sometimes take place every night. In aggra- 
vated cases, the seminal sacs are so weakened that the warmth 
of the bed, friction of the clothing, reading obscene literature, 
indulging in lewd conversation, or even being in the presence of 
women, produces a waste of semen, many times unattended by 
erections. When there is great weakness, seminal discharges 
may be induced by lifting heavy weights, pressure upon the 
genital organs, horseback riding, straining at stool, or even when 
urinating, as observed when muscular efforts are made to expel 
the last drops, which appear thick and viscid. If the urine be 
allowed to stand for a few hours, the seminal discharge will be 
precipitated, and will form a light-colored deposit at the bottom 
of the vessel. If the sediment is examined with a powerful 
microscope, spermatozoa are found in it. 
Atrophy, or Wasting Away, of the Testicles. 
Masturbation and spermatorrhea not only occasion loss of 
Fig. 236. 
Fig. 237. 
The Testicle in a healthy condition 
A Testicle wasted by Masturbation 
semen, but frequently the testicles waste away until they become 
nearly destroyed. Fig. 236 is a good representation of one of 
these glands in a healthy condition, while Fig. 237 represents 
one nearly absorbed. 
The penis, as well as the testicles, sooner or later, if the 826 
COMMON1 SENSE MEDICAL ADVISER. 
disease is allowed to progress unchecked, shares the same fate 
as the testicles, and gradually wastes away and diminishes in 
size, until it becomes incapable of performing its function. 
The celebrated Dr. Drewry, of London, speaking of the rea- 
son why masturbation and spermatorrhea are so extremely injur- 
ious in their effects upon both body and mind, says: 
" This is a question I have often been asked by patients, and 
it is one which is rather difficult to explain to any one not 
acquainted with the phenomena of reflex nervous action." 
" Perhaps the simplest mode of putting it is to say that the 
effects produced by the excitement of the parts are not the 
direct result of the stimulation, but the excitement of the ex- 
tremities of the nerves is conveyed through them to the spinal 
cord and brain, and that the emission which occurs, when suffi- 
cient stimulus has been applied, is the result of nervous force 
reacting upon the parts from the spinal cord back again. This 
action is termed reflex, and is similar to that of vomiting, which 
is only produced through the medium of the great nervous cen- 
tres; so that if the nervous communication between the stomach 
and spinal cord and brain is cut off, nothing in the stomach 
could possibly cause vomiting, whereas if the communication 
remains intact, this action can be immediately produced by 
irritation of nerves far away from the stomach, viz., by tickling 
the fauces, as every drunkard is well aware who has ever put 
his finger down his throat for the purpose of emptying his 
stomach of the contents which are poisoning him, but which 
without the additional stimulus he is unable to expel. It will be 
seen, therefore, from this, that the act of emission is only pro- 
duced through the agency of the spinal cord, and not by any 
direct nervous action between the parts which are stimulated, 
and those which are concerned in the emission." 
"The brain is also concerned to the fullest extent in the pro- 
duction of these phenomena, as are all the senses of the body; 
this is proved by the fact that emissions occur during sleep, 
without any excitement beyond the engorgement of the parts 
with blood, produced by the cerebellar congestion of the brain 
usually found to follow lying upon the back during sleep. This, 
however, is unnatural and unhealthy, and is usually the result, as 
before pointed out, of masturbation. But these two important SPERMATORRHEA AND IMPOTENCY. 
827 
points must be remembered-that emission may be produced by 
friction merely as a purely spinal reflex action, and it may be 
caused by the action of the brain without any friction whatever. 
Both these results are unhealthy and injurious. A true natural 
and healthy act of sexual intercourse demands the excitement 
of brain, spinal cord, and every nerve in the body simultane- 
ously, and resembles the lightning flash which restores the 
equilibrium of electric force disturbed during a thunderstorm." 
" It is useless to endeavor to describe the marvelous actions 
of nervous force, but from what has been said it is not difficult 
to comprehend that, if a convulsive action is produced in any 
part of the body by the sole excitement of the spinal cord, when 
it is necessary for its healthy and natural production that the 
brain and senses should be equally excited, the balance of nerve 
power is destroyed, which fact alone is proved by the effects 
upon the nervous system always following masturbation, which 
is the irritation of the spinal cord without the assistance of the 
brain." 
Various complications are likely to arise in the progress of 
this terrible malady. Tumors which sometimes degenerate into 
cancerous disease of the testicles and finally result in death, are 
not uncommon. 
Stricture of the urethra is a very common complication and, 
even when quite slight, generally interferes very seriously with 
the cure of the spermatorrhea when overlooked by the attend- 
ing physician. This complication is very frequently neglected, 
especially when the constriction of the water passage is slight. 
Often in examining a case of this disease that has been the 
rounds of the doctors, we find a stricture which has been 
entirely overlooked by other practitioners, being too slight to 
occasion serious obstruction to the flow of urine but yet sufficient 
to interfere materially with the cure of spermatorrhea. 
Hydrocele, or dropsy of the scrotum, which is fully described 
further on in this work, consists of an undue secretion of the 
fluid which moistens the tunica vaginalis, and may arise from 
an irritation of the testicle produced by masturbation. 
Varicocele, which is also fully described and illustrated further 
on in this work, is a dilatation of the veins of the spermatic cord 
and scrotum, and is frequently a result of spermatorrhea. It is 828 
COMMON SfiNSE MEDicAL AbViSEfi. 
readily distinguished under the form of a soft, doughy, com- 
pressible, knotty, and unequal enlargement of the veins, and a 
tumid condition of the adjacent parts. One writer speaking of 
the enlargement of the spermatic vessels, describes them as 
"feeling like a coiled-up bundle of worms." 
Disease of the prostate gland is frequently caused by solitary 
indulgence. Venereal excesses produce congestion and the gland 
is overnourished and consequently becomes greatly enlarged. 
This condition gives rise to a heavy feeling or pressure in the 
region below the bladder, and often interferes seriously with 
nutrition, and gives great pain and uneasiness, and sometimes 
results in grave and dangerous complications. 
Pl'OStatori'liea consists of an unnatural flowing or dis- 
charge of the prostatic secretion, which may be known by its 
mucus-like appearance, and, when placed under a microscope, by 
the absence of spermatozoa, or fecundating germs. It is often * 
mistaken for spermatorrhea or for gleet, by inexperienced and 
careless physicians. 
Spermatorrhea may lead to a morbid diminution in the size of 
the prostate gland. This condition, which is exactly the oppo- 
site of hypertrophy, is termed atrophy. Any disease which ren- 
ders the circulation in the prostate gland languid and feeble, in- 
terferes with the nutrition of that organ and impairs its function. 
Illipotency. {Loss of sexual power.) Masturbation per- 
verts the excitability of the nervous system and sexual organs 
and causes debility, which is indicated by the premature dis- 
charge of semen during sexual intercourse. These premature 
emissions indicate not only partial impotency, but also that the 
nerve-centers have become morbidly sensitive by the practice of 
self-abuse or marital excesses. At length the powers of the 
erectile tissues are diminished, and there is weakness at the root 
of the penis when erect, thus preventing the act of copulation, 
or the erection may be slow and not last long enough, on 
account of a faulty functional condition of the spinal cord. 
This condition is sometimes associated with a morbid irritability 
of the urethra, which, being inflamed, may become sufficiently 
constricted to prevent the emission of semen when the penis is 
erected, causing it to pass back into the bladder. The inflam- 
mation may extend downward to the prostate gland, and cause SPERMATORRHEA AND 1MP0TENCY. 
829 
a discharge of thick, ropy, viscid slime. The reader will ob- 
serve, in Fig. 103, that the gland is deep seated; and, when the 
inflammation in the urethra proper has subsided, it may still 
extend to the prostate and cause a discharge of mucus unat- 
tended with pain. When patients send us a small quantity of 
this discharge on glazed writing paper, which will not absorb it, 
we can determine its true character and decide whether it is 
seminal fluid or simply a discharge from the prostate. The 
remedies which are useful in acute gonorrhea are not suitable in 
chronic prostatorrhea. This prolonged discharge is often mis- 
taken for gleet, and so long as it is treated with injections, 
Fig. 238. 
Fig. 239. 
Microscopic appearance of 
healthy semen. 
Microscopic appearance of semen 
which will not fecundate. 
copaiba, capsules, and other similar mixtures, it resists all efforts 
made to effect its removal. 
Venereal excesses pervert and finally destroy the secretory 
functions of the testes. They sometimes cause chronic inflam- 
mation, which may result in obliteration of the minute seminal 
canals, or in obstruction of the conveying ducts. The sperm is 
imperfectly elaborated and totally unfit for procreative pur- 
poses. Sometimes the spermatozoa are entirely absent, and, 
when present, are very few in number, incomplete in structure, 
diseased, and deficient in power as well as in organization. Fig. 
238 represents the spermatozoa in a healthy condition, and Fig. 
239, when they are sickly, deficient, and inanimate. The hus- 
band may appear to be healthy, and his inability to procreate 
may be erroneously considered a defect in his wife. 830 
COMMON' SENSE MEDICAL ADVISER. 
Symptoms of Sexual Debility. The indications of 
abuse of the sexual organs are loss of nervous energy, dullness 
of the mental faculties, and delight in obscene stories. The 
expression of the face becomes coarse, and the movements slow; 
the eye is sunken, the face bloated and pale, and the disposition 
is fretful and irritable; the appetite is capricious, the throat irri- 
tated, and the patient makes frequent attempts to clear it, in 
order to speak distinctly. There are pains in the chest, wake- 
fulness, and, during the night, lascivious thoughts and desires. 
The relish for play or labor is gone, and a growing distaste for 
business is apparent; there is a determination of blood to the 
head, headache, noises and roaring sounds in the ears, the eyes 
may be bloodshot and watery, weak, or painful, the patient 
imagines bright spots or flashes passing before them, and there 
may be partial blindness. There is increasing stolidity of ex- 
pression, the eye is without sparkle, and the face becomes 
blotched and animal-like in its expression. The victim is care- 
less of his personal appearance, not scrupulously neat, and not 
unfrequently a rank odor exhales from his body. 
There are annoying itching and crawling sensations, in and 
about the scrotum. Subsequently, there is obstinate constipa- 
tion, and all the symptoms of dyspepsia follow. Gradually the 
pallor deepens, and the patient becomes emaciated. There is a 
shortness of breath, palpitation after even moderate exercise, 
trembling of the knees, and eruptions on the skin. There may 
also be cough, hoarseness, loss of voice, and darting pains in the 
side. The sleep is not refreshing, the patient has frequent 
nightmare, or the dreams are lascivious, and the involuntary 
emissions of semen become more frequent. As the debility in- 
creases, the sufferer experiences a weakness in his legs and 
staggers like a drunken man, his hands tremble and he stam- 
mers. 
The victim is unable to concentrate his thoughts, cannot re- 
member what he reads, and is mentally indolent. He becomes 
suspicious of his friends, has little confidence in others, and de- 
sires to be alone, is despondent and sometimes contemplates 
suicide. He has pain in the back, feels disinclined to walk or 
take other exercise. The semen is prematurely discharged upon 
attempting coition, and, if he has offspring, it is apt to be feeble SPERMATORRHEA. AND IMPOTENCY. 
831 
or subject to scrofula, consumption, or convulsions. The genital 
organs, especially the penis and testicles diminish in size, as the 
disease progresses, lose their energy, and the glans penis becomes 
cold and flaccid. There is frequent desire to urinate, chronic 
irritation in the neck of the bladder, and pain in the spermatic 
cord and testicle, and sometimes in the end of the penis. The 
microscope shows that semen involuntarily discharged may be 
devoid of spermatozoa, or, if present, they are imperfect. The 
urine is loaded with mucus or contains a filmy, membranous, 
transparent matter. It may be covered with a thin fluid having 
an oily appearance, but, in rare instances, it is clear. Again, it 
may hold substances in solution, which are deposited in crystals 
or which incrust the urine, or it may precipitate a material hav- 
ing the appearance of brick-dust. It sometimes contains semen 
tinged with blood. The dyspeptic symptoms, when present, are 
followed by diarrhea. The limbs are cramped and rigid, the 
feet bloated, and the patient becomes melancholy and relin- 
quishes all hope of recovery. 
When the erections are imperfect and the semen is prema- 
turely discharged, or when a lengthy coition is required before 
the sperm can be ejected, it is evident that the patient is rapidly 
becoming impotent; the virile powers are vanishing and man- 
hood is surrendering sway to a merciless foe. We frequently 
witness this condition in men, even at the age of thirty-five, 
when the summit of vigor and strength should only have been 
reached. How often are we solicited to restore these lost hopes 
and powers I To what tales of ignorance and recklessness, or 
submission and remorse, do we repeatedly listen from these 
unfortunate sufferers I In patients of this class, sexual inter- 
course prevents spontaneous emissions, but it does not remove 
the functional and organic derangements of the nerve-cen- 
tres ; hence, at a time when the victims of this disease should 
be in the prime of life, they are impotent, and epilepsy, apo- 
plexy, paralysis, softening of the brain, or insanity, frequently 
results. 
Epilepsy (or Fits). This dread disease is one of the 
most common and serious complications of the more advanced 
stages of spermatorrhea. The injury done to the nerve-centres 
by the practice of masturbation is manifested in epileptic 832 
COMMON SENSE MEDICAL ADVISEE. 
convulsions, more or less frequent. If proper treatment be 
early adopted, and faithfully pursued, the case is not yet 
hopeless; though, in the majority of cases, the patient never 
recovers after the disease assumes this phase. 
Paralysis. Paralysis, or Palsy, when occurring as a com- 
plication of spermatorrhea, may be preceded by an attack of 
apoplexy, in which the patient loses consciousness, and lays in 
a condition of profound stupor for a time, and on recovering 
from his unconscious state, finds himself unable to use one or 
more of his limbs, or the disability and loss of power, which 
may also be accompanied by more or less loss of sensation, may 
come on gradually, without any premonition or marked mani- 
festation of its approach. In either case, its appearance is to 
be regarded as a matter of serious importance. Paralysis, when 
occurring as a consequence of masturbation or sexual excesses, 
is usually difficult of cure ; yet, now and then, cases are cured 
at our Institutions even after this grave malady has appeared 
as a complication. 
Softening' Of the Brain. This malady, although less 
common as a result of masturbation than the complications 
mentioned in the preceding pargraphs, is of sufficiently fre- 
quent occurrence to entitle it to a passing notice here. This 
condition usually results ultimately in complete dementia, or 
loss of reason. It is an incurable disease. 
Insanity. This deplorable malady is not a very un- 
common result of masturbation and its various resultant 
morbid conditions, as the records of the many institutions 
for the unfortunate class of sufferers from this disease bear 
abundant witness. Sometimes it manifests itself in the milder 
forms of hallucination, or monomania, but in the majority 
of cases, the patient sinks into a despondent hypochondria, 
which is many times followed, sooner or later, by a raving 
mania. 
In cases of monomania resulting from masturbation, the 
mental derangement is often so slight as to escape detection 
by the patient's friends, the peculiar freaks of disposition 
being regarded rather as eccentricities of character than as 
symptoms of serious disease. Fits of despondency are usually 
common with such sufferers. In most cases there is danger SPERMATORRHEA AND IMPOTENCY. 
833 
of the patient's committing suicide, if not closely watched. 
Especially is this true of those who suffer from fits of hypo- 
chondria. 
Except in its milder forms, insanity resulting from mastur- 
bation and sexual excesses, is rarely curable. 
A Peculiar Form of Ini potency is associated with 
certain abnormal nutritive changes, which give rise to a lym- 
phatic or fat condition of the system. Not that the tempera- 
ment in all these cases is originally lymphatic, but the system 
degenerates in consequence of nutritive perversion. With the 
loss of sexual ardor, there is also apathy of mind, loss of manli- 
ness, and the victim becomes cold, dispassionate, treacherous 
and devoid of any admiration or love for the opposite sex. He 
acquires rotundity of person, the face is fat, smooth, often 
beardless, and the voice is feminine. 
The victims of this disease represent two distinct classes; 
those who are fearfully tormented by the consciousness that 
they are losing their virile powers, and become irritable, jealous, 
and often desperate; and those who are completely indifferent 
to this deprivation. 
Patients of the former class are readily restored to health by 
proper treatment, for they are willing to make an effort for the 
recovery of their lost powers. There is not complete loss of 
sexual desire, yet their disappointment is so great that they may 
entertain suicidal thoughts. They are moody, fickle, discon- 
tented, excitable, and remarkably impulsive. With proper 
treatment, they regain strength of body, vigor of mind, an 
increase of sexual desire, and become more attentive to busi- 
ness affairs, and less indifferent to the opposite sex. With the 
restoration of the general health and the sexual functions, re- 
markable constitutional changes occur. It is often the case 
that their most intimate friends hardly recognize them by looks 
or acts. 
It is equally true that those who are wholly indifferent to the 
loss of virile power, uninterested in the evidences of their man- 
hood, are sometimes incurable. In fact, it is useless to treat 
the latter class, because they will neither co-operate with the 
physician, nor persist in the treatment necessary to effect a radi- 
cal and constitutional change. 834 
COMMON SENSE MEDICAL ADVISER. 
Spermatorrhea Affecting Carried Men. Sper- 
matorrhea affecting married men as the result of self-abuse, or 
excessive indulgence in sexual intercourse, is more likely to go 
on unobserved and be neglected, than when affecting the un- 
married. Frequent sexual intercourse obviates the involuntary 
emissions, but does not lessen the strain upon and depiction of 
the system, but rather aggravates it. The weakness of the 
organs often becomes so great, under these circumstances, that 
straining while at stool is sufficient to produce a slight discharge 
of semen. It also in many cases passes off unobserved with the 
urine. 
This condition is not, however, confined to married men, for 
some of the worst cases of spermatorrhea which we have ever 
treated, even in very young and single men, have been those in 
which there was little or no loss of semen except as it passed off 
unconsciously and unobserved with the urine. A microscopical 
examination of the urine in such cases is the only safe guide 
for the physician. Such a drain, if unchecked, is almost certain 
to result in impotency and a wasting away of the generative 
organs. In many of these cases which we have had to deal 
with, the patient had, upon noticing his general loss of strength, 
energy, and health, consulted the home physician, who had 
almost invariably been misled by the symptoms and had treated 
the sufferer for something entirely different from the real dis- 
ease, and, of course, had failed to relieve him. Discouraged, and 
often little dreaming of their real condition, and knowing that 
our staff treat all forms of chronic disease, they have finally 
come to us, and by microscopical examinations of the urine, we 
have discovered their true disease to be this hidden and unsus- 
pected drain upon the system. 
Misdirected Statements. Not only are many men sub- 
jected to useless treatment by general practitioners who over- 
look the real disease, caused by pernicious youthful habits or 
venereal excesses in latei' life, but the female sex are also quite 
as often subjected to treatment for diseases which do not exist, 
the real trouble being nervous debility and other weaknesses 
which have resulted from the pernicious practices common to 
both sexes. We have referred to the terrible effects produced 
on the female by self-abuse in a preceding part of this book. SPERMATORRHEA AND IMPOTENCY. 
835 
Treatment is quite as important for one sex as for the other, and 
our practice in such cases has reached a magnitude entirely un- 
expected. 
Although we have minutely described the symptoms common 
to the different stages of spermatorrhea and impotency, yet no 
one case will present more than a few of those enumerated. 
Moral Considerations. Masturbation is a habit which 
tyrannizes over the mind, perverts the imagination, and forces 
upon the victim venereal desires, even while he is forming the 
strongest resolutions to reform. It constrains into its service 
the higher faculties, such as friendship, confidence, love, reason, 
and imagination, to make its ideal graceful and beautiful. 
We can only partially delineate the terrible effects resulting 
from the abuse of the sexual organs. The symptoms are multi- 
tudinous, but no two persons are similarly influenced by this 
disease. The symptoms vary according to the severity of the 
affection, the age of the patient, and his constitutional pecul- 
iarities. The presence of only a few of the symptoms which 
we have enumerated is evidence of abnormal weakness, which 
demands treatment. 
Montaigne says: "We must see and get acquainted with our 
sins if we expect to correct them." Virtue predisposes trials 
just as much as victory implies warfare. The triumph of virtue 
consists in overcoming morbid or excessive passion. As men in 
all ages have been influenced by passions, so temptation has ever 
found its victims. It is an obligation on everyone to overcome 
every evil passion or weakness to which he is subject, and the 
discharge of this personal duty requires moral courage. 
Our Saviour invited all erring mortals to enter upon a higher 
life when He said, " Come unto Me, all ye that labor and are 
heavy laden and I will give you rest." The invitation is accom- 
panied with a promise. To all who are weary of excess and 
bowed down by passion, rest and restoration are promised, 
if they will but reform and employ proper means to that end. 
Just as there is no spiritual restoration without obeying the 
Saviour, so there can be no physical restoration unless we fulfill 
nature's imposed conditions. There can be no salvation unless 
sin is discarded, and so there can be no redemption from the bad 
effects of a practice so long as it is continued. It is no easy task 836 
COMMON SENSE MEDICAL ADVISEE. 
to master a despotic passion. The appetite is often stronger than 
the will. The treatment must begin with moral reformation. 
Every manly impulse, and all the higher qualities of the patient's 
nature must be enlisted in the struggle for virtue and health. 
When the passions are restrained, then the capital of health 
increases, for the saving of the vital secretions is equal to com- 
pound interest. This illustrates the truth of the Latin proverb: 
" Ao gain is so certain as that which proceeds from the eco- 
nomical use of what you have." The patient actually acquires 
confidence and courage by the retention of the seminal fluid, 
which directly increases his virile powers. 
Hygienic Advice. Daily physical exercise and regular 
habits should be established. It is important that the mind, as 
well as the physical powers should be directed into active and 
wholesome channels. There should be restraint and discipline. 
It is useless to begin medical treatment while the patient con- 
tinues to read exciting, amorous stories and obscene books, 
which are suggestive of lewd thoughts. Something practical 
ought to occupy the thoughts and engage the hands. 
Regular and vigorous physical exercise is necessary to assist 
the circulation of the blood and compel its determination into 
the minute and extreme parts of the vascular system. When 
the blood is thus directed, nutrition is more vigorous and the 
activity of all the functions is augmented. 
Not only should there be regularity in eating, but sound dis- 
cretion should be exercised in selecting a plain, wholesome diet, 
consisting of those articles of food which favor a daily and free 
evacuation of the bowels. Avoid the use of those articles of 
food which produce excessive acidity of the stomach. Hearty 
or late suppers are not permissible. The patient should use no 
alcoholic beverages, and should abstain from the use of tea, 
coffee, beer, wine, and tobacco. 
The subject should sleep in a well-ventilated room, on a hard 
bed, and have only sufficient covering for warmth and comfort. 
He should not lie upon the back, because in this position nightly 
emissions are most likely to occur. The patient should go to 
bed when he feels sleepy, and not resist the inclination until 
wakefulness is induced. 
He should rise early in the morning and immediately take a SPERMATORRHEA AND IMPOTENCY. 
837 
cold hand-bath. For this purpose a quart or two of water and 
a common towel only are required. After bathing, rub the 
surface of the body with the dry hand or a crash towel, and 
continue the friction until the skin is red and a reaction is estab- 
lished. A refreshing bath changes the morbid sensibilities to a 
more healthful state by the reaction of the nervous system. 
It is beneficial to apply a towel saturated with cold water to 
the genital organs fifteen minutes before leaving the bed. 
Douching, or showering, the genital organs with cold water 
once or twice a day will also be beneficial. It should not be 
practiced, however, just before going to bed. It is well to 
bathe the head with cold water, and this can be done much bet- 
ter if the hair be kept closely cut. 
Horseback riding, climbing, and all exercises which rub, chafe, 
or excite the genital organs should be avoided. Even the cloth- 
ing should be loose, so that walking will not produce friction 
or cause any excitement of these organs. The calls of nature 
should receive prompt attention, and the urine be voided at any 
time, especially during the night, when there is an inclination. 
If there be irritation of the bladder and lower bowels, the 
patient will receive decided benefit from the daily use of an 
injection of cold water into the bowels. From a half pint to a 
pint of cold water may be used at one time, and the injection 
should be retained for a few minutes before going to bed. The 
bowels will thus be relieved, the heat and irritation subdued, 
and the liability to seminal emissions lessened. 
Patients afflicted with spermatorrhea should not allow their 
thoughts to dwell upon their ailments, for they are apt to 
become moody, melancholy, and even insane upon this subject. 
To avoid this, harmless amusements should be indulged in and 
good moral associations formed. They often become suspicious, 
skeptical, and imagine that they are victims of imposture. 
When they lose self-reliance, their faith and trust in others 
begins to waver, especially if their health does not improve so 
rapidly as they had anticipated. As much depends upon the 
faithful observance of the hygienic rules as upon the constant 
and proper use of medicines. The rapidity of recovery depends 
upon the constitutional energies and the vigor of the vital 
resources. If the blood be greatly impoverished, or the nervous 838 
COMMON SENSE MEDICAL ADVISER. 
system much impaired, recovery will be necessarily slow. Time, 
patience, and perseverance are just as essential to a recovery 
from the effects of these abuses as any medical treatment that 
can be employed. 
The medical Treatment of Spermatorrhea and 
Impotency. No other class of diseases requires so many 
modifications of treatment to suit the peculiarities of individual 
cases as spermatorrhea, because no other is attended with so 
many complications and morbid functional and structural 
changes. Every complication should be considered, and great 
judgment exercised in the selection of remedies. As this selec- 
tion should depend upon the peculiarities of the case involved, it 
is impossible to impart to unprofessional readers sufficient med- 
ical knowledge to enable them to choose the appropriate reme- 
dies for these intricate affections. Hence, it will be useless to 
specify the various medicines which we employ in treating them. 
It would only lead to many fruitless experiments, which might 
result in great harm to the afflicted, for remedies powerful 
enough to effect cures of spermatorrhea and impotency are 
capable of doing great harm when improperly employed. Es- 
pecially all proprietary medicines, which are sold in drug-stores 
and chemists' shops, should be avoided, for reasons already 
mentioned. Great harm, also, often results from the employ- 
ment of the so-called "galvanic belts," "galvanic batteries and 
pads," and other catch-penny devices, with which the credulous 
are constantly not only duped and swindled, but terribly in- 
jured. They are all worse than useless, and often render the 
mildest case very difficult to cure, by inducing serious complica- 
tions. It is better to take no medical treatment, but rely solely 
on the hygienic advice we have given, rather than to resort to 
any of the so-called specifics found in the drug-shops. 
The invalid should restrict his attention to hygiene, and learn 
that patient endurance and heroic perseverance are necessary, 
even when taking the most efficient remedies. His entire sys- 
tem having gradually become deranged, corrective medicines 
must necessarily be gradual in their operations. Some of the 
symptoms of sexual weakness will, under proper hygienic and 
medical treatment, generally begin to disappear within a month. 
If the nervous system be very much impaired, however, a 839 
SPERMATORRHEA AND IMPOTENCY. 
longer time will elapse before the restorative effects of treat- 
ment will be observed. Neither the physician nor the patient 
should expect that a broken-down constitution can be immedi- 
ately repaired. The age of miracles is past. The most rational 
method of treating the sick promises nothing supernatural, 
nothing which is not in accordance with science. 
Years ago our specialists resolved to pay particular attention 
to the investigation and treatment of these diseases, which are 
not only alarmingly prevalent, but sadly neglected and improp- 
erly treated by the general practitioner of medicine. Accord- 
ingly, we have tested and developed a series of vegetable 
remedies, which not only arrest all forms of seminal discharges, 
but which restore the wasted organs to their normal condition. 
Having successfully treated many thousands of cases, we can 
safely say that our remedies are certain in their remedial effects. 
We prescribe them with the same confidence in their efficacy 
that we would feel in giving bread and beef to a starving man 
to satisfy his hunger. The uniform success which has attended 
the employment of these remedies has led us to rely upon them 
with implicit faith. By their persistent use, spermatorrhea, par- 
tial, and even complete impotency, if not due to organic disease 
of the brain or spinal cord, can be as easily cured as any other 
chronic or lingering disease. For these reasons, we particularly 
•solicit those cases which have heretofore been regarded as incur- 
able.. This method of treatment requires no surgical operation, 
and does not interfere with any ordinary occupation in which 
the patient may be engaged. These delicate diseases should 
not be intrusted to physicians who advertise under fictitious 
names, or to those of ordinary qualifications. The general 
practitioner may be theoretically acquainted with these diseases, 
but be cannot acquire the skill of a specialist who annually 
treats thousands of cases, for he seldom, or never, has occasion 
to prescribe for them. 
Under our original and improved system of treatment, gradual 
amelioration in the patients' condition is soon manifested. The 
eye becomes more brilliant and sparkling, he is less morose, the 
digestion improves, he is less listless and despondent, takes more 
interest in business and other affairs, his sleep is less disturbed 
and more refreshing, the strength improves, and, if the sexual COMMON SENSE MEDICAL ADVISEE. 
840 
organs have become wasted in size, weak in function, and flaccid 
and soft, they begin, in a few weeks, to have more tone and 
firmness, and to develop and increase in size, as their nutrition 
is restored, by the checking of the exhausting drain which they 
had sustained. If nocturnal emissions occur occasionally, the 
discharge will, under the microscope, be found to be less watery, 
and to contain increased numbers of perfect spermatozoa. The 
patient now begins to gain confidence, courage, and other manly 
attributes, and, instead of a bashful, retiring, nervous, languid 
hypochondriac, he becomes ambitious and energetic, competent 
to battle with the adversities of life. Who would begrudge all 
their earthly goods and treasures, when thus afflicted, to be so 
restored to health and enjoyment; for of what avail are the 
greatest riches when health and manhood itself are lost? 
Occasionally persons solicit us to undertake the cure of these 
derangements and, in case of failure, receive no compensation. 
They write: "If you will warrant that your prescriptions will 
result in a perfect restoration to health, we will gladly pay the 
fees that you ask." The absurdity of such a request is appar- 
ent, and, therefore, we answer: "We cannot warrant that you 
will live even for the next twenty-four hours. We do not bet, 
play for stakes, or wager our skill for money. Personal respon- 
sibility cannot be shifted or evaded, and life and health, with 
all their momentous considerations, are necessarily individual 
affairs. Therefore a proposal to make the conditions of health 
a subject of speculation, is a challenge to gamble." The patient 
may not comply with the specified conditions, and the physi- 
cian's success depends upon a faithful application of the pre- 
scribed treatment. For these reasons, only a quack will be a 
party to any such transaction. Ours is not a trading, hazard- 
ously speculative profession. Besides, thousands of our patients 
reside long distances away, and we cannot know of their respon- 
sibility or honesty, nor spend time inquiring after their financial 
standing. 
Evidences of the Curability of Spermatorrhea 
and Impoteiicy. Many individuals afflicted with sperma- 
torrhea and impotency, particularly those who have been swin- 
dled by some of the many charlatans who are to be found in 
nearly every city, are incredulous, and doubt our ability to cure SPERMATORRHEA AND IMPOTENCY. 
841 
these maladies. Others are skeptical, because their physician, 
who may be a very skillful general practitioner, but who has 
had very little or no experience in treating these delicate mala- 
dies, has failed to relieve them, and, perhaps, has told them that 
the disease is incurable. 
We therefore beg the indulgence of our readers for here 
offering some undisputable evidence of the extraordinary success 
which we have achieved, by our original methods of treating 
these affections, as pursued at the Invalids' Hotel and Surgical 
Institute. 
This evidence is introduced for the encouragement of an un- 
fortunate class of invalids, for many of whom existence has 
ceased to possess any charms. The grateful testimony which we 
have received from this class of sufferers has afforded us one of 
the greatest pleasures of our lives, and has alone been a rich 
remuneration for the diligent study and arduous labors devoted 
to the investigation of these diseases, and to the perfecting of 
our peculiar and successful methods of treating them. 
In the extracts from records of cases treated, the names of 
the Writers are omitted, as we regard all such communications, 
whether oral or written, as sacredly confidential. The affidavit 
of the President of the World's Dispensary Medical Association, 
certifying to the genuineness of these extracts and statements, 
is given at the end of this volume. They are fair samples of 
thousands which have been received. They illustrate cases in 
almost every stage of treatment, some soon after commencing, 
others further advanced, and still others which are cured. 
CASES TREATED. 
Case 21,437. Impotency. 
World's Dispensary Medical Association: Gentlemen-I have, 
as a result of your treatment, been more of a man than before in six 
years. I have felt, worked, and eaten better than ever before. My 
strength is in every way fully restored. C., Jordanville, N. Y. 
Case 22,511. Impotency. 
World's Dispensary Medical Association: Gentlemen-Accept 
my thanks for the great benefit received from your treatment. I never 
thought I could be so fully restored. G., Peru, Indiana. 
Case 33,928. Spermatorrhea. Resulting in Consumption. 
World's Dispensary Medical Association: Dear Sirs-I would 
have been beyond the reach of aid now but for your treatment. I am 
now enjoying perfect health. Yours gratefully, 
H., Gillies' Hill, Ont. 842 
COMMON SENSE MEDICAL ADVISEE. 
Case 38,005. Impotency. 
World's Dispensary Medical Association: Gentlemen-When I 
first wrote you I had given up all hope of ever getting well. I had not 
worked for two years. I had not been under your treatment three 
months before I went to work, and have been at it ever since. I gain 
every day. My manhood is fully restored. C., Hinsdale, N. H. 
Case 38,973. Spermatorrhea. 
World's Dispensary Medical Association: Gentlemen - You 
have cured me sound and well of the terrible effects of early indiscre- 
tion. My case was worse than any I have ever read of, and I never 
expected to get well. With eight months' treatment taken at my 
home, I have been fully restored. You have my sincere and hearty 
thanks. C., Halifax, N. S. 
Case 39,625. Seminal and Nervous Debility. 
World's Dispensary Medical Association: Gentlemen-My case 
was one of long standing, and had brought me to think and meditate 
more of dying a consumptive than of living. The ill success I had 
met in trying to recover my lost manhood, had put me in such a con- 
stantly low-spirited condition that nothing was interesting or pleasur- 
able. I am highly pleased to report the improvement in my condition. 
My voice, weak and hoarse when 1 commenced treatment, is now 
strong and masculine. Hope and self-confidence have returned, and 
my countenance is firm and resolute. The dull, heavy, pressing pain 
under my left shoulder, is entirely gone, long ago. The pain and 
weakness in hips, back, and side, are never felt. I am in every way 
fully restored to health and manhood. 
Yours sincerely, 
O., Sheboygan, Michigan. 
Case 42,921. Spermatorrhea, Resulting in Dyspepsia. 
World's Dispensary Medical Association: Gentlemen-I am 
deeply indebted to you. The disagreeable head symptoms, dyspepsia, 
and weakness are all gone. I can now eat and digest as hearty a meal 
as any one and feel well, healthful, and energetic. Never have any 
losses. I was very sick when I commenced treatment but was speedily 
relieved. Yours truly, 
S., Charles River Village, Mass. 
Case 44,198. Nervous Prostration, caused by Self-abuse. 
World's Dispensary Medical Association: Gentlemen-Your 
kindness to me I can never forget. I cannot express half my feelings 
of gratefulness to you. I had despaired of ever getting well. Thanks 
to your skill, I am now a new being. 
Yours very truly, 
B., Steuben County, N. Y. 
Case 44,464. Nervous Prostration. 
This gentleman, engaged as the head of a large academy, suffered 
severely from mental depression, weakened memory, nervous exhaus- 
tion, and lack of intellectual power, the result of the drain upon the 
nervous system and his severe labors. We append his letter after four 
months' treatment: 
World's Dispensary Medical Association: Gentlemen - My 
friends all notice and speak of my decided improvement. My health 
and faculties are again as they were years ago. Yours, 
H., Philadelpliia, Pg, SPERMATORRHEA AND IMPOTENCY. 
843 
Case 41,573. Impotency. 
World's Dispensary Medical Association: Gentlemen-As a re- 
sult of your three months' treatment, I am feeling better than I have 
for twenty years, more of a man in every way. 
S., Prairie Star, Neb. 
Case 44,866. Spermatorrhea, with Marked Loss of Intellect, 
Health, and Tone of System. 
World's Dispensary Medical Association: Gentlemen-I took 
two months' treatment of you last summer. The improvement was 
marked, and I have continued to grow healthier and stronger notwith- 
standing I have been busy all the time, and have studied very hard. Do 
not get fatigued as before. I read six orations of Cicero in seven 
weeks and passed with honor a very close examination. My limbs are 
solid and strong, whereas before 1 was weak, and my flesh cold, soft 
and clammy. I am in college working hard. Yours truly, P. 
Case 45,757. Spermatorrhea. 
World's Dispensary Medical Association: Gentlemen - I am 
happy to say that I have so far recovered as to believe further treat- 
ment unnecessary. I feel like a new man, am able to do a full day's 
work without pain or laziness. I am very thankful for the benefit I 
have received through your skill, and should I think it necessary at any 
time for me to renew the treatment, I will be glad to call on you. 
Yours with great respect, 
A., Zanesville, O. 
Case 48,927. Nervous Debility and Impotency. 
World's Dispensary Medical Association: G'eniZemen-My head 
is clear and I feel like myself again, and now only wish that the money 
I spent for useless medicines and experimenting doctors, had at once 
found its way to you. By recommending you to others suffering as I 
did, I hope to assist in your honorable work. For my restoration to 
health and manhood, I am deeply grateful. Truly yours, 
B., Philadelphia, Pa. 
Case 51,002. Spermatorrhea. 
World's Dispensary Medical Association: Gentlemen-When 
I sent to you for medicines, I little expected the remarkable benefit that 
has resulted. The rheumatic pains that have so long troubled me 
ceased within a week. I am now able to attend to my business with 
my former ability and energy. You have my gratitude for the cure 
effected in my case. Very respectfully, 
P., Bloomington, Ill. 
Case 51,203. 
(First letter.) 
World's Dispensary Medical Association: Gentlemen-It was 
my pleasant privilege to read concerning your skill in the treatment of 
all kinds of diseases and concerning your reputation, which is most 
justly merited. Encouraged by these facts to place explicit confidence 
in you, I beg leave to state my own case as clearly as I may be able. 
It is as sad as it is fatal, if no thorough cure can be effected. I have 
from my twelfth year onward been practicing, though not excessively, 
the evil, self-abuse. Although I have been led to abandon the perni- 
cious habit for several years, my age being twenty-four, the horrible 
effects have not disappeared. The serious result is that I am suffering 
from spermatorrhea. An involuntary discharge of the seminal fluid 
occurs invariably once, not unfrequently twice, every week during 844 
COMMON SENSE MEDICAL ADVISEE. 
sleep. The genital organs have become diminished in size. I will pro- 
ceed to state the symptoms which I have been able to observe. They 
are a disposition to solitude, inaptitude for study, indolence, forgetful- 
ness, weakness in the back, especially perceptible after standing, a 
lack of confidence in my own ability, want of energy, sometimes pain 
in the chest, elbow, arm, knees, and loins. Uneasy nights, disturbed 
and highly disagreeable dreams, becoming more and more irritating as 
the time for the discharge of the seminal fluid draws nearer, also a 
desire to lie longer in bed in the morning. 
Now permit me to ask your kind advice as to what means are to be 
taken. I have tried numerous remedies for more than a year, but with 
no effect. My suffering grows severer. Please reply as speedily as 
you may be able. Very respectfully, 
M., Wheeling, Cook Co,, 111. 
(At the close of treatment.) 
World's Dispensary Medical Association: Gentlemen-I have 
finished the eight months' treatment, had I been able to follow the 
directions more closely, three months' treatment would have effected a 
permanent cure of my case. Now I am well, body strengthened, mind 
invigorated, memory revived, energy to work restored, cheerfulness 
and bright hopes, once altogether lost, are now fully regained. Indeed, 
1 feel like a new being. And now in closing our important correspon- 
dence, permit me to render to you my heart-felt thanks for your kind- 
ness to me, and for the benefit received from your invaluable treat- 
ment. Very truly yours, M., Wheeling, Cook Co., Ill. 
Case 51,417. Impotency. 
World's Dispensary Medical Association: Gentlemen-I am 
getting along so well with the medicine, that I am a standing wonder 
to my friends, and I shall not cease, while life lasts, to praise the skill 
that has brought about such miraculous results. 
Truly yours, K., Chillicothe, Ohio. 
Case 52,004. Seminal Emissions. 
World's Dispensary Medical Association: Gentlemen - I re- 
ceived the month's treatment sent for, and took it. It worked like a 
charm. I have no more emissions and my weight, energy, and strength 
are fully restored. R., Fort Collins, Colo. 
Case 52,121. Spermatorrhea. 
World's Dispensary Medical Association: Gentlemen-I have 
waited several months and find my cure perfect and permanent. 
Thanks to you my health and manhood have been perfectly restored, 
and I am as fat as a bullock. S., Millbrook, Ont. 
Case 52,272. Seminal Debility, with General Weakness, from 
Excesses. 
World's Dispensary Medical Association: Gentlemen-I took 
your medicines according to directions, and I feel that I am fully re- 
stored to health and the enjoyment of my manly pow'ers. My health 
is better than it has been for years, and is improving all the time. The 
headache and dizziness have entirely left me. You have my honest 
recommendations to all sufferers. Thankfully yours, 
M., Hudson, N. Y. 
Case 52,920. Spermatorrhea, Resulting in Dyspepsia and 
Heart Disease. 
World's Dispensary Medical Association: Gentlemen-I am 
gratified to be able to report my cure after two month's treatment. SPERMATORRHEA AND IMPOTENCY. 
845 
My case was a very severe one, the insidious drain upon my system pro- 
ducing general debility, attacks of severe palpitation of the heart, and 
obstinate dyspepsia. Since using your medicines, 1 have been, cured of 
these troubles. I have no palpitation, my digestion is good, I am not 
easily worried, am able to work hard without undue fatigue, and my 
strength is greatly increased. My weight is now 163. I am thankful 
to God and you for the evidence of my final cure. 
Yours devotedly, R. 
Case 53,144. Spermatorrhea. 
World's Dispensary Medical Association: Gentlemen - My 
improvement during the past few weeks has been so marked and 
decided that I feel assured another month's course will result in a 
perfect cure of a disease that has unmanned and otherwise annoyed me 
me for many years. Thanking you for the unexampled and extra- 
ordinary skill which you have displayed throughout in the management 
of my case, I remain, very truly yours, 
B., Council Hill, Jo Davies Co., Ill. 
Case 53,578. Spermatorrhea. 
World's Dispensary Medical Association: Gentlemen-The con- 
dition of my health is highly satisfactory, thank Heaven and you as the 
instrument. It has often been the cause of astonishment to me, to 
think how admirably your medicines controlled my case, it seems won- 
derful even now. I say, with all my heart, God bless your noble work, 
for the cure of my disease and perfect restoration of my health and 
strength. A., Shongo, Allegany Co., N. Y. 
Case 53,816. Seminal Debility, caused by Self-abuse. 
My health has improved so that I no longer need treatment. You 
have my heart-felt thanks for the good you have done me, and may you 
have as good success in treating hundreds of others as you have had 
with me. I remain, yours very truly, 
J., Jacksonville, Ill. 
Case 53,859. Spermatorrhea. 
World's Dispensary Medical Association: Gentlemen-Pardon 
me for not sending you a report of my condition before this. I have 
been waiting to see if there would be any relapse. I am assured that 
my cure is complete and perfect. Kone of the symptoms of the dis- 
ease remain. Your medicines I can recommend as the most powerful 
and direct to accomplish good I have ever taken. I feel it my duty 
now to give you my heart-felt acknowledgment for the good done me. 
Respectfully, 
H., Goshen, N. Y. 
Case 53,913. Seminal Debility and Impotency. 
World's Dispensary Medical Association: Gentlemen-I shall 
ever remember you with gratitude. My relief is perfect and perma- 
nent. I feel so much better. I remain, yours truly, 
J., Jacksonville, Ill. 
Case 54,803. Seminal Debility and Impotency. 
I have taken the last of the medicine which you sent me, and feel 
satisfied it has entirely cured me. I return my thanks to you for the 
good you have done me. F., East Liverpool, Ohio. 
Case 56,811. Seminal Debility. 
World's Dispensary Medical Association: Gen tiemen-Five 
years have elapsed since my case was cured by you with one month's 846 
COMMON SENSE MEDICAL ADVISEE. 
treatment. Since that time I have not had the first symptoms of the 
disease. I know 1 am cured. Yours with thanks, 
C., Kalamazoo, Michigan. 
Case 57,757. Seminal Debility. 
World's Dispensary Medical Association: Gentlemen-While 
taking your medicine I labored physically. I am cheerful, hopeful, 
joyous, glad, and grateful for my restoration to sound and vigorous 
health. My friends daily express surprise at the great change in my 
personal appearance and declare that I appear younger than I did 
fifteen years ago. I always reply that I obtained my new lease of life 
from the World's Dispensary Medical Association, Buffalo, N. Y. 
With sincere gratitude and great respect, I subscribe myself 
W., Canyon City, Grant Co., Oregon. 
Case 62,365. A very bad case of Spermatorrhea and Impo- 
tency. 
World's Dispensary Medical Association: Gentlemen-It has 
now been nine months since I stopped your treatment, and, as there 
has been no return of former symptoms, I judge that there can be no 
doubt as to my cure being permanent. I must confess that, having 
been duped and swindled by so many previous to visiting you, I bad 
not much confidence when I went to Buffalo to see you. But your 
specialists, and your chief of staff, or financial manager, seemed to talk 
so straightforwardly and without making any of those extravagant 
promises that I have been so used to, that I became convinced of your 
skill before I had long been in your wonderful institution. I think 
almost any invalid who will visit your hotel, and see for himself the 
wonderful appliances that you have accumulated for the cure of dis- 
ease, must soon become convinced that, if there be any hope of relief, 
it can be secured there, if anywhere. There I saw those who told me 
they were brought there on beds or couches for hundreds of miles, and 
that they had not been able to walk for from two to four years, and 
yet with two or three months' treatment they were able to go about 
everywhere, and were about ready to return home. Such experiences 
as these established my confidence, and to-day I bless the day I first 
visited the Invalids' Hotel. True it took six months to cure me, but I 
presume you seldom have cases to equal in severity the condition 1 was 
in when I applied to you. I was so bad, as you will remember, though 
I do not suppose you rely upon anything but your records in referring 
to cases, having so many under your treatment at all times; at all 
events, if you will turn to the record of my case, which is File No. 
62,365, you will see that I had discharges of semen every time my 
bowels moved and without erections. In fact, I was completely im- 
potent. I am now as strong and vigorous as any man. You told me it 
would probably take a year to cure me, but as you accomplished it in 
five months, though I continued to take medicine a month longer to 
insure against a relapse, I think myself very fortunate. Should any of 
your staff have occasion to come this way, I should be only too glad to 
do any thing I can to entertain them. Gratefully yours. 
C., St. Louis, Mo. 
Case 67,004. Impotency. 
World's Dispensary Medical Association: Gentlemen-I am 
only too happy to say that I have fully recovered my powrers in every 
particular since placing myself under your treatment. I would not take 
$5,000 for the good you have done me. I am only sorry that I did not 
go to you before wasting my money on the quacks connected with that 
"Museum of Anatomy" in New York. T., Philadelphia, Pa. SPERMATORRHEA AND 1MPOTENCY. 
847 
Case 67,070. Spermatorrhea. 
World's Dispensary Medical Association: Gentlemen-I have 
now returned home a new man, after four months' treatment from you. 
I need no more medicines now. I would urge all sufferers to go to you 
for help. Thanking you for your services, 
I remain, yours truly, 
R., Bunch, Iowa. 
Case 67,208. Spermatorrhea. 
World's Dispensary Medical Association: Gentlemen-When 
placing myself under your treatment, I was told that my case, being an 
exceedingly bad one, would probably require six months in which to 
effect a perfect cure. After taking your remedies for four months, I 
found myself in perfect health, and have remained so ever since. I 
can never half repay the debt of gratitude I owe you. 
Gratefully yours, 
T., Norfolk, Virginia. 
Case 67,746. Spermatorrhea, cured in four months. 
World's Dispensary Medical Association: Gentlemen - It is 
with great pleasure that I write you. I have taken but one month's 
treatment from you, and if I should just give you a full history of my 
case before and since I have taken your medicine, you would not be- 
lieve the improvement could be true. I feel better every way. I am 
without language to express my thanks to you for the great work you 
have done for me. Your ever true friend, 
B., Blountville, Sullivan Co., Tenn. 
Case 69,116. Seminal Weakness, with Cancerous Testicle. 
World's Dispensary Medical Association : Gentlemen-It has 
now been over two years since you treated me and found it necessary 
to remove one testicle on account of cancerous disease, which must soon 
have destroyed life had the operation not been performed. I feel that 
I am a strong, healthy man, having had no symptoms of the seminal 
weakness for months past. Yours, P., Pittsburgh, Penn'a. 
Case 70,648. Spermatorrhea. 
World's Dispensary Medical Association: Gentlemen-Please 
accept my sincere thanks. Words at my command are inadequate to 
express my feelings when I realize the great beneficial features of your 
most excellent remedy. I have spoken to several of my most intimate 
friends who are similarly affected, and after I took the first dose, I was 
completely relieved, and the flesh I gained was in such abundance, that 
I was scarcely identified by them. I gave part of your excellent med- 
icine to a bosom companion of mine, named O. S. He became conva- 
lescent, but desires another bottle. Your name will be held in the 
highest esteem by these invalids, and by yours respectfully, 
H., Cincinnati, Ohio. 
Case 70,922. Spermatorrhea in its worst stages. 
The following communication was received some time ago from 
one who had been cured in four months. We received a letter from 
him describing his case, and asking if we could cure him. After giv- 
ing his case careful consideration, we frankly told him that his case 
was one of the worst that we had ever had to deal with, and that it 
would probably require eight months or a year to effect a cure, if, 
indeed, it should be found possible to accomplish that desirable result. 
Although we had succeeded in curing quite a number of cases quite as 
bad as his, yet we did not feel like giving too great encouragement. 848 
COMMON SENSE MEDICAL ADVISER. 
We are frank to acknowledge that in his case our treatment was more 
potent in its results than we had reason to expect, inasmuch as we 
elfected a perfect and permanent cure in a marvelously, short time, 
considering the deplorable state of his health when we undertook the 
treatment of his case. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-Agreeable to my promise, given to you in my last, I will, for 
the benefit of the erring young men of the land, give you a history of 
my former terrible condition, together with a statement of where 1 
found relief and a permanent cure, only requesting that should you 
publish my plain statement, you will, for obvious reasons, omit my 
name. This I see you do in other cases that you have published, 
verifying such statements and testimonials by the solemn oath of the 
President of your Association. 
I feel like one risen from the dead, for to me all earthly affairs were 
without interest or significance, and I now declare to the world that 
you, gentlemen, have done for me what no other physician has been 
able to do, and I desire to express my deepest gratitude. 
When but eleven years old, I witnessed my older companions prac- 
tice self-abuse, and from that tender age dates my downfall. But for 
that terrible experience, I would have grown up a man. It is a lesson 
very generally learned by boys, but seldom suspected by fond parents. 
It was not long before the vile habit was firmly fixed on me. 1 
sought every opportunity to masturbate, and this, too, before semen 
was formed or discharged or any special regard for the opposite sex 
was developed. Before I was fourteen years old my nervous system 
became so shattered from the shock given it by my frequent and 
unnatural practice that I became pale, puny and feeble. Frequently 
every thing would appear suddenly dark and I would experience 
great dizziness. My sleep was disturbed by fearful dreams. Often I 
would feel myself falling from a terrible height. Ow ing, as I suppose, 
to a deranged or obstructed circulation, 1 would in my dreams ex- 
perience all the agonies of all manner of deaths. Emissions would 
occur almost every night in my sleep, and before I was eighteen 
years old they occurred without erections or much sensation. I felt 
so debPitated that I could only creep around, stooping over like an 
old man, and I was, in short, a complete wreck. I was awakened to 
a sense of my condition by an advertisement that chanced to meet 
my notice. I also procured books that informed me of the true 
cause of my decline and loss of strength and health. I resolved to 
abandon the vile practice, but this required more fortitude and de- 
termination than 1 could command. Besides, when, for any length 
of time, I abstained from the solitary practice, I had nightly 
emissions. My parents and friends expected me to die. The family 
physician exhausted his skill with no favorable result. I tested the 
merits of all catch-penny advertisements headed "Avoid Quacks," 
"Self-help for the Unfortunate," ''Manhood. How Restored," 
"Healing Pool." " House of Mercy," "A Victim. Receipt Sent Free," 
"Address Rev. T. Inman, Station D, Bible House," and found them 
all to be a miserable set of swindlers. I tried several so-called "Speci- 
fics" or patent medicines, with no benefit, also the worse than useless 
"Pads," " Batteries and Pads," and "Galvanic Belts." My last resort 
before applying to you was to a wrell-known eastern institution. 
Four months' treatment from them did me no good. I took 
great quantities of medicines and used any number of appliances, 
consuming four years, and throwing away many hundreds of dol- 
lars on quacks. Fortunately, I ran across a copy of "The People's SPERMATORRHEA AND IMPOTENCY. 
849 
Common Sense Medical Adviser," and by its straight-forward lan- 
guage, I was induced to write and lay my case before your Medical 
Council. Your manly, candid answer, so unlike those I had before 
received from others, stating that my case was, indeed, a very bad 
one, and, if curable at all, such a result could only be accomplished 
by several months' treatment, at once convinced me that you were 
honorable gentlemen. You stated that, while you had cured some 
cases apparently as bad as mine, yet you would not be warranted 
in making anything like a promise that you would cure me. I 
had become so used to the "No-cure-no-pay" and "Cures-guaran- 
teed " dodge of the quacks, that it seemed refreshing to read a frank, 
candid statement from honorable physicians, and 1 resolved to place 
myself under your treatment. Your moderate fee was forwarded, and 
in due time I received your medicines and advise. I could see very 
little improvement when the first month's medicines were exhausted, 
but did not feel discouraged as you advised me that it would at best be 
slow. Before I had completed the second month's treatment, I had 
begun to experience some manifestations of improvement. I gained 
strength, the emissions became somewhat less frequent, my head felt 
better, I was less melancholy and despondent, and began to take an 
interest in business affairs. The third month I mended still faster, and 
by the time the course was finished, felt that I probably did not need 
further treatment. But, being advised to continue at least another 
month, that permanency of relief might be insured, I sent for another 
lot of medicine, and, after using it, discontinued all treatment and con- 
sider myself, ever since, a well and strong man. It is most wonderful, 
too, that the organs that had been wasted away, or checked in their 
growth, through such early indulgence in the wicked practice, have, 
ever since the first mouth's treatment, been enlarging, until I think I 
am a well formed and perfect man. Words cannot express the grati- 
tude I feel, and I hope some day, not far distant, to be able to attest 
my sense of obligation by something more substantial than words. I 
have written thus fully in the hope that, should you deem my letter 
worthy of publication, it may be the means of directing many sufferers 
to an institution where they will be honorably and most skillfully dealt 
with. Gratefully yours, B., San Francisco, Cal. 
Case 71,250. Spermatorrhea of thirteen years' standing. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-I can honestly say, as the result of your treatment, that I feel 
better now than at any time previous for years. My disease is under 
complete control, and I have no fear of any further trouble in that 
direction. In a word, I feel that I am cured and well, and you may 
rest assured that I shall take great pains to avoid in the future the 
cause that brought me to my former condition. I am, indeed, thankful 
to you, as your treatment has made it possible for me to lead a better 
life, and effectually to resist those passions which so long dominated 
over me. I remain, very respectfully yours, 
H., Council Bluffs, Iowa. 
Case 82,127. Spermatorrhea. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-Your last month's treatment has entirely cured me. I have 
been married three weeks and am happy, thanks to your unexampled 
skill. R., Blackberry, Kane Co., Ill. 
Case 83,155. Seminal Weakness. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-I have to say that your special medicines, in controlling my 850 
COMMON- SENSE MEDICAL ADVISER. 
weakness, have done more than fulfill my expectations. After having 
been under your treatment and advice only one month, the seminal 
losses were entirely arrested and have thus far shown not the slightest 
disposition to return. My general health improved at once; and 
greatly; indeed, I have worked hard every day during the past summer, 
and this is the first season for a number of years that I have not been 
troubled with intestinal cramps and diarrhea, all of which I attribute 
to the local and general benefit I derived from that one month's treat- 
ment. I assure you that your great skill is beyond all praise. 
' Yours truly, 
H., Moscow, Livingston Co., N. Y. 
Case 85,052. Spermatorrhea. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-I have concluded that it will be best for me to return to your 
treatment. I have been under medical treatment continuously ever 
since I stopped yours, and I do not believe I have derived as much 
benefit from their treatment in ten months as I did from yours in two. 
I never had any doubt of your curing me, but thought their personal 
attention would accelerate my recovery. 
Very truly yours, 
G., Clarksville, Tenn. 
Case 86,291. Spermatorrhea. 
This gentleman had suffered during eleven years from seminal ■weak- 
ness, as the result of indiscretions in youth; nocturnal emissions were 
present, and there was also a seminal loss with the urine, and at stool; 
the patient's memory was greatly impaired and his mind otherwise 
affected, from the vital drain; he was dyspeptic, his bowels were con- 
stipated, and threatening symptoms of consumption had already begun 
to manifest themselves when he came under our care. Two months of 
our special treatment, at the patient's home, effected a perfect and per- 
manent cure, and completely arrested all abnormal seminal losses. 
The following grateful letter is from the gentleman in question. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-Permit me to say that, six months after having discontinued 
your treatment, my cure remains perfect. This great permanent and 
enduring benefit was secured to me through only two months of your 
skillful treatment and careful management of my case. Your medi- 
cines had a wonderful control over my disease, driving away its terrible 
symptoms as if by magic; they imparted to me a new power, filled my 
body and mind with unusual vigor, and transformed me from one 
racked with pain and living death or worse, to a full measure of health 
and happiness. I feel that if I had not been opportunely and success- 
fully treated by you, that my life would have been permanently 
blighted, and that the happy and contented mind that now inspires 
these lines, would ere this have been dethroned of reason. I feel that 
you have been my savior. I have not had a single nocturnal emission 
since leaving your treatment, six months ago. Thanking you, gentle- 
men, from the depths of a grateful heart, I remain 
Your obedient servant, 
G., Cayuta, Schuyler Co., N. Y. 
Case 88,589. Spermatorrhea. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-I have used the last medicines you sent me and I believe they 
have resulted in a perfect cure. One week this season I drove the 
mower every forenoon and the rake every afternoon, which is some- 
thing I had hot done before for three seasons; hence, I claim that I am spermatorrhea and imfotency. 
851 
perfectly cured of my complaint, because it was this which caused my 
previous general debility. I thank you most heartily for the blessing 
of good health. In case a relapse should occur, which I do not expect, 
I shall at once resume treatment. 
I remain, truly your well-wisher, 
G., Bakersfield, Franklin Co., Vt. 
Case 88,736. Spermatorrhea 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-Sure enough 1 am well, and I desire to thank you for your 
medical skill. My strength is very greatly increased, my digestion and 
appetite are perfect, I sleep well and awake refreshed, and, in fact, feel 
better every way. My eyesight, which was weak, is wonderfully im- 
proved, and my physical condition is now perfect in every way. The 
emissions have ceased. Respectfully, 
B., Fayette, Howard Co., Mo. 
Case 91,656. Spermatorrhea. An obstinate case of eight 
YEARS' STANDING. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-I have taken seven months' treatment from you, and to-day I 
am a well man. My friends are surprised at the great change which 
has taken place in me. The emissions have ceased entirely and I am 
strong and well. I am a thousand times obliged to you for the good 
your treatment has done for me. Respectfully yours, 
U., Topeka, Kansas. 
Case 93,264. Seminal Weakness. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-Allow me to thank you most sincerely for the great benefit I 
have derived from your two months' treatment. When I first wrote 
to you I felt as if my life on earth was short, indeed; but, thank God, 
through His help and yours, 1 have been saved from filling an early 
grave from the results of self-abuse. Before I began treatment I was 
pale and sickly; I had palpitation of the heart so bad that I often ex- 
pected to drop dead in the street; I had loss of voice; I always felt tired; 
I had involuntary emissions of semen in the night, which always made 
me feel weak through the next day; whilst quite often my mind was 
filled with suicidal thoughts. Such was the price I was compelled to pay 
for violating the laws of God and nature. Now, every thing is changed. 
I thank you a thousand times for the great good you have done me. 
May God bless you. I shall always be pleased to recommend your 
treatment to everybody, and I will cheerfully answer any communica- 
tion that I may receive in relation to this. W., Lynn, Mass. 
Case 110,666. Spermatorrhea. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-Permit me to say that my health is better now than it has 
been before in twenty years. My strength is very much increased 
and my sleep and appetite are perfect. The emissions have been con- 
trolled entirely, and my manly powers have returned. 
B., Denison, Texas. 
Case 110,837. Spermatorrhea. 
World's Dispensary Medical Association: Gentlemen-My sem- 
inal trouble was cured long since, and I had forgotten it. Your medi- 
cines relieved me of that in a short time and I am satisfied that it will 
cure the worst cases in a few weeks. I am also satisfied that you 
accomplish more in the healing art than any other faculty in the 852 
COiiMON SENSE MEbiCAL AbVisEB. 
country, and I cannot say too much in recommendation of your insti- 
tution. 1 have tried your institution, and have found your words true 
in every sense, and take pleasure in authorizing you to use my name 
in any way to suit yourself. My appetite is good, and I have no 
pain or trouble whatever. The neuralgia in the chest, the tough 
phlegm, and weakness have all disappeared. A. 
Case 110,838. Seminal Weakness, with Fistula in Ano. 
A case of anal fistula that had been unsuccessfully treated by 
Prof. , of Nashville, who had operated with the knife. He had 
also been unsuccessfully treated by several home physicians, who 
stated that his symptoms of spermatorrhea were all that could be de- 
scribed, and more too. The sensations of crawling and itching in the 
rectum were very severe, and, as a result of weakness, there was a 
serious palpitation of the heart, and general debility. The generative 
organs were unduly excitable and weak. He complained of weakness 
in the rectum and loins, with irregularity of the bowels, trembling and 
weakness of the entire system. There was a profuse discharge from 
the fistula and also from the urethra. We undertook his case without 
making any promises of a radical cure, as it seemed that the disease 
had progressed so, that it would be impossible to effect more than an 
improvement in his general condition, and a palliation of the symp- 
toms of disease. At the end of seven months' treatment he wrote as 
follows: 
"The result of the medicine you have sent me is a permanent cure 
of the fistula beyond a doubt, and in a magical manner. My heart is 
very much improved, so that it does not trouble me in the least. My 
health is perfect in every way. It is unnecessary for me to order any 
more medicines, but should I think at any time that a little is required 
to keep me in good health, I will order at once. I think I am entirely 
through with the fistula and sympathetic weakness, and I can truly say 
that your remedies delivered me from the jaws of death. With sincere 
thanks to you, I am, yours forever." D. 
Case 111,477. Spermatorrhea and Irritable Bladder, cured 
BY TWO MONTHS' TREATMENT. 
This was a badly complicated case of spermatorrhea, the patient 
being also troubled with frequent urination, partial impotency, mucous 
discharges from the urethra, and a burning sensation in the testicle and 
groin. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-I took the two months' supply of medicines sent me by you as 
directed. After taking the first month's medicine the emissions ceased 
entirely, my appetite increased, and I slept much better. Eight months 
ago I finished the second month's treatment and have since been in per- 
fect health. I am fully convinced that you do every thing that you 
promise. I am gentlemen, yours respectfully, 
R., Fort Totten, Dakota. 
Case 111,489. Seminal Emissions, with Loss of Memory and 
General Decline. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-Inclosed please find money for my last supply of medicines. 
You seem to understand my condition thoroughly. My color, appetite, 
and strength have improved wonderfully, and my sleep is sound, undis- 
turbed and refreshing. Under the influence of your medicines, I have 
completely recovered my mental and physical powers, and I feel that I SPiSiiMATOilRiiEA And IMpoteNt Y. 
853 
am able to discontinue further treatment. The emissions have become 
less and less frequent until now they do not trouble me at all. 
I remain, yours truly, 
H., Eagle Springs, Coryell Co., Texas. 
Case 111,571. Spermatorrhea. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-Under the influence of your last course of medicine my health 
has improved so greatly that I feel any further treatment to be unnec- 
essary. My health is better now than at any other time for years. 
The night emissions have ceased entirely, I have not had one now for 
many months. I feel better in every way. Respectfully, 
P., Pittsburg, Pa. 
Case 140,056. Spermatorrhea. 
The following long-standing and aggravated case of seminal debility 
began to yield at once under the specific influence of our medicines. 
Frequent nocturnal emissions were present, and the semen also passed 
off unobserved and unsuspected in the urine, of course a ceaseless 
vital drain of this character began quickly and profoundly to impress 
the constitution, so that, when the patient under consideration applied 
to us for relief, the most unmistakable symptoms of commencing 
organic disease of the heart and lungs had plainly declared themselves 
to be present. Like many hundreds of similar cases which we cure 
annually, the disease yielded promptly and perfectly to the well 
directed efforts of our specialist in this important branch of practice; 
indeed, so easy, swift, and perfect was the cure that the patient failed 
to realize the necessity of continuing the treatment a few weeks in 
order to insure himself against the possibility of a relapse, and discon- 
tinued his correspondence with us, whereas it is in precisely such cases 
that we recommend the treatment to be not too abruptly discontinued. 
World's Dispensary Medical Association, Buffalo, JST. Y.: Gen- 
tlemen-Your kind favor thoughtfully inquiring after my health came 
duly to hand. In answer permit me to say that it was not my intention 
to take further treatment, as I considered my cure to be perfect, all 
local and general symptoms having wholly subsided before I had fin- 
ished the month's course, and thus far manifesting no disposition to 
return. However, in the light of your wisdom and experience, I have 
reconsidered the matter and now believe with you that another month's 
course of treatment is advisable, in order to effectually guard against 
the possibility of a relapse; I accordingly inclose you the price of 
the additional month's course. The second morning after commencing 
the use of your medicines, I awoke refreshed in body and mind, and 
this experience has been repeated every morning since. The emissions 
were arrested at once, and I have not had a single unnatural discharge 
since, except once when I experienced a slight nocturnal emission 
which, however, was followed by no depressing after effects, but alto- 
gether the reverse. I feel so much stronger and better in all respects 
that it is a positive pleasure for me to do a hard day's work now. 
Respectfully, 
B., Crystal Lake, Wis. 
Case 140,153. Spermatorrhea. 
World's Dispensary Medical Association: Gentlemen-When 
I consulted you a few months ago. I procured from you sufficient med- 
icine to last one month, and took the same regularly until it was all 
finished; and I must say, in justice to you, that the effect of the medi- 
cine referred to was simply wonderful in my case. The nocturnal 
emissions were arrested at once, if I except a slight discharge which 854 
COMMON SENSE MEDICAL ADVISER. 
occurred about the time I commenced the treatment. I will, however, 
act upon your advice and continue the treatment a while longer to 
insure a permanent cure. 
I remain, gratefully yours, 
II., Merritton, Lincoln Co.. Ont., Canada. 
Case 140,948. Spermatorrhea. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-I believe myself to be free of the trouble for which you have 
been treating me. It seems too good to be true, yet I feel satisfied that 
I am more of a man than ever before in my life. I have not the time 
nor ability to thank you in the high-flown language peculiar to testi- 
monial writers, but suffice is to say that I am, 
Most gratefully yours, 
S., Brooklyn, N. Y. 
Case 141,318. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-I did not find it necessary to take all of the last month's medi- 
cines you sent me, as I found myself cured and twice the man I ever 
was before. One month ago I married happily, and I shall ever 
remember you as being the means of contributing greatly to that 
event. Yours truly, 
B., Mount Mourne, Iredel Co., N. C. 
Case 141,635. Spermatorrhea. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-The last lot of medicines was duly received, and taken strictly 
according to directions; and when done I found myself well, but I have 
deferred writing to you until I could observe whether the cure was a 
permanent one or otherwise. I am prepared to say now that I have 
gained in flesh and strength and that I feel better than I have before 
for a long time. I am, indeed, a thousand times obliged to you for 
what you have done for me, and I am fully satisfied that you can cure 
anything that can be cured. May God grant you a long life that you 
may benefit the afflicted, is one of the best wishes of your most hum- 
ble servant. H., Cohoes, N. Y. 
Case 142,842. Spermatorrhea Cured. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-It is with great thankfulness to you that I pen these few lines. 
I am to-day a strong and healthy man, which I never would have been 
but for your kind and skillful attention. My health was completely 
broken down by the effects of self-abuse, and I doctored with other 
physicians for two years, but with no success. However, after a few 
months of your treatment, I feel my health fully restored. I am now 
in a condition to enjoy the world, and take comfort wherever I am; in 
a word, I am " a man among men." I most cordially invite all persons 
requiring skillful medical treatment to apply to the Invalids' Hotel and 
Surgicallnstitute. M., Fredericville, Michigan. 
Case 154,136. Seminal Weakness. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-I see no further use in continuing your medicines, as I now 
feel perfectly well and the emissions have stopped entirely. I used to 
feel dizzy, exhausted, and irritable on arising in the morning, but now 
I feel nothing of the kind. Respectfully, 
K., Johnston, Pa. SPERMATORRHEA AND IMPOTENCY. 
855 
We could add to the preceding list an almost endless number 
of extracts from letters written by grateful patients, expressing 
their heart-felt thanks for having been cured of spermatorrhea 
and impotency by our treatment, but we trust that a sufficient 
number has been given to convince the most skeptical and dis- 
heartened sufferer from these diseases that his case may yet be 
cured. 
There is no affection which is more neglected, and less under- 
stood by practitioners than spermatorrhea. Its treatment has, 
therefore, furnished a lucrative field for quackery. 
A Caution to the Afflicted. We are daily consulted 
by persons suffering from spermatorrhea and impotency who 
have been victimized by ignorant charlatans. Some seek to 
dupe and swindle the unwary by claiming to have themselves 
been cured of spermatorrhea or impotency by some prescrip- 
tion, which they offer to send free to any sufferer. When the 
prescription is obtained it is found to consist of a few articles 
well-known to every druggist, coupled with certain arbitrary 
and fictitious terms, unknown to everybody and not to be found 
in any medical work extant. Following the prescription is a 
modest suggestion that if it cannot by filled by the home drug- 
gist, the benevolently-disposed party furnishing the prescription 
will be pleased to send the medicine, already prepared, for from 
three to five dollars. Of course, the whole scheme from begin- 
ning to end being a swindle, when the " medicine " is obtained 
and taken it proves entirely useless. Skill and genuine merit do 
not go begging. Men who spend hundreds of dollars for the 
publication of advertisements offering to give away valuable in- 
formation can always be safely set down as swindlers. 
In the public prints will be found advertised various ready-pre- 
pared, " put-up," or proprietary, so-called " remedies," " Specifics," 
"Boluses," "Pastiles," "Urethral Crayons," "Voltaic Belts," 
" Galvanic Belts," " Batteries," and " Pads," all recommended 
as infallible remedies for spermatorrhea and impotency. 
A vast experience in the treatment of these affections has sat- 
isfied us that each case must be studied and treated according 
to the symptoms manifested, and that medicines that are adapted 
to one stage of the disease are entirely unsuited to other stages 
of the same case. No " Pad," or " Battery and Pad," " Galvanic " 856 
Common sense medical adviser. 
or "Voltaic Belts," "Battery," " Bolus," or " Soluble Crayon," 
ever did or can help a case of this disease, except it be in the 
imagination. Although the proprietors of the most popular 
proprietary medicines in the market, medicines carefully adapted 
to the cure of the diseases for which they are recommended, yet, 
should we attempt to get up a general remedy to cure spermator- 
rhea and kindred maladies, we are certain it would be an utter 
failure, and this is entirely true of all such preparations now and 
heretofore offered for sale, and, from the very nature of the dis- 
eases they are recommended to cure, ever must be. Each case 
must have medicines carefully prepared to meet the conditions 
present, and when these conditions, from the effects of treatment 
or other causes, change, the treatment must be varied accordingly. 
positive Injury instead of benefit often results from the 
employment of some of the nostrums advertised for the cure of 
spermatorrhea, impotency and kindred affections. Especially 
have we found that the use of "Soluble Urethral Crayons," 
" Boluses," " Pastiles," and kindred contrivances, which are so 
extensively advertised, are exceedingly injurious, and often 
render otherwise moderate and simple cases complicated and 
incurable. 
Although of pretended French origin, they are evidently the 
invention of an ignoramus, who knows nothing of the delicate 
anatomy of the generative organs or of the proper treatment 
of the diseases incident thereto, for none other would ever 
have thought of such a preposterous plan of treatment. No 
man should insert such absurdly devised and mischief breed- 
ing contrivances into his urethra (urinary canal), for thereby 
he is almost sure to do himself a permanent injury. So far 
from having been invented by an eminent French surgeon as 
claimed, such treatment is entirely unknown in France, and 
ever has been, as the writer well knows from personal observa- 
tion and enquiry while sojourning in that country and visiting 
its most noted hospitals and medical institutions. 
Many of these quacks claim that they can and will cure those 
formidable diseases resulting from self-abuse and excessive ven- 
ery, on receipt of surprisingly small fees. This fact alone 
should arouse suspicion, for physicians of skill and eminence do 
not offer their services for a trifle. The proper treatment of PHIMOSIS. 
857 
these diseases requires not only experience and skill, but the use 
of expensive medicines. 
We have considered the subjects of spermatorrhea and im- 
potency at some length, on account of the prevalence of these 
diseases and the very unsatisfactory manner in which they are 
treated by general practitioners. 
Many physicians assume to treat these delicate diseases, but, 
being inexperienced, their efforts almost invariably result in 
failure. By ordinary treatment, these affections prove very 
obstinate,, the physician becomes tired of his patient, and, wish- 
ing to be rid of him, recommends marriage as a final remedy. 
If the patient follows this advice, domestic unhappiness, and, 
perhaps, divorce are frequently the results. A man suffering 
from spermatorrhea, impotency, or nervous debility should not 
marry until he has regained his health. Let him fully recu- 
perate his energy and strength, that his children may not inherit 
any morbid sexual tendencies. The issue of his love will then 
be pure, sweet, and promising, and his home be made an earthly 
paradise. It has been said that the greatness of the human soul 
is shown by keeping within the bounds of moderation. It is a 
French proverb, that the happiness of the human race in this 
world does not consist in being devoid of passions, but in learn- 
ing to command them. 
PHIMOSIS. 
This is one of the most common deformities of the male gen- 
erative organs and often constitutes an impediment to marriage. 
It consists of an unnatural contraction of the prepuce, or fore- 
skin, in front of the orifice of the urethra, or water-passage. 
The foreskin cannot be drawn back so as to uncover the glans 
penis. In some cases, the opening through the foreskin is so 
small as to diminish th.e size of the stream of urine flowing 
through it. The deformity sometimes exists at birth. In other 
cases, it is due to inflammation, caused by injuries or uncleanli- 
ness. It often results from venereal diseases, and not unfre- 
quently it is a result of masturbation. In some cases, the fore- 
skin is greatly elongated, while in others, it is of normal length, 
yet so contracted at its orifice that it cannot be pulled backward 
sufficiently to expose the glans. The affection gives rise to 
much inconvenience and suffering. Large quantities of whitish 858 
COMMON SENSE MEDICAL ADVISER. 
matter collect under the foreskin, inflammation is induced, and 
the foreskin adheres to the glans. This complicated condition 
can only be relieved by a careful dissection of the parts. The 
affection produces intense irritation throughout the genito- 
urinary system. Stricture of the urethra, inflammation of the 
bladder, and disease of the ureters and kidneys are common 
results of phimosis. Ulceration of the contracted parts is not 
uncommon, and, in rare instances, cancers are produced, involv- 
ing the prepuce and glans, and requiring amputation of the 
penis to save the victim's life. Mr. Hey, a very distinguished 
English surgeon, found phimosis present in nine cases out of 
twelve in which he performed amputation of the penis for the 
removal of cancerous tumors. 
Treatment. No course of medical treatment can effect a 
cure of either congenital or acquired phimosis. The only rem- 
edy is circumcision. When performed by a skillful surgeon, the 
wound being closed by a few stitches, uniting the skin and the 
mucous lining of the foreskin, the parts heal in a few days, and 
the deformity is entirely removed. In cases in which the fore- 
skin is not abnormally long, it may be slit and the skin and 
mucous membrane united. When the deformity exists at birth, 
it should be remedied without delay. A very large number 
of operations for this affection have been performed at the 
Invalids' Hotel and all have been followed by the most satisfac- 
tory results, showing conclusively that it is devoid of all danger. 
We employ either local or general anaesthesia, to render the 
patient insensible to pain. 
We here present a few typical cases illustrating the success of 
the above described method of treatment. 
Case 8,733. 
Mr. C. G. H. applied to our surgeons, stating that he desired to get 
married but feared that he was so malformed as to be unable to have 
sexual intercourse. Upon examination we found the prepuce, or fore- 
skin, very long, and so contracted as to prevent drawing it back. When 
erect the penis was crooked and drawn out of shape to such an extent 
that sexual intercourse would have been impossible. A very slight 
operation, which only confined the patient to the house for two days, 
entirely corrected the deformity. 
Case 10,379. 
Mr. C. G. consulted us, and stated that six months before, he had 
an operation performed for phimosis by the surgeons of a Western 
Surgical Institute, but that it had failed to improve his condition. PHIMOSIS. 
859 
Examination disclosed the fact that the deformity had been badly dealt 
with and the parts had contracted down and produced greater distor- 
tion than we had ever before seen in any case of this kind. A careful 
operation resulted in a complete removal of all deformity, to the 
patient's complete satisfaction. This case would seem to admonish 
those who have need of any surgery upon the genital organs to go to 
those who have constant experience in such cases. 
Case 12,360. 
Mr. P., of Harrisburgh, Pa., consulted us and stated that he had 
been recently married, and had found that he could not have sexual 
intercourse with his wife, and said he feared the fault was on his part. 
Examination disclosed a very long foreskin, closely contracted. The 
usual operation was performed, and in two days he'left for home, and 
two weeks later reported himself all right. 
Case 53,615. 
World's Dispensary Medical Association: Gentlemen-I return 
you my sincere thanks for the benefit received by me at your Invalids' 
Hotel, as I have been cured of a life-long disability by a surgical opera- 
tion performed by one of your staff. With best wishes for your pros- 
perity, I remain Very gratefully yours, 
S., Cohocton, N. Y. 
Case 54,854. 
World's Dispensary Medical Association: Gentlemen-I desire 
to express to you my thanks for the relief afforded me by a skillful 
operation, from a deformity that has from my birth been a constant 
source of annoyance and distress. The operation was painless, and, 
five days after, I returned home cured. 
I can earnestly recommend all who may require medical or surgical 
treatment to consult you. Very truly yours. 
G., New York Mills, N. Y. 
Case 56,081. 
World's Dispensary Medical Association: Having been cured 
of a life-long deformity by a skillful operation at your hands, I desire 
to express my gratitude and thanks. I was operated upon for the cure 
of phimosis on Wednesday, and on Saturday I was able to return home 
a well man. You have my most heart-felt thanks for your kind and 
skillful treatment and for that of your nurses. They are the best I 
have ever seen. Your surgeons excel in skill any that the country 
possesses. Gratefully yours, 
K., Allerton, Iowa. 
Case 65,112. 
World's Dispensary Medical Association: Gentlemen-After 
having suffered nine years with phimosis, I placed myself under your 
care and treatment. I am happy to state that, through your skill and 
the goodness of God, I was able in five days to return home completely 
cured. Thanking you and your excellent nurses for the kind attention 
given me, I remain Very respectfully yours, 
P., Sharpsburgb, Pa. 
Case 68,592. 
World's Dispensary Medical Association: Gentlemen-I am 
pleased to say that, having been subject to phimosis for about twelve 
years, I was operated upon at the Invalids' Hotel, and am going home 
at the end of a week satisfied with the operation, and free from the 
deformity. Yours truly, 
P., Buffalo, N. Y. 860 
COMMON SENSE MEDICAL ADVISEE. 
VARICOCELE. (Enlarged Spermatic Veins.) 
Varicocele consists of an enlarged condition of the spermatic 
veins. In well-marked cases, the veins have a knotted appear- 
ance, shown in Fig. 243, and feel much like a bundle or mass of 
earth-worms. In warm weather, and when the patient takes 
active exercise on his feet, the veins become most distended, and 
often give rise to great uneasiness, and sometimes to consider- 
able pain. The affection commonly results from long-continued 
Fig. 21$. 
Fig. 
A healthy Testicle. 
and fatiguing exercise in an upright position, strains, over-ex- 
citement of the sexual organs, constipation, or anything which 
obstructs the free circulation of the blood in the spermatic veins. 
In bad cases, the pressure of the enlarged veins upon the testi- 
cles produces a wasting of these organs, which generally results 
in impotency. Fig. 242 shows a healthy testicle. It is round, 
full, and plump like an egg, with only sufficient vessels to 
supply it with blood, and to carry off its secretion. Fig. 243 
A Testicle wasted by Varicocele. VARICOCELE. 
861 
shows a shrunken or wasted testicle, having the appearance of a 
shriveled-up nut. This condition is often present in spermator- 
rhea, and is a complication which is not unfrequently overlooked 
by inexperienced physicians in treating this disease. 
Treatment. In all ordinary cases, the application of 
proper lotions, and the wearing of a suitable apparatus, which 
we can send by mail, will effect a cure. The worst cases can 
only be cured by a surgical operation. 
Having operated with unvarying success upon a very large 
number of cases of varicocele at the Invalids' Hotel, we now 
invite attention to an operation which is neither severe nor 
dangerous, and from which the patient makes a more rapid and, 
in every respect, a more satisfactory recovery than from any 
other with which we are acquainted. Instead of being confined 
to his bed for ten days and to his room for a month, the patient 
can leave his bed by the third day after the operation, and 
return to his home in a week, taking the precaution to wear a 
well-fitting bandage. When we contrast these results with those 
formerly obtained by ligation, graduated pressure by clamps, 
suture-pins, and other methods, every unprejudiced surgeon 
must perceive the marked superiority of the operation to which 
we allude. It effects a radical cure of varicocele. The patient 
being placed under an anaesthetic, and the scrotum denuded of 
hair, the parts are firmly compressed and the spermatic cord ren- 
dered as tense as possible by the fingers of an assistant. An 
incision twenty lines in length is then made in the upper third 
of the scrotum, the fascia carefully divided upon a director; the 
vein separated from the nerve and artery is then completely 
divided and allowed to bleed externally for a few moments. 
By this method all infiltration and ecchymosis of the scrotum 
are avoided. The hemorrhage is trifling. The wound is not 
closed by sutures, but allowed to heal by granulation. When 
associated with spermatorrhea, the cure of the latter disease 
generally results in a removal of the varicocele. In bad cases 
requiring a surgical operation, we employ a new method, which 
we have now practiced in over nine hundred cases with uniform 
success. We subjoin a few typical cases illustrating the results 
obtained by the methods of treatment practiced at the Invalids' 
Hotel and Surgical Institute. 862 
COMMON SENSE MEDICAL ADVISEB. 
CASES TEEATED. 
Case 46,314. 
World's Dispensary Medical Association: Gentlemen-I wish 
to inform you of the success of your treatment of me for varicocele on 
the left side, and its attendant weaknesses, impotency, etc. I am now, 
thank God, through the agency of your surgical skill and the efficacy of 
your medicines, a healthy, strong, and perfect man. I am most happy 
to make the above statement, as I suffered terribly for three years pre- 
vious to the operation, with acute pain in the parts and continued men- 
tal anxiety. During the eight days that I remained at the Invalids' 
Hotel, I never experienced such uniform kindness and attention as I 
did from the attending surgeon, and from all the attaches of your hotel. 
I am now married and happy, and at all times willing to bear* testimony 
to the above statement. Yours in remembrance, 
R., Albany, N. Y. 
Case 48,638. 
World's Dispensary Medical Association: Gentlemen-Having 
been operated upon at the Invalids' Hotel, Buffalo, N. Y., for the radi- 
cal cure of a varicocele, from which I had suffered for twelve years. I 
take pleasure in certifying to the speedy and certain relief afforded, 
and the painless nature of the operation, as performed by the surgeons 
of the World's Dispensary Medical Association. One week from the 
time of the operation, I returned home, radically and permanently 
cured. I desire to express my thanks to the Medical Staff for their 
skill and attention. Gratefully yours, 
A., Saegerstown, Pa. 
Case 49,843. 
World's Dispensary Medical Association: Gentlemen-Having 
been painlessly and skillfully cured of a very bad varicocele in one 
week, when I had suffered from it for years, I confidently advise all 
who require medical or surgical aid to consult the World's Dispensary 
Medical Association, Buffalo, N. Y. Truly yours, 
L., Driftwood, Pa. 
Case 53,482. 
World's Dispensary Medical Association: Gentlemen-Having 
been a patient at the Invalids' Hotel, and undergone an operation for 
the radical cure of varicocele, from which I had suffered for years, I 
desire to express my entire satisfaction with the superb hotel and its 
attendants, and to express my thanks to the medical staff for their 
skillful treatment of my case, as my varicocele had for years resisted 
ordinary medical treatment. I recommend all similarly afflicted to 
consult you. Very truly yours, 
L., Killbuck, Ohio. 
Case 55,923. 
World's Dispensary Medical Association: Gentlemen-Having 
been operated upon at the Invalids' Hotel for the radical cure of a 
bad varicocele from which I had suffered for years, I am happy to be a 
witness to the success of the operation, as I am able to return home 
four days after, freed from my distressing disease. I cannot sufficiently 
praise the hotel or the skill and care of the attending surgeons. I rec- 
ommend all sufferers to the World's Dispensary Medical Association. 
Truly yours, 8., South Bridge, Mass. 
Case 56,232. 
World's Dispensary Medical Association: Gentlemen-Having 
been operated upon with entire success for the radical cure of a severe VARICOCELE. 
863 
case of varicocele, from which I had suffered for years, I desire to thank 
you for the kind and permanent relief afforded me. I can recommend 
you and your skillful operation as beyond anything I had imagined 
possible. Very sincerely, 
B., Pimento, Ind. 
Case 64,303. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-Having been operated on for a very bad case of varicocele of 
many years' standing, I am happy to say that the operation was entirely 
successful, and that I was able to return home the sixth day after the 
operation. I shall take pleasure in recommending you to all. 
Very sincerely yours, 
W., Orwell, Addison Co., Vt. 
Case 65,209. 
World's Dispensary Medical Association: Gentlemen-This is 
to certify that I have been afflicted with varicocele for five years, and 
came here April 8th; was operated on the same day and return home 
to-day, confident of a cure. I can cheerfully recommend this Associa- 
tion to all who are thus afflicted. Sincerely yours, 
M., Massena, N. Y. 
Case 65,607. 
World's Dispensary Medical Association: Gentlemen - I am 
pleased to state that I have been operated upon at your institution for 
the cure of varicocele, from which I had suffered for the past five years, 
and that now, after ten days' treatment, I am cured and able to return 
home. Respectfully yours, 
F.. Washington, Conn. 
Case 67,473. 
World's Dispensary Medical Association: Gentlemen - I am 
happy to certify to the safety and success of your operation for the cure 
of a very bad varicocele, from which I had suffered for years. I recom- 
mend all who suffer from this, or any serious trouble, to apply to the 
World's Dispensary Medical Association. Very truly yours, 
H., Maynard, Mass. 
Case 69,043. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-This is to certify that I have been successfully treated for vari- 
cocele of twenty-five years' standing at the Invalids' Hotel; and on 
leaving the institution 1 desire to express my gratitude and thanks for 
your kindness and skill. I earnestly recommend all who are afflicted 
to call on you, and be made well and happy. 
Yours truly, M., United States Army. 
Case 70,924. 
World's Dispensary Medical Association: Gentlemen-Having 
been operated on with entire success for the radical cure of a severe 
case of varicocele, from which I had suffered for seven years, I desire 
to thank you for the permanent relief afforded. I can recommend you 
and your skillful operation and treatment, and kindest care, to be be- 
yond any thing I had imagined possible. Gratefully yours, 
F., Ashford, N. Y. 
Case 72,848. 
World's Dispensary Medical Association: Gentlemen-I take 
pleasure in stating that I have been operated upon by you for varico- 
cele of long standing, which has proved successful in every respect. 
Respectfully yours, 
B., Goshen, Ind. COMMON SENSE MEDICAL ADVISEE. 
864 
Case 75,959. 
World's Dispensary Medical Association: Gentlemen:-I desire 
to add my testimonial to the thousands you already have as to the suc- 
cess of your treatment for varicocele. Having been afflicted with that 
disease for the past fifteen years, I was extremely doubtful as to your 
ability to effect a cure in my case; but now, after the short space of 
five days, I am confident of a perfect cure. The operation was entirely 
painless, and I was able to leave my bed the third day after. I further- 
more desire to express my thanks to the surgeon in charge for skillful 
treatment, and also to the nurse in attendance for the kind care and 
attention that I received. Yours respectfully, 
W., Binghamton, Broome Co., N. Y. 
Case 76,666. 
World's Dispensary Medical Association: Gentlemen-Having 
been afflicted with varicocele for eight years, I had an operation per- 
formed by you, and returned home in nine days-well, and a perfect 
cure effected. Yours respectfully, 
M., Punxsuatawney, Jefferson Co., Pa. 
Case 80,763. ' 
World's Dispensary Medical Association: Gentlemen - I am 
happy to certify to the safety and success of your operation for varico- 
cele. I have been cured of a varicocele that has troubled me for 
several years-thanks to your surgical skill. I recommend all suffering 
from this affection to come to your institution. Truly yours, 
L., Dwight, Ill. 
Case 82,314. 
World's Dispensary Medical Association: Gentlemen - I am 
happy to inform you that by your skillfully performed operation in 
November last, I now find myself completely cured of my varicocele, 
although all my physicians had informed me that mine was an unusu- 
ally bad case. By using your after-treatment, my sexual powers have 
been entirely restored. The spermatorrhea, from which I had so long 
suffered, is entirely cured. My health is now perfect in every respect, 
and, thanks to your institution, I am now in all respects a man and at 
last freed from a disease which had for years baffled the efforts of our 
best physicians. With sentiments of the deepest gratitude to you for 
the inestimable benefit received at your hands, I remain, 
Very sincerely yours, 
P., Front Street, New York. 
Case 91,722. 
This gentleman consulted us in December, 1881, stating that he was 
suffering severely with pains across the kidneys, frequent sick-head- 
aches, a dull, dizzy sensation, with great nervous debility, physical 
weakness, frequent night-sweats, horrible dreams, and loss of manly 
strength. His affection had been pronounced by many physicians to 
be Bright's disease. Upon advising him that his case was curable, 
which he seemed to doubt, he was at last induced to take treatment 
for two months, with the following result: 
World's Dispensary Medical Association, Buffalo, N. Y: Gen- 
tlemen-I desire to state that I am perfectly well, and very thankful 
to you for curing me. The medicines, which I used for two months 
only, have effected a permanent and perfect cure of my case. I feel 
that my health is fully restored, and that the result is permanent, as 
there has been no tendency to a return of the disease. 
Sincerely yours, 
M., Fairfield, Kan. DROPSY OF THE SCROTUM. 
865 
DROPSY OF THE SCROTUM. (Hydrocele.) 
This affection consists of a collection of water in the tunica 
vaginalis, or membranous sac which contains the testicles. It 
may affect either one or both sides. In health, the sac or invest- 
ing membrane of the testicle secretes a limpid fluid, which lubri- 
cates its inner surface. When secreted in excess, it accumulates 
and constitutes hydrocele. 
The tumor commences at the bottom of the scrotum and in- 
creases very gradually, while hernia, or rupture, with which it is 
sometimes confounded, progresses from above downwards and 
makes its appearance suddenly. Rupture may generally be dis- 
tinguished from hydrocele by the facility with which the pro- 
truding intestine can be returned to the abdominal cavity by 
having the patient lie upon the back and grasping the protru- 
sion and gently pressing it upwards, outwards, and downwards; 
while hydrocele is not affected by such manipulation. At first, 
the tumor is soft and the testicle may readily be distinguished; 
but, as it increases in size, it becomes firm and incompressible, 
and the testicle can scarcely be distinguished from the tumor. 
The tumor is generally pyriform, and its growth is attended 
with little or no pain. The swelling is generally so translu- 
cent, that, by placing a lighted candle behind it, the light 
may be seen through the affected parts. There are cases, how- 
ever, in which the skin becomes so thickened, and the accumu- 
lated liquid so opaque that the passage of the rays of light is 
obstructed. 
The affection is sometimes associated with chronic enlarge- 
ment of the testicle, and it is then termed hydro-sarcocele. In 
the latter case, the tumor is opaque. In all forms of the disease, 
the skin usually retains its normal color. 
Sometimes the water accumulates in the investing membrane 
of the spermatic cord, and it is then called encysted hydrocele 
of the cord. This form of disease occurs more frequently in 
children than in adults, and is very often confounded with 
hernia, or rupture, by ignorant or careless surgeons. We were 
recently consulted by an aged gentleman, whose disease a dis- 
tinguished surgeon had pronounced double hernia. On ex- 
amination, we found the disease to be hydro-sarcocele. We 866 
COMMON SENSE MEDICAL ADVISER. 
drew off four ounces of fluid from one side, and six from the 
other, through an aspirator needle, and in due time a cure was 
effected. 
Causes. Injuries from blows or bruises are among the most 
common causes of this disease. It may also result from inflam- 
mation of the testicle or from venereal excesses. It has been 
known to result from stricture of the urethra, or water-passage, 
and also from local irritation along that passage. 
Diagnosis. Hydrocele may generally be easily recog- 
nized by the following peculiarities: the growth of the tumor 
from below upwards, its softness and fluctuation when touched, 
and its translucency and lightness when compared with a solid 
tumor. Its smoothness, the absence of pain, and the lack of im- 
pulse in it, caused by coughing, which is generally perceptible 
in rupture, are also distinguishing features in this affection. 
Some of these peculiarities, however, are not always present; as, 
for instance, the freedom from pain. In some cases, very severe 
pain is experienced. 
Sometimes the quantity of water contained in the scrotum is 
enormous. Gibbon, the historian, is said to have had six quarts 
of water removed from his scrotum at one tapping. We have 
drawn four pints at one operation, and three pints not un- 
frequently. 
Treatment. In children, the disease sometimes disappears 
spontaneously, but such is not the case with adults. Medical 
treatment, although sometimes employed by physicians, has not 
in our practice been productive of any benefit. The only treat- 
ment which promises permanent relief, consists in tapping and 
drawing off the accumulated fluid. In many cases, the water 
will accumulate again, unless some stimulating liquid be injected 
into the sac after the water is drawn off. After many years' ex- 
perience in the use of stimulating injections, we have discovered 
a liquid which seems to answer the purpose admirably. Unlike 
iodine, it causes only a slight smarting sensation for a few sec- 
onds, but it produces such a modifying influence on the lining 
of the sac as to completely arrest the secretion of further liquid, 
thus making the cure permanent. The water may be drawn off 
by means of an ordinary trocar and canula, or through a small 
trocar canula, or hollow needle, attached to an aspirator pump, DROPSY OF THE SCROTUM. 
867 
Fig. 244. We generally employ the latter instrument in tap- 
ping all kinds of dropsical effusions. The needles are much 
smaller than a trocar. By the aid of an air-pump, with which it 
is connected by a rubber tube, an amount of suction is applied 
which promotes the flow of liquid through the needle. By 
the use of aspirator 
needles, the surgeon 
can safely tap the 
chest, abdomen, and 
other cavities, and 
the operations are 
attended with very 
little pain. Ab- 
scesses of the liver 
may also be reached, 
and the accumu- 
lated liquid drawn 
off through these 
needles. Ovarian 
and other encysted 
tumors may be ex- 
plored, and their 
contents drawn off, 
by the use of this 
instrument. The fa- 
cility with which 
this instrument may 
be used, the freedom 
from pain, and the 
perfect safety at- 
tending its use, ren- 
der it superior to the 
instruments usually employed by surgeons. Some surgeons 
still resort to the use of setons for the cure of hydrocele, but 
this method of treatment is extremely painful. We consider 
the employment of such means little less than barbarous, es- 
pecially since we are now acquainted with methods of treat- 
ment which are painless, efficient, and attended with no danger 
whatever. 
Fig. mA. 
The Aspirator. 868 
COMMON SENSE MEDICAL ADVISEE. 
CASES TREATED. 
Case 17,901. Hydrocele with Cancerous Testicle. 
Mr. H., of Pennsylvania, consulted us for what he supposed to be 
simple hydrocele. After removing the liquid accumulation from the 
scrotum, we found the left testicle to be greatly enlarged and affected 
with cancer. The testicle was promptly removed. The parts healed 
readily and the patient made a rapid recovery, and has remained well 
ever since, now over four years. 
Case 46,097. Cystic Hydrocele. 
Mr. P. D., of Davenport, Iowa, consulted us, stating that previous to 
leaving home he had sought the advice of two home physicians, both of 
whom were undecided as to the nature of his malady, yet both expressed 
their belief that he was suffering from rupture, or breach. These med- 
ical gentlemen were misled by the formation of several cysts, or small 
sacs, filled with water and located high up on the spermatic cord. As 
stated heretofore, hydrocele usually first manifests itself by an enlarge- 
ment at the bottom of the scrotum, whereas hernia, or rupture shows 
itself at the top of the scrotum and the enlargement extends downward. 
As the cysts, or bags of water, had, in this case, grown high up on the 
cord, the physicians had been misled. In the case of Mr. D., the cysts 
were removed from the cord, and the cure made permanent. The 
moral taught by this case is to admonish sufferers from any disease of 
the generative organs to consult only those who have abundant experi- 
ence. 
Case 61,045. Cystic Hydrocele of many years' standing, with 
great thickening of the tissues. 
The cyst was of an enormous size, and rapidly increasing. From the 
advanced age of the patient and the peculiar nature of the tumor, it 
had been pronounced incurable by several physicians. 
We desire to call special attention to the endorsement given by 
this well educated and widely known physician. The fact that he 
placed his case in our hands for the treatment of so dangerous a 
trouble, indicated his high esteem for our institution and method of 
treatment. 
World's Dispensary Medical Association: Gentlemen-I feel 
great pleasure in expressing to you my sincere thanks for the cure that 
has been effected in my own case, by your very skillfully performed 
operation, whereby I am now entirely and permanently freed from a 
dangerous disease, which had defied the utmost skill of all medical 
attendants for the past five years, and from which I had despaired of 
being relieved, owing to my advanced age (69 years) and the length of 
time that I had been a sufferer. I am happy to state that my health is 
now entirely restored and a very great deformity removed. I am a 
physician of more than thirty years' standing, and I can testify to the 
skill of your surgical staff, the attention and care of your nurses, and 
the magnificence and comfort of your palatial hotel. All persons 
requiring either medical or surgical aid should consult you at once. No 
hospital in the world can exhibit such an unbroken record of surgical 
triumphs as your institution presents. Having been personally cogni- 
zant of many of your successes while I was under your care, I can 
conscientiously recommend your institution as being, in all respects, 
without a peer in the world. Wishing you a long and prosperous career, 
I remain Very gratefully yours, 
D., Kokoma, Indiana. CHRONIC ENLARGEMENT OF THE PROSTATE GLAND. 
869 
Case 66,163. Cystic Hydrocele. 
World's Dispensary Medical Association: Gentlemen-Allow 
me to thank you for the great kindness and skillful treatment I received 
while at your institution. I have been cured, by a skillful operation, of 
a disease which had for several years made life a burden. I feel reju- 
venated, and as if I were another man. My trouble, cystic enlargement 
of the spermatic cord and its consequent complications, rendered me a 
constant sufferer from nervousness and debility. The operation was 
performed July 20th. On the 21st I sat up on a couch. On the 
22nd I was up and dressed, and on the 23rd was able to go home in 
safety. I cannot speak too favorably of your care, perfect institution, 
and skill. Very gratefully, W.. Ellery, N. Y. 
CHRONIC ENLARGEMENT OF THE PROSTATE 
GLAND. 
The prostate gland lies just in front of the base of the blad- 
der, surrounding the urethra, or urinary canal. Enlargement, 
therefore, of this body, if it is of considerable extent, causes 
it to encroach and press upon the base of the bladder, and to 
more or less constrict the urinary canal near the base or out- 
let of the bladder. The enlargement may be Only slight, or 
the dimensions of the gland may be increased from the size of 
a large chestnut, its normal dimension, to the volume of a pul- 
let's egg, or even to the size of an orange. 
Hypertrophy of the prostate generally arises from causes 
which operate in a slow and permanent manner. Whatever has 
a tendency to produce a determination of blood to, and an en- 
gorgement of this organ, is capable of producing the affection, 
an augmented flow of blood to the part having the effect of in- 
creasing the nutrition of it. Among the most frequent causes of 
this affection, are excessive venery, masturbation, disease of the 
bladder, stricture of the urethra, horseback exercise, gonorrhea, 
and the employment of strong, stimulating diuretics. Some of 
the worst cases that we have had to deal with have occurred in 
old men, and, in fact, the malady is more common to those ad- 
vanced in life; but it is frequently produced in those of middle 
age by the causes enumerated. 
Among the earliest symptoms of the disease is an uneasy 
feeling in the region of the base of the bladder. There is a 
more frequent desire to urinate than usual, and, in the course of 
time, this frequency becomes more urgent; still no particular 
notice may be taken of it, as it is considered only a slight 870 
COMMON SENSE MEDICAL ADVISER. 
derangement. After several months, or perhaps years, the dis- 
comfort increases, and there are frequent calls at night to empty 
the bladder. The patient begins to find the discomfort of 
getting out of his warm bed very troublesome; still no notice is 
taken of it. He does not think it necessary to consult a doctor 
for what he considers a trifling matter. In the course of time, 
the patient is obliged to get out of bed twice during the 
night. Afterwards the calls become still more frequent and 
urgent, the inconvenience more evident; finally, pain is substi- 
tuted for inconvenience, and then the doctor is consulted. Un- 
less a specialist of experience be consulted, the bladder will 
most probably be examined, and medicine will be prescribed 
to excite the kidneys to secrete more urine, which does harm 
instead of good, the disease slowly, but surely progressing. 
Patients often write us that they have had something wrong 
with the bladder for a number of years, having to urinate more 
frequently than they ought; sometimes having to do so three 
or four times during the night; in extreme cases, even every half 
hour or so, and that they are not able to pass it freely, but only 
in small quantities, and attended with much pain. These symp- 
toms are not always constant, but disappear for a few weeks 
and then return again. This continues for a year or two, per- 
haps, when the passage of the urine is completely shut off for 
several hours, and the patient is in great agony until the bladder 
is relieved by the use of the catheter. After such instrumental 
relief, the urine may be natural again for a day or two, coming 
at first, perhaps, in very small quantities, but by and by more 
freely. Then, after a week or two intervening, there may be 
another complete stoppage, attended, as before, with intense suf- 
fering, which will have to be again relieved by the use of an 
instrument. 
This is a fair account of the usual progress of the disease and 
its symptoms. As the prostate gland becomes more irritated and 
inflamed from the natural progress of the disease, or from the 
irritation caused by the passage of instruments, or the employ- 
ment of strong, harsh, stimulating diuretics, the urine becomes 
cloudy, and still later is found to have deposited during the 
night a quantity of thick, tenacious, and usually offensive mucus. 
There is apt to be more or less discomfort in the rectum, or CHRONIC ENLARGEMENT OF THE PROSTATE GLAND. 
871 
lower bowel, produced by the pressure of the enlarged prostate 
upon it. Rarely, the first intimation of a large prostate occurs 
through a sudden retention of the urine, and the patient being 
under the impression that there was nothing wrong with the 
organ previously. When closely questioned, however, the in- 
formation is elicited that there has been a long train of mild 
symptoms, similar to those which we have described, preced- 
ing the attack of retention of the urine. This shows the im- 
portance of early attention and proper treatment, when such 
symptoms are manifested. However slight the inconvenience 
experienced, it should not be neglected. The disease should be 
brought under control at the outset by skillful and appropriate 
treatment. Usually before a person suffers from toothache, the 
decay occasioning it has been gradually progressing without 
pain for from five to eight years. Just as the decay of the 
tooth may be arrested by the early attention of the dentist, so 
may prostatic disease by early attention be not only promptly 
relieved, but permanently cured. 
Disease of the prostate being slow in its inception and pro- 
gress, is also slow to yield even to the most skillful treatment. 
Being slow to develop, patients rarely seek assistance until the 
organ has become so large as to be seldom capable of being 
reduced to a size in wjiich mechanical means can be wholly dis- 
pensed with for relieving the bladder. Most surgeons are too 
much in the habit of depending on the catheter for the relief of 
the patient, and usually instruct the sufferer how to use it, tell- 
ing him that this, the catheter, is to be his only source of relief 
for life. Great as is the benefit afforded by the catheter, which 
has often saved life, yet it is a fact that its frequent and pro- 
longed use often renders disease of the prostate very intractable 
and sometimes wholly incurable. Frequent use of the catheter, 
without any treatment to prevent the further enlargement of 
the diseased gland, or to reduce its size, permits the continued 
enlargement of the gland and, besides, the constant use of the 
catheter irritates the prostatic portion of the urethra, causing 
thickening of the lining membrane, and, sooner or later, a more 
or less complete organic stricture of this canal, caused by 
thickening of the lining mucous membrane, as well as by the 
encroachment of the gland itself upon this canal. Besides, when 872 
COMMON SENSE MEDICAL ADVISER. 
the use of the catheter is once commenced, even when the en- 
largement is not very great, it is with the utmost difficulty that 
patients can be induced to discontinue using it. The bladder, 
becoming accustomed to its presence refuses to obey the will 
without this assistance. The irritation set up in the parts by the 
friction of the catheter causes inflammation and exudation in 
the lining membrane. This extends to the structure of the 
prostate itself and increases the hypertrophy, or enlargement. 
It will, therefore, be seen how important it is to early resort to 
treatment to relieve the first manifestations of this affection. 
A disease of so delicate a nature, and one so often confounded 
with other affections by inexperienced physicians, should only be 
intrusted for treatment to expert specialists of large experience 
in the management of this and kindred derangements. The fol- 
lowing case serves to illustrate the symptoms of the disease and 
the results of appropriate treatment. 
Case 96,126. 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-For years before consulting you, I suffered severely with en- 
largement of the prostate gland, and irritation at the neck of the 
bladder. The disease appeared as the result of a slight cold and irreg- 
ularity of the bowels. My urine appeared very irritating. 1 had fre- 
quent desire to pass it off in the night, and, on rising from my bed, it 
was necessary for me to walk the floor a considerable time before I 
could start it. During the day I had less trouble. The difficulty grew 
worse and worse, and I suffered from day today the symptoms of this 
disease, which are so perfectlv described in your book. Fearing that, 
if I neglected longer, I would become incurable, I consulted my family 
physician. His treatment did me little or no good. I exhausted the 
skill of the doctors in my neighborhood without success. I was at last 
induced to try you, and, after four months' treatment, I am happy to 
state a perfect cure has resulted. I now have to get up only once in 
the night, and then only after working very hard, or drinking excess- 
ively before going to bed. My strength is fully restored, and 1 feel in 
every way like another man. The pain in the back and lower part 
of the abdomen has all disappeared. I cannot express the gratitude 1 
feel at the relief you have given me. Very truly yours, 
A., Dunkirk, N. Y. 
VENEREAL DISEASES 
Regarding the origin and nature of these maladies, a great 
diversity of opinion prevails. In some form, they have afflicted 
humanity from the earliest times of which we have any record. 
Among the early writers who referred to them, we may mention 
Herodotus and Hippocrates, thus clearly proving that these 
diseases were known to the ancients. For several centuries, they VENEREAL DISEASES. 
873 
have been exceedingly prevalent. It is not fully determined 
whether there are one or more distinct poisons which produce 
the various venereal diseases. Some medical writers claim that 
there is but one poison, and that the varieties of venereal affec- 
tions are simply modifications of one disease, while others believe 
that these several affections are due to different poisons, and, 
therefore, are distinct diseases. 
The celebrated John Hunter believed that there was but one 
venereal poison, and prior to 1857 was supported in this view by 
the renowned Ricord. Sigmund, Von Baerinsprung, Rollet, 
Diday, Michaelis, and others who have thoroughly investigated 
the subject, differed in their opinions, while the results of Dr. 
Marston's late researches are in favor of the unity doctrine. In 
our own experience, circumstances have occurred which can only 
be explained by the latter theory. 
This theory supposes that when the poison comes into contact 
with the unbroken surface of the mucous membrane, it produces 
gonorrhea, or clap; and, when it comes in contact with an 
abraded surface, it produces syphilis, or pox. On the contrary, 
those who advocate the plurality hypothesis affirm that gonor- 
rhea and syphilis are produced and perpetuated by distinct 
poisons coming into contact with either raucous or abraded 
membranes. 
Another subject of dispute is whether constitutional infection 
is ever caused by clap or by soft chancre or chancroid. The 
advocates of the former theory claim that the system may be 
infected from either clap, chancroid, or chancre, while those who 
believe in the plurality theory maintain that hard chancre is the 
only source of infection. However, we are inclined to the belief 
that constitutional infection may, and sometimes does, though 
very rarely, result from clap and soft chancre, as well as from 
what is known as the true, hard, Hunterian chancre. 
Therefore, so long as we are liable to error, it is best to be on 
the safe side, hence, we should treat every case of this kind as 
though constitutional infection were certain to occur, and take 
the proper steps for its prevention. The importance of such a 
course is illustrated by facts which are daily coming under our 
observation. Individuals have been lulled into fancied security 
by their medical advisers, have rejoiced at the disappearance of 874 
COMMON SENSE MEDICAL ADVISER. 
the local symptoms, and neglected to pursue the constitutional 
treatment, upon which safety solely depends. The disease still 
lurks in the system, gradually increases in strength and viru- 
lence, until, finally, the deluded victim is overwhelmed by a 
multitude of symptoms, due to what is termed secondary 
syphilis. 
Whichever theory is correct, it is certain that all venereal dis- 
ease is the result of contagion, the virus being communicated by 
actual contact. Laying aside all prejudice against either theory, 
it is proper to say here that, notwithstanding the most thorough 
investigation and criticism, scientists have failed to discover a 
law which governs the action of this virus. We cannot go back 
to the origin of venereal disease, for it is involved in obscurity; 
but doubtless it arose from promiscuous and excessive venery, 
under certain conditions which favored its development. 
GONORRHEA. (Clap.) 
This form of venereal disease is a specific inflammation of the 
lining membrane of the urethra, or water-passage. When it 
occurs in females, it affects the mucous membrane of the vagina, 
and may extend to that of the urethra. It is communicated 
from one person to another by sexual intercourse. It is very 
rarely imparted in any other manner, though it may be com- 
municated by the least quantity of virus coming into contact 
with any of the mucous membranes. Sometimes sexual inter- 
course with a female afflicted with leucorrhea, produces a dis- 
ease in the male which is apparently similar to gonorrhea. 
Gonorrhea is usually developed in from three to eight days after 
exposure to the affection. Sometimes the inflammation is lim- 
ited to the mucous membrane covering the glans penis, and it 
is then called balanitis. 
Symptoms. In from two to ten days after infection, the 
patient experiences an itching and uneasy sensation in the 
urethra, the mucous membrane appears unusually red, the lips of 
the urethral orifice are swollen, a scalding sensation is experi- 
enced in voiding the urine, and there is a profuse discharge of 
thick, yellow matter. The head of the penis is swollen and the 
stream of urine divides. The warmth of the bed causes trouble- 
some erections; as the inflamed condition of the urethra will not VENEREAL DISEASES. 
875 
permit extension, the penis has a crooked appearance, curving 
downward, and is exceedingly painful, constituting what is 
termed chordee. If the disease be not cured in its early stages, 
it may become complicated with inflammation of the bladder, 
enlargement of the glands in the groin, stricture of the urethra, 
or with swelling and inflammation of the testicles. The inflam- 
mation may extend to the whole lining membrane of the blad- 
der, causing a frequent desire to urinate. If cleanliness is not 
observed, the irritating discharge, by contact with the surface, 
produces warts, or, being re-absorbed into the system, occasions 
fever, rheumatism, or eruptions. 
If the patient be a female, the same length of time will elapse 
between the exposure and the appearance of the local symptoms. 
She will experience an itching or uneasiness in the urethra, a 
sense of fullness in the vagina, and, in a day or two, there will 
be a scalding sensation in voiding urine, chills, and feverish 
symptoms, evidences of a general disturbance. The lining of 
the urethral orifice, and that of the vagina and outer lips, is red 
and swollen, while the inner lips are thickened. If the treat- 
ment is not promptly applied, the constitutional disturbance 
increases, the local inflammation becomes more intense, and 
there is a copious discharge of thick, yellow, poisonous matter. 
The symptoms being similar to those of leucorrhea and men- 
struation, she does not seek relief until they become violent. 
The inflammation may extend to the womb and Fallopian tubes, 
and the ovaries be sympathetically affected. The urethra, and 
even the bladder, may become involved, in which case, the symp- 
toms are essentially the same as in the male. 
Treatment. The cure of this disease is speedy and cer- 
tain, if proper treatment is employed; yet there are few dis- 
eases worse managed than this. Improper injections frequently 
cause inflamed and swollen testicles, which are sometimes very 
slow and very difficult to cure. Stricture of the urethra is also 
a not unfrequent result of improperly treated gonorrhea. A 
person suspecting that he or she is attacked with this disease, 
should at once take a good, brisk cathartic. Dr. Pierce's Pel- 
lets are as good as any thing for this purpose. No time should 
be lost in procuring proper injections and soothing diuretics. 
In order to allay the disease for the time being, and until the 876 
COMMON SENSE MEDICAL ADVISER. 
most scientific treatment can be obtained from men of experi- 
ence, the following mixture may be freely taken internally: 
sweet spirits of nitre, three ounces; tincture of fluid extract of 
gelseminum, two drams. Take two-thirds of a teaspoonful, in 
a little water, four or five times a day. 
Also use as an injection into the penis, if a male, or into the 
vagina, if a female, the following: tincture of aconite leaves, 
four drams; water, four ounces. This lotion should be injected 
freely four times a day. Or instead of the foregoing, an in- 
fusion of golden seal root may be used as an injection. The 
foregoing means will hold the disease in check until a physician 
of experience can be consulted in regard to the treatment of 
the case. 
Persons suffering from this disease and fearing exposure, 
should they apply to their local physicians, can send a descrip- 
tion of the case to the World's Dispensary Medical Association, 
Buffalo, N. Y., together with fifteen dollars, and receive by re- 
turn mail or express a supply of the proper remedies to effect a 
cure. Our medicines are speedy in their effects, and necessitate 
no neglect of business. Their use is never followed by swelled 
testicles or by stricture. 
This disease is indicated by a chronic discharge of muco- 
purulent matter from the urethra. It is the result of badly 
treated, clap or repeated attacks of the same, in persons of a 
scrofulous diathesis or depraved constitution. It is very often 
perpetuated by a slight stricture which has been neglected, 
and sometimes by disease of the prostate gland. As long as 
the patient does not complain seriously of difficulty in voiding 
the urine, the inexperienced physician never thinks of examining 
for a stricture. In a vast number of cases, a slight stricture, 
by preventing the injections from freely reaching all affected 
surfaces, is the real cause of failure in arresting the gleety 
discharge. Besides, these slight strictures, which are easily 
cured in their first stages without an operation, become worse 
and more difficult to cure when overlooked and neglected. All 
the violent symptoms of clap subside, leaving the walls of 
the urethra thickened. The chronic discharge debilitates the 
GLEET. (Blenorrhea.) VENEREAL DISEASES. 
877 
system, and is a constant source of annoyance. There are apt 
to be fibrous deposits, which narrow the urethral passage and 
interfere with the flow of the urine; or there may remain a 
granulated condition of the lining of the urethra. The dis- 
charge is usually white, sometimes profuse, and, at others, 
scarcely perceptible. Any irritation makes it yellow. Alco- 
holic stimulants, sexual intercourse, violent exercise, or exposure 
to sudden changes of temperature are followed by a scalding 
sensation on urinating, a purulent discharge, and all the symp- 
toms common to the acute stage of the disease, thus making it 
as contagious as in the beginning. In the female, the symp- 
toms of this disease are very similar to those of leucorrhea, 
and only a knowledge of the previous history of the case can 
enable the physician to distinguish between them. 
Treatment. This affection is apt to be very intractable, 
hence, it should always be treated by a physician who has had 
large experience in its management. The specialists of our 
staff have treated many thousands of cases of this malady 
within the past twenty-five years, and have been wonderfully 
successful in curing it, without ever seeing their patients. They 
have frequently sent medicines hundreds of miles distant to 
those who have failed to get cured by home professional skill. 
Their success in this way has been truly marvelous, and has 
proved that cases which have lingered along under the care of 
several physicians need but little of the proper medicine to 
arrest the discharge and permanently cure the patient. 
A bad stricture or fistula, from sloughing of the tissues, which 
permits the urine to dribble away without control, is the penalty 
many a poor fellow has paid for neglecting to apply to those 
who have had great experience in the management of this affec- 
tion. Were it not that patients who have suffered from this 
disease feel delicate about being referred to, we could give the 
names of thousands whom our specialists have speedily cured, 
after they had been the rounds of the home physicians. The 
disease should not be neglected, for it is almost certain to cause 
stricture sooner or later, if allowed to progress unchecked. 
Slight but very troublesome strictures can only be discovered 
by the use of very delicate measuring instruments, introduced 
into the urethra. As we have before stated, the size of a normal 878 
COMMON SENSE MEDICAL ADVISER. 
or healthy urethra bears a regular and exact proportion to the 
size of the penis, and when the measurement of that canal 
shows it to be too small, means should be employed to enlarge 
its caliber to the proper size. For, unless this be done, gleet 
affecting a person in whom this condition exists will be found to 
be incurable; besides, the impeded flow of the urine, although 
the obstruction be slight, may cause serious disease of the blad- 
der, and it has frequently resulted in spermatorrhea and finally 
in impotency. 
INFLAMMATION OF THE TESTICLES. (Orchitis.) 
This is generally a complication of gonorrhea and is most 
frequent in the later stages of that disease. It is caused by the 
inflammation extending to the testicle, and is liable to follow 
the use of strong injections. It is also sometimes a complication 
of mumps. The left testicle is most often affected. The devel- 
opment of the disease is attended with pain, swelling, and more 
or less fever. The acute form sometimes becomes chronic, and 
the testicle remains enlarged, though the other symptoms are 
mitigated. Atrophy of the testicle sometimes follows orchitis 
resulting from mumps. 
Treatment. To avoid irritating the affected parts, the 
patient should assume the recumbent position, and the testicles 
should be supported with a pillow or cushion. In a majority of 
cases, warm applications are preferable to cold ones. For this 
purpose, a lotion composed of one ounce of muriate of ammonia 
and a pint of water will prove very beneficial. If the pain be 
severe, it will be necessary to apply and administer anodynes. 
As a liniment and sedative, Dr. Pierce's Compound Extract of 
Smart-weed is not excelled. If the disease is not promptly 
arrested, and the enlargement reduced, there will be difficulty in 
effecting a cure. It is, therefore, necessary to employ a skillful 
and experienced physician. 
SYPHILIS. (Pox.) 
With the exception of cancer, this is the worst of all diseases. 
Few persons have any idea of the extent to which it prevails. 
In its countless forms, it is sapping the sources of vitality and 
destroying beauty, vigor, and manhood. When the system is VENEREAL DISEASES. 
879 
once inoculated with syphilitic poison, unless the effects are 
promptly counteracted, the disease continually increases in viru- 
lence, manifests itself in multifarious forms, and may be trans- 
mitted to posterity. 
One generation may escape its effects, the disease cropping 
out in the next, and those affected, being ignorant of its nature, 
allow it to progress uninterruptedly. By the ordinary treatment 
for this disease, with mercury and sarsaparilla, the outward signs 
may disappear for a time, but, sooner or later, they will return, 
and perhaps with greater intensity. Many skin affections are 
evidently traceable to syphilitic infection. None of the tissues 
escape the ravages of this dreadful poison. The bones and 
muscles are destroyed by its corroding influence. The infected 
husband transmits the disease to his wife, and its indelible 
impress is stamped upon the germ. An infected wife may 
impart it to her husband and child, or the infant may become 
infected through the milk of its nurse. It may also be con- 
tracted through impure vaccine virus or in any manner by which 
the smallest quantity of virus is brought in contact with an 
abraded surface. 
Symptoms. Three successive stages mark the progress 
of this disease, namely: the primary, secondary, and tertiary. 
During the primary stage, chancres, or virulent ulcers, appear 
at the point of infection, while in the two latter stages, consti- 
tutional symptoms are manifested. The period - intervening 
between the time of exposure and the appearance of the local 
manifestation of the disease, varies from one to four weeks, 
seldom being longer. At first there is a little redness, then a 
pustule is formed, which soon breaks, leaving ' an open sore, 
usually under the covering and near the bridle of the penis in 
the male, or on the external • genital parts, in the vagina, or on 
the mouth of the uterus in the female. 
Hard Chancre. The infecting or hard chancre is always 
single, and surrounded by a hard border. This variety is repre- 
sented in Fig. 27, Colored Plate V. In this form, the local sore 
is small and usually unobserved until the virus enters the circu- 
lation and produces constitutional symptoms. 
Soft Chancre. Of the soft variety of chancre, two or 
more frequently appear at the same time. They sometimes 880 
COMMON SENSE MEDICAL ADVISER. 
coalesce and cause considerable destruction of the tissues, but 
are not surrounded by a hard border. This variety is well 
illustrated in Fig. 28, Colored Plate V. Fig. 24, Colored Plate 
IV, represents this form as it appears on the mouth of the 
womb. 
Bubo. After the local sores have existed for some time, 
small hard tumors or swellings appear in the groin, which 
enlarge and merge into one 
another until a blue tumor, 
called a bubo, is formed (see 
Fig. 245). It frequently 
attains the size of a goose 
egg, and sometimes disap- 
pears in a few weeks; at 
other times, it breaks and 
discharges, forming an open 
sore, which is healed with 
great difficulty. 
Eruptions. During 
the secondary stage of the 
disease, an eruption of cop- 
per colored spots may ap- 
pear upon the face and 
body. The hair sometimes 
falls out, and the glands in 
the back of the neck en- 
large, becoming very painful. 
Ulceration of the Throat. In the course of six or 
eight months, ulcers usually appear in the mouth and throat. 
They destroy the soft parts, as seen in Fig. 32, Colored Plate V, 
which is a good representation of these sores. Syphilitic pains 
are experienced in different parts of the system, especially 
harassing the patient at night. 
The eye is now liable to become affected. Inflammation of 
the iris, a condition well represented in Fig. 31, Colored Plate 
V, is a common complication. 
Lumps, called nodes, appear on the bones and finally ulcerate, 
causing decay and exfoliation. The bones of the shin, elbow, 
and forehead are most frequently affected. A fine illustration 
Fig. 245. 
Bubo. Plate V. 
Fig. 29. 
Fig 27 
Fig 28 
Fig 30 
Fig. 31 
Fig 32 VENEREAL DISEASES. 
881 
of syphilitic ulceration over the superficial bones is given in Fig. 
30, Colored Plate V. 
Syphilitic Catarrh, or ozaena, is a very common affec- 
tion. Ulcers appear in the nose and destroy the surrounding 
parts, so that the nasal passages and mouth often form one 
cavity, presenting a hideous appearance. 
The body is disfigured by eruptions, some of which appear in 
clusters, while others are spread over the whole surface. In 
some cases, they fester and break, and hard, thickened crusts are 
formed. They are exceedingly indolent. It is a peculiarity of 
these eruptions that one form often changes into another. 
Morbid Crrowths. Large morbid growths may appear 
about the arms or upon the external genital parts of the female, 
and sometimes elsewhere. These tumors are represented in Fig. 
29, Colored Plate V. It may be seen from the illustrations, that 
this is a most terrible disease; yet we have not shown the worst 
forms of the affection. 
What can be more loathsome than a being with the hair de- 
stroyed; eruptions covering the body; large, corroding open 
ulcers, nodes, or bony tumors, upon the forehead, the shins, and 
other thinly covered bones; the bones of the nose destroyed, the 
soft parts depressed, and the whole body emaciated, and the 
countenance blanched and haggard! Death itself is a welcome 
messenger to such a sad wreck of humanity. 
Treat men t. Under no circumstances can the patient ex- 
perience greater necessity for skillful treatment than in this 
disease; but, alas, how often is he duped by the promises of 
quacks, who assure a speedy cure. He swallows their useless 
drugs, only to find that his condition is but temporarily, if at 
all, improved. 
In the primary stage, the sore should be thoroughly cauter- 
ized, to destroy its specific character. Nitric acid, nitrate of 
silver, and chloride of zinc are the most efficient caustics. The 
first is to be preferred, and should be applied as follows: dip a 
small pine stick in the acid, and, after wiping off all superabun- 
dant liquid, apply it to every part of the sore. Afterwards 
apply a dressing of lint, saturated with a mixture composed of 
half a drachm of carbolic acid and an ounce of glycerine. At 
the end of a week, if the sore has not commenced to heal, the 882 
COMMON SENSE MEDICAL ADVISER. 
cauterization should be repeated. The cauterization must be 
thorough, in order to destroy every part of the virus in the sore. 
Constitutional treatment is indispensable, and should be per- 
sisted in even when no visible trace of the disease remains. No 
matter in what form the disease manifests itself, or what the 
complications may be, the cure depends mainly on constitutional 
treatment. This should be modified according to circumstances, 
as individual peculiarities necessitate changes. 
The diet ought to be nutritious. The skin, liver, and kidneys 
should be kept active, to favor elimination of the poison. Fre- 
quent bathing is beneficial, and the sulphurous acid, Turkish, or 
spirit vapor-baths are preferable. As constitutional treatment, 
Dr. Pierce's Golden Medical Discovery is an agent of inestim- 
able value in this affection, although there are cases in which it 
may fail to effect a cure. It can not be expected that a remedy 
adapted to so many diseases, should be sufficiently powerful to 
eradicate, in every instance, this terrible scourge. To accom- 
plish such a result, it would be necessary to introduce certain 
ingredients which would render it harmful if misapplied, as it 
might be by unprofessional people. 
The efficacy of the Discovery may be increased in severe or 
obstinate cases, by adding to each bottle from one-half to an 
ounce of the iodide of potassium, which can be had at any drug- 
store. If the kidneys be torpid, instead of the iodide, the same 
quantity of the acetate of potassium may be added to each 
bottle. The bowels should be kept regular. For this purpose, 
as well as to increase the efficacy of the other remedies, small 
doses of Dr. Pierce's Purgative Pellets should be daily adminis- 
tered. They are a powerful alterative when taken in such small 
doses that they do not produce active purging. Their use 
should be continued for a protracted period. The treatment 
must be persisted in for a considerable length of time, before its 
beneficial effects become apparent. This treatment, although 
good in all cases, if thoroughly carried out, will occasionally, on 
account of complications or peculiarities of constitution, require 
to be changed or modified somewhat in order to thoroughly 
cleanse the system of the virulent poison. Besides, in extremely 
obstinate cases, one class of alteratives or blood purifiers will, in 
a great measure, after several weeks' employment lose their VENEREAL DISEASES. 
883 
power to affect the system, and a change of alteratives is recom- 
mended. When this is made, improvement will generally go on 
rapidly again. In a disease fraught with such terrible conse- 
quences, the treatment should be of the best possible character, 
and continued until every vestige of the poison is fully elimin- 
ated from the system. This is the only safe course to pursue. 
We treat many thousands of cases of this disease every year 
without a visit or personal consultation, forwarding those spe- 
cific medicines which are adapted to each individual case by 
express. 
To prevent suppuration of buboes, treatment should be in- 
stituted as soon as they appear. Compresses wet in a solution 
composed of half an ounce of muriate of ammonia, three 
drachms of the fluid extract of belladonna, and a pint of water, 
are beneficial, and should be continuously applied. The tumor 
may be discussed by painting it once a day with tincture of 
iodine. 
The treatment of the eruptions should be mainly constitu- 
tional. Perfect cleanliness should be observed, and the sulphur, 
spirit vapor, or alkaline bath freely used. Good diet and the 
persistent use of the Golden Medical Discovery will generally 
prove successful. 
The morbid growths represented in Fig. 29, Colored Plate V, 
may be removed by the application of chromic acid to them, 
using the acid full strength, and applying the same as recom- 
mended for primary chancre. 
For syphilitic catarrh, employ the constitutional treatment 
already advised and use Dr. Sage's Catarrh Remedy. The 
nasal passages should also be cleansed, once a day, by a lotion 
composed of five or ten grains of permanganate of potassium 
dissolved in a pint of water, or one drop of carbolic acid to one 
ounce of water. 
Secondary ulcers, which occur over the superficial bones, can 
only be cured by the protracted use of the best alteratives and 
proper local applications. The sore should be cleansed daily 
with Castile soap and warm water, and then apply a lotion com- 
posed of one drachm of carbolic acid, one ounce of glycerine, 
and one ounce of water. Whatever topical or local applica- 
tions may be employed for any of the local manifestations of 884 
COMMON SENSE MEDICAL ADVISER. 
syphilis, the patient should never lose'sight of the fact that this 
reliance must be upon constitutional treatment. 
We advise every person afflicted with this terrible disease 
to procure the best professional skill. While the local and 
general treatment which we have advised in the primary or 
early stages, will accomplish all that is possible, if thoroughly 
employed, and while Dr. Pierce's Golden Medical Discovery, 
with the addition of the iodide of potassium, will cure many 
cases, yet the best of alteratives or blood-cleansing medicines, 
sometimes lose their control over the system after having been 
taken for a considerable time, and it is necessary to change 
them for other agents of the same class, in order to keep up the 
alterative action so essential to control this terrible disease. 
Therefore, we advise those who have pursued the foregoing 
treatment until it has accomplished all the good results which 
can be expected, to consult a physician of experience, and obtain 
special advice, in order to make the cure complete. 
Our vast experience in this disease has convinced us that the 
specific poison can be thoroughly eradicated from the system, so 
that the disease will not only never show itself in the subject, 
but so that the offspring will also be free from any taint. The 
length of time required in which to cure a case of constitutional 
syphilis depends somewhat upon the length of time the disease 
has existed, and the constitution, temperament, and habits of 
the patient. 
If appropriate treatment be taken before terrible destruction 
of the bones or extensive ulceration of vital organs and parts 
has occurred, the blood and system can be cleansed and reno- 
vated, and the disease will not re-appear. The treatment must, 
however, be perseveringly used. We can treat the secondary or 
constitutional forms of this disease successfully at a distance, 
without seeing the patient, and adapt remedies to the patient's 
requirements, from the knowledge of his condition which may 
be obtained from a written description of symptoms. It is use- 
less to patronize mineral and hot springs, drinking their waters 
and bathing in them, for the cure of this disease. Syphilis is 
never cured by such inefficient means. Something more active 
as an alterative is required. Sulphur, medicated, and chemical 
baths are far preferable to any natural mineral-spring baths, be VENEREAL DISEASES. 
885 
their temperature what it may. Hundreds of patients who had 
spent months at hot and other springs with little or no benefit, 
still suffering untold torments from constitutional syphilis in its 
worst forms, have been cured by the baths and other remedial 
agents employed at the Invalids' Hotel and Surgical Institute. 
At the Invalids' Hotel and Surgical Institute there is every 
facility for the successful management of this disease. But it 
is not absolutely necessary for a patient to enter a sanitarium in 
order to be cured, for we have successfully treated many cases 
at their homes without a personal examination, but when pos- 
sible, it is advisable that those suffering from this affection 
should be where, in addition to medicinal treatment, they can 
receive the benefits to be derived from sulphur, Turkish, and 
medicated baths. We cite a few cases out of the thousands 
which we have cured, to illustrate the character of the disease 
and the results obtained from appropriate treatment. 
„ CASES TREATED. 
Case 110,035. 
A youth, aged 18. He had noticed a small growth on the penis before 
applying to us. This had gradually increased in tenderness and size 
until he had become seriously alarmed. A small swelling appeared in 
the groin, and an abscess formed there which discharged considerable 
"matter," his throat was sore, and there was some falling of the hair, 
with evidences of a general decline in his health. After four months' 
treatment, he wrote that he felt that his disease was entirely under 
control. Two years afterwards, he wrote as follows: 
World's Dispensary Medical Association: Gentlemen-I am 
thankful to state that the brief course of treatment given me by you, 
effected a radical and permanent cure of my disease, as I have had no 
manifestation of the trouble since I was under your care. Please 
accept my sincere thanks. J., Fremont, Ohio. 
Case 110,057. 
This gentleman had been suffering from the effects of an ulcer that 
had appeared about six months previously. He had contracted the 
disease when in Arizona, and had been treated by many of the best 
physicians in the territory, and in St. Louis. During this treatment, he 
had been given mercury, iodine, and other preparations internally, 
together with the most severe caustic applications to the ulcer, but 
these had failed to relieve or improve him. On examination, we found 
a large phagadenic ulcer on the right side of the glans. There was 
enlargement in the glands of the groin and neck. He complained of 
considerable pain, and of an annoying and debilitating discharge. After 
a month's treatment, he left the Invalids' Hotel perfectly cured. Subse- 
quently he wrote as follows: 
World's Dispensary Medical Association: Gentlemen - I have 
to thank you for the radical and permanent cure in my case. After 
over eight months' time, no manifestation of the disease has appeared, 
nor has it given further trouble. After leaving your institution, there 886 
COMMON SENSE MEDICAL ADVISER. 
was no outbreak of the affection. I consider your treatment and insti- 
tution the most perfect in the country, and can most highly recommend 
others to your care. It is very gratifying for me to see so satisfactory a 
cure, after I had apparently exhausted all the resources of the best phy- 
sician. I consider that had I applied to you first, I would have been 
spared much suffering, and also the unpleasant effects of the poisons 
that were administered to me in the many unsuccessful attempts made 
to cure this disease. Y., Sinking Spring, O. 
Case 110,604. 
This single man, aged 29, held a prominent government position. 
He had contracted syphilis four years before consulting us. He was 
alarmed at his condition. He had suffered from sore throat, with fall- 
ing of the hair. A troublesome cough and night-sweats had reduced 
his strength until he was barely able to attend to business. A large 
sore had formed in the groin, and there was an unhealthy discharge 
from the urethra. He was suffering constantly from severe catarrh in 
the nose and throat. An examination of the chest was made, and the 
apex of the left lung was found to be seriously affected by a syphilitic 
deposit, and there was also severe bronchitis. After six months' treat- 
ment, he wrote: 
World's Dispensary Medical Association: Gentlemen - It is 
with pleasure that I inform you that the medicine sent me has effected 
most wonderful improvement. The night-sweats, headache, etc., have 
disappeared. The lungs are sound, the falling out of the hair has 
ceased, and these symptoms have left me permanently, as I have had no 
return of them, and it has been months since I discontinued the treat- 
ment. I am to-day the picture of health, and able to do a hard day's 
work without fatigue. You have my sincere thanks and best wishes 
for your success. M., Toronto, Ont. 
Case 111,004. 
This patient was a lady. She had suffered from syphilis for fifteen 
years. After being treated for four months, she wrote as follows: 
World's Dispensary Medical Association, Buffalo, N. Y.: Gen- 
tlemen-I am now well. I have used your special medicines for four 
months. I have thus far derived fully seventeen thousand dollars' 
worth of benefit. It is truly wonderful what an improvement your 
treatment has wrought in me in this short time; as a result, all my 
friends, many of whom expected to see me die, are inquiring about 
you and your system of treatment. 
Through your means I am to-day a happy woman, and I feel myself 
resting under life-long obligations to you. You may rest assured that 
I will do all I can to acquaint the community with your extraordinary 
skill in the cure of those obscure, difficult, and complicated cases that 
baffle the efforts of ordinary medical talent. 
Sincerely and gratefully yours, 
L., Springdale, Valiev Co.. Nebraska. 
Case 111,376. 
This gentleman, a German, wrote us that he had been sick for two 
years with syphilis. His tongue was badly coated. He was troubled 
with palpitation of the heart, and a burning sensation in the lower 
extremities; the urine was of a bad color, and he had the character- 
istic syphilitic eruption on the face. The stools were of an unnatural 
green or yellow color. He was low-spirited, and felt miserable in 
every way- He had taken the Golden Medical Discovery with the 
most decided relief, but wished to know if we could not send him VENEREAL DISEASES. 
887 
medicines to effect a more speedy and perfect cure of the constitu- 
tional disease. He took two months' treatment and some time after- 
wards wrote us as follows: 
World's Dispensary Medical Association: Gentlemen-I re- 
ceived your letter, and can confidently say that I am well. I have been 
examined by one of the best physicians in the State, and he has 
declared me perfectly healthy. Please accept thanks for my cure. 
T., San Antonio, Texas. 
Case 112,028. 
A single man, aged 22. He contracted the disease one year before 
coming under our care. He had spent several months at the Hot 
Springs, where he had received mercurial treatment, which had tempo- 
rarily benefited him. On his return home he became much worse. 
Large ulcers appeared, and he was covered with a copper-colored 
eruption, for which he consulted us. After six months' treatment, he 
reported as follows: 
World's Dispensary Medical Association: Gentlemen-I feel 
like a new man. The eruption disappeared with the first month's treat- 
ment, and the sores gradually healed. The flesh is sound and firm 
where they existed, and is not tender to the touch. Soon after com- 
mencing your medicines, I was relieved of the pains in my bones and 
other symptoms of the disease, and I have worked steadily while under 
your treatment. Thanking you, I am. yours, F., Renovo, Pa. 
Case 112.115. 
A single gentleman, aged 23. He contracted the disease when a 
youth at college, and had been under the care of several eminent phy- 
sicians, who had freely administered mercury and iodine. He was 
inclined to be melancholy, and his sleep was poor and disturbed by 
unpleasant dreams. His general appearance was that of a feeble, 
irritable, and emaciated invalid, with no desire to live, and no energy for 
work. His throat was sore, bones tender, stomach weak, and digestion 
poor. He remained one month in our institution, and then returned 
home with the intention of continuing our treatment at home for six 
months. Nearly a year after, he wrote: 
World's Dispensary Medical Association: Gentlemen-You have 
my heart-felt thanks for restoring my health. I have felt no symptoms 
of disease for months, and have therefore used no treatment. My cure 
was little less than miraculous. Yours, B., Kansas City, Mo. 
Case 170,113. 
A married man, aged 38. He had been troubled two years with 
syphilis in a severe form. He was frequently annoyed with ulcers in 
the mouth and throat. There was great general debility and loss of 
appetite. His digestion was greatly impaired, and, from the appear- 
ance of the ulcers in the mouth, and from the nature of the pains in 
the stomach, it was evident that there was also ulceration of the 
stomach. His disease had originated in what was thought to be a mild 
attack of but after some three or four months' time the 
usual symptoms of syphilis developed in copper-colored eruptions, sore 
throat, and falling of the hair. After two months treatment, he wrote: 
World's Dispensary Medical Association: Gentlemen - I eat 
and sleep well, and everything seems well. I am most happy to say 
that I believe I am perfectly cured, as I have felt no symptoms of my 
disease for the last four months. I am in perfect health. I can assure 
you that you have my best thanks and good wishes. I will do my best 
to recommend you and your treatment. Believe me when I say that I 
remain, Ever gratefully yours, B., Alliance, O. 888 
COMMON SENSE MEDICAL ADVISER. 
HERNIA. (Rupture, or Breach.) 
The term Hernia is applied to the protrusion of any viscus 
from the cavity in which it is naturally placed. In this article, 
however, its meaning is restricted to protrusions of the con- 
tents of the abdomen through the 
walls of that cavity. The most 
common varieties of hernia are 
umbilical, inguinal, and femoral. 
Children are most subject to um- 
bilical, males to inguinal, and fe- 
males to femoral hernia. 
Causes. These are either 
predisposing or exciting. Any- 
thing which occasions general or 
local muscular debility, such as 
dropsy, pregnancy, abscesses, 
wounds, or obstructions to natural 
evacuations, may be a predispos- 
ing cause of hernia. The excit- 
ing cause is pressure applied to 
the contents of the abdomen, such 
as that produced by straining in 
evacuating the bowels and blad- 
der, lifting heavy weights, or vio- 
lent physical exertion. 
Symptoms. The only char- 
acteristic symptom of hernia is 
the presentation of an elastic or 
doughy tumor of variable size, 
which either gradually or sud- 
denly makes its appearance. 
There is flatulence, uneasiness, and sometimes pain ft the ab- 
domen. 
Sharp and dull pains, frequently recurring and confined to 
the locations where ruptures appear, should receive attention. 
Examination not unfrequently reveals a small enlargement. If 
a hernia, this usually disappears after a night's rest and may 
not be again observed until the next day, or for several days 
Fig. 2Jfi. 
INDIRECT INGUINAL HERNIA. 
Sketched from a case subsequently 
cured by our improved method 
of treatment. HERNIA. 
889 
afterwards. If the finger is applied to the enlargement and 
the subject coughs, an impulse, caused by a slight additional 
protrusion, is felt. 
The affection may appear at any time of life. An analysis 
of seventy thousand cases has shown, that it is most common in 
debilitated persons, and that there is a constant decrease in the 
frequency of the affection from the first to the thirteenth year, 
after which rupture is more and more frequently met with as 
age advances. 
Inguinal Hernia, Fig. 246, is more common than all 
other forms of rupture. It is more frequently met with in men, 
and, when severe, a mass of 
intestine generally falls into 
the scrotum, producing an- 
noying symptoms by press- 
ing upon the testicle. The 
protrusion follows the sper- 
matic vessels and hence it 
usually appears low down in 
the abdomen and on one or 
both sides of the pubic bone. 
Femoral Hernia, 
represented by Fig. 247, is 
most common in women of 
mature life. It appears in 
the form of a tumor below 
the strong ligament in the 
groin which forms the line 
of separation between the 
thigh and the abdomen. On 
its outer side and close to 
it, can be felt the beating or 
pulsation of the large artery 
of the thigh. 
Umbilical Hernia, 
(see Fig. 248) appears at or 
near the navel and is most common in children. It may be 
present from birth, or it may result from fretting and crying at 
any period of childhood. 
Fit/. 2J>7. 
This figure illustrates a case of femoral 
hernia, which was subsequently cured at 
the Invalids' Hotel and Surgical Institute 
by our improved method. 890 
COMMON SENSE MEDICAL ADVISER. 
Sufferers from any form of rupture are constantly subject to 
the danger of strangulation. This occurs when, from any cause, 
the free return of the contents of the protruded part of the in- 
testine is prevented. It is an accident of a serious nature, inas- 
much as nearly fifty per cent, die, if not carefully operated 
upon, and, with the most skillful treatment, one out of every 
four cases terminates in death. 
Every individual should guard against rupture by maintain- 
ing, by proper exercise, diet, 
and rest, a condition of vigor 
and tonicity of the muscular 
system. 
When debilitated, all strains 
and exertions should be care- 
fully avoided until the health 
is built up, and the relaxation 
of the muscles is overcome. 
Treatment. The pallia- 
tive treatment of hernia con- 
sists in the reduction of the 
protruding part and its reten- 
tion in its natural cavity. Re- 
duction consists in returning 
the protruding intestine to its 
proper place through the open- 
ing by which it escaped. This 
is accomplished either by ma- 
nipulation or by a surgical op- 
eration. Retention is effected 
by wearing a mechanical appli- 
ance called a truss. 
As soon as the tumor pro- 
trudes or the intestine comes down, the patient should assume 
the recumbent posture, with his shoulders and feet elevated. 
The patient or an attendant should grasp the hernia, and, with 
gentle, but gradually increasing pressure upon the tumor, at- 
tempt to replace it. At the same time, the patient should knead 
the bowels upward by pressing upon the integument, so that the 
intestine may, as far as possible, be pushed away from the point 
Fig. 2Jp8. 
UMBILICAL HERNIA, 
Sketched from a case subsequently 
cured by our new method. HERNIA, 
891 
of protrusion. Sometimes the contraction of the muscular 
fibres at a point where the hernia makes its exit is so great that 
the tumor cannot be replaced. In this case, the system should 
be relaxed with lobelia, given in doses sufficient to produce 
nausea but not vomiting, and, as soon as the subject is thor- 
oughly under its influence, the manipulations should be resumed. 
When there is any diffi- 
culty experienced in 
putting back the hernia, 
or rupture, professional 
assistance should be 
promptly summoned. 
After the reduction of 
the rupture, a properly 
fitting truss should be 
applied and constantly 
worn, to prevent the pro- 
trusion of the intestine. 
There are several hun- 
dred varieties of trusses 
for sale. With the ex- 
ception of four or five 
kinds, which embody the 
correct principles of a 
proper truss, they are in- 
jurious. Unless proper 
support is given to the 
walls of the abdomen, 
without constant press- 
ure, a truss does harm; 
then, too, the shape of 
the pad must be such as 
to avoid pressure where it is not required; otherwise, as when a 
tight ring is worn upon a finger, there is a gradual loss of 
strength and a depression is formed in the healthy tissue, which 
can be plainly seen and felt. Such evil consequences may fol- 
low the improper application of a good truss. 
Surgical Treatment. When the hernia has become 
strangulated and cannot be returned by manipulation, a surgical 
Fig. 2$. 
Scrotal Hernia. 892 
COMMON SENSE MEDICAL ADVISER. 
operation is necessary. Whenever the necessity for such a pro- 
cedure is apparent, it should be performed immediately, for the 
greater the delay, the greater the liability to fatal results. The 
operation consists in cutting down upon the strangulated bowel, 
thus relieving it of its constriction and facilitating its replace- 
ment. It is a delicate operation, and should be skillfully per- 
formed. After the operation, the patient requires appropriate 
hygienic treatment. 
The Radical Cure. A small percentage of cures will 
follow the use of a good truss, and the advertisements of 
" rupture cures " are founded upon such cases. There are 
impostors who pretend that 
the use of some vaunted 
salve, ointment, or styptic 
lotion, applied to the out- 
side, will heal and cure the 
deep-seated separation of the 
muscular fibres. The truss 
in these cases is the curatife 
means in the small number 
which are relieved, and for 
it but a few dollars should be 
charged instead of the exor- 
bitant prices demanded. 
Fortunately there is a safe 
and certain cure for this un- 
pleasant and dangerous affec- 
tion. The process is a recent 
discovery in the art of sur- 
gery, and entirely does away 
with all necessity for cutting, 
stitching, and other opera- 
tions. No pain is experienced and no danger is incurred. 
While the treatment is such that it cannot be easily under- 
stood by the unprofessional reader, not thoroughly familiar with 
the minute anatomy of the parts involved, yet it may be proper 
for us to say that its object is to effect the obliteration and 
complete closing up, not simply of the rings and canal through 
which the intestine protrudes, but also of the full extent of the 
Fig. 250. 
This figure illustrates a Double Inguinal 
Hernia of large size. The left side, b, 
shows the direct descent of the bowel into 
the scrotum, c, while on the right side, a, 
the rupture is indirect, the bowel descend- 
ing through the internal ring and inguinal 
canal. HERNIA. 
893 
hernial sac, so as to interpose strong, consolidated, and firm 
tissues, and prevent the formation of a new breach. 
The personal attention of the surgeon for from two to four 
weeks is all that is usually necessary in the worst cases. During 
this time the patient is able to go about and even to attend to 
business or do light work. 
The following typical cases illustrate the wonderful results of 
this treatment. 
CASES TREATED. 
Case 111,210. 
A physician, aged sixty-two. He had a troublesome rupture caused 
by a fall from a wagon. Treatment was instituted to effect a radical 
cure, which was accomplished in three weeks. Four months' afterwards, 
the cure was perfect except that some weakness was felt on the opposite 
side, for which the patient was advised to wear a light bandage. He 
reported satisfactory results after nearly a year. 
Case 111,371. 
A man twenty-four years of age. His general health was good but 
he had a double rupture, represented by Fig. 250, which could not be 
held in place by any truss which he could obtain. It gave him severe 
pain and he could do no heavy work. Being a laborer, he was, there- 
fore, unable to earn his living. He was intelligent, and, had it not 
been for his deformity, would have been in good circumstances. The 
radical treatment was applied and in four weeks he returned home 
sound and well. A truss was worn six months, when at heavy work. 
A year afterwards, he wrote that the cure was perfect. 
Case 112,410. 
A man, aged fifty, with a rupture of fifteen years' standing, caused 
by lifting heavy weights when debilitated. The right side of the 
scrotum was filled with a mass of intestine the size of a child's head. 
Fig, 249 is a fair representation of the hernial tumor in this case. His 
health had been poor since the time of the first rupture, regarding 
which he had consulted a surgeon when he first suffered pain. His case 
was erroneously pronounced a varicocele and incurable. Supposing 
this to be his disease he came to us for treatment. He was weak and 
weighed at that time about 115 pounds, and suffered constantly from 
dyspepsia. After several days' treatment, the intestine was returned to 
the abdomen and the radical treatment carried out carefully. A cure 
was effected in forty days, and, after nine months, no weakness or 
rupture could be found by the surgeon. His dyspepsia was entirely 
relieved and had not troubled him since the operation. His weight had 
increased to 139 pounds, and he felt that he had a new lease of life. 
Case 112,813. 
A man aged twenty-two. He had a very troublesome rupture for 
which trusses gave very imperfect support and caused unpleasant symp- 
toms. He had suffered intensely from strangulation twice, for which 
he had to call a physician. The radical treatment was applied, and, in 
two weeks, a cure was effected. Ten months after, he wrote that the 
relief was worth thousands of dollars and that he considered the result 
perfect, no bandage or truss being necessary and no signs of the former 
weakness being felt. 
Case 111,371. 
Case 112,410. 894 
COMMON SENSE MEDICAL ADVISER. 
Case 113,400. 
This patient, a contractor, had been troubled over four years with a 
rupture. The cause was heavy lifting and over-exertion when debili- 
tated. The rupture could not be kept in place by a truss, but always 
came out when he was subjected to any sudden strain or jerk. His 
general health had been greatly impaired, and his debility was such 
that he had been forced to avoid all hard labor. He remained in our 
institution three weeks, and, during this time', was given a careful course 
of treatment for the rupture, which was perfectly cured. He returned 
home sound and well, and, after a period of six weeks, wrote that he 
had been somewhat careful in regard to the rupture, and it had not 
troubled him in the least, and he was sure his cure was perfect. 
Case 113,698. 
A single man, 34 years of age and by occupation a farmer. He had 
been troubled with a hernia on the left side for one year. He stated 
that although he had worn a truss, yet it seemed to give him no relief, 
and he was suffering constant pain. He had worked hard all the 
time, and at times his strength seemed to leave him entirely, due to 
the pressure of the intestine upon the testicle, when the rupture de- 
scended into the scrotum. We applied the treatment for the radical 
cure, and, at the end of two weeks' time, he was able to return home 
perfectly cured. The results of this operation have remained perfect, 
and he is able to labor as steadily as before the trouble appeared. 
LOCAL ANAESTHESIA. 
We cannot overestimate the benefits derived from the dis- 
covery of anaesthetics. The unpleasant and frequently distres- 
sing incidents formerly attending surgical operations are now 
avoided. In the majority of cases, besides producing insensi- 
bility to pain in the patient, the operation can be more perfectly 
performed, and the results are, therefore, more satisfactory. 
Local anaesthesia, or the production of insensibility only in a 
limited portion of the body, while the patient retains conscious- 
ness, is preferable to general anaesthesia, in those minor surgical 
operations which do not involve an extensive dissection of the 
tissues. Several means have been devised for producing local 
anaesthesia. The freezing process, or production of local insensi- 
bility by the application of intense cold, was, it is believed, first 
introduced and employed by Dr. James Arnot, of London. He 
applied a mixture of pulverized ice and salt to the affected part. 
This mixture has been employed by eminent surgeons, and with 
uniform success, yet it has not been generally approved by the 
profession. 
Among the more satisfactory methods devised, we prefer the 
one introduced by Dr. B. W. Richardson, as the most reliable. 
It consists in directing a spray of ether or rhigolene against the ACCIDENTS AND EMERGENCIES. 
895 
affected part. The apparatus used for this purpose is repre- 
sented by Fig. 251. The bottle is partially filled with ether or 
with a ' small quantity of rhigolene. It is provided with a 
slender tube, p, p, passing downward into the fluid, and through 
which the liquid flows upward, because of the pressure gener- 
ated by compressing the ball at the end of the rubber tubing. 
Fig. 251. 
Spray Apparatus for producing local insensibility to pain. 
When the liquid is thus forced upward and outward, it flows 
through the opening at the end of the tube and is there atom- 
ized by the current of air coming through the inner tube, R, R. 
The liquid being separated into such minute particles, rapidly 
evaporates, and thus freezes the part upon which it is thrown. 
The effect is momentary, and, therefore, harmless, for before it 
has lasted sufficiently long to injure the tissues, the operation is 
performed, and warmth and sensation have returned. We have 
frequently employed this mode of anaesthesia in lancing felons, 
in removing tumors, and in other minor operations, and always 
with the most satisfactory results. 
Accidents and emergencies which require immediate attention 
frequently occur. Professional aid cannot always be quickly 
ACCIDENTS AND EMERGENCIES. 896 
COMMON SENSE MEDICAL ADVISER. 
obtained, and hence fatal results often follow. It is, therefore, 
important that all persons should not only know how to proceed 
under such circumstances, but that they should be able to exer- 
cise that deliberation and self-control so necessary in emergen- 
cies of all kinds. Most persons are more or less affected by 
the sight of blood or severe wounds, and it requires an effort 
to maintain self-possession. One should act resolutely; other- 
wise he will find himself overcome and unable to render any 
assistance. 
WOUNDS. 
Wounds may be classified as incised, punctured, contused, 
lacerated, or poisoned. 
Incised wounds are those which are made with a sharp, cut- 
ting instrument, and are characterized by their extent of surface. 
Punctured wounds are made with a pointed instrument, and 
distinguished for their depth rather than breadth. 
Contused wounds are those produced by bruises. 
Lacerated wounds are those in which the flesh is torn and 
mangled. 
Poisoned wounds are made with a poisoned instrument, or by 
some poisonous reptile or insect or rabid animal. 
In all cases of wounds, the immediate danger is in the shock 
produced upon the nervous system, and in the liability to 
hemorrhage. 
Shock. If severe, the shock is attended with symptoms of 
extreme prostration, such as a feeble pulse, shivering, partial un- 
consciousness, fainting, hiccough, vomiting, and involuntary dis- 
charges of the urine and feces. 
Treatment of Shock. The clothing should be loosened 
immediately after the accident, so that the blood may have free 
circulation, and the patient should be kept in a recumbent posi- 
tion. He should have plenty of fresh air. Camphor or am- 
monia may be inhaled. If he can swallow, stimulants may be 
given, as whisky or brandy, but with care that they do not run 
into the trachea, or windpipe. If he be unable to swallow, they 
may be administered as injections, but should gradually be dis- 
continued as reaction takes place. A warm pillow placed at the 
back and the use of electricity may be beneficial. 
Hemorrhage, or bleeding, may generally be controlled ACCIDENTS AND EMERGENCIES. 
897 
by a compress, tourniquet, flexion of the joint, or styptics. A 
compress consists of several folds of cloth laid upon a wound, 
the edges of which have 
been brought together, and 
made secure by a moder- 
ately tight bandage. 
A tourniquet may be ex- 
temporized by rolling a 
handkerchief into a cord 
and tying it around the 
limb, over a compress, be- 
tween the wound and the 
heart. A stick should then 
be thrust between the handkerchief and skin, and twisted 
around several times, until the pressure is sufficiently great to 
arrest the circulation of the 
blood in the wounded part. 
A representation of this op- 
eration may be seen in Fig. 
252. 
Flexion of the joint, as rep- 
resented in Figs. 253, 254, and 
255, is adapted to many cases 
of hemorrhage. As water can- 
not flow through a rubber 
tube bent at a sharp angle, 
so the acute flexion of a limb 
prevents the free flow of blood 
through the arterial tubes. 
In some cases, styptics may 
be directly applied to the 
wounded tissues. Cold acts 
as a powerful styptic, and 
may generally be made avail- 
able for arresting hemorrhage. 
Poisoned Wounds. 
The treatment of these should 
chiefly consist in the prevention of the spread of the poison. 
This may be done by tightly applying bandages above the 
Fig. 252. 
The Field Tourniquet as applied. 
Fig. 253. 
Mode of employing- flexion for the 
arrest of hemorrhage from a wound 
located below the elbow. 898 
COMMON SENSE MEDICAL ADVISER. 
Fig. 25J±. 
Mode of employing flexion for the arrest of hemorrhage from a wound 
below the knee. 
Fig. 255. 
Mode of employing flexion for the arrest of hemorrhage from a wound 
located between the thigh and knee. ACCIDENTS AND EMERGENCIES. 
899 
wound and scarifying or sucking the parts. Nitrate of silver 
may then be used and the ligatures removed. Alcohol, in any 
form, is an antidote to snake poison. For the stings of insects, 
apply aqua ammonia, fresh earth, raw onion, plantain, or spirits 
of turpentine. 
FRACTURES AND DISLOCATIONS. 
The treatment of injuries received from the fracture of bones 
and the dislocation of joints should never be attempted by the 
inexperienced, nor should the management be left to incompe- 
tent physicians but skillful surgical aid should at once be sum- 
moned. 
SPRAINS. 
A sprain consists of a sudden and forcible stretching of the 
ligaments and tendons connected with a joint, without there 
being any dislocation. It is attended with severe pain and is 
followed by rapid swelling. 
The treatment should consist of measures to prevent inflam- 
mation, promote absorption, and restore a healthy action. The 
affected part should be kept at rest in an elevated position, and 
hot or cold water applied frequently. If there is much inflam- 
mation, fomentations of hops may be used. The Compound 
Extract of Smart-weed is an excellent application. 
When the acijte symptoms have disappeared, absorption 
should be favored by systematic rubbing and the application 
of stimulating liniments, or by the use of a well-adjusted band- 
age. Passive motion may be resorted to gradually and the 
subject may use the joint moderately. Should any stiffness 
remain, warm salt water douches should be employed and the 
Extract of Smart-weed applied once a day. 
BRUISES. 
Bruises or contusions are caused by falls, wrenches, or blows 
from blunt instruments, without breaking the skin. The soft 
tissues are lacerated and blood is poured out into them, consti- 
tuting ecchymosis. The discoloration passes through various 
shades from a bluish-black to a violet, a green, and finally, 
a yellow. 900 
COMMON SENSE MEDICAL ADVISER. 
If the bruise is severe, the affected part should be kept at 
rest and frequently bathed with the Compound Extract of 
Smart-weed or the tincture of arnica. If inflammatory symp- 
toms supervene, fomentations and poultices should be applied. 
FOREIGN BODIES IN THE NOSE. 
Foreign bodies, such as beads, peas, coffee-grains, and small 
gravel-stones are occasionally introduced into the nostrils of 
children, becoming fastened there, and causing great anxiety 
and alarm. If allowed to remain, they generally cause inflam- 
mation and suffering. 
Such bodies may generally be washed out by gently injecting 
a stream of tepid salt water with a syringe or Dr. Pierce's 
Nasal Douche. In no case should force be used. If this means 
fail, a competent surgeon should be consulted. 
FOREIGN BODIES IN THE THROAT AND 
AIR-PASSAGES. 
Foreign bodies are generally arrested so high up that they 
may be seen by simply depressing the tongue, and removed with 
the finger or a pair of forceps. The head should be thrown 
back in such a position as to cause the chin to project as little 
as possible beyond the prominence known as Adam's apple, in 
order that the finger or forceps may be readily introduced and 
the body released and ejected. When the foreign bodies are 
so small as to pass out of sight in the larynx, windpipe, or 
esophagus, it is generally difficult to extract them, and the 
services of a surgeon are required. Fortunately, however, 
there is not much immediate danger from suffocation in such 
cases. 
DROWNING. 
Recovery from drowning sometimes occurs when life is appar- 
ently extinct. The treatment, however, should be immediate 
and energetic, and should be given in the open air, unless the 
weather be too cold. 
Treatment. The patient should be gently placed upon the 
face with his wrists under his forehead. The tongue will then 
fall forward and the water run out of his mouth and throat, ACCIDENTS AND EMERGENCIES. 
901 
while the windpipe, or air-passage, will be free. To restore 
respiration, he should be instantly turned upon his right side, 
his nostrils excited with snuff or ammonia, and cold water 
dashed upon his face and chest. If this operation prove unsuc- 
cessful, replace the patient upon his face, care being taken to 
raise and support his chest, then turn the body gently on the 
side and quickly again upon the face. Alternate these move- 
ments about every four seconds, and occasionally change sides. 
When the body is turned on the face, gentle but efficient pres- 
sure should be made along the back, between the shoulder blades, 
to assist in forcing the air out of the lungs, but this pressure 
ought to be removed before the patient is turned back on his 
side. Persistently repeat this operation, and success will often 
be the reward. As soon as respiration is established, warmth may 
be promoted by the application of warm flannels to the body and 
bottles of hot water to the stomach, armpits, thighs, and feet. 
During the entire process of restoration, the body should be 
thoroughly rubbed upwards. Turning the body upon the back 
or handling it roughly should be avoided. The person should not 
be held up by his feet, or be rubbed with salt or spirits. Rolling 
the body on a cask is improper, and injections of the smoke or 
infusion of tobacco are injurious. Avoid the constant applica- 
tion of the warm bath, and do not allow a crowd to surround 
the body. 
FAINTING. 
When a person faints, he should be allowed to remain or be 
placed in a recumbent posture, and his clothing immediately 
loosened. The extremities should be rubbed, the patient per- 
mitted to have plenty of fresh air, and, if at hand, ammonia or 
camphor should be applied to the nostrils. 
BURNS AND SCALDS. 
The danger arising from burns and scalds depends not only 
upon the extent of surface involved, but also upon the depth of 
the injury. Burns are most dangerous when occurring upon the 
head, chest, or abdomen. 
Treatment. Soothing applications, and those which will 
exclude the air, should be made. Grated potato, poultices of 
slippery-elm, sweet oil, cotton saturated in a mixture composed 902 
COMMON SENSE MEDICAL ADVISER. 
of two or three grains of carbolic acid and two ounces of gly- 
cerine, and linseed oil and white lead, are all beneficial for the 
treatment of burns. If internal treatment be necessary, it 
should be given under the direction of a competent physician. 
In cases of sun-stroke, the patient should be at once removed 
into the shade. If the face is flushed, apply cold water to the 
head and neck, and mustard to the feet. The body should be 
bathed in tepid water and the head slightly elevated. If the 
countenance is pale, the symptoms denote exhaustion, and the 
patient should be kept in a recumbent position, the extremities 
rubbed, camphor and ammonia inhaled, mustard applied to the 
spine, and stimulants, such as brandy or whiskey, should be 
administered. 
SUN-STROKE. 
Poisons. 
Antidotes. 
acids. 
Acetic Acid. 
Citric Acid. 
Muriatic Acid. 
Tartaric Acid. 
Alkalies-carbonate of soda and potash- 
also lime and magnesia are antidotes to these 
poisons. As soon as the acid is neutralized, 
mucilaginous teas, such as flax-seed, gum 
arabic, or slippery-elm, may be given. 
Sulphuric Acid 
{Oil of Vitriol'). 
Soap, hi solution, or magnesia will counter- 
act its influence. Water should not be given 
as it causes great heat when mixed with this 
acid. 
Nitric Acid 
{Aqua Fortis). 
Oxalic Acid. 
Lime-water, carbonates of lime and magne- 
sia in solution, are the only antidotes. Give 
mucilaginous drinks. 
Carbolic Acid. 
There is no special antidote. Oil, glycer- 
ine, milk, flour and water, whites of eggs, 
magnesia, and flax-seed tea may be used. 
Prussic Acid. 
Laurel Water. 
Oil of Bitter Almonds. 
Ammonia, by inhalation or in solution, may 
be used. Apply a cold douche to the head. 
These agents are speedily 
fatal. 
POISONS AND THEIR ANTIDOTES. POISONS AND THEIR ANTIDOTES. 
903 
Poisons. 
Antidotes. 
alkalies. 
Liquor of Ammonia. 
Water of Ammonia. 
Muriate of Ammonia. 
Vegetable acids, such as vinegar, lemon- 
juice, citric and tartaric acids, neutralize this 
poison. 
Liquor of Potassa. 
Nitrate of Potassa 
(Saltpetre). 
Carbonate of Potassa 
(Pearlash). 
Salts of Tartar. 
All the fixed oils, such as linseed, castor, 
and sweet oil, also almonds and melted lard, 
destroy the caustic effects of these poisons. 
Mucilaginous drinks may be given. 
IODINE. 
In its different forms. 
Starch, wheat flour mixed with water, 
whites of eggs, milk, and mucilaginous 
drinks are excellent antidotes. 
VOLATILE OILS AND 
AGENTS. 
Creosote 
(Oil of Smoke). 
Oil of Tar. 
Oil of Turpentine. 
The same antidotes as in case of poisoning 
with iodine may be used in this, or the stom- 
ach may be evacuated with an emetic or a 
stomach-pump. 
ALCOHOL. 
A powerful emetic of white vitriol or mus- 
tard should be given at once, cold should be 
applied to the head, and the extremities vig- 
orously rubbed. 
ANTIMONY AND ITS 
COMPOUNDS. 
Tartar Emetic. 
Butter of Antimony. 
Oxide of Antimony. 
If vomiting has not occurred, induce it by 
tickling the throat and giving large draughts 
of warm water, after which administer astrin- 
gents, such as infusions of galls, oak-bark, 
Peruvian bark, or strong green tea. 
ARSENIC AND ITS COM- 
POUNDS. 
White Arsenic. 
Yellow Sulphuret of Ar- 
senic. 
Red Sulphuret of Ar- 
senic. 
King's Yellow. 
Fly Powder. 
Arsenical Paste. 
Arsenical Soap. 
Scheele's Green. 
Paris Green. 
Oils or fats, lard, melted butter, or milk 
should be given, then induce vomiting with 
sulphate of zinc, sulphate of copper, or mus- 
tard; fine powdered iron rust or magnesia 
may be given every five or ten minutes. 
Mucilaginous drinks should be given as soon 
as the stomach is evacuated. 904 
COMMON SENSE MEDICAL ADVISER. 
Poisons. 
Antidotes. 
COPPER AND ITS COM- 
POUNDS. 
Blue Vitriol. 
Verdigris. 
Avoid the use of vinegar. Give albuminous 
substances, such as milk, whites of eggs, wheat 
flour in water, or magnesia; yellow prussiate 
of potash in solution may also be given freely. 
LEAD AND ITS COM- 
POUNDS. 
Acetate of Lead 
(Sugar of Lead). 
White Lead. 
Red Lead. ■ 
Litharge. 
In lead, or painters' colic, purgatives and 
anodynes may be given, together with large 
doses of iodide of potassium. 
MERCURY AND ITS COM- 
POUNDS. 
Corrosive Sublimate. 
White Precipitate. 
Red Precipitate. 
Calomel. 
Albumen in some form should be given; if 
the poison is not absorbed, follow with a 
mustard or lobelia emetic. 
ACRONARCOTICS. 
Ergot. 
Black Hellebore. 
Veratrum Viride 
{American Hellebore). 
Aconite. 
Fox-glove. 
Gelseminum. 
The general treatment indicated for this 
class of poisons, is to evacuate the stomach 
with a stomach-pump or an emetic composed 
of fifteen or twenty grains of sulphate of 
zinc oi- copper, or large doses of mustard, re- 
peated every quarter of an hour until the 
full effect is produced. 
Belladonna. 
Stramonium. 
Morphine, sassafras, iodine, and stimulants. 
Nux Vomica. 
Strychnia. 
Large doses of camphor, chloroform, and 
tobacco, may all be beneficial. 
Poison Oak. 
Poison Vine. 
Muriate of ammonia, in solution, may be 
applied externally, and from ten to fifteen 
grains given internally; soda is also useful. 
NARCOTICS. 
White Henbane. 
Opium. 
Sassafras may be used as an antidote 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. 
Spanish Fly. 
Potato Fly. 
Excite vomiting by drinking sweet oil. 
Sugar and water, milk, or linseed tea in large 
quantities, and emollient injections are valu- 
able. APPENDIX. 
STRICTLY CONFIDENTIAL. 
We regard all communications, both oral and written, as 
strictly confidential, and we have, therefore, omitted to give 
the names of those patients whose statements and letters we 
have quoted. Hence, the President of the World's Dispensary 
Medical Association has made the affidavit here published. 
AFFID I T_ 
STATE OF NEW YORK, 
County of Erie. 
•ss. 
Dr. R. V. Pierce, of the City of Buffalo, County of Erie, 
and State of New York, being duly and solemnly sworn, 
declares that all statements of cases, letters, extracts from 
letters, and testimonials of skill, published in this book, 
are all genuine and true statements and letters, and quota- 
tions from letters, received either by him or the World's 
Dispensary Medical Association, and that the said letters 
are now on file at the Invalids' Hotel and Surgical Insti- 
tute, and that they are but fair samples of numerous others, 
on file, and'of those daily received. 
R. V. PIERCE, M. D., 
President of the World's Dispensary Medical Association. 
Subscribed and sworn to before me, this 12th day of Feb'ry, 
A- D., 1885. p. W. Dorris, 
[seal.] Notary Public, County of Erie, State of New York. 
905 IN THE TREATMENT OF 
CHRONIC DISEASES. 
We have, in different parts of this work, referred to a large 
variety of ingeniously devised machinery and apparatus em- 
ployed at the Invalids' Hotel and Surgical Institute, in the 
treatment of chronic diseases. Although we can, on paper, 
give but a meagre idea of the variety and adaptability of these 
valuable mechanical appliances, yet we will endeavor to illus- 
Fig. 1. 
The Manipulator. 
trate and explain a few of our machines for the application of 
transmitted motion. 
Fig. 1 represents a machine, called the Manipulator, which 
transmits motion through suitable attachments, which are 
adjustable by means of the ratchet G, so as to reach all parts 
of the body. It is equally available for applying motion to the 
head, feet, or any intermediate part of the body. 
906 APPENDIX. 
907 
B, B are rubbing attachments, with two opposing elastic, 
adherent surfaces, between which an arm or a leg may be 
included. These have alternate reciprocating action from the 
rock-shaft II, and are made to approach each other, and press 
the included part at the will of the patient. This is sometimes 
called the double-rubber, and is made detachable if desired. 
A is the lever, by which the two parts of the double-rubber 
are made to compress the arm or leg. 
D is a single attachment for rubbing. It may be connected 
at either side of the machine, so as to present the rubbing 
Fig. 2. 
Fig. 3. 
Manipulator Extended. 
Manipulator Folded. 
surface in four different directions, as may be most convenient. 
It will act perpendicularly, horizontally, or diagonally, and from 
below or from above the part receiving the action, according to 
requirements. The shank of the rubber may have any special 
form to suit special cases. 
C is the foot holder. It communicates to the leg the semi- 
rotary or oscillating motion of the rock-shaft. It may be 
attached to either end of the rock-shaft. 
E is the hand holder, which, grasped by the hand, com- 
municates motion to the arm, shoulder, and chest; or the hand 908 
APPENDIX. 
may be inserted passively, when the effect of motion is more 
confined to the hand and fore-arm. 
In the position shown in Fig. 2, by means of the single- 
rubber attachment, the manipulator acts upon the upper por- 
tion of the trunk, neck, 
head, and arms; by means 
of the hand-holder, upon 
the arms ; by means of the 
double-rubber, upon the 
arms, shoulders, and scalp. 
When the acting part or 
head is lowered to its ex- 
treme limit, the machine 
occupies the least space. 
In this position, by means 
of the foot-holder, it com- 
municates oscillation to the 
legs; by means of the single- 
rubber, it acts upon the feet, 
ankles, and lower leg; by means of the double-rubber, it acts 
upon the legs, including the feet, the patient either sitting or 
lying. 
In all of these applications of motion, energy travels from 
inanimate to animate matter; non-vital contributes to vital 
energy; and the various pro- 
cesses through which vital 
power is developed are pro- 
moted and carried forward 
in a degree till the point 
which constitutes health is 
attained. 
The name, Manipulator, is 
very naturally applied to the 
instrument, the action of 
which resembles so much that 
of the living operator. It is, 
however, impossible for the 
unaided hand to impart the degree of rapidity necessary 
to secure the effects easily attained by this machine; and, 
Fig. Jf. 
Rubbing the Arms. 
Fig. 5. 
Rubbing the Legs. APPENDIX. 
909 
practically, restoration is otten secured m cases in which it is 
quite unattainable by any other remedial agent. 
Motion, transmitted by the manipulator, exerts a curative 
effect in all chronic affections, and is not limited, as is some- 
times supposed, to para- 
lytic affections and de- 
formities. In these latter 
affections it is a great 
assistance in effecting a 
cure; while, in chronic 
affections, whatever the 
local symptoms, it sup- 
plies the additional en- 
ergy which is indispen- 
sable for recovery in all 
diseases of long standing. 
Mode of Operation.- 
Fig. 4 represents the ma- 
nipulator in operation. 
The machine is propelled 
by steam power at the Invalids' Hotel and Surgical Institute, 
but may be worked by hand, as here represented. One arm is 
inserted between the double-rubbing pads, which are raised to 
about the height of the shoul- 
ders, the patient being seated 
at the side of the machine; 
the other hand is placed on 
the lever, and as much press- 
ure is applied as is perfectly 
agreeable, care being taken to 
diminish the pressure at any 
part which is unusually sensi- 
tive. All portions of the arm 
from the shoulder down are 
successively included in the 
rubbers, while a suitable de- 
gree of reciprocating or rub- 
bing action is obtained by giving motion to the wheel. 
To apply the same operation to the other arm, the patient 
Fig. 6. 
Rubbing the Chest and Abdomen. 
Fig. 7. 
Rubbing the Back. 910 
APPENDIX. 
may either turn in his seat or change his position to the 
opposite side of the machine. 
If any portion of the extremity is affected with inflammation 
or swelling, it is necessary to apply the action described to the 
whole of the unaffected por- 
tion first; after this the 
affected part may be bene- 
ficially operated on, provided 
that the sensations are strictly 
heeded, and that it is so man- 
aged that only a comfortable 
feeling is produced. 
In Fig. 5, the patient is so 
seated beside the machine 
that he can insert one thigh 
between the pads of the rub- 
ber; and also control the lever 
with the hand. It is some- 
times more convenient to sus- 
pend a movable weight from the lever. While the machine is 
running, he can withdraw the leg gradually, as each portion 
receives its proper amount of action, till the whole, including 
the foot, becomes glowing with 
the effect. The boot or shoe 
affords no impediment to the 
effect, and should remain on. 
To subject the other leg to 
the same movement, it is nec- 
essary to change position to 
the opposite side. 
This operation can be ap- 
plied to those who are ex- 
tremely feeble, in the reclining 
position, by the aid of an ex- 
tension chair or couch. 
Sometimes, especially in the 
beginning, or when the feet are habitually cold, it is better to 
apply the action only from the knees down. 
The rubbing-pad (d) may be attached to either side of the 
Fig. 8. 
Oscillating the Arms and Chest. 
Fig. 9. 
Oscillating the Legs. APPENDIX. 
911 
machine, according to convenience or effect sought. The action 
derived from the right end of the rock-shaft is much less severe 
than that from the left, on account of the shape of the rubber 
appendage, and at the beginning should be used in preference. 
In Fig. 6, the patient sits on an ordinary stool, or, if feeble, 
in a chair, and presents any portion of the chest or abdomen 
to the action of the rubber. The instrument is raised or low- 
ered to suit convenience, while the patient gently presses por- 
tions of the trunk successively upon the rubbing-pad. The 
degree of the effect is thus always under the absolute control 
of the one receiving the action. This operation, like the pre- 
ceding, produces great heat, reddens the skin, relieves pain, 
Fig. 10. 
Vibrator operated by Manipulator. 
and greatly stimulates the functions, not only of the skin, but 
of the organs contained in the cavities of the chest and the 
abdomen. 
The same operation may be applied also to the legs while the 
patient is standing. 
In Fig. 7, the back is presented to the action of the rubbing- 
pad. The action will, if desired, be made to reach from the 
neck to the hips, and even to the thighs. All sensitive portions 
of the back should at first be omitted, in order that they may 
be benefited by the counter-irritation or drawing away of the 
blood. This is easily produced by those familiar with the use 
of the machine. The rubbing of the back should be deferred 
till the close of each application, in order that the spinal centers 
may be relieved of hyperaemia, or excess of blood. 912 
APPENDIX. 
The machine, as represented by Fig. 8, is brought to the 
desired elevation, about as high as the shoulders, and the 
hand-holder is attached. One arm is extended horizontally, 
and the hand grasps the hand-holder, while rapid motion is 
given by turning the wheel. An alternate twisting motion is 
communicated to the arm, which causes corresponding pressure 
and relaxation of all the soft tissues of the limb, combined with 
slight rubbing or attrition. The action is increased by con- 
tracting the muscles, and also by grasping at greater distance 
from the center. Both hands may grasp at the same time, or 
the two sides may receive the motion in turn. The effect is 
Fig. 11. 
Vibrating Kneader. 
similar to that of the rubbing before described, but it is less 
limited; by grasping firmly, it may extend to the whole chest. 
The foot-holder is attached, as shown in Fig. 9, and brought 
by the means before described to a position to receive one foot 
at a comfortable elevation, the leg being extended, while the 
patient is seated in an ordinary chair in an easy position. The 
action is precisely like that above described as applied to the 
arm, and extends to the thigh and pelvis. If the knee is 
slightly flexed, the action is almost entirely confined to the 
lower leg. Each leg may be operated on in turn. 
Mode of Applying Mechanical Movements to Very Feeble 
Invalids.-Experience demonstrates that no degree of feeble- 
ness excludes the beneficial use of these operations. Invalids APPENDIX. 
913 
too weak to stand, or able to help themselves in the least degree 
are often treated with perfect success. A judicious use of the 
Manipulator always increases nutrition and strength without 
any fatigue or exhaustion, however feeble the patient may be. 
It is only necessary to provide for these cases additional con- 
veniences, so that the applications can be made in the recumbent 
position, and also that proper intervals of rest be allowed be- 
tween successive operations. For this purpose couches are pro- 
vided, each containing a certain portion of the Manipulator. 
These are operated by means of a short connecting-rod, joining 
the rock-shafts of the two pieces of mechanism, as shown in Fig. 
10. The Vibrator has two small discs, or heads acting through 
Fig. 12. 
Apparatus for Rubbing- in a Recumbent Position. 
an opening in the couch on which the invalid rests. These im- 
pinge with a rapid, direct stroke upon the portion of the body- 
exposed to the action. The top of the couch is adjustable, and 
is quickly placed at the elevation which secures the proper force 
of the instrument, as shown in Fig. 11. By simply turning and 
moving the body, the patient brings any part into contact with 
the vibrating discs. The cut represents the Vibrator, in which 
the force impinges at right angles with the surface of the body, 
sending waves of motion through its substance. 
The rubbing which is shown in Figs. 4 and 5 may be applied 
to all parts of the body in a recumbent position. A couch is 
required of similar construction to the vibrating couch, but with 
a rubbing-pad instead of vibrating heads acting through the 914 
APPENDIX. 
opening and operated by appropriate connections, as shown in 
Fig. 12. The top is adjustable, and the degree of effect desired 
is capable of easy regulation. The patient turns different por- 
tions of the body to the action of the rubber as required. 
Kneading. Kneading is a process applied chiefly to the 
abdomen. The purpose of this operation is to increase nutri- 
tion, the muscular power and action of the abdominal walls, and 
the function of the organs which they contain. Three modes 
of applying this operation by the mechanical apparatus are in 
use, effected by the Direct, the Rotary, and the Revolving 
Kneader. 
The Direct Kneader. This resembles in form and 
Fig. 13. 
Apparatus for Rotary Kneading. 
action the vibrating instrument shown in Fig. 11. The imping- 
ing heads, however, are made broader, the motion greater in 
extent, and the rate of motion less than one-tenth of that em- 
ployed for the purpose of vibrating. This slowness of motion 
seems to increase the action of the muscles. 
The Rotary Kneader. The action of the kneading 
heads in this form of apparatus, as shown in Fig. 13, is inward 
and upward alternately, and it is eminently well calculated to 
stimulate the action of the abdominal organs. 
The Revolving1 Kneader. In the form of kneading 
apparatus, shown in Fig. 14, two thick rollers, which move 
freely on axes at the extremities of arms, projecting on either APPENDIX. 
915 
side of a shaft turned by a crank or belt, are made to act alter- 
nately upon each side of the abdomen. 
In the methods of kneading above described, the degree of 
force acting on the body is governed by an arrangement for 
elevating or depressing the upholstered top of the couch upon 
which the patient rests, and through which the action is trans- 
mitted to the body. 
If this form of apparatus is driven at a rate ten times more 
rapidly than is desired for kneading, the effect is vibratory, and 
it is, in fact, used for that purpose. 
THE CURE OF SWELLINGS AND TUMORS. 
The application of motion through the Manipulator promotes 
absorption, and thus all kinds of swellings and non-malignant 
Fig. 74. 
Apparatus for Kneading with Rollers. 
tumors are made to diminish under its use. In these cases the 
vessels of the affected part are distended with stagnant blood, 
and a portion of the fluid passes through their walls, distending 
the surrounding tissues, which become more or less hardened. 
By the transmission of active motion to the affected parts, the 
contents of the vessels are urged forward; the outside fluids are 
thus permitted to return to the general circulation and become 
subject to the energetic vital action of the general system, local 
deficiencies of oxidation being increased to the normal degree, 
causing destruction of morbid matter and giving place for new 916 
APPENDIX. 
and wholesome nutritive materials for vital use. In short, nor- 
mal functional activity is established, both locally and gener- 
ally. Scrofulous, dropsical, rheumatic, and other local accumu- 
lations disappear, and even tumors are dispersed, by the use of 
the Manipulator, in cases in which the knife would otherwise be 
required. 
Artificial means have always been employed to produce an 
energetic flow of blood in different parts of the body, thereby 
relieving morbid distention of the vessels, and consequent irri- 
tation and pain in neighboring parts. Cupping, hot applica- 
tions, mustard, capsicum, blisters, and other irritants, are resorted 
to, but their effects, while generally very good in acute cases, 
are too transient to be of material aid in chronic affections. 
By the use of the Manipulator, we can produce the most thor- 
ough revulsive effects, operating upon large surfaces, and caus- 
ing large masses of muscle to receive an increased amount of 
blood, thus drawing it away from parts oppressed by too great 
a supply, constituting engorgement. No injury is done to the 
parts acted upon; on the contrary, they are strengthened by 
the application, which can be repeated as often as necessary 
till relief is permanent. Thus, the head, heart, digestive organs, 
liver, chest, or whatever part is oppressed by excess of blood, 
may be speedily and permanently relieved. By means of this 
ability to relieve any part of the system from engorgement, and 
consequent inflammation and its results, are we enabled to per- 
manently cure a large variety of chronic inflammatory, ulcer- 
ative, and nervous affections. 
Local inflammations by this method of treatment may be 
speedily cured. 
COUNTER-IRRITATION AND REVULSION. 
By the transmission of motion through the Manipulator and 
other ingeniously devised apparatus and machinery, we increase 
the functional power and activity of the muscles, and thereby 
diminish morbid sensibility of the nerves, which is present in 
neuralgia. Prolonged and excessive nervous action is attended 
with too great a rush of blood to the nerve-centers, which can 
CURE OF NEURALGIA. APPENDIX. 
917 
only be relieved by increasing the flow in the muscles. Con- 
gestion, or hypersemia, in the spinal cord or brain, or both, 
is a condition ever present in neuralgia. The application of 
motion through the manipulator causes the blood to flow to 
the muscles, thus relieving nervous congestion and consequent 
neuralgia. 
CURE OF PARALYSIS. 
In no single disease has the transmission of motion through 
the Manipulator proved more thoroughly efficacious than in 
paralysis. The most prominent requirements in these cases 
seem to be the following: 
Excess of blood in the brain and spinal cord needs to be re- 
moved and diverted to parts in which it will be useful instead 
of obstructive. 
The contractile power of the capillaries should be improved. 
The quality of nutritive fluids should be improved by the 
promotion of oxidation through increased circulation. 
These and many more wants of disordered nerves, are readily 
supplied by transmitted motion. 
The Manipulator combines, in a single ingenious mechanical 
contrivance, the several movements best adapted for the promo- 
tion of healthy functional activity. 
CURE OF DEFORMITIES. 
Deformities arising from paralysis and contractions of mus- 
cles and tendons, producing stiffened joints and distorted limbs, 
are of common occurrence. A rational explanation of the 
wonderful curative results which follow the employment of 
transmitted motion in these cases may not be without interest 
to the reader. The muscles are composed of bundles of little 
fibers which glide upon one another in every movement. An- 
other set of fibers called connective tissue, holds the fibers 
together in bundles or separate muscles, and interlaces and 
crosses them in every direction. Now, if these fibers remain 
long in a fixed position, or are involved in inflammation, there 
is danger of adhesions forming between them, producing per- 
manent immobility; gliding movements are interfered with, 
and the muscle ceases to perfoim its function. Inflammation 918 
APPENDIX. 
gives rise to effusion, or the formation of a kind of cement 
which binds together the muscular fibers and prevents motion. 
Rubbing, kneading, and actively manipulating the affected 
parts with that intensity of administration secured by the 
manipulator, rends asunder and breaks up 
these minute adhesions, re-establishing glid- 
ing motions, causes absorption of effused 
materials, and restores the affected part to 
a normal condition. 
The deformed limb is straightened by 
the filling out of the muscle - cells, and 
increasing the length and also the nutri- 
tion of the affected muscles. No pulling 
or forced extension is required. Deformity 
ceases when the conditions upon which it 
depends are removed by rational appli- 
ances, which are always agreeable. No 
brace, splints, or other confining appliances are necessary, 
except in rare cases in which the bones are very badly 
distorted. 
In withered and deformed limbs, resulting from infantile 
paralysis, the manipulator furnishes the most agreeable, direct, 
and certain remedy. It restores nutrition, sensation, and power, 
and dispenses almost wholly with mechanical supports. Club- 
feet, wry neck, spinal curvature, hip-joint disease, white swell- 
ings, and stiffened joints, are all readily amendable to the cur- 
ative effects of motion administered by the manipulator and 
other machinery. 
Contracted and shortened muscles are gradually lengthened 
by vigorous, long-continued, and frequently repeated rubbing 
with the manipulator across their longitudinal fibers; bound- 
down and confined tendons are liberated and normal movements 
established. 
Fig. 15. 
Muscular fibers highly 
magnified. 
DISEASES OF WOMEN. 
Uterine and ovarian congestion, chronic inflammation, dis- 
charges, morbid enlargement, prolapsus, anteversion and retro- 
version, anteflexion and retroflexion, and other derangements of 
the womb and its appendages, are radically cured by the vibra- 
tory, rubbing, kneading, and other movements, administered APPENDIX. 
919 
through the manipulator and other mechanical appliances em- 
ployed at the Invalids' Hotel and Surgical Institute. 
To those who are tired of taking medicine, this mode of treat- 
ment commends itself as being both agreeable and efficient. 
There is no case too weak, nervous, or helpless for the use of 
this curative agent. It is entirely devoid of objectional feat- 
ures, being always applied outside the clothing. 
Cause of Female Weakness. The true relations of 
cause and effect are very liable to be misunderstood, when con- 
sidering the various diseases incident to the organs contained in 
the female pelvis. Treatment intended to be remedial is there- 
fore very often misdirected and fails to afford relief, positive 
injury frequently resulting instead. When the nature of these 
diseases is properly understood, their cure can be effected with 
comparative ease. 
These diseases are always attended with weakness, which is 
often very great, of the muscles that hold the diseased organs in 
position. The muscles forming the walls of the abdomen, and 
the diaphragm, or midriff, all of which are concerned in the 
act of respiration, become feeble and only partially perform 
their functions. In health, they act constantly, even during 
sleep, producing a rhythmical movement, which is communicated 
to the contents of the abdominal and pelvic cavities. This 
motion promotes a healthy circulation in the parts. In almost 
all affections of the pelvic organs, this normal condition is 
greatly diminished. 
Diminution of the motions of respiration is attended with an 
increase of the amount of the blood in the pelvic organs, consti- 
tuting an engorgement of the parts, called congestion, or inflam- 
mation. This gives rise to enlargement of the womb, ulcera- 
tions, tumors, and a multitude of kindred secondary effects, 
usually considered as the primary disease and treated as such. 
The contents of the cavity of the trunk, weighing several pounds, 
are allowed to gravitate down and rest upon the contents of 
the pelvis, forcing the congested uterus and ovaries down out of 
their natural positions, and often bending or tipping the womb 
in various directions. A long list of symptoms follows as the 
natural consequence of these abnormal conditions. 
Rational Treatment. Ovarian congestion and inflam- 920 
APPENDIX. 
mation, inflammation of the uterus, ulceration of this organ, 
deranged menstruation, leucorrhea with the attendant pain, 
nervousness, and other derangements depending upon loss of 
supporting power in the abdominal muscles, all result from loss 
of the natural motions of respiration, and consequent deranged 
circulation. These several conditions can be cured by removing 
their cause. When the power of the parts involved in the 
weakness is restored, all these morbid conditions disappear. 
Judicious cultivation of power in the weakened supports is 
attended with certain curative results. This is best accom- 
plished by mechanical motion, by which the normal circulation 
is restored, inflammations and congestions are subdued, dis- 
placements corrected, ulcers healed, and functional activity is 
re-established. 
RECAPITULATION. 
Motion properly transmitted to the human system by mechan- 
ical apparatus is transformed into other forms of force identical 
with vital energy, by which the ordinary processes of the system 
are greatly promoted. 
It increases animal heat and nervous and muscular power to 
the normal standard. 
It removes engorgement or local impediments to the circu- 
lation. 
The electrical induction produced renders it a most efficacious 
remedy for paralysis of all kinds. 
It removes interstitial fluids and causes rapid absorption and 
disappearance of solid and fluid accumulations. 
It is a powerful alterative, or blood-purifier, increasing oxida- 
tion and stimulating excretion. 
It diminishes chronic nervous irritability and promotes sleep. 
Deformities are easily cured without the cutting of tendons, 
or use of mechanical supports. 
It hardens the flesh by increasing muscular development and 
improves digestion and nutrition. World's Dispensary Medical Association 
Incorporated under Statute Enacted by the Legislature of New York. 
Dr. R. V. Pierce, having acquired a world-wide reputation 
in the treatment of Chronic Diseases, resulting in a professional 
business far exceeding his in- 
dividual ability to conduct, 
some years ago induced several 
medical gentlemen of high pro- 
fessional standing to associate 
themselves with him, as the 
Faculty of the World's Dis- 
pensary and Surgical Institute, 
the Consulting Department of 
which has since been merged 
into the Invalids' Hotel. The 
organization is duly incorpo- 
rated under a statute enacted 
by the Legislature of the State of New York, and under the 
name and style of the " World's Dispensary Medical Asso- 
ciation," of which Dr. Pierce is President, and in the affairs 
of which he will, as heretofore, take an active and constant part. 
EUROPEAN BRANCH, No. 3 New Oxford Street, LONDON, Eng. 
IMPORTANT ANNOUNCEMENT. 
Dr. R. V. Pierce, having in the Fall of 1880 resigned his 
seat in Congress, has since been able to devote his whole time 
and attention to the interests of the Association, and those 
consulting our Medical and Surgical Faculty have the full ben- 
efits of his counsel and professional services. That he should 
prefer to give up a high and honorable position in the councils 
of the nation, to serve the sick, is conclusive evidence of his 
devotion to their interests and of love for his profession. 
921 Invalids' Hotel and Surgical Institute, 663 Main Street, Buffalo, N. Y. INVALIDS' HOTEL 
k 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 accommo- 
date the large number of invalids who visit Buffalo from every State 
and Territory, as well as from many foreign lands, that they may avail 
themselves of the professional services of the Staff of Skilled Specialists 
in Medicine and Surgery that compose the Faculty of this widely- 
celebrated institution. 
On the sixteenth of February, 1881, the original Invalids' Hotel was 
totally destroyed by fire. Although occupied at the time by a large 
number of invalids, yet, through the extraordinary exertions of the 
Faculty and employes, all were safely removed from the building with- 
out injury to any one. The Board of Trustees took prompt steps to re- 
build, for the accommodation of the many sufferers who apply, to avail 
themselves of the skill, facilities and advantages of treatment which 
such a perfectly equipped establishment affords. Profiting by the ex- 
perience afforded by several years' occupancy of the original Invalids' 
Hotel building, which at the date of its erection was the largest and 
most complete establishment of its kind in the world, we believe we 
have, in the building of the elegant structure illustrated herein, made 
great improvements over the original Invalids' Hotel, for the accommo- 
dation of our patients. Although our new building has only been oc- 
cupied about two years, yet already (November 1st, 1884) our business 
has required the erection of a very large addition thereto, to accommo- 
date our growing practice. This large Annex, which is about the size 
DESTROYED BY FIRE. 
923 924 
APPENDIX. 
of the original building, although but recently occupied, is now well 
filled with patients, hailing from every State and Territory of the 
Union. 
THE INVALIDS' HOTEL AND SURGICAL INSTITUTE IS 
PLEASANTLY SITUATED AT No. 663 MAIN STREET, 
in the city of Buffalo, just above and outside the business and bustle 
of this Queen City of the Lakes. It is easily reached from the railroad 
Grand Entrance. 
depots by the Exchange and Main Street car lines (see map on last 
page of this book). It is a substantially built brick building, trimmed 
with sandstone, well lighted and provided with a patent hydraulic ele- 
vator, so that its upper stories are quite as desirable as any, being more APPENDIX. 
925 
■quiet than those lower down. It is w'ell provided with fire escapes, and, 
in fact, nothing has been neglected that can add to the comfort and 
home-like make-up of this popular national resort for the invalid and 
afflicted. Great pains and expense have been assumed in providing 
perfect ventilation for every room and part of the building. The sur- 
roundings of the Hotel are very pleasant, it being located in the finest 
built part of the city, among the most elegant residences. 
Ante-room.-Invalids' Hotel and Surgical Institute. 
STAFF OF PHYSICIANS AND SURGEONS. 
Only men who are, by thorough education and experience, especially 
fitted to fill their respective positions, have been chosen to serve as 
physicians and surgeons in this institution. After having spent a very 
large sum of money in erecting and furnishing this national resort for 
invalids with every requirement and facility for the successful treat- 
ment of all classes of chronic diseases, it is the determination of the 
Board of Directors that the Faculty of Physicians and Surgeons shall be 
superior in culture, experience and skill. 
We have not the space to speak, individually, of the eighteen profes- 
sional gentlemen composing the Faculty, but will say that among them 
are those whose long connection with the World's Dispensary and Sur- 
gical Institute has given them great experience and rendered them ex- 
perts in their specialties. Several of them had previously distinguished 
themselves in both private and hospital practice, had held important 
chairs as lecturers and teachers in Medical Colleges, and had filled 926 
APPENDIX. 
responsible positions in military and civil hospitals; also in some of 
the most noted Asylums, Dispensaries, and Sanitary Institutions, in 
the land. 
With such a staff of Physicians and Surgeons, efficient and trained 
nurses, and with all the most approved sanitary, medical and surgical 
appliances which study, experience, invention and the most liberal 
expenditure of money, can produce and bring together in one institu- 
tion, the Invalids' Hotel and Surgical Institute affords the afflicted 
unusual opportunities for relief. 
THE GRAND ENTRANCE. 
The entrance to the Invalids' Hotel and Surgical Institute is covered 
by a lofty porch of beautiful design, the roof of which is supported 
upon heavy iron columns. Above the massive double doors, through 
which the visitor enters, are large, heavy panels of beautifully wrought 
stained glass, on which the words " Invalids' Hotel and Surgical Insti- 
tute" stand out conspicuously. 
Gentlemen's Reception-room.-Invalids' Hotel and Surgical Institute. 
FIRST FLOOR. 
The first floor of the building is reached through a beautifully finished 
vestibule, by a short flight of broad, easy stairs, and once inside the 
visitor is struck by the beauty of design as well as by the home-like APPENDIX. 
927 
appearance of the surroundings. The wood-work is mainly of hard 
woods, oak and cherry predominating. In a large part of the house the 
floors are of oak, with a cherry border, neatly finished in oil and shellac, 
and covered with rich rugs and elegant carpets of the very best quality. 
Ladies' Parlor.-Invalids' Hotel and Surgical Institute. 
On the first floor is the gentlemen's reception-room, which is thronged 
with patients from early in the morning until late in the afternoon. It 
is entirely distinct from the large reception-room and parlors for lady 
patients, and the utmost privacy is secured throughout the whole 
arrangement of the Institution. On this floor are the suites of offices, 
parlors, and private consultation-rooms, some fifteen in all, also a well 
furnished reading-room and circulating library, for the use of the 
inmates of the Institution. On all sides are beautifully frescoed walls 
adorned with numerous choice engravings and other pictures. All the 
rooms throughout the house are furnished in the best of style, and in a 
manner to afford the utmost comfort and cheerfulness of surroundings 928 
APPENDIX. 
for the sick and afflicted who seek this remedial resort. The Turkish 
and other baths are elegantly fitted up on the first floor, opposite the 
reading-room. 
Above the first, or main floor, the building is divided off into separate 
rooms and suits of rooms for the accommodation of patients. All are 
THE UPPER FLOORS. 
Library and Reading-room.-Invalids' Hotel and Surgical Institute. 
well lighted, have high ceilings, and are cheerful and well ventilated 
apartments. On the second floor is the large medical library and 
medical conncil-room, for the exclusive use of the Faculty, also the 
museum-room, which contains a large and valuable collection of 
anatomical and morbid specimens, many of them being representations 
of cases treated in the Institution. On this floor are also suits of 
rooms, occupied by the Bureau of Medical Correspondence, wherein 
from ten to twelve physicians, with their stenographers, or short-hand 
writers, are constantly employed in attending to the vast correspondence 
received from invalids residing in all parts of the United States and 
Canada. Every important case receives the careful consideration of a 
council composed of from three to five of these expert specialists, before 
being finally passed upon and prescribed for. APPENDIX. 
929 
ON THE THIRD FLOOR 
are the large treatment-rooms, supplied with all the apparatus and 
appliances for the successful management of every chronic malady inci- 
dent to humanity. Electrical apparatus of the latest and most approved 
kinds, some of it driven and operated by steam-power, dry cupping and 
equalizing-treatment apparatus, " vitalization " apparatus, numerous 
and most ingenious rubbing and manipulating apparatus and machinery, 
driven by steam-power, are among the almost innumerable curative 
agencies that are here brought into use as aids in the cure of human 
ailments. 
FOURTH FLOOR. 
On the fourth floor are located the surgical operating-rooms and 
surgical wards. There are also a large number of nice, large, well fur- 
nished separate rooms on 
this floor, used principally 
for the accommodation of surgical 
cases. Strong, broad, iron staircases 
connect all the upper floors with the 
ground, so that in case of fire, patients 
need have no fear of being able to get out safely. In fact, the build- 
ing has been constructed so as to render the rapid spread of fire 
through it impossible, all the floors being laid on cement. 
President Pierce's Business Office. 930 
APPENDIX. 
A STEAM PASSENGER ELEVATOR 
is provided, so that the upper floors are quite as desirable as those lower 
down. The dining-rooms for gentlemen, as well as those for ladies, are 
located in the basement, which is reached either by stairways or by 
the elevator. The kitchen, store-rooms, chill-rooms, pantries, and all 
culinary arrangements are also in the basement. In the opposite end 
of the basement are the large dispensing-rooms, stocked with drugs and 
medical compounds of almost endless variety, and representing every 
branch of the materia medica. Here all medicines prescribed are most 
carefully and specially prepared for each individual case. Those to be 
sent away by mail or express, to patients being treated at a distance, 
Office of our Chief-of-Staff.-Invalids' Hotel and Surgical Institute. 
are placed in trays, with full directions for use, and sent to another 
large room, where they are carefully packed and shipped thence to 
their destination. 
FIRE-PROOF VAULTS. 
Six large fire-proof vaults are provided in this building in which to 
preserve, secure from observation, as well as from fire, all records of 
cases examined and treated by the Faculty. 
Throughout all this vast building the visitor is struck with the won- 
derful order and system with which every detail is carried out. APPENDIX. 
931 
THE BATH DEPARTMENT. 
The Invalids' Hotel and Surgical Institute, as hereinbefore indi- 
cated, is provided with Turkish, and other approved baths, witli a 
treatment-room, fitted up with vacuum and movement-treatment 
apparatus of the most modern and ap- 
proved style. These and much more in- 
geniously devised apparatus and appliances 
are brought into use in a great variety 
of chronic affections with marvelously suc- 
cessful results. A perfect system of physical 
training, especially adapted to the wants of 
the invalid and weak, and most skillfully 
conducted and applied, is not the least im- 
portant among the many advantages that 
the chronic sufferers here find. 
THE SURGICAL DEPARTMENT. 
In the Surgical Department, every instru- 
ment and appliance 
approved by the 
modern operater is 
provided, and many 
and ingenious are the 
instruments and de- 
vices that the Fac- 
ulty of this institu- 
tion have invented 
and perfected to 
meet the wants of 
their numerous cases. 
A glimpse at the Turkish Bath Department. 
In the prescribing of remedies for disease, the Staff resort to the 
whole broad field of materia medica, allowing themselves to be ham- 
pered by no school, ism, pathy, or sect. The medicines employed are 
all prepared by skilled chemists and pharmacists, and the greatest care 
is exercised to have them manufactured from the freshest and purest 
ingredients. Our Faculty probably employ a greater number and 
variety of extracts from native roots, barks and herbs in their practice 
than are used in any other invalids' resort in the land. All of the 
vegetable extracts exployed in our practice are prepared in our own 
Laboratory. 
REGULATION OF DIET. 
The table is supplied with an abundance of wholesome and nutritious 
food, especially adapted and prepared to suit the invalid, it being varied 
to suit each particular case. The Faculty recognize the importance of 
OUR REMEDIES. 932 
APPENDIX. 
proper food as one of the greatest factors in the treatment of chronic 
diseases. While properly regulating and restricting the food of the 
invalid when necessary, they also recognize the fact that many are 
benefited by a liberal diet of the most substantial food, as steaks, eggs, 
View of Buffalo Park Lake. 
oysters, milk, and other very nutritious articles of diet, which are 
always provided in abundance for those for whom they are suited. 
From previous experience somewhere, some people get the impres- 
sion that they are to be half starved at such an institution as this. If 
this is the case anywhere it is not so here, as any one who has ever 
resided at our sanitarium will attest. 
A sufficient number of trained and experienced nurses are employed, 
that those requiring attendance may have the very best of care. 
TRAINED ATTENDANTS. 
The institution is conducted in an orderly manner, that the utmost 
quiet may be secured. The Faculty insist, upon the part of the invalid, 
while under treatment, on the observance of habits of regularity in 
eating, sleeping, bathing and exercise. Only by such observance of 
hygienic laws can they succeed in their course of remedial training, 
and make their treatment curative. 
GOOD ORDER. 
AMUSEMENTS. 
While insisting upon strict observance of rules established for the 
good of the patient, they do not make their requirements so rigid as to 
interfere with the comfort and enjoyment of their patients, but, on the 
contrary, endeavor, in every manner possible, to provide innocent and APPENDIX. 
933 
entertaining amusements for all, recognizing the great importance of 
pleasant occupation of the mind, as an essential part of the treatment. 
Hence the introduction of music, amusing games, light reading, and 
kindred agencies for pleasant entertainment, is not neglected. 
UNPARALLELED SUCCESS. 
The founder of this institution commenced, many years ago, with 
little capital, to build up a business in the treatment of chronic diseases 
and devoted himself diligently to that end. His reputation for skill in 
his chosen field 
of practice 
gradually ex- 
tended until, to-day, his 
fame and that of the World's 
Dispensary and Invalids' Hotel 
and Surgical Institute, is simply 
world - wide. As the business 
increased those eminent for skill have been induced to join the 
Faculty, until eighteen professional gentlemen, each devoting his 
One of the Private Consultation-rooms, 
Ladies' Department. 934 
APPENDIX. 
attention to a special branch of practice, now (November 1st, 1884) 
constitute the Medical and Surgical Staff. 
One reason why we excel in the treatment of chronic diseases is the 
fact that we are supplied with all the modern improvements in the way 
of instruments, appliances and remedial agents used in the healing art, 
the expense of which deters the local physician in general practice from 
procuring, for the treatment of the limited number of cases that come 
within the circuit of his practice. The treatment of such cases requires 
special attention and special study to be successful. 
View of Prospect Park, Buffalo, from Prospect Avenue. 
It is a well-known fact, that appeals to the judgement of every think- 
ing person, that a physician who devotes his whole time to the study 
and investigation of a certain class of diseases, must become better 
qualified to treat such diseases than he who attempts to treat every ill 
to which flesh is heir, without giving special attention to any particular 
class of diseases. Men, in all ages of the world, who have made their 
marks, or who have become famous, have devoted their lives to some 
special branch of science, art or literature. 
A COMMON SENSE VIEW. 
LIBERALITY. 
We wage no war against any physician, no matter what school of 
medicine he may represent; but, on the othei' hand, we invite the APPENDIX. 
935 
co-operation of all regular physicians. We are always ready and will- 
ing to impart to them any information or render any assistance that 
will be of mutual benefit to them and their patients. 
OUR PHYSICIANS AND SURGEONS 
do not travel to solicit practice, having all the business that they can 
attend to at our institution, nor do we employ any agents to travel and 
peddle or otherwise sell our medicines. If any one engaged in such 
business represents himself as in any way connected with our institu- 
tions he is a swindler and should be apprehended and prosecuted as 
such. And any one who will give us such information as will lead to 
the arrest and conviction of any person so misrepresenting will be lib- 
erally rewarded. 
President Pierce's Private Consultation-room. 
While not permitting any member of our professional staff to travel 
and solicit practice, yet we are always willing to accommodate and send 
a specialist to visit important or critical cases in consultation, or other- 
wise, or to perform important surgical operations as explained on page 
971 of this book. 
Let no one deceive you by representing that they have heretofore 936 
APPENDIX. 
been connected with our institution and have thereby learned our 
original and improved methods of treatment. We have a large and 
competent Staff of Specialists and while we have sometimes found it 
necessary to make changes, yet we always manage to retain the most 
expert and skillful, as we cannot afford to part with the services of 
those who excel. 
By adopting similar names to those which have long designated our 
world-famed institutions, some have endeavored to deceive and mislead 
Scene in Buffalo Park.-Artificial Lake and Boat-house. 
invalids who were seeking relief. Others have named so-called 
"Electric" Trusses, "Liver Pads," and other contrivances after our 
President, thereby expecting to reap benefits from Dr. Pierce's well- 
known professional standing. Neither the Doctor nor this Association 
have any interest in any such articles. 
NO BRANCHES.-Remember we have no branches except at 
No. 3 New Oxford Street, London, England. 
Those desiring to consult us by letter, should address all communica- 
tions plainly to 
WORLD'S DISPENSARY MEDICAL ASSOCIATION, 
No. 6 63 MAIN STREET, 
BUFFALO, 1XT- "ST- APPENDIX. 
937 
WORLD'S DISPENSARY. 
The immense building erected and occupied by the World's Dispen- 
sary Medical Association as a Laboratory, wherein are manufactured 
our Dr. Pierce's Standard Family Medicines, as well as all the various 
World's Dispensary.-New Laboratory Building. 
Tinctures, Fluid Extracts and other pharmaceutical preparations used 
by the Staff of Physicians and Surgeons of the Invalids' Hotel and 
Surgical Institute in their practice, is not inappropriately called the 
World's Dispensary, for within its walls are prepared a series of reme- 
dies of such exceeding merit that they have acquired world-wide fame, 
and are sold in vast quantities in nearly every civilized country. 
The structure, located at 660 to 670 Washington Street, immediately 
in the rear of the Invalids' Hotel and Surgical Institute, is of brick, 
with sandstone trimmings, six stories high, and 100 feet square. Its 
most striking architectural features exteriorly are massiveness, com- 
bined with grace and beauty of outline, and great strength. 
THE BASEMENT. 
The basement or first story opens on a level with the Washington 
Street sidewalk, and is occupied by a plant of three large boilers, which 
supply the steam used to run a huge Corliss engine, of 100 horse-power, 938 
APPENDIX. 
which is also located on this floor. This powerful engine drives all 
the machinery of the establishment, including drug mills, pill machines, 
packing machinery, a large number of printing presses, folding 
machines, stitching, trimming, and many other machines, located on 
the different floors, and used in the manufacture of medicines, books, 
pamphlets, circulars, posters, and other printed matter. On this floor 
is also located much ingeniously-devised bottling, labelling, wrapping, 
and packing machinery, and also the shipping department. Here 
may be seen huge piles of medicine, boxed, marked, and ready for 
shipment to all parts of the civilized world. A large steam freight 
elevator leads from this to the floors above. 
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 
Postal Advertising Department, Wrapping and Mailing-room. 
Institute. On this floor are located reception-rooms, business oflices, 
counting-room, the advertising department and mailing rooms. Large, 
tire-proof vaults are provided for the safe keeping of books, papers, 
and valuables, whilst the counting-room and offices are elegantly 
linished in hard woods, and present a beautiful and grand appearance. APPENDIX. 
939 
THIRD FLOOR. 
Ou this floor are the Association's extensive printing and binding 
works. Thirteen large presses, driven by power, with numerous folding 
machines, trimming, cutting, and stitching machinery, are constantly 
running in this department. Here is printed and bound Dr. Pierce's 
popular work of over a thousand pages, denominated ''The People's 
Common Sense Medical Adviser," over 250,000 copies of which have 
been sold. Millions of pocket memorandum books, pamphlets, circulars 
and cards are also issued from this department and scattered broadcast 
to every quarter of the globe. 
A corner in Printing Department.--World's Dispensary. 
FOURTH FLOOR. 
Large mills for crushing, grinding and pulverizing roots, barks, herbs, 
and other drugs occupy a considerable part of this floor. Extensive 
drying-rooms, in which articles to be ground in the drug mills are 
properly dried, are also located upon this floor, as are also many large 
tanks containing thousands of gallons of medicine ready for bottling. 
In a large room set aside for that purpose, are stored vast quantities of 
labels and wrappers, for use in putting up medicines. 
FIFTH FLOOR. 
This entire floor is occupied with mixing, percolating, distilling, 
filtering, and other apparatus employed in the manufacturing of medi- 
cines. Every process is conducted under the watchful care of an 
experienced chemist and pharmacist, and in the most perfect and orderly 
manner; the apparatus employed being of the most approved character. 940 
APPENDIX. 
Here are manufactured all the various medicinal preparations and com- 
pounds prescribed by the Faculty, in the treatment of special cases. 
SIXTH FLOOR. 
This is wholly occupied for the storage of paper, crude drugs, glass, 
corks, and other supplies employed in the general business. 
In all departments of this vast business establishment, the visitor is 
struck with the perfect system which everywhere prevails, and the 
GENERAL CONSIDERATIONS. 
Small Section of Chemical Laboratory.-World's Dispensary. 
wonderful accuracy with which every process and transaction is carried 
on and consummated; hence the uniformity of purity and strength 
for which the medicines here manufactured have so long been cele- 
brated. To this, also, is due much of the marvelous success attained in 
the department established for the special treatment of chronic and 
obstinate cases of disease. In this department the Faculty are not at 
all limited or hampered in prescribing, and do not confine themselves 
in the least to the proprietary or standard medicines manufactured for 
general sale through druggists, but employ a range of curative agents 
unsurpassed in variety and range of application. They aim to care- 
fully adapt their prescriptions to each individual ease. APPENDIX. 
941 
THE 
Invalids' Hotel and Surgical Institute 
SOME OF THE CAUSES THAT LED TO ITS ERECTION, 
AND THE ADVANTAGES WHICH IT AFFORDS. 
The destinies of institutions, like those of men, are often determined 
by pre-existing causes. The destinies of some men are like those of 
way-side plants, springing up without other apparent cause than the 
caprice of nature, developing without any apparent aim, yielding no 
One of the Private Consultation-rooms, Gentlemen's Department. 
perfected fruit, and, finally, dying, leaving scarcely a trace of their 
existence. Thus it is with institutions which have their origin only in 
man's caprice. To be enduring, they must be founded upon the needs 
and necessities of humanity. Many of the great men of the world owe 
their greatness more to surrounding circumstances than to the genius 942 
APPENDIX. 
within them. For the highest genius can be dwarfed or deformed by 
the force of adverse circumstances; hence the poetic truth of Gray 
in those exquisite lines: 
" Some mute inglorious Milton here may lie. 
Some Cromwell guiltless of his country's blood." 
Opportunity is the guiding star of genius. Without it, genius would 
drift hither and thither upon the restless, ever-changing waves of cir- 
cumstance, never casting anchor in a secure haven. Upon opportunity, 
too, depends the success of institutions. By opportunity we mean a 
real and acknowledged public want. Whoever undertakes to supply 
this want finds himself upon the crest-wave of prosperity. It was to 
supply such a want that this institution was erected. 
A REMEDIAL HOME. 
Of the forty millions of people living in the United States to-day, it 
is estimated that nearly eight millions are sufferers from chronic 
disease. Think for a moment! Eight millions of people slowly but 
surely dying by the insidious and fatal development of chronic disease! 
This is an appalling fact. And yet this is the very class of diseases 
with which the general practitioner is least familiar. 
As a general practitioner of the healing art, fresh from curriculum, the 
founder of this Institution early realized that the great unpardonable 
sin of the medical profession is the neglect to more thoroughly study 
and investigate this class of diseases. 
The profession is diligently cauterizing and poulticing the sores 
which now and then appear on the surface, but the internal chronic 
disease, of which these are merely the external signs, is too often over- 
looked or neglected. 
Some years ago we devised and put into practical operation a 
method of 
without requiring them to undergo personal examinations. We rea- 
soned that the physician has abundant opportunity to accurately 
determine the nature of most chronic diseases without ever seeing the 
patient. In substantiating that proposition, we cited the perfect accu- 
racy with which scientists are enabled to deduce the most minute 
particulars in their several departments, which appears almost miracu- 
lous, if we view the subject in the light of the early ages. Take, for 
example, the electro-magnetic telegraph, the greatest invention of the 
age. Is it not a marvelous degree of accuracy which enables an 
operator to exactly locate a fracture in a sub-marine cable nearly three 
thousand miles long? Our venerable "clerk of the weather" has 
become so thoroughly familiar with the most wayward elements of 
nature that he can accurately predict their movements. He can sit in 
Washington and foretell what the weather will be in Florida or New 
York, as well as if hundreds of miles did not intervene between him 
TREATING PATIENTS AT THEIR HOMES, APPENDIX. 
943 
and the places named. And so in all departments of modern science, 
what is required is the knowledge of certain signs. From these, 
scientists deduce accurate conclusions regardless of distance. A few 
fossils sent to the expert geologist enables him to accurately determine 
the rock-formation from which they were taken. He can describe it to 
you as perfectly as if a cleft of it were lying on his table. So also the 
chemist can determine the constitution of the sun as accurately as if 
that luminary were not ninety-five million miles from his laboratory. 
The sun sends certain signs over the "infinitude of space," which the 
Medical Library and Council-room.-Invalids' Hotel and Surgical Institute. 
chemist classifies by passing them through the spectroscope. Only the 
presence of certain substances could produce these solar signs. 
So, also, in medical science, 
DISEASE HAS CERTAIN UNMISTAKABLE SIGNS, 
or symptoms, and, by reason of this fact, we have been enabled to 
originate and perfect a system of determining with the greatest accuracy 
the nature of chronic diseases without seeing and personally examining 
our patients. In recognizing diseases without a personal examination 
of the patient, we claim to possess no miraculous powers. We obtain 
our knowledge of the patient's disease by the practical application of 
well-established principles of modern science to the practice of medicine. 944 
APPENDIX. 
And it is to the accuracy with which this system has endowed us that 
we owe our almost world-wide reputation for the skillful treatment 
of all lingering, or chronic, affections. This system of practice, with 
the marvelous success which has been attained through it, demonstrates 
the fact that diseases display certain phenomena, which, being sub- 
jected to scientific analysis, furnish abundant and unmistakable data to 
guide the judgment of the skillful practitioner aright in determining 
the nature of diseased conditions. 
So successful has been this method of treating patients at a dis- 
tance that there is scarcely a city or a village in the United States 
that is not represented by one or more cases upon the "Records of 
Practice" at the Invalids' Hotel and Surgical Institute. In all 
chronic diseases that are curable by medical treatment, it is only in 
very rare cases that we cannot do as well for the patient while 
he or she remains at home, as if here in person to be examined. 
But we annually treat hundreds of cases requiring surgical opera- 
tions and careful after-treatment, and in these cases our Invalids' 
Hotel, or home, is indispensable. Here the patient has the services 
not only of the most skillful surgeons, but also, what is quite as neces- 
sary in the after treatment, of thoroughly trained and skilled nurses. 
What should be the essential characteristics of an Invalids' Home ? 
Obviously, the most important of these characteristics is climate. 
Climatology, from being a mere speculative theory, has arisen to the 
deserved rank of a science. The influence of the climate of a country 
on the national character has long been observed and acknowledged. 
The languid but passionate temperaments of the South are like its 
volcanoes, now quiet and silent, anon bursting forth with terrible 
activity, flooding entire cities with molten fire; or, like its skies, now 
sunny, cloudless, an hour hence convulsed with lightnings and deluging 
the earth with passionate rain; or, like its winds, to-day soft, balmy, 
with healing on their wings, to-night the wind fiends, the destroying 
simoom, rushing through the land, withering and scorching every 
flower and blade of herbage on its way. On the other hand, the calm, 
phlegmatic temperament of the North accords well with her silent 
mountains, her serener skies, and her less vehement, but chilling winds. 
The South, too, is the native home of the most violent acute diseases, 
such as yellow fever and cholera. But, aside from this general 
climatic influence, there is the yet more restricted one of locality. 
It has often been observed that certain classes of diseases are most 
prevalent in certain localities, the prevalence in every instance being 
due to peculiarities of climate. 
CLIMATE. 
EXTREME HEALTHFULNESS OF BUFFALO. 
In the published records of the examination for military service in 
the army, during our late civil war. this fact was clearly and definitely APPENDIX. 
945 
stated, and maps were prepared and presented showing the comparative 
prevalence of certain diseases in the several States and districts repre- 
sented. The maps are prepared by a graduation of color, the lighter 
shades indicating the localities where the special disease under con- 
sideration is least prevalent; and it is a very significant and important 
fact that in all chronic diseases, not due to occupation or accident, 
Buffalo and its immediate vi- 
cinity is marked by the lighter 
shades. Thus, in epilepsy, pa- 
ralysis, scrofula, rheumatism, 
and consumption, our city is 
little more than tinted with 
the several colors used to de- 
note these diseases. 
There is a popular, but un- 
A Patient's Room.-Invalids' Hotel 
and Surgical Institute. 
founded, belief that Buffalo is a 
hot-bed for pulmonary diseases. 
This idea could have originated 
only in an ignorant disregard 
of facts; for medical statistics 
prove that in her freedom from this class of diseases she is unri- 
valed by any city in America, not excepting those on seaboard. 
EVIDENCE OF HEALTH STATISTICS. 
Compare, if you please, the statistics of Buffalo with those of the 
great Eastern cities in this respect. In Boston and New York the 
death-rate from consumption shows a ratio of about 1 to 5 of the whole 
number of deaths. In Baltimore and Philadelphia the ratio is 1 to 6, 
while in Buffalo the death rate from consumption is only 1 to 10 - a 946 
APPENDIX. 
very remarkable difference in favor of our city. Only last summer a 
gentleman residing in the eastern part of our State collected and com- 
pared the health statistics for 1876 of all the prominent cities in the 
United States. The result showed that 
BUFFALO OUTRANKS ALL IN HEALTHFULNESS. 
A great deal of precious breath has been expended in blustering 
about Buffalo zephyrs, as our delightful lake breezes are sometimes 
ironically termed. It seems to be a popular belief among our sister 
cities that old Boreas has chosen Buffalo for his headquarters. When we 
hear a person dilating upon "Buffalo's terrific winds," we are reminded 
of one of our lady acquaintances who recently returned from a 
European tour. She was asked how she enjoyed her sea voyage, and 
she replied, "Oh, it was delightful, really charming! There is some- 
thing so grand about the sea!" We were not a little surprised at this 
enthusiastic outburst, as we had been told by a member of her party 
that the lady had industriously vomited her way to Hamburg and back 
again. But the lady's enthusiasm was easily explained. It is fashion- 
able to characterize sea voyages as delightful, charming, etc. Now, we 
suspect this popular notion about our "trying winds" is traceable to 
the same source. It has become customary to call Buffalo a "windy 
place," and so, when the traveler feels a slight lake breeze, he imagines 
it to be a "terrific gale." Whatever may have originated this notion, 
certain it is that it is utterly, undeniably false; and, in making this 
denial, we are not dependent upon observation, but upon the 
The issue of July 18, 1874. of the Buffalo Commercial Advertiser, con- 
tained a series of tables, furnished by the Signal Service Bureau, show- 
ing the velocity of the wind at eleven prominent cities for the year 
1873. An examination of the table shows that the total velocity for 
the year was the lowest in Buffalo of any of the lake ports; while 
Philadelphia and New York showed far higher aggregates of velocity 
than our city. On this subject, in the issue of August 21st of the 
same year, the editor pleasantly remarks: "Only the interior and 
southern seaboard cities, and not many of them, show a lower total 
velocity of wind than is marked against this city; and as for those 
places, heaven help their unfortunate inhabitants in the sultry nights 
of the summer season, when they are gasping in vain for a breath 
of that pure, cool lake air, which brings refreshing slumbers to the 
peculiar people of blessed, breezy Buffalo." 
FACTS OF SCIENCE. 
EQUABILITY OF CLIMATE. 
Then, in regard to equability of climate, the great disideratum for 
invalids in any locality, here again sentiment and science are greatly 
at variance. An examination of the official records of the Signal 
Service Bureau, and the statistics of the Smithsonian Institute, showed 
that out of a list of forty cities on the continent Buffalo ranked highest APPENDIX. 
947 
for equability of climate. Thus we quote from an editorial of the 
Advertiser's issue of July 18,1874: "While the aggregate of chauge for 
Buffalo stood at 67 for the year, that of Philadelphia reached 204, 
Washington was 224, Cincinnati 205, St. Louis 171. Winchester, in one 
of the healthiest parts of Virginia, reached as high as 201. Aiken, 
in South Carolina, a 
famous resort for inva- 
lids, touched 220. St. 
Augustine, one of the 
lowest in the list, 
showed a much less 
equable climate than 
that of Buffalo, being 
94 to our . 67." The 
transition from sum- 
mer to winter, and 
vice versa, is exceed- 
ingly gradual, and, 
consequently, Buf- 
falonians are seldom afflicted with those epidemic diseases which gener- 
ally appear in other localities during the spring and summer months. 
Thus the thermometric readings of the Signal Service Bureau for 
1873, shows that the average temperature for July and August was 
74°. For September it was about 64°, which was again reduced by 
about 10® for October. The monthly average for November was 73°, 
One of our Physician's Rooms-Bureau of Corres- 
pondence.-Invalids' Hotel and Surgical Institute. 948 
APPENDIX. 
and for December 25°, which was also the average for January. Then 
the readings for February showed an average of 26°, for March 32°, and 
43° for April. A more equable and gradual transition from midsum- 
mer heat to midwinter cold cannot be shown by any locality on this 
continent. Seldom does the mercury rise above ninety during our 
warmest summers, or fall below zero in our most severe winters. 
In J. Disturnal's work, entitled "The Influence of Climate in North 
and South America," published by Van Nostrand, in 1867, the climate of 
Buffalo is thus characterized: "From certain natural causes, no doubt 
produced by the waters of Lake Erie, the winters are less severe, the 
summers less hot, the temperature night and day more equable, and the 
transition from heat to cold less rapid, in Buffalo than in any other 
locality within the temperate zone of the United States, as will be seen 
by the following table." The table referred to shows that, "during the 
summer months, the temperature of Buffalo is from 10 to 20 cooler 
than that of any other point east, south, or west of the ports on Lake 
Erie; while the refreshing and invigorating lake breeze is felt night and 
day." The author further adds that, during the winter months, "the 
thermometer rarely indicates zero, and the mean temperature for Janu- 
ary, 1858, was 20® above." 
A careful investigation into the comparative climatology of the 
several great social and commercial centers, proved Buffalo to be super- 
ior to all others in the climatic requirements for the invalid. Besides, it 
has the important advantage of being a central point of traffic and 
travel between the West and the East. 
ADVANTAGES OF LOCATION. 
The second important consideration in projecting this home for 
invalids was location. Is has generally been customary to locate insti- 
tutions of this character in rural districts, removed from the advantages 
of city life, on the plea of escaping the confusion and excitement so 
detrimental to recovery. The result is well known. Invalids have 
regarded them more as pleasure resorts than health resorts, spending 
the summer months there, but fleeing to their homes at the fall of 
the first snow-flake. The good that was done in the summer is undone 
by carelessness and exposure in the winter. A location that would 
combine both city advantages and rural pleasures, seemed to us, upon 
reflection, to be the desirable one. Fortunately, Buffalo afforded the 
happy mean. Our extensive parks, our unsurpassed facilities for yacht- 
ing, fishing, and all aquatic sports, our many sylvan lake and river 
retreats, our world-famed Niagara,-certainly a more desirable selec- 
tion of rural scenes and pleasures cannot be found in another locality 
in America. 
Tn erecting the Invalids' Hotel and Surgical Institute, our paramount 
design was to make it a genuine home - not a hospital - a home where 
the child of fortune would miss none of the comforts of her palatial 
A GENUINE HOME. APPENDIX. 
949 
home, while the poor man would find not only health but his pleasures 
multiplied a thousand fold. 
The wholesale merchant's prices are far less than those of the retail 
dealer. He can afford it, his sales are so much larger. Now, it is on 
precisely the same principle that we are able to make the rates at 
the Invalids' Hotel and Surgical Institute comparatively low. If we 
had only a limited number of patients, we should be obliged to make 
the charges commensurate with our expenses; but our practice having 
OUR TERMS MODERATE. 
become very extensive, and the income being correspondingly large, 
we are enabled to make the rates at the Invalids' Hotel and Surgical 
Institute so moderate that all who desire can avail themselves of its 
medical, surgical, and hygienic advantages. 
Prescription Department.-Invalids' Hotel and Surgical Institute. 
FACILITIES OF TREATMENT. 
Of the many advantages afforded by the Invalids' Hotel and Surgical 
Institute, in treating disease, we can make only brief mention of a 
few of the more prominent. 
In the examination and treatment of patients, our practice is divided 
into specialties. Each member of the Faculty, although educated to 
practice in all departments of medicine and surgery, is here assigned 
DIVISION OF LABOR. 950 
APPENDIX. 
to a special department only, to which he devotes his entire time, 
study, and attention. 
The division-of-labor system proves as effectual in the exercise of 
the professions as in manufactures. In the legal profession this has 
long been a recognized fact. One lawyer devotes his attention spe- 
cially to criminal law, and distinguishes himself in that department. 
Another develops a special faculty for unraveling knotty questions 
in matters of real estate, and, if a title is to be proved, or a deed an- 
nulled, he is the preferred counselor. In a certain manner, too, this 
has long been practiced by the medical profession. Thus some physi- 
cians (and we may add physicians who call themselves "regular," and 
are specially caustic in their denunciation of "advertising doctors") 
are accustomed to distribute cards among their patrons, certifying 
that they give special attention to diseases of women and children. 
In this institution each physician and surgeon is assigned a special 
department of medicine or surgery. By constant study and attention 
to his department, each has become a skillful specialist, readily 
detecting every phase and complication of the diseases referred to him. 
Not only is superior skill thus attained, but also rapidity and accuracy 
in diagnosis. 
Thoroughness and efficiency in any branch of learning can be 
secured only by devoting to it especial study and attention. When 
the faculty of a university is to be chosen, how are its members 
selected ? For instance, how is the chair of astronomy filled? Do 
they choose the man who is celebrated for his general scholastic 
attainments, or do they not rather confer it upon one who is known 
to have devoted special attention and study to the science of astron- 
omy, and is, therefore, especially qualified to explain its theories and 
principles? Thus all the several chairs are filled by gentlemen whose 
general scholarship not only is known to be of the highest standard, 
but who devote special attention to the departments assigned them, 
thus becoming proficient specialists therein. The same system of 
specialties is observed in the departments of a medical college. 
The professor who would assume to lecture in all the departments 
with equal ease and proficiency would be severely ridiculed by his 
colleagues; and yet it is just as absurd to suppose that the general 
practitioner can keep himself informed of the many new methods of 
treatment that are being constantly devised and adopted in the several 
departments of medicine and surgery. 
ADVANTAGES OF SPECIALTIES. 
PROGRESS IN MEDICINE. 
In no other science is more rapid and real progress being made 
at the present time than in that of medicine. Even the specialist 
must be studious and earnest in his work to keep himself well 
and accurately informed of the progress made in his department. APPENDIX. 
951 
Thus it so often happens that the general practitioner pursues 
old methods of treatment which science has long since replaced 
with others, acknowledged to be superior. The specialist, on the 
contrary, by confining his studies and researches to one class of 
diseases only, is enabled to inform himself thoroughly and accurately 
on all the improvements made in the methods and means of practice in 
his special department. 
The difference between the practice of specialists and that of 
general practitioners is aptly illustrated by the difference between 
the old-fashioned district school, in which the school-master taught all 
the branches, from a-b-abs to the solution of unknown quantities and 
the charmed mysteries of philosophy, and the modern seminary, 
with its efficient corps of teachers, each devoting his or her whole 
attention to the study and teaching of one special department of 
learning. 
We attribute the success which has attended the practice at the 
Invalids' Hotel and Surgical Institute, in a great measure, to a wise 
adoption of this system of specialties. 
ADVANTAGES OFFERED TO INVALIDS. 
Obviously, the most important of these advantages is facility of 
treatment. Of the thousands whom we have cured of chronic dis- 
eases, we have probably not seen one in five hundred, having 
accomplished the desired result through remedies sent either by mail 
or express, and advice given by letter. Yet in some obstinate forms 
of disease, we can here bring to bear remedial means not to be 
found or applied elsewhere. 
That thousands of cases of chronic disease, pronounced incurable, 
have, by our rational and scientific treatment, been restored to per- 
fect health, is conclusively proved by the records of practice at the 
Invalids' Hotel and Surgical Institute. Here, in obstinate cases, are 
brought to bear all the most scientific remedial appliances and meth- 
ods of treatment. 
A system of mechanical movements, passive exercises, manipu- 
lations, kneadings, and rubbings, administered by a large variety 
of ingeniously-contrived machinery, driven by steam-power, has been 
found especially efficacious and valuable, as an aid to medical and 
surgical treatment, in the cure of obstinate cases of nervous and 
sick headache, constipation, paralysis, or palsy, stiffened joints, crooked 
and withered limbs, spinal curvature, tumors, diseases of women,, 
especially displacements of the uterus, or womb, such as prolapsus, 
retroversion and anteversion, chronic inflammation, enlargement 
and ulceration of the uterus, and kindred affections; also in nervous 
debility, sleeplessless, and most chronic diseases. Mechanical power, 
or force, is by these machines transmitted to the system, in which 
it is transformed into vital energy and physical power or strength. 
This mechanical, passive exercise, or movement-cure treatment, differs 952 
APPENDIX. 
widely from, and should not be confounded with, " Swedish move- 
ments," to which it is far superior in efficacy. Coupled with our 
improved and wonderful system of "Vitalization" treatment, it affords 
the most perfect system of physical training and development ever 
devised. For the restoration of power to wasted, undeveloped, or 
A glimpse of some of the 
rooms for the application of 
Electricity, Mechanical Mass- 
age, " Vitalization " treatment 
and other agencies prescribed 
by our Staff; furnishing a per- 
fect system of physical and 
remedial training, carefully 
adapted to the wants of the 
most delicate and feeble, as well 
as to those of greater strength. 
weakened organs or parts, or for their en- 
largement, this combined movement and 
" Vitalization " treatment is unequaled. 
It can be applied to strengthen or enlarge any organ or part. We also 
employ both Dynamic and Static electricity, " Franklinism " and Elec- 
trolysis, and chemical, Turkish and other baths, in all cases in which 
they are indicated. Inhalations, administered by means of the most 
approved apparatus, are employed with advantage in many obstinate 
lung, bronchial, and throat affections. We have no hobby or one-idea APPENDIX. 
953 
system of treatment, no good remedial means being overlooked or 
neglected. 
A FAIR AND BUSINESS-LIKE OFFER TO THE AFFLICTED. 
Reader, are you accustomed to think and act for yourself ? Do 
you consult your own reason and best inserests ? If so, then do 
not heed the counsel of skeptical and prejudiced friends, or jealous 
physicians, but listen to what we have to say? 
You perhaps know nothing of us, or our systems of treatment, 
or of the business methods we employ. You may imagine, but you 
knoiv nothing, perhaps, of our facilities and advantages for perform- 
ing cures in cases beyond the reach or aid of the general practi- 
tioner. Knowing nothing, then, of all these advantages, you still 
know as much as the would-be friend or physician who never loses 
an opportunity to traduce and misrepresent us, and prejudice the 
afflicted against us. 
Now to the point-are you listening? Then permit us to state 
that we have the largest, the best, and the finest buildings of any 
like Association, company, or firm in this country. We employ more 
and better Medical and Surgical Specialists in our Invalids' Hotel 
and Surgical institute than any similar Association, company, or 
individual, and actually have more capital invested. We have a 
thoroughly qualified and eminent Specialist for every disease that 
we treat. We treat more cases, and absolutely cure more patients 
than any similar institution in America. In addition to those we 
treat medically, we perform all the most difficult surgical operations 
known to the most eminent Surgeons, and so frequently do many 
of these operations occur with us that some of our Specialists have 
become the most expert and skillful Surgeons on this continent. 
We wish to add further that we are responsible to you for what 
we represent ; we therefore ask you to come and visit our institu- 
tions; and, if you And on investigation that we have misstated or 
misrepresented in any particular our institutions, our advantages, or 
our success in curing Chronic Diseases, we will gladly and promptly 
refund to you all the expenses of your trip. We court honest, sincere 
investigation, and are glad and anxious to show interested people 
what we can do and are daily doing for suffering humanity. Can a 
proposition be plainer? Can an offer be more fair and business-like? 
If, therefore, you are afflicted, and are seeking relief, come where 
genuine ability is a ruling feature, where success is our watchword 
and the alleviation of human suffering our mission. 
Whether arriving in our city by day or night, come directly to the 
Invalids'1 Hotel and Surgical Institute, 663 Main Street, where you 
will be hospitably received and well cared for. 
Address all correspondence to 
WORLD'S DISPENSARY MEDICAL ASSOCIATION, 
663 Main Street, BUFFALO, A Y. 954 
APPENDIX. 
SUCCESSFUL TREATMENT 
OF 
CHRONIC OR LINGERING DISEASES. 
For many years the founder of the Invalids' Hotel and Surgical Insti- 
tute and World's Dispensary has devoted himself very closely to the 
investigation and treatment of chronic diseases. Some few specifics have, 
during this time, been developed for 
certain forms of chronic ailments, and 
given to the public, but they have 
not been lauded as "cure-alls," or 
panaceas, but only recommended as 
remedies for certain well-defined and 
easily recognized forms of disease. 
These medicines are sold through 
druggists very largely, and have 
earned great celebrity for their many 
cures. So far from claiming that these 
proprietary medicines will cure all 
diseases, their manufacturers advise 
the afflicted that, in many complicated and delicate chronic affections, 
they are not sufficient to meet the wants of the case. These must 
have special consideration and treatment by a competent physician 
and surgeon, the medicines and other remedial 
means required being selected and prepared with 
reference to each particular case. 
In order to be able to offer those afflicted with 
chronic ailments the most skillful medical and 
surgical services, Dr. Pierce, many years ago. 
associated with himself several eminent physicians 
and surgeons, as the Faculty of the old and 
renowned World's Dispensary, the consulting 
Department of which is now merged with the Invalids' Hotel and 
Surgical Institute. 
DIVISION OF LABOR. 
In the organization of the medical and surgical staff of the Invalids' 
Hotel and Surgical Institute, several years ago, we assigned to one 
physician the examination and treatment of diseases of the nervous 
system; to another, surgical operations and the treatment of surgical 
diseases; a third had charge of catarrhal and pulmonary diseases and 
affections of the heart; a fourth attended to diseases peculiar to women; 
a fifth, to diseases of the eye and ear; a sixth, to diseases of the 
Type-writer APPENDIX. 
955 
digestive organs; a seventh, to special surgical cases; to another we 
entrusted diseases of the urogenital organs; and to others, various 
other specialties. Now that our practice has become so very exten- 
sive as to require for its conduct a greatly increased number of 
physicians and surgeons, we have been obliged to detail to several 
of these divisions or specialties in practice, two, three, and even four 
physicians and surgeons. Thus four physicians and surgeons devote 
their undivided attention to the examination and treatment of diseases 
of the urinary and generative organs of men. Three physicians give 
their sole attention to diseases peculiar to women and three to those of 
the nasal organs, throat and chest, embracing all chronic diseases of 
Faculty of Invalids' Hotel and Surgical Institute in Session.-Council-room. 
the respiratory organs. Thus we have a full council of three and 
four physicians in these several specialties. In several other divisions 
we have two specialists. No case is slighted either in the examination 
or in the treatment. All doubtful, obscure or difficult cases are 
submitted to a council composed of several physicians and surgeons. 
Skilled pharmaceutists are employed to compound the medicines 
prescribed. For the purpose of enabling us to conduct our extensive 
correspondence (for we have an extensive practice in every part of the 
United States and Canada as well as in Great Britain, from our London 
branch), stenographers are employed, to whom replies are dictated and 956 
APPENDIX. 
by them taken down in short-hand. Afterwards the letters are written 
out in full, generally on a type-writing machine, which prints them 
in a plain, legible style. These machines are operated as rapidly as 
a person can think of the letters which compose a word, each operator 
thus accomplishing the work of several copyists. This system, by 
which we are enabled to correspond with our patients as rapidly as we 
can talk, has been rendered necessary by the growth of our business, 
which has attained immense proportions, giving rise to so large a 
correspondence that a dozen physicians cannot possibly conduct it all 
and give each patient's case careful attention, without the employment 
of short-hand writers and all other facilities which modern invention 
has given us. By the adoption of these various means, we are enabled 
to fully meet the demands of the afflicted, and give every case the most 
careful attention. 
As many persons, particularly young ladies and gentlemen, having 
catarrh or almost any other chronic disease, especially if of the uro- 
genital organs, are very sensitive and fearful that somebody will know 
that they are afflicted and employing medical treatment, precautions 
are taken that none who consult us may incur the least risk of 
exposure. Although none but the most honorable and trustworthy 
gentlemen are employed as assistants, yet as a guarantee of perfect 
security to our patients, that every communication, whether made 
in person or by letter, will be treated as sacredly confidential, each 
professional associate, clerk, or assistant, is required to take a solemn 
oath of secrecy. Great care is also taken to send all letters and 
medicines carefully sealed in plain envelopes and packages, so that no 
one can even suspect the contents or by whom they are sent. 
ADVANTAGES OF SPECIALTIES. 
By thorough organization and a perfect system of subdividing the 
practice of medicine and surgery in this institution, every invalid 
consulting us is treated by a specialist - one who devotes his undivided 
attention to the particular class of diseases to which his or her case 
belongs. The advantage of this arrangement must be obvious. Medical 
science offers a vast field for investigation, and no physician can. 
within the limit of a single life-time, achieve the highest degree of 
success in the treatment of every malady incident to humanity. A 
distinguished professor in the medical department of one of our univer- 
sities, in an address to the graduating class, recently said: "Some 
professional men seem to be ashamed unless they have the character of 
universal knowledge. He who falls into the error of studying every- 
thing will be certain to know nothing well. Every man must have 
a good foundation. He must, in the first place, be a good general 
practitioner. But the field has become too large to be cultivated in 
its entirety by one individual; hence the advantage of cultivating 
special studies in large towns, which admit of the subdivision of 
professional pursuits. It is no longer possible to know everything; APPENDIX. 
957 
something must be wisely left unknown. Indeed, a physician, if 
he would know anything well, must be content to be profoundly 
ignorant of many things. He must select something for special study, 
and pursue it with devotion and diligence. This course will lead to 
success, while the attempt to do everything eventuates unavoidably in 
failure. Let there be single hands for special duties." Our institution 
is the only one in this country in which these common-sense-ideas are 
thoroughly carried out. The diversified tastes and talents of physicians 
cause each to excel in treating some one class of diseases, to which he 
devotes more attention and study than to others. One medical student 
manifests great interest in the anatomy, physiology, pathology, and 
treatment of diseases of the eye. He becomes thoroughly familiar 
A glimpse at our Bindery, 
World's Dispensary 
with all the minutest details relative to that 
organ and its diseases, and so thoroughly 
qualifies himself in this branch of knowl- 
edge that he is able to cure an inflamma- 
tion or other affection of the eye in a very short time. Another 
student is more interested in some other class of diseases, for the 
study of which he has a liking, and neglects to inform himself in 
the ophthalmic branch of medical and surgical science. If, after 
engaging in the practice of his chosen profession, he is consulted by 
persons suffering from diseases of the eye, he tortures them with 
unnecessary and ofttimes injurious applications, clumsily and care- 
lessly made, and, as the result of such unskillful treatment, the ines- 
timable blessing of sight is many times sacrificed. 
The great majority of physicians allow acute maladies, diseases of 
children, and the practice of midwifery, to engross most of their time 
and attention. They manifest an absorbing interest in everything that 958 
APPENDIX. 
relates to these subjects, and devote little or no time to acquiring an 
intimate knowledge of the great variety of chronic maladies which 
afflict mankind. They acquire skill and reputation in their favorite 
line of practice, but are annoyed if consulted by one suffering from 
some obscure chronic affection, usually turn the invalid off with a very 
superficial examination, and, perhaps, only prescribe some placebo,* 
apparently indifferent as to the result, but really desiring thus to 
conceal their lack of familiarity with such diseases. The specialist, the 
treatment of chronic diseases being his vocation, is equally annoyed if 
consulted by those suffering from acute diseases, but does not pursue 
the inconsistent course of assuming to treat them. He refers them 
to those of his medical brethren whose daily dealings with such cases 
make them, in his way of thinking, more competent than himself to 
render valuable service to such sufferers. He recognizes the fact that 
no man is likely to succeed in any line of study or business for which 
he possesses no talent or relish, nor does he believe in being a "jack- 
at-all-trades and master of none." 
Having thoroughly qualified himself for the practice of some par- 
ticular branch of the healing art, the specialist sees no impropriety in 
acquainting the public with his ability to relieve certain forms of 
suffering. He believes that medical men should possess equal rights 
with other business men, and that any code of medical ethics which 
would deprive him of any of the sacred rights guaranteed to all by the 
liberal laws of the country, is professional tyranny, and merits only 
his contemptuous disregard. Nor does he display any false modesty in 
the manner of making known his skill. He maintains that he has an 
undoubted right to place his claims to patronage before the public 
by every fair and honorable means. He recognizes the display of 
goods in the merchant's show-windows as no less an advertisement and 
in no better taste than the publication of a card in the newspaper. So. 
likewise, he regards the various devices by which the extremely ethical 
physician seeks to place himself conspicuously before the public, as 
but so many ways of advertising, and as not more modest than the 
publication of cures actually performed, or than his announcement 
through the public press of his professional sources for treating certain 
maladies. 
The physician who expresses a "holy horror" of the "arfrer/ts- 
ing doctor," liberally bestowing upon him the epithet of "quack." 
announces himself a graduate, talks learnedly and gives notice to the 
public in some way that he is ready to serve them. He endeavors to 
impress upon the mind of the patient and family his skill, frequently 
exaggerates as to the extent of his practice, rides furiously about when 
he has no professional calls, keeps up business appearances by driving 
ADVERTISING. 
*A placebo is a harmless and valueless prescription, which physicians some- 
times make merely to gratify the patient, as a dose of " bread pills," etc. APPENDIX. 
959 
several horses, or joins influential societies. He may make a great 
display in style, manner, dress, pretensions, writing for the newspapers, 
exhibiting literary pedantry, referring to the superior facilities afforded 
by some particular school or society to which he belongs; or by editing 
and publishing a medical journal, ostensibly for the advancement of 
medical science, but practically to display titles or professorships, to 
publish reports which flatteringly allude to cases he has treated, the 
number of capital surgical operations he has performed, or the distin- 
guished families he is treating. All these are but modes of advertising 
professional wares; in short, are artful, though not refined, tricks, 
resorted to for private announcement. We say to all such adventurers 
in modern advertising diplomacy, that these indirect, clandestine 
methods are not half so candid and honorable as a direct public 
statement of the intentions and proposals of a medical practitioner, 
who thereby incurs an individual responsibility before the law and his 
fellow-men. 
No good reason has ever been assigned why any well educated 
physician, trained in the school of experience until he becomes pro- 
ficient in medical skill, may not publish facts and evidence to disclose 
it, especially when these are abundant and conclusive. The following 
extracts from an able article by the Rev. Thomas K. Beecher em- 
bodies a sound view of the subject of medical advertising. He says: 
* * "I am glad that the doctor cured him; I am glad that 
the doctor put it in the paper that he could cure him. And if any 
doctor is certain that he can cure such diseases and don't put it 
in the paper, I am sorry. What a pity it would have been had 
this doctor come to town with his wealth of science and experience 
and gone away leaving him uncured! What a pity it would have 
been if he had been so prejudiced against advertising as to read 
the responsible certificate of the doctor and give him the go-by as 
a quack! What are newspapers for, if not to circulate information? 
What more valuable information can a newspaper give than to tell 
a sick man where he can be cured? If a man has devoted his life 
and labor to the study of a special class of diseases, the necessity 
of his saying so becomes all the more pressing. His duty to advertise 
becomes imperious. 
"When I was in England. I found on all the dead walls of 
London, placards, declaring that Dean Stanley, Chaplain to the 
Prince of Wales, would preach at such a place; that his grace the 
Archbishop (I think) of Canterbury would preach at another time 
and place; again, that an Oxford professor would preach. In short, 
religious notices were sprinkled in among the theater bills, and the 
highest church dignitaries were advertised side by side with actors, 
singers, and clowns. Of course, I was shocked by it, but in a 
moment I bethought me-if it be all right and dignified to hire a 
sexton to ring a bell when the minister is going to preach, it is all 
the same to silence the bell and hire a bill-sticker to tell the same 
news, the essential thing being to tell the truth every time. The 
remedy for the lying advertisements is for honest men to tell the 
truth. 'When iniquity cometh in like a flood, then the spirit of 
the Lord lifts up the standard.' A really able man, whatever be his 
gifts, makes a great mistake if he fail to use those gifts through 
want of advertising." 960 
APPENDIX. 
If a physician possesses knowledge that enables him to remedy 
diseases heretofore regarded as incurable, what virtue or modesty is 
there to "hide his light under a bushel"? In this free country the 
people think and act for themselves, and hence all have a deep 
concern in the subject of health. The strong popular prejudice 
against the doctors who advertise is due to the fact, that by this 
method so many ignorant charlatans are enabled to palm off their 
worthless services upon the uneducated and credulous; but the 
practice of such imposition should not cause a presumption against 
the public announcement of real skill, for the baser metal bears 
conclusive evidence that the pure also exists. 
Every step in scientific investigation, every proposition which 
relates to the interest and happiness of man, every statement and 
appeal involving a valuable consideration, must be submitted to the 
scrutiny and judgment of individual reason; for every person has 
the right to form his own conclusions, and justify them by expe- 
rience. Those claims which are only supported by empty assertion 
are very doubtful. Misty theories vanish before the sun of truth. 
He who renders professional services cannot be successful, unless 
he be sustained by real merit. 
TREATING PATIENTS WHO RESIDE AT A DISTANCE. 
We can treat many chronic diseases as successfully without as 
with a personal consultation, as our vast experience enables us to 
correctly determine the malady from which the patient is suffering, 
from a history of the symptoms, and answers to questions furnished. 
We have never seen one person in five hundred whom we have 
cured. 
Some may suppose that a physician cannot obtain, through corre- 
spondence, a sufficiently accurate idea of the condition of a patient 
to enable him to treat the case successfully; but a large experience 
in this practice has proved the contrary to be true, for some of 
the most remarkable cures have been effected through the medium 
of correspondence. In most long-continued cases, the patient has 
thought over his symptoms hundreds of times. The location of 
every pain, whether acute or mild, constant or occasional, and the 
circumstances under which it occurs, have been carefully noted. He 
has observed whether he had a rush of blood to the head, was 
feverish or chilly, whether troubled with cold hands and feet, 
whether full of blood, or pale and bloodless; and he states these 
matters with accuracy and common sense when writing to us, for he 
has a very good, if not a professional, knowledge of the relative 
importance of these symptoms. So in regard to digestion, he states 
what kinds of food agree with him, or whether he is troubled with 
excessive acidity or a flatulent condition of the stomach. He also 
informs us whether his tongue is coated and bilious, or clean and 
healthy, and gives many other particulars too lengthy to enumer- APPENDIX. 
961 
ate, by which we are enabled to gain a perfect understanding of 
the case. If his description be not sufficiently complete to enable 
us to obtain an unmistakable understanding of the case, he is 
Binocular Microscope used at the Invalids' Hotel and Surgical Institute. 
requested to answer a list of important questions which are sent 
him. The people are far more intelligent in these matters than 
physicians are generally willing to admit. A patient is often con- 
fused while being personally examined by a physician, and gives 
imperfect or incorrect answers. After he has left the presence of 
the physician, he finds that he has failed to enumerate many of the 
most important symptoms. In consulting by letter, the patient is not 962 
APPENDIX. 
embarrassed, he states the exact symptoms, and carefully reads over 
the letter to see if it is a complete and accurate description of his 
sufferings. In this way he conveys a much better idea of the case 
than if present in person, and subjected to the most thorough 
questioning and cross-examination. The timid lady and nervous 
young man write just as they feel; and one important reason why 
we have had such superior success in treating intricate and delicate 
diseases, is because we have obtained such true and natural state- 
ments of the cases from these letters, many of which are perfect 
pen-pictures of disease. As bank-tellers and cashiers, who daily 
handle large quantities of currency, can unmistakably detect spurious 
money by a glance at the engraving or a touch of the paper, so the 
experienced physician, by his great familiarity with disease, becomes 
equally skilled in detecting the nature and extent of a chronic 
malady from a written description of its symptoms. 
A careful microscopical examination and chemical analysis of the 
urine is a valuable aid in determining the nature of many chronic 
diseases, particularly those of the nervous system, blood, liver, kidneys, 
bladder, prostate gland and generative organs. This important fact is 
not overlooked at the Invalids' Hotel and Surgical Institute, where 
an experienced chemist is employed to make such examinations and 
report the result to the attending physicians. Medical authors, pro- 
fessors, and practitioners of all schools, admit and even insist upon 
the importance of such examinations in diagnosticating diseases. 
Many practitioners neglect to take advantage of this invaluable aid, 
while others fear that if they attach much importance to such 
examinations they will be ranked with "uroscopian" or "water" 
doctors, a class of enthusiasts who claim to be able to correctly 
diagnosticate every disease by an examination of the urine. Per- 
sons consulting us and wishing to avail themselves of the advantages 
afforded by these examinations can send small vials of their urine 
by express. The vials should be carefully packed in saw-dust or 
paper and enclosed in a light wooden box. All charges for trans- 
portation must be prepaid, and a complete history of the case, 
including the age and sex of the patient, must accompany each 
package, or it will receive no attention. This saves valuable time 
by directing the examination into the channels indicated, and 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. 
There is a natural, definite proportion of the component elements 
of every solid and fluid of the human body. These proportions 
have been reduced to definite standards, a deviation from which 
bears evidence of disease. Thus, there being a fixed standard in a 
normal proportion of the elements of the blood, any deviation from 
URINARY SIGNS. APPENDIX. 
963 
it as in anaemia, leucocythaemia, etc., indicates disease. So also the 
standard proportion of the urinary elements being known, any con- 
siderable change, either in quantity or quality of its parts, bears 
unmistakable evidence of dis- 
ease. The invention of the 
microscope has provided in- 
creased facilities for detecting 
diseases by examination of the 
urine. By the aid of this won- 
derful instrument, we are en- 
abled to discover with absolute 
certainty the various urinary 
deposits characteristic of dif- 
ferent maladies; thus in Fig. 
1, A represents the residue of 
normal human urine, as seen 
under the microscope. In di- 
vision b is represented oxalate 
of urea. An excess of this 
element indicates indigestion, 
and is also characteristic of a plethoric, or full habit of the body. 
Nitrate of urea is represented in division c. A deficiency of urea 
in the renal secretion is a certain indication of anaemia. The average 
quantity present during health is 21.57 parts in 1,000. The micro- 
scopic examination of the urine, 
notwithstanding the distaste, 
and even contempt, which 
many physicians manifest for 
such investigations, is pursued 
at the Invalids' Hotel and Sur- 
gical Institute, with inestima- 
ble benefit to our patients. It 
has revealed the existence of 
many serious affections, which, 
with all our other modes of in- 
vestigation, we have been un- 
able to detect. It has also 
thrown light upon many ob- 
scure chronic diseases. 
We have already spoken of 
the marked changes effected 
in the urine by a derangement of the digestive functions. It is a matter 
of surprise that physicians generally pay so little attention to the 
urine when dyspepsia is suspected, since all admit that an exami- 
nation of that excretion furnishes unmistakable evidence of the 
nature and complications of the disease. In this way we are many 
times enabled to determine whether the indigestion is caused by 
Fig. 1. 
Fig. 2. 964 
APPENDIX. 
congestion or functional disease of the liver or kidneys or by ner- 
vous debility. And when such 
cases are treated in accordance 
with the indications furnished, 
increased success attends our 
practice. In Fig. 2 (divisions 
A and B), highly magnified 
urinary deposits, which indi- 
cate different degrees of im- 
pairment of the digestive func- 
tions are represented. The 
crystals seen in division c in- 
dicate the same debility accom- 
panied with derangement of 
the mental faculties. Those 
in divisions D and e indicate 
still more aggravated forms of 
the same disorder. 
Fig. 3. * 
INVALUABLE AIDS IN DETERMINING DISEASES OF THE 
KIDNEYS AND BLADDER. 
The various forms of gravel, Bright's disease of the kidneys, 
hasmaturia, inflammation of the kidneys and bladder, diabetes, and 
other functional and organic 
diseases of the urinary organs 
effect characteristic changes in 
the urine, thus enabling us to 
distinguish them with certainty 
and exactness. Some of the 
various microscopical appear- 
ances of the urinary deposits 
in diseases of the kidneys and 
bladder, are represented in 
Fig. 3. In division A is rep- 
resented pus and mucus, the 
presence of which indicates 
suppuration of the kidneys 
(Bright's disease). In B pus 
globules are alone represented. 
In the division marked c are 
shown blood corpuscles as they are arranged in blood drawn from a 
vein or artery. D represents the same separated, as they always are 
when present in the urine. In E highly magnified oil globules are 
represented. If present in the urine, they indicate disease of the 
kidneys. In the division marked F are represented epithelial cells, 
the presence of which in large numbers is indicative of diseases of the 
mucous lining of the urinary organs. 
Fig. 4. APPENDIX. 
965 
Fig. 4 represents the microscopic appearance of phosphates in the 
urine. These are present in great quantity in cases of nervous debility 
and kindred affections. By attaching the camera lucida to the micro- 
scope we can throw an image 
of these urinary deposits upon 
paper. By the art of the en- 
graver this may be faithfully 
traced, and thus we are ena- 
bled to produce an accurate 
representation of them. Some 
of the beautiful crystalline 
deposits shown in Fig. 4 rep- 
resent less than a millionth 
part of a grain, yet their forms 
are delineated with geomet- 
rical precision. In divsion a 
are represented urinary crys- 
tals, which indicate an irrita- 
ble state of the nervous sys- 
tem. The crystals shown in 
division B are of the same character as the preceding, but bear 
evidence of greater mental debility. In division c are represented 
crystalline deposits indicating malassimilation of food and a tendency 
to hypochondria. Division d contains a representation of the mixed 
phosphates. They are indica- 
tive of severe diseases attended 
with hypochondria and general 
nervous prostration. 
Fig. 5 represents the micro- 
scopic appearance of mixed 
urinary deposits. In division 
A are represented the mixed 
urates as they appear during 
idiopathic fevers, as intermit- 
tent, remittent, etc. When 
appearing as seen in division 
B, a less violent affection of 
the same character is indi- 
cated. Division c represents 
urate of ammonia, occasionally 
observed when there is a tend- 
ency towards albuminuria, or dropsy, resulting from granular degen- 
eration of the kidneys, as in incipient Bright's disease. In division 
D is represented urate of soda, which is present in the urine of per- 
sons suffering from gout. The crystals shown in division E consist 
of the same salt. 
In division A, Fig. 6, is represented purulent matter as it appears in 
Fig. 5. 
Fig. 6. 966 
APPENDIX. 
the urine. The absorption of pus from abscesses in different parts of 
the system is frequently followed by the appearance of pus globules in 
the urine. When fat globules, represented in division B, are found 
in the urine, they indicate fatty 
degeneration. In division c 
are representations of the cells 
found in the urine of persons 
suffering from consumption or 
other scrofulous diseases. 
Fig. 7 represents the differ- 
ent forms of cystine found in 
the urine of scrofulous and 
consumptive persons. In di- 
vision A it is represented as 
seen in an amorphous (non- 
crystallized) form, and in b it 
appears in crystals. In divis- 
ion c is a representation of 
the deposits seen in the urine 
of those who are greatly de- 
bilitated. In division D are seen epithelial cells mixed with mucus. 
In division A, Fig. 8, are represented the caudated cells characteristic 
of hard cancer. The cells represented in division b are concentric, and 
characteristic of the soft varieties of cancer. 
Fig. 9 represents the appearance of spermatozoa as seen in the urine. 
When present, they afford in- 
disputable evidence of the es- 
cape of semen in the renal 
excretions. 
We might add many other 
illustrations of urinary depos- 
its and state their several in- 
dications, but a sufficient num- 
ber have been introduced to 
show the importance and prac- 
tical value of microscopic ex- 
aminations of the urine in dis- 
tinguishing obscure diseases. 
Although the microscope is 
of inestimable value, it does 
not entirely supersede other 
valuable instruments and 
chemical re-agents, in determining the constitutional changes by the 
renal excretion. By the urinometer we determine the specific gravity 
of the urine; by the use of litmus its acid or alkaline reaction is ascer- 
tained; while various chemicals, when added to it, produce certain 
specific changes, according to the morbid alterations which it has 
Fig. 7. 
Fig* 8. APPENDIX. 
967 
undergone by reason of disease. By the application of heat, or the 
addition of a few drops of nitric acid, the albumen, which is invariably 
present in Bright's disease of the kidneys, is coagulated. By the 
employment of other re-agents we may determine the presence of 
sugar - a characteristic of diabetic urine. And thus we might enu- 
merate almost innumerable chemical tests by which the several 
changed conditions of the urine, characteristic of different diseases, 
may be ascertained with absolute certainty. 
THE MOST EMINENT MEDICAL AUTHORITIES 
ENDORSE IT. 
Dr. Eberle, a distinguished allopathic author, thus writes: "What- 
ever may be the disease, the urine seldom fails in furnishing us with 
a clue to the principles upon which it is to be treated." 
Dr. Braithwaite also says: "We can arrive at a more accurate 
knowledge respecting the nature of diseases from examining the urine 
than from any other symptom." 
Golding Bird, whose writings are regarded as sound and practical by 
the most learned of the medical profession, says: " The examination 
of the urine in disease is now regarded as one of the most important 
aids in diagnosis, and which it would 
be injurious alike to the welfare of 
the patient and the credit of the 
practitioner to avoid." 
The eminent Dr. F. Simon writes 
as follows: "From the physical and 
chemical state of the urine, the at- 
tentive and observing physician may 
obtain a great quantity of informa- 
tion for ascertaining and establish- 
ing a diagnosis. More than all other 
signs, the correct examination of the 
sediment is of importance to the 
physician. * * * For the medical 
man it is the compass which guides 
him in the unlimited chaos of disease and its treatment; for the patient 
it is the thermometer of his condition, the premonitory indication of the 
decrease or aggravation of his malady; and for the healthy man it 
is the regulator of his diet and his life. Every one is aware of the 
variations of the barometer, and we know that the fluctuations of the 
column of mercury are closely associated with the variable conditions 
of the atmosphere; so, to the practical observer, variations of the urine, 
as well as the elements composing it, point out with certainty the 
changes in health, and the condition of the organs." 
While we recognize the importance of examining the urine as an aid 
in distinguishing diseases, and have made this old German method of 
diagnosis a special study, yet we do not claim that all diseases can 
Fig. 9. 968 
APPENDIX. 
be unmistakably distinguished by such examinations alone. We take a 
conservative position and have no confidence in that class of ignorant 
fanatics whose pet hobby is "uroscopy." 
From every person who solicits our professional services, we require 
explicit answers to numerous important questions, that we may know 
the age, sex, vocation, etc., as well as the prominent symptoms 
manifested. 
Formerly, we published in this book a very extensive list of questions 
to be answered by those consulting us, but a large experience has 
convinced us that beyond requiring answers-to a few leading questions, 
which we still retain, it is better to let the patient describe the malady 
in his or her own way and language. After receiving and considering 
such a history, if we do not fully understand the patient's malady, we 
will ask such further questions as may be necessary. The patient 
should, however, in addition to writing name, post-office, county, and 
state, plainly, state the name of the town containing the nearest 
express office. Next give age, sex, whether married or single, com- 
plexion, height, present and former weight, if known, and occupation. 
State also if you have been a hard worker, and whether it is necessary 
for you to labor hard now, how long you have been out of health, and 
from what particular symptoms you suffer most. Follow this with a 
history of your case in your own language. If you find in this 
pamphlet an accurate description of your disease, state the page and 
paragraph where it occurs. 
CONSULTATIONS BY LETTER. 
FREE CONSULTATION. 
We now make no charge for consultation by letter, but, instead of 
the one dollar formerly charged by us as a consultation fee, as we are 
desirous of making our facilities for treatment known to invalids far 
and near, we request that all persons writing to us for advice send 
us the names of all those within the circle of their acquaintance that 
are in any way in need of medical or surgical treatment for chronic 
diseases. If convenient, send the list on a separate piece of paper. 
CHARGES MUST BE PREPAID. 
Should you send a vial of urine for analysis, a very small one will 
do, and all express charges on it must be prepaid. All liquids are 
excluded from the mails, when discovered, and yet we have received 
hundreds of samples through the mails safely when put in homoeopathic 
or other very small vials, well corked and carefully packed in a light 
tin can or wooden box, or in a light pine stick bored out hollow, the 
vial being carefully packed in sufficient sawdust or blotting paper to 
absorb all liquid should the vial get broken. Letter postage, that is, 
two cents for each one ounce or fraction thereof, must be paid upon 
these sealed packages. Send the urine that is first passed after rising 
in the morning. APPENDIX. 
969 
RELIABLE MEDICINES. 
Next in importance to a correct understanding of the patient's 
disease, is the possession of reliable remedies for its treatment. Many 
of the medicines employed by physicians engaged in general practice 
are prepared from old drugs that have lost all their medicinal virtues, 
and hence are utterly useless and ineffectual. Many vegetable extracts 
are inert, because the plants from which they are produced were not 
gathered at the proper time. To give the reader an idea of the great 
care which we exercise in the selection and preparation of our medi- 
cines, he is requested to read under the head of ''The Preparation 
of Medicines," in "The People's Common Sense Medical Adviser." 
OUR TERMS FOR TREATMENT 
require the payment of monthly fees, in advance, which entitle the 
patient to medicines specially prepared for and adapted to his or her 
particular case, and to all necessary attention and advice. Our fees 
for treatment are moderate, varying according to the nature and 
requirements of each particular case, and will be made known at the 
time of consultation. 
WHY OUR FEES ARE REQUIRED IN ADVANCE. 
We receive applications from strangers residing in all parts of 
America, and even in foreign countries, and it is not reasonable to 
suppose that credit could be dispensed so indiscriminately. It would 
not be a correct business transaction for a merchant to send a barrel of 
sugar or a roll of cloth to a stranger living hundreds of miles away, 
to be paid for when used. Our knowledge and medicines constitute 
our capital in business, and an order upon that capital should be 
accompanied with an equivalent. Some applicants refer us to their 
neighbors for. a testimonial of their integrity. We cannot spare the 
time or employ assistants to make such inquiries for the sake of 
trusting any one. Should credit be thus indiscriminately given, there 
would necessarily be losses, and, to compensate for these, and the extra 
expense incurred by the employment of assistants, our fees would have 
to be much larger, thereby imposing the burden upon those who do 
pay. Instead of following this method of procedure, we place pro- 
fessional services within the reach of all, so that a greater number 
may be benefited. Many invalids say that they have paid large 
sums of money to medical men for treatment without obtaining relief. 
Unfortunately our land is cursed with quacks and unprincipled prac- 
titioners, who seek no one's good but their own, and it is a defect in 
our law that it permits such swindlers to go unpunished. Not so 
reprehensible is the family physician who fails, because his limited and 
varied practice does not permit him to become proficient in treating 
chronic diseases. 970 
APPENDIX. 
The following beautiful sentiment of Hood truthfully expresses the 
sacredness of the physician's trust: 
" Above all price of wealth 
The body's jewel. Not for minds or hands profane 
To tamper with in practice vain. 
Like to a woman's virtue is man's health; 
A heavenly gift within a holy shrine I 
To be approached and touched with serious fear, 
By hands made pure and hearts of faith severe, 
E'en as the priesthood of the One Divine." 
We are in regular practice, responsible for what we say and do, 
and cordially invite those who desire further evidence of our suc- 
cess in curing chronic diseases to come to the Invalids' Hotel and 
Surgical Institute and satisfy themselves of the truthfulness of our 
statements. 
We are warranted in saying that our responsibility and disposition 
for fair dealing are known to many of the principal mercantile houses, 
as well as by all prominent American editors. We also refer to our 
present and former patients, one or more of whom may be found in 
almost every hamlet of America. To all who are under our treatment 
we devote our highest energies and skill, fully realizing that an untold 
blessing is conferred upon every person whom we cure, and that such 
cures insure the permanency of our business. On the contrary, we 
realize how unfortunate it is for us to fail in restoring to health any 
person whom we have encouraged to hope for relief. We are careful, 
therefore, not to assume the treatment of incurable cases, except when 
desired to do so for the purpose of mitigating suffering or prolonging 
life; for we never wish to encourage false hopes of recovery. 
TERMS FOR BOARD AND TREATMENT AT THE INVALIDS' 
HOTEL AND SURGICAL INSTITUTE 
are moderate, varying with the nature of the case and the apartments 
occupied. So great is the number at times applying to avail themselves 
of the skill of our Faculty, and the advantages which our institution 
affords, that we are unable to receive all applicants. To be sure of 
securing good apartments, it is well to engage them sometime ahead, 
and make an advance payment of fifty dollars or more upon them, 
which will be refunded in case acute sickness or any similar cause 
should prevent the patient from occupying them at the time specified. 
Complete terms for treatment and board can be arranged only when 
personal application for entrance to the institution is made, and the 
nature and extent of the disease and the necessary treatment fully 
determined by personal examination of the case. If satisfactory terms 
and arrangments cannot at that time be agreed upon, or if the case be 
deemed incurable, any advance payments that have been made to 
secure good apartments will be promptly refunded. APPENDIX. 
971 
VISITING PATIENTS WHO RESIDE AT A DISTANCE. 
We are frequently asked to visit patients residing hundreds of miles 
away, that we may personally examine their cases, perhaps consult 
with the attendant physician or surgeon, or perform difficult surgical 
operations. If those who desire to avail themselves of the medical or 
surgical skill afforded by our organization of associated physicians and 
surgeons, will indicate as nearly as possible the nature of the patient's 
malady for which our services are desired, we can generally detail 
the physician or surgeon having charge of the special branch of 
practice to which the case belongs. Our charges will be moderate for 
such visits at a distance, depending somewhat upon the distance to be 
traveled, and will be made known at any time by request. Different 
members of our staff have traveled many thousands of miles to visit 
important cases and to perform surgical operations. 
wishing to consult us in intricate cases of chronic diseases under their 
treatment, we desire to say that we shall, as in the past, take pleasure in 
responding to their solicitations. We have all the necessary instru- 
ments and appliances required in executing the most difficult surgical 
operations, and, as we have had much experience in this department, 
we are always ready and able to assist physicians who do not practice 
operative surgery. In this age of railways and telegraphs medical and 
surgical aid can be summoned from a distance and promptly obtained. 
TO PHYSICIANS 
OUR MEDICINES 
as put up for sale through druggists, are not recommended as "cure- 
alls," or panaceas, but only as superior remedies for certain common 
and easily-recognized diseases. They are our favorite prescriptions, 
improved and perfected by long study and a vast experience in the 
treatment of chronic diseases, and have gained world-wide celebrity 
and sale. We are well aware that there are many chronic diseases 
that can only be successfully treated and cured by careful adaptation of 
remedies to each individual case. This is especially true of the ever- 
varying and delicate diseases of the kidneys and bladder. It is not 
less so with reference to nervous debility, involuntary vital losses, 
with which so many young and middle-aged men are afflicted; and we 
may also include in this list epilepsy or fits, paralysis or palsy, obstinate 
gleety discharges, and many other chronic and delicate ailments for 
which we do not recommend any of our put-up, ready-made, or pro- 
prietary medicines, but of which our staff of physicians and surgeons 
cure annually many thousands of cases. 
NO RELATIONSHIP WITH HUMBUGS. 
Had our put-up or proprietary medicines, as sold by druggists the 
world over, been adapted to all classes and forms of chronic diseases, 972 
APPENDIX. 
there would have been no necessity for our organizing a competent 
staff of physicians and surgeons to act as experts in the treatment of 
difficult, obscure, and complicated cases of chronic diseases. That we 
keep constantly employed, in our Buffalo and Loudon institutions, 
eighteen medical gentlemen, with such helpers as stenographers, clerks, 
etc., is indisputable proof that the medicines we offer for sale through 
druggists should not be classed with the humbug nostrums recom- 
mended to cure everything. They are the outgrowth of our vast and 
extended practice in the treatment of chronic diseases; are well-tried, 
world-famed, and honest medicines. They are not unduly puffed and 
lauded, but simply recommended for such diseases as are easily 
recognized and which they are known to cure. 
NOT CONFINED IN PRESCRIBING. 
Our physicians, in the treatment of cases consulting us, prescribe 
just such medicines as are adapted to each particular case. They are 
not confined in the least to our list of a few put-up or proprietary 
medicines (valuable as they are when applicable to the case) but resort 
to the whole broad range of the materia medica, employed by the 
most advanced physicians of the age. They are not hampered by 
any school, ism or "pathy." 
OUR MEDICINES PREPARED WITH THE GREATEST 
CARE. 
The medicines employed are all prepared in our own Laboratory by 
skilled chemists and pharmacists, and the greatest care is exercised to 
have them manufactured from the freshest and purest ingredients. 
Our Faculty probably employ a greater number and variety of native 
roots, barks, and herbs, in their practice than are used in any other 
invalids' resort in the land. Using vast quantities of these indigenous 
medicines, we can afford and do not neglect to have them gathered 
with great care, at the proper seasons of the year, so that their medici- 
nal properties may be most reliable. Too little attention is generally 
paid to this matter, and many failures result from the prescribing of 
worthless medicines by physicians who have to depend for their 
supplies upon manufacturers who are careless or indifferent in obtain- 
ing the crude plants and roots from which to manufacture their 
medicines for the market. While depending largely upon solid and 
fluid extracts of native plants, roots, barks, and herbs, in prescribing 
for disease, yet we do not use them to the exclusion of other valuable 
curative drugs and chemicals. We aim to be unprejudiced and inde- 
pendent in our selection of remedies, adopting at all times a rational 
system of therapeutics. This liberal course of action has, in a vast 
experience, proved most successful. 
WORLD'S DISPENSARY MEDICAL ASSOCIATION, 
6G3 Main Street, Buffalo, N. Y. appendix. 
973 
PRESIDENT GARFIELD'S 
ENDORSEMENT OF THE 
Invalids' Hotel and Surgical Institute 
AND ITS FOUNDER. 
The following letter from an eminent lawyer of Tennessee, is note- 
worthy, inasmuch as it shows the estimation in which Dr. Pierce 
and the institutions which he has founded were held by the lamented 
Garfield, who was one of the Doctor's intimate friends and colleagues 
while he was serving as a member of Congress : 
Office of H. F. Coleman, 
Attorney at Law, 
Sneedville, Tenn., Aug. 11, 1884. 
World's Dispensary Medical Association, 663 Main St., Buffalo, N. Y. 
Gentlemen:-Your letter of the 31st ult. just received and contents 
noted. I am perfectly satisfied with the explanation, and ask pardon 
for the sharp letter written you some days since. The mails are very 
irregular, as you know, and we are too apt to be impatient and attribute 
our mishaps to the wrong cause. Your honesty, integrity and ability 
are not doubted in the least by me. 
I have, perhaps, a higher endorsement of you than any other patient 
under your care, and for your gratification I will give it to you. 
Some time since I was in conversation with Congressman Pettibone, 
of this State, when the following conversation took place : "You say," 
said the Major, " that you have visited Dr. Pierce's medical establish- 
ment in Buffalo, New York ?" "Yes, sir, I. did." "You found every- 
thing as represented ?" "Yes, sir, as was represented, and which I 
assure you was quite encouraging to a man who had traveled as far as I 
had to visit an institution of that kind." "That man, Dr. Pierce," said 
the Major, "is one of the best men of the times. While at Washington, 
during my first term," he continued, " one day I was in President Gar- 
field's room and a fine-looking, broad-foreheaded gentleman came in, 
and President Garfield arose and took him by the hand and said, 'Good 
morning, Doctor, I am so glad to see you,' and then turned and intro- 
duced him to me as Dr. Pierce, of Buffalo, New York. Knowing the 
Doctor by reputation, and having seen his pictures, I at once recog- 
nized him. He, in a short time, left the room, and Garfield said to me, 
' Major, that is one of the best men in the world, and he is at the head 
of one of the best medical institutions in the world.'" 
With this high endorsement, I have unbounded confidence in your 
integrity and ability. Very truly yours. 
H. F. COLEMAN. 974 
APPENDIX. 
NOTICES OF THE PRESS. 
OUR PROFESSIONAL STAFF. 
The Buffalo Evening News says: "Each and every member of the 
medical and surgical staff of the Invalids' Hotel and Surgical Insti- 
tute is a graduate in medicine and surgery from one or more legally 
chartered medical colleges, and several of the members have had many 
years of experience as army surgeons, and in hospital and general as 
well as in special practice. One is a licentiate of the Royal College of 
Physicians, Edinburgh ; licentiate of the Faculty of Physicians and 
Surgeons, Glasgow; licentiate of midwifery, Glasgow; member of the 
Royal College of Surgeons, London, England; extraordinary member 
of the Royal Medical. Society, Edinburgh, etc. Another is a graduate 
of the University of Pennsylvania, at Philadelphia; another of the 
New York Medical College; another of the Buffalo Medical College, 
and of the College of Physicians and Surgeons, New York; another of 
Cincinnati Medical College, and of the University of New York; an- 
other from Buffalo Medical College, and diplomas from all these insti- 
tutions, as well as from many others equally noted, can be seen at the 
offices of this institution, if any one feels any interest in them." 
From the " Roman Citizen," (Rome, N. Y.). 
THE INVALIDS' HOTEL AND SURGICAL INSTITUTE. 
One of the most extensive institutions in this country for the treat- 
ment of chronic ailments is the Invalids' Hotel and Surgical Institute 
at Buffalo, under the control of the World's Dispensary Medical Asso- 
ciation, of which Dr. R. V. Pierce is President. The hotel itself is a 
wonderful affair, combining all the comforts and conveniences of a 
luxurious home with the most complete facilities for the successful 
treatment of all chronic diseases incident to humanity. Dr. Pierce 
has a world-wide fame as a skillful practitioner, and his corps of as- 
sistants comprises many physicians and surgeons of great ability and 
large experience in the treatment of chronic and surgical diseases. 
Those who have been treated by the Association are loud in their 
praises, and we understand that the number of its patients increases 
with each succeeding year. The country is full of people who have 
been "doctoring" year after year without successful results, and the 
probabilities are that in a majority of such cases a few months spent at 
the Invalids' Hotel and Surgical Institute in the care of its medical 
experts, would result in material and permanent benefit. 
From the Washington (D. C.) Chronicle of Jan. 4, 1885. 
President-elect Cleveland is not by any means the only attraction at 
Buffalo. In that enterprising city some eminent and capable profes- 
sional people have established an " Invalids' Hotel and Surgical Insti- 
tute," under the comprehensive direction and control of the "World's 
Dispensary Medical Association" at 663 Main Street, in that beautiful 
city. This Institute is organized with a full staff of eighteen physi- 
cians and surgeons, and the hotel is exclusively devoted to treatment 
of chronic diseases. This corps of doctors make a specialty of chronic 
ONE OF THE ATTRACTIONS AT BUFFALO APPENDIX. 
975 
maladies, and the Institute is reputed to have abundant skill, facilities, 
and apparatus for the successful treatment of every form of chronic 
ailment, whether requiring for its cure medical or surgical means. 
The building occupied is a massive one of five stories. 
From the Missouri Republican (St. Louis). 
A REMARKABLE PROFESSIONAL SUCCESS. 
Among the notable professional men of this country who have 
achieved extraordinary success is Dr. R. V. Pierce, of Buffalo, N. Y. 
The prominence which he has attained has been reached through 
strictly legitimate means, and so far, therefore, he deserves the envi- 
able reputation which he enjoys. This large measure of success is the 
result of a thorough and careful preparation for his calling, and exten- 
sive reading during a long and unusually large practice, which has 
enabled him to gain high commendation, even from his professional 
brethren. Devoting his attention to certain specialties of the science 
he has so carefully investigated, he has been rewarded in a remarkable 
degree. In these specialties he has become a recognized leader. Not a 
few of the remedies prescribed by him have, it is said, been adopted and 
prescribed by physicians in their private practice. His pamphlets and 
larger works have been received as useful contributions to medical 
knowledge. He has recently added another, and perhaps more import- 
ant work, because of more general application, to the list of his pub- 
lished writings. This book, entitled "The People's Common Sense 
Medical Adviser," is designed to enter into general circulation. For 
his labors in this direction, Dr. Pierce has received acknowledgments 
and honors from many sources, and especially scientific degrees from 
two of the first medical institutions in the land. His works have been 
translated into the German, Spanish, French, and other foreign lan- 
guages. 
From the Toledo Blade. 
Dr. Pierce has now been before the general public long enough to 
enable the formation of a careful estimate of the efficiency of his treat- 
ment and his medicines, and the verdict, we are glad to know, has been 
universally favorable to both. 
From the St. Louis Globe. 
THE SUCCESSFUL PHYSICIAN. 
Dr. Pierce is a type of a class of men who obtain success by careful 
and well-directed effort, not attempting too much, nor creating false 
ideas as to ability. The only reliable physician, in these days of com- 
plicated disorders and high-pressure living, is the "Specialist," the man 
who understands his own branch of the business. Such, in his line, is 
Dr. Pierce. He has written a " Common Sense Medical Adviser," 
which is well worth reading. With strict business honor, high profes- 
sional skill, reasonable fees, and a large corps of competent assistants 
Dr. Pierce has made his name as familiar as " household words." 
From the Rocky Mountain Herald. 
Dr. R. V. Pierce, the greatest American specialist, and proprietor 
of the World's Dispensary, Buffalo, N. Y., has sent us his new book 
entitled " The People's Common Sense Medical Adviser," which is a 
handsome, large volume, elegantly got up, with hundreds of wood-cuts 976 
APPENDIX. 
and colored plates, and a complete cyclopedia of medical teachings for 
old and young of both sexes. It has every thing in it, according to the 
latest scientific discoveries, and withal is wonderfully commonsensical 
in its style and teachings. 
From the Lafayette Daily Courier. 
Dr. R. V. Pierce, of Buffalo, distinguished in surgery, and the gen- 
eral practice of the profession he honors, has made a valuable contri- 
bution to the medical literature of the day, in a comprehensive work 
entitled "The People's Common Sense Medical Adviser." While scien- 
tific throughout, it is singularly free from technical and stilted terms. 
It comes right down to the common-sense of every-day life, and, to 
quote from the author himself, seeks to "inculcate the facts of science 
rather than the theories of philosophy." This entertaining and really 
instructive work seems to be in harmony with the enlarged sphere of 
thought, as touching the open polar sea of evolution. He considers 
man in eveiy phase of his existence, from the rayless atom to the grand 
upbuilding of the noblest work of God. Dr. Pierce is a noble speci- 
men of American manhood. He has sprung from the people, and with 
many sympathies in common with the masses, has sought to render 
them a substantial service in this the great work of his life. 
From the New York Independent. 
LAURELS FOR TRUE WORTH. 
"A wise physician, skill'd our wounds to heal. 
Is more than armies to the public weal." 
To be honored in his own land is the crowning blessing of the man 
who has been "the architect of his own fortune"-the man who has 
made for himself, with his own hands and brain, a princely fortune and 
an enduring fame. From Comley's History of New York State, con- 
taining biographical sketches of the men who "have given wealth, 
stamina, and character" to the Empire State, we clip the following 
brief sketch of the distinguished physician, Dr. R. V. Pierce, of Buf- 
falo: "Every nation owes its peculiar character, its prosperity-in 
brief, every thing that distinguishes it as an individual nation,-to the 
few men belonging to it who have the courage to step beyond the 
boundaries prescribed by partisanship, professional tradition, or social 
customs. In professional no less than in political life there occasionally 
arise men who burst the fetters of conventionalism, indignantly reject- 
ing the arbitrary limits imposed upon their activity, and step boldly 
foi-ward into new fields of enterprise. We call these men self-made. 
The nation claims them as her proudest ornaments-the men upon 
whom she can rely, in peace for her glory, in war for her succor. Of 
this class of men the medical profession has furnished a distinguished 
example in the successful and justly-celebrated physician, Dr. R. V. 
Pierce, of Buffalo, N. Y., and any history treating of the industries 
of the Empire State would be incomplete without a sketch of his use- 
ful and earnest work. * * * Specially educated for the profession 
which he so eminently adorns, he early supplemented his studies by 
extensive and original research in its several departments. He brought 
to his chosen work acute perceptive and reflective powers, and that in- 
domitable energy that neither shrinks at obstacles nor yields to circum- 
stances. In physique, Dr. Pierce is an ideal type of American man- 
hood. Of medium stature, robust, his appearance is characterized by a 
healthful, vigorous vitality, while the full, lofty brow and handsomely- 977 
APPENDIX. 
cut features are indicative of that comprehensive mental power and re- 
markable business sagacity which have combined to place him among 
the distinguished men of the age. * * * As an earnest worker for 
the welfare of his fellow-men, Dr. Pierce has won their warmest 
sympathy and esteem. While seeking to be their servant only, he has 
become a prince among them. Yet the immense fortune lavished upon 
him by a generous people he hoards not, but invests in the erection and 
establishment of institutions directly contributive to the public good, 
the people thus realizing, in their liberal patronage, a new meaning of 
the beautiful Oriental custom of casting bread upon the waters. Noted 
in both public and private life for his unswerving integrity and all those 
sterling virtues that ennoble manhood, Dr. Pierce ranks high among 
those few men whose names the Empire State is justly proud to inscribe 
upon her roll of honor." Dr. Pierce has lately erected a palatial 
Invalids' Hotel for the reception of his patients, at a cost of over half 
a million dollars. It was opened to the public May 1, 1878. 
Speaking of Dr. R. V. Pierce, the Buffalo (N. Y.) Commercial says: 
"He came here an unknown man, almost friendless, with no capital 
except his own manhood, which, however, included plenty of brains 
and pluck, indomitable perseverance, and inborn uprightness, capital 
enough for any man in this progressive country, if only he has good 
health and habits as well. He had all these great natural advantages, 
and one thing more, an excellent education. He had studied medicine 
and been regularly licensed to practice as a physician. But he was still 
a student, fond of investigation and experiment. He discovered, or in- 
vented, important remedial agencies or compounds. Not choosing to 
wait wearily for the sick and suffering to find out (without any body to 
tell them) that he could do them good, he advertised his medicines and 
invited the whole profession of every school, to examine and pronounce 
judgment on his formulas. He advertised liberally, profusely, but with 
extraordinary shrewdness, and with a method which is in itself a lesson 
to all who seek business by that perfectly legitimate means. His suc- 
cess has been something marvelous-so great, indeed, that it must be 
due to intrinsic merit in the articles he sells, more even than to his un- 
paralleled skill in the use of printer's ink. The present writer once 
asked a distinguished dispensing druggist to explain the secret of the 
almost universal demand for Dr. Pierce's medicines. He said they 
were in fact genuine medicines-such compounds as every good physi- 
cian would prescribe for the diseases which they were advertised to 
cure. Of course, they cost less than any druggist would charge for 
the same article, supplied on a physician's prescription, and, besides, 
there was the doctor's fee saved. Moreover, buying the drugs in such 
enormous quantities, having perfect apparatus for purifying and com- 
pounding the mixture, he could not only get better articles' in the first 
place, bpt present the medicine in better form and cheaper than the 
same mixture could possibly be obtained from any other source. 
A MAN OF THE TIME. 
Extracts from Biographical Sketches of New York Senators. 
At the age of eighteen, he (Dr. Pierce) entered a medical school, 
and proved a devoted student, graduating at twenty-three with the 
highest honors. A simple knowledge of the routine of practice as then 
in vogue, was not enough. He sought new means of healing, and 
explored "schools" of practice that were prohibited by his sect. He de- 978 
APPENDIX. 
nounced errors in the prevailing "schools" and accepted truths belong- 
ing to those prohibited. Every one knows how such daring and de- 
structive innovations are regarded by the medical profession generally. 
Dr. Pierce was no exception to the rule. But he paid no attention to 
detraction, pursuing his own way with that energy which proves now 
to be a most excellent ally of his medical instincts. 
The World's Dispensary is to-day the greatest institution of its kind in 
the world. More than two hundred persons are employed, fifteen be- 
ing skillful physicians and surgeons. Each of them devotes himself to 
a special branch of the profession, all acting together when required, 
as a council upon serious cases. The printing department of the Dis- 
pensary is larger than the similar department of any paper outside of 
the New York Herald. 
The People's Common Sense Medical Adviser will often save 
the family from the necessity of contracting large doctor's bills. It 
costs only $1.50. Hon. P. T. Barnum says : "It is overflowing with 
instruction." 
From the JVew York Times. 
WELL-MERITED SUCCESS. 
The author of "The People's Medical Adviser" is well-known to the 
American public as a physician of fine attainments, and his Family 
Medicines are favorite remedies in thousands of our households. As a 
counselor and friend, Dr. Pierce is a cultured, courteous gentleman. 
He has devoted all his energies to the alleviation of human suffering. 
With this end in view and his whole heart in his labors, he has achieved 
marked and merited success. There can be no real success without 
true merit. That his success is real, is evidenced by the fact that his 
reputation, as a man and physician, does not deterioriate; and the fact 
that there is a steadily increasing demand for his medicines, proves 
that they are not nostrums, but reliable remedies for disease. The 
various departments of the World's Dispensary in which his Family 
Medicines are compounded and his special prescriptions prepared, are 
provided with all modern facilities. 
From the " United Aid Journal." 
THE ART OF PROLONGING LIFE. 
People generally desire long life and good health. Sickness and pre- 
mature death are almost always due to violations of the laws that 
govern our physical being, and of which the masses are ignorant. If 
men knew better they would do better; but how can they avoid an evil 
that they kjiow not of? While efforts are made through the public 
schools to give each child a so-called common English education, yet 
the children are permitted to grow up and enter upon the responsible 
duties of active life, profoundly ignorant of the structure of their own 
bodies, and the laws of physical being upon which their health and 
lives depend. They are sent to school and crammed with arithmetic, 
grammar, and geography, by teachers who, in many instances, have 
never studied physiology and hygiene. They are taught to locate the 
mountains and trace the rivers of foreign countries, but are never 
taught to locate the vital organs and glands of their own bodies, or 
trace the veins, arteries, and nerves, in their various ramifications. They 
are instructed in the flow of the tides, the course of the ocean currents, APPENDIX. 
979 
and the philosophy of winds and storms; but they have no correct con- 
ception of the relative effects upon their health of breathing pure or 
impure air, nor has their attention ever been called to the importance 
of keeping their bodies clean and healthy by regular bathing. The 
criminalty of such neglect in teaching becomes apparent when we 
consider that the masses, ignorantly violating the laws of health, bring 
upon themselves sickness, suffering and death, that might otherwise be 
avoided. In this condition of things we welcome into being any work 
that is calculated to impart to the masses a knowledge of the structure 
of their own bodies, the laws of health, and the importance of observ- 
ing those laws. We find Dr. Pierce's "Common Sense Medical 
Adviser" to be just such a work. It is physiological and pathological, 
and the major part of it should be converted into a text-book for the 
use of common schools. Its careful study will enable the healthy to 
preserve their health, and the sickly to regain health. Every parent 
should read it, and as their children become of proper age instruct 
them in the all-importent truths it contains. Were this done, much suf- 
fering and premature death would be prevented, and many a youth 
saved from a -life of shame and licentiousness. The book contains 
over one thousand pages, is profusely illustrated with colored plates 
and wood-engravings, and can be had for $1.50 (post-paid), by address- 
ing the World's Dispensary Medical Association, Buffalo, N. Y. 
" The American mind is active. It has given us books of fiction for 
the sentimentalist, learned books for the scholar and professional 
student, but few books for the people. A book for the people must re- 
late to a subject of universal interest. Such a subject is the physical 
man, and such a book 'The People's Common Sense Medical Adviser,' 
a copy of which has been recently laid on our table. The high profes- 
sional attainments of its author,-Dr. R. V. Pierce, of Buffalo, N. Y., 
-and the advantages derived by him from an extensive practice, should 
alone insure for his work a cordial reception." Price $1.50, post-paid. 
Address,World's Dispensary Medical Association, Buffalo, N. Y. 
The New York Tribune says: 
From the Buffalo Times. 
Ray Vaughn Pierce was born on the 6th of August, 1840, in the 
town of Stark, County of Herkimer, N. Y. His ancestors were among 
the early settlers of Massachusetts, and afterward a branch of the fam- 
ily removed to Central New York, and were the progenitors of the 
subject of this sketch. While yet young, his parents left New York 
and located in Venango County, Pennsylvania. The chosen home was 
in a newly-settled region, amid wild and romantic scenery, and did not 
possess the most promising surroundings for educational pursuits, or 
mental culture. Young Pierce early developed a yearning for knowl- 
edge, and exhausted all the resources within his reach for self-improve- 
ment. The local schools were utilized to their utmost capacity, and 
what they lacked was made up by home study and private tuition, 
until he prepared himself for professional studies. 
At the age of eighteen he commenced the study of medicine, and 
at the end of four years graduated with the highest honors. He at 
once entered upon the duties of his profession, at the City of Titusville, 
in Crawford County, Pennsylvania. Four or five years of country 
practice created a desire for larger opportunities and a broader field of 
operations. In 1867, he came to Buffalo and opened an unpretending 
BIOGRAPHICAL SKETCHES OF MEN OF NOTE. 980 
APPENDIX. 
office on Clinton Street, for the practice of medicine. He was a com- 
parative stranger in the city, and he found it a slow and discouraging 
undertaking to build up such a practice as his ambition craved. His 
active brain soon evolved other plans and different methods of busi- 
ness, as well as new fields of usefulness for the employment of his 
time and energies. Not content with the daily routine of the ordinary 
practitioner, he determined to enlarge his sphere of operations, and to 
provide required remedies and specifics for multitudes beyond the 
range of a narrow circuit of daily routine calls. 
He began in a small way, the preparation of medicines, and adver- 
tised their healing qualities, and soon found a favorable response from 
the sick and afilicted, and his business increased beyond his most san- 
guine anticipations. The little room on Clinton Street was soon given 
up for a store on Main Street, and in due time this was abandoned 
for larger quarters, that were obtained elsewhere until the "World's 
Dispensary " was established, with its manifold appliances for the prep- 
aration arid circulation of his numerous remedies. 
Dr. Pierce knew the value of judicious advertising, and thereby he 
created a demand for his medicines in all parts of this country, as well 
as from abroad. Within five years after he established himself in 
Buffalo, the World's Dispensary was known throughout the globe. 
The fame of the institution led to frequent applications from abroad 
for opportunities for personal treatment, and to meet this demand Dr. 
Pierce conceived the idea of erecting an Invalids' Home. The concep- 
tion finally culminated in the construction of the famous Palace Hotel, 
one of the finest, largest, and best equipped public houses in the State. 
The structure was designed to provide an Invalids' Home for non-resi- 
dent patients. It was a magnificent building, and cost, including the 
grounds, its furnishing and equipments, more than half a million 
dollars. It was an ornament to Buffalo, and one in which every citi- 
zen felt a just pride. Its fame spread far and near, until nothing in 
or about the Queen city was better known than Pierce's Hotel. Tour- 
ists made long journeys to see the famous building, and Buffalonians 
rarely failed to take their visiting friends to the Palace, as one of the 
objects of interest in the city. 
The fire fiend destroyed this beautiful structure in the winter of 1881, 
and then Dr. Pierce erected suitable buildings, on Main and Wash- 
ington Streets, above Chippewa, to accommodate both branches of his 
growing business. The buildings were completed and occupied in 
May, 1882, and are a model, not only in architectural design, but in 
their appointments for the purposes required. The premises have a 
frontage of 100 feet on Main and Washington Streets, and a depth of 
200 feet. The Invalids' Hotel and Surgical Institute occupies the Main 
Street front, and the Dispensary the Washington Street side. The 
buildings are six stories high, and are constructed of brick, with sand- 
stone trimmings. 
The basement, or first story of the Dispensary, opens on a level from 
the Washington-street sidewalk, and is occupied by a plant of three 
large boilers, which supply the steam used to run a huge Corliss engine, 
of 100 horse-power, which is also located on this floor, and drives the 
machinery of the whole establishment. 
The main or second floor is entered from Main Street, by a short walk 
through the corridor of the Invalids' Hotel and Surgical Institute. 
On this floor are located reception-rooms, business offices, counting- 
rooms, the advertising department, and the mailing-rooms. 
On the third floor is the Association's extensive printing and binding APPENDIX. 
981 
works. Fourteen large presses, driven by power, with eight folding 
machines, trimming, cutting, and stitching machines, are constantly 
running in this department. 
Large mills for crushing, grinding, and pulverizing roots, barks, 
herbs, and other drugs, occupy a considerable part of the fourth floor. 
Extensive drying-rooms, in which articles to be ground in the drug 
mills are properly dried, are also located upon this floor, as are also 
many large tanks containing thousands of gallons of medicine ready 
for bottling. 
The entire fifth floor is occupied with mixing, percolating, distilling, 
filtering, and other apparatus. Every process is conducted under the 
watchful care of an experienced chemist and pharmacist, and in the 
most perfect and orderly manner, the apparatus employed being of the 
most approved character. 
The sixth floor is wholly occupied for the storage of paper, crude 
drugs, glass, corks, and other supplies employed in the general business. 
The Invalids' Hotel and Surgical Institute is provided with Turkish, 
electric, and other approved baths, with an extensive treatment-room, 
fitted up with vacuum and movement-treatment apparatus of the most 
modern and approved style. It also has accommodations for invalids 
and patients,-who are cared for not only medically but physically. 
The establishment furnishes employment to a small army of men and 
women, about 250 altogether-engaged in the several departments in 
compounding and preparing medicines, packing and shipping goods, 
printing, folding, wrapping, and mailing advertising literature, besides 
an array of superintendents, clerks, and accountants, to look after the 
details and financial affairs of the concern. The steam presses are con- 
stantly running, throwing off circulars and pamphlets by the million, 
that are sent to all parts of the earth. The paper used in the establish- 
ment costs over $100,000 per annum. Car loads of medicines are ship- 
ped in all directions, and thousands of the afflicted in every clime are 
relieved by the remedies that are flowing in a steady and constant 
stream from the justly-styled World's Dispensary. 
The Invalids' Hotel and Surgical Institute, where resident patients 
are treated, is an equally busy institution. A corps of nearly a score 
of competent physicians devote their entire time and attention to 
the resident patients and to the written requests for directions and 
advice from abroad. 
Such in brief is a mere outline of the business enterprise that the 
subject of this sketch has created during the last eighteen years, with- 
out capital to commence upon, or other adventitious aids in its prosecu- 
tion. He has relied upon his indomitable energy, persevering applica- 
tion, wise foresight, far-seeing calculation, and thorough knowledge of 
the business in hand. It is the result of a determined purpose, industri- 
ously and zealously pursued, with an intelligence that was equal to the 
requirement. The most complete system is observed in all the Doctor's 
transactions. Nothing is done at random, but everything for a pur- 
pose. Economy is rigidly enforced, yet nothing is done grudgingly. 
The whole establishment is so thoroughly systematized that it runs 
with the regularity of clock work. 
Dr. Pierce has found time amid his other varied duties, to prepare 
valuable medical works, and has enrolled himself among well-known 
authors. Chief among these is " The People's Common Sense Medical 
Adviser," which is a popular work upon diseases and their remedies, 
and has been introduced in all parts of the civilized world, and of 
which over 250,000 copies have been sold. 
Dr. Pierce has been too closely confined to his business to give much 982 
APPENDIX. 
attention to politics, yet he yielded to the persuasions of the Republi- 
cans in the Fall of 1877 to allow the use of his name as a candidate for 
State Senator. His opponent was one of the strongest men in Erie 
county, but the Doctor entered the campaign as he would a business 
enterprise-to win-and he was successful. He carefully mapped out 
the canvass and put his whole energies into it, and won the victory 
against a bitter and unrelenting opposition. 
In the autumn of 1878, before the expiration of his Senatorial term, 
he was placed in nomination by the Republicans for Congress, and was 
elected by a decisive majority. His career in the Senate and in Con- 
gress was creditable to him and gratifying to his constituents. He dis- 
charged the duties of both stations intelligently and faithfully, so long 
as he occupied them. An evidence that public life is distasteful to him 
is found in the fact that he resigned both offices before the expiration 
of their respective terms. The Senatorship, however, was resigned to 
enable him to take his seat in Congress, made necessary by a special 
session that convened before the close of his Senatorial term. The 
Congressional office was resigned after the special and the long sessions. 
Since his retirement to private life, Dr. Pierce has devoted his atten- 
tion to the varied interests of his extensive business, and is, apparently, 
one of the happiest and most self-satisfied citizens of Buffalo. Judged 
by results, he is a man of extraordinary ability and accomplishments. 
He has carved fortune and fame out of his own brain and industry in 
a remarkably brief period. Best of all, he bears his prosperity in a 
becoming manner; he is absolutely free from any appearance of pride, 
exclusiveness or snobbery, that frequently attend the rapid accumula- 
tion of wealth. He is as readily approached now at his Main Street 
palatial establishment, as he was eighteen years ago at his Clinton 
Street office in a one-story wooden cottage. 
Outside of the business of his profession, Dr. Pierce has been and 
still is an extensive business operator. He was joint owner in the erec- 
tion of the American Grape Sugar works, which he subsequently dis- 
posed of. He is President of, and four-fifths owner in. the Big Bend 
Tunnel and Mining Company, which owns the fee simple to fifteen 
miles of the Feather River, in Butte County, California. This is one 
of the richest streams in gold on the Pacific coast. The Company have 
cut a tunnel a distance of two and a third miles through a spur of the 
mountain, to divert the stream from its natural channel, thereby ena- 
bling the claim to be worked. It is the most gigantic mining enterprise 
ever attempted in California, and the well-known productiveness of the 
river-bed leaves no room to doubt its ultimate success. He is also 
President of the Buffalo Loan, Trust and Safe Deposit Company. 
From the Boston Daily Globe. 
What can be accomplished by judicious enterprise, when backed 
up by ability and professional skill, is shown by the magnificent 
buildings of the World's Dispensary and the Invalids' Hotel and Surgi- 
cal Institute, at Buffalo. While models of architectural beauty and 
completeness, their real worth and usefulness consist rather in the hu- 
manitarian objects they are made to serve. They stand superior to all 
institutions of their kind, not only in material proportions but as well 
in the medical knowledge and practical experience of those connected 
with them. In each department are those and those only who by nat- 
ural bent and training are specially adapted to combating their par- 
ticular class of "the ills which flesh is heir to." 
A CURE FOR MANY EVILS. APPENDIX. 
983 
A CONSPIRACY OF JEALOUS DOCTORS. 
AVhj Knvious 
Doctors Oppose Us. 
The great majority of the medical profession are actively engaged 
in treating acute diseases, attending obstetrical cases and emergency 
surgical cases. Most general practitioners also attempt to treat Chronic 
Diseases to some extent. Now, we hold that men whose best thought 
and chief attention are given to the management of fevers and other 
acute and often extremely dangerous diseases, have quite enough to 
attend to, if they discharge their duties properly toward their clients, 
to keep well-posted on these maladies, and properly care for their pa- 
tients, and that they are not so competent to treat old-standing, or 
chronic, diseases as are those physicians who give their whole time and 
attention to the study and treatment of some particular class of chronic 
ailments. We hold that no man whose mind is preoccupied with the 
study and treatment of acute diseases, can, at the same time, excel 
in the treatment of chronic diseases. Better, therefore, turn his chronic 
cases over to specialists whose sole business it is to treat such cases. 
Careless Doctors. 
The hasty and often indifferent manner in which the general prac- 
titioner has, of necessity, to deal with such cases, does not result to 
the patient's good. 
Why, then, do not general practitioners send these cases to special- 
ists? Some of them, not so grasping as the majority, do,, and we re- 
ceive a very large number of such referred cases annually, but others, 
we are sorry to say, the great majority, pursue a kind of a dog-in-the- 
manger policy; if they have not the time, or the experience and skill 
necessary, to cure their patient, they are not willing that any one else 
should cure him. 
Doctors' Mistakes. 
We get a great many such cases after-they have been badly treated, 
and all kinds of mistakes made with them, and cure them, too, and this 
is very exasperating to these self-conceited, medical bigots, and, to re- 
taliate, they circulate all sorts of foolish lies about us, and even pay for 
the publication of slanderous articles*concerning us. Inasmuch as they 
lie about us, we are forced, in self-defense, to tell the truth about them, 
and explain why they oppose us. Now, as there are a great many of 
these jealous doctors in this great country of ours, and as each has his 
friends and relatives to help him, taken collectively, they are capable 
of keeping the air full of rumors and reports, circulated to injure our 
professional standing and the well-earned fame of our institutions. 
It has come to our knowledge, through the most trustworthy chan- 
nels, that a wicked, most malicious and deep-laid, secret conspiracy 
of narrow-minded, jealous doctors, who are envious of the wide celeb- 
rity which our institutions have acquired for the successful treatment 
of obscure, complicated and obstinate Chronic Diseases, as well as in 
the field of Operative Surgery, is practically supporting, actuating, and 
A Foul Conspiracy of Doctors. 984 
APPENDIX. 
backing up, financially, the malicious, slanderous attacks made upon us 
by a notorious, irresponsible and villainous Philadelphia "Crank," of 
many aliases, who publishes a most disreputable monthly sheet, in that 
city, ostensibly devoted to the wants of agents, but which is almost 
wholly prostituted to attempts at black-mailing advertisers (and espe- 
cially solid, medical and drug establishments which advertise), and to 
the publication of many swindling, catch-penny schemes, for duping 
the unwary, with which its columns are constantly filled. 
This besmirched sheet is a fit organ, and its vile and in every way 
irresponsible editor a fit representative, for such jealous, narrow- 
minded, medical bigots as have subsidized it in their impotent attempt 
to injure our professional standing, by cowardly, lying attacks, through 
its columns, by which disreputable means they hope to cripple us in the 
good work which our Institution in Buffalo, and its Branch in London, 
are doing for suffering humanity, on both sides of the Atlantic. How 
futile are their efforts to injure our well-earned reputation for integrity, 
fair dealing and professional skill, by such foul and damnable means, is 
manifested from the constantly increasing and vast extent of our prac- 
tice, which was never so prosperous as at present. 
This desperate manifestation of malice on the part of our envious 
competitors bears upon its face and its whole front such palpable evi- 
dence of jealous cupidity, that the honest-hearted, intelligent reader 
readily perceives the sordid motives which actuate our avaricious ene- 
mies in making these slanderous attacks. Hence it is that invalids re- 
siding in different parts of the country often send us their applications 
for medicine and treatment, with our customary fees, and enclosed in 
the same envelopes send copies of these furious tirades against us, 
thinking that probably our attention has not previously been called 
to these loudmouthed vaporings. Others, in coming to our institu- 
tions for consultation, advice and treatment, and laboring under simi- 
lar suppositions, sometimes bring with them these outlandish publica- 
tions, thinking they are doing us a kindness in calling our attention to 
them, but assuring us that they have, at the first glance, discovered the 
malicious character of the vile production and the foul purpose of its 
author. Having minds of their own, they are not slow to understand 
that if we were running our institutions on other than the most honor- 
able principles, we would not offer, as we do, to pay all traveling ex- 
penses, both ways, to any invalid who will visit our Invalids' Hotel and 
Surgical Institute, in Buffalo, if it is found, on investigation, that we 
have misstated or misrepresented in any particular our institutions, our 
advantages, or our success in curing chronic diseases, whether requiring 
medical or surgical means for their relief. Men who are conducting 
dishonest operations do not court srtch investigation, and offer to pay for 
it besides, if everything is not found exactly as represented. 
A Fit Representative. 
We would not have the reader infer that all the doctors oppose us. 
On the contrary, there are very many, and they are among the most 
skillful, broad and liberal-minded men in the profession, with whom 
we are on the best of terms, both socially and professionally. From 
many of these we often receive cases not in the line of their practice, 
or for treating which, they feel they have not as good appliances and 
facilities as we possess. As we pen these lines, an experienced phy- 
sician of Indiana, brings his invalid wife to our Institution, and desires 
to leave her for treatment, because, after thorough investigation, he 
is convinced that we possess advantages and facilities for treating her 
case which he does not possess at home. 
Our Friends in the Profession. APPENDIX. 
985 
Crusade Against Dr. Pierce. 
Although our Dr. R. V. Pierce is only one amongst our Staff of 
Eighteen Physicians and Surgeons, yet he seems to be the target at 
which most of the slanderous abuse of our envious, would-be rivals is 
directed. Now, Dr. Pierce, be it known, is not the narrow-minded 
man that his detractors would have people to believe. He does not ad- 
vise people that his few "put-up," "ready-made," or proprietary medi- 
cines, are "cure-alls," or panaceas, but on the contrary, he investigates 
all means and methods of cure -holding fast to that which is good. In 
other words, he is truly eclectic, independent and rational in his practice 
of the healing art. So far from recommending his few proprietary 
medicines, as sold through druggists, to cure all diseases, he takes 
especial pains in all his pamphlets and writings to inform the people 
generally that they are not "cure-alls" and should not be taken for any 
of the large catalogue of human maladies for which they are not rec- 
ommended. 
No Relationship with Humbugs. 
As proof that Dr. Pierce's Family Medicines should not be classed 
with the humbug nostrums of the day that are puffed and lauded to 
cure all diseases, it is only necessary to state that, meritorious as these 
favorite prescriptions of the Doctor's are, the Staff of Physicians and 
Surgeons, organized by him for the treatment, at the Invalids' Hotel 
and Surgical Institute, of the more obscure, complicated and obstinate 
forms of Chronic Diseases, has ever, by his direction, freely resorted to 
as great a variety of remedies and curative agents, in prescribing for 
patients, as are employed by any similar number of practitioners of 
medicine of whatever school they may be. They are not hampered by 
any one-idea ism or pathy, but freely resort to the whole broad domain 
of the Materia Medica of all the schools. They prescribe of Dr. Pierce's 
Standard Family Medicines freely when adapted to the case in hand, 
and only in such cases. 
They advise with reference to diet, bathing, exercise, and other hygi- 
enic requirements, and do not hesitate to employ surgical means and 
methods of treatment in cases requiring it. 
Notwithstanding that each and every one of the eighteen professional 
gentlemen on our Staff possess diplomas, conferred by from one to three 
medical colleges and universities of an acknowledged high standard of 
requirements, and notwithstanding that they practice a liberal and sci- 
entific system of treatment, yet envious rivals and bigoted doctors are 
ever ready to traduce and slander them. This has been especially the 
case with a few old fogies of this city, who never lose an opportunity to 
misrepresent our institutions and our practice. Narrow-minded men 
are ever envious and illiberal toward those who distance them in pro- 
fessional or business success. 
Are They Quacks ? 
Favorite Prescriptions. 
The fact that Dr. Pierce has seen fit to put up in convenient form, 
for sale and use, a few of his choice and favorite prescriptions, long and 
most successfully used in his private practice and has recommended 
them to the people to be used for certain easily recognized maladies, 
has furnished sufficient pretext for his enemies and those jealous of his 
unprecedented success in the treatment of chronic diseases, to endeavor 
to lower him in the estimation of the people by denouncing him and 
all those associated with him as " quacks," regardless of their qualifica- 
tions. Long and diligently pursued study in the line of their several 
specialties, and vast experience in the treatment of disease, count for 986 
APPENDIX. 
nothing in the estimation of such narrow-minded men. Parrot-like, 
they can only shout "quack"! or "fraud"! 
Fortunately, the people of this country are too intelligent to be mis- 
led by any such set of bigots, and our business, especially in the line of 
Operative Surgery and the treatment of Chronic Diseases, was never 
so prosperous and extensive as at present. Although employing eight- 
een physicians and surgeons, eight stenographers as assistants, in taking 
notes of cases, making records, doing correspondence, etc.; also numer- 
ous file clerks, prescription clerks, nurses, and other assistants, in order 
to be able to give that close and careful attention to every case consult- 
ing us that it should have, yet we promise our would-be rivals that if 
they continue their imbecile croaking about " quacks," " frauds," etc., 
we will increase our Staff materially within the next twelve months- 
not, however, by gratifying any of their clan by an invitation to accept 
a place thereon, for we have use only for men of liberal and progressive 
ideas, in harmony with the spirit of the age in which we live. 
We Thrive Under Their Abuse. 
A certain medical society of this city, which we must credit with 
doing the people of Buffalo a good service, in taking steps that have 
resulted in weeding out a few of the real quacks practicing without 
authority in this city, occasionally oversteps the mark in its officious- 
ness, and renders itself somewhat ridiculous. 
A cheeky ignoramus of a busybody, who, to particularize a little 
more fully, was, sometime ago, unceremoniously kicked out of a subor- 
dinate position in our institution, proclaimed to the officers of the said 
society that a certain member of the Faculty of the Invalids' Hotel and 
Surgical Institute did not possess the legal qualifications to entitle him 
to practice medicine and surgery in this State. 
A Good Joke on Some of Our Envious Rivals. 
"Caught A Tartar." 
The society promptly notified our associate, who had been so unjustly 
accused, to appear before the chairman of their committee appointed 
to look into such matters, and " show cause," as the lawyers would 
say, why he should not be made the subject of prosecution. Being 
ever willing to accommodate those who are desirous of knowing what 
the qualifications of each member of our Staff of Physicians and Sur- 
geons are, our confrere called upon the proper officer of the medical 
society and presented what we trust was satisfactory evidence that our 
worthy medical representative could "double discount" any member 
of that society in the number and character of his credentials. Since 
the matter of qualifications of one of our associate physicians has been 
called in question, wre may very properly, and we trust without being 
considered egotistical, state that the said member of our Staff is a 
Member of the Royal College of Surgeons, London; also licentiate 
of the Royal College of Physicians, Edinburgh, and of the College of 
Physicians and Surgeons. Glasgow, etc. He, as his credentials amply 
show, is fully competent to teach the poor, miserable slandering igno- 
ramus of a Munchausen, who acted as informant in carrying his name 
before the officers of the medical society above referred to. 
A Challenge I 
Promptly after the foregoing amusing transactions occurred, we is- 
sued, and circulated freely among our brethren of the medical profes- 
sion, the following challenge, addressed to the medical society that had 
made itself so officious, which, however, has never been accepted : 
" Perhaps your medical society, acting on the vaporings of a rene- APPENDIX. 
987 
gade and outcast from our institution, would like to call in question 
the qualifications of some other member of our Staff. If so, gentle- 
men, don't let your native modesty cause you to be backward. We are 
ready to compare notes any day with the best of you. And this we 
say not in a spirit of egotism, but rather in self-defence, since you have 
seen fit to question the professional standing of one of our associates. 
And, furthermore, we are excusable for throwing out this challenge to 
you, gentlemen, since it has been the fashion with some of your mem- 
bers in the past, on every possible occasion, to speak of members of our 
Faculty as 'quacks' and 'frauds,'regardless of the fact that there is 
not a physician or surgeon on our Staff whose diploma is not on file at 
the county clerk's office, in this city, and who does not possess quite 
as good credentials as yourselves, and who is, therefore, as much enti- 
tled to the confidence of those requiring medical and surgical aid as 
any membei- of your Trades Union Society. 
'"Where the Shoe Pinches.' 
'That we do enjoy such confidence to an extent that gives us more 
practice in the line of our several specialties (embracing the treatment 
of all forms of chronic diseases) than is done by all the members of 
your society combined, is probably where the shoe pinches' you, gen- 
tlemen. But are we to blame for this? Because the sick and afflicted 
flock from all the States and territories of our great country, and many 
times come from foreign countries as well, to avail themselves of our 
services as practitioners, devoting ourselves especially to the study and 
treatment of chronic diseases, in preference to patronizing you, who 
claim to know all about all diseases to which human flesh is heir, and 
whose practice is, for the most part, confined within the narrow limits 
of this city-does this difference in our practice constitute us 'quacks' 
and 'frauds,'and you. gentlemen, eminent physicians and surgeons? 
If so, then we shall continue to be ' quacks,' for we rather like it, and 
the people share with us in our preference. We had supposed that 
quackery consisted in laying claim to knowledge not actually possessed. 
Now we have never set up any claim 'to knowing it all.' We have 
never offered to treat all diseases of whatsoever class or character, acute 
or chronic, as so many of you do. We choose a certain field of practice 
and then subdivide this up again, giving to each member of our Staff a 
certain disease or class of diseases, to treat. Thus diseases peculiar to 
women are given to one, diseases of the digestive organs to another, 
diseases of the nervous system to a third, diseases of the eye and ear 
to a fourth, diseases of the genito-urinary organs to a fifth, and so on 
through the whole catalogue of chronic ailments. In several classes of 
diseases, our practice is so extensive that we have been obliged to assign 
two and three physicians to a single class of diseases. This, again, is an 
advantage, as these Specialists are in constant consultation with one an- 
other, and it is an old adage,that 'two heads are better than one.' A 
constantly growing professional business shows pretty conclusively that 
the people of this great country of ours approve of our system of doing 
business, notwithstanding the ' dogs in the manger' that bark at them 
and constantly snarl at us." 
These petty jealousies are not confined to the medical profession of 
the City of Buffalo, nor to the City of Philadelphia, where the chosen 
organ of our envious rivals and jealous conspirators is published, al- 
though the two cities named seem to be the headquarters of this shame- 
ful plot and lying crusade against us. 
The same petty jealousies seem to actuate our narrow-minded breth- 
ren of the profession throughout the country generally. It is a very 
Narrow-minded Doctors Everywhere. 988 
APPENDIX. 
frequent experience with us to be told by a patient whom we are 
about to discharge perfectly cured, that he came to us against the ad- 
vice of his home physician who told him we were "quacks" and adver- 
tising " frauds," and could do him no good. 
Sometimes these bitter denunciations are thrown out to deter patients 
from coming to us, through fear that our experts will discover how 
egregious have been the blunders committed in the case, by these self- 
same narrow-minded, and ignorant fellows, whose sole aim is to cover 
up their mistakes. They fear that if their patient comes to us, their 
errors may be exposed, or, perhaps, they reason that, if we cure the 
case, people may think that we possess skill superior to themselves. To 
one who professes to know it all, this is, no doubt, a serious considera- 
tion, but to the really wise physician, who does not profess to be an ex- 
pert in every branch of medical practice, it is not a humiliating experi- 
ence at all. He sends us his chronic cases because he has neither the 
time nor all the appliances and facilities for treating every form of 
chronic ailment. He has generally all that he can properly attend to 
in looking after his patients suffering from acute maladies. Which is 
the wiser map? A narrow-minded, conceited, grasping, dog-in-the- 
manger fellow, who tries to treat everybody and all kinds of ailments, 
making himself a kind of Jack-of-all-trades and master of none, or he 
who is contented with cultivating as much of the field of practice as he 
can manage, and do it well, leaving to others the responsibility of taking 
care of the balance ? 
Try to Cover Up Their Tracks. 
Opposed to Advertising. 
But, they say we are quacks because we advertise. Well, so long 
as we pay the printers' bills, we deny anybody's right to deprive us 
of this very common privilege of the people. Our method may be 
different from those adopted by some of our professional brethren, 
yet we hold it to be quite as legitimate as theirs. Some, for instance, 
accept professorships in medical colleges, giving their services free, 
for the sake of the high-toned advertising they thereby secure, in con- 
nection with the college announcements, for it is a fact that many 
people suppose that medical men who hold college professorships must 
necessarily be very competent and skillful physicians. Quite the con- 
trary, however, is generally true, so far as skill in practice is concerned. 
It has been happily said that the best teachers of music are often the 
poorest performers, and this is equally true of professors in medical 
colleges. There are not a dozen teachers in the medical colleges in 
the United States who could earn an independent living by the prac- 
tice of their profession in the ordinary way, were it not for the pres- 
tige their position as professor gives them, and, knowing this, they 
render their services as teachers for little or no compensation. 
The following from the Banner of Light, Boston, is pertinent to this 
subject: 
"Beating the Printer." 
The wily M. D. is on the war-path in Ohio, it seems, having " covered his tracks " 
quite nicely under a bill (now pending before the House of Representatives) for 
the creation of a State Board of Health. The Cleveland Daily Leader, however, 
points out and condemns a section in the new bill, which virtually covers the 
whole mooted ground of medical protection for the Regulars, since this section 
would act to exclude from practice (by and through a fine of $50 per month in 
every county in the State where they practice), all physicians, however skillful, 
who, as specialists, etc., " advertise." The Leader very properly points to the fact 
that this is a progressive age: that the " Irregulars " keep themselves in harmony 
with its demands by general advertising, and pay their bills, while the Regulars 
have a way of getting notices peculiar to themselves, which the sarcastic Leader 
pungently shows us, as follows: APPENDIX. 
989 
" The code of ethics of the regular school, which, by the way, is considerable of a hum- 
bug, prevents a physician of that school from advertising his business-or rather from pay- 
ing for such advertising. No regular physician would dare pay for his card iu a newspaper 
giving the location of his office, but he is at liberty to get all the gratuitous advertising he can." 
Now, we prefer to do our advertising in a more business-like way. 
paying for it, just the same as if we were engaged in any other honor- 
able business. We are not ashamed of our business; hence we let the 
people know of it through the press. We believe that we have superior 
appliances, remedies, and facilities for treating chronic diseases, and 
we do not believe in hiding our light under a bushel. Neither do 
we adopt the "dead-head " system of advertising, securing notices of 
important cases treated, or surgical operations performed, without pay- 
ing therefor. 
A Gentle Hint. 
Our Business Methods. 
If these medical gentlemen whose chief business consists in treating 
acute maladies, would give their exclusive attention to this branch of 
medical science, making a specialty of acute diseases, as we do of 
chronic affections, they would be far more successful, and there 
would not be so much chronic disease in the land as the result of 
badly treated acute diseases. For it is a fact, patent to every special- 
ist dealing largely with chronic maladies, that a large percentage of 
the diseases which he is called upon to treat could have been easily 
and promptly cured in their acute stage, had proper treatment been 
employed at that time. 
If, they, our brethren of the profession throughout the country 
would prevent their patrons from drifting into our hands for treatment 
of chronic diseases, let them render such skillful treatment in the acute 
stage of diseases as to prevent their becoming seated and lingering ail- 
ments. Our patients have, generally, already tested thoroughly the 
skill and resources of their home physicians" before applying to us; 
hence, one would suppose their former attendants would be quite will- 
ing that they should seek relief wherever it is to be found and not play 
the part of "dogs in the manger," but such does not seem to be their 
pleasure, if we are to j udge by the desp erate efforts made to keep suf- 
ferers from applying to us for relief. 
"Dogs in the Manger." 
But Still We Prosper. 
Being human, it is but natural that we should be more or less an- 
noyed by such unfair treatment at the hands of those who should be 
our warm friends and supporters. But, notwithstanding the envy, 
jealousy, and active opposition of the most narrow-minded and bigoted 
members of the profession throughout the country, our professional 
business has continued to grow from a small beginning, many years ago, 
when one physician, unaided and alone, managed all its affairs, until 
noweighteen physicians and surgeons, including those employed at our 
London Branch, are kept constantly busy in properly caring for our 
patients. Surely, these results prove more conclusively than any word 
of ours, that those who have so strongly opposed and in some instances 
shamefully slandered us have labored to little purpose. Under their 
persecution and abuse we thrive and flourish like a green bay-tree. 
WORLD'S DISPENSARY MEDICAL ASSOCIATION. HOW TO AYOID SWINDLERS 
wiio Sometimes Infest tlie Cars and Depots in 
and this City. 
We warn all those who contemplate visiting 
US, that we have the most positive proofs that a gang of 
confidence men have at different times made it their business 
to watch for sick and infirm people on the way to our insti- 
tutions, and divert them into the hands of " sharpers," confi- 
dence men and swindlers. Thes5" men have watched for the 
coming of invalids on the cars, in and around the depots, in 
the offices of the hotels located near the depots, and if inquiry 
was made for our institutions, or if the object of the visit 
to the city was made known or suspected from the invalid 
appearance of the traveler, they at once commenced weav- 
ing their skillfully-wrought web to catch a victim. 
therefore, 
Advise all those Desiring to Visit Us, 
FIRST.-To ask for no information from 
policemen, or those appearing to he policemen, 
in or about our depots. Confidence men often 
assume a style of dress similar to that worn 
by policemen. 
SECOND.-Eet the object of your visit to the 
city be known to no one whom you meet on 
the cars, or in the depots or near them. 
THIRD.-If you have a check for baggage, 
when the baggage-man conies through the cars, 
as one does on every train before it reaches 
the city, asking if you will have your baggage 
delivered anywhere in the city, or, if you will 
have a carriage; if you have a trunk, give him 
the check for it, pay him 25 cents only and 
he will have it delivered at the INVALIDS' 
HOTEL AND SURGICAE INSTITUTE, 663 
Main Street. (Do not forget the number). You had 
990 APPENDIX. 
991 
better, also, procure a ticket from this baggage-man, or agent, 
for a coupe, or carriage to our place, for which you will have 
to pay only fifty cents. (Outside prices are higher.) This 
saves all trouble and anxiety, as the agent will look carefully 
after both yourself and baggage, and you are sure of reaching 
our place promptly and safely. If you have only hand- 
baggage, such as bundles, traveling-bags, or similar luggage, 
you can take it with you in the carriage without extra cost. 
Mr. C. W. Miller, whose agents solicit on all the in-coming 
trains for the delivery of passengers and baggage, has an 
office in every passenger depot in this city, to which you can 
apply if, by any chance, you miss his agent on the train. 
THE INVALIDS9 HOTEL AND SURGICAL 
INSTITUTE IS OPEN DAY AND NIGHT, 
and you will be cordially received and well 
taken care of. 
The table is provided with the best of food. 
No hotel in the city has better rooms or beds 
than the Invalids9 Hotel. 
This institution is not a hospital, but a com- 
modious and comfortable invalids9 home. 
If all we say of our institutions, and our advantages and 
facilities for the successful treatment of disease is not found, 
on your arrival and investigation, to be just as we have 
represented them, we will pay all the expenses of 
your trip and you can return home at once. 
"A Word to the Wise/' 
in the nature of advice, to those about to visit us, in con- 
clusion, may not be out of place. 
Keep your business to yourself while on the 
road here, also when about the depots, and ask 
no questions of ANYBODY. 
Make no traveling acquaintances. They are 
dangerous. 
Observe the foregoing directions, and any child of twelve 
years, possessed of ordinary intelligence, can reach our con- 
spicuous place, 663 Main Street, Buffalo, N. Y., with- 
out fail. 
World's Dispensary Medical Association. MAP REPRESENTING CENTRAL PORTION OF THE 
CITY OF BUFFALO 
SHOWING LOCATION OF BAILKOAD DEPOTS AND THE 
INVALIDS' HOTEL, 663 MAIN STREET, 
(Heticeen Chippewa, and Tripper Streets,) 
The black dotted line represents the Street Railroad 
over which horse-cars run up Exchange Street past the Depots, 
ain Street, and thence up Main past the Invalids' Hotel. 
Trains of the Canada Southern Railroad use the Central Depot. / 
Don't get off at the Terrace Depot. It is only a local station. / 
The Grand Trunk and 
Great Western Railroads 
use both the Central and 
Erie Depots. The Grand 
Trunk also runs a part 
of its Passenger Cars to 
its Depot on Erie Street.  
A 
PAGE 
Abortion748 
Abscess, Lumbar438 
Abscess, Psoas438 
Absence of the Ovaries . . .710 
Absence of the Womb ... 708 
Absorption48 
Acacia Catechu325 
Accidents895 
Acetabulum25 
Acetate of Potash .... 338 
Acid, Aromatic Sulphuric . . 310 
Acid Bath367 
Acid, Carbolic318 
Acid, Gallic325 
Acid, Hydrochloric .... 310 
Acid, Muriatic310 
Acid, Tannic325 
Acid, Uric . . • • • • 86 
Acids 309, 902 
Acidum Gallicum .... 325 
Acidum Tannicum .... 325 
Acne 689,699 
Aconite346 
Acute Articular Rheumatism . . 425 
Acute Bright's Disease . . .773 
Acute Bronchitis518 
Acute Catarrh476 
Acute Cystitis - . . . .788 
Acute Gastritis539 
Acute Gout430 
Acute Hepatitis569 
Acute Inflammation of the Bladder 788 
Acute Inflammation of the Bowels 549 
Acute Inflammation of the Kidneys 773 
Acute Inflammation of the Liver . 569 
Acute Inflammation of the Stomach 539 
Acute Laryngitis490 
Acute Nephritis773 
Acute Peritonitis 551 
Acute Pleurisy521 
Adhesion400 
Adhesion of the Eyelids . . . 675 
Adipose Tissue20 
Affections, Alphous .... 697 
Affections, Boil-like .... 701 
Affections, Bullous .... 694 
Affections, Eczematous . . . 683 
Affections, Erythematous . . .692 
Affections, Furuncular . . , 701 
Affections, Nervous, of the Skin . 696 
Affections of the Hair-follicles. . 698 
Affections of the Male Generative 
Organs814 
Affections of the Tympanum . . 679 
Affections of the Urinary Organs 769 
Affections of the Urinary Organs, 
Sympathetic770 
Afferent Nerves87, 93 
Afterbirth216 
Ague405 
Air-cells63 
Air-passages, Foreign Bodies in the 900 
Air, Pure .... 222,223,378 
Albumen 53, 238 
Albuminuria422 
Alcohol 349, 903 
Alcoholic Liquors .... 255 
Alder301 
Alkalies 309, 903 
Alkaline Bath367 
Allopathic School of Medicine . 293 
Alnuin305 
Alnus Rubra304 
Aloes328 
Alphos697 
Alphous Affections .... 697 
Alteratives303 
Alteratives. Compounding of . . 308 
Alternate Generation .... 16 
Althea Officinalis .... 336 
Amaurosis661 
Amenorrhea708 
American Colombo .... 353 
American Hellebore .... 347 
American Poplar .... 350 
Ammonia349 
Amnion216 
Amygdalus Persica .... 346 
Amyloid Degeneration of the Kid- 
neys 774 
Amyloids238 
Anaemia419 
Anaesthesia, Local .... 894 
Anaesthetics894 
Anal Fistula602 
Anasarca422 
Anatomy . •11 
Anatomy, Physiological 11,19, 30, 37, 48, 
56, 63, 68, 75, 84, 87 
Anatomy, Physiological, of the 
Male Generative Organs . . 810 
Anatomy, Physiological, of the Uri- 
nary Organs768 
Angina Pectoris533 
Animalcular Life, Universality of . 16 
Animal Faculties .... 130 
Animal Food, Value of . . . 241 
Animals, Cold-blooded ... 55 
Anise-seed325 
Anodynes310 
Anteflexions of the Uterus . . 752 
Anthelmintics313 
Anthrax476 
Antidotes for Poisons .... 902 
Antiperiodics315 
Antiseptics317 
Antispasmodics ... . . .318 
Anus, Fissure of the .... 606 
Aorta58 
Aperients326 
Aphasia614 
Apnoea421 
Apoplexy611 
Appendix Veimiformis ... 41 
Apthae 503, 535 
Aqueous Humor107 
Arachnoid Fluid90 
Arachnoid Membrane ... 90 
Arbutus, Trailing .... 336 
Arctium Lappa307 
Areolar tissue19 
Aristolochia Serpentaria . . . 333 
Aromatic Sulphuric Acid . . . 310 
993 994 
INDEX. 
PAGE 
Arteries 58 
Artery, Pulmonary .... 58 
Art of Swimming .... 274 
Ascaris Lumbricoides . . . 580 
Ascaris Vermicular is .... 581 
Ascites 423 
Asclepias Tuberosa .... 332 
Asclepin 333 
Ashes 335 
Ash, Prickly 349 
Aspen Poplar 315 
Asphyxia 421 
Aspiaium Filix Mas. .... 315 
Aspirator 867 
Assafetida Ferula . . . .318 
Assimilation 233 
Asthma 524 
Asthma, Hay. . . . . .488 
Astringents 320 
Ataxia, Locomotor . . . .615 
Atresia Pupillaris .... 059 
Atropa Belladonna .... 312 
Atrophy of the Heart.... 532 
Atrophy of the Testicles ... 825 
Atrophy, Progressive Muscular . 618 
Atropia 312 
Atropin 312 
Auditory Nerves, Paralysis of the . 681 
Auricle 57 
Auscultation 391 
Axis, Cerebro-spinal .... 89 
Axis-cylinder 87 
B 
Back, Crooked 450 
Baked Mutton 248 
Balanitis 874 
Balmony 315 
Baptisia Tinctoria . . .318 
Baptisin 318 
Barber's Itch . . . . .699 
Bark, Cramp 320 
Bark, 81ippery-elm .... 335 
Barosma Creriata 338 
Barosmin 338 
Barrenness "34 
Base Ball 273 
Basilar Faculties 132 
Bath, Acid 36* 
Bath, Alkaline 36* 
Bath, Cold 356 
Bath, Cool 3o7 
Bath, Douche 365 
Bath, Foot 366 
Bath, Head 367 
Bath, Hot 358 
Bath, Iodine 368 
Bath, Russian . s ' • 358 
Bath, Scott's Acid ••••££ 
Bath, Shower 365 
Bath, Sitz 367 
Bath, Spirit Vapor .... 362 
Bath, Sponge 3fo 
Bath, Sulphur 368 
Bath, Temperate 35* 
Bath, Tepid 357 
Bath, Turkish 358 
Bath, Warm 3.17 
Bathing 356 
Bathing, Sea 3b4 
Baths, Medicated . . • 367 
Bed 279, 377 
Bedding 380 
Beef Soup 247 
PAGE 
Beef Tea 381 
Belladonna 312 
Beverages 248 
Bicarbonate of Potasli . . . 309 
Bile 80 
Biliary Calculi 879 
Biliary Salts 81 
Bilious Colic 562 
Bilious Disorder 570 
Bilious Fever 406 
Biliverdin 81 
Biology 11 
Blackberry-root 321 
Black Cohosh .... 305,341 
Black Pepper 348 
Black-root 327 
Black Salve 461 
Black Snake-root .... 305, 341 
Black Vomit 540 
Bladder 768 
Bladder, Acute Inflammation of the 788 
Bladder, Chronic Inflammation of 
the 789 
Bladder, Stone in the .... 795 
Blennorrhea 876 
Blood 53 
Blood Corpuscles 53 
Blood, Physical Properties of the . 53 
Blood-root 306 
Blood, Vital Properties of the . 53 
Bloody-flux 553 
Blue Flag 307 
Blushing 62 
Boiled Fish 247 
Boiled Meat 247 
Boil-like Affections .... 701 
Boils 475 
Bones 19 
Bones, Disease of the .... 461 
Bones, Inflammation of the . . 462 
Bones of the Head .... 22 
Bones of the Lower Extremities . 27 
Bones of the Upper Extremities . 25 
Boneset 316, 341 
Bowel, Falling of the .... 599 
Bowels, Compression of the . . 566 
Bowels, Inflammation of the . . 549 
Bowels, Stricture of the . . . 566 
Boxing . 273 
Boxwood 351 
Brain 95 
Brain, Congestion of the ... 608 
Brain, Inflammation of the . . 609 
Branny Tetter 685 
Breach 888 
Bread 248 
Bright's Disease, Acute . . .773 
Broiled Steak 247 
Bronchia 63 
Bronchial Cells 63 
Bronchitis .... .481 
Bronchitis, Acute . . . .518 
Bronchitis, Chronic .... 519 
Bronchocele 473 
Bruises 899 
Bubo 880 
Buchu 338 
Bugle-weed 323 
Bullous Affections .... 694 
Burdock 307 
Burns 901 
Burste Mucosas 29 
Butterfly-weed 332 
Butternut 328 
Butter-weed 324 INDEX, 
995 
c 
PAGE 
Cachexia 431 
Caecum 41 
Calculi 579,793 
Camp Fever 408 
Camphor 312 
Canada Fleabane 324 
Canals, Haversian .... 21 
Canals, Semicircular .... 110 
Cancer 467 
Cancer-cells 467 
Cancer of the Stomach . . .537 
Cancers, Curability of ... 468 
Canker 535 
Cannabis Indica 344 
Capacity, Cranial 139 
Capillaries 50 
Capsicum Annuum .... 348 
Capsule, Synovial .... 29 
Carbolic Acid 318 
Carbonate of Iron .... 354 
Carbuncle 476 
Carcinoma 537 
Carminatives 325 
Carpus 26 
Cartilage 29 
Cartilaginous Tissue ... 20 
Cascara Sagrada 328 
Casein 82,338 
Castor Oil 328 
Catalepsy 630 
Cataract .663 
Catarrhal Conjunctivitis ... 641 
Catarrhal Ophthalmia . . . 641 
Catarrh, Acute 476 
Catarrh, Chronic Nasal . . .478 
Catarrh, Hay .'.... 488 
Catarrh, Syphilitic .... 881 
Catechu 325 
Cathartics 326 
Catheterism 786 
Catnip 334 
Caustics 331 
Caution in the use of Instruments . 805 
Cayenne Pepper 348 
Cellars, Damp 228 
Cells, Bronchial 63 
Centres of Ossification . . . 20, 27 
Centre, Specific . . . . . 14 
Cephaelis Ipecacuanha . . .339 
Cephalalgia 637 
Cerebellum 95, 97 
Cerebral Hemorrhage . . .611 
Cerebral Nerves 89 
Cerebral Physiology .... 114 
Cerebro-spinal Axis .... 89 
Cerebro-spinal Meningitis . . 610 
Cerebro-spinal System ... 89 
Cerebrum 95, 98 
Cerevisiae Fermentum . . .317 
Ceruminous Glands .... 77 
Cervical Rheumatism. . . .427 
Cessation of the Menses . . . 728 
Chalybeate Waters .... 250 
Chamomile 350 
Chamomile, Wild 334 
Chancre 879 
Chelone Glabra 315 
Chelonin . 315 
Chicken-pox 412 
Chimaphila Umbellata . . . 338 
Chimaphilin 338 
Chloride of Iron, Tincture of . . 355 
Chloride of Sodium .... 315 
Cholagogues 326 
PAGE 
Cholera, Epidemic .... 559 
Cholera Infantum .... 553 
Cholera Morbus 561 
Cholesterin 81 
Chordae Tendineae .... 57 
Chordee 875 
Chorea 630 
Chronic Articular Rheumatism . 426 
Chronic Bright's Disease . . 774 
Chronic Bronchitis .... 519 
Chronic Conjunctivitis ... 647 
Chronic Cystitis 789 
Chronic Diarrhea 556 
Chronic Gastritis 540 
Chronic Gout 430 
Chronic Hepatitis .... 570 
Chronic Inflammation of the Bladder 789 
Chronic Inflammation of the Bowels 549 
Chronic Inflammation of the Eye . 647 
Chronic Inflammation of the Liver . 570 
Chronic Inflammation of the Stomach 540 
Chronic Laryngitis .... 491 
Chronic Nasal Catarrh . . . 478 
Chronic Peritonitis .... 552 
Chronic Ulcers 459 
Chorion 216 
Chonoid 107 
Chyle 45,49 
Chyme 45 
Cimicifuga Racemosa . . 305,341 
Circulatory Organs .... 56 
Citrate of Iron 354 
Clap 874 
Classes of Food 238 
Clavicle 26 
Cleanliness of Body . . . 281, 380 
Cleft Palate ...... 457 
Clergymen's Sore Throat . . .491 
Climate .243 
Closure of the Pupil .... 659 
Closure of the Tear-duct . . . 482 
Clot 54 
Clothing 264, 380 
Coagulation 55 
Coccyx 23, 25 
Cochlea 110 
Cochlearia Armoracia ... 331 
Coffee 253 
Cohosh, Black .... 305, 341 
Cold-blooded Animals ... 55 
Cold on the Lungs . . . .518 
Colic 562 
Colica Pictonum . . . . . 563 
Colic, Bilious ' 562 
Colic, Flatulent 563 
Colic, Lead 563 
Colic, Painters' 563 
Collinsonia Canadensis ... 337 
Colloid Cancer 467 
Colombo, American .... 353 
Colon 41 
Colts-tail 324 
Column® Carneae .... 57 
Column, Spinal 24 
Comedones 699 
Compound Extract of Smart-weed 
312, 326, 335, 342, 349 
Compounding of Alteratives . . 308 
Compression of the Bowels . . 566 
Conception, Double . . . .215 
Conception, Prevention of. . . 212 
Congestion of the Brain ... 608 
Congestive Fever .... 406 
Conium Maculatum .... 311 
Conjugal Love 186 996 
INDEX. 
PAGE 
Conjunctivitis, Catarrhal ... 641 
Conjunctivitis, Chronic . . . 647 
Conjunctivitis, Granular . . . 649 
Conjunctivitis, Purulent . . . 642 
Conjunctivitis, Scrofulous. . . 645 
Connective Tissue .... 19 
Consumption 481, 496 
Consumption, Curability of . . 503 
Consumption, Tubercular. . . 496 
Constipation585 
Continued Fevers .... 407 
Contractility34 
Contused Wounds .... 896 
Convolutions98 
Cookery . 246 
Copper, Sulphate of . . . .339 
Coptis Trifolia354 
Cord, Spermatic811 
Cord, Spinal90 
Cord, Umbilical217 
Core 399, 475 
Cornea106 
Cornea, Inflammation of the . . 651 
Cornea, Opacities of the ... 653 
Cornea, Ulceration of the . . . 654 
Corneitis . . . . . . 651 
Corns702 
Corpora Olivaria95, 96 
Corpora Pyramidalia .... 95 
Corpora Qitadrigemina . . .95,97 
Corpora Restiformia .... 95, 96 
Corpus Callosum98 
Corpuscles, Blood .... 53 
Corpuscles, Ganglionic . . .87,89 
Cornus Florida351 
Coryza476 
Costiveness585 
Cotton-wool Respirator ... 230 
Cough 502,520 
Countenance394 
Counter-irritants331 
Cowper's Gland . . . . . 814 
Cow-pox411 
Coxalgia 439 
Cramp Bark320 
Cramp, Writers'617 
Cranberry, High320 
Cranesbill322 
Cranial Capacity139 
Cranial Nerves 100 
Cranium22 
Creation, Special14 
Creeping Palsy618 
Creasote . . . . ' . . .317 
Cricket273 
Criminal Abortion . . . .749 
Crocus Sativus333 
Crooked Back450 
Cross-eye 669 
Croup, Membranous .... 493 
Croup, Spasmodic .... 495 
Crow-foot322 
Crura Cerebelli97 
Crusted Tetter688 
Crystalline Lens107 
Cucurbita Cltrullus .... 338 
Cucurbita Pepo338 
Culture, Mental276 
Culver's-root327 
Cupri Sulphas339 
Curability of Cancers .... 468 
Curability of Consumption . . 503 
Cure, Radical, for Hernia . . . 892 
Curvature of the Spine, Lateral . 450 
Curvature, Posterior Spinal . 446 
PAGE 
Cuticle68, 70 
Cutis Vera68 
Cypripedin 320,345 
Cypripedium Pubescens . . 320,345 
Cystitis, Acute788 
Cystitis, Chronic789 
D 
Damp Cellars228 
Dancing276 
Dandruff685 
Danger in the use of Instruments . 805 
Datura Stramonium .... 344 
Deadly Nightshade . . . .312 
Deafness 481,678 
Debauchment, Venereal . . . 814 
Debility, Sexual, Symptoms of . 830 
Decidua216 
Decoctions303 
Deformed Feet453 
Deformed Hands453 
Deformed Limbs453 
Degeneration of the Heart, Fatty . 532 
Degeneration of the Kidneys . ' . 774 
Deglutition233 
Derangements incident to Pregnancy 767 
Desquamative Nephritis . . 773,774 
Development of the Individual . 192 
Development of the Testicles . . 811 
Diabetes782 
Diagnosis390 
Diagnostic Symptoms.... 390 
Diaphoretics'332 
Diaphragm32 
Diarrhea553 
Diarrhea, Chronic .... 556 
Diathesis . . . . . .391 
Diathesis, Scrofulous . . . .431 
Diathesis, Strumous .... 431 
Diet380 
Digestibility' of Food .... 243 
Digestion37 
Digestive Organs37 
Digitalis Purpurea .... 337 
Dilatation of the Heart . . . 532 
Dilatation of the Stomach . . . 538 
Diluents335 
Dioecious Reproduction . . . 202 
Dioscorea Villosa .... 320 
Dioscorein 320 
Diphtheria414 
Discharge from the Ear, Purulent . 676 
Discovery, Golden Medical 308, 316, 355 
Disease, Dust and .... 229 
Disease, Bright's . . . 773, 774 
Disease, Hip-joint .... 439 
Disease in Women, Masturbation a 
cause of744 
Disease of the Bones .... 461 
Disease of the Larynx ... 481 
Disease of the Ovaries . . . 738 
Disease of the Throat.... 480 
Disease, Pott's446 
Disease, Remedies for . . . 298 
Diseases and their Remedial Treat- 
ment 386 
Diseases of the Ear .... 675 
Diseases of the Eye .... 640 
Diseases of the Heart.... 526 
Diseases of the Kidneys . . . 772 
Diseases of the Liver .... 567 
Diseases of the Skin .... 682 
Diseases of the Stomach . . . 537 
Diseases of the Urinary Organs . 771 INDEX 
997 
PAGE 
Diseases of Women .... 706 
Diseases, Venereal .... 872 
Disinfectants 317 
Dislocations 899 
Displacements of the Womb . . 751 
Distilled Liquors 264 
Diuretics 336 
Dock, Yellow . . . . . 304 
Dog-button . . _. 350 
Dog-fennel . . . . 334 
Dogwood . . . . .351 
Domestic Management of Fevers . 403 
Dose 300 
Double Conception .... 215 
Douche Bath 365 
Douche, Dr. Pierce's Nasal . . 487 
Dover's Powder 311 
Drastics 326 
Dropsies 422 
Dropsy of the Scrotum . . 827. 865 
Drowning 900 
Dryness of the Ear . . . . 681 
Ducts, Lactiferous .... 82 
Duodenum ...... 40 
Dura Mater 90 
Duration of Pregnancy . . . 219 
Dust and Disease 229 
Dwellings, Ventilation of . . . 226 
Dynamometer 391 
Dyscrasia 431 
Dysentery 553 
Dysmenorrhea 713 
Dyspepsia 543 
Dyspnoea 503 
E 
Ear 109 
Earache 675 
Ear, Diseases of the . . . .675 
Ear, Dryness of the .... 681 
Ear, External, Obstruction of the . 680 
Ear-drum 110 
Eating 233 
Ecchymosis 466,899 
Eclectic School of Medicine . . 294 
Ecthyma, 701 
Ectropium 673 
Eczema 683 
Eczema, Infantile .... 684 
Eczematous Affections . . . 683 
Efferent Nerves . . . '. . 87, 93 
Effusion 400 
Egyptian Ophthalmia .... 642 
Elder, Sweet 307 
Elixir of Vitriol 310 
Elongation of the Neck of the Womb 737 
Elongation of the Uvula . . . 419 
Emergencies 895 
Emetics 339 
Emetic-weed 340 
Emmenagogues 341 
Emissions, Involuntary Seminal . 823 
Emissions, Nocturnal . ... 824 
Emotive Faculties . . .126 
Encephalic Temperament . . 177 
Encephaloid Cancer .... 467 
Encysted Hydrocele of the Cord . 865 
Endocarditis 529 
Endocardium 57 
Endolymph 110 
Enlarged Spermatic Veins . . 860 
Enlarged Tonsils .... 417 
Enlargement of the Prostate Gland 869 
PAGE 
Enteric Fever 407 
Enteritis 549 
Entropium 674 
Enuresis 786 
Envelope 19 
Epidemic Cholera .... 559 
Epidermis 68, 70 
Epididymis 813 
Epigea'Repens 336 
Epiglottis 67 
Epilepsy 626 
Epithelial Cancer .... 467 
Epsom Salts ■ 328 
Erect Carriage 272 
Ergot 341 
Erigeron Canadense .... 324 
Eruption, Heat 683 
Eruptions, Syphilitic .... 880 
Eruptive Fevers 408 
Erysipelas 413 
Erythema 692 
Erythematous Affections . . .692 
Esophagus 39 
Ethmoid Bone ' 22 
Eupatorin 316,341 
Eupatorin (Purpu) .... 338 
Eupatorium Perfoliatum . . 316,341 
Eupatorium Purpureum . . . 338 
Eustachian Tube 110 
Eustachian Tube, Obstruction of the 678 
Eversion of the Eyelids . . .673 
Evolution 14 
Examination, Microscopical . . 398 
Examination of the Urine . 397,771 
Excrescences of the Eyelids . . 673 
Excretion ...... 84 
Exercise . .* . . . .382 
Exercise, Horseback .... 2'6 
Exercise, Physical . . . . 270 
Exercises of the Gymnasium . . 275 
Exfoliation . .' . . . 463 
Expanding Uterine Speculum . . 757 
Expectorants 342 
Expectoration 502 
External Auditory Meatus . 77,109 
External Ear, Obstruction of the . 680 
Extract of Smart-weed 
312, 326, 335, 342, 349 
Exudation . . . . . .422 
Eye ■ 397 
Eve, Chronic Inflammation of the . 647 
Eye, Diseases of the .... 640 
Eye, Foreign Bodies in the . . 668 
Eye, Inflammation of the . . . 641 
Eye, Purulent Inflammation of the 642 
Eye, Scrofulous Inflammation of the 645 
Eye-salves 640 
Eye-water 640 
Eyes, Watery 671 
Eye-lashes, Ingrowing of the . . 673 
Eyelids, Adhesion of the . . .675 
Eyelids, Eversion of the . . . 673 
Eyelids, Excrescences of the . . 673 
Eyelids, Inversion of the . . .674 
Eyelids, Tumors of the . . .673 
F 
Face, Bones of the .... 23 
Facial Paralysis 617 
Factories, Ventilation of . . .226 
Faculties, Animal .... 130 
Faculties, Basilar .... 132 
Faculties, Emotive . . . .126 
Faculties, Volitive .... 129 998 
INDEX. 
PAGE 
Fainting901 
Falling of the Lower Bowel . . 599 
Falling of the Uterus . . . .751 
Fallopian Tubes209 
False Measles413 
False Membrane493 
False Passages805 
Fascia30 
Fasciculus30 
Fats238 
Fatty Degeneration of the Heart . 532 
Fatty Degeneration of the Kidneys 774 
Favorite Prescription, Pierce's 
342, 346, 355 
Favus698 
Feces, Impacted565 
Fecundation211 
Feebleness, Region of . . . 134 
Feeding Infants . • . . . 235 
Feet, Deformed453 
Felon704 
Female Generative Organs . . 206 
Female Regulator . . . .341 
Female Urinary Organs ... 206 
Femoral Hernia889 
Femur27 
Fencing273 
Fennel-seed325 
Fergusson Speculum .... 757 
Fermented Liquors .... 263 
Fern, Male315 
Ferri Carbonas354 
Ferri Citras354 
Ferri Ferrocyanidum .... 316 
Ferri Pyroptiosphas .... 354 
Ferri Redactum . 4 . . .354 
Ferrocyanide of Iron .... 316 
Ferrum354 
Fever401 
Fever and Ague405 
Fever, Bilious406 
Fever, Camp408 
Fever, Congestive .... 406 
Fever, Enteric407 
Fever, Gastric405 
Fever, Hay488 
Fever, Hectic502 
Fever, Hospital408 
Fever, Intermittent .... 405 
Fever, Jail408 
Fever, Lung518 
Fever, Pernicious .... 406 
Fever, Remittent406 
Fever, Scarlet408 
Fever, Ship408 
Fever, Spotted610 
Fever, Typhoid407 
Fever, Typhus408 
Fever-sore .... 433, 459, 462 
Fevers, Continued .... 407 
Fevers, Domestic Management of . 403 
Fevers, Eruptive408 
Fevers, Malignant . . . .407 
Fevers, Putrid407 
Fibrilla30, 32 
Fibrin 53,238 
Fibroid Polypus489 
Fibroid Tumors762 
Fibula27 
Fish247 
Fissure of Sylvius .... 98 
Fissure of the Anus .... 606 
Fistula in Ano602 
Fistula, Lachrymal .... 671 
Fits626 
PAGE 
Flag, Blue307 
Flatulent Colic563 
Flax-seed335 
Fleabane, Canada324 
Flesh30 
Flexions of the Uterus or Womb 738, 752 
Fluid Arachnoid90 
Focus108 
Foetus216 
Follicles of Lieberkuhn ... 79 
Follicular Laryngitis . . . .491 
Follicular Ulcer757 
Fomentations386 
Foreign Bodies in the Eye . . 668 
Foreign Bodies in the Nose . . 900 
Foreign Bodies in the Throat and 
Air-passages900 
Foreskin811 
Food233 
Food, Classes of238 
Food, Digestibility of . . . . 243 
Food, Preparation of . . . .236 
Food, Value of Animal ... 241 
Food, Variety of, Necessary . 236, 239 
Foot-bath366 
Foxglove337 
Fractures899 
Frasera Carolinensis .... 353 
Fraserin353 
Frontal Bone22 
Function11 
Furuncular Affections . . .701 
Furunculus ... . . 475 
G 
Gall-bladder ... . . 80 
Gallic Acid325 
Gall-stones579 
Gamboge327 
Ganglia 89, 103, 115 
Ganglionic Corpuscles . . .87,89 
Gangrene400 
Garget304 
Gastralgia542 
Gastric Fever405 
Gastric Juice45, 79 
Gastric Ulcer537 
Gastritis, Acute539 
Gastritis, Chronic .... 540 
Gaultheria Procumbens . . . 325 
Gelatinoid Polypus .... 489 
Gelsemin - 320,348 
Gelseminum Sempervirens . 319,348 
General Paralysis .... 614 
General Treatment of Paralysis . 620 
Generation . . . • . . . 11,12 
Generation, Alternate ... 16 
Generation, The Process of . . 15 
Generative Organs, Hygiene of the 282 
Generative Organs, Male, Affections 
of the814 
Generative Organs, Male, Physio- 
logical Anatomy of the . . . 810 
Gentian350 
Geranin323 
Geranium Maculatum . . .322 
Geranium, Spotted . . . .322 
Germ-cell12, 15 
Ginger 325,335 
Gland, Prostate813 
Gland, Prostate, Enlargement of the 869 
Gland, Sublingual .... 38 
Gland, Submaxillary . . . • . 39 
Glands, Ceruminous .... 77 INDEX, 
999 
PAGE 
Glands, Cowper's814 
Glands, Meibomian .... 78 
Glands of Brunner .... 79 
Glands, Parotid38 
Glands, Salivary38 
Glands, Sebaceous . . . . 70,77 
Glands, Sudoriferous .... 69 
Glans Penis811 
Glaucoma659 
Gleet876 
Glycocholate of Soda .... 81 
Glycosuria782 
Goitre473 
Golden Medical Discovery 308,316, 355 
Golden Saffron333 
Golden-seal352 
Gold-thread354 
Gonorrhea874 
Gonorrheal Ophthalmia . . 642,644 
Gout, Acute430 
Gout, Chronic430 
Gout, Retrocedent .... 430 
Granular Conjunctivitis ... 649 
Granular Lids . . . . .649 
Granular Ulcer756 
Gravel792 
Gravel-plant336 
Gravel-root 336,338 
Gravel-weed338 
Gray Matter91 
Great Sympathetic System . . 101 
Growths, Morbid881 
Grubs699 
Gubernaculum Testis . . . 812 
Gum Arabic335 
Gutta Rosacea689 
Gymnasium, Exercises of the . . 275 
H 
Hzematoxylon Campeachianum . 321 
Haemoptysis 502, 508 
Hair-follicles, Affections of the . 698 
Hairs72 
Hamamelin322 
Hamamelis Virginica . . . 321 
Hands, Deformed .... 453 
Hard Chancre879 
Hardback323 
Harelip457 
Haversian Canals .... 21 
Hay Asthma488 
Hay Catarrh488 
Hay Fever488 
Headache637 
Head Bath358 
Head, Scald698 
Head, The Bones of the ... 22 
Health, Light and .... 231 
Hearing109 
Heart56 
Heart, Atrophy of the . . . 532 
Heart, Dilatation of the . . . 532 
Heart, Diseases of the . . . 526 
Heart, Fatty Degeneration of the . 532 
Heart, Hypertrophy of the . . 531 
Heart, Neuralgia of the . . . 533 
Heart, Organic Disease of the . . 527 
Heat Eruption683 
Heat. Prickly.687 
Hectic Fever502 
Hedeoma Pulegioides ... 341 
Hellebore, American .... 347 
Hellebore, Swamp . . . .347 
Hellebore, White347 
PAGE 
Hemiplegia612,614 
Hemloek, Poison311 
Hemorrhage896 
Hemorrhage, Cerebral . . .611 
Hemorrhoids591 
Hemp, Indian344 
Henbane311,343 
Hepatitis, Acute569 
Hepatitis, Chronic .... 570 
Hermaphrodite199 
Hermaphroditic Reproduction. . 199 
Hernia888 
Hernia, Radical Cure for . . . 892 
Herpes694 
High Cranberry320 
Hilus84 
History of Marriage . ... 188 
Hip-joint Disease .... 439 
Hives693 
Homes, Site for227 
Homoeopathy294 
Hops312, 345 
Hordeolum672 
Horseback Exercise .... 276 
Horse-balm337 
Horse-radish331 
Hospital Fever408 
Hot Bath358 
How to use Vaginal Injections. . 734 
How to use Water .... 252 
Human Temperaments . . . 149 
Humerus26 
Humid Tetter683 
Humor, Aqueous107 
Humor, Vitreous107 
Humpback446 
Humulin312, 345 
Humulus Lupulus . . . 312,345 
Hydragogues326 
Hydrargyri Sulphas Flava . . 339 
Hydrarthrus442 
Hydrastia, Muriate of ... 352 
Hydrastin352 
Hvdrastis Canadensis .... 352 
Hydrocele .... 423,827,865 
Hydrocephalus423 
Hydrochloric Acid .... 310 
Hydro-sarcocele865 
Hydrothorax423 
Hygiene222 
Hygiene of the Reproductive Organs 282 
Hygiene, Practical Summary of . 288 
Hygienic Treatment of the Sick . 375 
Hymen, Imperforate .... 709 
Hyoscyamin311, 344 
Hyoscyamus Niger . . . 311, 343 
Hypertrophy of the Heart. . . 531 
I 
Icterus578 
Ileum40, 41 
Impacted Feces565 
Impaired Vision . . . . .661 
Impediments to Marriage . . .857 
Imperforate Hymen .... 709 
Impetigo688 
Impotency 823, 828 
Impurities, Mineral .... 249 
Incised Wounds896 
Incontinence of Urine . . . 786 
Incus110 
Independent Physician . . . 295 
Indian Hemp '344 
Indian Physic327 1000 
INDEX. 
PAGE 
Indian Poke 347 
Indian Tobacco 340 
Indigestion 543 
Indigo, Wild 318 
Individual, Development of the . 192 
Indolent Ulcer 459 
Indulgence, Solitary .... 814 
Induration 400 
Induration of the Stomach . . 538 
Infantile Eczema .... 684 
Infantile Paralysis .... 616 
Infants, Feeding of ... . 235 
Inferior Maxillary Bone ... 22 
Inferior Turbinated Bones . . 22 
Infusions 303 
Inflammation 398 
Inflammation of the Bladder, Acute 788 
Inflammation of the Bladder, Chronic 789 
Inflammation of the Bones . . 462 
Inflammation of the Bowels . . 549 
Inflammation of the Brain . . 609( 
Inflammation of the Cornea . . 651 
Inflammation of the Eye ... 641 
Inflammation of the Eye, Chronic 647 
Inflammation of the Eyelids . . 672 
Inflammation of the Eye, Purulent 642 
Inflammation of the Iris . . . 656 
Inflammation of the Liver . 569, 570 
Inflammation of the Membranes of 
the Brain 609 
Inflammation of the Stomach, Acute 539 
Inflammation of the Stomach, Chronic 540 
Inflammation of the Testicles . . 878 
Inflammation of the Vagina . . 731 
Inflammation, Phlegmonous . . 399 
Inflammation, Termination of . .400 
Inflammation, Treatment of . . 401 
Influences, Sexual .... 383 
Influenza . ... . • 476,477 
Ingrowing of the Eyelashes . . 673 
Ingrowing Toe-nails .... 703 
Inguinal Hernia 889 
Inhaler, Pocket 491 
Insalivation 233 
Insertion 31 
Instruments, Danger in the use of . 805 
Intermediate Muscles. . . 32 
Intermittent Fever .... 405 
Internal Ophthalmia .... 656 
Interpretation of Symptoms . . 393 
Intestinal Canal, Obstruction of the 564 
Intestinal J nice 79 
Intestinal Worms 580 
Intestines 40 
Introductory Words .... 9 
Intussusception 564 
Invagination 564 
Inversion of the Eyelids . . . 674 
Involucrum 463 
Involuntary Muscles .... 32 
Involuntary Seminal Emissions . 823 
Iodine 307,903 
Iodine Bath 368 
Ipecac 339 
Ipomoea Jalapa 326 
Iridectomy 659 
Iris 107 
Iris, Inflammation of the . . . 656 
Iris Versicolor 307 
Irritable Vagina 759 
Iritis 656 
Iron 354 
Iron by Hydrogen .... 354 
Iron, Carbonate of ... . 354 
Iron, Citrate of 354 
Page 
Iron, Ferrocyanide of. . . .316 
Iron, Pyropliosphate of . . .354 
Iron, Tincture of Muriate of . . 355 
Irritable Ulcer 459 
Irritation, Spinal .... 633 
Itch 689 
Itch, Barber's 699 
Itching of the Vulva . . . .731 
J 
Jaborandi 334 
Jail Fever 408 
Jalap 326 
Jalapin 327 
Jaundice 578 
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 80 
Juice, Tamarind 335 
K 
Keratitis 651 
Kidneys 768 
Kidneys, Diseases of the . . . 772 
Knee-joint, Tuberculosis of the . 443 
Knot-root 337 
L 
Labyrinth no 
Lacerated Wounds .... 896 
Lachrymal Bones .... 22 
Lachrymal Fistula . . . .671 
Lachrymo-nasal Tube, Obstruction of 
the 671 
Lacteals 48 
Lactiferous Ducts .... 82 
Lady's-slipper, Yellow . . 320,345 
Laryngitis, Acute .... 490 
Laryngitis, Chronic . . . .491 
Laryngitis, Follicular.... 491 
Larynx 68 
Larynx, Disease of the ... 481 
Latent Life 11 
Lateral Curvature of the Spine . 450 
Late Suppers 235 
Laudanum 310 
Laxatives 326 
Lead Colic 563 
Lead Palsy ...... 618 
Lemons .' 335 
Lens Crystalline 107 
Leptandra Virginica .... 327 
Leptandrin 327 
Lesions, Valvular .... 530 
Leucocythaamia 421 
Leucorrhea ?30 
Liberal Physician .... 295 
Lichen 686 
Lids, Granular 649 
Lids, Inflammation of the . . .672 
Life, Latent 11 
Life Line 169 
Life, Origin of 17 
Life-root 341 
Life, Transmission of. . . .181 
Life, Turn of 728 INDEX. 
1001 
PAGE 
Ligaments 29 
Light and Health .... 231, 378 
Limbs, Deformed 453 
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, Acute Inflammation of the . 569 
Liver, Chronic Inflammation of the 570 
Liver Complaint 570 
Liver, Diseases of the . . .567 
Lobelia Inflata 340 
Lobes 64, 80 
Lobules 64, 80 
Local Anaesthesia .... 894 
Local Paralysis 617 
Locomotor Ataxia .... 615 
Logwood 321 
Loss of Sexual Power . . . 828 
Lower Extremities, the Bones of the 27 
Love 184 
Love, Conjugal 186 
Lumbago 427 
Lumbar Abscess 438 
Lung Fever 518 
Lungs 63 
Lungs, A Cold on the .... 518 
Lycopin 324 
Lycopus Virginicus .... 323 
Lymph 51 
Lymphatics 49 
Lymphatic System .... 49 
Lymphatic Temperament. . . 157 
M 
Macrotin 306 
Macrotys 305 
Mad-dog Weed 345 
Magnesia Sulphas .... 328 
Malar Bones 22 
Malaria 227 i 
Male Fern 315 j 
Malformation of the Vagina . . 708 
Malformation of the Womb . . 708 
Male Generative Organs . . .207 
Male Generative Organs, Affections 
of the 814 
Male Generative Organs, Physio- 
logical Anatomy of the . . . 810 
Malignant Fevers .... 407 I 
Malleus 110 
Malted Liquors 262 
Management, Domestic, of Fevers . 403 
Mandrake 304 
Manipulator 373 
Marriage 184 
Marriage, History of . . . . 188 
Marriage, Impediments to . . 857 
Marsh-mallow 336 
Maruta Cotula 334 
Massage 362 
Mastication 233 
Masturbation 286, 814 
Masturbation, a Cause of Disease in 
Women 744 
Matter, Gray 91 
Matter, Sebaceous .... 77 
Maxillary Bones 22 | 
PAGE 
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 Treat- 
ment of Paralysis .... 621 
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 
Melanoid Cancer 467 
Membrane, Arachnoid ... 90 
Membrane, False 493 
Membrane, Mucous .... 37 
Membrane, Pituitary .... Ill 
Membrane, Synovial .... 29 
Membranous Croup, . . . . 493 
Meningitis 609 
Meningitis, Cerebro-spinal . . 610 
Menorrhagia 723 
Menses 210 
Menses, Cessation of the . . .728 
Menses, Retention of the 708, 710, 711, 713 
Menses, Suppression of the 
708, 710, 711, 713 
Menstruation 210, 707 
Menstruation, Painful. . . . 715 
Menstruation, Profuse . . . 723 
Mental Culture 276 
Mentha Piperita 326 
Mentha Viridis 326 
Metacarpus 26 
Metatarsus 27 
Mercury 307 
Mercury, Yellow Subsulphate of . 339 
Miasm " 405 
Microscopical Examination . . 398 
Miliaria . 695 
Milk 82, 381 
Mind, Nature of 146 
Mineral Impurities .... 249 
Mineral Foods 238 
Mitral Valve 57 
Miscarriage 748 
Modified Small-pox . . . .411 
Monogamy 188 
Morbid Growths 881 
Morphine 311 
Motherwort ...... 342 
Motion as a Remedial Agent . . 369 
Motion, Peristaltic .... 49 
Motor Nerves 87,93 
Mouth 37 
Mouth, Nursing Sore .... 535 
Mouth, Sore 534 
Movements, Mechanical, in the Treat- 
of Paralysis 621 
Mucosin 78 
Mucous Membrane .... 37 
Mucus 78 
Mumps 474 1002 
INDEX. 
PAGE 
Muriate of Hydrastia .... 352 
Muriate of Iron, Tincture of . . 355 
Muriatic Acid310 
Muscles30 
Muscles, Intermediate ... 32 
Muscles, Involuntary .... 32 
Muscles, Voluntary' . . . . 31 
Muscular Atrophy, Progressive . 618 
Muscular Tissue20 
Mustard 331, 339 
Mutton Soup247 
Myalgia427 
N 
Nails73 
Narcotics 343,904 
Nasal Bones22 
Nasal Catarrh, Chronic . . . 478 
Nasal Douche, Dr. Pierce's . . 487 
Nasal Polypus489 
Nature of Disease .... 390 
Nature of Mind146 
Nature's Mode of Sustaining Health 371 
Neck, Thick 473 
Neck, Wry465 
Necrosis462 
Nepeta Cataria334 
Nephritis, Acute774 
Nephritis, Desquamative . . . 774 
Nerve-fibers87 
Nerve, Pneumogastric . . .101 
Nerves, Afferent87, 93 
Nerves, Auditory, Paralysis of the 681 
Nerves, Cerebral . . ' . . . 89 
Nerves, Cranial100 
Nerves, Efferent87, 93 
Nerves, Motor87, 93 
Nerves, Olfactory. . . . 100.111 
Nerves, Sensory'87, 93 
Nerves, Spinal'89 
Nerves, Sympathetic .... 101 
Nervines345 
Nervous Affections of the Skin . 696 
Nervous System87 
Nervous Tissue20 
Nettle-rash693 
Neuralgia634 
Neuralgia of the Heart . . . 533 
Neuralgia of the Stomach . . . 542 
Neurilemma89 
Nightshade, Deadly .... 312 
Nitre, Sweet Spirits of . . . 338 
Nocturnal Emissions .... 824 
Nodes880 
NoseIll 
Nose, Foreign Bodies in the . . 900 
Nucleolus19 
Nucleus19, 54 
Nurse 375,376 
Nursing Sore Mouth .... 535 
Nux Vomica350 
Nymphomania745 
O 
Obscene Literature .... 285 
Obstruction of the Eustachian Tube 678 
Obstruction of the External Ear . 680 
Obstruction of the Intestinal Canal 564 
Obstruction of the Lachrymo-nasal 
Tube671 
Obstruction of the Tear-duct . . 671 
Occipital Bone22 
(Edema422 
PAGE 
Old School of Medicine ... 293 
Old Sores459 
Oleum Ricini328 
Olfactory Nerves .... 100, 111 
Onanism 286, 814 
Onyx is703 
Opacities of the Cornea ... 653 
Ophthalmia640 
Ophthalmia, Catarrhal ... 641 
Ophthalmia, Egyptian ... 642 
Ophthalmia, Gonorrheal . . 642,644 
Ophthalmia Infantium Purulenta 
642, 644 
Ophthalmia, Internal .... 656 
Ophthalmia, Military .... 642 
Ophthalmia Tarsi .... 672 
Opium310 
Opium, Use of384 
Oranges335 
Orchitis878 
Organic Disease of the Heart . . 527 
Organic Impurities in Water . . 251 
Organs, Circulatory .... 56 
Organs, Digestive .... 37 
Organs, Generative . . . 206,207 
Organs of Respiration ... 63 
Organs, Urinary .... 206, 207 
Orifice, Pyloric82 
Origin31 
Origin of Life17 
Os Hyoides23 
Osmosis46 
Os Orbiculare110 
Ossa Innominata23, 25 
Osseous Tissue20 
Ossification20 
Ossification, Centers of . . ' . 20, 27 
Osteitis462 
Osteoid Cancer467 
Otalgia675 
Otorrhea676 
Otoscope679 
Ovarian Tumors762 
Ovaries209 
Ovaries, Absence of the . . . 710 
Ovaries, Disease of the . . . 738 
Ovulation209 
Ovum12,209 
Ozaena 478,479 
P 
1 Pack, Wet Sheet368 
Pain395 
Painful Menstruation .... 715 
Painters' Colic563 
Palate Bones22 
Palate, Cleft457 
Pallor62 
Palsy613 
Palsy, Creeping618 
I Palsy, Lead618 
Palsy, Shaking619 
Palsy, Wasting618 
Pancreas44 
Pancreatic Juice80 
Pancreatin80 
Pannus651 
Papillae69,112 
Papaver Somniferum . . . .310 
Paralysis618 
Paralysis Agitans .... 619 
Paralysis, Facial617 
Paralysis, General . . . .614 
Paralysis, General Treatment of . 620 INDEX, 
1003 
PAGE 
Paralysis, Infantile .... 616 
Paralysis, Local 617 
Paralysis, Progressive . . .615 
Paralysis, Writers' .... 617 
Paraplegia 613,615 
Paregoric 310 
Parietal Bones 22 
Parotid Glands 38 
Parotitis 474 
Parsley, Poison 311 
Passages, False 805 
Passions, Influence of Physical La- 
bor on 283 
Patella . . 27 
Patient, Clothing and Bedding of . 380 
Peach Tree 346 
Peduncles of the Cerebellum . . 97 
Pelvis 25 
Pelvis, Bones of the .... 25 
Pemphigus 695 
Penis, 811 
Pennyroyal 341 
Pepper, Black 348 
Peppermint 326 
Pepsin 79 
Percussion 391 
Pericarditis 529 
Pericardium 56 
Perichondrium 29 
Perilymph 110 
Periosteum 27 
Peristaltic Motion .... 45 
Peritoneum 84 
Peritonitis 551 
Permanganate of Potash . . . 318 
Pernicious Fever 406 
Perpetual Reproduction ... 11 
Perpetuation of the Species . . 194 
Perspiration 75 
Pertussis 523 
Pettenkoffer's Test .... 81 
Phalanges 27 
Pharynx 39 
Phimosis 811,857 
Phthisic 524 
Phthisis Pulmonalis .... 496 
Physical Exercise .... 270 
Physical Properties of the Blood . 53 
Physician, Independent . . . 295 
Physiology 11 
Physiology, Cerebral .... 114 
Physiological Anatomy 
11,19, 30, 37, 48, 56, 63, 68, 75, 84, 87 
Physiological Anatomy of the Male 
Generative Organs .... 810 
Physiological Anatomy of the Uri- 
nary Organs 768 
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 Discoverv 
308. 316, 355 
Pierce's Nasal Douche . . .487 
Pierce's Purgative Pellets . 308,328 
Pigeon-berry 304 
Piles 591 
Pile Tumors, Radical Cure of . . 595 
Pine-apples 335 
Pink-root 314 
Pin-worm 581 
Pipsissewa 338 
Pituitary Membrane .... Ill 
PAGE 
Pityriasis 685 
Placenta 216 
Pleura 64 
Pleurisy, Acute 521 
Pleurisy-root 332 
Pleurodynia 427 
Pleuro-pneumonia . . . 518,522 
Pleximeter 391 
Pneumogastric Nerve. . . .101 
Pneumonia 518 
Pocket Inhaler 491 
Podophyllin 304 
Podophyllum Peltatum . . . 304 
Poison Hemlock 311 
Poison Parsley 311 
Poisoned Wounds . . . 896,897 
Poisons and their Antidotes . . 902 
Poke 304 
Poke, Indian 347 
Politzer's Air-bag . . . .679 
Pollution, Voluntary' .... 814 
Polygamy 188 
Polypi '.763 
Polypoid Tumors 763 
Polypus, Fibroid 489 
Polypus, Gelatinoid .... 489 
Polypus, Nasal 489 
Polyuria 782 
Pond's Sphygmograph ... 528 
PonsVarolii 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 . . 446 
Potash, Acetate of ... . 338 
Potash, Bicarbonate of . . . 309 
Potash, Nitrate of .... 338 
Potash, Permanganate of . . . 318 
Pott's Disease 446 
Powder, Dover's 311 
Pox 878 
Practical Summary of Hygiene . 288 
Preface 5,7 
Pregnancy 212 
Pregnancy, Derangements Incident 
to • . 767 
Pregnancy, Duration of . . . 219 
Pregnancy, Signs of . . . .219 
Prehension 233 
Premature Labor .... 748 
Preparation of Food .... 236 
Preparation of Medicines . . .301 
Prepuce 811 
Prescription, Pierce's Favorite 342,346,355 
Prevention of Conception. . . 212 
Prickly-ash 349 
Prickly Heat 687 
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.... 723 
Prognosis 390 
Progressive Muscular Atrophy . 618 
Progress of Medicine . . . . 292 
Progressive Paralysis . . .615 
Prolapsus Ani 599 
Prolapsus of the Rectum . . . 599 1004 
INDEX. 
PAGE 
Prolapsus of the Uterus . . .751 
Properties of Medicine . . . 300 
Proprietary Medicines ... 298 
Prostatorrhea 828 
Prostate Gland 813 
Prostate Gland, Enlargement of the 869 
Proteids 238 
Prurigo 697 
Pruritus Vulvse 731 
Prussian Blue 316 
Psoas Abscess 438 
Psoriasis 685 
Pterygium 667 
Ptyalin . . . . . . . 78 
Puberty 210 
Puccoo'n, Red 306 
Pulmonary Artery .... 58 
Pulmonary Veins' 60 
Pulmonary Tuberculosis ... 496 
Pulse 61,395 
Pulsatilla Nigricans . . . .346 
Pumpkin Seeds 338 
Puncta Lachrymalia .... 77 
Punctured Wounds .... 896 
Pupil . . . . . . . 107 
Pupil, Closure of the .... 659 
Pure Air .... 222,223,378 
Purgatives 326 
Purification of Water . . . 252 
Purulent Conjunctivitis ... 642 
Purulent Discharge from the Ear . 676 
Purulent Inflammation of the Eye . 642 
Purulent Ophthalmia of Newborn 
Children 644 
Putrid Fevers 407 
Pyaimia 529 
Pyloric Orifice 82 
Pyrophosphate of Iron ... 354 
Q 
Quackery Exposed .... 855 
Queen oi the Meadow .... 338 
Quickening 217 
Quinine 315 
Quinsy 416 
R 
Rachitis 445 
Radical Cure for Hernia . . . 892 
Radical Cure for Pile Tumors . . 595 
Radius 26 
Rational Medicine .... 292 
Rash 692 
Rash, Papular 686 
Rash, Rose 413 
Receptacuhim Chyli .... 46 
Rectum 42 
Rectum, Prolapsus of the ... 599 
Red Puccoon 306 
Reflex Action of the Spinal Coni . 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 793 
Reproduction .... 11,196 
Reproduction, Dioecious . . . 202 
Reproduction, Hermaphroditic . 199 
Reproductive Organs, Hygiene of the 282 
Resolution 400 
PAGE 
Respiration, Organs of ... 63 
Respiration, Pure Air for ... 223 
Respirator, Cotton-wool . . . 230 
Rete Mucosum 70 
Retention of the Menses 708, 710, 711, 713 
Retention of Urine .... 785 
Retina . . . , . . 106,107 
Retrocedent Gout 430 
Retroflexion of the Uterus . 752, 753 
Rhagades Ani 606 
Rheumatism, Acute Articular . . 425 
Rheumatism, Cervical . . .427 
Rheumatism, Chronic Articular . 426 
Rheumatism, Muscular . . . 427 
Rhubarb 327 
Ribs 24 
Rickets 445 
Right to Terminate Pregnancy . 218 
Rooms, Sleeping 278 
Rose Rash 413 
Rosy Drop 689 
Rowing 275 
Rubbing 372 
Rubeola 412 
Running Scali 683 
Running-sores 459 
Rupia 696 
Rupture 888 
Russian Bath 358 
S 
Sacrum 23, 25 
Sage 313, 333 
Saleratus 309 
Salicin 315, 351 
Saliva 38, 78 
Salivary Glands 38 
Salt 315 
Saltpetre 338 
Salt-rheum 683 
Salts 53 
Salts, Biliary 81 * 
Salvia Officinalis .... 313, 333 
Sanguinaria Canadensis ... 306 
Sanguine Temperament ... 163 
Santonin 313 
Sarcolemma 32 
Saturnine Colic ■ 563 
Scabies 689 
Scald Head 698 
Scalds 901 
Scali 688 
Scali,Running 683 
Scaly Skin Diseases .... 697 
Scapula 26 
Scarlatina 408 
Scarlet Fever 408 
School-rooms, Ventilation of . . 225 
Sciatica 635 
Sclerotic 106 
Scott's Acid Bath 367 
Scrofula 431 
Scrofulous Conjunctivitis ... 645 
Scrofulous Inflammation of the Eye 645 
Scrotum ' . 811 
Scrotum, Dropsy of the . . 827,865 
Scull-cap 345 
Scurvy 466 
Sea Bathing 364 
Seat 390 
Seat-worm 581 
Sebaceous Glands 70, 77 
Sebaceous Matter 77 
Secretion 75 INDEX, 
1005 
PAGE 
Sedatives346 
Self-abuse 286,814 
Self-pollution814 
Semen811 
Semi-circular Canals . . . .110 
Semilunar Valves .... 58 
Seminal Emissions, Involuntary . 823 
Sense of Hearing109 
Sense of Sight106 
Sense of SmellIll 
Sense of Taste112 
Sense of Touch113 
Senses, Special106 
Sensory Nerves87, 93 
Serum 54, 55, 238 
Sexual Abuse, Story of . . . 394 
Sexual Debility, Symptoms of . . 830 
Sexual Influences .... 383 
Sexual Power, Loss of . . . 828 
Shaking Palsy619 
Shingles694 
Ship Fever408 
Shock896 
Shower Bath365 
Sight106 
Signs of Pregnancy .... 219 
Sick, Hygienic Treatment of the . 375 
Sick-room377 
Sick, Visiting the383 
Site for Homes227 
Sitz Bath367 
Skeleton22 
Skin68 
Skin, Diseases of the .... 682 
Skin Diseases, Scaly .... 697 
Skin, Nervous Affections of the . 696 
Skoke304 
Sleep 278,382 
Slight Affections of the Urinary 
Organs769 
Small-pox410 
Smart-weed, Compound Extract of 
312, 326, 335, 342, 349 
SmellHl 
Snake-head315 
Snake-root, Black .... 306 
Society, Welfare of .... 193 
Soda, Glycocholate of . . . . 81 
Soda, Sulphite of309 
Soda, Taurocholate of . . . . 81 
Sodium, Chloride of ... . 315 
Soft Chancre879 
Softening of the Stomach . . . 538 
Solitary Indulgence . ... . 814 
Sore Mouth534 
Sore Mouth, Nursing .... 535 
Sore Throat, Clergymen's . . .491 
Soups246 
Spasmodic Croup.... 493, 495 
Spearmint 326 
Special Creation14 
Special Senses106 
Species . 14 
Species, Perpetuation of the . . 194 
Specific Center14 
Speculum677 
Sperm811 
Spermatic Veins, Enlarged . . 860 
Spermatozoon12 
Spermatic Cord811 
Spermatorrhea . . . ... 823 
Spermatorrhea Affecting Married 
Men834 
Sperm-cell15 
Sphenoid Bone22 
PAGE 
Sphygmqgraph, Pond's . . . 528 
Spigelia Marilandica .... 314 
Spinal Column24 
Spinal Cord25, 90 
Spinal Cord, Keflex Action of the . 93 
Spinal Curvature, Posterior . . 446 
Spinal Irritation633 
Spinal Nerves89 
Spirit Vapor-bath362 
Spirometer 391,392 
Spleen44 
Sponge Bath365 
Spotted Fever610 
Sprains899 
Squaw-root305 
Stapes110 
Staphyloma655 
Stethoscope391 
Sterility734 
Sternum23 
Stimulants348 
Stomach39, 52 
Stomach, Cancer of the . . . 537 
Stomach, Dilatation of the. . . 538 
Stomach, Diseases of the . . . 537 
Stomach, Induration of the . . 538 
Stomach, Inflammation of the . . 539 
Stomach, Neuralgia of the . . . 542 
Stomach, Softening of the . . . 538 
Stomach, Structural Diseases of the 537 
Stomach, Ulceration of the . . 537 
Stomatitis534 
Stomatitis Materna .... 535 
Stone in the Bladder .... 795 
Stone-pock699 
Stone-root337 
Story of Sexual Abuse . . . 394 
Strabismus669 
Stramonium344 
Striae31 
Stricture of the Bowels . . • 566 
Stricture of the Urethra . . . 800 
Structural Diseases of the Stomach 537 
Structure of the Testicles . . . 812 
Strumous Diathesis . . . .431 
Strumous Synovitis .... 443 
St. Vitus's Dance630 
Stye672 
Styptics 320, 897 
Sublingual Gland39 
Submaxillary Gland .... 38 
Sudatorium359 
Sudoriferous Glands .... 69 
Sudorifles332 
Sulphate of Copper .... 339 
Sulphate of Quinia . . . 315,339 
Sulphate of Zinc318 
Sulphite of Soda309 
Sulphur Bath368 
Sulphuric Acid, Aromatic . . . 310 
Sulphur Vapor-bath .... 368 
Summer Complaint .... 553 
Sun-stroke . . . . . .902 
Superior- Maxillary Bones ... 22 
Suppers, Late235 
Suppression of the Menses 
708, 710, 711, 713 
Suppuration400 
Sutures23 
Swamp Alder304 
Swamp Dogwood351 
Swelling400 
Swelling, White442 
Sweet Spirits of Nitre .... 338 
Swimming274 1006 
INDEX. 
Sweet Elder 307 
Sycosis 699 
Sylvius, Fissure of .... 98 
Sympathetic Affections of the Uri- 
nary Organs 770 
Sympathetic Nerve . . . .101 
Symptoms .... 390,392, 393 
Symptoms, Interpretation of . . 393 
Symptoms of Sexual Debility . . 830 
Synovia 29 
Synovial Capsule 29 
Synovial Membrane .... 29 
Synovitis 442 
Synovitis, Rheumatic .... 443 
Synovitis, Strumous .... 443 
Synovitis, Syphilitic .... 443 
Syphilis 878 
Syphilitic Catarrh .... 881 
Syphilitic Eruptions .... 880 
Syphilitic Synovitis .... 443 
System, Cerebro-Spinal ... 89 
Systemic Veins 60 
System, Lymphatic .... 49 
System, Nervous 87 
System, the Great Sympathetic . 101 
System, Vascular . . . . . 56 
Taenia 581 
Tag Alder 304 
Tall Speedwell 327 
Tamarind 335 
Tanacetum Vulgare . . . .341 
Tannin 325 
Tansy 341 
Tape-worms 581 
Tarsus 27 
Taste, Sense of 112 
Taurocholate of Soda .... 81 
Tea 253 
Tear-duct, Closure of the . . . 482 
Tear-duct, Obstruction of the . . 671 
Tears 77 
Teeth 37 
Telegraph Operators' Cramp . . 617 
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 
Testicles 811 
Testicles, Atrophy of the . . . 825 
Testicles, Inflammation of the . . 878 
Tetter, Branny 685 
Tetter, Crusted 688 
Tetter, Humid 683 
Thick Neck 473 
Thoracic Duct 42 
Thorn-apple 344 
Thorougnwort 316 
Thread-worm 581 
Throat, Disease of the . . . 480 
Throat, Foreign Bodies in the . . 900 
Throat, Ulceration of the . . . 880 
Thrush 535 
Tibia 27 
Tic-douloureux 635 
Time for Sleep 279 
Tinctura Ferri Chloridi . . . 355 
Tincture of the Chloride of Iron . 355 
Tincture of the Muriate of Iron . 355 
PAGE 
Tinctures 302 
Tissue, Adipose 20 
Tissue, Areolar 19 
Tissue, Cartilaginous .... 20 
Tissue, Connective .... 19 
Tissue, Muscular 20 
Tissue, Nervous 20 
Tissue, Osseous 20 
Tobacco, Indian 340 
Tobacco, Use of 384 
Toe-nails, Ingrowing .... 703 
Tongue 3 394 
Tonics 350 
Tonsillitis 416 
Tonsils, Enlarged . . . .417 
Torpid Liver 570 
Torticollis 427 
Touch. Sense of 113 
Tourniquet 897 
Trachea 63 
Trailing Arbutus 336 
Transmission of Life .... 181 
Transudation 422 
Treatment 390 
Treatment of Diseases, Remedial . 386 
Treatment of Inflammation . . 401 
Treatment of Paralysis ... 620 
Treatment of the Sick, Hygienic . 375 
Trichina Spiralis 584 
Trichiasis 673 
Tricocephalus Dispar. . . .581 
Tricuspid Valve 57 
Trigone Vesical 796 
True Skin 68 
Trumpet-weed 338 
Trunk 23 
Truss 890 
Tube, Eustachian .... 110 
Tube, Eustachian, Obstruction of the 678 
Tubercle 431 
Tubercular Consumption ... 496 
Tuberculosis of the Knee-joint . 443 
Tuberculosis, Pulmonary . . . 496 
Tumors, Fibroid . . ' . . .762 
Tumors of the Eye-lids . . .673 
Tumors, Ovarian 762 
Tumors, Polypoid .... 763 
Tumors, Uterine 762 
Turkish Bath 358 
Turn of Life 728 
Turpeth Mineral 339 
Tympanum 110 
Tympanum, Affections of the . . 679 
Typhoid Fever 407 
Typhus Fever .... 407,408 
u 
Ulceration of the Cornea . . . 654 
Ulceration of the Stomach . . 537 
Ulceration of the Throat . . . 880 
Ulceration of the Uterus ... 756 
Ulcer, Follicular 757 
Ulcer, Gastric 537 
Ulcer, Granular 756 
Ulcer, Indolent 459 
Ulcer, Irritable 459 
Ulcer, Varicose 460 
Ulcers, Chronic 459 
Ulna 26 
Umbilical Cord 217 
Umbilical Hernia .... 889 
Umbilicus 217 
Universality of Animalcular Life . 16 
Upper Extremities, the Bones of the 25 INDEX. 
1007 
PAGE 
Urea 86 
Ureters 84 
Urethra 86, 768 
Urethra, Stricture of the . . . 800 
Uric Acid 86 
Urinary Fistula 767 
Urinary Organs, Diseases of the . 771 
Urinary Organs, Physiological Anat- 
omy of the ... . . 768 
Urinary Organs, Slight Affections 
of the 769 
Urinary Organs, Sympathetic Affec- 
tions of the 770 
Urine 86 
Urine, Examination of the . 397, 771 
Urine, Incontinence of . . . 786 
Urine, Retention of ... . 785 
Urinometer 392 
Urticaria 693 
Use of Tobacco and Opium . . 384 
Uterine Pregnancy .... 215 
Uterine Speculum .... 757 
Uterine Tumors 762 
Uterus, Falling of the . . . 751 
Uterus, Prolapsus of the . . . 751 
Uvula, Elongation of the . . .419 
V 
Vaccinia 411 
Vagina, Inflammation of the . . 731 
Vagina, Irritable 759 
Vagina, Malformation of the . . 708 
Vaginal Injections, How to Use . 734 
Vaginismus . . . . . 759 
Vaginitis 731 
Valerian 320 
Valeriana Officinalis .... 320 
Value of Animal Food . . .241 
Value of Mechanical Movements . 371 
Valve, Mitral 57 
Valve, Tricuspid 57 
Valves, Semilunar .... 58 
Valvulae Conniventes .... 40 
Valvular Lesions .... 530 
Vapor-Bath 358 
Vapor-Bath, Spirit .... 362 
Vapor-Bath, Sulphur .... 368 
Varicella 412 
Varicocele 827,860 
Varicose Ulcer 460 
Variety of Food necessary . . 239 
Variola 410 
Varioloid 411 
Vascular System 56 
Vas Deferens 813 
Veins 59 
Veins, Enlarged Spermatic . . 860 
Veins of the Portal System ... 60 
Veins, Pulmonary .... 60 
Veins, Systemic 60 
Vena Cava 56, 60 
Venereal Debauchment . . . 814 
Venereal Diseases .... 872 
Ventilation of Factories ... 226 
Ventilation of Dwellings . 226 
Ventilation of School Rooms . . 225 
Ventilation of Workshops . . 226 
Ventricle 57 
Veratrum Viride 347 
Vermifuge 313 
Versions of the Uterus or Womb 738, 752 
Vertebrae 23 
Vesical Calculi .... 793,795 
Vestibule 110 
PAGE 
Viburnin 320 
Viburnum Opulus .... 320 
Villus 41, 48 
Virginia Snake-root .... 333 
Vision, Impaired 661 
Visiting the Sick 383 
Vital Principle 15 
Vital Properties of the Blood . . 53 
Vitreous Humor 107 
Vitriol, Elixir of 310 
Vitriol, White 318 
Volitive Faculties .... 129 
Volitive Temperament . . .171 
Voluntary Muscles .... 31 
Voluntary Pollution . . . .814 
Vomer . ' 22 
Vomit, Black 540 
Vulvitis 731 
W 
Wafer-ash ... . . 351 
Wakefulness 608 
Warm Bath 357 
Warmth 379 
Warts 702 
Wasting away of the Testicles . 825 
Wasting Palsy 618 
Water 248 
Water-bugle 323 
Water-hoarhound .... 323 
Water-melon Seeds .... 338 
Water, How to use .... 252 
Water, Organic Impurities in . . 251 
Water-pink 336 
Water, Purification of . . . 252 
Waters, Chalybeate .... 250 
Waters, Saline 250 
Waters, Sulphurous .... 250 
Watery Eyes 671 
Welfare of Society .... 193 
Wet Sheet Pack 368 
Wetting the Bed 787 
White Hellebore 347 
White Poplar 350 
White Swelling 442 
White Vitriol 318 
White-root 332 
Whitewood 350 
Whites 730 
Whitlow 704 
Whooping-cough 523 
Wild Chamomile 334 
Wild Hairs 673 
Wild Indigo 318 
Wild Yam 320 
Willow ....... 351 
Windpipe ...... 63 
Wintergreen 325 
Winter Cough 520 
Witch-hazel 321 
Woman and her Diseases . . . 706 
Womb, Absence of the . . . 708 
Womb, Displacements of the . . 751 
Womb, Elongation of the Neck of 
the 737,752 
Womb, Flexions of the ... 738 
Womb, Malformation of the . . 708 
Womb, Versions of the . . 738, 752 
Workshops, Ventilation of . . 226 
Worms, Intestinal .... 580 
Wounds 896 
Writers' Palsy 617 
Writers' Cramp • 617 
Wry Neck ... ... 465 1008 
INDEX. 
X 
PAGE 
Xanthoxylin 349 
Xanthoxylum Fraxineum. . . 349 
Y 
Yam, Wild 320 
Yeast 317,335 
Yellow Dock 304 
PAGE 
Yellow Jessamine . . . 319,348 
Yellow Lady's-slipper . . 320,345 
Yellow Sub-sulphate of Mercury . 339 
Z 
Zinci Sulphas .... 318,339 
Zinc, Sulphate of . • . . . 318, 339 
Zingiber Officinalis . . . 325,335 
INDEX TO APPENDIX. 
PAGE 
Advantages of Location . . . 948 
Advantages Offered to Invalids 951 
Advantages of Specialties . . 950, 956 
Advertising 958 
Affidavit 905 
Aids, Invaluable, in Urinary Diseases 964 
Amusements 932 
Appendix 905 
Bath Department .... 931 
Board and Treatment, Terms for . 970 
Buffalo Outranks all in Healthfulness 946 
Careless Doctors 983 
Caution 936 
Charges Must be Prepaid . . . 968 
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 Swellings . . . .915 
Cure of Tumors 915 
Deformities, Cure of . . .917 
Disease Has Certain Unmistakable 
Signs 943 
Diseases of Women .... 918 
Division of Labor . . . 949,954 
Dogs in the Manger .... 989 
Eminent Medical Authorities . . 967 
Endorsement, President Garfield's 973 
Equability of Climate . . 946.947 
Evidence of Health Statistics . . 945 
Extreme Healthfulness of Buffalo . 944 
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 
General Considerations . . . 940 
Gentle Hint, A 989 
Genuine Home, A 948 
Good Order 932 
Home, A Genuine .... 948 
Home, Remedial 942 
How to Avoid Swindlers . . . 990 
Important Announcement . . 921 
Invalids, Advantages Offered to . 951 
Invalids' Hotel and Surgical Insti- 
tute 922, 924, 941 
Invaluable Aids in Urinary Diseases 964 
Jealous Doctors .... 983 
Kneader 914 
Liberality 934 
Location, Advantages of . . . 948 I 
PAGE 
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 
Narrow-minded Doctors Everywhere 987 
Neuralgia, Cure of ... . 916 
No Relationship with Humbugs . 985 
Not Confined in Prescribing . . 972 
Notices of the Press .... 974 
Offer, Fair and Business-like . . 953 
Opposed to Advertising . . . 988 
Our Friends in the Profession . . 984 
Our Honorable Business Methods.. 989 
Our Medicines Prepared with the 
Greatest Care 972 
Our Physicians and Surgeons . . 935 
Our Remedies ... - . 931 
Paralysis, Cure of .... 917 
Patients, Treating at a Distance 960, 971 
Physicians, Consultation with . . 971 
Physicians and Surgeons, Staff of . 925 
President Garfield's Endorsement . 973 
Press Notices 974 
Progress in Medicine .... 950 
Recapitulation 920 
Regulation of Diet .... 931 
Reliable Medicines .... 969 
Remedial Home, 942 
Revulsion 916 
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 
Terms for Board and Treatment . 970 
Terms for Treatment . . . 969 
They Try to Cover Up Their Tracks 988 
Trained Attendants . . . .932 
Treating Patienis at their Homes, . 942 
Treating the Wrong Disease . . 983 
Treatment of Chronic Diseases . 954 
Treatment, Facilities of . . . 949 
Tumors, Cure of 915 
Unparalleled Success . . . .933 
Urinary Signs 962 
Visiting Patients who Reside at a 
Distance 971 
Why They Fail 983 
Why They Oppose Us. . . . 983 
World's Dispensary . . . .937 
World's Dispensary Medical Asso- 
ciation 921