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NATIONAL LIBRARY OF MEDICINE
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ARMY  MEDICAL  LIBRARY

         WASHINGTON

            Founded 1836
AJUOT
Section
Number .•<?..
J67 II
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           Fobm 113c, W. D.. S. G. O.
!■•  3—10543    (Revised Juno 13, 1936)
NLM005544258 
DUE TWO WEEKS FROM LAST DATE






    [>fcG I 8 1«* 
* 

i 
 
NATIONAL
u <
Surgical  Institute
"LIFE IS NOT TO LIVE BUT TO BE WELL."'
    INDIANAPOLIS, IND.
PUBLISHED BY THE NATIONAL SURGICAL INSTITUTE..
       1876.
• 
133h
Entered according to Act of Congress, in the year 1876, by




       NATIONAL SURGICAL INSTITUTE,




In the Office of the Librarian of Congress, at Washington. 
CONTENTS.
Preface,    .........
Introduction,  ........

                          CHAPTER  I.
Inception of the Enterprise—A Sad Illustration of Heroic Prac-
      tice—Humane Convictions—Common Sense Reflections,
   A Little Sufferer from the Disease of the Spine—Humane Treatment-
Questions to be Considered—Systematic  Relief—The Enterprise an Assured
Success.
                          CHAPTER  II.
Incorporation—The National  Surgical Institute—Surgeons and
      Assistants—Buildings and Machinery—Hotel  Accommoda-
      tions—The Institutes  at Philadelphia, Atlanta  and San
      Francisco,   ........
   The Central Department—Eastern Department—The Southern Branch—
The "Western Branch.

                         CHAPTER III.
Report of the Recording Secretary—Number and Character of
      Cases Treated at  the National Surgical Institute—Ma-
      terial and Expenditures,       ■
   Number of Cases Treated—Material Expenditures.

                         CHAPTER  IV.
General  Considerations—Successful  and Unsuccessful Cases—
      Where to Apply for Correct Information—Failure to Pro-
      vide Adequate Facilities for the Deformed and Crippled—
      Advertising—Plain, Common Sense Talk,
   The Advertising Bugbear—Plain, Common Sense Talk.

                          CHAPTER  V.
Reception of  Patients—First Impressions—Careful Examination
      of Cases—Candid Hope for the Afflicted—Failures—Du-
      ties Required of Patients,      -
   Careful Examination—Incurable—Failures—The Duty of Patients—How
to write—How to Direct. 
4                            CONTENTS.

                         CHAPTER  VI.                      pAGE
Preservation of Health,      ....--    54

                        CHAPTER VII.
Deformities,  .    -      -     -      -      *      •      *     -    61

                        CHAPTER  VIII.
Mechanical Principles, and  Mechanico-Vital  Operations in the
      Cure of Disease and the Correction of Deformities,     -    71

                         CHAPTER  IX.
Atmospheric Pressure—Its  Effects Upon  the Human Body—Its
      Influence Upon Health and Life,     -      -      -          75

                         CHAPTER X.
Electricity,       ........    82

                        . CHAPTER  XI.
Surgery,    ..-....--84

                        CHAPTER XII.
Diseases of  the Bones,   .......    87

                        CHAPTER  XIII.
Diseases of  the Joints,  .......    90
   Hip Disease—Treatment—Successful Treatments—Diseases of the Knee—
Results of Treatment—The Ankle Joint—The Shoulder Joint—The Elbow
Joint—The Wrist Joint—Fingeits and Toes.

                        CHAPTER XIV.
Diseases of  the Rectum, ....            .         109
   Fistula in Ano.

                        CHAPTER  XV.
Rheumatism,      -      *     -      •      -      -      «     -   114

                        CHAPTER XVI.
Plastic Surgery,  -      -     -      -      -      -      -     -   118

                        CHAPTER  XVII.
Tumors,     -      -      -     -      -.      .      .     -119 
                              CONTENTS.

                        CHAPTER  XVIII.
Paralysis,   ........

   Causes—Variety—Treatment and Curability—Some Reasons why we sue
ceed—Some of the Reasons why the Old Methods fail—Letters and Refer
ences—Paralysis.

                         CHAPTER  XIX.
Catarrh,    .........   136

   Causes—Symptoms—Results of Catarrh—Treatment.


                           CHAPTER  XX.

Club Feet, • -       -      -     -      -      -      «      •      -   140

   Bad Case of Club Feet.


                          CHAPTER   XXI.
Spinal  Affections,       ...             ...   148


                         CHAPTER XXII.

Female Diseases,   .      -     -      -      -      -      •         159


                         CHAPTER XXIII.

Sending Measures  for Braces and other Surgical Apparatus,   -   170


                         CHAPTER XXIV.

The Eye and  Ear,       -     -      -      -      -      -      -   172

   Cross Eyes (Strabismus)—Conjunctivitis—Granular Ophthalmia—Staphy-
loma— Entropeon—Ectropeon—Amurosis—Pterygium—Chronic Inflamma-
tion of the Edges of the Lids—Diseases of the Tear Passages—Cataract—Arti-
ficial Eyes—Delays are Dangerous—Diseases of the Ear.


Illustrations of Apparatus,     .....     185—191
   5

PAGE
  121 
 
PREFACE.
MJITN  presenting  this brief work to the public,  the  intention is
nfl  to Swe a better knowledge of the history, objects and facili-
 f   ties of the National Surgical Institute and its Departments
than can  possibly be  conveyed by  letter  or circular.   The in-
creased correspondence growing out of the wide-spread  reputa-
tion of the Institute,  renders  some  such medium of  information
necessary, but it  will not prevent a response by letter to  any
application for further particulars or  more explicit details.
  We  shall strive to present the most important  facts in a plain
and comprehensive manner, free from the  professional technical-
ities and  Greek and  Latin phrases  commonly used  by medical
writers.
  While endeavoring to impart a knowledge of our great enter-
prise, in behalf of suffering humanity, we have neither  time  nor
inclination to engage in controversy  with  those who  differ from ,
us  in practice  or  opinion.  An experience  of sixteen years in
the successful treatment of every species of deformity and bodi-
ly injury,  gives us the  right,  without rendering ourselves liable
to the  charge of egotism,  to  assert  our views,  however  greatly
they may differ from the traditional and accepted  theory  and
practice of medicine.
  While  the burden of our thoughts and labor is devoted to the
restoration of the  suffering and deformed to health and physical
perfection, we should be unfaithful to humanity and to  ourselves
if we failed to give timely warning and advice to those who, by
constant violation  of  nature's  laws, are fast becoming the victims
of  pain, disease and  deformity.   If physicians, like  guardian
angels,  were  ever  pointing out  the  dangers  arising from a disre-
gard of these laws, there  would  be inconceivably less  sickness
and misfortune to  relieve.
  No  more  important  subject can come within the  range of
human  thought than the laws which  govern the physical system. 
g .             NECESSITY FOR UNDERSTANDING

The mind may roam  untrammeled through  limitless realms of
space, and seemingly  forget its  earthly home;  yet the  fairest
castle must have solid foundation.   If there is no root there can
be no fruit.   The most powerful and the most delicate machinery
can not be propelled in mid-air,  but  must have foundation and
frame work to support and sustain it, else its movements  must
cease.
  As surely as death comes to all, so surely is the time of its
final7 coming greatly under our control.   Neglect or ignorance
will cause the injury or destruction of the most delicate as well as
the most substantial piece of machinery, while with  proper care
and attention it may be made to run an indefinite length of time.
We greatly fear that these admonitions will not be heeded; and
the sad thought will obtrude itself that, with a full knowledge of
these truths, self-interest  is sacrificed,  health is destroyed,  and
splendid wrecks  are strewn along life's pathway.   If we start on
a long and perilous  voyage, will we not inquire about the ship in
which we trust our life ?   Would we not desire to  know that it
was  perfect and  strong, its hull and machinery safe, sound and
reliable, and that it  was in every respect seaworthy ?
  Are we not all mariners on life's tempestuous, uncertain ocean?
And are our barks safe and sound, and do we  understand how to
meet and overcome all obstacles and emergencies that may con-
front us on the way?  Shall we wreck before our sails have fairly
caught the breeze;  or,  escaping the perils of youth or early  man-
hood, go  down  in  mid-ocean,  in  the  prime  of  life  and in full
possession of mental power; or shall we make a  safe and happy
landing  on "the other shore,"  with silvery hair and with  life's
fullest, choicest  cargo?  These wrecks are not  confined to the
drunkard, the libertine, or  the  glutton; but they include artists,
scientists,  students,  business men, school children, and represent-
atives from every walk and station in life.
  Many strange facts  have been  developed  in our  inquiries, in
the comparatively unexplored field of deformities.   One is that
full blooded Negroes or Indians almost never have club feet, hare
lip, cross eyes, or paralysis (except from physical injury).   If there
is an exception, we  would be thankful for the address.
  These facts hold good in the  brute  creation, showing that the
nearer we approach to mere animal  life the  nearer we arrive at 
THE  LAWS OF  HEALTH.
9
physical perfection; and that the higher we  ascend in the scale
of mental culture and brain development, the  weaker the physi-
cal system becomes, and the more prone it seems to be to  leave
its work unfinished, and maintain but feeble action.
  We can readily see how this condition, acquired in the parent,
may be transmitted to the child.  It is naturally asked,  should
mental culture cease, that the physical may be developed?  Are
they antagonists, and not in harmony?  Must one sink that the
other  may ascend?  Not  so!  But  our carelessness in physical
culture must not increase with our zeal for learning.   Both  must
be elevated and cared for,  as inseparable and indispensable con-
comitants; and our mental development may yet attain heights
far more sublime, with physical system far more complete.
   We have all read the horrid tales  of Hindoo  worshipers, with
arms  fixed in one position for  years,  to  appease or please their
 God!   These limbs become entirely useless and immovable.  So
 any part  of the system  may lose  its  power from  want of use.
 Are we not responsible for  the  reason  given us and  its action?
 We can not  escape the  responsibility, but must  discharge our
 duty  or pay  the penalty.  Physical  exercise should  not  be
 neglected ; neither should it be forgotten that periods of rest and
 sleep are an essential'to both mental and physical vigor. 
 
INTRODUCTION.
     HE announcement by a circular,  or by the press,  of an
      institution of an ordinary kind, in the beaten path, excites
   t  no particular interest; but when something unexpected or
new appears, bearing upon its face  opposition to old usages, the
first impulse of most persons—unless the  necessity for the inno-
vation be made plain—is to question and condemn.   We  are all
creatures of habit; we love  to recall the  landmarks  of the  past
and adopt them as fixtures for life.  We  naturally  cling  to old
methods of thought and old forms of action.  It is neither easy
nor pleasant to relinquish the  teachings of youth or the convic-
tions  of more  mature years.   It happens, therefore,  that  men
almost always resist the conclusions of science if they interfere
with  preconceived notions or prejudices,  and especially if they
establish the fact that a lifetime has been spent  in the practice
of errors and abuses, instead of having served the cause of truth
and humanity.   How fondly  did  the  old philosophers cherish
their theories in  relation  to the earth!  And with what dismay
and opposition did they receive the discovery of Galileo, that it
is round, and that, instead of being stationary, it revolves on its
own axis and moves in its celestial  orbit.   Again, how  the med-
ical world  denounced  Hervey's theory of the circulation of the
blood, simply because it proved the humiliating fact that thous-
ands  of years had been spent in  ignorance and stupidity.   And
however easy  it is  for us,  of this  day and  generation, to  look
back and condemn the false theories and  incredulity of the past,
we are  blind to the fact that in many respects our minds may be
overshadowed by the same dark clouds of prejudice and error.
  To make a particular application of these general remarks, we
need only a brief retrospect of our individual experience,  to con-
vince us that the theory and practice .of medicine are  constantly
changing with the advancement of science and diffusion of knowl-
€ 
12
THE  DARK DAYS OF MEDICAL SCIENCE.
edge.  It is absurd  to say that men have mastered  the whole
science of medicine.   Such a claim has no foundation in reason,
and is not justified by the developments in any other branch of
human  knowledge.   It is the province of true science to dis-
card the errors of the past and press on to better and truer things.
While, then, it  is noble to admit the wrong and  espouse the
right, it argues the utmost degree of  bigotry and egotism on the
part of any physician to flippantly condemn new remedial agents,
simply because he does not  understand  them, or because they
are beyond his reach.  Equally, nay, still more culpable, is it for
him, through vanity and avarice,  to  attempt the treatment of
diseases  and deformities which  he  has neither the  skill nor
appliances  to cure  and  correct.  The days  of  seatons,  blist-
ers,  blood  letting, moxas,  red hot irons,  salivation,  &c, were
the  dark  days  of medical  science.   Like torturing  fiends in
pandemonium they  trifled with  their  poor victims.    These
horrible practices  of the  past are too well known by all  in-
telligent  persons to  be now  conceded as the perfection of sci-
ence.  Therefore,  suffering reader, when your family physician
attempts to decry or ridicule the latest discoveries in the healing
art, remember that he may be actuated more by self-interest than
by your interest, and that jealousy and prejudice unite to induce
him to deceive you.
   The practice  of specialties has always been  denounced and
ignored as "quackery" by the  medical  profession.   This term
quackery is a favorite word  with the  old school,  hide-bound
practitioners.  They apply it to everything new, and especially
to everything in medical science which  they do not understand.
To avoid the imaginary  odium which  they  have succeeded in
attaching to the practice of  specialties, many honest but timid
physicians  are compelled to scatter a meagre amount of intelli-
gence over a vast field of practice,  thus sacrificing human  life
and comfort, and their own reputation; whereas, their ability and
research, concentrated upon  a single  object in medical science,
would elevate them to the rank of benefactors of  mankind.
   Another rigid rule of the  regular code of medical  ethics is
that no physician shall advertise in  the  newspapers or through
any other medium  of print.   This, of course, does not prevent
any amount of gratuitous advertising by patients and professional 
      LEGITIMATE ADVERTISING AND ILLEGITIMATE PUFFERY.    13
brethren.    All  physicians  are  exceedingly anxious  that  their
names should be extolled before*ttie public and every meritorious
act made  public, but in some  private or underhanded manner,
instead of by the press.  While  pretending to deprecate and con-
demn advertising, they are constantly on the alert for every kind
of illegitimate puffery.   We leave it to the candid reader, with
a proper appreciation of the value  of legitimate advertising, to
decide which course is more honorable and advantageous.
   But our object  is not to discuss the merits and demerits of
the allopathic, homoeopathic, or other theories of practice.  It is
rather to  point  out the  means  of relief to the discouraged and
afflicted.
   In  the perusal of these pages, we  trust our readers will  exer-
cise the candor and liberality they would ask if called upon to
vindicate their own  religious, political,  or social views.   Above
all, their judgment should not  be warped and their inclinations
checked by those who have failed to give them relief, and who
know nothing  of the character and facilities of the National
Surgical Institute and its Branches.
1 
* 
THE
National  Surgical Institute.

               ------------cS^|^fc------------

                     CHAPTER  I.

INCEPTION OF TEE ENTERPRISE—A SAD ILLUSTRATION OF EEROIC PRAC-
      TICE—HUMANE CONVICTIONS—COMMON SENSE REFLECTIONS.

     IKE every other great and philanthropic  enterprise, the
      National Surgical Institute had its origin in sympathy
      for individual suffering.   As illustrating how a seemingly
unimportant event may  become  the  starting point  of a great
movement, a brief notice of the origin of this Institution can
hardly fail to prove interesting.
  In the year 1856, during a course of medical  lectures  in one
of the principal hospitals in our country, the founders of  the In-
stitute had their attention attracted and intensely fixed  by the
case of
                   A LITTLE SUFFERER.

From disease of the spine, a little girl some  five years of age,
who had been presented for treatment to a surgeon of skill and
celebrity, then in charge of the hospital.  This was the story of
the little victim of cruel but orthodox treatment:  When brought
to the hospital, her parents were told that her case would  readily
yield to judicious treatment, but that she must remain  in the
hospital under the  immediate care of the surgeon, and might be
obliged, for some  months, to lie on her back in bed.
  The necessity of a separation from their child was very trying
to the parents,  but their exceeding love and  the hope of relief
reconciled them to any sacrifice for her sake.   Positively assured
of her speedy cure, they went home with joyful hearts,  little
dreaming of the cruel  ordeal their child was to undergo. 
i6
BARBAROUS  treatment.
   Grieved, terrified, alone with strangers, the poor  little exile
from home was placed in bed, large blisters were applied to her
back, upon which she was  compelled to lie through long days
and nights of intense suffering.  As  the sores healed, fresh irri-
tants were applied,  and the  torture was  renewed.   Days and
weeks wore away with no change excepting great reduction of flesh
and  strength, increased pain,  and pallor of the sunken cheeks.
When, in the slow progress of the torture, it was deemed neces-
sary to resort to more vigorous treatment, the seaton was ordered.
It was before chloroform was so  generally used  to  dispel the
terrors of surgical  operations,  and it was like witnessing a scene
of the inquisition to  behold the little sufferer in the hands of the
surgeon and attendants.  The emaciated form was turned  on the
side, nearly on the face, and the inflamed and irritated skin along
the spine was lifted between the fingers, and the cold steel forced
through,  until a succession  of seatons was  placed in line.   The
silken cords were ordered to be drawn backwards and forwards,
daily, through the suppurating wounds, until a plentiful discharge
was  induced.  The child, meanwhile,  was forced  to  lie on her
back, and to  aggravate her  trials, was given all sorts of nauseous
drugs, in the  delusive hope of building up the constitution.  Time
dragged on, and as life seemed slowly but surely ebbing, more
heroic treatment was resorted to.   The seatons were removed,
and  the  fiery,  blazing  "moxa"  was  put  in  requisition.   The
child begged  piteously to be allowed  " to go home," or  left to
die in peace.   Of course she  grew weaker every  day, and less
able  to offer even the feeble resistance  of shrieks and moans to
the horrors inflicted in pursuance of orthodox teachings.  The
doctors were  in despair, but were eager to give relief for fear that
death might intervene.
  Having been taught that  "counter irritation " was the  "sheet
anchor" of the profession in such cases, they  determined to ex-
haust every power of that treatment.   Accordingly, the "actual
cautery," or red hot iron, was  next to be employed ; but  before
its application the mother of the chHd arrived.  Her feelings may
be imagined  but not described, when, instead of  the  little  dar-
ling recovered or recovering, she had so confidently hoped  to see,
she found a wreck, a skeleton, which she would never have recocr-
                                                          o
nized but for the  eyes  that grew brighter at her coming, the 
%
                     HUMANE TREATMENT.                   1/

wasted arms that clasped tightly and pleadingly around her neck,
and  the  feeble cry:  "Mother,  dear  mother,  take  me  home."'
   How her soul  recoiled  with horror, and her heart stood still
with pity for her darling!  With all the strength  of a mother's
love she appealed from further torture,  preferring  that her child
should live  deformed rather than be offered a sacrifice upon  the
altar of ignorance or orthodoxy.
   The little sufferer was taken home, where she was given plenty
of fresh air and  wholesome food.   Alter her  sickening wounds
were healed, she  was allowed  gentle  exercise, and her health
began to improve.   She gained some flesh, and lived for years
comparatively free  from pain,  but dwarfed in  stature and sadly
deformed.
                    HUMANE  TREATMENT.

   This case, with its revolting history,  suggested  to the writer's
mind the necessity for  a humane and rational treatment of de-
formity and disease.  The thought presented itself with startling
force, that if  this was the best that medical science  could do for
such a case, it was not worthy to be called a science, and still less
to be practiced as such.  From this sprang a resolution on  the'
part of the writer to seek a better way,  and a determination that
if science and reason could possibly  afford relief, a life's study
should be devoted to the amelioration of such cases.
   At the threshhold of his investigations, the following inquiries
presented themselves as

              QUESTIONS TO BE CONSIDERED.

   What is to be hoped for from the old method of treatment?
   Is it possible,  while  confined in bed,  prostrate on the back, to
have sufficient exercise to induce and maintain a healthy growth
of the system, a proper formation and  circulation of the blood,
or a perfect  assimilation of food, digestion, and  action of the
bowels ?
   Is it possible, further, to maintain a healthy respiration,  and
development of  the luags, while pent up in impure air?
   Will destruction of the flesh,  fetid  ulcers, and  discharge of
offensive matter, build up the constitution and insure  its strength?
       2 
t
 18             QUESTIONS TO BE CONSIDERED.

   Will irritation and torture of the spine drive inflammation and
disease from the body?
   Will this irritation  prevent  spasmodic contraction of muscles
 and curvature  of  the spine when the  bones are diseased and
 there is nothing to support them ?
   Would it not be a strange practice, if we had a crooked tree
 in our orchard  that was bending to the ground, because one side
 of it had been  blighted or destroyed, to bruise  the  bark on the
 opposite side, or chop  it to pieces, for the purpose of restoring
 the diseased or decayed part ?
   Is not childhood the time for development?
   Is it possible to  develop the human frame, in the fullness of its
 mysterious and wonderful mechanism, without  the  air and sun-
shine and exercise that Providence designed and nature requires?
   What  degree of condemnation and odium is due  to  the cruel
practices which we have described, we  leave for humanity and
the intelligent public to pronounce.  It is not to be wondered
that parents dread and physicians distrust such  treatment.
   Had we, to-day, no more humane method at our command,
conscience would  not permit  us  to  offer a ray of hope to the
afflicted.
   But the object of our life has been to discover and adapt every
means of humane, pleasant and effective treatment; not only for
such cases as the one we have described, but for all other serious
and painful maladies that come within  the range of our special
practice.
   The case  mentioned is only  one of many of a similar charac-
ter, which may be  daily seen in the ordinary treatment of such
maladies as diseases and deformities of the joints.   None but the
sufferer and his friends can realize the cruel torture and wretched
consequences!  Pain, amounting  to  exquisite  agony,  shocking
deformity and  loss  of limbs, are the common sequel!  The
number of valuable lives blighted or destroyed is sickening to detail.

                   SYSTEMATIC RELIEF.

   The great question, then, in the minds of the founders  of the
 National Surgical Institute, was how systematic relief could
be afforded this large  class of sufferers.   The effort must, at first,
be very much of an experiment, and would necessarily involve a 
             THE ENTERPRISE AN ASSURED  SUCCESS.           19

vast expense.   The  most reasonable plan suggested, was  the
treatment of a number of similar cases at the same time.   In this
way, the different methods and remedies could  be fairly  tested,
the results classified and made available for future use.   It  was
self-evident that this aim  could  never  be accomplished  in a
private practice.  It was likewise plain  that  public  charitable
institutions, being mere asylums  for the indigent and afflicted,
could not be made available.  Even had these hospitals possessed
the requisite accommodations and appliances,///^ code of ethics by
which they were controlled closed the  door to innovation  and
improvement.   The  rigid  regulations of "the faculty," which
have condemned countless  sufferers  to death, rather than  have
them cured by irregular means, would allow  no departure  from
stereotyped rules.  The honored shades of Esculapius and Galen
imperatively forbade the practice of any new means and appliances
in the healing art, while the medical  traditions  of past centuries
required  a strict adherence to  the  old  and  accepted plan of
salvation!
   None felt this truth more keenly than ourselves, whose medical
education had been according to the strictest professional code.
Every  other way being closed against the progress  of reform,
nothing remained but to brave the storm of opposition by erect-
ing a large private hospital,  and notifying the afflicted, in a public
manner, that accommodations and. remedies had  been provided
for their relief.

          THE ENTERPRISE AN ASSURED SUCCESS.

   Some sixteen years have passed since that  determination to
relieve the afflicted was carried into effect, and the most gratifying
and assured success has rewarded the pioneer  enterprise.   The
National Surgical Institute, inaugurated under the most dis-
couraging auspices,  and with  a limited patronage, is to-day  a
proud monument of liberality and skill;  and, prominent among
the most philanthropic enterprises of the age, is fulfilling its great
mission of subserving to the relief of human misery, every dis-
covery, invention and improvement, within the  scope of science
and at the command of money.   The eminent success attained
can not  be over estimated.  The thousands made happy,  the 
20        FOUNDED ON  NATURE AND COMMON  SENSE.
magnanimous treatment  of the poor, the moderate fees demanded
of the rich, and the explicit and candid manner in which all are
treated, have gained for the Institute the confidence and support
of good  people throughout  the country.   Furthermore,  the
Institute has been endorsed  and sustained by  all the intelligent
physicians who  have availed themselves of an opportunity to
study its claims to merit  by visiting the Institution.
  So far  from  shunning notice  or  investigation, it courts  the
closest  scrutiny and  the widest publicity.   We claim that  our
practice is founded on nature and common sense, that it is strictly
scientific  in  character,  and that it  accomplishes incomparably
greater results for less outlay and  with infinitely less pain, than
any other treatment.  We should  speak with less confidence of
our system if it were a mere theory ; but long  years  of practice,
with thousands of .cases of suffering relieved, diseases cured,  and
deformities  removed, leave no room to doubt its merit or ques-
tion its efficiency.   Nothing but the inherent  merit  of our  sys-
tem, and  a  firm  confidence in its ultimate success,  could have
brought  the Institute from  its small beginning to  its  present
mammoth proportions and wide reputation.  Every person that
visits it confesses admiration of its wonderful and ingenious ap-
pliances  for the treatment of disease; and every patient who
goes forth from its walls,  relieved from  suffering and deformity,
and restored to health, becomes a walking advertisement of its
scientific  methods of practice, its honorable management,  and
its pure,  social atmosphere.
  Thus encouraged, and invoking  the same  providential  aid
which has sustained the  Institute  in the past, the founder  and
managers renew  their efforts with unfaltering determination to
extend relief to  suffering humanity in the future. 
Missing page 21-28 
 
RECORDING SECRETARY'S  REPORT OF CASES TREATED.     20,
                  NUMBER  OF CA!

Talipes (Club and Crooked  Foot)
Equinas,     .     .     .     .    281
Varus,     ....      862
Valgus,      ....    42^

Diseases and Deformities  of the
From Coxalgia,    .    .     .  *i,oi2
From Rheumatism,   .     .      181
From contraction  of the Mus-
  cles,   .....1,131
From Paralysis  of  the Muscles,    275
From Synovitis,      .     .      263

Diseases and Deformities  of the
Spina Bifida,  .   .    .     .     21
Bent Spine from Caries,     .      846
Of the Cervical Vertebra,    .    210
Of the Dorsal Vertebra,    .      386
Of the Lumbar Vertebra,    .    250
Same, connected with  Lateral
  Curvature,    .     .     .      132
Anterior  and Posterior  Curva-
   ture from Contracted Muscles,    120

 Deformities  of Fingers  :
 Congenital Deficiency,   .    .      10
 Congenital Webb,    .     .        15
 Congenital Deformity,  .    .      35
 Congenital Flexion,   .     .        6
 From  Rheumatism,      .    .     158

 Deformity of the Ankle Joint:

 From  Necrosis,    .    .    .      61
 From  Synovitis,      .            327
 From Fractures and Injuries,  .     465

 Flexed,  Deformed, Anchylosed

 From  Tuberculosis,      .    •     241
 From  Necrosis,  .    .             9°
 From Synovitis,    .     .    •     32°
 From  Exostosis,      .     •         2
 From  Rheumatism,      .    .     379
 From  Fractured Patella,   .        8
 From Burns,   ...          i2
TREATED.
Calcaneus,    ....     141
Equivarus,      .    .     .       162
Equivalgus,  ....      82

lip Joint:

From flattening and elongation
   of Acetabulum,       .    .      21
From  relaxation of Teres and
   Capsular,     ...        49
 From  Exostosis,   ...      4
 From  Fracture,      .    .        26

Ipine :

Anterior and Posterior  Curva-
   ture from paralyzed Muscles,    187
 Lateral Curvature of Lumbar
   Vertebra,     .    .    .       350
 Lateral  Curvature  of  Dorsal
   and Lumbar,   .     .    .     846
 Lateral  Curvature  of  Dorsal
   and Lumbar and Cervical, .     24
 Torticollis,      ...        45
From Burns,      .     .     .    no
From Injuries,  .     .    .       156
From contraction  of Muscles,    220
From Paralysis,   .     .     .    426
From Relaxed Ligaments,    .      5
From Paralysis,      .     .      460
From Congenital Malformat'n,     15

id Diseased Knees:
From Traumatic Inflammation,     EI
From Congenital Malformat'n,     61
From Contracted Flexor Mus-
  cles,  .....268
From  Maltreated  Fractures,     21
From Paralysis Recti Muscles,    210 
30
NUMBER AND CHARACTER OF CASES  TREATED.
Deformities of Tibia, Fibula and Femur :
From Necrosis,    .    .    .    360    From Bow Legs,                3^
From  Ununited or Malunited           From Anterior and Posterior
  Fractures,     ...       24      Curvatures,   ...       10
From Molitis Ossium,   .    .     21

Hernia, 61.
Tumors Mammary Glands,  49.
Syphilis, 800.                          *
Gonorrhoea,  300.
Skin Diseases, 600:
    Of which the following have been most frequent:
Erythematous Eruptions,                Scrofuloderma, .
Lichenous Eruptions,                   Kelis,
Eczemutous Eruptions,                  Elephantiasis,
Impetiginous Eruptions,                 Naevi Vasculosi,
Scorbutic,                            Chloasma,
Lupus,                               Acne.

Indolent Ulcers, 410.
Varicose Ulcers, 270.
Diseases and Deformities  of the Ear:
Operation to restore Congenital Deficiency of External Ear,  ...   20
Operation to restore Deficiency of External Ear caused by wounds,  .       4

For Deformities of the Face :
From Burns,  .    .    .    .    '41    From Nevus,     ...    20
From Ptyalism,  ...       70    From Anurism of  Facial Ar-
From Tumors,     .    .    .     21      tery,     ....        6
From Lachrymal Fistula,   .       12    From Gunshot Wounds,      .    10

Plastic Operations for Deformed Noses—making new ones:
To restore Noses destroyed by           To restore Noses destroyed by
   Ptyalism,   ....     23      Caries,     ....    16
To restore Noses destroyed by           To restore Noses destroyed by
   Syphilis,      ...       41      Injury,    .    .        .      46
To restore Noses destroyed by           Hypertrophy of  Nose,  .    .     3
    Cancer,   .    .    .    .     15

Operations for Cleft Palate :
Involving ssft parts,    ..........    42
Involving entire Palatine Bones and soft parts,  .....      30

Ranula, 9.
Fibrous Tumors in the Mouth, 12. 
NUMBER AND CHARACTER  OF  CASES TREATED.         31
Cancer of  the Tongue,  4.

Enlarged Tonsils, 30.
Necrosis of  Inferior Maxillary,  8
Tracheotomy, 2.

Operations upon the Eye :
For Strabismus,    •    •    •     75
For Cataract,    ...       30
For Ectropion,     ...     42
For Entropion,   ...       31
For Canalicula (closure of),   .     15

Deformities and Diseases of the
Tuberculosis,      .     .    .    100
Synovitis,  ....       89
Bursa Mucosa (Tumor),      .    120
Rheumatism,    .    .    .      160

Diseases and Deformities of the
Congenital Malformation,    .     10
Caries,     ....       58
Tuberculosis,      .     .    .     51
Luxation of  Ulna,    .     .       40

Diseases and  Deformities of the
Paralysis of  Muscles,   .    .     75
Relaxed  Ligaments,      .      102
Synovitis,    ....     4°

Plastic Operations:
For Hare Lip, Single   .     .    150
For Hare Lip, Double,    .       120
For Deformed Lips from Burns,     42
For Deformed Lips from Ptyal-
   ism,  .....     65
For   Deformed   Lips   from
   Injuries,      ...        60
For   Deformed   Lips   from
   Facial Paxalysis,      .     .      5

Diseases of the Internal Ear:
Catarrh,      ....     75
Chronic Otorrhcea,    .    .       221
Inflammation of Internal Ear,     20
Disease of Mastoid Cells, .        30
  Pterygium,   ....    25
  For Iridectomy,      .    .       10
  For Exterpation,  ...     5
  For closure Nasal Duct,   .       20


Wrist:
  Injuries,     ....    50
  Paralysis,  ....       250
  Contraction of the Muscles,   .    150


Elbow:
  Synovitis,    ....    68
  Contraction of Muscles,   .       55
  Injuries,     .    .     .     .    91


Shoulder:
  Rheumatism,     ...    46
  Luxations,      ...      46
For  Deformed   Lips   from     14
  Syphilis,   ....     14
For  Deformed   Lips   from
  Cancer,       ...       21
For  Deformed   Lips   from
  Varix Tumors,  ...      5
For Deformed Lips from
  Aneurism,     ...        I
Ulceration of Meatus,  .    .     95
Penetrated Tympanum,   .       30
Cerebro Meningitis,    .    .      5 
32         NUMBER  AND CHARACTER  OF  CASES TREATED.
Diseases of the Rectum
Hemorrhoidal Tumors, Exter-		Fissure,
nal, .	426	Ulceration,
Hemorrhoidal Tumors, Inter-		Syphilitic Affection
nal, ....	918	Cancerous,
Stricture, ....	58	Fistula,
Polypus, .	12	
Deformities and Diseases of  Genital Organs:
                                      Diseased Testicle,
                                      Prostatorrhea,"   .
                                      Spermatorrhoea,
                                      Stricture Urethra,
Extrophy of Bladder,	10
Hydrocele,	175
Varicocele,	150
Cystocele,	41
Uterine Diseases:
Leucorrhcea,  .
Uterine Polypus,
Fibrous Tumors,
Ovarain Tumors,
Vesico Vaginal Fistula,
Lacerated Perenium,
Myelitis, Chronic,
Spinal Meningitis,
Spinal Congestion,
Spinal Irritations,
Lead Palsey,  .
Progressive
     Muscular Atrophy,
Chorea,
Insanity from Opium,
Spermatorrhoea,
Progressive
     Locomotor  Ataxia,
Opium  Eaters,  185.
Stammering, 45.
Sore Eyes:
Our Eye cases, including charity cases, would exceed fifteen hundred
Diseases of the Conjunctivia,     600    Diseases of the Retina,  .
Ulceration, ....	520
Hyperthrophy, .	260
Inflammation, Acute and Sub-	
acute, ....	285
Retroversion,	31
Anteversion, ....	120
Prolapsus, ....	768
NerVous Diseases:	
Infantile Palsy,	860
Hemiplegia,	i,275
Paraplegia, .	680
Paresis, ....	250
Myalgia, ....	10
Sensory Palsy, .	40
Vertigo, ....	10
General Nervousness,	5o
Hysteria, ....	75
Caiebro-Spinal Sclerosis,	iS
Paralysis Agitans, .	5°
Cerebral Anemia,	158
Diseases of the Cornea,
Diseases of the Iris,
600
230
 90
Amblyopic Affections,
Diseases of the Choroid, 
MATERIALS  AND  EXPENDITURES.                  33
Diseases of the  Ciliary Body           Glaucoma,      ...       10
  and Sclerotic,  ...       20    Diseases of the Lachrymal Ap-
Diseases of  the  Crystalline             paratus,   ....     39
  Leas, .....     48    Affections of the Muscles of
Diseases of the  Vitreous  Hu-             the Eye, ....       75
  mor,     ....             Diseases of the Orbit,   .     .     10

Diseases and  Deformities of the Shoulder:
Paralysis of Muscles,    .    .     75     Rheumatism,     .    .    .     46
Relaxed Ligaments,   .     .       102     Luxations,      .     .     .       46
Synovitis,     .     .    .    .    . 40

Plastic Operations :
For Hare Lip, Single,      .       150     For Deformed Lips from Syph-
For Hare Lip, Double,   .     .    '120      ilis,    .....     14
For Deformed Lips from Burns,     40     For Deformed Lips from Can-
For Deformed Lips from  Ptya-             cer,     ....       60
  lism,     ....        60     For Deformed Lips from Varix
For Deformed  Lips  from In-             Tumors,    ....       5
  juries,      ....     60    For Deformed Lips from An-
For Deformed Lips from Facial             eurism,  ....         I
  Paralysis,      ...         5

                 MATERIAL AND EXPENDITURES.

Chamois Skin, for lining braces,.......$1,003 4^
Strap Leather, for apparatus,   .......        l,9°3 °°
Sheep Skin, for  lining apparatus,  .......       256 80
Belting, for machinery,    ........          261 00
Kid and Morocco Leather, for trimming apparatus,     .    .    .     1,682 oo-
Felting, for trimming apparatus,    ......          472 00
Cotton Wadding, for padding braces,  .......       205 32
Cotton Flannel, for lining apparatus,.....        i,3°6 00
Sheet Steel, for  making apparatus,......4>3°6 16
Bar Steel,  for making apparatus,......        6,689 24
Repairing Furniture, in offices,   .......i»249 l&
Copper Rivets, for apparatus,  .......          987 80
Brass Rivets, for apparatus,  .....-•►       794 65
Iron  Rivets, for apparatus,.......          586 40-
Silk Thread,..........       398 23
Cotton and Silk Thread,........          230 00.
Iron, for apparatus,     ........    •■     *>299 32
Emery,  for polishing,........           896a
Rubber Pumps,..........»>o8° 63
Elastic Rubber,  for bandages........          769 60
Rubber Ice Bags,..........       418 64
Rubber Molds,..........          655 52
Rubber Tubing,   .          ........^°°z 9<»
         3 
 34                  MATERIALS  AND  EXPENDITURES.

 Rubber  Webbing,.........         $106 80
 Rubber Skerred...........       1,267 04
 Sheet Rubber, for receivers,    .......          793 24
 Boxes, for packing medicines and apparatus,      ....       L890 60
 Glass Bottles, for medicines,    .......        2,598 44
 240,840 yards cotton bandages, (138 miles,) .....       I,°7S °4
 Hardware,..........         L471 74
 Files,............        227 80
 Repairing steam engine, boiler, and machinery,     .    .     .         L895 00
 Brass Tubing,..........1,060 84
 Freight and Express charges,   .          .....         1,559 92
 Buckles, for apparatus,      .     .     .     .     .          .     .        177 20
 Sundries, embracing various articles in the drug department,         10,200 96
 Surgical  Instruments,     ........         I>758 5^
 Books, for replenishing Library,       ......      2,272 00
 Coal, for engine and offices,    .......         3>321 20
 Silver Plating, for apparatus,     .     .    .    .    .     .    .         226 00
 Electro Plating, for printing,       ......         1,758 90
 Engraving and Printing,     ........     15,107 80
 News, Book and Manilla Paper,     ......        35,496 00
 Drugs,...........15,864 00
 Receivers, Steam  Cans, Brackets, etc.,    .....         3,060 60
 Gas Fitting, Plumbing, etc.,      .......       1,454 i«6
 Decorating and Paper Hanging,     ......         1,580 00
 Lumber, for  repairing buildings,      ......       1,851 56
 Repairing, masonry and brick  work,     .    .     .     .     .         1,412 80
 Insurance on Institute Buildings,       ......       4,004 14
 Grindstones for polishing Steel,    ......             85 52
 Taxes on  Institute Buildings,    .......       2,246 80
 Sewerage,     ..........            840 00
 Folding and Mailing Circulars,        ......       4,599 96
 Postage,       ..........         44,208 00
 Labor>...........73,957 80
Salaries,        ..........        77,971 90
 Anatomical  Casts and  Models from Paris,       ....        400 00
Anatomical Charts and Models from London,        .     ,    .           350 00
 Rubber Springs,       .........        530 00
Steel  Springs,       .........            75 OI
Brass Wire,      ..........         67 50
 Blank Books,        .........           6"o 30
Stationery and Paper,       ........     12 308 54
Emery Wheels,      .........           576 00
Improvement in Gymnasium Department,  including new Combination
    and other Movement Machines,    ••.;..      ? 094. 00 
CHAPTER  IV.
GENERAL   CONSIDERATIONS—SUCCESSFUL  AND UNSUCCESSFUL  CASES—
       WHERE TO APPLY FOR CORRECT INFORMATION—FAILURE TO PRO-
       VIDE ADEQUATE FACILITIES FOR THE DEFORMED AND CRIPPLED—
       ADVERTISING—PLAIN, COMMON SENSE TALK.

      RDINARILY, when we receive a circular from the direc-
       tors of an institution of learning or beneficence, we de-
   ♦   pend largely upon their statement of facts  respecting its
merits, as any falsehood or misrepresentation would be damaging
to  their  reputation and to  the perpetuity of the institution.
Receiving statements  from  more than one institution,  we can
judge which is the most worthy of patronage.  In  the  case  of
the National Surgical  Institute,  however, there are no other
institutions of a  similar character  with  which  you may make
comparison.    The  Institute  is entirely  original in  design,
organization and  management.   Its methods and appliances are
based upon the  latest  discoveries of medical  science, and have
never before been introduced into any curative institution in this
or any other  country.   For these reasons we deem it proper to
state  its object and work more fully.   While there are surgeons
at home, and in our large cities, ready to  undertake the relief and
cure  of all kinds of cases, they often do so without being  pos-
sessed of the necessary appliances, or a suitable institution  in
which to  use them.  It is important, therefore, that the public
should be made fully acquainted with the merits of an institution
which has  discovered  the  true methods of  treating  chronic
deformities and disease, and which  has all the necessary appli-   \
ances  for  treating them.  The  fact that  this institution  has for
sixteen years  continued  its  great work  in  the  interests of the
suffering and deformed, with its business yearly increasing, is, we
submit, very strong assurance  of its  character.  Our mission is
far  above the  little ethical quibbles on a mere question of just
how we shall notify the afflicted of the existence of the  institu-
tion,  or of the  preparations  made  for their treatment.   If a 
3^               human life worth saving.
starving man is informed where bread mav be  obtained, he does
not stop to criticise the manner in which the  glad news is con-
veyed, or to question the channel through which it may have
come.   It may be whispered to him in a  dark closet, proclaimed
by  a newspaper, or brought on  the  wings of the wind.  The
manner of its conveyance does not concern him, nor can it affect
the quality of the food.
  There is  nothing whatever  about the Surgical Institute,
save the style of  its circular, to which the most technical stickler
for the code can take exception, and we are content to leave this
matter for those more interested  in mere technicalities than we
to digest, believing that right will triumph, and just means for
the relief of the suffering be maintained.
  If you have a suffering, deformed, or paralytic child, or if you
are yourself suffering from some obstinate disease of long stand-
ing, what matters it how you  hear of the Surgical Institute?
The one thing of paramount importance is that you should  hear
of it in some way, and that you  should  become informed of its
new methods and  wonderful  appliances for  treating disease.
Many  of the  old school  practitioners   would say:   "Better
let  your child die than trust its  care to  physicians who adver-
tise."  We say:  "A human life is worth saving, and  human
suffering ought to be relieved, even if the absurd requirements
of the  code have to be broken."  As a matter of justice to all,
we desire that information concerning the Institute and its mana-
gers should  be obtained from  unprejudiced persons, and  from
those whose opportunities  of  procuring it have been  ample.
We do not expect to escape criticism, and are even aware that
we have enemies.  Every good thing that ever existed has had
its enemies, and no project for the relief and benefit of mankind
was ever yet started that did not meet with opposition.   It  is
even possible that some of those whom  we have treated may
speak ill of  us.   It would be very strange, if  among the many
thousands we have treated there were  not some careless and
unfaithful to their own interests; and the first impulse  of such
natures  is to shift the burden of their own wrong doing upon
other shoulders.   Some men  ruin  themselves  voluntarily by
intemperate  and  pernicious habits,  others by  indolence and
neglect, while  others  destroy themselves outright by  suicide. 
      THOUSANDS GLADLY TELL THE STORY OF THEIR CURE.    37

We can not submit to be held responsible for the negligence and
misdeeds of others.
  If the public desires correct and reliable information in regard
to us, it certainly will not depend upon the statements of jealous
competitors,  or  of patients who,  by their  own carelessness and
neglect, have failed of  cure.  It should  either investigate for
itself, or else seek information from those who know, and espec-
ially from  patients who, having  been faithful to our directions
and  co-operated intelligently with our  treatment,  have been
restored to health  and strength.  It should be  borne in mind
that the  benefit  of the cured  patient begins just where the
unbenefited one leaves off, and that it is therefore impossible for
the latter to trace the subsequent steps of the former.   To learn
how any thing may be done, we go to those who have success-
fully accomplished it—not to those  who  have  failed.   And as
we have many thousands who would gladly tell the story of their
cure, we have permission to furnish their names and addresses to
those who desire them.  We think  it fair to  state that ninety
out of every hundred cases that we treat,  have  been treated for
the same maladies by other physicians before coming to us, and   •
have been  left uncured;  hence our task  is far more difficult than
that of  the general practitioner, because the cases  which he can
cure never come to us,  while only those which he can not cure
are left for our treatment.  This every one comprehends at once;
for if your family physician could cure you, you would not seek
other help, or leave home for it.
   In this connection, we would  call attention  to a great  and sad
truth which exists, and that is  the  total inadequacy of means
provided for the cure of the thousands of deformed and  helpless
beings all over our land, whose lamentable condition cries aloud
for help.   Asylums are provided  for the deaf,  the blind, and
insane; homes and charities for the indigent, sick and  infirm;
bastiles and reformatories for the vicious and the criminal; yet,
alas! where shall the great multitude of diseased and  deformed,
numbering more than all of the above combined, find succor and
relief?  With a  wonderful apathy or indifference, the wail of the
indigent and suffering cripple is unheeded save  at  the house of
alms, where necessary surgical skill and appliances are not to be
found.  The homes  of the wealthy are also darkened  by the 
38          OUR  EFFORTS HAVE NOT BEEN  IN  VAIN.
protracted and helpless deformity of many of their inmates.   For
this sad and lamentable condition the general practitioner deserves
neither condemnation nor reproach.   His legitimate work, if con-
scientiously done, enjoins study and responsibility enough, leaving
little time for exploring a field so far removed from  the legitimate
sphere of his labor.   He finds that to  combat the invasions  of
acute diseases successfully requires the most untiring study, and
the  most acute observation, and  brings enough  responsibility
to fully  satisfy the most ambitious and aspiring members of the
profession.  The fact that over four hundred thousand crippled
and deformed human beings in this country are without adequate
and proper treatment, should suggest a great and momentous duty.
  The grateful letters, of which we are in daily  receipt,  are a
pleasing assurance to us that our efforts, in  behalf of suffering
humanity, have not  been made in  vain.   Perhaps some of our
readers  may doubt that such cures are performed at the Surgical
Institute, and say it is impossible, because the methods are new
and not within the range  of their personal observation.  We too
often doubt the existence or propriety of that which we have
not seen; but the world  would long since have  been unorna-
mented and unimproved if the generations of men had accepted
only  personal or individual  deductions  of truth.   What,  then,
would have become of the inventions of printing, telegraphy, etc.
Of the marvelous advance in medical science,  we will speak in a
separate chapter.
  Some, again, object that we are specialists. To this we answer,
this  is our pride.   We  have devoted  our  talents,  time and
money to the study and  relief of suffering and  deformity, and,
without vanity or egotism, feel ourselves  better prepared to treat
such  cases than good physicians in general practice,  who have
not  the necessary means and appliances.  And we  may be
allowed  to ask if, by the immutable laws of necessity, all men
are not to a certain extent specialists.   Some are created for one
special act in life's drama, some for another; and he who tries to
act all parts, ignoring the prime object of his  being, is a  bigot,
slave or fool, for none  but  the Deity  is universally good and
wise.  We might ask you,  reader, are  you not  better at one
business than another?  Do you  not like some  parts of your
business more than others?   And  are you not more successful 
        AMPLE MEANS AND EVERY CONCEIVABLE APPARATUS.      39

in conducting the business you like?  Then you must allow us
to claim that we were designed for the special  purpose in  life of
relieving and  curing  these  special  diseases  and deformities,
having been endowed with peculiar taste and love and practical
ingenuity for  this  great and noble  work.  In  the  treatment
of ordinary  fevers and  diseases of the country,  your physician
would doubtless excel us; but with Institutions  of original and
most approved character, with ample  means and every conceiv-
able apparatus  and facility, and with varied  and valuable experi-
ence  of having treated  over  thirty thousand  cases, we do not
consider ourselves vain  or boastful in saying that it  is in our
power to excel, and effect  cures  impossible to them.   If your
physician is honest, and is not  selfishly desirous  of obtaining
your money, he will admit our claims, and advise you to come
to us for treatment.   If your physician  says "humbug," reflect
whether he has cured you or  charged  you for not doing it, or if
he proposes to undertake your case when he has not the experi-
ence and facilities to do it justice.   Nothing is more certain than
that even good practitioners of medicine have not the experience
and means requisite to correct such deformities.   Human  life  is
too brief for  one man  to  be a  good  general  practitioner of
medicine, ministering to the complicated ills of flesh, and  at the
same time a  skillful surgeon, manufacturing and  applying the
multiplicity of apparatus and machinery necessary to success.
It is the fault of the suffering reader if he allows jealousy and
ignorance,  on  the part  of his medical adviser, to  prevent him
from  availing himself of  the relief tendered by the philanthropy
and skill of the National Surgical Institute.

               THE ADVERTISING BUGBEAR.
   Of all the objections urged  against the Surgical Institute by
those who  connot understand, or  who willfully misrepresent its
purposes and operations, the most senseless and absurd is that
against  its advertising.   When all other objections  fail, this one
is introduced.   It has long been an established  principal of med-
ical ethics, that no doctor or medical  institution  must advertise,
the theory, apparently, being  that the  value of a  man's services,
or of a  new discovery in medical science, is depreciated by  being
made known to the public.  Such an assumption is an insult to in- 
40
ADVANTAGES  OF LEGITIMATE ADVERTISING.
     telligent persons.   It is one of the relics of a by-gone age which
     still clings to the medical profession, to the great detriment of its
     progress and usefulness.   The simple fact is, that advertising is
     as legitimate and proper in the  practice of medicine as in  any
     other profession or business.
        The object of advertising is to acquaint business  and profes-
     sional men with each others avocations and wants, and especially
     to inform the world of whatever is  new or valuable  in  science,
     art, or literature.  It is the only way to reach  the masses;  it is
     the only way to keep up the current of popular communication.
     Whatever is worth doing or worth offering for sale is worth ad-
     vertising.  Life is too short to trust to the people  finding things
     out by their own efforts or by intuition—they must be informed,
     and the only way to do this is by advertising.
        Men  are entitled  to a  difference of opinion in  this  as on all
     other subjects, but the fact that one  man, or set of men  do  not
     wish to advertise, does not make it disreputable for others to do
     so.  Neither is the value of  legitimate advertising lessened by
     the fact  that some quacks,  and some  unprincipled scoundrels,
     make use of this means to deceive the people.  It would be  just
»     as reasonable to assume that all doctors who do not advertise are
     learned and  skillful,  (an  assumption  which  everybody knows
     would be false), as to assume that all those who do advertise are
     impostors or quacks. Doubtless,  some quacks and impostors ad-
  •   vertise,  but  there is a  still larger  number who  do  not.  The
     whole question is of little importance, and  we only allude to it
     because of the objections and criticisms of a few stickling physi-
     cians, who  imagine they  find, on this score,  a  strong  point
     against us.
       The following passages,  from  the Journal of the National
     Surgical Institute, July, 1875, will  suffice to  show the weak-
     ness and folly of these arguments against advertising:

       " We are confident that the few old fogy doctors who oppose advertising a good
     institution for the  cure of deformities, will, when the  light of progress convicts
     them of error, be as heartily ashamed as they are now of the old system of reckless
     bleeding,  blistering, salivating, cauterizing, the prohibition of cold  water  and
     fresh air, etc., etc.   And the doctor-ridden people will realize that their prejudice
     -was blind, their judgment enslaved, and interest subverted to his selfish ends.
       Many medical societies find it to the interest of some of their  members to op-
     pose advertising.  Is that custom regulated by the Decalogue, by  the Bible, by 
              ADVANTAGES  OF  LEGITIMATE ADVERTISING.           4I

the laws of our country, by any sacred obligation to man ?   Or is it an antiquated
custom, clinging to a profession which was once, by its votaries, a sworn secret
from the people, and thus kept, by solemn oaths to imaginary gods?    *   *
  For ordinary physicians to falsely proclaim extraordinary facilities and abilities
is quackery.   For thousands of ignorant  physicians to quietly and unfairly, or by
the influence of friends, gain the confidence of communities, and through their
own ignorance destroy health and life, sadden homes, and populate graveyards,
is the vilest quackery and vandalism, and is to-day cursing the American people
under  the cloak of the medical profession.  Are doctors ever  discharged from
medical associations on account of ignorance,  on account of crime, on account of
maltreatment  of patients, or too frequent death of patients in their practice, or life
long suffering as the result of bad treatment ?   Is it  the  dear people who  are so
carefully protected,  or are these rigid laws against advertising only for the protec-
tion of the doctors ?
  To say that a regularly  incorporated institution like this,  with  ample buildings
and all kinds of machinery, and every facility  for curing  surgical cases, conducted
by regularly educated surgeons, of age and experience, should not be advertised,
is simply ridiculous!
  Men differ in religion,  in politics, and in medicine ; yet  that difference  makes
neither a quack nor a humbug.  And he that is most ready to debase his competi-
tor is most debased.
  A physician desiring a  practice does not live who wishes his skill and knowledge
unknown.  And physicians who want to be advertised, are trying daily to have it
done,  through the  mouths of friends and patrons who  laud their skill and urge
others to employ  them.   A nostrum vender mounts his goods box in the streets,
and proclaims to  the gaping crowds  the virtues of his medicine; both are only
cheap methods of advertising.
   Every medical college,  hospital, book, paper, and society is advertised.
   Every doctor is anxious to have his name in the newspapers, reporting a great
surgical operation, or the successful treatment of a case.
   County and State medical societies ' resolve ' to publish their proceedings (if the
newspapers will do  it for  nothing).
   Daily we see, going the rounds of the  press, sensational reports of a great surgi-
cal operation, common or uncommon, by Professor or Dr.  Smith or Jones, A.  M.,
M. D., etc.  The doctor, in the presence of his fellows,  with a pharisaical frown,
denounces the villainous reporter, who thus compromises the doctor's professional
honor, while a ripple of joy soothes his angry soul, as he submits to the eclat thus
obtained!   What a farce  !  But a discriminating and intelligent public is not de-
ceived ; the dodge is apparent to everybody.
  The labors, discoveries, operations, and experiences  of learned  and leading
men in the profession ought to be advertised for public good.
  If a community is wronged, it is not by  advertising.  Another wrong consists
in physicians  condemning and professing to  ignore what  they  really desire ; in
pretending to oppose advertising, while  in fact they are advertising most skillfully.
Under this code the printer must be defrauded, or else be rewarded sub rosa,
either  of which is dishonorable.
  By a few physicians, who see this circular, you will be told that it  is a flaming
advertising sheet, with horrid pictures to frighten or  convince the stupid and
credulous; and that, because it is an institution that advertises, consequently it is 
42          ADVANTAGES OF LEGITIMATE  ADVERTISING.

a 'humbug.' We are not surprised that such doctors do not like to see this work,
as it often is but a mirror, reflecting back into their faces sights of many horrible crip-
ples which their ignorance, or want of suitable appliances, have produced.  And we
do not doubt that a cure of many of these poor helpless cripples would bring a blush
of shame to their cheeks and discredit to their pretensions.  And he  who growls
and howls the loudest is hurt the most.
  Every picture in this circular is a true representation of a poor maimed creature
who came to us uncured.  But the conceited sneer of the ignorant or guilty physi-
cian does not bring back to the unhappy victim relief or  happiness.  And of all
men, the doctor who has thus failed should be the last to play the ' dog in the
manger!' when perhaps the very case in question brands him as a quack.

  There are thousands of noble physicians, of high moral principles, to whom the
above does not apply.  They live above a  life guided by  blind prejudice  or jeal-
ousy, and they are not the slaves of  unmeaning, ridiculous, and  antiquated cus-
toms; hence they send such cases to the Surgical Institute for relief.  The Bi-
ble portrays to the world the existence of great moral deformities and diseases, and
points to the remedy ; and denials, wincing or crying 'humbug,' will not invalidate
the fact of the existence of sin, or prove that institutions and associations for mor-
al and religious treatment should not be  established, and proclaimed throughout
the world.   So should  physical vices, deformities, and defects, have reformato-
ries for their relief, and these should  also be proclaimed wherever physical suffer-
ing and deformity exist."

                 PLAIN, COMMON SENSE  TALK.

  Afflicted reader, do you want  to be  cured?   If so,  and  your
doubts and prejudices prevent your coming  to the  Institute, are
you willing  to  investigate and see if your doubts and prejudices
are well founded ?  Then do  yourself and us the justice to state
your objections in a frank and friendly manner,  that we may put
you in the way to  see the truth,  or give you faith,  evidence, or
explanation; and, if we are wrong,  that we may know  it, and be
corrected.   This  we  ask  as a personal favor, and in justice to
humanity.
   If  you  could be at the Institute in  person, with eyes and ears
to investigate  for yourself the marvelous  cures  which we per-
form, you would realize  that  half  the truth  has  not  been told.
As a patient, you might say such cures look unreasonable  and
incredible.  Carrying  on  an  imaginary dialogue, such as often
takes place between the  consulting physician and  patient arriving
at the Institute, we answer :
  This is not  a valid objection,  for  thousands of scientific  and
mechanical triumphs  seem quite as  incurable,  and yet,  like these
statements,  are facts. 
              MAKE THE EFFORT AND PERSEVERE.            43

  Patient—My doctors have tried, failed, and charged me for it,
and tell me a cure is impossible.
  Answer—They doubtless have done the best they could with
what  facilities they had.   But if a thing is impossible to  one
without the means, it does not follow that  it is impossible when
ample means, experience, and appliances are at hand.
  Patient—I  have tried those  who  lied and deceived me,  and
took my money without benefit.
  Answer—This we do not doubt, but you and I are not respon-
sible for the crimes of others, nor do we like undeserved epithets
or censure.   If your  home doctor was  a  quack,  you ought to
have known he had not the necessary experience or facilities.
  Patient—I  would like  to  obtain  relief, and would  try your
treatment if I were sure of a cure.
  Answer—You never can be  cured unless you  try;  reward is
only for those who make  the  effort and  persevere, and you  are
certain of a cure here if it is possible anywhere.
  Patient—The case is of too long standing; I am too bad to be
cured, or to travel, and must suffer on.
  Answer—That is simply deciding that you will not avail your-
self of means which  Providence has placed within  your reach
for regaining health and happiness.  Hundreds whose cases were
as bad or worse than yours,  have been  cured under  our treat-
ment,  though condemned and abandoned as incurable under the
old methods.
  Patient—I have not the time or money now; besides it is too
far  for me to travel and I will wait.
  Answer—Where there is a will there is a  way, and human suf-
fering demands privation, exertion,  and immediate  attention,
while relief may be obtained.
  Patient—It will cost too much and I can't afford it.
  Answer—The  man  does not live who  can not afford relief,
while the cost is within his reach, and such cures never cost their
value.
  Patient—I  have tried the doctors with much pain and expense,
and repeated failure, and I am discouraged.
  Answer—You know that your doctors have not the vast  ex-
perience, and can not afford the multiplicity of machinery,  ap-
pliances, and other facilities necessary to success.   This  is why 
44              SOME CASES TREATED AT HOME.
we have invested $500,000 and over fourteen years' time to pro-
cure relief for such unfortunates.  You have not failed under our
treatment, and never will, if we undertake it, and your part  is
done.
  Patient—I am afraid of danger, pain, death, or some bad results.
  Answer—We take no dangerous risks or  hopeless cases.
Failures and disappointment of patients  do not  make reputation
or profit us in any way.   Our treatment is mild and humane—
never injures the most delicate.
  Patient—I know I  ought to, but  have neglected it from time
to time.
  Answer—Of all excuses, that of negligence and indifference  is
the most  censurable and inhuman.   Self-preservation and care
for others are divine commands.
  Patient—I will let some one else try it,  and if they succeed I
will go too.
  Anszver—Do you  wait for others to obey civil laws or do their
duty, to support their families  or relieve their sufferings, before
you attempt a like  duty ?  Too  often .procrastination  seals the
doom of  the  sufferer with the stamp of  incurability,  or  death
claims him  for  his own.   Besides, scarcely two cases  are alike,
and the result of one case  is no guide for another.
  Patient—Is  the  Institution  responsible?   Are  the  surgeons
regular graduates,  and successful?
  Anszver—The means of the  Institute  are ample, its  credit un-
questionable,  the surgeons  regular  graduates,  and  have  had
longer and wider experience in the treatment of such cases than
any others in America.
  Patient—What are the charges, and how long must I stay?
  Anszver—We never fix a  price until we examine the patient.
They are never exorbitant, and are within the means of the poor.
Most cases return  home  immediately, and complete  the  cure
there, with appliances and treatment furnished  by the  Institute.
  Patient—Do you treat all diseases?
  Answer—No, we do not; nor do we believe a doctor lives who
excels in all branches; for it is impossible, in the  brief term  of
human existence, that one man should grasp all  the details of the
healing art and become  proficient.   Concentration  of  time,
thought and money  are requisite to success. 
                 OUR FEES ALWAYS REASONABLE.               45

  Patient—Why can this Institution cure cases that doctors can
not?
  Answer—Because we have had over fourteen years' experience
in the treatment  of such cases, and every thing that money,
genius or science can afford, with a staff of over fifty surgeons,
instrument makers and  assistants,  constantly  devoted to  one
specialty.  It is absurd  and false  for physicians to  deny that
practice makes perfect; and we do excel  all who do not make it
a special business.
  Patient—Why do some physicians  object to  the  Institution,
and to invalids patronizing it ?
  Anszver—The large majority do  not—honest ones never do;
for if they have not  visited  it,  they know  nothing of the facts,
and if they have,  they will recommend it.   Some object  to our
advertising, but the intelligent business world laughs at these an-
tiquated whims and  prejudices, and points to every other noble
enterprise or business that is advertised  in some way.   Again,
they  fear  the loss  of bread and  butter, or reputation, though
they advise you under a garb of disinterested friendship.
   Patient—It is said by some that  you charge unreasonable fees
for your services.
   Anszver—We do want  a just remuneration for a cure, and no
more.  We have to live  and pay our expenses; to this, no rea-
sonable person  can object.   Please, while you are cautioned by
your doctor, see if he has not  charged you or others for failure
to, cure, and ask yourself if such advice is for your relief.
   Patient—Can't our doctors operate or send for apparatus just
as well?
   Anszver—Yes;  if you  wish to prolong suffering by trying ex-
periments, or to realize the  sad failure of a hopeless operation.
Does reading works  on agriculture make a farmer, or a work on
engineering a surveyor?   Or does it not  take daily experience to
insure skill and success? To  send a measure  for apparatus is
downright  cruelty—swindling  the  pocket  and  torturing the
patient.   You might as well have him measure  your mouth and
send for a set of  artificial teeth, expecting a  fit or satisfaction.
All apparatus must  be  perfectly fitted to the patient, requiring
many changes in  shape and form, which  must be done  at the
Institute, under the charge  of experienced surgeons. 
46           QUESTIONS FOR PATIENTS TO CONSIDER.
  The foregoing is a  specimen of hundreds of interviews  held
with invalids who come to the Institute  in person,  or who  seek
for  information  by letter.   Many of  them have suffered  long
years, and are wearied with pain  and failure, suspicious of the
whole science of medicine, and almost  hopeless of any  escape
from suffering, except  in death.  Many, also, have been preju-
diced against  the  Institute by interested parties,  often  times,,
sad to say, by the very physicians who should be their best and
truest advisers.  It is equally a duty and a pleasure for us to dis-
abuse the minds of invalids making such inquiries, to  show them
the great  advantages  of the Institute, wherein its methods  of
treatment excel  all others, and why we are  able to effect cures
where every other means have failed.   We make no concealment
of our methods or appliances;  but, on the contrary, court the
greatest publicity, knowing that our enterprise is as meritorious
as it is humane.
  Having answered all the questions and objections of the in-
valid, we may  be permitted to ask one or two.  Is it possible for
any institution to be patronized as this has been for twelve years
past with such an overwhelming  business, its patients increasing
faster than its  accommodations, unless it was worthy of confi-
dence?   Would the best, the most honest,  intelligent, and trust-
worthy men of the country lend their names to it continually if
it were a fraud or a swindle? This Institute is the largest of the
kind in America, does  a more extensive business, and has better
appliances than  any similar institution in  the world, and is en-
dorsed by the  best men of the city and state where it is located,
and by thousands who  have received its benefits.   Do not these
facts furnish conclusive evidence of its merit and efficiency,  or
will you listen instead to the interested sneers of your home doc-
tor, who never has done and never can do you any permanent good,
and to the false advice of those who know absolutely nothing of the
facilities or the treatment of the National Surgical Institute ? 
CHAPTER V.
RECEPTION OF PATIENTS — FIRST IMPRESSIONS — CAREFUL EXAMINATION
     OF CASES—CANDID HOPE FOR THE AFFLICTED— FAILURES —
                 DUTIES REQUIRED  OF PATIENTS.

4l| T is natural that invalids—who are apt to be very sensitive,
qj|^ and sometimes even  timid, in regard to their treatment—
 t    should desire to know something about the internal man-
agement of the National Surgical Institute, and if they have
decided to visit it for treatment, what sort of reception they will
meet with.   To gratify this desire the following information is
given—premising, beforehand, that the law of kindness  prevails
in every department:
   On arriving  at  the  Institute, or  either  of its branches, each
patient is shown by the usher into the  Reception Room, where
he awaits the examination of the  throng preceding him.  It is
well to mention that the ordeal of waiting for his turn may be
very tedious to the new comer, unaccustomed to Institutions  of
such magnitude, but it is a necessity of the situation.
   The patient will no doubt experience the greatest surprise  of
his life in beholding the number of crippled, deformed, and help-
less persons, under treatment at the  Institute.  It is not amiss to
say that the average number of  patients  is not not less than fif-
teen hundred.  These are  not all at  the  Institute at one time, as
those who are supplied with needed apparatus and other  facili-
ties,  and are making  satisfactory  progress, are at  their  homes.
Another important fact is  likewise to be borne in mind by the
newly arrived patient:  cured or benefited patients do not remain
long in the Institute.   Hence, the majority that  meet the eye
have either just arrived or are under  process of cure.  But, even
among these,  the evidence of relief is all that can be asked by
the most incredulous.   The words of praise  and gratitude from
the conscientious  and faithful patients who  are  improving  in
health, and regaining the use of long useless limbs, are the best
testimonials of  skill that could be given. 
48
INCURABLE CASES DISCHARGED WITHOUT COST.
                  CAREFUL EXAMINATION.
   When  his turn arrives, the patient is conducted  to  the  Sur-
 geon's Room for examination.  Here a careful diagnosis is made
 of his particular ailment, including peculiarities of constitution,
 temperament, &c.   If his case is considered

                         INCURABLE,

 He is at once notified of  the fact and discharged without cost, as
 it is not in the province of the  Institute to undertake  cases which
 can not be  benefited, or  at least  partially relieved from pain  or
 deformity.  In this connection, many sad scenes occur.   Numbers
 of those who come to the Institute for treatment have been for a
 long  time under the care of unskillful  physicians, without  any
 appliances for proper treatment, and have thus wasted  years  of
 valuable time.  After losing all hope, and when in many cases it
 is too late to  obtain any  relief or  benefit, the patient comes  to
 the Institute.  One of the most painful duties that  we have  to
 perform is that of breaking the sad truth to such a patient, that
 he is  a hopeless cripple  for life, and that the Institution can do
 nothing for him.
   But if the case is curable,  the patient is directed to the Secre-
 tary,  whose business it is  to record the name of  the  patient  and
 all the important particulars connected with the case.
   The cost of treatment, for  the  course required, is also here
 considered, and such charges as are equitable and just,  are satisfac-
 torily arranged.  We are  often asked, by letter,  the  cost of ap-
 paratus and treatment.  We  reply  that our charges  are reason-
 able,  and  no exorbitant prices  are  ever demanded.   Our treat-
 ment is more expensive to us than the usual treatment employed
 by other physicians is to them; yet the charges made by us are
 often  less  than the fees  charged by others for operation and ad-
 vice alone.  We should be glad to inform every patient, before
 he leaves  home, just what the apparatus and treatment will cost-
but until we know,  from  a personal examination, the condition
and wants of a case, with the kind and number of appliances
needed, or the operation or treatment necessary to  relieve and
restore, we can not say what the expense will be.  No one need
hesitate or stay away on this account, as every case  received by 
                 CO-OPERATION OF THE PATIENT.               49

us for treatment is at a price that is mutually satisfactory.   When
this  is done, if the  case  requires apparatus, the  patient is con-
ducted into the Apparatus Room, where measures are taken for
the required appliances.
  Thence the patient is  shown to the  Prescription Department,
where the  necessary medicines  are compounded,  dispensed, and
proper directions are given.
  Afterwards,  the patient is  taken  to  the Treatment and Bath
Rooms, according to the direction of the Surgeon.
  Withal,  the  patient must bear in mind  that all can  not  be
waited upon or served at once.  As soon as possible, the neces-
sary appliances will  be made  and fitted, and the requisite pres-
cription will be filled.
  It should also be remembered, that in all cases where  the  ap-
paratus can be properly adjusted, and there is a certainty of  the
treatment being faithfully carried out, the patient  is permitted to
return home.   Under no other circumstances would the mana-
gers of the  Institute feel themselves  justified in granting  the
privilege,  for the reputation of the  Institute and the welfare of
the patient are equally involved in the  success of  our treatment.
Experience has taught us that much depends on the faithful and
conscientious co-operation of  the patient, his strict obedience to
orders, and an  intelligent use of our appliances.   It is  only in
cases, therefore, where we feel we can  implicitly rely on patients
for such co-operation,  that we permit  them to return home and
undertake  to  treat them there.  Happily,  however,  there is a
very large  number of such cases, and it is a pleasure for us to be
able to inform  such  patients that they can can be treated at home
as well as at the Institute.
                         FAILURES:
Or Some Account of the Cases which Fail to Obtain Relief at the Surgical Institute.
  It may be asked by some of our readers, "Doall persons who
apply to  the  Surgical  Institute and who are  received under
treatment,  get  cured or obtain permanent relief? "
  We answer,  "No," and beg leave to call the attention of  our
readers to the following important considerations:
 All intelligent and  discriminating minds must readily perceive
that, out of thirty  thousand cases which have been treated at
       4



                                   ,-. r.. ^ ■ 
50           UNWISE AND UNMANAGEABLE PATIENTS.
the Surgical  Institute, there would be some fickle,  frivolous,
fretful, impatient and  unmanageable  patients.   There are some
who are so unwise as to soon consider their own judgment  bet-
ter than that of the physicians in charge; some are unwilling to
expend the means necessary to visit  the Institute as often as re-
quired, and others are, unfortunately, too poor.   Hence, the nec-
essary changes of the appliances used, the instructions for wearing
them, and other essentials of successful treatment, are not complied
with.  Very many  patients  are disheartened  by  meddlesome
friends, and some, having never learned or realized the truth of
the old adage that only  "fools and children judge of work  half
done," give way to  dissatisfaction before the treatment is fairly
begun, thus inducing negligence  and failure.
  Some persons, again,  expect almost miraculous cures in a lim-
ited space of time.   If the cure  is not apparent to them at once,
and weeks or months  pass  by without  visible  improvement  (to
them), they lose courage and hope, and hastily  conclude that the
old story of disappointment is again to be realized.   In this con-
nection, we would  say, for  the  benefit of  all the patients who
have been, or may come to the  Surgical Institute, that nearly
all the cases which come under our care are of a chronic  nature.
We repeat these facts.   The majority of our patients have been
treated zvithout success by their physicians at home.   Discouraged
and doubtful of relief, they are  nevertheless irresistibly impelled
to come to the Surgical Institute by reason of the many cures
which  are  performed  here.   The  hope of  relief on coming here
is still  overshadowed  by the disappointments of the past; and,
with the suspicions and doubts which, in  addition, may be in-
stilled into their minds by thoughtless or  envious persons, it is
not surprising patients should be too  quick to conclude  that they
are deriving no benefit from  the  treatment,  and despair of relief.
Such persons should consider that if their maladies had not been
serious and  obstinate, their physicians at home might have ef-
fected a cure.   They should bear in mind that our  principal ob-
ject in founding and sustaining  the Surgical Institute is to af-
ford the relief and remedies from life-long suffering and deform-
ity which can not be obtained at home.
  It must also be remembered  that, after  the  system  has once
been  shattered by  disease, and  the  '' human form divine" has
« 
                    THE DUTY OF PATIENTS.                  51

been distorted  by long continued deformity, the restoration to
health and bodily perfection must necessarily be slow.
  If all cases could be remedied by surgical operations, the cure
would be speedy and satisfactory.  By the  skillful touch of the
instrument, the most shapeless, disfigured, and mutilated face  is
transformed to its normal outlines, or, at least, to an appearance
of comeliness.   The painful, loathsome tumor,  sapping the vi-
tality from the system,  can be at once removed, &c., &c.
  But the cure of deep seated disease and long continued  deform-
ityis a different proces; and requires  as much skill on  the part
of the operator,  as patience and obedience on  the  part of the
patient.
                  THE DUTY OF PATIENTS.

  Few patients realize that they have as important a part to per-
form  in  the process of cure as the physicians of the Institute.
This is true; and the following points should be strictly observed
by all patients seeking  relief at our hands :
  First.   To come immediately to the  Surgical Institute,  and
examine for yourselves whether the statements made in regard
to it are true or  false.  If it is  impossible for you to come, in-
vestigate statements  in regard to it  by every  means  in your
power.
  Second.  When you become satisfied of the correctness of the
statements in regard to the Surgical Institute, and conclude to
place  yourselves under our charge for treatment, bear it  im-
plicitly in mind, that a strict compliance on your part,  with all
our directions  and instructions, is absolutely necessary  to your
improvement and  cure.   No other course will  do justice to
yourselves and the Institute.
  Third.   Do not fail to consider the  importance of remaining
at the Surgical Institute  as long, or visiting it as  often as  is
necessary to promote a cure.  Some delay and expense  may be
involved; but what, to  you, is the value of a few dollars and  any
amount  of time  in comparison with restoration  to  health and
bodily perfection ?
  Fourth.   We always aim to  make traveling and boarding ex-
penses as light as possible  to the  patient; feeling assured on the
one hand that no one will want to barter with health and life as 
52
HOW TO WRITE.
with property, and, on the other, that no one will hesitate to ex-
pend a reasonable amount of time and money to obtain relief.
  In fine,  we desire that every  patient  not  in the Institute,
should inform us weekly of his or her condition and  necessities.
Every case, with its full history, is duly recorded on our books.
A record is likewise kept of every prescription given and appa-
ratus applied, which at all  times  enables  the physicians to pre-
scribe and give directions according to the necessities of the case.
Sometimes there are annoying delays in receiving prescriptions
and apparatus by mail and express, which  all reasonable people
will understand and make allowance for.   This frequent and griev-
ous source of trouble arises chiefly from omissions and mistakes on
the part of patients,  in their letters.   Many fail to  sign their
names;  some  omit their post office  or express office address;
others direct to a particular surgeon, and use wrong initials, and
the letters are never received.   Braces are often  returned for  re-
pair, with nothing to  show  where they belong.   Letters are  re-
ceived, informing  us  that  shoes have  been sent to us to be  at-
tached to braces, but the shoes come unmarked,  and we can not
possibly indentify them.   Always mark your  name,  and direc-
tions for returning, on  apparatus, shoes, or any thing else you
send to the Institute.   Letters may miscarry, even when prop-
erly addressed.   In cases where prompt attention is not paid  to
his requests, the patient may feel neglected.  But every letter
received by. us, having name and address, is immediately answer-
ed; and every order for medicine,  apparatus or  repairs, if correct,
is promptly filled, and the patient  notified how and where it has
been sent.
                     HOW TO WRITE.

  Give  your name, (and, if under age, the name of parent  or
guardian who placed you  under treatment), post office, express
office, and  State;  also state your disease  or affliction,  present
condition, and the condition of apparatus, fully; also, action  of
medicines,  whether you  are improving  or not,  and say candidly
if you are complying strictly with all directions, or if some things
are not neglected.  Your own welfare demands this, that neces-
sary changes  of treatment  may be made;  and if you have not
done as directed, do not attempt to deceive us, as  we mio-ht 
Missing page 53-54 
 
          AS WE KNOW MORE, SHOULD WE SUFFER MORE?        55

indulgences, and straying farther and farther from the simplicity
of nature.   Thus they are  constantly opening up new paths in
which indulgence may cross natural laws.  The multiplicity of
means of enjoyment counteracts the force of greater intelligence
in exposing the evils of excess or abuse.   Men will  sin while  it
is pleasant,  and only think of the penalty when  it comes.  The
more numerous the opportunities and incitements to sin are, the
more frequent are the  sufferings that reproach and punish it.  Is
it impossible, then, that mental and physical development should
go together?   As we  know more, should we suffer  more?  As
we improve the means of correcting disease, should we  increase
the liability to  incur disease?  By no  means.  This would be a
hasty conclusion  from an imperfect generalization, as  unphilo-
sophical as it is false.
   We know that many men of the most  cultivated minds and
greatest attainments are as perfect in physical as in mental devel-
opment.  What  man  has done, man  may do; and if "a sound
mind in a sound body" be possible in one case, or a dozen cases,
it is possible in more, and there  need be no limit.   The safe con-
clusion  is, that we do  not,  in the higher order of life, properly
balance mental with bodily education.  We do not give too much
attention to the former, but we do not give enough to the latter.
Undoubtedly it is the duty of doctors to enforce the  lesson of
observance of the laws of health and physical  development, but
doctors can not go about giving lectures on diet, irregular habits
and vicious  pleasures.   Not unfrequently the  disease comes of
the sins of progenitors; for the  language of the Bible is strictly
true that "the sins of the fathers may be visited on the children."
Not unfrequently, too, the operation of the laws of health is  so
hidden or uncertain, that  it may be diffcult to determine where
and to what extent they have been broken.  Doctors give direc-
tions in individual cases, but their  efforts to enlighten the public
on  questions of hygiene and the. proper  observance of health
laws, have not been crowned with  signal  success.  It is far bet-
ter to enforce  the necessity of prevention rather than cure.  If
this received half the  attention  and study that  is devoted to the
subordinate one of cures  and remedies, the world would be in-
finitely  better off.   Disease  is the penalty exacted by nature
for the violation of her laws; and,  like  most penalties,  it is not 
56                  TRYING TO SIN SAFELY.
always in proportion to the offender's notion of the magnitude of
the offense.   What he thinks a slight transgression, may be pun-
ished with  a severity much  in excess of his sense of culpability.
And  a  gross violation may not, in all cases, be followed with
equal suffering.   Therefore, there can be no more silly conduct
than trying to sin safely.   It is  as  silly as pulling the trigger of
a gun easily, to send the bullet out gently.  The duty of men of
sense, to themselves, to their families, and to the community, is
to  study not to  transgress  at all.   The  forms  of error, in  this
regard, are almost innumerable.   The abuse of bodily functions
and powers  by excess, and their abuse by perverted or inadequate
use or neglect, constitute the two chief classes of transgression.
A man who eats too much, may suffer from  indigestion;  but he
may  suffer  equally from not eating enough.   If he exerts  any
limb or organ too much, he impairs its strength  and usefulness;
but he also impairs it by not using it enough, and still more by
neglecting its use entirely.   We  retain  posession, in the  highest
degree,  of our faculties and powers, only by their judicious,  reg-
ular use.  The great rule is moderation,  equally in use and the
opposite—vices, of course, being out of the  case.  The time to
preserve health is while it is ours, and not when we begin to feel
that we are  losing it.   It is an  experience as old as the world,
yet every generation has to learn it anew, that '' we  never know
the value of what we  have, till  we have  lost it;" and of health,
the most  valuable of all  nature's endowments,  this is especially
true.
   The sick  man  measures  no wealth or  effort against recovery,
but how little does the well man seem  to care to keep what the
other is so  eager to  regain.    He trifles with  it, risks it,  and
finally,  when he least expects it, finds it slipping away from him,
and sees what a fool he has been.   Better, then,  take the lesson
of universal  experience,  and study to preserve  health while we
have it, and make sure of the best legacy to  our children, in the
sound constitutions which  are among the surest gifts of sound
parentage.    This, alone, should  be a sufficient incentive to heed
the inculcations of experience and science, in observance of the
rules necessary to the preservation of the health.   No  trait or
quality  is more certain of transmission  to children  than  bodily
vigor and integrity, and the man who would not take the  trouble 
THOUGHTLESS AND IGNORANT PARENTS.
57
to study his own physical well being, in order to secure that of
his children, is unworthy to be a parent.
   The duty of preventing  deformity and disease is as important
as that of preserving the health.   The burden of this work falls
largely  upon parents and  teachers and we therefore make  the
appeal directly to them, in the full hope of securing their hearty
co-operation.
   Our lives have  been devoted to the relief of human suffering
and deformity;  and, hearing the constant  wail and cry for help,
from suffering fellow-creatures from every nook and corner of the
land, and knowing that no adequate means of relief can  ever be
extended—that the great tide.of  human woe is  rolling onward,
and that nothing can mitigate or abate its fury but to  exhaust its
fountain—we make this appeal to parents as the source of hu-
manity's brightest hopes.   While  you stand as beacon lights to
the young, and as their  pilots to guide  them  on the rugged
waves into  the haven of knowledge,  you must also stand as  the
guide and guardian of their physical safety.   Ignorance  and  dis-
obedience of nature's laws are  the source of nine-tenths of  hu-
man suffering, deformity and premature death; and while par-
ental love and care would seem ample to vouchsafe to the young
hygienic culture,  good constitutions  and health, they often fail
most lamentably.
   The child makes that love a means to extort from better judg-
ment, permission  for pernicious indulgence; besides, thousands
 of thoughtless  and ignorant  parents bring  new responsibilities
 upon themselves  and the world, as  though chance, or animal
life, without intelligent guidance, would suffice,—unconscious of,
or ignoring the higher destinies or possibilities of a human being.
 Great opportunities lie before you; the aggregate  good you may
 do, and the suffering you may avert, eternity alone can tell.  If
you would wring body and soul from Satan's grasp, and the rack
 of physical torture, and lead them to higher enjoyments; if  you
would give your children good constitutions  as a firm foundation
and frame work in which to develop,  protect and render useful
the intricate mental machinery, do not neglect this great oppor-
tunity.
   Too few school teachers realize that they are. the  Lord's  and
humanity's great shepherds and  nurserymen:  that  they, too, 
58                    WILL YOU HELP?
have power, like the potter over the clay, to make  vessels to
honor and to  dishonor, fitted  for wrath  or the joys of heaven.
You are sewing the seeds for future harvest, and you should sow
what you will not be ashamed to reap.  No higher mission is al-
lotted to man than to shape the destiny of his fellows.   Do  not
think it a servile task.  High heaven and humanity smile upon
you; intelligence, social happiness, and the unfolding of the pow-
ers  and joys of the human soul, are the  rewards of your labor;
and as we would  plead in behalf of the  downcast, the suffering
and deformed, we  ask you to give your  hearty co-operation to
the work  of alleviating and diminishing human woe.  We all
have a mission on earth, whose reward is  above.   Will you help?
  A very important question has ever been:  What should  a
child first study, and how  should an education be commenced?
In answer to this, we have one suggestion.   Before Geography,
Arithmetic, English  Grammar, History, or any of the sciences,
teach the  child  Anatomy and  Physiology.   This study, with
every human being, should come next to the Bible.   First care
for the soul, then for the body.  First learn God's attributes—
care, love  and mercy to us—then learn our obligations to Him
and ourselves.
  No one for a moment doubts the necessity of a sound, vigorous
body to usefulness or enjoyment in life;  nor does  any one deny
the fact that a knowledge of our bodies and the laws of health is
indispensable.   All admit that a brilliant  mind in  a decaying or
feeble body is a failure; that the body, like the mind, is suscep-
tible of development,  and its  imperfections  may  be removed.
But when  is this work  to begin ?  As early as possible.  Make
it the first study, that it may be practiced in the most important
period of life.   The constitution is made or lost during the de-
velopment of the body.  You say there are so many hard terms.
Are they harder than the  fearful geographical names; are they
harder to  understand than the  seemingly arbitrary rules of lan-
guage, or the intricate rules of mathematics?  Is it not as easy,
instead of teaching them the products and peculiarities of dif-
ferent countries and nations, to teach the use and peculiarities of
our different organs? While they should learn of commerce and
of commercial centers, of its great avenues and their utility •  tell
them also of the heart as the great center of distribution to  our 
HOW TO TEACH CHILDREN.
59
system, and of the arteries as the great avenues or thorough-
fares, laden with all  the freight, labeled and destined to the in-
numerable stations, and delivered for the manufacture of muscle,
bone, ligaments, skin, hair, nails, nerves, blood vessels,  fat, etc.,
etc., and  that  at each of these stations worn out particles  are
taken instead, and by the veins are brought back to be expelled
by the great chemical laboratory  and furnace—the lungs and
liver.  Instead of other mathematical problems, teach them  the
ever and incessant power and pulsations of the heart, which, like
the water-works of a mighty city, drives the fluid through many
miles of pipes  in our bodies to water our whole system, expend-
ing a force of thousands of pounds  per day.   Teach them that
the grandest telegraphic system in the universe, with its centre
in the brain, and  its millions of sentinels and operators, relays,
etc., as far transcending the master-piece of a Morse or a Field
as Jehovah  does poor fallen men.    In every bone, muscle or tis-
sue, interest and  instruction  are found if properly studied; and
even the  smallest child  can be taught in a simple  manner  and
with interest to them, all the important facts in Anatomy or Phys-
iology and the laws of health.
   While  you  would tell them of icebergs, of polar seas, snow-
capped mountains, and that our lakes  and  rivers are useless for
navigation  during the cold season—teach  them  also that cold
extremities interrupt the flow of the vital fluid through the many
little rivulets and streams within therh, thus forcing the blood in
undue quantities  upon  the lungs, brain, spine or other organs,
from which sickness and death may follow.
   Teach  them that the inhalation of plenty of pure air is as im-
portant to give action and power as steam is to the engine, and
that all the  organs of respiration should  be ample,  free and un-
 impeded  in their action.   That, as food supplies the waste of the
system it is also fuel; it must be oxodized,  that  heat can not be
generated in the system  without any ample supply of air, any
more  than fire will burn without  it.  That those who compress
the chest with corset or clothing,  and limit the amount of air in-
 haled, have cold hands  and feet,  poor blood, feeble circulation,
 and soon die.
   While they are  exercising  in  gymnastics, they should be
 taught practical Anatomy and Physiology;  whenever a motion 
6o
FLEE YOUTHFUL LUSTS.
is made, let them know what bones are moved and what muscles
do it.  By combining the study with the practice, facts are riv-
eted upon the mind never to be forgotten.
  This knowledge of oneself, under the guidance of parent and
teacher, may be so systematized,  simplified, and imparted to the
young, that they may easily conform to nature's laws, and readily
comprehend their duties to " God, their neighbor and themselves."
Food, clothing, ventilation, hours of  study, exercise, sleep, self-
control, and social duties,  are all important elements in such  an
education.   Sweetmeats,  rich and highly seasoned food, contain-
ing a  super-abundance of carbon  or heat  producing principlej
should be excluded;  while food containing nitrogen and phospho-
rus—muscle  and  brain-producing  elements—should take their
places.  Stimulants of every description—tea, coffee,  tobacco,
spirituous lie-.iors,  and opium in all forms and  in every guise—
should be forever banished from presence and sight.
  Every line and every sentence of that most wonderful  of  all
prayers is fraught with interest; yet the simple words, " lead  us
not into temptation," have an importance and  significance which
can not be over-estimated.  There can be  no compromise, no half-
way ground.   Stimulants and narcotics of every kind should  be
excluded  from all grades  and classes of society.   Make  them
disreputable and unfashionable, and if those already enslaved have
no  hope of deliverance,  see to it  that coming generations are
protected  and saved.
  Paul lays down a golden  rule  when he says, '' Flee  youthful
lusts."  Here the whole class of lewd and libidinous evils are
forbidden.   Moral and hygienic laws both say,  flee these lusts, if
you would have purity, health and happiness.   Transgressors  at
this point are numerous.   Let the pure be pure still, and let
sinners believe, obey and reform.   " Live soberly, righteously and
godly," is one of the most comprehensive laws of health.
  Holy Writ declares we are " fearfully and wonderfully made,"
and he who early has unfolded to  him the truths of his own  exist-
ence —viewing the image of God, the masterpiece of His creative
power—exalting  his  own  conceptions of Deity and  self, and
placing in his hands the chart and compass to guide him  from
shipwrecks, will be  saved  untold bodily suffering through life,
and be able to prolong it to its fullest period. 
CHAPTER VII.
                        DEFORMITIES.

 Aw AN was created in the image of God, and when he came
 fllM from the hands of his Maker was perfect.   Every feature
^ "^reflected the divine attribute of  perfection, every organ
performed its function with absolute precision, and every  bone
and  muscle  were faultless.  Had this pristine condition of man
continued, deformities and afflictions would be unknown; but
with sin  and the sentence of death, came disease and deformity.
In reality, any deviation from perfect physical manhood is de-
formity.   Yet from  long abuse,  maltreatment,  excess  and de-
bauch, the human form has been so changed, that to find, in the
present day, an approximation to the original type, is indeed grat-
ifying, and now only very grave deviations are called deformities.
Yet the  most lamentable structures, "bandy legs" and  "spindle
 shanks," and all variations in figure, from the  angular,  bony
 frame to the embonpoint  of obesity, are found to exist.
   Thousands of crooked backs, round shoulders, hollow  or point-
 ed chests, and crooked necks throng our thoroughfares,  covered
 from the popular gaze by ingenious clothing.   So great was the
 difficulty experienced by Powers, in his production of the Greek
 Slave, that, 'tis said, many different models from the finest living
 specimens were selected and used in fashioning the various parts
 of the statue; and, to make it complete,  he was obliged, after all,
 to refer  to the old specimens of art for a  perfect model.   From a
 retrospect of the past, whether we gather from the voice of tra-
 ditionary lore, from written history, mythology,  or the old art
 treasures, we are pointed back to ages past, when sin and suffering
 were less prevalent, when  life was longer, and the body more
 beautiful and symmetrical  than now.  They also proclaim  man's
 degeneration.  To make even brief reference to all the varied de-
 formities to which the human body is  subject, or their causes,
 can not now, with our limited time and  space, be attempted.
   Innumerable causes for  deformities have been  assigned, each 
62
THE FANGS OF SUPERSTITION.
 sufferer having his or her own explanation, which is generally
 erroneous and unsatisfactory.   A large number of cases result
 from injuries and diseases of the joints; very  many are  the  se-
 quels of paralysis, some of the muscles having made a partial or
 complete recovery, while their antagonists  remain powerless and
 inactive.   In this way constant  flexion of the joint is kept up,
 until it becomes fixed and motionless.  Rheumatism is  a fruit-
 ful source of deformity.
   A very large class of malformations and  monstrosities are con-
 genital ; as crooked feet, hands, legs, and arms, hair lip, cleft palate,
 web fingers and toes,  spina bifida, tumors, marks, deficient mem-
 bers or parts, &c., &c.  In accounting for these freaks  of  nature,
 the parents or  sufferers too often leave disease  and  disobedience
 of physical laws out of the question, and attribute them to mater-
 nal frights, unsatisfied longings,  and other foolish and  imaginary
 causes.   Through ignorance and superstition, the fear of witches,
 hobgoblins, and ghosts, like a fiend, has followed mankind from
 the dark ages of mental depravity to the noon  day  of  light and
 knowledge, making them miserable and unhappy.  Thousands
 of mothers, even in the present enlightened age, are tortured by
 false and silly traditions, while many physicians, through  apathy
 or taint  of superstition,  fail to denounce the  lie.   It is  a sad
 thought, that in the light of the nineteenth  century this monster,
 superstition, should have its fangs so deeply rooted in so many
 mothers' hearts; yet strange and sad as it is, to assail it and try
 to convince mothers of its falsity, only arouses a# fierce combat
 in its defense, and the "old believer" is astounded  by your au-
 dacity.   Quick as the lightning flash she scans the field  of her
 past life, and marshals a host of red blotches, cherry spots, hairy
 moles, representing rats or other  animals—in fact, a  menagerie of
 snakes,  monkeys, elephants, and domestic animals, is summoned
 in defense of her views.   These marks, or narva, it is thought by
 many, result from the thoughtless or careless gaze of the mother,
 during her pregnancy, upon some improper or hideous object,
 some deformed or mutilated human  being, or his  picture,  when
by some mysterious power, and for some purpose, devilish or di-
vine, the impress is carried from the eyes  of the mother  down
through the body, in some unknown way,  to the unborn  child,
and branded there as with a hot iron; or, under a like influence, 
              NOT PRODUCED BY EXTERNAL OBJECTS.            63

it may twist and distort its hands, feet or other parts,  and  play
pandemonium generally.   Lycurgus,  one  of the  wisest men of
ancient times,  was fully persuaded of the truth of this marking
theory, and because there was in his day no cure for the maimed,
disfigured, or deformed, he ordered an examination of every new
born child,  and if a blemish appeared it was to be killed at once,
that it might not meet  the  gaze of those who  were about to be-
come mothers.
  Witches  were  hung  in Massachusetts, and only last year in
Mexico!   How an expectant mother,  with this ancient, solemn
lie impressed upon her mind, trembles and  cowers, like an  es-
caped criminal, fearing that she may want, see, hear,  smell,  or
taste something that will injure or ruin her unborn child.  Jacob's
experience and triumph with Laban, are cited as biblical evidence
touching this mode of producing monstrosities, and it is claimed
that the ringed, streaked and striped  sticks, by some incompre-
hensible process, imprinted these streaks and stripes upon the
unborn calves!
  Since we find no account in the  Bible of the  women of that
day suffering from these causes, is it not ridiculous for the women
of the present day to attempt to imitate Jacob's cattle?   If it
was not a miracle of the Almighty  to favor Jacob and convince
his idolatrous  uncle, why do we not to-day see the same results?
If it was from  natural causes, as fright of the cow,  was it not
wicked in Jacob to deceive  and swindle his father-in-law ?  It was
as much God's plan and work, as  was his choice of Jacob before
he was born;  or the ladder and the angels which Jacob saw  on
his way to  Mesapotamia; or  the  angel with  which  he wrestled
  Note.—If it is true that the mere sight of the deformed reproduces like afflic-
tions, what a multitude each cripple must produce like himself, and how sad the
train of cumulative misery each must send drifting, along the stream of time/ end-
ing only with the extinction of the race.  BetterJ far, even in this age, to follow
the example of Lycurgus, and kill the cripples, than to permit them thus to maim
so many thousands of innocent beings.  What superstition!  If we believe the
origin of monstrosities depend upon such causes, this alone would be sufficient in-
centive to spend our lives in the cure of such cases, and no conscientious person,
entertaining this belief, could for a moment hesitate to bring, or send them to the
Institute for treatment, thus saving untold misery to  generations yet unborn.
In this view the Surgical  Institute could justly lay  claim to the accomplish-
ment of the grandest work on earth. 
64               BELIEVING IN DREAMS,  ETC.
on his return.   Such effjcts are not produced by external ob-
jects, frights, or desires, on man or beast,  any more than a rod
can by like means be turned into a serpent; or a rock to be made
to pour forth torrents  of water;  or rivers run with  blood; or
seas and rivers  open for retreating armies to pass through, then
close to  engulf their pursuing  foes.  Such miracles  were  for
specific times and purposes.  The Bible, of all books, is the last
to which we should  appeal in proof of  such  absurdities.   The
Lord never intended  to rest the perpetuity of our race upon
so uncertain and capricious a foundation,  by which the least de-
sire or fright might malform, piece by piece, the human body,
and by reproduction in kind, end the whole race in monstrosities,
incongruous and unrecognizable by God or man.
   Yet we find  people planting  crops  in certain phases of the
moon; and  observing  the signs of the Zodiac  for suitable times
to wean babies  and calves.
   Some  use the horse  shoe as  a  protection  to their  homes;
others believe in dreams.  Some think they have held commu-
nion with spirit messengers from  heaven.  Some believe a tale
because it is old,  and has long been cherished.   Paganism is old;
mythology is old; idolatry  of many kinds is old;  so are igno-
rance and superstition.   The superstition of which we are speak-
ing is ancient and almost universal; yet it has  not the  slightest
foundation in reason,  truth  or science.   All  monstrosities, all
deformities and malformations, all extraordinary marks  are the
result of natural laws, or rather of the  violation  of some natural
law.  Nature, a stern but faithful mentor, teaches us the penalty
of violating her laws, and warns  us that the iniquities  of the pa-
rents shall be visited upon the children to the  third and fourth
generation.   It warns us against all kinds of vice and debauch,
which to-day is producing all this marking and deformity.  We
should recognize these as the sequel of  our wrongs, instead  of
shielding ourselves by some vague superstition.  Did space per-
mit, we should love to give an  exposition  of this  cloud of re-
maining ignorance, if by so doing, in  upholding the  truth, the
fears and painful forebodings of those whose  trials are already
too grievous to be borne, could  be mitigated or dispelled; but
we must forego this for the present.   You then may ask,  how
do you account for all  these so  called marks  and  deformities? 
                 NATURE REPEATING HERSELF.               65

We might answer by asking what causes knots and marks on
trees, or why are some crooked?  What makes  a Negro black,
a Mongolian yellow, or an Indian red ?  What causes tumors, or
why do cancers torture us ?  In fact, what causes nearly all our
suffering and misery ?
  Is it not in some instances, but Nature repeating herself—like
producing like—even reproducing from  the fourth generation
past, from seeds then sown and waiting to be loosed from some
constraining influence, and for favorable soil or system for devel-
opment.  "As ye sow, so shall ye reap.   If in  corruption,  you
shall reap in corruption."  This is true  in a physical sense as  well
as spiritual.   Now if we could only see ourselves as our Maker
sees us, and behold the heinous crimes we commit against  our-
selves, and the daily torture we bring upon ourselves by violated
physical law, all  your questions as to cause would be answered.
Were we to stand, as a sentinel or spy, and see what passes into the
stomach of man, instead of simple, nutritious diet and water, to
sustain life without tax upon  the organ, we would behold, as it
were, a caravan from all nations and climes, laden with a con-
glomeration of innumerable articles, incompatible and villainous,
with all manner of  compounds,  mixtures and concoctions;  and
this indigestible stuff, some  boiling hot,  some cold as  ice, con-
taining a dozen oils,  acids, and alkalies, stimulants, narcotics and
poisons, all goes into the  revolting stomach, because fashion or
perverted taste commands  obedience.  And now, from this a
sound body is expected, free from spot or  blemish.  Add to this,
injurious clothing, exposure,  dissipation, turning night into  day
and day into night,  and is it not marvelous that a  perfect child
should be born of parents whose bodies  have been so  outrage-
ously treated.   With dangerous pressure by foolish mothers, with
poor blood, the germs of  scrofula, syphilis, consumption, erysip-
elas, and other poisons in its composition, it is strange that some
of the minute cells, so mysteriously and wisely arranged in  line
to make vessels, should occasionally be defective or disarranged,
and thus  either arrest the development of a blood vessel, and,
as a consequence, stop all  growth beyond, preventing the forma-
tion of a foot, hand,  toe, or some other member; or as the devel-
opment is from both sides of the body, when the vessels fail to
meet and  unite in the median line, that cleft palate or hare-lip is
       5 
66
NOT A WORD OF T.RUTH IN IT.
is the result?  The bursting of a vessel may be caused by these
diseased or defective little cells; and by enlargement of the cap-
illaries, a red spot or wart is formed on the skin; or the position
of the  child, under the  unnatural  pressure of a corset, may  be
such as to  allow one set of muscles to contract, while the oppos-
ing set is prevented from doing so by the  pressure,  and  thus a
crooked foot or a crooked limb is  formed.  Actual disease may
produce much and serious trouble in this direction.
  There can be no  doubt that before birth  the  child may  be
influenced  by the condition of the mother's health, and that ab-
normal nutrition, in various parts, occurs.  In some  it is exces-
sive; in others diminished or entirely suspended.  Diseases of
the small blood vessels may cause their rupture,  and thus give
rise to marks and spots.  In fact, none of these phenomena are
as inexplicable as the finding of hair in the ovaries, or teeth in
the bladder, or half a bushel of hair balls, large and small, in the
stomach of a cow.  As yet, the  explanation of many things is
hard; but  to implore astrology,  witchcraft, or  foolish  legends
for their solution  is absurd; fjr though they may be hidden from
us,  they have, nevertheless, been produced by natural causes.
  It is strenuously claimed that the marks adduced  in evidence
bear a  strict resemblance to the article longed for, or at which
the fright was taken.   Now, if this is not true, why attribute it
to such causes?   If it is true, why is it that when  the object of a
mother's longing is a new dress, the child is not marked  with a
dress;  or if green peas, why do we not  find a green  mark; or if
she be frightened at a locomotive, why not have the eh Id a gen-
uine, diminutive locomotive;  or if the fright be from the firing of
a cannon, or the explosion of a boiler—very impressive things—
why are they not correctly represented ?   Mothers, let us tell you,
it is all false; there is not a word of truth  in it, no matter what
may be said to the contrary.   That idiotic or insane parents may
expect similar children is true, and that scrofula,  consumption,
syphilis, and other constitutional diseases are transmissible is also
true, for this is  in conformity  to  the law that like begets like,
whether good or  bad;  hence,  the necessity and  importance  of
cherishing health and obeying its laws, for it is not  alone  parents
vvho suffer  the penalties of violation, but  thousands  yet  unborn
must suffer for the sins of their ancestors. 
                REGENERATE THE PHYSICAL MAN.              67

  In this connection we will mention a sad and striking fact, viz:
That physical degeneracy is in nearly  the same ratio, and goes
hand in hand with civilization and knowledge.  As man emerges
from barbarism, and advances to high  civilization  and mental
power, physical deformity and suffering are his ghostly compan-
ions.   The  abject servitude  of  slaves to  their  masters, or  of
woman in heathen lands to her liege lord, produces far less phys-
ical injury than the  negligence and debauch of the civilized and
intelligent, together with the systematic  violation  of the laws of
health, practiced among educated people.
  With our knowledge of physiology, chemistry, and the laws
of health, were we to worft as zealously in regenerating the phys-
ical, as Plato  did in regenerating the moral man, we could  lay
broad  and deep the  foundation upon which the finest and most
cultivated organization might rest, and we could mitigate human
deformity and woe.  Then should we see the noblest monument
that could possibly be reared to art, science, civilization,  and re-
ligion—a perfect man.
  One thing seems very plain upon examination, and that is, the
nearer we approach the animal creation,  where simple diet and
habits prevail, the closer is  the approach to the original sym-
metry; and the farther we ascend the scale of mental culture and
brain  development,  the more malformations, paralysis, and ner-
vous diseases increase.  This is not necessarily  so.   Our vanity
and intellectual pride  sometimes soar above the groveling clay,
and revel in fancy free, until  the neglected or abused body calls
home  its counterpart to  rejoin the suffering endured.   We look
upon  the body as subordinate in importance, instead of being
the very bulwark, as it really is.   Its development is regarded as
of minor consequence.  Its  necessities are neglected, its rights
infringed upon, its demands are unheeded.  It is coerced by fash-
ion into submission to all manner of indignities.   Food, clothing,
sleep,  and exercise are all perverted.   Is it strange that disasters
follow ?
   When we examine into the condition of the barbarous and un-
civilized portion of our race, we find them comparatively free
from the physical  alterations and defects that afflict us.  Take,
for instance, the African race in its purity.  Where do you find
among these people a club-foot, cross-eye, hare-lip,  cleft-palate,. 
68
DEFORMITIES RAPIDLY INCREASING.
spina bifida, or infantile paralysis?  The same fact will be found
if we examine the Indian tribes.  With none of them do we find
the well marked temperaments that distinguish the Anglo-Saxon
race.  Instead of the well marked nervous, lymphatic, sanguine
and bilious temperaments, we find a great uniformity in personal
appearance, disposition and habits.   Even in our Southern States,
where comparatively few full-blooded Negroes are  to be found,
deformities are rare and temperaments uniform.  The truth is,
that, as far back as authentic history will carry us, we find  that
as the mind is cultivated, the laws of nature and of health are
violated.
  That  deformities are rapidly increasffog, is apparent to the most
casual observer.   The distortions and deformities resulting  from
paralysis alone are fearful in their numbers.   The effects of defor-
mity upon the sufferi-ng subjects  have ever been distressing  and
baneful.  The most ancient of historians sadly pictures the  fate
of those who,  by birth or accident, were deformed.  See the fol-
lowing  in Leviticus, xxi., 17, 20:  "Speak  unto Aaron, saying,
whosoever he be of thy seed, in their  generations,  that  hath a
blemish, let him not approach to offer the bread of his  God.
For whatsoever man he be that hath  a blemish,  he shall not ap-
proach : a blind man, or a lame man,  or he that  hath a flat nose,
or any thing superfluous;  or a man that is broken-footed [club-
footed], or broken-handed, or crook-backed, or a dwarf,"  &c.
If mankind had always exercised the  same generosity to cripples
that  King David did, their lot  would  have been less gloomy.
He took Mephibosheth, Jonathan's son, who,  at the  age  of five
years', became crippled in both feet from a fall, when he and his
nurse were fleeing, after hearing  of Saul's defeat (it was doubtless
from paraplegia,  as  both feet were lame), and bestowed many
and large favors upon him.   David, having sent for and brought
him to his palace, gave him large possessions, and commanded
that he should, thereafter, eat at the King's table.   Alexander
the Great had wry neck.  Socrates,  >Esop, Lord  Burleigh, Sir
Walter Scott, and Lord  Byron, it is said, were  deformed, more
or less.  Their transcendent genius, however, spread a mantle of
tolerance over them.
  The visitation of deformity,  whether from disease or some freak
of nature, played upon these victims, making them different from 
               SYMPATHY FOR THE UNFORTUNATE.             69

their fellows, is  sad indeed;  and though,  as often happens,  to
make amends, as it were,  for physical imperfection, these afflict-
ed ones are endowed with genius, learning and  fortune; yet that
ever-morbid consciousness, and the derision of  the heartless,  or
the involuntary  shudder  of the good,  when in their presence,
ultimately drive  them into seclusion, and bars them for life from
the social joys and associations so dear to all.  Sometimes their
minds are also dwarfed, their society loathed and shunned.  These
distinctions are unchristian-like and  often thoughtless, yet they
are none the less hard to  bear.   Enduring the deformity and its
privations is  enough, without the heartless raspings and goad-
ings of the thoughtless and ungrateful.
   Much as we love to uphold the cause of the afflicted and in
every way  to mitigate their woes, yet the sad fact exists that  the
vital organs are  often compressed and distorted to  such an extent
as to  seriously interfere with  and prevent mental as well as phy-
sical  development and  usefulness;  and  if vital organs  be  not
involved, the locomotion is so impeded, and the moral effect so
depressing and  overpowering, that little benefit is expected or
realized from their own feeble attempts to obtain relief.   But, as
before stated, now and then a bright light appears,  even in a  de-
formed body, and in spite of earthly fetters compels homage  and
admiration.
   From our long experience we have learned that  very few per-
sons  know or realize  how many of the hapless  and  helpless
await in seclusion their journey to the better land, expecting no
relief in this.  Even  the  immediate relatives  and friends may
seem, in apathy, to be reconciled to this fate, and scarcely an
emotion of sorrow or sympathy  is felt, or an effort made for their
relief.   Many even seem anxious to disbelieve the triumphant
achievements of the age in restoring such cases.  Perhaps it may
be from  pecuniary  considerations, or from being  victimized by
wandering quacks.   Yet the  duty to strive to obtain  relief does
not cease with one or a dozen efforts.  So long as deformity and
suffering exist,  so  long should relief be sought.   In no other
way can duty be discharged.
  Sympathy for the  maimed, downcast and  suffering should
prompt every interested friend to seek for  their restoration, and
the sight of such cases should arOuse in every parent's  heart a 
JO              STUDY AND OBEY NATURE'S LAWS.
determination to study and obey nature's laws, to raise and train
their children, as to food, exercise, clothing and  mental culture,
so that these terrible  calamities  may not befall them; or if it
should occur that a child is born with imperfect or  deformed
parts, to have the trouble at  once and  properly  treated and re-
moved.  Mechanical therapeutics  is becoming an art  of untold
importance to our race.   It is one of the greatest curative agents
of this century, and the profession will  yet be compelled to  lay
hold of it as  an  engine of power  to accomplish  what medicines
have so far failed to perform. 
CHAPTER  VIII.
MECHANICAL PRINCIPLES, AND MECHANICO-VITAL OPERATIONS IN THE CURE
         OF DISEASE AND  THE  CORRECTION OF DEFORMITIES.

     HE  progress  of  medicine as an  art, and  the application
      of mechanical principles and physical laws to the cure of
      diseases  and deformities, must  go  hand  in  hand.   The
neglect of these invaluable  curative auxiliaries, and, as a conse-
quence, the failure  on the part of physicians and  people to ap-
preciate their importance, arise more from  indifference and want
of familiarity with them, than from any well founded opposition.
It is so much  easier to take a  dose  of calomel  or salts, for the
relief of a  congestion or a sudden cold, than it is to re-establish
the retarded or deranged circulation of the fluids of the human
system by natural or mechanical means, by exercise, or the regula-
tion of temperature, atmospheric  pressure, electrical condition,
&c, that the chances are largely  in favor of the former..  This
fallacy, as well as  the sad results  of this dependence upon med-
icine alone, to the exclusion  or  neglect of hygiene, and suitable
mechanical and physical agencies, is attested by the hundreds
of thousands of crippled and diseased persons scattered all over
our land.  The action of drugs upon the system is variable, un-
certain, and not well understood.   Moreover, they are admitted
evils.  While they  are supposed  to  exercise  curative powers,
they  are  known to be  capable of producing damaging effects.
  While most  of the mechanical remedial agencies are real, not
imaginary, their mode  of action can be comprehended and ex-
plained; besides, there is no danger of making them the instru-
ments  of destruction and death.  But their chief merit lies in this:
that they give more prompt and certain relief than can be expected
from the use of drugs, and do not leave a sequel of life-long suffer-
ing.  In considering the mechanical agencies and powers available
for our purpose, we shall endeavor to separate them from those of
a purely chemical nature.  Changes brought about  in the human
body by purely mechanical  forces, do  not involve change in
constitution or  chemical composition, except as molecular change. 
JT2            THE EFFECTS  OF MECHANICAL FORCE.
is produced by accelerated'or diminished nutrition.  It is  true
that a deformed and wasted limb may be restored to  its natural
form, and so nourished as to become like its fellow;  but this
change is brought about chiefly by  augmented nutrition forced
into it  by  mechanical means.  The limb  is crooked  and dis-
torted,  muscles contract irregularly, small  bones are  pressed
out  of  their  natural  positions,  articular  surfaces  are   beveled
off, and nothing but the force exerted by a properly constructed
apparatus will correct these malpositions  and  conditions.   The
blood flows to this limb in diminished quantity, and with  a feeble
current.   By  raising the temperature and relaxing its  vessels,
and, at the same time, placing the limb in a vacuum, the shriveled,
shrunken  vessels and soft parts at once begin to fill and become
distended, pure blood flows into it in greatly increased quantities—
kneading, shaking, muscular movements, voluntary, passive, and
by machinery, with static or dynamic electricity (as the case may
require), complete the conditions necessary for cure.  The chemical
constituents of the various tissues going to make up this limb, are
essentially the same before and after restoration.  The mechanical
obstacles  in the way of a free circulation of the blood have been
removed by mechanical means; and the forces in operation to still
farther distort and deform, have been  so modified and changed in
their direction, by the apparatus employed, as to become powerful
agents in  effecting and maintaining the restoration.
  The effects of mechanical force, when slowly and continuously
applied to the body, in a given direction,  are truly marvelous.
In this  way, changes in the form of limbs and of bones are pro-
duced;  so that, as in the foot of a Chinese woman, the origi-
nal model may be lost, the long diameter of the os calcis, or heel
bone, being vertical instead  of horizontal,  and all the other bones
of the foot more or less distorted and changed.   Precisely the
same principle is involved (that of gradual, constant pressure) in
the  muscular contractions,  which result in  the deformities and
monstrosities so universally  found.  The weight of the body, or a
portion of it, thrown beyond its natural poise, acts,  by leverage,
to increase and confirm the slight deformity initiated by irregular
muscular  contraction.  The mechanical force exerted upon the
trunk of the body by tight corsets was sufficient, in a case which
fell under the  observation of the writer, to force the small intes- 
                   THE INFLUENCE EXERTED.                 73

tines, colon, portions of the liver and stomach, and other abdomi-
nal organs, down into the pelvis, where they were distorted  and
crammed together  promiscuously, and almost to the obliteration
of their anatomical land-marks; the ribs being flattened and forced
down to  the hips, and the vital organs so crushed and crippled as
to cause the death of the foolish and misguided victim.   This
was  not  done suddenly,  or by the occasional  application of a
powerful force;  but by the daily resort to a compression with
the corset, which, although tolerated for a time,  resulted in disas-
ter and death.   Thousands of deformities of spine and limbs are
but the result of pernicious pressure  upon muscles, nerves  and
blood vessels, depriving the parts of nutrition necessary to their
development and use.   By the application  of a gentle, constant
pressure or extension upon a limb, or a set of rigid muscles, or
cicatrix,  or the adhesion  of the smooth surfaces of a joint,  the
limb may be straightened or lengthened, the scar be  overcome,
the adhesions of the joint be broken up.  So, in like manner the
fibrous deposits  around the joints,  or the  many hypertrophies
resulting from injuries or perverted nutrition, are found to disap-
pear by absorption, under the application of the same principle,
by elastic pressure  with air, or other  means.    Carrying our  in-
vestigations still farther,  we  find that the chronic inflammation
and  congestion  of cystitis,   and the  various  congestions  and
hyperaemias of  the uterus and its appendages,  may be relieved
by calling increased quantities of blood to the surface and to the
extremities, at the same time reducing the temperature of the
parts, and by ingeniously-applied internal pressure, force the blood
out  of  the  diseased  organs; also, by removing a part of the
pressure of the atmosphere.   One  or  all the limbs  or the whole
body, placed in  a rarified atmosphere, will call a volume of blood
away from the trunk sufficient to relieve at once the over-distended
blood vessels and capillaries at the seat of disease.  The forms by
which the application of mechanical means for the cure of disease,
and  the  correction of deformities, are  made available, are too
numerous and too varied to be treated of in detail.  It is not in the
apparatus alone (although here it has its greatest scope) that this
principle is made available.  The influence exerted by mechanical
forces, and those mechanico-vital operations which can not be sep-
arated from them without doing violence, is a matter of profound 
   74          A MATTER OF PROFOUND ASTONISHMENT.
   astonishment.   In  our  treatment-rooms the active and  passive
   movements, frictions, kneadings, positions, elevations and depress-
   ions of temperature, and  increase and  decrease of atmospheric
:   pressure, are such as to influence and greatly retard, or augment, as
\   desired, the heart's action, the circulation of the blood in the vessels
   and capillaries; to increase muscular contraction and tonicity, or to
   relax rigid muscles; to increase frequency of respiration, facilitate
   digestion, stimulate absorption, favor assimilation; to increase, de-
1  crease,  and modify  the  excretions and  secretions generally.
   Hence, their  application and great value  in  the  treatment of
   paralysis in all its forms, general and local, (except when depend-
   ent on fatal organic disease, or the pressure of a foreign  body);
   in the development of feebly nourished muscles, the correction of
   spinal curvatures, the various forms of female diseases;  in stimu-
   lating peristaltic and vermicular motion in the intestines, and thus
   relieving constipation; in influencing the stomach and liver, as in
   kneading, shaking and succussions, thus affording relief in dyspep-
   sia and derangements of the liver.   We find, too, a tonic effect
   as the result of their employment; hence, debility of the  muscular
   and nervous'systems soon shows evidences of improvement under
   their use.   They are found to be invaluable in spermatorrhoea,
   private  diseases, and general  prostration.   We might catalogue
   the long list of  distortions, malformations,  and diseases in which
   these mechanical principles and forces are either indispensable or
   of great value in affording relief and effecting cures; but the hints
   and suggestions hastily thrown together in this cursory chapter will
   suffice, we hope, to awaken interest and call attention to this all
   important subject. 
CHAPTER  IX.
   ATMOSPHERIC PRESSURE—ITS EFFECTS UPON THE HUMAN BODY-
              ITS INFLUENCE UPON HEALTH AND LIFE.

      ILLIONS upon millions of people have lived and died,
        not  only unconscious of the vital necessity of air to  life,
        its use in maintaining the temperature of the body, in
burning up the worn-out tissues, and in carrying off evaporating
and poisonous material; but in ignorance  of  the  fact  that  it
exerted any pressure whatever upon the body, or that variations
in this pressure affected health and life.
  True, its power was  seen in  the  tornado, the whirlwind, the
water-spout, the trade-winds and the typhoon; and its voice  was
heard in thunder, as its atoms, in the wake of lightning, collided
with each other, and reverberated with terrific grandeur; yet these
phenomena were not rationally explained or understood until the
pressure of the atmosphere was  demonstrated and proven.   By
the barometer, invented in  1643 by Torricelli, this pressure could
be measured  at various altitudes and  undei; different circum-
stances.   Pascal's elucidation of atmospheric pressure, five years
later, threw much additional light upon the subject.
  The statement was so startling and the human  body  was so
unconscious of this influence, that  it seemed impossible that a
pressure of thirty thousand pounds was constantly exerted upon
it at the level  of the  sea; yet such  is the well established  fact.
Soon after this truth was admitted, physicians imagined that they
saw  in  it  a glimmering ray of light dawning  for  the cure of
disease, and in accordance with their custom in all time the most
vague and contradictory theories were promulgated.   Dr. Hud-
son, of England, in  1664, proposed the treatment of acute diseases
by increased atmospheric pressure,  and of chronic diseases by
diminished pressure.
  But in the misty wilderness of theory the subject slept for more
than a hundred and fifty years.
  The use of diving bells  and the startling effects produced by
them upon the human system aroused a new interest in the mat- 
j6            POWER OF  ATMOSPHERIC PRESSURE.
ter;  but, like a somnambulist, it vaguely wandered, reaching no
definite results.
  After the publication of Colladon's reports on the effects of the
diving bell, and Junod's theory of the potential curative power of
atmospheric  pressure (could it be regulated at will), eccentric
and  one-idea  physicians  caught the  aerial mania, and started
numerous  institutions  in  Germany  and France,  which  were
known as "Compressed Air Baths,"  and " Rarified Air Baths,"
and were lauded  and puffed as  " Cure-Alls," but being in ig-
norance of,  or ignoring valuable and important adjuncts, their
efforts were unsatisfactory and futile, and their business resulted
in failure.
  Yet, as  a remedial agent, atmospheric pressure,  increased or
decreased at will, is of untold value.  While it is not  a cure-all
in the sense  usually claimed for new remedies, yet to ignore its
power is to deprive us of one of nature's greatest boons and bless-
ings.   The total pressure at the sea-level, as  has been stated, is
thirty  thousand  pounds on an average body; and for the  first
thousand feet that we ascend the pressure is lessened about twen-
ty-five hundred pounds ; at an elevation of a thousand feet, about
forty-eight  hundred pounds; and at three and a half miles,  one-
half  the pressure,  gr fifteen thousand pounds, is taken off.   This
can be readily understood when we reflect  that, the  higher we
ascend the less air there is above us and the more there is below
us; and, vice versa, the lower we descend toward the level of the
sea the greater the  thickness of the  stratum,  and consequently
the greater the weight of the air above us.   When we ascend a
high mountain the heart beats faster, and  the blood is  thrown to
the surface in greater quantities, and with  more rapidity.   The
reason for this is found not in an increase in the  force of the heart's
action, but in diminished force or opposition, brought about by the
withdrawal in part of the atmospheric pressure: hence, the  lips,
eyes and nose may bleed; the vessels near the surface become en-
larged and turgid; face red; and if we go high enough the blood
may exude from the mucous membranes  of  the nose, mouth and
other parts.  On  the other hand, if we descend in a diving bell,
or into one of the cassions used in the construction of bridges at
London, and more recently in St.  Louis, New York and other
localities in the United States, the face, hands and surface of the 
              EFFECTS OF  ATMOSPHERIC  PRESSURE.            JJ
body generally, become pallid and shrunken—giving, where the
pressure is very great, the  appearance of death.
  The heart is taxed with  an additional burden, and is unable to
force the blood along through the smaller vessels of the skin and
muscles, and  thus keep them  distended, because the external
pressure is forcing it back with terrible  power,  operating  upon
the entire surface of the body.   The brain and spinal cord suffer
more in  consequence of this pressure, because of the bony pro-
tection  afforded them  by the skull and spinal column.  The
skull is an unyielding bony sphere, hence it can not contract like
the walls of the abdomen  and the skin and soft structures gener-
ally, and it surrounds and protects the brain as the  spinal  column
surrounds and protects the spinal  cord.
   Now when the blood,  under this immense pressure,  recedes
from the periphery and from the soft parts, and  is  finally driven
out of the cavities of the abdomen, and  even, to a certain extent,
of the thorax, it accumulates in the cavity of the skull and in the
spinal column, filling and distending the vessels and resulting in va-
rious disturbances and lesions of interest and importance, as we
shall see.  The lungs and liver are partially protected only, by the
bones of the  chest,  yet they suffer in consequence of the con-
gestion produced by the general pressure.
   Paralysis is a most frequent  result of increased pressure, and
those who died from its effects were found to have  congestion  of
the  brain and spinal cord, and  sometimes of the lungs.  While
in the caissons the senses of hearing, taste, touch and smell were
impaired, speech was difficult, and whistling impossible.   Motion
is more difficult than in an ordinary atmosphere, and even  a watch
will run more slowly and lose time in  a  dense atmosphere,  while
it will gain time in a rarer  one.
   A remarkable fact, in connection with the effect produced upon
the  body by  a brief stay  in an atmosphere  of forty pounds  or
more to  the  square  inch,  is that the ill results are often not ap-
parent until the pressure is removed by bringing the subject into
the open air, when pain, vertigo or paralysis may speedily ensue.
While the active force is in operation  the sensibility is benumbed,
and  on removal of the pressure reaction occurs, and with it return-
ing  sensibility.   If  persons thus  exposed are not speedily  re-
moved, death will take place. 
78              DEATH  SOMETIMES THE RESULT.
  When violence or injury causes severe and serious lesions, pain
and inflammatory action follow; they do not attend the accident,
but follow.  So too, when a severe exposure to wet or cold occurs,
the pneumonia, or inflammation of the brain, which may  be in-
duced, does not show itself immediately; or  if we sit upon a hard
body,  as the  edge of a bench or  chair,  until the leg becomes
numb and fails to respond to  our  will,  the  electric shocks, the
tingling and pain will be felt at the moment when the obstructed
circulation is being re-established.   Another result produced by
a short stay in this compressed atmosphere, is an increased and
copious secretion of urine,  and also greatly augmented perspiration
—the sweat standing in great drops upon the clammy skin. The
specific gravity of the urine thus secreted is not lessened, showing
an increase in the  breaking down  and disintegration of  tissue.
Another evidence of increased activity in these molecular changes
is found in the increased  appetite of those employed as laborers
in these  caissons.
  If the pressure is long continued, the brain becomes  stupefied
and death follows.  Many practical and valuable deductions may
be drawn from the lessons so forcibly taught in the foregoing
illustrations.   Applying the  principle of increased or decreased
weight of atmosphere, we will find that facts  and experience bear
us out in the conclusions that would necessarily follow.   Atmos-
pheric pressure,  even  at the  sea-level, by  throwing an  undue
amount of blood into the  brain, becomes a fruitful source of brain
diseases.  We find that  the inhabitants of mountains and ele-
vated countries and districts are comparativley free from apoplexy,
paralysis, and  other troubles and diseases originating at the brain:
this is true of all congestive diseases.  Thrombus and anemia are
exceptions,  perhaps, to this rule.  In the valleys and low lands,
congestions of the  brain,   liver and lungs are  prevalent.  The
brain is  less tolerant of stimulants in low lands  than  in  high,
because of the increased atmospheric pressure to which it is sub-
jected.   Hence, intemperance in eating or drinking, or undue ex-
cesses or exposures,  are  more dangerous in the low  countries
than in the mountainous regions.
  Neuralgia is increased by atmospheric pressure.  In very lean
persons,  where from a deficiency of fat the  bones are  not suffi-
ciently padded and protected,  the pain may perhaps be  greatly 
                       AN ILLUSTRATION.                     jg

aggravated by the mechanical pressure of the air  exerted  upon
the skin covering the prominences, and  pressing  directly  upon
the nerves lying between the point of pressure and the  point  of
resistance.
   In functional derangement and disease of the liver, a removal
to a more elevated locality, other things being equally favorable,
is  usually followed by decided improvement  or complete relief.
   From these and  kindred phenomena,  we find that marked
changes do occur under variations of atmospheric  pressure, and
that by making these facts available as curative agents, when the
condition of a patient is such as to require treatment, we proceed
to treat the case by  applying the means to increase or  diminish
the external  pressure, as the  case demands, and relieve the
affected organs  or members, or  even the  whole body,  and thus
afford the blood vessels time and  opportunity to return to  their
natural conditions,  thereby preventing serious, permanent con-
gestion of organs which control the vital processes  of life.   Fur-
thermore, if a limb is enfeebled by paralysis or other cause, blood
may be forced  into it, and a renewal  of  muscular action and
nerve-force be imparted to the enfeebled member, and its proper
functions be  re-established.
   To  do this, it  is  not necessary to  remove the paralytic  or
billious patient  to the mountain  regions, or to the sea shore,  in
order that he may have the benefits of rarified or condensed air, for
by means provided at the Surgical Institute we can place a limb,
or any portion of the body, or the entire body, in an atmosphere
dense  or rare as we choose, thus relieving the brain,  liver and
spinal  cord of the excess of pressure, and bringing back to a
wasted, shriveled,  useless  limb, the returning glow which follows
the introduction of an increased quantity of the fluids so necessary
and vital to the performance of normal  functions.
   By these means we cause the blood to flow in  large  or  small
quantities, as may be desired, to various parts of the body,  mod-
ifying  the circulation in them at will.   It may be suggested that
rarified or condensed air can not be permanently  provided and
supplied by artificial means.   Very true; and could we  do  so it
would  not be desirable.   We only need the use of either  to lift
temporarily the  burden, and give to nature the opportunity  of
doing the work she ever faithfully performs in the cure of disease. 
So
AN EXPERIMENT.
  Medicines are, or should be,  administered upon this  principle
as a rule.   A simple experiment, easily made, will serve to illus-
trate one of the many effects of atmospheric pressure  upon the
circulation of the blood, and through it upon the brain, nervous
centres  and general system.   Stand erect, the shoulders thrown
well back,  chest free:  take a deep, long  breath, expanding  the
lungs to their full capacity; retain the air thus forcibly inspired as
long as  you can, then suddenly expel  it by a  forced  expiration.
A sense of giddiness, dizziness, or temporary loss of consciousness,
or confusion  of ideas, may follow.   The  excess of air that you
have drawn into the lungs displaces and drives out from the lungs
a quantity of blood which flows in part to  the brain, and the gen-
eral circulation is  momentarily  impeded;  then, the sudden  ex-
pulsion  of the air from the lungs, calls back the blood hurriedly
from the brain, and the result of this disturbance in  the equable
flow of the blood is seen in the dizziness and confusion that follow
the experiment.
  Can any sane mind,  in this  age, doubt for  a moment that a
difference of one,  two, or five  thousand  pounds pressure upon
the surface of the  body would make a  great  variation in  the
heart's action, in digestion, respiration, or the secretory functions?
No machine under heaven, except   the work  of the Divine
Architect, could endure  the  wonderful range  of pressure and
change  of circumstances.   And these are modified in their action
by the physical conditions surrounding them.    Every creature is
endowed with a given amount of defensive and offensive power,
and either may be exhausted.   You may suggest that the air in
the body counteracts the external pressure.  Not so.   '' No two
bodies can occupy the same space at the same time."  Physiolo-
gists agree that about three-fourths of the  whole body is water;
the balance, solid  bones or other tissues.  Every minute mesh
or interstice in these, are filled  with water.   Now,  whatever air
water may absorb is contained in the body at all times.  You say
high pressure causes greater absorption of  air by the fluids of the
body.   Blood taken from animals in these caissons, and tested by
the most careful experts, proves it to contain no increased amount
of air.  But if it were true (which it is not) that more air is forced
into the body while under pressure, does  this mitigate  the con-
dition?   Is not air condensed  by pressuse,  and is not  every 
A CONFIRMED FACT.
8l
particle of tissue in the body compressed equally as hard, whether
it is done by elastic air condensed on the inside as well as  on the
outside?   There  is no evading the fact, that most serious, or
most beneficial results, may follow the  change  of  atmospheric
pressure.
       6
! 
CHAPTER X.
                          ELECTRICITY.

      VER since the discovery of this subtle agent, the medical
       profession has been  trying to utilize it as a remedial agent
       for the treatment of diseases.   At the  present  time  it is
 used to quite a considerable extent,  by a few scientific physi-
 cians and surgeons,  with results that are often times wondrous.
 It is an agent of great power, and should never be used except as
 prescribed by those who understand its peculiar qualities.   The
 dose to be administered should  be as carefully defined  as that of
 any of the powerful drugs  and medicines of the materia mcdica.
 It would be quite as scientific for the physician to direct his patient
 to take medicine, without prescribing the kind,  quality and quan-
 tity, as it would for him to direct him to take electricity without
 prescribing  the  proper dose to be taken, as well as the kind,
 quality, and quantity of it;  for it should be remembered  that elec-
 tricity has various  forms;  is possessed of several qualities;  and
 may be varied in quantity, from a gentle, insensible current pass-
 ing through the system, to that of very powerful shocks.  More-
'Over, it is not introduced into the system as medicine is into the
 stomach, but can be applied directly to the diseased organs, or any
 portion of the body; and this wonderful power of adaptation is the
principle that gives to it, among other things, its inestimable value.
   The people have faith in its curative powers  to such an extent
that many will trust the charlatan to administer it, and doubtless
 many have been benefited  by its use under such circumstances;
 but,  on  the  other  hand, very great harm has often been done
 by such unscientific and indiscriminate use of it.
   It is an agent of too great a power to be trifled with or to be
 used  by unskilled hands, and no one should permit its  use, ex-
cept it be prescribed by one who thoroughly understands how to
properly administer it.   As a remedial  agent, it  is indicated in
 many forms  of  nervous diseases.  Of all the known  remedial
means in use at the  present time, none are so closely allied to
the so-called nervous force as electricity is; and none  come so 
           POWERFUL, STIMULATING, SEDATIVE TONIC.          8}

near supplying  the  place  of the  interrupted nervous fluid, that
originates in the nervous  centers, as it  does.   Such being the
fact, this wonderful agent is entitled to a high place in the list of
remedial means, for  the treatment of diseases arising from or fol-
lowed by derangements and disturbances of the nervous system.
In  scientific  hands,  electricity  is superseding the use  of many
medicines that were formerly used.
  When the use of electricity is more generally and better under-
stood ; when the general laws that govern and control the health
are more carefully observed by  the masses, very much less  med-
icine will be consumed; people will  live longer, enjoy more im-
munity from disease, and be infinitely happier in all stations and
relations of life,  than can possibly be  under the present artificial
system of living and overdrugging.
  It may be asked what are some of the indications for the use
of electricity.  It is a powerful stimulating, sedative tonic, and as
such is indicated in a great variety of diseases.   Very many dis-
eases of apparently opposite characters are treated successfully
by  this agent, and it is because of the wide range of its therapeu-
tical use, that makes it so valuable in the hands of the judicious
electrician.  When applied to the diseased body it improz>es nutri-
tion, and renders direct aid to all  the processes  of restoration.
  In paralysis, when  the limbs are  shrunken  and powerless,  it
stimulates the flow  of blood  to the parts, increases  the nerve
force, and thus  favors the muscular growth and renews the life
and actions of the limbs.   In neuralgia, the result of its use is the
re-establishing of the interrupted nerve currents, and  thus re-
lieves the pain.   Its remedial powers are often  manifested in the
removal  of abnormal growths,  tumors, etc.   It is not intended
in  this work to designate the particular diseases in which  its
use is  known to be  of value, but to  state to the reader that we
resort to its use daily in a very great variety of diseased condi-
tions, with success, and in many cases the results are marvelous.
Administered with proper caution and skill, it works wonders in
the art of  healing, causing the lame to walk, the blind to see,
the deaf to hear, and unloosening the paralyzed tongue,  that  it
may  speak.   This is  not an over-drawn picture, for all these
results and conditions have occurred  in the treatment of patients
in the National Surgical Institute. 
CHAPTER XI.
                          SURGERY.

C^HE word surgeon is a contraction of the French word chirar-
%P J geon.   The two original words from which it was  derived
   t  mean " hand" and " work; "  hence, surgery is understood
to be that part of the healing art which  relates to the treatment
of external diseases, and  particularly to the manual  operations
employed for their cure.   The popular idea that surgery consists
mainly in the free  and extensive use of  the scalpel and the catlin
—in other words, in " cutting and slashing" generally—is quite
an erroneous one.   If the people are to be set  right  upon  this
subject, give them correct, sensible,  and reasonable ideas of the
great mission of surgery;  let them understand that surgery is not
a thing to be dreaded and shunned,  but that genuine  surgery is
their true friend and benefactor.
  Before  the people can  accept  this truth, much of the pomp
and circumstance thrown about capital and severe surgical opera-
tions must be abolished,  and the people be informed that the
object is to save and preserve, rather than  mutilate  or  destroy
injured and diseased portions of the human  frame divine.  The
operation should always be for  the good of the patient, not for
the  benefit  of  the  operator.  There is a world-wide difference
between genuine and spurious surgery.   The one is unassuming,
conservative, yet decided and bold; gentle,  yet unmoved  and
intrepid;  seeing and comprehending the end from the beginning,
yet giving no unnecessary pain or inconvenience in its attainment;
mindful only of the patient's welfare, and oblivious of private or
mercenary ends.  The other seeks,  first, to enhance the reputa-
tion of the operator, making  his claims paramount to those of
patient and friends, and deciding doubtful points in his favor.
   The populace is charmed, amazed, and captivated by the suc-
cessful  and  bold  capital operation,  without once stopping to
inquire if the sacrifice was unavoidable.   Let it be understood that
the chief glory of surgical science,  and the broad, inviting field 
          LIVES SAVED AND THE AFFLICTED MADE GLAD.        85

for its most earnest and successful labor, are not  in brilliant and
great operations alone, where members are removed or destroyed;
but rather in the every day work, where pain,  suffering, and de-
formity are relieved and removed, lives  saved, and the afflicted
restored and made glad.
  Many surgeons have fallen into the error of attaching too lit-
tle importance to the preparatory, and also to the after treatment
of the patient.   In the  majority of cases the "operation" is in
reality but a small part  of the treatment, and should not receive
exclusive or  undue attention.   It is infinitely better to rely more
upon mechanical devices,  and well  gotten  up appliances for the
removal of a tumor, the cure by absorption  of an hypertrophy,
or the straightening of a crooked limb, than to resort hastily to
the knife, make  a dashing operation, and then neglect the careful,
patient work which should follow, in order to make it in the high-
est degree successful.  Experience has taught that  the severity
of surgical operations may be greatly  modified, the shock  less-
ened, danger and pain avoided or mitigated,  by due attention to
conservative principles.   Not only  so, but  it also demonstrates
the fact that many surgical operations which, if performed early
in the treatment, would be formidable in character, may be avoided
entirely, and the same  results, or better, be reached by proper
mechanical and  medical means.
  Let it not be  understood that  we underestimate or place too
low a value upon real skill and dexterity in  the  performance of
necessary surgical operations.   What we  protest against  is the
fact, that the desire to improve an  opportunity and  gain  favor,
too often predominates in making a decision as to the propriety
and necessity of putting the patient upon the operating table, and
the doubt is given in favor of the operator,  not  of the suffering
and powerless patient.  The proportion of cases in which surgical
interference is required at once, in order to save life,  or avert
terrible calamity, is small indeed when compared with  the great
army of patients, chronic sufferers,  who drag along from  day to
day, dying for want of  proper surgical treatment.
  An artery is occasionally wounded  or severed by  accident or
design, a grain of corn  or a bean passes suddenly into the wind-
pipe, a sudden asphyxia may occur, or poison may be swallowed,
in either case requiring prompt,  ready, and  efficient surgical or 
86         WELL DONE,  GOOD AND FAITHFUL SERVANT.
medical aid;  but these cases occur infrequently, and the surgeon
who waits only for opportunities to ligate arteries, open the wind-
pipe, re-establish  suspended  respiration,  administer antidotes,
or use the stomach-pump, will find  much leisure for reflection
and  long intervals between  calls; while he who buckles  on the
whole armor, and by faithful, earnest, unremitting work and study,
qualifies himself for the discharge of  the duties and responsibili-
ties  of the true surgeon, may reasonably expect his full share  of
professional work, and,  if true  to his  trusts, in the end he may
claim the reward of "well done, good and faithful servant." 
CHAPTER1 XII.
DISEASES  OF THE BONES.
     >ONES are composed of animal  matter and earthy phos-
       phates, the latter increasing with age, rendering the bones
       friable and brittle.
  The exterior or cortex of the bones is dense and hard, and is
nourished by blood vessels ramifying  the investing or periosteal
membrane.
  The interior  of them is  cancelous,  soft, and spongy,
and is nourished by blood vessels ramifying the canals.
If the  exterior of a bone should be denuded of its nu-
trient membrane, it dies, and the  dead pieces exfoliate.
  The interior being cancelous,  is liable to deposits of a
cancerous, scrofulous, or  tuberculous character.
  Near the large joints the bones  expand, and become
more  porous and vascular, and the size  of the articular
surfaces is increased, and they are covered with a smooth,
shining cartilage, which is  also subject to disease.
  Bones  are subject to various forms of disease, such as
inflammations,  atrophy, hypertrophy, rickets,  &c.  In-
flammation of the bones may be either acute or chronic,
and may arise from injuries or some vice of constitution,
            such  as  syphilis, scrofula,  cancer, rheumatism, &c.
            The shafts and extremities  of long bones are most
                      frequently affected, and the bones of the
                      lower extremities are   more  frequently
                           affected than those of the upper.
                             Acute inflammation of the bones is
                           always a grave affection, and is gen-
                                       erally the result of ex-
                                       posure or injury, and is
                                       usually met with in fee-
                                       ble and scrofulous sub-
 
88
SYMPTOMS OF ACUTE AND CHRONIC INFLAMMATION.
jects, while growing.   It  may be  ushered in with a deep, aching
pain, or with high fever and great constitutional disturbance, or
both ; the  bone becomes exceedingly tender,  the surrounding
tissues soon become  involved  and swollen,  rigors  supervene,
abscesses form, and the matter finds its way  out,  and fistulous
                                  openings are made through
                  55s!S5^^TS!^-—-s*^ which  it  continues  to  dis-
                                  charge,  frequently  accom-
                                  panied with dead pieces of
                                  bone.   If the  inflammation
should commence in the cancelous  structure, this condition is  not
reached  so soon as when it commences in the investing mem-
brane, but in either case it almost invariably ends in the death of
more or  less of the bone, which then acts as a foreign body,  and
must be thrown off by the efforts of nature, or removed by  sur-
gical interference.  Sometimes large portions of the cancelous
structure dies,  and is enveloped within healthy or sound  bone,
having fistulous openings through the  shell  or cortex.  These
pieces of dead bone are called sequestra.
   Chronic inflammation of the  bones is but little else than acute
inflammation modified by time or circumstances.   The bones are
invariably found carious, and this  condition is sufficient to con-
tinue the inflammation as an effort of nature to rid the system of
the  broken down and disintegrated structure.   The  symptoms,
as would be expected, are nearly identical—the only difference
being in intensity;  the pain is less  severe,  the parts  are not so
tender, and the constitutional symptoms are
less urgent.  However, in chronic as well as
in acute  inflammation of the bones, the  ten-
dency is to necrosis,  or death of the  bones
or parts  of them.   Should the exterior and
interior both die, the prospect for new bone
forming is hopeless; but a sequestrum may
be  removed   with every
prospect of a  new forma-
tion, provided the nutrient
membrane be left sound.
   Disease of  the bones,
either acute   or  chronic,
 
                   DELAYS ARE DANGEROUS.                 89
may be attended with, or followed by, more or less deformities of
one kind or another, and hence too early attention  can not be
bestowed upon this disease, as frightful ravages may be avoided,
and great pain and deformity prevented.
  Hundreds who are limping on such legs and suffering with such
arms, can  just as well have  sound ones if they desire  them.
Their treatment is simple, giving relief at once,  and a cure in a
few weeks. 
*
                      CHAPTER XIII.

                    DISEASES OF TEE JOINTS.

Q||rT is unnecessary to weary the reader with a lengthy disserta-
mm  tion on the anatomy of the joints, or the pathology of their
 f    diseases;  but in order that we may convey some idea of the
terrible  consequences resulting from their disease, we will state in
brief that the bony framework is admirably formed, and peculiarly
adapted by an all-wise  Creator,  for the support of the numerous
organs and  complicated  machinery which compose  the human
body, and the joints are  far more intricate and beautiful in con-
struction and movements than the mind of man can conceive.
  The bright,  silvery bands, or glittering ligaments, which hold
the bones together; the smooth,  shining  cartilage tipping the
ends of the bones and lining the sockets; the soft, elastic cushions
between the bones of the spinal column, giving  varied and easy
motion and adaptation,  being constantly reproduced as fast as worn
out; the lubricating fluid filling the saculated synovial  membrane,
lubricating the joint and preventing friction; the porous, vascular,
and semi-elastic  condition of the ends of the bones, with projec-
tions for the attachments of muscles, and grooves through which
the tendinous chords glide, each  part performing the work assigned
it so perfectly, and all acting in such harmony, render the joints
objects  of profound study and admiration—and, when diseased,
produce great depression and untold suffering.
  Multitudes throng the thoroughfares of our cities,  and may
be seen all over our broad land, distorted and twisted into  every
conceivable  shape, supported  by crutches or  canes,  hobbling
their  way  through the  world—objects of pity to the sympa-
thetic, and subjects of derision to the thoughtless.   Like King
Richard, these unfortunate cripples  "have  no  delight to pass
their time away, unless it be to  spy their shadow in the sun, and
descant on their own deformities."
  The great distress  and  suffering to which these unfortunates
have  been subject, is  only known to themselves.  Their mental 
           OBJECTS OF PITY AND SUBJECTS OF DERISION.         91

agony is but little less than their physical suffering.   A conscious-
ness of increasing deformity, the physical suffering always present,
the cause of which is but imperfectly understood, the  prospects
for relief under the ordinary management naught but discouraging,
the constant dread of what the future may bring forth,  the  de-
struction of all early formed hopes for the future of life—all these
prey upon the mind, rendering the  poor unfortunates  miserable
indeed,  and objects of unfeigned pity and commiseration.
   Disease of the joints frequently comes on insidiously.   It often
arises without any apparent  cause, beginning with  a slight pain
or a scarcely noticeable inconvenience.   This is followed by a
sharper pain, or possibly by some inflammation.  The sufferer pays
little or no attention to these premonitory symptoms,  and soon
there comes  a sense  of stiffness  in the joint,  with  restricted
motion.   Then, gathering strength by  what it  feeds upon,  the
pain becomes intensified, the throbbing more severe, great swell-
ings with rigors supervene, large abscesses form, which bursting,
discharge, and a fearful work is done.  Thus the strong  man or
the tender child (if left alive), is twisted and deformed.
   The joints  most subject to  disease, and which when  diseased
produce the greatest amount of physical suffering, constitutional
disturbance and deformity, are the spine, hip and knee.
   Inflammation of the joints usually begins either in the synovial
membrane,  or in the soft and spongy portions of the bones, and
from thence spreads to the surrounding tissues, frequently involv-
ing all the structures in and around the joint.   The synovial mem-
branes,  like the serous membranes,  which line the  cavity of  the
abdomen, the walls of the  chest, and invest or cover  the brain,
are shut sacks, highly  vascular, exceedingly sensitive and irrita-
ble, and, when disturbed by  disease or injury, are prone to active
inflammation, which frequently runs a  rapid course,  ending in
effusions, adhesions, fearful destruction and deformity.
   It makes but little difference whether the inflammation begins
in the synovial membrane or the bones, the entire joint is sooner
or later  involved, and if not  promptly and properly  treated must
almost invariably end in great  suffering and deformity, or death.
  The fact is now well established and admitted beyond question
(as it should  have  been long ago), that there  is but one way
to treat such  diseases  successfully, and that  is with a well fitted 
92
MECHANICAL APPLIANCES INDISPENSABLE.
apparatus.  This apparatus—as  a foundation,  a necessary pre-
requisite  to  successful medication—must  be  changed and re-
adjusted from time to time, as each  individual case may require,
and  as the cure  progresses.   Certain  ends are  to  be accom-
plished by it, which can be accomplished in no other possible way.
Medicine and  local applications  are important and useful  as
adjuncts, but if the patient is to be saved months of great suffer-
ing and life-long deformity,  proper mechanical appliances are
absolutely indispensable.

                        HIP  DISEASE.
  When we consider the importance of so useful a joint as that
of the hip, we are surprised  at the indifference  so  often  mani-
fested as to the consequences resulting from the diseases effecting
it.  If parents would  only consider,  and recognize fully their
responsibility to their children, and their duty toward them when
overtaken by disease, they could not calmly observe the progress
of that dreadful malady,  hip disease, which inflicts  so  much tor-
ture, and entails such hideous deformity,  without availing them- 
       HOW INFLAMMATION OF THE JOINTS USUALLY BEGINS.     93

selves of every means which Providence has brought within their
reach for their relief; and yet, all about us, parents may be seen
watching with apparent indifference, while from day to day  the
monster grapples with the very life of their children, and insidiously
works their destruction, or blasts forever their future prospects for
usefulness, leaving them stalking monitors of careless indifference.
  The first  indications of this disease, in many instances,  are
so obscure as almost to escape the notice of the  patient.   The
attention may be first arrested  by  a stiffness  about the  hip,
restricting, somewhat, the motion of  the joint, producing a sense
of weariness of the  limb, especially after exercise; sometimes  a
dragging of the foot, with  a dull, aching  pain,  extending  down
the thigh to the inside of the knee,  is observed.  Gradually the
pain in the knee  becomes more and more intense, occurring in
paroxysms,  chiefly at evening  and  night;  handling the limb
provokes an  increase of pain.   If the patient  stoops,  he will
bend the  sound  knee  only—if  he  stands,  he will  place  the
afflicted  limb in advance of the other—he can not support the
body in  a perpendicular direction, but is obliged  to rest on  the
sound  side, both in the erect and  recumbent positions.

                                       1    <<%iji'   ***^
     As Received. As Dismissed.            As Received.  As Dismissed.

  As the disease advances, the  patient becomes feverish and
fretful, and, toward evening and night, restless; loss of appetite,
with general  debility, supervenes; the muscles of the thigh be-
come soft  and flabby; the hip is flattened, and the  leg  length-
ened.  If the  disease  be  not arrested,  all the  symptoms are
greatly aggravated ;  the pain in the knee becomes more intense;
 
94               SYMPTOMS OF HIP  DISEASE.
movement of the limb produces intense suffering;  deep seated
pain is felt in the socket;  the surrounding parts become swollen,
hot and tender; the fever is augmented, and is of a hectic type;
rigors are  felt;  abscesses  form, which, when opened, discharge
a  sanious  or  curdy  matter, sometimes attended with pieces of
bone.   The head and sometimes more of the bone is destroyed;
the ligaments are softened and give way, and the bone slips from
the socket; the muscles contract, and the limb is shortened from
three to  four  inches; and, if the patient  be not worn out with
the long continued  suffering  and consequent  waste, he  may
finally recover, but  with  a  most  distressing deformity  and
lameness.
   Thousands  of  children  and  adults  annually fall victims to
this  disease, and  from the  prosecution  of the old, erroneous,
tedious,  and torturing treatment, many, after long endurance of
a  cruel  regimen, succumb,  and,  in  exhaustion, death  relieves
them  of their torment.   Others, scarcely  less fortunate, endure
their sufferings until,  after formation  of abscesses,  discharge of
matter, diseased bones, destruction of joints, untold suffering and
wasting  of the constitution,  nature  attempts relief and leaves
them  deformed for life.  These are  not far-fetched or  isolated
cases, but  the heart would ache and  the blood run cold at sight
of the untold number of just such sufferers all over  our land.
And  though  a father's stout  heart  and  protecting arm,  or a
mother's tender love for  her suffering  child, would sacrifice all
for its relief, yet with  disappointed  hopes their aching hearts
recoil as the child goes down.   Had not hundreds of just  such
sad cases,   on  their way to  untimely  death  or  permanent
deformity, applied for relief, sympathy never would have been so
highly wrought, or necessity  for better means of relief so  keenly
felt.   No one but  the pitiful  sufferer can know or feel the reality
of a disease of the largest and most important joint of  the body,
and the  disease  of no other bones  except the spine  is  ever
fraught  with such pain or danger.   Any parent who  does not,
upon  the very first  symptoms of disease of the hip or spine,
at once  seek relief  at competent and experienced  hands, is
either unconscious of the  child's impending doom, or lost to all
parental  love or care; and the physician who does not, upon the
application of such cases, at once direct them to a surgeon who 
      SUFFERERS, ON FIRST SYMPTOMS, SHOULD SEEK RELIEF.    95

manufactures and fits proper apparatus for relief and support, and
makes a specialty of the treatment of such cases, does not do his
whole duty to the  suffering  or  himself.   Humanity and philan-
thropy should brand with ignoble scorn any
attempt,  through  selfish  interest or pro-
fessional  pride,  to  keep  a  sufferer  from
going to  institutions  established for the
cure  of  such  cases.   Your faithful and
competent physician,  who  has long and
ably combatted all the complicated or fatal
forms of fever, etc., is no more prepared to
treat hip or  spinal disease  than a black-
smith to  make a steam-engine,  a  house-
joiner to  make a piano, or we to treat con-
sumption or asthma.   It must  be made a
specialty.  Peculiar and perfectly adapted
apparatus,  which   can only be  made by
skillful workmen, directed by  the  expe-
rienced surgeon, must be applied, and treat-
ment quite different from that of ordinary
inflammation pursued.
  Some  cases of disease of  the hip  joint
are easily traceable  to falls,  injuries, etc.,
hut the majority of cases come without any assignable cause or
accident.
  Usually the first symptoms are weakness of  the leg, lameness,
and a sensation of fatigue and  pain  in the knee; sometimes in
the calf of the leg,  ankle, or along the side of the thigh ;  but in
most cases, for  a long time, the pain is referred to  the  knee.
The limb is handled cautiously, kept a little drawn up; but when
straightened seems a  little too  long.  At night the child is sud-
denly aroused and cries out with pain, and sleep  is disturbed by
a twitching and jerking of the leg.   During  this stage of the
disease the inflammation is confiaed  to the  acetabulum (socket)
and head of the femur (thigh bone).
  The synovial  and other membranes  now  begin  the  fearful
work of  destruction.   First the swelling  forces the bones  apart,
giving the limb a lengthened appearance; the hip is fl ittened,
and assumes a peculiar position.  The flesh or muscles of the leg
Figure 1. 
EARLY STAGES OF  HIP  JOINT  DISEASE.
diminish;  the limb is  smaller; this continuing, softening of the
bones, destruction of the synovial membrane and ligaments rap-
idly  follow, and while  in  this condition the symptoms  become
aggravated by contraction of the powerful muscles of the hip,
Figure 2.                         Figure 3.
and the head and neck of the bone by decomposition is changed
in shape.   (See Fig.  I).  The hip is more or  less swollen and
painful, and in many cases abscesses have, either before  or dur-
ing this change,  formed and broken,  discharging  a great quan-
tity of matter.   As the disease progresses, the limb is short-
ened.   (See Fig. 2.)   The patient, from long pain and suffering
from the terrible disease, losing flesh  and strength, looks more
or less  pale and  haggard; and, during the  formation of matter,
fever,   chills,  loss of appetite, etc., generally occur.
  As  the disease progresses, the destruction of  the bone contin-
ues; the dislocation becomes  greater as the head of the bone,
by  contraction of the muscles, slides higher  upon  the pelvis.
(See Fig. 3.)   The neck or head of the femur becomes  shorter, 
                         TREATMENT.                       gy

or even obliterated.  Extensive caries (death of the bones) takes
place;  the disease continues month after month, and sometimes
year after year.   Although the agony is to some extent abated,
yet a cure is by no means approaching, if left to the  ordinary
treatment.   If nature begins to make  repairs,  it is simply done
by effusion of lymph and binding  the  diseased bones together,
retaining  the limb in  the  contracted and  deformed condition,
making the leg from one to six inches too short, the hip thrown
back, and the joint stiff.                     *
  The  foregoing is the course of nine out of ten  of all cases of
hip disease.   Occasionally  we see an isolated case attended with
astonishingly  little  constitutional disturbance, going through
all the  stages, free  from suffering.   While this may  be occa-
sionally true, far—lamentably far—is  it from the untold agony
and  suffering endured by  many;  and, while  these mild  cases
occur,  there are  others  to whom death would be a most wel-
come messenger, since, even if they  live,  it is only to endure
pain and deformity.
                        TREATMENT.
  Treatment of disease of the hip should commence early, with
a perfect apparatus,  keeping the diseased bones  from  being
forced  together  by the  contraction of the  large muscles  of  the
hip,  and relieving at once all the pain and twitching of the limb.
  A thorough constitutional treatment should at once be adopted,
to sustain the vital forces and prevent  decline.   We  can  not in-
sist too much upon immediate  attention to such cases,  or  too
warmly deprecate or denounce the indifferent manner in which
they are generally treated.  Even in  this late day  of scientific
research and mechanical triumph, when such ample means  for
the restoration of the deformed are afforded, we find some phy-
sicians so ignorant or indifferent, as  to grope in darkness, and
seemingly shun or denounce the only means  of hope and  relief;
and, while they stand professedly  as guardians of the  sufferers'
physical safety, they seem to allow them to struggle in the agonies
of pain, torture, and deformity, with scarcely an emotion of pity or
an effort f#r relief.  This is, however, we are  happy to know,  the
case with but very few of the physicians at the present day, as
all who are honest, and care for the welfare  of their  patients,
       7 
98           NECESSITY OF  IMMEDIATE ATTENTION.

will  frankly confess that they have not the necessary apparatus
for the successful treatment  of such cases;  and hundreds are be-
ing  sent to this institution, which has been established especially
for their treatment.   The local practitioner  is thus  relieved of
the  great care and anxiety, and  the fruitless  task  of treating
such cases without apparatus  and other facilities, as well  as of
the reproach of the patient  and censure of friends on account of
deformity and failure to cure.
  As soon as inflammation commences, the limb becomes slightly
flexed, and as the disease progresses, the limb  obeys the law of
all other inflamed joints, seeking the most comfortable position.
An  inflammation  or  irritation of any part produces  contraction
of all the muscles involved,  or in close proximity to—as, when a
leg  is broken,  the irritation causes  the  muscles to contract and
shorten the limb.  When the abdomen is inflamed, the knees
are drawn up, etc., etc.  Now, the large gluteal, psoas, obturator,
and  other muscles, contract in hip  disease, and the  position
occupied  by all   limbs with inflamed joints is that  which will
allow relaxation   of  the  greatest  number  of  muscles  at the
same time.
  For instance, suppose the normal position of the leg in a line
with the body (No. 1, Fig. 12), and in this condition  the gluteal
muscles (back part of hip)  are fully contracted,  and the psoas
muscles (front part of hip) relaxed, and when the knee is drawn
up close to the abdomen (No. 3), the opposite muscles are relaxed
and  contracted, vice versa.   These muscles, being antagonistic,
will be most at rest just half way between the extreme points of
motion  (No.  2).   Thus all  inflamed joints become crooked, and
hence the danger of deformity, and the  necessity  of  immediate
attention, with suitable and comfortable apparatus, to  prevent or
relieve this difficulty.
  The rubber helix is a most admirable instrument for the treat-
ment of the inflamed joint, applying constant cold with a stream
of water, without moisture to the limb  or wetting the clothes,
maintaining a low temperature during the active stage of disease—
often, if not always, preventing suppuration.
  Hundreds of cripples, who have been made so from this disease,
are going through life upon  crutches, with the leg too short,  and
flexed upon the abdomen, as in Fig.  10, who, by the application 
AN ADMIRABLE  INSTRUMENT.
of proper apparatus, might have the limb straightened, thereby
lengthening it and making it useful.  Fig. 11 represents back view
of patient with apparatus applied.
Figure 10.               Figure 12.                 Figure 11.
   If your child or friend is suffering severely, and is very weak or
emaciated, do not listen for a moment to the statement that it is too
bad or weak to treat, or to have attention.  Hundreds of persons
are brought to the Surgical Institute on pillows or couches, to
obtain relief from suffering and pain, and prevention of deform-
ity.   Do  not wait  until destruction has done its  work, for  the
joint, ligaments, bones, and all the delicate structures are being
destroyed.   We say  again,  come at  once,  to save pain and
deformity.
   In the whole catalogue of human suffering, that of caries of the
hip joint is  most to be dreaded, and, strange as it  may  appear, 
IOO
TAKE  WARNING.
little has heretofore been done to mitigate the torture or cure the
disease.  The barbarous moxa, blisters,  seaton, the cautery, the
miserable, torturing farce of the weight and pulley, etc., etc., have
done their work to  increase suffering and deformity.
   Take warning, and as you love your child or your own life, do not
allow the above  treatment,  or any apparatus to be applied which,
               After Treatment.                   After Treatment.
As Received.   A useless and deformed   As Received.   He can walk erect
             limb is fully restored.               and without support.
by straps, pads, supports, plasters, or any device whatever, goes
around  the diseased hip or  groin  in  any manner.  All  such
appliances do harm ; they excite contraction of the muscles, and
press upon the tissues around the joint, increasing the sloughing
and deformity.   The diseased hip is  always too high without this
pressure.   Strange as it may seem,  we have devised  a complete
apparatus, that extends  the  diseased limb by  pressing upon the
sound hip, leaving the sore hip free from irritation, and for the ap-
plication of remedies.   And if you have been so unfortunate as to
have ordered or obtained any apparatus that is not made upon this
(the only true) principle, throw it away at once.  You never can
cure with  it, or get your money out of it, and the longer you wait
to see the result, the farther you are  drifting by neglect from  re-
covery, and the more you will have  to regret at last. 
THE  DISEASE ENTIRELY ERADICATED.             IOI
                    SUCCESSFUL TREATMENT.

   Letters from patients who have  been  under treatment  of the
National Surgical Institute:

  I was a sufferer for years with Hip Disease.  I found no relief until I applied
to the National Surgical Institute, and after  receiving treatment from  that body
for  a short space of time, I was restored  from a comparative dwarf to perfect
health.   To my fellow sufferers,  I would say  that the Institution is worthy your
attention.  To the  skeptical,  I would say,  investigate the matter.  To  the
afflicted in general, I would say, be relieved.
                                                 JESSE  ROGERS,
  August 24, 1873.                                       Speedwell, Tenn.
As Received.           The results attained
                    by skill and perseverance.
  My daughter, when eleven years old, was attacked most violently with hip-joint
disease.  Her sufferings were intense.  The leg became drawn up, and was two
inches too short.  I finally placed her under the treatment of the National Sur-
gical Institute, when all her pain and deformity were removed, the limb made as
long as natural, with the motion of the joint retained.
                                                    WM. H. TYLER,
                                              Reelsville, Putnam Co., Ind.

  My son (Charlie) suffered for years all the horrors attendant upon  the  severest
case of hip disease.  I tried all the means ordinarily used in the  treatment of this
class of cases, but to no effect other than to increase the trouble.  I had become 
102
DISEASES OF  THE  KNEE.
disheartened and discouraged, in the belief that his case was hopeless, and that
he would be doomed to a life of misery and deformity, when I heard of the
National Surgical Institute, to which I at once made application, and in the treat-
ment which followed I was made to rejoice in the restoration of my dear  child,
and I revere the memory of this most noble and able Institution.  The disease
was entirely eradicated, the  deformity almost entirely removed, and he is now
able to go about as well  as any one.                              __
      *                                 MRS. E. J. HARRISON,
                                                    Belleville, 111.

                  DISEASES OF THE KNEE.

   The knee, like  all other joints, is  subject to inflammation  and
disease.
   The articulate ends of the bones are broad, the synovial mem-
brane  large.  The  movements of these joints  are  complicated
and often rapid, at the same time they support the weight of the
entire  body.   They are less protected by muscles and other tis-
sues, consequently, more exposed to violence, injury and disease
than most of the other joints;  hence, statistics show that of all
the various joints of the body, diseases affecting the knees afford
a very large per centage.
   Disease of the knee may  result  from injuries,  rheumatism,
tubercular deposits within the soft and spongy ends of the bones,
scrofula, syphilis, etc.;  and is productive of great depression, dis- 
                   PREMONITORY  SYMPTOMS.                IO3

tress, and suffering, generally resulting in loss of limb or fearful
deformity.
  The importance of  the knee-joint  in locomotion,  and the
almost certain destruction of it if left alone or badly managed
when diseased, renders  it absolutely  necessary to  arrest the
inflammation  as  promptly as  possible.   The   ligaments  soon
become softened and lengthened, permitting displacement  of the
bones, abscesses may  form in or around  the  joint, frequently
the muscles contract and distort the limb, the bones of the lower
leg are drawn backward  so that the knee-cap  and bone of the
thigh shelve  over, adhesions of the fibrous structures take place,
the cartilages are destroyed,  and the bones thus divided,  coming
in contact,   sometimes grow  solidly together,  producing true
anchylosis or bony union.
  This contraction is due  to the fact  that  the  same trunks of
nerves whose branches supply the muscles moving the limb, also
supply the interior structures of the joint, and when inflamed, are
irritated and  keep the muscles in a state of spasm or contraction.
This spasmodic contraction  of the muscles  draws the ends  of
the diseased  bones together, and with every motion of the joint
there is a grinding irritation, which constantly augments and con-
tinues the inflammation.   So long  as this continues the  disease
will  continue.   We must  separate the diseased surfaces and re-
move the source of constant irritation. 
104
WELL FITTED APPARATUS NECESSARY.
  We might as well expect a  toe crushed under a stone to get
well while the stone remained upon it;  all the medicine in the
world would not  accomplish a cure while the cause producing
the trouble continues in force.  We must first remove the stone;
then, with proper care, the member will recover.   So with disease
of the knee; we must remove the pressure by separating the
bones which are held firmly together by contraction of the  mus-
cles, and by so doing we will relieve that source of irritation so that
a cure may be effected.  To do this, well fitted apparatus is abso-
lutely necessary.   In  no diseases  has  mechanical surgery  been
As Received. As Dismissed.
As Dismissed.   As Received. 
DISEASES PECULIAR TO THE ANKLE JOINT.           105
so triumphant as in the treatment of the diseases of the  joints,
and the knee-joint is  no  exception  to this rule.  Hundreds of
limbs are  thus  yearly  saved  from  destruction,  ulceration,  and
needless amputation.

                   RESULTS OF  TREATMENT.

  My daughter's knee had been  diseased for eight  years,  the joint being  much
enlarged, and the limb flexed at right angles.  All other treatment failed, until I
took her to the National  Surgical  Institution, at Indianapolis,  where the pain
was removed, the enlargement  reduced,  and the limb is now almost  entirely
straight, so that she can walk about comfortably  with a cane.  I believe in two
or three months she will be entirely restored.
                                             M. T. BRYAN,
                                                     Granville,  Ohio.

  My daughter's knee is improving very fast.   The leg is made perfectly straight,
and when placed under your treatment, was bent at right angles, from the knee.
She will soon no doubt be well  entirely.
                                        JAS. F.  MILSTEAD,
                                              Palo, Caldwell Co., Mo.

                        THE  ANKLE JOINT.

   Like the  hip and  knee, the ankle joint is exposed to injuries
from falls,  etc.,  and consequent inflammation and disease.
As Received.     As Dismissed.          As Received.   As Dismissed.
   Scrofula,  syphilis,  and gout effect  this joint, but  not so fre-
quently as  the  hip  and knee.   The structures  entering into
the composition  of the ankle joint, being  identical  with those  of 
106     THE VARIOUS AILMENTS OF THE SHOULDER JOINT.
the other joints, render  it, when diseased, subject to the same
morbid changes which effect them.   The  synovial  membrane,
the bones, cartilages,  and ligaments, are all subject to disease;
abscesses  may form  in  and around the joint, producing great
deformity, suffering, destruction, and lameness.   As the diseases
effecting this joint are identical with those effecting the others, it
is but rational to conclude that the treatment must be conducted
upon the same general principles, which consist in extension, rest,
and such constitutional and local measures  as the necessities of
each individual case may  demand.
  By these means cures are  made, and  untold suffering, lame-
ness, and deformity are prevented or relieved.

                   THE SHOULDER JOINT.
  The shoulder joint is composed of the same kinds of structure
as enter into the formation of other joints ;  and,  being a ball and
socket joint, it admits of  a great degree of  motion,  and is more
constantly used than other joints.   It would therefore be a mat-
ter of some  surprise that  it is  not more frequently diseasedi
were it not for the fact that it is relieved of  the constant pressure
to which the hip and knee are subject, in not  having to support
the weight of the body.  Nevertheless, it is occasionally subject to
disease resulting from  injuries, rheumatism, scrofula,  tubercular
deposits, etc., and when diseased is attended with great suffering.
The bones,  cartilages, synovial membrane,  and  other tissues
become  involved.  The  constitutional  symptoms  are  severe.
Abscesses form around the joint, which, discharging, leave fistu-
lous openings, frequently  connected with  dead bone, small pieces
of which sometimes escape.  There are  few diseased conditions
more severe than this, as they invariably lead to complete loss of
the joint if  not  promptly and properly treated.
  The treatment should  begin early.  Any  pain deep  seated
and continued in the shoulder should be regarded with suspicion,
as it may be the precursor of serious disease of the joint.
   Dislocations of the shoulder joint are frequently left unreduced,
thus depriving the  patient of the free  use  of the arm for life.
This maiming is not, as is generally supposed, incurable.   During
the past two years,  we have treated and entirely replaced and
cured many of these old dislocations of the shoulder, to the un- 
                THE  ELBOW AND WRIST JOINTS.             I07

speakable joy of the sufferers.  We append the names and ad-
dresses of two such, that parties similarly afflicted, who desire  to
do so, may learn  the  facts from the  patients themselves.  We
could give many others, but  these  will suffice :   Mr. Peeples,
Shelbyville, Ind; Mr. Beach, Nebraska City, Neb.

                    THE ELBOW JOINT.

  As in other joints, so  in the elbow, we meet with inflammation
involving the ends of the bones, synovial membrane, and, indeed,
all the structures entering into its formation.   Disease of this joint
may be  the  result of injuries, rheumatism,  scrofula,  cold, etc.
This joint being more complicated and exposed than the shoulder,
is more frequently effected.
  When it is inflamed, it is subject  to the same changes which
take place in other  joints, and which, if not arrested, will very
generally end in destruction.
  Early attention should be given to this disease, inasmuch as it
sometimes runs a rapid course, and the patient is made a cripple
before he is aware.
  The same  general principles apply in the treatment  of this  as
in other joints; rest,  extension,  local applications,  and constitu-
tional remedies.

                     THE WRIST JOINT.

  Diseases of the wrist are usually to be regarded  as  grave,,
inasmuch as  the small bones constituting the carpus are*  numer-
ous—each  supplied   with articular surfaces and synovial mem-
branes, and there may be no limit to  the  inflammation, as they
are in opposition one with another.   Inflammation of the wrist is
usually the result of rheumatism, scrofula, and injuries, and, like
the same affections of other joints, may produce the same morbid
results.
  Too early attention can not be  bestowed in the treatment  of
this joint, as  the cartilages are soon destroyed, and the bones  of
the wrist may unite and become anchylosed, and  the  joint ren-
dered useless.  Adhesions often take  place, producing permanent
contraction of the hand and fingers, thereby destroying the use-
fulness of the entire hand. 
io8
DISEASES OF THE  SMALLER  JOINTS.
                    FINGERS AND TOES.

  Contraction and distortion of the fingers and toes are not in-
frequent,  as a  result of disease,  injuries, scalds,  burns,  gout,
rheumatism, and paralysis;  and are occasionally seen as  con-
genital.  Such contractions of the fingers give rise to great annoy-
ance, destroying the usefulness of the hand,  and rendering it
unsightly and repulsive.
  When the toes are thus effected, they impede locomotion greatly,
and  frequently give rise to serious mischief.   These  deformities
can almost invariably be overcome with proper appliances. 
 
Explanation   of  ^late?.
                          FILES.

   Plate I.—Represents the intestine cut open as high up as a, knowing the
blood vessels on the inner coat of the bowels.  The larger folds in the •en-
ter below are pile tumors; at c, the tumors cut open; b, sphincter muscles.

   Plate II.—Fig.  2 is designed to represent, in life size, the lower bowel
rectum, with pile tumors protruding from  b to c, with engorged blood ves-
sels above the sphincter muscles, etc., in a bad case of piles.

   Plate III.—Fig. 1 represents the artery o, which conveys the blood from
the heart into the lower bowel; c. represents the vein that returns the blood;
the little loops a and b  represent the capillaries that connect the branches of
the vein and artery.
   Fig. 2 represents the artery -1, conveying the  blood to the lower bowel
vein ; B returning it, and the enlarged capillaries connecting the branches of
the two.  From B to C the vein is cut open, showing the decreased calibre
of the vein at G, after  being compressed for a length of time, rendering it
permanently too small  to convey the blood out of the enlarged sacks below
as fast as thrown in through artery A.
   Fig. 3 represents the artery 0, conveying the blood  to the lower bowel
and the enlarged capillaries or pile tumors; F connecting it with the vein
C.  S is designed to represent a collection of hardened feces (contents of
bowels) pressing upon the vein and  decreasing its  calibre, preventing the
return of blood from piles F.


                      FISTULA.

   There are three conditions in which Fistula in Ano may exist
   First—Complete Fistula (Fig. 5).—When the opening  is continuous
from the cavity of rectum or bowel,  to the surface of the skin, so that
liquids, gases, etc., escape.
   Second—Internal Incomplete Fistula (Fig. 6).—"When the opening ex-
tends from the inside of the rectum into the tissues surrounding it, but not
through the skin.  Many cases of this kind exist, while the sufferer is un-
conscious of the nature of the difficulty, supposing it to be piles, or some
trouble they know not what.
   Tliird—External Incomplete Fistula (Fig. 4).—When the opening ex-
tends through the  skin into the  tissues around the rectum, but  does not
enter the bowels.
   Other  complications, such  as pendulous tits or projections, from one-
fourth to one and a half inches in length, are attendant upon Fistula.   Two
or more openings may  appear in the skin, all communicating with the same
sinus, or opening into the rectum. 
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CHAPTER XIV.
                   DISEASES OF THE RECTUM.

    'HE rectum,  or lower  bowel, is the seat of many trouble-
      some,  annoying, and  dangerous diseases.   A false deli-
      cacy too often prevents early and prompt resort to proper
remedies for their removal.  Hence we are constantly meeting
patients who have suffered  months,  even  years, of  discomfort
and pain rather than  submit to necessary measures for relief.
Another cause that operates largely to encourage neglect is the
fear of painful or dangerous surgical operations, the dread of the
knife being universal.   From these causes, and from  inadequate
and improper treatment, the number of cases of diseases of the
rectum has reached a figure  that should cause alarm as well as
astonishment.  We can not stop to deal in abstract questions, or
go into an extended examination of the predisposing or  exciting
causes of these diseases.  It will suffice  bur present  purpose to
say, in brief, that the errors and  irregularities, as pointed out in
chapters on " Preservation of the Health," and on " Food," will
account reasonably, for most, if  not all, this fearful list of afflic-
tions.  Without repetition, therefore, we shall speak  practically
and plainly of the more common forms of disease as found in
the rectum.
  Piles, or hemorrhoids, are blood tumors caused by  obstructed
or retarded venous circulation, and undue fullness or distension
of the blood vessels.  These tumors may be  internal or external
to the sphincter or closing muscle of the bowel, and they may
exist in the form of small, well defined tumors, standing out from
the mucous surface of  the bowel, or they may be large, aggre-
gated, and in connection with a general thickening  and engorge-
ment  of the  mucous or lining  membrane.   They are a source
of much inconvenience and pain, particularly while  at stool, and
immediately after.   Bleeding from these tumors frequently occurs.
This,  with the depressing  influence so uniformly  felt, and the
impairment of the digestive organs  so sure to  accompany,  or 
110
PLAN OF THE CIRCULATION OF THE BLOOD.
*         precede,  the  disease,  is  sufficient to ruin, in time, the strongest
          constitution.
            To understand the rational treatment of piles, it is necessary
          first to be acquainted with the plan of the circulation of the blood,
          and the manner in which every part of the body is supplied with
          blood by the action of  the heart, and also with  the return of
          this blood to the heart  again, when it has served its purpose in
          the process of nutrition.   The blood, after being  purified in the
          lungs, is carried from the heart by means of arteries (vessels with
          three coats, and not easily compressed or closed  by pressure), to
          every part of the system.   These vessels branch, divide,  and
          sub-divide as they extend from the heart to the remote extremi-
          ties and surfaces of the  body,  until  they become  very minute
          and very numerous, and  finally connect with veins, which gather
          up this blood and return  it to the heart.   These  veins are  com-
          posed of thin, yielding coats, and are easily compressed.  Their
          minute branches unite,  by means of the capillaries, with the
          terminal  branches of the arteries.   Wherever an artery carries
          blood, there must be, close at hand, and connected with it, a vein
          to gather up and return this blood to the heart.   (See plate III.,
          Figures I and 2.)
            We  have seen that  the  coat of the artery  is dense  and un-
          yielding,  while the vein is thin  and easily compressed.   Now, if
          pressure  is applied equally to an artery and a *vein, the vein  will
          be compressed more than the artery, and the result will b2 that
          the artery, being relatively larger than the vein, will carry more
          blood  to  a given part;  hence the  part  will become distended
          and  engorged, or filled with blood.   This can bz demonstrated
          by tying  a string  around  the finger.  The  pressure djes not
          compress the arteries, and  make them smaller in the same pro-
          portion that   it  does  the  soft  veins, hence more  blood flows
          into  the  finger  than  flows out,  and the  result  is, as seen,
          distension of  blood vessels,  capillaries, and,  if long continued,
          great enlargement and tumefaction of the entire soft structures of
          the finger.  A vessel will become more or less inflamed, and its
          walls thickened,  if kept  partially or wholly closed for a consid-
          erable time; hence from pressure  the hemorrhoidal veins become
          too small to  return the  blood, while the  heart  continues, with
          the force of every pulsation or beat, aided by the force of gravity, 
A GREAT MISTAKE.
Ill
to drive the blood  through the enlarged arteries into the dis-
tended capillaries, thus causing a constant, superabundant supply
of blood in  the part, and giving increased suffering and enlarge-
ment, resulting in pile tumors.  The pressure that causes this
changed condition of the blood vessels may ariss:  i st—From the
hardened, impacted faeces in constipation of the bowels.  2d—By
contraction of the upper fibres of the sphincter muscle.  3d—By
the muscular contraction  of the intestines.  4th—By stricture of
the rectum.   5th—By derangement or obstruction of the  portal
circulation.
   Now, after a pile tumor has thus formed, the veins that  return
the blood, being made permanently too small, is it possible  that
medicine, applied to the tumor,  can enlarge the contracted veins
that are two inches or more above it in the bowel,  and that  it can
not possibly touch?   Has medicine any mechanical power to
force out the excess of blood in the tumor, even if  the contraction
was removed?  Certainly not.   And because treatment by medi-
cine alone must necessarily fail,  shall we  say there is  no  cure?
Disappointment and death  have followed this error,  and thus
people have been led to believe the disease incurable.   But this
is a great mistake.   Relief may  be obtained from all this pain
and nervous irritation, loss of  blood, wearing away of the consti-
tution, and danger to life.
   The nature of the treatment, our large  experience, and the
unqualified success attending it, present themselves to the gloomy
victim, as if to reassure and kindle fresh hopes of speedy deliver-
ance.   Life is jeopardised by operations with the  knife, hence it
should not be depended upon.   Dieting, cold water injections,
electricity, bouges, or compression, will not cure.   Painful, dan-
gerous treatment is hurtful, and should never be employed.   The
true principle of treatment is to make the calibre  of the arteries
equal only to that of the veins.  To allow no more blood to flow
to the parts  than the veins can carry away in the same time; to
make the influx and the efflux of blood exactly the same.
   In s:>me  cases it  is necessary to obliterate the small artery
entirely, thus cutting off the source of extra supply.  The tumors
will then speedily subside and disappear—and the  operation need
not be followed by pain, and is entirely free  from danger.  In
other cases a partial closing of the principal trunks of the arteries 
112
FISTULA IN ANO.
is all that is required to regulate the blood supply, and thus in-
augurate the process by which the change from distention, inflam-
mation and pain, to a natural and healthy condition, is brought
about.

                      FISTULA IN ANO.

  Fistula in ano, a discharging sinus, or ulcer,  near the anus, is
usually less painful, but more dangerous than  piles.   It  begins
with uneasiness, pain, or an intense itching about the anus, exter-
nally, and a little offensive discharge; or the first indication may
be a small abscess, or boil, which finally discharges matter.   The
soreness soon subsides,  but the discharge  of matter continues
and the sore does not heal  up, or  if it heals, it soon gets  sore
and breaks out again;  and this constant drain  upon the system
is liable, sooner or later,  to undermine the health and lead to con-
sumption, or other fatal diseases.
  Any unusual irritation or pain in, or the  discharge  of matter
from the rectum, should receive prompt attention,  while the cure
is so easily effected.   Even in confirmed cases of fistula,  the
operation  is not attended with danger, besides it is  simple and is
free  from the objections so forcibly urged by those  who use
the knife.   It is worse than folly  to attempt the  treatment of
either of these diseases—piles or fistula—by prescribing remedies,
without having first seen and examined the case.
  An idea is quite prevalent among the people that these affect-
ions  can be cured by 'the advertised specifics of the day.  Noth-
ing could  be more dangerous or  fatal.  The same remedy for
every phase and condition, could not meet  the demands of the
cases in which it is promiscuously employed, even  if it possessed
merit.   These  nostrums result in  disaster  and disappointment
to the patient.   Never neglect fistula; never attempt the foolish
task  of trying to get well under the use of medicines prescribed
by persons who are ignorant of your real condition and needs;
and,  above all, place yourself in the hands of those only who, by
reason of  their long observation and experience, are competent
to give you relief in  the  shortest  possible  time,  and without
suffering or danger.
  While piles and fistula are the more' common diseases, they
are by no  means the only ones which effect the rectum.   Indeed, 
        THE RECTUM IS THE SEAT OF MALIGNANT DISEASES.     11 3

from special reasons,  this seems to be a vulnerable and salient
point of attack.   Acute and  chronic  inflammations, ulcerations,
eruptions, syphilitic troubles,  stricture, malformations, cancer,
etc., here find frequent lodgment.
  A careful  examination  of the  patient,  with or  without  the
speculum, is indispensable to a correct knowledge of the nature
of the disease present, and the  kind of treatment needed to arrest
or cure.   The rectum is so often the  seat of malignant diseases,
and those that become incurable by neglect, that the early symp-
toms of trouble should attract the notice and receive the prompt
attention  of the subject, and  if not speedily corrected and re-
moved, proper treatment should be early secured.   Many slum-
ber  on in unconsciousness,  while cancer  or other threatening
dangers which they mistake for piles, or  some slight derange-
ment, is surely and stealthily fastening its coils about  them, and
they discover, but too late, the fatal error.   Taken  in time,  and
properly treated, diseases of the rectum may be readily arrested
and cured.   If  neglected they undermine  the health, wreck the
constitution,  and make  life  a  grievous burden, or terminate in a
lingering death.
8 
CHAPTER XV.
                         RHEUMATISM.
  +
     HEUMATISM is a constitutional disease, attended with a
      peculiar irritation or inflammation, to which nearly all parts
      of the system are liable, but  the tissues most  usually in-
volved are the fibrous, muscular, and nervous.
   For convenience of description, rheumatism may  be  divided
into four varieties, depending more or  less upon  the  grade and
the particular tissues involved :
The Acute, in which there is violent local inflammation, attended
     with constitutional disturbance and fever;
The Sub-acute, in which the  inflammation is less violent,  and
     there is little or no fever;
The Nervous, in which there is  neither inflammation nor fever,
     consisting almost exclusively in irritation, and especially di-
     rected to the nervous tissues;
The Chronic,  characterized by long duration,  and  the lowest
     grade of  inflammatory action.
   Acute rheumatism is almost invariably attended with more or
less  constitutional disturbance and fever, developing  itself,  how-
ever, as a local inflammation attacking one or more of the joints,
and  in a majority of cases the joints of the lower extremities.
There seems also to be a preference manifested for the large joints.
The disease may effect one joint  only,  or  the joints  of a whole
limb; or more frequently it  effects  several of  the  limbs,  and
sometimes  different portions  of the  trunk successively,  and it
may  occasionally  involve nearly the  entire  body.   The small
joints, such as the fingers and toes, are less frequently effected
than the large ones, such as the knee, ankle, elbow, and wrist.
   Commencing  in  one part,  the inflammation  may extend to
others, as from the ankle to the knee, or from the joints  of one
limb to the corresponding joints of the other, then to the wrist or
elbow, sometimes attacking  neighboring  parts, or even distant
parts in succession; sometimes deserting one part and attacking 
                  SYMPTOMS OF RHEUMATISM.               IIJ

another.  In most cases the inflammation is confined to the joints
and surrounding tissues.  Sometimes the disease is confined  to
the ligaments of a joint; at others  the  synovial membrane may
be involved, and indeed, the muscles, and investing  membrane of
the bone, the sheaths of tendons and  nerves, and  in this way a
whole limb may become effected, swollen, hot and tender.   The
gravity of the disease is greatly increased when the lining  or
investing membrane,  or the valves of  the heart are attacked,
or when the meningies or membranes of the brain, or spinal cord,
are effected.  Acute  rheumatism is generally  ushered in  with
violent pain, followed by heat and swelling; it may  begin with a
feeling of soreness or stiffness in the  part, which soon amounts
to positive pain, especially upon moving the part.   The surface
is usually reddened, but in some cases there is no change  in the
natural color.   Very  soon  after the local symptoms, and some-
times before, rigors  and  other symptoms  of approaching fever
are experienced;  the pulse becomes more  frequent, the tongue
furred, loss of appetite and  occasionally  headache  supervene.
The  fever is generally active, and  is proportionate  in violence to
the  local inflammation; the  surface is usually  warm,  though
not generally so hot as in other febrile affections.  Sometimes the
skin  is not  only moist, but the surface is bathed in perspiration,
which  has  a peculiar  sour and sickening odor, but even when
present does not in the least  mitigate the  pain or inflammation.
  The urine is high  colored, and  generally deposites a reddish
or brick dust  sediment  upon  cooling.   Perhaps there is  no
symptom of rheumatism so universally present as  pain,  which,
with the fever,  is usually  increased toward evening and night.
Atmospheric vicissitudes  and change  of  temperature  usually
aggravate the symptoms.
   Sub-acute rheumatism is a variety in  which the  constitutional
symptoms are very slight,  and all the symptons much less urgent
than in the acute variety,and its duration is ephemeral as com-
pared with the  chronic form.  While the acute variety expresses
a preference for the joints,  the sub-acute most  frequently effects
the muscles.   The local symptoms  are analagous to those of the
acute variety, though  much less severe;  the pain amounting often
to only a slight aching or soreness.  There  is but  little  heat  or
swelling, if the  seat be in  the joints, but one is usually effected 
ii6
NERVOUS AND CHRONIC RHEUMATISM.
at a time; a single muscle, or sets of muscles, may be involved;
pain may be entirely wanting  except on motion of the parts
effected, as in attempting to rise up or turn in bed.
   This  form is  much more liable  to  change about than either
of the  other varieties, on account  of  a strong constitutional
tendency, while the  local effection is feeble;  hence  it readily
yields to causes which give the irritation another direction.   This
variety  is intermediate between  the  acute and  nervous.   This
form may effect the muscular and fibrous tissues of the scalp, or
the muscles and fibrous coats of the eyes, or  the  mu scles of the
neck, under the name of stiff or wry  neck;  or the walls of the
chest, under the name of pleurodynia;  the  muscles of the  smxll
of the back,  in lumbago ; or the parts  about the hip, in sciatica;
and it sometimes attacks the membranes of the spinal cord, under
the name of spinal irritation.
   Nervous rheumatism is  a form unattended with fever, and is
without the least sign of inflammation;  it is  evinced  by pain or
other disordered sensation, and sometimes  by  irregularities in
the motor power.   Rheumatic  irritation may produce neuralgic
pains in almost any  part of the body.   The exciting causes of
this form of rheumatism are the same as  that  of other varieties.
   Chronic rheumatism is most frequently met with in  the joints;
yet it  sometimes attacks  other tissues, such as  the synovial or
serous membranes, the fibrous tissues and the muscles.   It may,
and no doubt often does occur as an  original disease, but most
generally it is a  consequence of the acute or sub-acute variety.
It 'n more fi.mly fixed than either of the other forms.   When
the museles are effected they may and often do  shr.nk or waste
away, and become shortened.  There is very little,  if any, fever, un-
less  an acute attack  should come on  with the chronic, which
sometimes happens in old cases.   It is often attended with stiffness
or immobility of the joints, from contraction and shortening of the
muscles, thickening and rigidity of the ligaments, and sometimes
from changes in the cartilages and bones, which undergo absorp-
tioa from the long continued irritation and  pressure caused by
the con .tant contraction of the muscles.  The joints are often
distorted, and the limbs deformed by  these causes; and in  long
continued cases the  muscles miy become  entirely  paralyzed.
This form of rheumatism  is sometim.s associated with a gouty 
             SMALLER JOINTS FREQUENTLY INVOLVED.          I IJ

condition of the system : then the different joints may be effected
with deposits of urate of soda, or the bones themselves may  be
enlarged.  While any of the joints  may be thus effected, yet the
small ones, such as the fingers and toes, are the most frequently
involved.  These nodosities increase as  the  disease advances-
deformity takes place; the fingers are bent or pushed  forwards
or backwards,  or to one side,  impeding motion.   If the large
joints should be effected in  this way, the poor patient would be
rendered helpless indeed. 
CHAPTER  XVI.
                       PLASTIC SURGERY.

     HERE is nothing more annoying and discomforting than a
      mutilated and disfigured face—always exposed to the gaze
      of the public.  With no means  of hiding the deformity,
the sufferer becomes the subject of remark and frequently of de-
rision.
  What  can destroy the symmetry of the face more than the
frightful contortions produced by scalds or burns—the cicatrix or
scar, twisting and distorting the countenance into every conceiv-
able shape ?
  What can be more repulsive than a face divested of that promi-
nent feature,  and useful member, the nose ?
  What  condition of the face can be more frightful than the loss
of a cheek, exposing the teeth and tongue ?
  How the loss of the lip by disease, or that congenital malforma-
tion, hare-lip, mars the features and detracts from the  beauty of
the face?  And yet thousands of  persons, young and old, are the
unfortunate subjects of these distressing deformities, produced by
calomel, cancer, catarrh, syphilis,  burns, etc., or the result of con-
genital malformations.   The great number of this  class of cases
in the country has induced the National Surgical  Institute to
give special attention to plastic surgery, with a view of affording
them  relief, and great advance has been made  in this branch of
surgery in the past few years,  insomuch that most  of  them  can
be rectified and all relieved.  While these operations on the face
are not dangerous,  and, in the main, are not attended with much
pain, yet to be successful they require long  experience  and con-
summate  skill; hence surgeons who are only occasionally called
upon to perform such operations, almost invariably fail of success. 
CHAPTER  XVII.
                           TUMORS.

    |ARIOUS enlargements and unnatural growths are found in
      the human body, which have received the name of tumors.
      These  may be  malignant,  or  non-malignant, hard, soft,
fleshy, fatty,  fibrous, brain-like, watery, cheesey,  etc., etc.   To
give lengthy descriptions of these  several varieties would result
in no practical  good  to the general reader.   To  determine the
nature and character of tumors, has long been considered a difficult
task, even for the professional man of large experience and varied
acquirements; hence it will be worse than folly for a non-profes-
sional individual having a tumor of any kind, to rely or depend
upon his own judgment in the  matter.
  Let it alone, don't handle  it, or make  any application  of medi-
cine whatever, but apply  at once to those, who, by reason of their
experience and qualifications, are best fitted to afford you relief.
Many tumors originally  benign in character,  have been goaded
into malignancy by  the injudicious treatment of meddlesome
old women, or physicians of limited experience.
  Many malignant tumors are incurable, and  all are,  if neglected.
Non-malignant tumors, with timely and proper means employed,
are amenable to treatment.  A very large class seem to occupy
medium ground, to partake somewhat of the  nature of both.
  It is here  that the greatest good is  often accomplished in
arresting the degeneration, preventing the accession of malignant
symptoms, and snatching the patient from a terrible fate.
  Never neglect these tumors.   A suspicious wart,  or mole, if
properly treated, may be forever removed, and thus  relieve you
of anxiety and  fear.  Subject it to irritating or exciting  in-
fluences,  and  a  metamorphosis  may speedily occur; and that
which was but a simple thing, scarcely worthy of your notice, so
recently,  may assume a fearful malignancy, sparing nothing in its
destructive march.
  The following cuts  sho\v tumors of the back, neck, and face, 
120         A WONDERFULLY LARGE TUMOR REMOVED.
all of which have since been successfully removed at the National
Surgical Institute.   These cases are  not selected  on account
of unusual size or peculiar location, yet they may be taken as fair
representatives of numerous classes of tumors and enlargements,
which are within the limit of safe surgical treatment.
  For many years I was tortured with a wonderfully large tumor on my back,
which was nearly as large round as my body.   It was a heavy burden and great
affliction.  I was told by many physicians to remove it, it would kill me, but I
resolved, over six years ago, to take the advice of the surgeons of the National
Surgical Institute, and had it removed. I am now perfectly well, so far as that
is concerned, and there is no sign whatever of any return.  The above is a correct
representation of my condition before operation.   The tumor weighed about forty
pounds, and the doctors made a cut sixteen inches long  to get it out.  Words do
not express my gratitude for my relief.
                                              MARTHA DEAN,
                                        Noblesville, Hamilton Co., Ind. 
CHAPTER  XVIII.
                          PARALYSIS.

     4AR back in the early history of the world, the pathology of
      paralysis was shrouded in profound mystery.   But  feeble
      if any attempts were made with a view of cure, and like
the leper, they who were thus afflicted were abandoned.   Hence
our Saviour, while on earth, selected a  case  of paralysis upon
which  to  perform one of his  most astounding and convincing
miracles.   Much of the same ignorance which prevailed then,
with reference to the pathology and cure of paralysis, has followed
the profession  of medicine down to the present century; and
notwithstanding much time had been  expended,  and extensive
research made in trying to develop something more definite as to
its nature, nothing very satisfactory was elicited.
  One theory after another was promulgated, which from time to
time prompted the  adoption of the most barbarous practices.
The poor unfortunate was made to writhe under the use of every
conceivable form of  counter-irritation.    Every department was
ransacked  for fresh instruments of torture, and among the appli-
ances brought into requisition were  the moxa, the red-hot iron,
the seton, irritating ointments of every description, such as tartar
emetic, blisters, etc., and a host of other  less severe appliances,
but all in vain.  The poor, unfortunate sufferer, after being almost
worn   out  with  this torture, was  left with  the  consoling
promise that he would probably out-grow  it.  Indeed, during this
stage of medical knowledge, so futile  were  all the efforts to relieve
that class  of diseases, that one suffering  from paralysis was re-
garded as hopelessly incurable.
  But,  thanks to the light of a glorious science, a new era has
dawned. The science of medicine and surgery, bringing all other
sciences and mechanical discoveries into a collateral relation with
it, has developed truths concerning that heretofore intractable
malady, which have entirely revolutionized our management and
treatment of this class of unfortunates.  Now, instead  of  the 
122
TABLE FROM UNITED STATES MORTUARY REPORTS.
moxa, the red hot  iron, the  seton, the blister, and  the tartar
emetic, we have more humane, rational and scientific means, em-
bracing mechanical appliances, electricity, atmospheric pressure,
together with a variety of  machinery  for the  purpose of devel-
oping and restoring the physical powers.  Very little medicine is
used by us, and the most gratifying feature of the new treatment
is that its success is daily attested by  the thousands who have
been  the  happy recipients  of  this  common  sense  method.
Enough is now known  and has  been demonstrated to warrant
the assertion that, with proper discretion and management, most
cases of paralysis, not  dependent upon some incurable organic
lesion, may be relieved.
  This truth is now so well established, that four  large institu-
tions have been opened for the treatment of those who  are thus
unfortunate, and it is with confidence and pride that we point to the
National Surgical Institute and its branches.   The  projectors
and founders of this  noble institution have, by their  untiring
energy, devotion and skill,  developed the  most perfect system
and elaborate appointments  for  the management and cure of
paralysis, now to be found  in the United States—and, indeed, it
is very doubtful if the  world can produce  one  better provided
or  more successful.  The various causes giving rise to  paralytic
affections are multiplying so  rapidly, in this country, at least, as
to very materially increase  the mortality from that source.
  The following table,  taken  from the U.  S. mortuary reports,
will be found both interesting and instructive"
Years.
Total deaths from all causes..
1850. ■{ Deaths in each 100,000..
     Percentage of deaths in each 100,000.,
     I
    f Total deaths from all causes...............
1860.-I Deaths in each 100,000..........................
    [ 'Percentage of deaths in each 100,000.
     {Total deaths from all causes...............
     Deaths in each 100,000...........................
     Percentage of deaths in each 100,000.
Grand to-tal, deaths f rom all causes.	Dealhfrom Paralysis.
323,023	2,709
100,000	839
1,392.8	11.7
394,153	4,637
100,000	1,176
1,253.5	14.7
492,263	7,.501
100,000	1,524
1,276.7	19.4
 
                THE CHIEF CAUSES OF PARALYSIS.             123

  It will be  perceived on examination of the foregoing  tables,
that the increase  in  the mortality from  paralysis is very great,
and  the percentage  has nearly doubled within twenty years.
From so large an increase in the number of deaths, it is reason-
able to infer that there has been a corresponding increase of the
number of attacks from the disorder.  Taking it for granted that
such is the fact, are not those who have in charge the lives  and
the health of the people, loudly called upon to inquire into some
of the
                           CAUSES.
  The causes of paralysis,  like all others  effecting the nervous
system, have been a source of much controversy among doctors
of medicine for many centuries.   They are no doubt multiform,
and in many instances are yet so obscure  as to perplex the most
profound student of etiology;  indeed, until within the past  few
years, very little comparatively was known, either of the pathology
or treatment of the disease.   Many theories on the subject have
been advanced which in  themselves  looked plausible, but which,
when tested by the light of experience, have fallen to the ground
as wholly  untenable.   Autopsies and  post-mortems have been
made, which have as often led  into  error as  to truth.   Lesions
have been taken for causes, when  the causes may have produced
the  lesions, or the lesions may have been merely concomitants,
and hence  doubts and perplexity  took the place of certainty and
confidence.
   It is therefore a matter  of great  gratification to  the medical
world, that a sufficient number of opportunities have in the  past
few years presented themselves to enable us to demonstrate the
source and origin of most paralytic  affections.   For the benefit
of all who may be suffering from,  or threatened with this disease,
we will now  state that the chief causes of paralysis are to be found
in whatever tends to  relax or enervate the system, or interrupt the
healthy flozo  of nerve power from  the brain and spinal cord to the
organs of motion.   This will be found true,  no matter  how the
enervation be produced, or the flow of nerve power interrupted.
 "  Congestions of the brain and spinal cord—no matter how  pro-
duced—are prolific of paralysis.  Perhaps no fact has been more
satisfactorily demonstrated, than that paralysis can be produced
at will, by subjecting a person to  an  exposure of a few hours to 
 I 24           EFFECTS OF ATMOSPHERIC PRESSURE.
an atmosphere compressed so as to exert a pressure  of from 45
to 50 pounds to the square inch.  A rare opportunity was afforded
for making such observations upon the workmen engaged in sink-
ing the caissons under the piers of the  mammoth bridge at St.
Louis, Mo., also the East River bridge  at New York, who were
obliged to work in an  atmosphere under a pressure of from 30
to 50 pounds to the square inch.   Paralysis was of frequent oc-
currence among the laborers who worked in this compressed air.
  Another  important  fact  was verified at the  same time, viz:
That persons addicted to the  use  of alcoholic  stimulants were
almost wholly  unable  to withstand this amount of pressure, on
account, no doubt,  of  the passive congestion already present as
a result of the stimulants.
  The careful student of etiology would not be long in determin-
ing the cause of these  cases of paralysis, for the  reasons are too
obvious.  The pressure being so much  greater  on  the outside
than the resistance within, the  blood  was forced from the whole
external surface and soft  parts into the cavitites.  Those, the walls
of which are fleshy, were also much lessened in size by the pres-
sure, while the bony and  comparatively unyielding cavities within
which the brain and spinal cord rests, were not diminished in their
diameters, but were left vacuum like, to receive the blood thus
forced out of the vessels.  Congestion or effusion into  the  sub-
stance of the brain and  spinal cord followed, and paralysis was
the result.   Now with these observations and demonstrable  facts
before us, we can readily perceive how the following causes  may
produce paralysis.by local or general congestions  of the brain and
spinal cord,  or by enervating the system, or by  pressure,  or by
otherwise interrupting  the healthy flow of nerve power  from the
brain and spinal cord to the organs of motion, viz:  [See article
on atmospheric pressure.]
The inordinate use  of  stimulants, such  as whisky, tobacco, cof-
     fee,  and tea;
Sudden and  overwhelming shocks to the nervous system;
Sudden transitions of temperature;
The suppression of habitual discharges;
Long continued spinal  irritation;
Exhausted vitality of  parents, transmitting to their children a
    predisposition thereto; 
             SOME CAUSES THAT PRODUCE PARALYSIS.          125

Excessive physical or mental exercise,  producing great prostra-
     tion ;
The long continued use of poisonous sedatives, as evidenced in
     lead palsy, &c.;
The inhalation of the poisonous fumes of metals;
Softening of the brain or spinal  cord;
Atrophy,  or wasting of the same;
Fractured or dislocated bones, by pressing upon the brain, spinal
      ord, or some of the nerves;
Diseases incident to  childhood, are often the exciting causes in
     susceptible  constitutions, such as  meningital inflammations,
     (cerebral or spinal);
Scarlet fever, measles, whooping cough, and convulsions;
In the careless handling of infants or children, the soft and imma-
     ture nerve tissues may be so injured as to produce  paralysis,
     although many months may intervene  before it becomes
     apparent;
Hydrocephalus, or effusions upon the brain or spinal cord, by
     pressure;
The breathing of unhealthy air;
The eating  of unwholesome food ;
Apoplexy, syphilis, self-abuse, scrofula, and rheumatism, are not
     unfrequently attended with  or followed by paralysis.
  There is no doubt that in very susceptible persons, irritation of
the  peripheral extremities of nerves may produce paralysis by
reflex action, as from worms, ingesta, burns,  etc.
  It  is  also highly probable that paralysis, in some instances,
may be due to  an  abnormal condition  of the  terminations of
nerves, which may be rendered unfit for receiving impressions,
either from  the external surface or the brain—by long continued
pressure, by disorganization of their own tissue, by the depress-
ing action of poisonous metals, and by prolonged disease.   The
latter is especially so in cases when the paralysis  continues  after
the cause producing it has ceased to exist.  In such cases there
seems to be a want of responsive action, or the will power having
been so long quiescent,  is  unable to enforce its commands, or
exercise but partial control over the organs of motion.
  This condition is more frequent  in chronic  cases than has  been
heretofore supposed.   It has been  often noticed, that in the treat- 
126
DIFFERENT FORMS OF PARALYSIS.
ment of some chronic cases, artificial movements did more  to de-
velop a return of the will power, and were therefore more conducive
to recovery than everything else.   How often are such expressions
heard, as, I have forgotten how to do this, or that.  May it not be
possible,  then, that after a long lapse of time, one may forget how
to bring into action  certain sets of muscles,  so  as to produce
certain motions, especially when from fatty deposits, or adhesions
of the myolemma, and an  indisposition to make  an effort,  the
will  power required to enforce obedience, must be much greater
than usual?
  The nerve  centres in the human body are so  peculiarly consti-
tuted as to render education necessary in  developing voluntary
motion.  The child, unlike the inferior animals,  must be taught to
walk, and to  do almost every other thing requiring the exercise
of the will power in controlling muscular action.  As it has to be
learned, may  it  not be forgotten ?  From the multiplicity of causes
presented, one  would naturally conclude that the proximate re-
sults must be the development of a great

                          VARIETY
of forms of paralysis: such is the fact.   These varieties depend
somewhat upon the location of the lesions, and character of the
causes producing them, and their nomenclature is usually derived
from the facts involved in the results.  Thus  we have hemiplegia,
where one-half of the body longitudinally is effected with paralysis.
This form is  usually produced by lesions of the brain, above the
medulla oblongata, or  upper portion of the spinal cord.
  The causes most commonly producing it are, apoplectic clots,
tumors of any  kind  pressing upon the brain, pieces  of bone,
embolism or softening.   On  account of the decussating fibers
of the anterior pyramids of the medulla, the paralysis is exhibited
upon the opposite side from the lesion.  Occasionally hemiplegia
may occur from  lesions  of the  spinal cord.    In such cases, the
paralysis is found upon the same side with the lesion.
  The next most common form of paralysis is paraplegia, in  which
one-half of the body transversely is paralyzed;  usually the lower
half, and frequently the  lower extremities only.  This form of
paralysis is generally the result of injuries, or  disease of some por-
tion of the spinal cord or its membranes, or both.  It is generally 
                  SMALLER FORMS OF PARALYSIS.              12/

ushered in by pain in the back, numbness of the feet, with or with-
out fever.  The power of voluntary motion is lessened or entirely
lost.  The muscles may be either relaxed or contracted; and, in
many cases, the power over the bladder and rectum is diminished
or completely destroved.  These are the two most common forms
of paralysis.
   Reflex Paralysis is a form usually produced by irritation of the
peripheral extremities of a nerve, and transmitted along it to the
nerve centre, overwhelming or  paralyzing it; the  effects  being
shown, of course, in the parts to which its branches are distributed.
   Locomotor Ataxy.—This is a form of paralysis in which there is
a want of co-ordination in the action of the  muscles; hence, the
gait in walking is unsteady and insecure.  This want of association
is sometimes felt in the arms, but more frequently and in a greater
degree in the lower limbs; giddiness is a frequent attendant; in
closing the eyes while standing, the patient is apt  to fall down;
in walking, the limbs are jerked forward very different  from the
dragging  of the limbs, as witnessed in ordinary cases of partial
paraplegia.
   Wasting Palsy.—In this form of paralysis, a few of the muscles
of one limb,  or  the voluntary  muscles of the whole body, may
waste away and become atrophied.  The shoulder and the ball of
the thumb, are frequently affected.   The  muscles of the calves
of the legs, those  of the small of the  back, and hips, are more
frequently involved.  Examinations after death do not reveal any
lesions of the brain or spinal cord which would give rise to it; its
pathology is  not well understood.  The fault may be found to be
in the nerve centres which regulate nutrition.
   There are quite a number of other forms occasionally met with;
such as hysterical, diptheritic, mercurial, syphilitic, lead palsy,
and palsy agitans; and local palsies, such as
Amaurosis, or paralysis of the optic nerve;
Scribner's, or writer's palsy;
Cophosis, or  palsy of the auditory  nerve;
Ageusia,  or paralysis of the gustatory or nerve of taste;
Anosmia, or paralysis of the olfactory or nerve of smell.
   These do not  require any particular  consideration.   But  there
is another form of so much importance as to require particular
mention,  viz: 
128
BARBAROUS AND INHUMAN APPLIANCES.
   Infantile  Paralysis.—This is  a disease affecting some of  the
nerve centres,  and extending so far as to arrest nutrition, and
abridge motion in the limbs.  It is usually a partial paralysis affect-
ingsingle muscles, or groups of  muscles.  Sensation is generally
unimpaired.   The bladder and rectum are frequently, although not
always, involved.  The muscles  paralyzed are never rigid in this
disease.   No violent symptoms attend an attack, although it may
come on quite suddenly.   Dissipation or ill health of patients, is
a  frequent  cause  of this form  of  paralysis.   Want of proper
knowledge and attention, generally allows this form  of paralysis
to result in deformities of one kind or another, talipes or club
foot being the  most common.    Probably there is  no form  of
paralysis  more  amenable to treatment, if attended  to in time,
and judiciously  and properly managed; but if  left an  indefinite
time,  it becomes very intractable, on account of fatty degeneration
of the muscles involved.
  After having said this much on  the subject of paralysis, we come
to consider what, to the patient, is of the most importance, viz: its

              TREATMENT AND CURABILITY.
  As  has been remarked before, the profession  of medicine has,
from time immemorial,  utterly failed to cure  the disease.   In the
early  history of medicine, when  but  little if anything was known
respecting its pathology, it was hardly to be  expected that  any
rational  methyl of  treatment  would have been adopted, and,
consequently,  few if any cures were  effected.  But in late years,
the disease h is been  much  better understood,  and  of course it
was f i.r to expect that the  treatment would become more rational,
and the cares more frequent.
  It is a 1 nitte 1 o l all sides thit many cases  of paralysis are now
cura'j  e, b it still fe.v c ises c> nparatively are  relieved.  The rea-
so.is are oo/bus.   W.ule the profession has ever been ready to
den kinee o: ler vagaries aid foil es of the fathers of medicine, it
has clang with a pertinacity unprecedented, to their absurd prac-
tices in the treatment of par ilysis.  Nearly, if not all,  of the same
barbarous and  inhuman appliances  used  three hundred  years
ago are u^cd to-d ly, and are handed  down  through  our medical
schools and books as sacred relics.
  The moxa, the red-hot iron, the seton, and  irritating ointments 
PRACTICAL MANAGEMENT OF THIS DISEASE.         I 29
are as much in vogue now as  they were then.  If this line of
treatment resulted in success it could be tolerated and even justi-
fied.   Unhappily, however, such is not the case.  It is, there-
fore, not  to be wondered at, that, with the constant increase of
causes and with no  corresponding improvement in the treatment
of the disease,  there should be an  increase in the ratio of mortal-
ity, as is shown to be the fact by the United  States mortuary
reports already alluded to.
   It would be absurd to assume the curability of every case of
paralysis, but while this is not possible, it has been demonstrated
that  very many cases hitherto considered incurable, are amenable
to treatment and susceptible of cure.   Not,  of course, by such
blundering methods and irrational treatment as those pointed out
in the foregoing pages, but by the union of intelligent science
with practical mechanics,  by assisting nature instead of resisting
and  baffling her efforts,  and by the use of wise and rational, in-
stead of cruel  and  senseless,  remedies.
   From what has been said of the causes of paralysis, it would
seem that in the majority of cases, the indications for treatment
were plain.  This is true in the main,  yet it must not be forgotten
that in many instances, the causes  which operated to produce the
paralysis have long  since  ceased to exist, and in such cases we
have to deal with results only.  Neither is it always easy to deter-
mine whether the paralysis is produced and continued by organic
lesions, such as softening, induration,  adhesions, etc.   The  loss
of motion, and sometimes sensation, the  wasted muscles,  etc.,
may be apparent, but this may be only  an effect, and must not
be confounded with the cause.   The causes operating to produce
nearly all forms of  nervous diseases, are from  their very nature,
frequently obscure,  and paralysis is not an exception;  hence,  any
one  presuming to treat it,  can  not be  too well  informed in all
matters pertaining  to the disease and the history of each  individ-
ual case.   Theories may be well enough in writing books, but the
practical  management of this disease, necessary to success, must
be determined  by the light of experience, for theories, however
plausible,  are wholly unreliable unless supported by facts.
   It is by the light of experience that the National Surgical In-
stitute proposes to treat this disease.  More than fourteen years
of careful observation and experience have developed many facts,
       9 
 I30   SOME SUCCESSFUL METHODS OF TREATING  PARALYSIS.
which point with unerring certainty to the most rational and sue-
cessful method of treating  paralysis,  the general principles  of
which are as follows:
   i.  The limb is cold and feeble ; by proper treatment the tem-
perature can be increased and muscular strength  imparted to  it.
   2.  The blood does not circulate freely and in  sufficient quan-
tity ;  the size of the blood  vessels should be increased,  the cir-
culation  accelerated, and thus supply the limb with its full quota
of nutrition.
   3.  There is no  motion of the limb; to regain motion  impart
nervous  force to the muscles, and by artificial motion cause mol-
ecular changes,  which will excite muscular contractions.
   4.  There is  little or  no disposition to muscular contractions;
to remedy this  fault produce artificial contraction until the will
power is  re-established.
   5.  Without use, muscular power will not be regained,  and the
limbs will continue weak and unable to sustain the weight of the
body; take the weight of the body from off them  by suitable
apparatus, allowing them motion free from pressure or exhaustion.
   6.  The limb is emaciated,  and the muscles smaller;  this must
be overcome by systematic development, of which there is noth-
ing more susceptible than the human  body; and  if it is possible
in the adult,  how much more is it in the growing  child?
   7.  The blood is  often impoverished; if so, It must  have iron
and oxygen, and  other necessary constituents  to make it nutri-
tious and healthy.

            SOME REASONS WHY WE  SUCCEED.
   We increase the size of the blood vessels, and  accelerate the
circulation of the blood, thus imparting  a full supply of nutri-
tive material to  the muscles,  thereby increasing the temperature
growth,  and development of the limb.
   As the limb  grows and becomes properly developed in all its
tissues, muscular contraction and  motion returns, and adding  to
all this the exercise of the power of the will, we obtain action  of
the limb together with voluntary motion.
   All these  vital changes are brought about by the use  of our
gymnasium,  machinery, and such  surgico-mechanical appliances
as are required in  each individual case. 
SOME REASONS WHY THE OLD METHODS FAIL.       I3I
  By the  use  of oxygen  gas we improve the vitality of the
system, with other remedial means we generate nerve force, and
the result is a  recovery  from a paralyzed, helpless condition, to
that of bodily vigor and  activity.
  Our treatment, though somewhat complicated, is easily under-
stood, and the results more  satisfactory, and  the  cost less than
can be obtained elsewhere.
  Many cases can be supplied with  apparatus and  machinery,
and be treated  at home successfully.
  Our treatment is based  upon  the  dictates of common  sense,
and each case is treated according to its special  indications, ir-
respective  of the  old theories or notions.   Our  practice  is to
make every discovery of science minister  to  the restoration of
our patients.   We harbor no hobbies,  but eure our patients,
hundreds of whom now enjoy life and the use of their limbs, and
are happy  in their restoration.

 SOME OF THE REASONS WHY THE  OLD METHODS FAIL.

  They fail because their  treatment  is directed to disease of the
spine, or other nerve centers, where  in  reality no  such disease
exists.
  Active remedies, such as strychnine, calomel, nux vomica, etc.,
do not cure, and are dangerous and useless.
  Blisters, the  hot iron,  the  moxa, and  other  cruel  and barbar-
ous methods, only increase the trouble and banish all hopes of a
cure.
  Volatile liniments, evaporating lotions, friction, and other irri-
tating applications only aggravate and annoy the patient.
  Forcing  the use of weakened and paralyzed limbs, and com-
pelling them to sustain the weight of the body without adequate
strength to do  so, only weakens them by the over-taxation  of the
muscles, and the ultimate  result  is a deformity and distortion of
the limbs.
   In .the old practice, no support is used to sustain the weight of
the body, no means employed to  dilate the blood vessels, no blood
forced into the limbs, no constant artificial heat is employed, all
of which are necessary  for the revitalizing of  the limbs, and the
restoration of muscular action and motion. 
132  DEFORMITY FROM RELAXED AND CONTRACTED MUSCLES.
  The most  foolish and heartless feature of all is to advise the
patient to outgrow it, assuring him  that nature is a wonderful
cure-all, because the doctors do not know what to do.
  In figure 1, the muscles on the inside of the thigh  and leg are
relaxed, thus allowing the weight of  the body  and the undue
contraction of the antagonistic or opposing muscles on the outside
of the thigh and leg, to bend the limb  in at the knee, producing
a very common deformity.
  In figure 2, the muscles of the right  leg, on  its posterior or
back part, are relaxed, while those in  front contract, giving rise
to a backward curve.   In the left leg of the same figure, the re-
Figure 4.                                       Figure 5.
verse is the case.   The rectus muscle in front is relaxed, and the
flexor muscles behind strongly  contract, producing the  most
common of all the deformities of  the knee.  By relieving the 
               THE MUSCLES MUST BE REGULATED.            I 33

limb of the whole or a part of the weight  of the body, so  that
the extra  weight will come directly upon an adjustable brace,
and then arranging the apparatus so as to overcome  and equalize
the undue contraction  of one set of muscles, and  support and
strengthen those  that  are relaxed, a restoration  and cure,  as
shown in figure 3, is readily made.
   In figures 4 and 5, the paralysis or relaxation and weakness is
in the muscles of the back part of the pelvis and  thighs, while
those in front strongly contract, bending the thigh  forwards and
towards the body, disabling the patient, and preventing  walking
or even standing.
Figure 6.              Figure 7.                  Figure 8.
  In figures 6 and 7, the same condition exists, with  the addi-
tional paralysis of the muscles of the legs.   Figure 8 shows par-
alysis of one leg only.
  In these cases, all treatment  by medicines, electricity, friction,
hot springs, baths,  etc.,  will be  vain  and  fruitless, unless the
proper mechanical support is applied, by which the weak muscles
will be  aided  in their work, and  the contracted ones  regulated
and brought into  their proper condition.   The result of this,
the only rational and successful plan  ever adopted,  is seen in the
illustrations given.  .

         LETTERS AND REFERENCES—PARALYSIS.

  The following is a letter from a gentleman fifty-three  years old,
who placed  himself under our treatment in  the  spring of 1874: 
134
LETTERS AND REFERENCES--PARALYSIS.
                                                        Calvert, Texas.
  From the progress in  improvement my arm  is making under your treatment,
I have no language sufficient to express my gratitude.   I  have been enabled to
use my arm to write this letter, and can  comb my hair  with the arm which has
been powerless to do either since the year 1848.                v  »  „., T

Drs. Allen, Johnson  & Peck :
  Dear Sirs—Three years ago,  the  fourth day of July, our little  darling was
stricken with paralysis, caused by poison  from green paint.  After trying physician
after physician, all of whom told me that  she could not be cured—what a thought—
that she, our only child, should be crippled for  life.  I could not believe it.  The
light of our lives, the sunshine of our home, should be deformed and crippled for
life!  The thought was too terrible to realize.   In visiting a friend in the country,
I came across one  of your circulars, and determined to bring her to your institu-
tion. .  I came, and commenced treating  her last January;  and, after having her
heel cords cut and  her limbs straightened, she is now, the  27th  day of  October,
nine month's time, able to walk three squares, and is perfect in form.  I  sincerely
believe she will be  entirely cured in one year, should God spare her  to us.   Oh!
how can  we feel grateful enough to the kind Providence in thus hearing of your
institution.  Feeling I am inadequate to  express to you the gratitude I feel to you
for the wonderful cure you have performed upon our darling girl, I can truthfully
say, that you have performed all  your circulars represent you do, and more.   I
found your surgeons and attending physicians to be kind to a fault, ever ready to
lend a  willing and patient ear to the afflicted, and ever ready to help the  poor and
rich alike.   Feeling I can not express  myself in terms strong enough  to  your
great and glorious institution, I remain,
                   Yours, most gratefully,         MRS. M. L. CAREY,
                        Formerly of Cleveland, O., now of Indianapolis. Ind.
  No.  171  Virginia Avenue.
                                   GlLBERTVILLE, BLACKHAWK Co., IOWA.
  At the age of nine months, I became paralyzed in all my limbs.   When  nineteen
years of  age, I placed myself under the treatment of  the  National Surgical
Institute, and now I attend to one span of horses, and do other work.
                                                        M. A. BROCHE.
  I was stricken down with paralysis when I was fifteen years old, entirely helpless
in my back and lower extremities.   My  physicians could do me no  good.   The
cords of  my legs were  so  badly  contracted that I could not  straighten them.
Under  Dr. Allen's  treatment, they  have been  made perfectly straight  and
wonderfully strengthened, so that I now get about very easily.  I am well pleased
with their treatment.                               w  H  DEWg

                                                         Chesterfield,  111.
  My son, from paralysis and contraction of the cords, was so deformed in his feet
and legs,  that he had no use of them whatever.   I placed him under the treatment
of the National Surgical Institute,  where  he was  rapidly  straightened and
strengthened, so that he can now walk and get about as well as any one.
                                            mathias Mcpherson,
                                 Moore's Prairie, Jefferson County, Illinois. 
LETTERS AND REFERENCES—PARALYSIS             I 35
  I have a son, eight  years old, who was paralyzed in infancy in  his lower ex-
tremities, thus losing all use of his legs, and being rendered completely helpless.
After many years endurance of this condition, I put him under  the treatment of
the National Surgical Institute,  at Indianapolis, Ind.,  where, I am most
happy to say, his legs were made to grow  and become strong, and he is now
walking  every where  in the full enjoyment of restoration  to a  life of usefulness
to himself and his parents, and gratitude to his benefactors.
                                              THOMAS McHATTON,
                                                            Nashville. 111.

  My son Ambrose, now seventeen years old,  from  infancy suffered from  a most
severe paralysis, and  deformity of the  legs and feet, being rendered completely
helpless, and, we had long supposed, hopeless.  His  legs were flexed at  right
angks at knees, and also thrown out to one side, and were so emaciated that there
was seemingly nothing but skin and bone.  His ankles were also terribly deformed,
and his feet likewise.   We were urged  to take him to  the National Surgical
Institute, at Indianapolis, Ind.   His legs, ankles,  and feet have been straight-
ened and made to grow large, strong, and well developed.  He is able  to walk
about easily,  and work upon the farm, for which I am most happy and grateful.
I would also  say,  when he commenced  treatment his mind was demented, and we
feared he would soon  lose it, but the treatment has  restored his mind also.
                                                  GEO. W. YOUNT,
                                         Cropper's Depot, Shelby Co.,  Ky.

   My daughter was stricken down with paralysis at the age of two years, causing
deformity of  the  feet, hands, and limbs.  She was  so  utterly  helpless that she
could not creep or help herself in any way for more than ten years.   She wrote
her correspondence with a pencil  held  between her teeth.  I  tried every  means
within my reach, but  all was of no avail.  At last I took her  to the  National
Surgical Institute, and with the treatment peculiar to that Institution she began •
to improve promptly,  and in  due course of time was perfectly cured, and is now
free from deformity, walks as well as other people, and  is happy.  No one can so
fully appreciate the value of such an Institution as one who has thus been restored
from a helpless, crippled condition to health and society.
                                                    GEO. MURRAY,
                                                            Linden, Mich.

   I was, for seventeen years, afflicted with a badly  deformed and paralyzed foot,.
which rendered it almost useless during that time.   My foot was very much like a
club foot, only a great deal worse, which made it very inconvenient for me  to get
around, and also very embarrassing.  I had almost given up all hopes of ever be-
ing benefited, when I  was directed to the great National Surgical  Institute,
whither  I at  once repaired for treatment.  My stay at the Institute terminated
most happily indeed,  for I am now walking as well as any one, and I feel that I
can conscientiously commend the Surgical Institute to the suffering every where.
                                                 CLARA  PARKER,
                                                         Marysville, Tenn.. 
CHAPTER  XIX.
                           CATARRH.

     CATARRH  is a very common disease, and those who are
      afflicted with it are of no particular class, age, or sex; but
   *  it  effects people  in  all the various walks of life.  An im-
portant fact to be remembered in  connection  with this disorder
is, that those who suffer  from  it rarely recover spontaneously,
or without the aid of medical treatment.   Moreover, when this
malady is left to run its  course, with no means used to check it, it
will surely run into  a chronic state.   Comparatively few people
have a perfectly healthy condition of the mucous  tissues of the
nose and its connecting  sinuses.
  This may seem to be a very surprising statement,  but  it is,
nevertheless, too true.  It is proper  to  state that in the use of
the word catarrh in this connection, we  mean to include the dis-
eased condition of the  mucous membrane of the nose, together
with all the cavities  and passages  communicating  with it.  The
disease may be acute or chronic; but  it is the chronic stage of the
malady that demands our particular attention.
  As before stated, catarrh is an  inflammation of the mucous
membrane lining the nose, but a very important fact in connec-
tion with this particular  disorder  should be remembered,  viz:
having once established itself, it becomes  very aggressive, and
extends  itself in  every  direction, wherever a particle of mucous
membrane is to be found connected with that of the nose: hence,
we find the eustachian tubes, the lachrymal ducts, the pharynx,
the larynx, the bronchial tubes, and finally the entire  structure of
the lungs becomes involved.   It  is  this particular tendency to
reach out into by-ways, the minute cells, and the  little crooked
passages, that baffles the physician  in his attempts  to cure it.   If
a section of the  diseased tissue remains  untouched and uncured,
the disease is quite sure to return, spreading  itself over all the
surfaces  previously involved. 
STAGE OF ULCERATION.
137
                           CAUSES.

   Among the numerous causes, the following may be mentioned
as the most common, viz:
   A frequent repetition of a common cold, with undue exposure,
the inhalation of the dust of mills, manufactories, chemical labor-
atories, stone cutting, etc.   It is a sequel to measles, diphtheria,
scarlet fever, and whooping  cough.    A  prolific cause  which
should be mentioned is the syphilitic taint.   If the disease ex-
ists as the result of this cause, the demand for prompt and posi-
tive treatment is imperative; for if the disease is neglected under
such circumstances,  results follow that are fearful.

                          SYMPTOMS.

   After having  described a disease which presents so many for-
midable features,  it  becomes a matter of no small  moment to
know something of  the symptoms which attend it, and indicate
the special disease of which we speak.
   The first symptoms are only those which usually attend a com-
mon cold in the head: if, however, these symptoms do not readily
subside by the use of the ordinary means for the cure of a common
cold, and if the mucous membrane of the  nose becomes thick-
ened and conjested, discharging  a secretion of thick, unhealthy
mucous, or even tinged with a little  blood, it will be evidence that
the patient has something more  with which to contend than a
common cold: and if the disease is not promptly checked at this
stage of it, all the phenomena of the  trouble will  become more
and more aggravated, and the  stage of tdceration will soon follow.
This stage is indicated by soreness of the inside of  the nose,
with muco-purulent discharges, and  scales or scabs  of semi-dried
bloody mucous  and pus.   At the  same time the upper and back
part of the throat will be involved, causing a good deal of hawk-
ing and expectorating of a tough, gluey mucous.   The disease,
if unchecked, will go on extending and involving  one part after
another, as mentioned hereafter, until all the mucous membranes
connected with  the  air passages of the lungs become effected,
impairing the general health to such a degree  as to make life a
burden, until death relieves the sufferer. 
I38        THE DISEASE REQUIRES PROMPT TREATMENT.

                  RESULTS  OF CATARRH.

  Some  of the serious results of catarrh  should be considered
for the purpose of showing the importance of giving proper at-
tention to its treatment and cure:
  ist.   Loss of Smell.—All persons value this important, special
sense, and the loss of it is a calamity of too serious  a nature to
be lightly passed by.  The process by which this special sense is
destroyed is as follows: The disease, when neglected in its treat-
ment, continues on into the chronic and ulcerative stage, and in
process of time the ulceration reaches the turbinated portions of
the ethmoid bone: it is this part of that important bone that forms
the support to the cells of the nose upon which.the olfactory
nerve, or  the nerve of smell,  is spread  out.   When  the  disease
reaches this stage, the patient's condition is really pitiable, for two
reasons, viz:   First, the sense of smell is destroyed:  and second,
the odor exhaled with every breath is so offensive as to deprive
the individual of the comforts of society and personal friends.
  2nd.   Partial Deafness.—The loss of hearing often occurs as
one of the results of catarrh, and  is caused by the closing up of
the eustachian tubes, or little  canals leading from the upper  and
back part of the throat to the internal ear.
  3rd.   Impaired Eyesight is  caused by the  closing up of the
lachrymal ducts, and an inflammation of the  membranes of the eye.
  4th.   Pharyngitis, or disease of the  mucous membrane,  and
glands of upper and back part of the throat.  A multiplicity of
troubles  are to be found in this region, as  the result of catarrh:
First, there will  be an enlargement and  an elongation of the
uvula or  pendulous  palate.   Second, a chronic enlargement of
the tonsils, resulting in frequent attacks  of  quinsy.  Third, a
diseased  condition of the  little  glands  or  fallicles of the throat,
which become  enlarged, and exude  a gluey, tough, tenacious
matter, causing much irritation, coughing, hacking, and the ex-
pectorating of the unhealthy exudation on  rising in the morning.
This condition  impairs the taste and  appetite.   Inflammation of
the pharynx often extends downward to the stomach, producing
a low form of gastric irritation, with dyspepsia.
  5th.  Laryngitis.—This serious  disease is perhaps one of the
most  common results of catarrh.   Clergymen and other public 
                    RATIONAL TREATMENT.                  I 39

speakers are the most frequent sufferers from this affection.  This
is the  malady that is  so  common, and known  by the name of
"minister's sore throat."   Thousands of  public speakers, whose
success in life depends on  the use of their voice, are the  victims
of this fearful malady.   The  same may be said of those whose
profession is that of vocal music.  How  many such have started
out in life with high  hopes  and joyous  prospects, only to be
crushed and  disappointed  by this fell destroyer of their  success
and happiness.  Uncured, the disease travels downwards, involv-
ing the mucous  membrane of the trachea and bronchial tubes to
their  minute ramifications, finally  ending in  consumption  and
death.

                        TREATMENT.

  To treat nasal catarrh successfully, it is necessary to understand
the anatomy of  the parts diseased.   An examination of the plate
will give some idea of the extent of the surface and  tissues in-
volved.  All the cavities from the frontal sinuses, Nos. 3  and 4,
down to, and  including the trachea or windpipe, and esophagus,
Nos.  12 and  13, are lined  and covered with mucous membrane,
the tissue that is  diseased in catarrh.  Besides  the points indi-
cated and to be  seen on the plate,  there are numerous little pas-
sages, cavities and cells involved which can not be shown on such
a plate.   After giving this plate a little study, it will not be very
difficult  to understand why  the disease  can not be  cured by
gargles and snuffing medicines into the  nose.   To treat the dis-
ease successfully,  remedies must be brought into contact with all
the inflamed parts, including every  little canal, cell  and sinus.
Our method of rational treatment, enables us  to offer relief and
cure to all who will avail  themselves of it, and when it is under-
stood that we include those formidable diseases, clergyman's sore
throat and bronchitis, under the head of catarrh, and  treat them
accordingly with success, it will be concluded that we are accom-
plishing a great  and good work for suffering humanity. 
CHAPTER XX.
                          CLUB FEET.

 ^JjjOjj UCH time and money has  been expended in developing
 jff allnl  theories for the restoration of  club feet.   Surgical talent
     *   has been employed in this work for hundreds of years,
 because  the rules of the profession do  not  forbid  its members
 from taking patents on books, which contain the results of their
 investigations, and selling the same for profit;  but,  if  one of
 these men invents a useful apparatus for the correction of a de-
 formity,  he is allowed neither  protection  nor reward for his time,
 genius, and money.   Hence,  if he be of an  inventive  turn of
 mind, other fields of usefulness are sought, leaving  the crippled
 and  deformed to  live on and suffer on without relief.
   In all  industries, and  scientific avocations as well, some hope
 of reward has been held  out to the inventor,  thus affording more
 substantial means for daily bread for his family than empty fame.
 If the farmer, with a patent drill or reaper, can save time,  labor
 and  expense for those who   use them,  who is  stupid or silly
 enough to say that the inventor should not be paid for his inven-
 tion  and  allowed  to  advertise his machine for sale ?   In the year
 1781, Scarpa devised an apparatus, which, in some  cases, made
 decided  improvement in the feet.   Stromyer afterward achieved
 some success in the treatment of this deformity.  Occasional re-
 ported cures kept alive the hope of relief, while the torture and
 cruelties  inflicted  upon this class of patients led them to  incred-
 ulity and despair.
  Our conceptions of right, and of justice to humanity, prompts
 our present course;  and we feel that,  although a few physicians
 may differ honestly from us  in regard to advertising our inven-
 tions and improvements  and facilities  for the treatment and cure
 of cripples, yet their manifest  benefit is so great  and their suc-
 cess  so much in advance  of our most sanguine expectations, that
 we feel inclined to continue to trust the  guidance of our  higher
sense of  duty.   It is gratifying to  us, however, to know that so 
             RECOMMENDING CASES TO THE INSTITUTE.         ja\

many  medical men of  the  present day,  who understand the
theory of the treatment  of such cases, tell their patients at once,
and frankly, that they have not the apparatus and other facilities
necessary to make  perfect feet, and  have no desire to inflict pain
or impose expense, to result  only in  disappointment and failure.
Hence, they recommend and send these cases to the Institute for
treatment.   In the full consciousness of our ability to perform
faithfully and  satisfactorily what is promised, we make the follow-
ing plain statements:
  Club, reel or crooked  feet can be made as perfect in appearance
and use, as though no deformity  had ever  existed.  Those who
are unacquainted with our. methods of treating these cases may
be disposed to doubt this, yet truth  is a strong foundation, and
upon it we base all our statements.   We have hundreds of living,
happy witnesses, whose  feet were crooked, deformed and useless,
now rejoicing, with feet as perfect in shape and as useful as though
no trouble had ever existed.   We effect a cure in much less time
than that occupied in making a painful failure by the old method,
while our plan is almost  free from pain.   The old plan being radi-
cally wrong, must be painful, and fail to give satisfaction, no matter
how skillful or attentive  the physician or surgeon, or how well
padded and carefully applied the apparatus may be.
  Our treatment, when concluded, leaves no tendency of the toes
to turn in,  or of the foot to roll over, or any lump on the outside,
or an unusual arch or kink, as in the old plans.  Walking, after
the completion of the first stage,  facilitates the treatment instead
of retarding it; the weight of the body is made a power to cor-
rect the shape of the foot.
  In many cases no surgical operation is required; but,  should it
be necessary, it is so simple as not to shed  a drop  of blood, or
cause any swelling, pain  or soreness  afterward.  The  treatment
does not in any way affect the health, cause the loss of sleep, or
of a meal; the skin does  not become  chafed or sore by the pres-
sure of the apparatus, if  the directions are followed.
  The deformity will not return after the treatment is concluded,
because the joints are perfect; therefore,  the  gait is  natural, and
all hobbling is removed.   Each apparatus is manufactured in the
Institute machine shops,  under the immediate supervision  of the
surgeon who orders it, and by whom  it is to be fitted and applied. 
142
LIGHT, SIMPLE AND EASY APPARATUS.
  All the appliances used are the invention of Dr. Allen, and by
him patented; therefore, they are made by no one  else in the
United States.   They are light,  simple, easy, and the only  com-
mon sense apparatus ever invented for crooked feet.  This will
be readily admitted on first examination.   We do not make ap-
paratus for sale, neither do we charge exorbitant fees for profes-
sional services;  but we furnish all needed apparatus, and give all
necessary treatment, for the relief of deformity, and the making of
perfect feet.
  After remaininga short time at the Institute, most patients return
home to follow up their treatment according to our instructions.
  The old  method of trying to straighten crooked feet has failed,
because it does not regard the foot as a machine, having a frame-
work of bones, with tendons, pulleys, fastenings, muscles, &c.
  Not only this, but it attempts  to do two# diametrically opposite
things at the same time, and so  does  nothing.
  By rounding off the angles of the articular surfaces, the shape
of the bones and of the foot are made worse.  The foot will roll,
the toes turn in, and the heel slip and crawl up, in spite of the
apparatus.   Should  partial success attend  the  effort, the  toes
will still turn in at every step; and, as  the body moves forward so
that its  weight  comes upon them, they rotate  in the direction
which is the easiest, and that, of course, is  toward the old  posi-
tion of deformity; hence,  the trouble  instead of being gradually
overcome,  and the parts carried in the direction of their natural
place, is only increased and confirmed by attempting  to walk.
  Walking, under these circumstances also tends to bend and
wear out the apparatus, so that  it soon  needs repairs, or to be
replaced by new.  Again, the surgeon who  treats the case does
not invent  or see  to  the  making of  the mechanical  appliances,
but trusts this to instrument makers who have no special respon-
sibility in the case, other than to make and deliver them, or repair
them as needed, or make new ones, each time charging and receiv-
ing the fee; and this continues as long as the patient  is able and
willing to pay.
  The  surgeon  who operates, charges his  regular fee, and ad-
ditional pay for the general care  of the case.
  After this, the patient  visits  the instrument  maker,  gets his
apparatus,  pays  the charges and goes  his way. 
                A SPECIAL STUDY AND PRACTICE.             T43

  When he  returns,  with matters rather worse  than before,
another operation,  another fee  demanded, another visit to the
instrument maker, with an additional charge; and home he goes,
to repeat the performance as often as his inclination or  his purse
will allow.
  No one can be eminently successful in any business  unless it
be made a special study and practice, nor can he succeed without
facilities for its prosecution.
  Physicians,  in general practice, although they may be worthy,
honorable, scientific  and  successful; yet their minds  must of
necessity be so pre-occupied and engrossed with the great prob-
lem of life and death  in the treatment of acute diseases,  fevers
and other maladies, as to leave  no time or opportunity for the
successful study and practice of orthopedic surgery, which alone
requires time,  labor and capital to insure success.          *
  The greatest disappointments are realized from taking measures
for apparatus,  and sending them to some instrument maker for
"club feet shoes," or other apparatus for straightening  crooked
feet.  The measure is  taken by one not familiar with such work;
and, as it is a critical and delicate matter, it is no wonder mistakes
are made, and failure to get a cure ensues.   When the appa-
ratus comes, the proper application of it, even if it were possible
that it was of any value,  requires more  than mere theory can
suggest.
  Actual and  long continued practice, in addition to anatomical,
theoretical and  physiological knowledge, is the  only avenue
through which this indispensable experience is obtained.  Should
the apparatus  appear to fit—one, two, three or more changes will
be necessary  to insure success.  We  often  make six  or eight
changes before the work  is properly done.   No  two feet, even
belonging to the same person, are exactly alike; hence the plan,
as adopted by makers  of orthopedic apparatus, of keeping them
on hand ready made, is as foolish and fruitless as to attempt the
melting of icebergs with moonbeams.
  The appliance must  be designed for the  particular foot  to be
treated.
  If an  operation  is  needed,  it  should be performed   only
after the  apparatus is made and  in  readiness, that the  cords
may not unite too soon, and that the correct position may be had. 
144
SOME COMMON FORMS OF CLUB FEET.
The correct pressure, bearings, joints, springs, ratchets and coun-
ter-bearings may be inspected; and  full directions given by  the
surgeon and understood by the patient, that neither too much
haste nor too little progress be made, avoiding both extremes, and
pushing steadily, smoothly,  easily and  certainly along,  to  the
final triumph that crowns  correct and faithful efforts.
  It must be made from actual measurement, and thoroughly
adapted to the wants of the case ;  otherwise, injury instead of ben-
efit will follow its use.
  The following cuts represent  the common  forms  of  club feet.
Many  complications exist,  as  the  result of paralysis, accident,
improper apparatus, and  unnecessary surgical operations, which
are not shown in these figures.
  These cuts represent  many  of  the  varieties  of club feet, of
which  we  have  treated  thousands successfully  by  our  new
method; and the feet  after treatment  look perfect, and  are as
useful as if they had never been deformed.
  Our new method of  straightening  this class of deformities
is practiced nowhere else in the world,  so far as we can learn.   It
is  quicker and easier than any other mode of treatment,  and
makes perfect cures. 
WRITE, PATIENTS, FOR PARTICULARS.            145
  Club feet, or crooked feet, are  so varied  in  shape and  condi-
tion, that an endless variety of mechanical  appliances is needed
for their cure; and, as with appliances for many other deformities,
there is not room to display them alone in this circular.   Our new
As Received.       As Dismissed.      As Received.       As Dismissed.
method of treating these affections obviates all the pain, chafing,
and  long,  tedious  uncertainties  of the  old method.  You  may
order a shoe made  for a foot by a shoemaker, and if it does  not
exactly fit, no harm is done; but a bad fit in treating crooked feet
is  ruinous;  and no  physician,  unless  constantly treating such
cases, can successfully treat them.   Mrs. Strubel, of Ohio,  had
her  boy treated by  her family physician, and  the boy's  toes
all  sloughed off,  making  a horrible foot—all  from improper
pressure.   Mr. Denison,  of Litchfield, Ohio,  had his son treated
at Cleveland, Ohio, and his feet were made  terrible, with large
sloughing sores,  and  not cured.   Both these cases have since
been cured at  the   Institute.  Write,  patients,  for  particu-
lars.  Many cases are made infinitely  worse by bad treatment.
They are the easiest cases to cure, and  the cure is  positive  with
proper treatment.
  There is, perhaps, no malady that ever came under the treat-
ment of the  surgeon in which more can be achieved, or greater
       10 
146
REFERENCES.
benefits confidently expected, than in club  feet; and  there is no
longer any excuse for parents to allow a child to grow up  in this
humiliating  and  deformed condition.  Humanity  and  justice
demand  better things.   Never wait till the child is older, for
every day increases the time required to cure it.
   It  has been formerly considered  useless  to  undertake the
straightening of crooked feet unless the patient was young ; but
we are straightening hundreds of cases after  maturity, some as
old as 35 years, making perfectly satisfactory feet.
   From  the thousands of cases treated, we have a carte blanche;
but for the present we refer to Hezekiah Hanshaw, of Palmyra,
111., whose boy was treated for a year by a physician of Jackson-
ville,  111., without benefit; David Reynolds, Marshall, 111.; Frank
Huston,  Marshall, 111.; David Adams, Neoga, 111.;Garret Osborn,
Dakota City, Nebraska; Wm. B.  Griswold, Mankato, Minn.; D.
A. Squiers, Decatur,Mich.; George Sanford, Trenton, Ark.; Wm.
J. Clarke, Paola, Miami Co., Kas.;  Lawrence W.  Baker, Green-
ford, Mahoning Co., O.; A.  J.  Skelton, Roaring Spring, Christian
Co., Ky.; W.  B. Smith, Kaysville, Utah; Henry G. Pittinger,
West Windsor, O.; Frank Shults, Zanesville, O.
   Besides these, we will furnish  as  many  more  as desired, on
application.

                  BAD CASE OF  CLUB FEET.

  I can say to you that my boy is greatly relieved of his deformity by your treat-
ment.  He can now walk flat-footed; but  for your treatment he would have con-
tinued to walk on his ankle-joint, with the bottom of  his foot turned up.  I have
been entirely satisfied with the relief afforded to my boy.  I would be  proud to
see your institution in Georgia, and I am confident that there are many afflicted
and deformed persons here who would like to place themselves under your care.
                                         BRYAN BATEMAN,
                                       Byron, Houston County, Ga.

   The following was one of the worst cases of club feet  in Cali-
fornia, and  between 30 and 35  years old.  The physicians  of
San Francisco  wanted  to perform a terrible and very dangerous
operation, by cutting a V shaped piece from the outside of the
feet, in order to draw them around  straight.   The cure has been
very easily performed without any such hazardous operation. 
ALMOST A MIRACLE.                      147
                                  Columbia, Cal., September 16th, 1873.
  Dr. H. R. Allen:—Yours of the 5th inst. is just received.   My feet  are still
improving.  * *  *  • I am satisfied that a  few weeks longer will make them
both well, *  *  *  and I shall be able to go back to San Francisco in about four
weeks; and when I do, I  shall let the people know what you have done for me,
*  * in hopes to help some one who may be afflicted,  and in  some measure  to
benefit you for the kindness and liberality with which you have  treated  my case.
People in this vicinity are much surprised at the effect of your  treatment, and
hardly a day passes but some one comes to see the " Miracle."  There are many
cases who will go to San  Francisco if you should visit that city again.
Yours, very respectfully,                   J. C. HOLMES.
As received.      Result of the        As Received.    After the Treatment.
                 Treatment.
   Knock knees,  bow legs  and all  kinds  of deformities speedily
cured without confining patient to  bed. 
CHAPTER  XXI.
                      SPINAL AFFECTIONS.

    'HE  SPINAL COLUMN (plate 4, figure 1) is composed of
      twenty-four bones or vertebra, articulating with each other.
      These bones are convex or circular in front, and flat upon
their upper and lower surfaces.   They have a projection at each
side and one behind, called  processes.  Each also  has a large
opening communicating with its fellow above  and below, making
the opening for the spinal cord.  This cord  is continuous, with
the brain at the top, and extends the whole length of the column.
The ^me membranes that cover the brain extend down  to and
inclose the cord.  This cord  gives off a pair of nerves between
each of the vertebra, to supply the limbs, all  of the vital organs,
muscles, etc.
  The muscles of the  neck,  back, chest and abdomen all con-
tribute more or less to the  support of the spinal column, and
maintain it in the erect position.  They comprise seventy-seven
pairs,  so arranged as to act in harmony, not only in keeping the
body in its natural, erect position, but in producing its varied and
complicated movements.   Extending from the trunk to the arms,
and from  the pelvis (hips and loins) to the thighs and legs,  we
find thirty-one  additional pairs, which in many  cases are con-
cerned in the production of spinal  distortions, making a total of
one hundred and eight pairs of muscles—the anatomy, physiology,
action and mechanism of which should  be well understood,  in
order to adapt proper appliances and treatment.
  In all spinal affections resulting in deformity, the bones  under-
go  a  change in shape, the spine becoming bent short, or at an
acute  angle, thus  narrowing the  canal and pressing on the cord.
To  illustrate this, take a lead or rubber pipe and bend it • the
more  it is bent, the narrower the cavity or  caliber will be, and if
bent very  short it is closed entirely.  In this manner the cord be-
comes so much compressed, that paralysis of the parts  below
often follows, with emaciation or arrested growth.  In caries of 
«.-. 
XXI.
v;
at
. • ' . making
 '•;-;US,  with
l; l column.
!o vn 'o :."<1
■■ '.-> '•■ :V-. ei-n
vY.li   T'VlIUi. 
JPIateUT
- •swS'ffl		
it III	W'Wm	*>* fl
	pjm	H 8
1, 
 
       CURES DO NOT OCCUR WITHOUT SUITABLE TREATMENT.    149

the bodies  of the vertebra,  called angular curvation, and Pott's
disease, the front or articulating edges become soft and yielding
as the disease progresses,  until,  utterly unable to  sustain the
usual weight which comes  upon  them, they flatten, grow thin
and wedge-shaped, or break down into the abscess, and allow the
spine to bend forward, as shown in figures 2, 3 and 4, of plate IV.
  If the disease be not arrested by the early and judicious use of
suitable apparatus and proper treatment, matter (pus and broken-
down tissues) collects at the point diseased, and sooner or later
breaks at some place on the body or legs below, thus adding a
new source  of danger and debility, as these abscesses rarely heal.
For reasons, mechanical as well as physiological, which  are sus-
ceptible of easy demonstration,  cures do not  occur without suit-
able treatment.
  The body, from disease of bone, or debility of muscle, or both,
is not capable of self-support.  Can anything be more reasonable
and self-evident than the fact, that it needs outside mechanical
FIUFRK 1.
support  to  maintain it  in  its natural position ?  Then why so
foolishly or criminally withhold the means of relief?  Proper sup-
port is always pleasant and grateful to the patient.  Children un-
able to  talk will not permit our apparatus to  be taken off until
the back is able to support itself without injury.  The body of a
child, with caries  of the back, will grow, even though it be but
slowly;  and, if the needed support is withheld,  it must grow out
of shape.  Thus too often is the inherent power of growth sub- 
i5o
EXPLANATIONS.
verted, and made a terrible lever in the production of deformity.
Of course, growth implies  increase of weight as well as in size.
How this weight acts to increase the deformity and add to the
pain and danger of the disease, may be readily seen from the ac-
companying cuts and explanations.
   Suppose a, in  figure I, to represent a  straight back or stick.
Now, while straight  it will sustain  a great weight;  but, if the
weight  is great enough to bend it, it will bend throughout the
entire length, as seen  at b.   But suppose a notch is cut, as shown
at/"and c; it will then represent the condition of the spine when
the  vertebra  are made wedge-shaped by  disease,  and a part
gone.  Now, if weight is  put on this, it bend^ at an acute angle,
as seen at d, figure I,  and  280, figure 2.   Now, the only way this
spine can be restored is, first to apply a  firm support or brace,
extending from one end of the spine to the other, pressing firmly
on each side of the spine at the diseased part, fastening the appar-
atus at the upper and lower end of the  spine,  as  seen at e and
figure 1.   Now, if the spine is bent, it will describe the original
curve b, as seen at g.
   Now,  in  order to  show the  ab-
surdity  of  a  treatment  without  a
proper  apparatus,  suppose  the  de-
fect to be at  the centre of the spine,
a—b, figure 2, in a child that will weigh
fifty pounds.   One-half of the weight
will be above the disease,  a—/;.  The
upright lines, m,  a, show where the a,
weight  would  be if  the  spine  were
straight—half of the weight  resting
on each side  of the vertebra, making
ten  (10)  pounds   on  each  side.
Even this should never  be allowed
where  the   bones   are   diseased ;
but  this pressure is  nothing com-
pared to the facts in such cases.   For instance,  suppose the  dis-
tance from the disease to the head be twenty-one  inches ; that the
width of the vertebra, from a to  b, is one and a half inches; that
the weight, as before stated, is twenty pounds; now, any scholar
can make a  calculation.   We  have a line, a—;/,  twenty-one

FIGURE 2. 
SOME OF THE EARLY SYMPTOMS.
lit
inches long, distance from a to b (or width of vertebra) one and a
half inches;  weight on  lever, a—n, twenty pounds;  pressure,
then, at b is  280 pounds, instead of ten, as  it ought  to  be in
health ; and this weight,  too,  pressing  the  decomposing  and
ulcerating bones together, causing rapid absorption and deformity,,
as seen by figures  2, 3 and 4, plate  IV.   Now,  is there  any
mechanical power in any blister, moxa or medicine that will lift
280 pounds, when applied to the skin, making a galling sore, to
exhaust the already enfeebled system ?  Oh, when will men stop
and  think, and let reason rule, and not travel a life-time in a tread-
mill ?
  As the  disease progresses, the sufferer becomes emaciated—
suffering, if not death, even more ; and, at last, unless rationally
treated, becomes a  poor, dejected,  abandoned and  unhappy
cripple for life.   The barbarous and irrational  treatment of the
moxa,  or the red-hot iron; or the modest, but torturing method
of blisters to the spine; or even  the more humane, but equally
useless, treatment with spinal apparatus, with crutches support-
ing the arms and resting on the hips, still leaves the  poor suf-
ferer to go on  in misery, pain or death, with  a most pitiable de-
formity, if life is spared.
FIGURE 3.
As received.
As cured.
  The  symptoms of  antero-posterior curvature  of  the spine
(with caries of the bones) forming a lump upon the back, are so
likely to  be mistaken by the inexperienced for other diseases,
that hundreds of poor sufferers are allowed to become deformed
for life before the real danger is  detected. 
152
MISTREATED OR NKC.LECTED.
  The following are some of the early symptoms :   The patient,
while able to get about as usual, is  seized occasionally with pain
in the stomach or bowels, sometimes constant for days, or per-
haps only momentarily; a hacking cough, difficulty of breathing,
pain in the legs, lassitude, sometimes loss of appetite and  flesh;
laying the hands upon tables, chairs, etc., as they are passed,and
leaning upon some support as much as possible.  Some of these
symptoms  occur;  but soon  a cautious gait  is  observed,  the
elbows thrown back,  chest protruded, the body kept straight if
possible—will kneel with one knee, or squat  instead of stooping,
Before treatment.
IKilHI. 4.
After treatment.
to pick up anything from the floor.  If the curvature is going to
come high up, or above  the shoulders, the  hand  is found sup-
porting the  chin or head;  if lower down, the hands are on the
knees.  As  the case progresses, the  suffering increases, and loco-
motion is more impeded.  Finally, a slight elevation is seen upon
the  spine.  Even then  many cases are heartlessly neglected,
being told it is nothing—will outgrow it.   The pains, not always
being in the back, mislead those ignorant of their true meaning.
Deformity ensues; and, when the health fails, locomotion is nearly 
               VARIOUS STAGES OF POTT'S DISEASE.            I 5 3

lost, and the struggle for life half over, danger begins to be feared,
weeks or months after the most vigorous treatment should have
been adopted.
  In this manner many thousands of children are  mistreated or
neglected, and the precious time which  should be employed in
rational treatment for spinal disease  is frittered away in foolish
and damaging efforts to destroy, with powerful  drugs, imaginary
worms, or cure supposed disease of the stomach and bowels.
1.           2.          3.
                    FIGURE 5.
  Figures 1,2,  3, 4 and 5 of this cut illustrate various stages of
Pott's disease, from  the first  appearance of the small lump or
prominence on the back, as shown in No.  1, to the  hopeless de-
formity of No. 5.
  This  deformity being produced by contraction  of muscles on
one side and partial paralysis on the other, wijth a  soft condition
of the bones,  it necessarily grows worse more  rapidly as  the
body becomes heavier and larger.  Hence, a case never existed
where nature has produced a cure, or the patient outgrew it.  If
the case is neglected, the vital organs suffer from compression by
distortion of the body, and serious diseases of the lungs, liver, heart
or other vital organs supervene.   Should the case escape death,
a life of deformity is th|  best that can be hoped for, unless a
proper mechanical and medicinal treatment is employed.
  We have  made the treatment of this class of diseases a special
study for years, and  are happy to state the result has been most
gratifying;   and  we   can  now say to the multitude who were
deemed heretofore hopelessly lost, that a cure can be made, the
 
154
NURSED UPON A PILLOW.
deformity prevented, and spine restored, provided  the  disease
has not existed too long.
  The little boy, as  shown  in this cut,
figure 6, when  taken  to  the  Surgical
Institute by his mother for treatment,
was so reduced and his health so  much
broken, that he was  carried and nursed
upon  a pillow.  His case, it was feared
by all, was hopeless,  and  his  mother
was   so   informed.   Nevertheless,  he
continued steadily to improve; and, al-
though  the deformity  is  not entirely
removed,  the lump  has grown smaller
and smaller, and his health has improved,       figure 6.
until he  is to-day a  bright, smart and useful boy.
nciKK r.
Before treatment.
Cured.
  The appliances used are varied, and must be adapted  to the
wants and needs of each case, in order to be successful.   They
are not, like the bungling and imperfect appliances of the shops
in our cities, sold by mere brace-makers—instruments of torture
to the patients who wear them.   On the contrary, they act upon
correct and scientific principles, bring the body back to its natural
position, relieve the diseased and paralyzed parts of the weight
which they can not support; and thus, with other proper  treat- 
EASY, RATIONAL AND SUCCESSFUL.             I 55
ment,  restoring symmetry and motion where deformity  and
paralysis so recently  existed.
  The symptoms of lateral curvature in  the earlier stages  are
often quite obscure.   Among  those first noticed is the  loss  of
vitality;  debility,  nervousness;  loss  of  appetite,   flesh,  and
strength.    One shoulder-blade seems a  little larger and more
prominent than the other.   If a girl or young lady (and the ma-
jority of cases are), it will be noticed on fitting-the clothing that
one side is longer than the other.
            FIGURE 10.                   FIGURE 11.

  Figure 10 represents a case of lateral curvature of the spine,
showing the condition when received by us for treatment.
  Figure 11, same case when discharged from the Institute. 
i56
APPARATUS AND APPLIANCES.
  The treatment  of curvature of the spine is easy, rational and
successful, when  properly  understood  and  conducted;  and no
child need grow up with a deformed spine if timely and properly
treated, thus saving untold  pain, sad deformity, blighted hopes,
and a ruined child.
tit
h
  These figures represent a  few of the  great  number of appli-
ances and  apparatus for affections  of the  spine.  There are
scarcely two cases requiring the same kind of support, and it re-
quires a great amount of ingenuity to adapt just the right appli- 
                     THROWING AWAY MONEY.                 I 57

ance for each case; and no case can be fitted without visiting the
factory where they are made,  as many changes in shape must be
made before justice can be done the case.   Hence the folly of or-
dering a brace by measurement being sent.   It  is only throwing
away money, and allowing the deformity and disease to progress
unchecked.
  We give below two extracts from letters received from patients
who have been  treated by the National Surgical Institute for
disease of the spine :

  " I was born with curvature of the spine.  In my childhood it could hardly be
noticed, but at the age of twelve it grew worse, and the older I became the larger
it grew.  All treatment was of no avail, until I applied to the National Surgical
Institute, at Indianapolis, Ind., when the disease was instantly checked. When I
first went to the Institute,  my spine was curved in the shape of the letter  S, but
not quite as much.  When I raised  the right arm, the shoulder-blade projected 
i58
TWO YEARS OF TORTURE.
out so far that I could lay my hand on the inside of it.  Since my treatment it
has pushed back into its old place.  The lower part of the spine was bent to  the
left, pushing the ribs upward.  I  also had a wry-neck, the head bending to the
left.  All previous treatment was  of no avail—made me even worse, if anything.
I consulted our village and city physicians, wore  their braces, and at the same
time was pronounced  incurable.   While  residing at Milwaukee, a  gentleman
recommended a prominent New York physician, had a brace made and sent me,
which did me no good whatever, except giving me a taste for  two  years  of tor-
ture, something like the thumb-screw of former ages.   I am  now almost cured;
my spine is nearly straight, my right shoulder as  high as the left, and my wry-
neck among the things that were.
                               KITTIE A.  SCHNACKE,  Waukesha, Wis.

  I placed myself under treatment at the National Surgical  Institute for dis-
eases of the spine,  and am now able to do as good a day's work as any one; while
for two  years previous to being treated at the Institute, I was utterly unable to
do anything.                             M. L. LANTZ, Westminster, Md. 
 
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CHAPTER   XXII.
                          FEMALE DISEASES.

  Mj|jTT IS not without feelings of delicacy that we make the  fol-
  ql I   lowing plain statements and explanations in regard to these
  T    common ills, but the work  is intended only for the perusal
  of those whose minds and bodies are tortured by such diseases,
;  and who have in vain sought relief at the hands of those to whom
I  they are  accustomed to appeal.   We  are  aware that heartless
i  itinerants and pretenders, destitute of reputation and business at
i  home,  are  daily  endeavoring, by means  of reckless advertise-
  ments, to entrap and victimize the anxious and perhaps too cred-
  ulous sufferer; but we trust that  such a thorough investigation of
  our standing and ability will be made, as shall satisfy all that we
  engage in no such ignoble traffic in human happiness and human
  life.  Had we not the most thorough preparation, the most per-
  fect and complete,mechanical appliances, with  long  experience
  in th treatment of such cases, we should be unwilling to assume
  this responsibility.   F.ew if any physicians in private practice can
  spare the time or make  the necessary outlay in order to treat with
  the highest  degree of success the varied forms of disease which
  we  are daily observing and  treating.   Many of these cases re-
  quire frequent  attention in the way of dressing, application of
  medicines,  supporters, instruments, etc.   For this purpose, and
  to have patients constantly under the best conditions for recovery,
  we employ competent and experienced lady assistants, whose duty
   it is to carry into effect, under the directions of the physicians of
  the staff, all needed measures for the case.
     The fearful increase in the number of victims, the  majority of
  whom are wives and mothers, who are daily succumbing to the dis-
.  eases peculiar to the sex, demands an increase of the facilities for
  affording medical and surgical treatment, adequate and within the
i  reach of all, for this  class of sufferers.   To accommodate all who
  . may apply  to  us  for treatment, large  additions and varied and 
i6o
OUR  FEMALE
DEPARTMENT.
invaluable  improvements have been recently completed in our
Female Department.
  The mechanical and surgical appliances pertaining to  the Fe-
male Department are extensive and varied, gotten up regardless
of cost, and from  designs furnished exclusively by ourselves.
The limits  of this work will not admit  of a  detailed account of
each individual  invention or appliance.   We feel justified,  how-
ever, in saying to our numerous friends, that nothing is wanting
to insure the comfort, happiness and welfare of our patients.
  In the routine of daily business and toil the husband and father
may overlook or fail to divine the  cause of the care-worn  face,
the lusterless eye, and the unsteady step of the sufferer as she
struggles along in her efforts to secure the happiness of her fam-
ily, at a cost of pain, physical and mental, and with a disregard
of self,  that challenges admiration and calls forth our warmest
sympathies in her behalf.   Unwilling  to add to the cares and
anxieties of her  friends,  she conceals as far as possible  her real
suffering and disease, and continues to drag along  a miserable
existence,  each  day bringing mental depression with increased
nervous pain and  debility, until,  totally disabled, she sinks  into
permanent ill-health or a premature grave.
  The causes which lead to the development of these diseases are
numerous.   Among the more common  we may mention excess-
ive work or domestic care, improper food, imperfect  nutrition, ir-
regular habits, excessive indulgence, unnatural and artificial mode
of life  peculiar to the times, abortions,  rapid child-bearing,  tight
lacing, hereditary taint, etc.    Disease follows its cause as surely
as night succeeds the day.  Sooner or later the strongest consti-
tution must yield, and the most vigorous and healthy female be-
come feeble and  anemic, if  exposed,  as  thousands are,  from
choice or necessity, to  one or more of the causes above  enumer-
ated.  Sometimes from a false delicacy,  oftener from neglect, the
premonitory symptoms are disregarded.  When concealment  is
no longer possible, and the disease is too firmly fixed to admit of
further neglect, some of the ordinary measures are employed and
pursued (so long as the urgency of present suffering demands),
and usually a palliation of symptoms will be the only result, and
the disease, checked for a time, will continue  its ravages until,
with constitution impaired, nerves  shattered, and health gone, the 
CONTROLING  INFLUENCE OVER THE MIND.         l6l
 once happy wife or mother is but a sad wreck of her  former self.
 That man is fortunate, indeed, who can successfully wage the bat-
 tle of life with such a helpmeet.  How many failures  in business,
 how many blighted prospects and unrealized hopes are chargeable
 to this cause.
   A word here to  parties interested.   While the legitimate exer-
 cise of married rights  has  been sanctioned by  the  good of all
 ages> yet we but reiterate the opinion of every competent  judge
 when we'make the statement that no woman who is  the subject
 of well-defined  uterine disease should submit  to the sexual em-
 brace until the disease, of whatever character or form, shall have
 been completely and thoroughly eradicated.
   The uterus is the most wonderful organ in  the  human  body.
 With an average length  in  the unimpregnated state of 3  inches
 and a weight of 2 ounces,  it is susceptible of an extension or
 growth, during pregnancy, to 12 or 15- inches in length and  40
 to 64 ounces in weight.  Physiologists find here the most power-
 ful known contractile tissue, the number of pounds pressure that
 it is capable of exerting reaching a figure  almost fabulous.  This
' wonderful fabric, provided to protect the foetus during pregnancy,
 and to perform a few hours of expulsive work at its close, returns,
 when its work is done, to its normal  condition in a brief space of
 time, affording a striking example  of the wisdom displayed in
 adapting means to  the  end  to be accomplished.  The womb,  by
 means of its extensive  nervous connections,  exerts in health and
 disease a controling influence over the mind.  In  disease  this is
 eminently the case, as is strikingly shown in hysteria, puerperal
 mania, paralysis, etc.
    The  following  plates, introduced  for the purpose  of  giving
 clearer and  better ideas of the malpositions and diseases  of the
 organs,  have been  prepared.  The designs were drawn from na-
 ture, hence their faithfulness.  We doubt not they will convey to
 the mind of the reader an  impression more  satisfactory and cor-
 rect than any description, however carefully prepared,  could possi-
 bly do.   To give representations of  all the  abnormal conditions
 and displacements  affecting the uterine system would be imprac-
 ticable in a work like this; therefore we select a few of the more
 common as well as  the  more  serious and  troublesome  forms.
 Should  we  succeed  in making the investigation and study of
       11 
162
SOME  OF THE SYMPTOMS.
these conditions  more satisfactory and clear by this  means than
it has been heretofore we shall be amply rewarded for the effort
made in this direction.
  Plate i represents the uterus, ovaries, fallopian tubes,  round lig-
aments and various parts of the organ  concerned in  utero-gesta-
tion.  The right hand side shows the parts with the serous mem-
brane  removed; on the left side  they are seen with the serous
covering intact.
  Fig.  i represents the uterus.   Fig.  2 represents the' fallopian
tube.  Fig. 3  represents  the  ovary, where the ovum  or egg  is
formed.   It escapes from the ovary, and is received  into the fal-
lopian  tube, the end of this tube being contracted and fimbriated
(Fig. 4.) Traversing the fallopian  tube, the  egg is discharged  into
the upper part of the womb, where it is ready for impregnation,
and  if this occurs it remains for development and growth.   Fig.
5, the vagina.   Fig. 6, round ligament.   Fig. 7, broad ligament.
Fig. 8, mouth of the uterus.
  Plate 2.  A  section of the female pelvis, showing the organs  in
their natural condition.    Fig.  I, the bladder.    Fig.  2, vagina.
Fig. 3,  the rectum.   Fig. 4, the uterus.   Fig. 5, last vertebra.
Fig. 6, pubic bone.
  Falling of the womb, (prolapsus uteri,) Plate 2, Fig. 4, perhaps
the most common of all its misplacements,  is usually attended by
the following  symptoms: Sense of weight and bearing down  in
the  lower  part  of  the abdomen,  pain extending from thence
across  the hips  to  the small of the  back and  down  the thighs,
frequent desire to void urine, inability to remain long  in the erect
posture, weak, trembling sensation, sense of weariness, nervous-
ness,  mental depression,  palpitation  of the heart, shortness  of
breath,  increased by violent exercise or going rapidly up stairs,
sleeplessness, capricious appetite, etc.   The causes are various,
any  thing that impairs  the general  health, lifting, tight lacing,
congestion, etc.     From the nature of  its function, the womb  is
necessarily so  situated as to admit of a large  scope  of motion,
thus enabling it to accommodate itself to its ever-varying  size
during  the critical  months of pregnancy.    This mechanical ar-
rangement or situation of the organ renders it peculiarly suscept-
ible to misplacements.
  Retroversion, or falling back of the upper part of the womb,  is 
                 VERY DISTRESSING SYM1TOMS.              163
shown in Plate 4,  Fig. 4.  In  consequence of this condition the
rectum,  lying  in close proximity behind the uterus,  is pressed
upon,  giving rise to frequent desire to go to stool, with a  failure
to be relieved  thereby, and  a  constant  feeling as though there
yet remained in the bowels something which ought to pass away
In this condition the womb usually enlarges, and, becoming con-
gested, is dragged down into the lower part of the pelvis, thus produc-
ing the ordinary symptoms of prolapsus, in addition to those symp-
toms which are the  usual attendants of the above displacements.
  Ante-version is  a tilting or falling forward of the upper  part of
the body of the womb, as shown in Plate 5, Fig. 4.   This gives
rise  to very distressing symptoms, chief among which are fre-
quent, painful, and often  ineffectual desire to urinate, this symp-
tom being greatly aggravated by the erect posture and walking;
extreme nervousness, with many of the ordinary symptoms  of pro-
lapsus of the organ.   This, like all the displacements and malpo-
sitions of the womb, results  from the disease of the organ or its
appendages, and can only be permanently  relieved by a cure  of
the disease from which it arises.
  The abnormal,  unnatural mode of life into- which  so large a
portion of the American women of the present  day have almost
irresistably and unconsciously drifted has developed a largely in-
creased proportion of cases  of congestion, inflammation and ul-
ceration of the mouth and neck of the womb.   A representation
of these  diseases  is  strikingly shown  in Plates 6 and 7.  The
ulcers, or sores, (Fig. I,) vary in size from a few lines to an inch
or more in breadth.    They are  situated  upon the neck  of the
womb,  and extend, in many cases, over the lips, and along the
mucous membrane lining its interior.    These plates  also repre-
sent another form  of the female disease to which the attention of
sufferers from its ravages has hardly been directed, namely, uter-
ine leucorrhea. (Fig.  2.) The unhappy,  disheartened and  debili-
tated sufferer from this disease can here  find an explanation of her
case, with a reason for the failure  of all remedies, regular and ir-
regular, which she has summoned to her aid. The disease, orig-
inating in the lining membrane of the  uterus itself, and not  in the
vagina, was never once attacked in its stronghold, never reached
by the means used to alleviate or cure,  hence the failure and dis-
appointment. 
164
AVERT THE COMING
CALAMITY.
  These diseases are more wide-spread and  common than  most
persons, not  excepting those who  are  among  their  victims,
would on first thought be ready to admit.    Very  few patients
who are the subject of ulceration  of the womb really  compre-
hend or realize  the  fact that an ulcerating, corroding sore has
fastened itself upon  them,  and is  slowly but surely destroying
the tissue  and impairing the  function of  this  delicate organ.
Nevertheless they feel feeble and nervous,  are  full  of neuralgic
pains, have dizziness, rush  of blood to the  head, pain and heat
on the top  of the head, pains in the back and across the bowels,
soreness in connection, or a strange want of usual and healthful
sensations,  and  an  absence of  former  desires, a  sallow  com-
plexion, a hectic flush; but these symptoms and conditions are not
interpreted aright, and the warning which they give  is too  often
unheeded or misunderstood.
  In addition to the  above symptoms the  mind partakes more or
less of the  diseased  condition of the body,  as evinced by fickle-
ness,  irritability and gloom.  The  world  looks dark, the charac-
ter changed, and is so during the continuance of the disease; in
fact no words can describe the pains and  ills, the  loss of health,
happiness and life that follow in the train.    The  presence  of all
the above symptoms will rarely, if ever, be found in a single case;
therefore the presence of two or  three,  in a well-marked degree,
should arouse suspicion  and call  for a strenuous  effort to  avert
the coming calamity.
  It is hoped that these  cuts and explanations will convey some
idea  of the nature and functions of these  important  and delicate
organs, and that the location and character of their diseases may
be better understood.   If the ovary fails to furnish the egg, or
the fallopian tubes are inadequate,  from disease  or other causes,
to the task of conveying it to the womb, or if, having arrived
safely at this receptacle, the organ  itself is diseased, barrenness
may follow.
  The nature and location of the disease will determine its  bear-
ing upon the reproductive process; for not every case of disease,
even though it be grave in character, will  be attended by barren-
ness: nevertheless tumors of the ovaries, congestion of the womb,
and many other  diseases may be followed by this result.
  Plate 8.   In this plate the blood-vessels are shown, traversing 
THE  ROSY HUE OF HEALTH.
I65
the organ in every direction, and giving it an abundant supply of
blood.   Local irritation  and many  forms of disease invite an
increased flow of blood to  the parts,  giving rise to pain, increase
of weight, displacements, leucorrhea, and ulceration.   A strik-
ing and  characteristic difference is observable between the dis-
eases usually  affecting the womb and its appendages, and the
ordinary diseases and fevers with which  the general  practitioner
has to deal.
  An inflammation of the lungs or a typhoid fever may run its
course  unassisted  to a favorable  termination,  the   cure being
accomplished alone by the powers  of nature, the vis medicatrix
naturae,  as physicans so often say;  but  a disease of the  uterus
or its appendages is  followed by no  such results.   On the con-
trary, its tendency is  to indefinite perpetuation; morbid, diseased
action ceasing only with the extinction of vital power.   Let no
sufferer  be deceived  by the advice of inexperienced persons, or
be prevented by  the  opposition of relatives or friends from seek-
ing relief while yet there is hope of a cure.    Rest assured that
nothing will so certainly  contribute  to your happiness and  wel-
fare,  as  well  as  to the happiness  and welfare of those around
you, as release from  the enfeebling,  painful,  miserable condition
into  which you  have been dragged by  disease;  and that your
friends will not be  slow to justify your course and approve your
spirit and determination  when the  rosy hue  of health and the
firm elastic step  announces your complete recovery.
   The treatment of  female diseases has been a fruitful source of
annoyance and perplexity to the general practitioner, and of suf-
fering and disappointment to the patients for obvious reasons.
For us to say that the time-honored methods for treating these
diseases are erroneous and injurious might seem like presump-
tion or egotism,  (especially to  the  older  members of the  profes-
sion,) but it is too often  true.    Galileo contradicted the philoso-
phy of his day, and  all know his persecution.   Harvey was con-
demned for overthrowing the medical theories of centuries.
   Presumptuous as  it may seem  for public sentiment to wrest
the lancet from  the  good old doctor's hands, and denounce its
use as murderous barbarism, (although it had been considered a
sheet-anchor  and "sine qua non,"  in many cases, for centuries,) 
166
ANCIENT BARBAROUS ORDEALS.
and leave him to sneer at progress and mourn his bosom friend,
yet the old ruts must be filled.
   The propriety of abandoning the indiscriminate use of the
lancet, or even of its frequent employment, is  no longer ques-
tioned  by the most ultra  regular.    All  now  admit that the
present age is one of  progress and  of investigations, that  our
march is  ever onward.    We do not  believe that the seaton,
the caustic or  the moxa ever really accomplished the good that
is claimed for them, any more than  we believe  that the duped
Greeks and Romans were really cured by the incantations and
secret  remedies,  such as  viper's  blood,  etc.,  or the  heathen
Chinese by the barbarous  ordeals which were  called into requi-
sition when they were sick.  Nor do  we to-day believe  that the
cauterization of the  uterus,  as a common  mode of practice, is
either judicious or beneficial.  Inflammation, congestion and ul-
ceration of the vagina and womb have the same characteristics
and  are governed  by  the same  laws and influenced  by  the
same conditions that similar affections are in other parts of the
body.   The   blood-vessels are distended and  engorged in  the
same manner,  and the swelling depends upon  the same unnat-
ural  condition. Any treatment, to be successful, must by some
rational means  unload the  distended  blood-vessels, restore them
to their proper size and  tone, and thus relieve the parts  affected
of the swelling, heat and pain.  Irritation precedes and is a fruit-
ful source of inflammation.  It is also one  of the most constant
and immediate results of the application of a caustic.  Which is
the most reasonable ? Apply a medicine which will of itself give
rise to inflammation, and, if persisted in, is total destruction of the
parts, or to cure  the diseased condition by  more rational means,
leaving the parts whole,  instead of  destroying  them with  the
vain and foolish hope of effecting a  cure ?  Suppose hundreds of
cases have improved after the use of caustics.    Hundreds have
also recovered after severe  bleeding and terrible burning with the
moxa; and hundreds also recovered after being  wounded upon
the battle-field, and submitted to the old practice of having the
wounds filled with boiling  oil.   But  might they not have done
better under a better, more reasonable, and sensible plan of treat-
ment?  Many old theories are manifestly false.    In consequence
of their habits  of life, the ladies of the present  day are prone to 
          PAINLESS AND UNOBJECTIONABLE TREATMENT.       167
congestion and inflammation of the os uteri and vagina, and the
almost inevitable result of these  conditions are leucorrhoea  and
ulceration, which  implies destruction of tissue.    We claim that
these conditions should be treated upon a plan that will not only
afford speedy relief, but a more lasting cure.   It is not only the
mucous lining  that is involved in this congestion, but the whole
pelvic organs suffer more or less: hence the application of med-
icines to  the  mucous  surface  alone can not  by  any possible
means restore  to  their normal size  and condition the thousands
of congested and diseased vessels situated at too great a distance
from these surfaces  to be in the least affected »by such applica-
tions.    The human body is like a wonderful  machine, and its
continuance  depends upon the  free and  harmonious  working of
its several parts, and when  but a single part becomes deranged,
or fails to act, the machine suffers,  and its usefulness is either
greatly impaired or entirely lost.  When inflammation exists in a
part, an undue amount of blood has accumulated there, giving
rise to  over-distension and consequent  impairment of nutrition.
This condition can not long exist without destruction and break-
ing down  of tissue;  hence we have  ulceration and  sloughing,
(see Plates vi and  vn), with its concomitant evils and disturbances
of the health. Now the object to be accomplished in these cases is
to invite, to call away from these  diseased structures the excess of
blood which they contain, and to equalize and restore the circu-
lation, to  give  a healthy tone to the coats of the vessels, to sub-
stitute a condition of ease and health for one of pain and ulcer-
ation.   Local  applications and general medication, as ordinarily
employed, can  not accomplish this end.   The truth of this state-
ment is abundantly established  in  the thousands of failures by
the ordinary method which meet us  at every step  in the progress
of our investigations.   And yet no mucous surface is more easily
reached or treated with more facility.  In this brief chapter a full
and exhaustive explanation of the rational, painless, and entirely
unobjectionable mode of treatment which long years of exper-
ience  and observation have led  us  to  adopt  can  not be given,
but a few suggestions  may not be out of place.
  The common syringe, with  rubber pipe and  bulb and metal
tubes, is superior  to the old glass or metal syringe, and yet it is
but a burden upon properly administered injections.    The fluid 
i68
BUILDING UP THE SYSTEM.
passes through  the tube  into the vagina in a broken stream of
not more than  one-fourth of an  inch  in diameter,  and, allowing
an  equal space  for its return,  the area of mucous membrane
reached would be little greater than that occupied  by the metal
tube.  No obstacle  is interposed to prevent the escape of the
injected fluid, no provision for distending the folds of the vagina;
hence many  folds and wrinkles are not reached by the medicine
or fluid used. The truth is that the vagina should be completely
filled by the  fluid, thus  distending and unfolding  its walls and
carrying the  uterus to its proper position and retaining  the  wash
as long as desired, and at the same time bringing the medicated
injection into direct  contact  with the  entire vagina surface and
mouth of the womb.
  The movement cure, with new arrangements for oscillation, the
oxygen gas, electrical baths and other appliances of various kinds
are in successful operation.   We discard the disgusting pessary
that every lady  has learned to despise who has had a trial of it.
Female assistants conduct the treatment prescribed by the  staff,
and there is  therefore no objectional exposure.    While we do
not discard the use of medicines,  we denounce the indiscriminate
and wholesale drugging generally in vogue, and declare our  want
of faith in  the so-called  specifics which  are  administered  by the
mouth with  the  hope that  in some manner,  unknown alike to
physician and patient,  they will reach and act upon the diseased
organs and structures.  The foolish quackery  which is for ever
"building up the system" ostensibly, while in feet the vital  pow-
ers  are being surely and  steadily  broken down, is equally repre-
hensible.   In this manner thousands of lady sufferers are "toned
up" with iron, bark, and all kinds of tonics and elixirs, until their
ruined health forces  upon them a realization of the almost fatal
mistake.    Better cure the disease than treat the symptoms.   A
lady looks pale, is anemic,  not  alone on account of a deficiency
of iron in the blood,  but from some  cause,  or  combination of
causes, the  blood is  not up to  the healthy standard  or type.
Iron constitutes  but a small and  comparatively unimportant part
of this deficiency.   Iron, although now deemed indispensible in
the construction of railroads, and for thousands of other purposes,
can never be manufactured  into  a main-spring for running the
delicate and complicated human machine;  hence the practice of 
                       IRON  AS A REMEDY.                  169
administering iron in powder,  iron in pill, iron in tincture,  and
iron ad infinitum must of necessity be a failure.   What is true
of iron is equally true of all  the specifics in popular use.    We
cast no censure or reproach upon the general practitioner of med-
icine.   His labors and responsibilities are great, and, if faithfully
and conscientiously discharged, will leave little time for the pre-
paration and  application of such remedies and  appliances as can
only be properly and satisfactorily used in an institution practice.
If these cases could be as  successfully treated  in private practice
as  elsewhere,  they should not have been permitted  to become
chronic.  We have scarcely ever received a patient  reduced in
flesh, who  did  not at  once  begin to  improve in  health  and
increase in weight and strength; and we are sincere in the belief
that our method of treating  this class of cases is more satisfac-
tory, yields better results, and is  therefore superior to any one
heretofore employed,  either  by the general practitioner  or  the
specialist. 
                     CHAPTER  XXIII.

  SENDING MEASURES FOR BRACES AND OTHER  SURGICAL APPARATUS.

       HEN cases of deformity occur, requiring surgical appara-
        tus in  the course of their treatment, it is quite common
        for the friends  and the attending physician to think that
the dimensions of the body or limb can be  taken and the meas-
urement sent to a machinist or instrument maker, and thus ob-
tain the required brace for the patient.
  Such a course would only end in disappointment, and if noth-
ing further was to be done than the application of such a brace,
the patient would remain a cripple  for life.
  In the treatment of spinal curvatures, hip-joint disease, and
other deformities, we find no two  cases  that  are exactly alike,
and no two persons or limbs are exactly of the same size and
shape; consequently, any ordinary  measurement would be of no
use to  us in the manufacture of braces for such cases.  This fact
is very conclusively shown  by examination  of our  apparatus
books, in which are recorded  thousands of measurements.
  It would astonish anyone to see  the variations in the measure-
ment of cases,  that appear to  the eye alone to be exactly alike,
but which upon careful examination by proper measurement are
found to be very unlike. Experience has taught us that surgeons
and  physicians, without  practical  knowledge  of this  specialty,
can not make  a measurement or diagram from which our me-
chanics can make a  satisfactory brace.  This being the  case, how
can persons without surgical  skill  or knowledge take  measures
that would be  otherwise than  very defective and incorrect.
  Should apparatus be made from such measurement and applied
to the patient, results  worse  than  simple disappointment would
occur.   Positive harm would be done in almost all such cases.
  If it were  possible in this way to obtain apparatus that would
be adapted to  the case when  first applied, a  failure of success
would doubtless  result, owing to the need of proper adjustment
daily,  by some  one of experience and  skill  in the  treatment
of such cases.  The pressure and bearings upon the person must
be looked after constantly, and such changes made from time to
 
CHANGING THE APPARATUS.
171
time as are indicated in the case.   It often occur% that  an appli-
ance  will accomplish the  special part  designed for  it in  a
comparatively  short space  of time, and then a radical change
in the apparatus must be made to finish up the work of correct-
ing the deformity, and the expert only is competent to make the
required  change, so as to insure the final  favorable results re-
quired.   Take, for example, a club foot: it is idle to suppose that
one brace will correct such a deformity; and yet, with the proper
changes  in the  brace as the case progresses, such a deformity
can be perfectly cured.  Such cases of deformity require constant
attention  and very close observation, in order to  accomplish the
results required; and what is true of club feet is equally true with
other limbs and other deformities.
  It is a very common occurrence for us to receive remittances of
money by the mails, with letters asking for prescriptions for the
treatment of  various diseases;  we also receive measurements for
surgical appliances.  Such communications  are always answered
with  the  information that we never  give medical treatment or
surgical appliances, without first having made a personal exam-
ination of the patient.  If it is necessary that we should take
our own  measurements  and  adjust our own mechanical appli-
ances to meet the various indications and conditions of each case,
is it not of equal importance that we have a personal examina-
tion of cases needing medical aid.   To  prescribe for a patient,
intelligently,  we must know the history of the case, the  tempera-
ment, hereditary peculiarities and taints; the age,  sex, stage and
progress of the disease, etc.—all of which are actually necessary to
know before a proper prescription can be made.  Having once made
a proper examination of a case, treatment may be successfully con-
ducted with the patient at his home, even if the distance be great.
  It is for the interest of every one desiring treatment at the In-
stitute, to visit us in person.   We dp not require a fee for per-
sonal examination.   If the case  is incurable, we do not  attempt
treatment but dismiss it at once,  as we  do not take any patients
that we think we can not either cure or greatly improve.
  Our advice is, take no medical treatment from  any physician
without a personal consultation;  wear no braces or other surgical
appliances that were not made especially for you,  from  measure-
ments taken  by the mechanical surgeon  in charge of the manu-
facturing department. 
CHAPTER  XXIV.
                       THE  EYE AND EAR.
 +
 211 T IS well known that the eye and ear require the most care-
 i*tji |  ful and delicate treatment.   One of the most eminent med-
 T   ical men now living, says:   "The treatment of diseases of
 the eye and  ear ought in all cases to be entrusted only to those
 who make these organs their constant and  special study.   The
 general practitioner leads too busy a life to  become proficient in
 these departments.   Never let any  one touch, prescribe  for, or
 operate on the eye or ear,  who is not known  to be thoroughly
 prepared and competent.
  That gross  errors are daily committed by both patients and
 physicians  in  the  treatment of diseases of the  eye and ear,  the
 myriads of the hapless blind and deaf all over  our land too fully
 demonstrate.   To the  considerate mind  the question  naturally
 arises, is all this sadness necessary,  or can  it not be prevented ?
 It is, we think, justly claimed that  no one  can  excel  in  many
 things.   No great man  was  ever great in many things,  but only
 great in his adopted speciality.  The mind must be concentrated
 if more than ordinary results are  attained; besides, to  deal with
 such  delicate and  intricate organs safely, requires  constant and
 extensive experience in their treatment, such as no general prac-
 titioner of medicine can have.   The eye is an organ not only the
 most sensitive and sympathetic, but when diseased requires the
 most prompt,  mild and efficient treatment.
  From recklessness, neglect and ignorance, many sad cases of
 blindness, suffering and misery occur.   Results of this kind and
 from such causes are perhaps pardonable; but when professional
 aid is sought  for,  even the  ignorant and simple-minded are not
 excusable for placing themselves  or their friends in the hands of
 ignorant pretenders—who know no more about  the eye than they
 do of the future world—ever  ready to prescribe nostrums for every
sufferer, utterly  regardless of consequences.   Competent,  scien- 

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                  CROSS EYES EASILY CURED.               173
tific oculists can be found, and such only should be trusted with
the treatment of this organ.
  There is no organ in the whole body in which the ravages of
disease are more frightful than the eye.  Our institutions for the
blind, could their history be known, would be a gigantic repeti-
tion of the story: neglected disease or improper treatment.  And
yet there is no part of the human body that gives such satisfac-
tory and even brilliant results to proper treatment as the eye.

                CROSS EYES—(STRABISMUS.)
                           (Figure 8.)

   There  is no  deformity  that attracts  greater attention and is
really more unsightly than cross-eyes.  The eye rests in a socket
and is moved and controlled  by six cords or muscles;  an undue
contraction of one of these muscles causes the eye to turn in or
out,  sometimes up or  down.   The failure of so many who oper-
ate for this deformity is due to their ignorance of the true cause.
We can assure every one who is afflicted with this deformity, of
a perfect cure.
   Why should it be done in early life?  If you ask any adult who
has a cross eye, in nine cases out of ten he will tell you:  "My
cross eye is partially blind."  If the eye had been straightened in
youth it would have been  as good  as the other.   Fathers and
mothers, your children will never outgrow it.    Do not let your
children reach maturity with this deformity, which ruins the sight
of the eye, and subjects the  child  to  a life -of ridicule, when  a
simple  and almost painless operation will cure it.
   This deformity  is produced by undue contraction of the inter-
nal recti  muscles of the eye,  drawing the  eye towards the  nose.
This may exist in one or in both eyes.   The causes are various,
such as spasms, fevers,  whooping-cough,  sore eyes, etc.   The
deformity is very  easily removed and the eyes straightened.   It
will cost but little, can be done instantly, without pain, and re.
lieve a life-long mortification.   However we may try to convince
those thus deformed that it is a trivial matter, yet the most stub-
born fact exists, that their enjoyment and prospects are compro-
mised for life unless it is removed.   And since the cure is as free
from pain and  danger as  any  surgical  operation, and  so perfect 
I74                    INFLAMED EYES.

and instantaneous,  none can afford  to endure the mortification
that cross eyes inflict.
                     CONJUNCTIVITIS.
                        (Figures 12 and 13.)
  Inflammation  of  the  eye (by most people called the common
sore eyes) is  so common  as to need no description.   It  may
attack the eyes of old or young at any season of  the year, and
with or without  any cold, injury or assignable cause.  This is far
more common than any other disease to which the eye is subject,
and the majority of cases  recover if properly  treated.   During
the inflammatory or active stage, which may last from two to
three days to as many  months, more or less pain, intolerance of
light, excessive flow of tears, and a discharge of more  or less mat-
ter attends the trouble.
  As the pain  and swelling subside, if the  eye is  not  lost,  a
chronic stage may follow,  and if there  is no ulceration of the
ball, the mucous papillae or follicles of the lids become hypertro-
phied, or increase in size, and what  is termed granulation of the
lid ensues.  (See granulated lids.)   The treatment of this acute
inflammation  of the  eye  should  be exceedingly cautious and
guarded, lest more  evil than good result  from it.   All  poultices
should  be most positively forbidden; no warm or hot appliances
should  be made unless cold produces  actual  pain, which will
never be the case,  unless much neuralgia attends the disease, or
produces it.   If such should be the  case, the ordinary treatment
of neuralgia  should be administered, doing nothing for the eyes
in the meantime.  But this disease is seldom attended with neu-
ralgia;  and cold applications, such as the cold atomized spray of
weak solution of acetate of lead, applied to the closed lids for
hours at a time, is not only the most grateful  but beneficial.
When  this  can not be had,  soft cloths, dipped very often in
some solution containing ice, should be applied constantly.   Ac-
tive saline or (cholagogue, if necessary,)  cathartics should be
given, and abstinence  from food and water enjoined for a time.
Avoid much exposure to heat  or cold, and the use of the eyes.
Very many  cases will soon yield to this treatment;  some, how-
ever, after a while  require a little medicine put in the eye, as an
astringent emulsion and anodyne, but this should be done most 
             GRANULAR OPTHALMIA--VERY COMMON.          175
cautiously and guardedly.  Of course, to prescribe a single treat-
ment adapted to all cases would be preposterous; or to prescribe
for individual cases without seeing the patient would be equally
fallacious.   Never listen to the medical advice of any one who is
not a physician, as danger  always attends such advice, and  you
may sacrifice your sight and  happiness for life by it.   Many of
these cases become chronic,  and linger for  years, even if the
sight is not destroyed.   If you would save the eye, don't neglect
this disease.  Never let your house burn down, and then get
anxious to put out the fire, but do it at once.   This trouble may
end in not only loss of sight,  but in a  hideous deformity.   (See
Figure 10.)
   The  causes and  varieties of this disease are numerous,  and
each variety requires a particular method of treatment.  The or-
dinary form, caused by exposure to bright light or a draft of cold
air, when taken in time, is easily cured; but, neglected, degener-
ates into that most common  of all chronic diseases of the eye—
granular ophthalmia.

                 GRANULAR OPHTHALMIA.
                           (Figure 1.)
   This is the most common of all chronic diseases of this organ.
Thousands  upon thousands  of sufferers from  this disease are
seen all over our land; some with occasional trouble, then a little
clear vision; over others the  cloud of darkness hovers, shutting
out with  a  constant mist from the mind all  satisfactory cogniz-
ance of the world; others, under a total eclipse of the  "windows
of the  soul," grope in thick  and impenetrable darkness during
the sad remnant of their existence on earth.

                    The dark abyss of earthly woes
                    The helpless blind man only knows.

   It is induced by a variety of causes.  Among the most prolific
is inflammation of the eye; or, as the patients say, they had the
 "common  sore eyes," and since then the eyes have remained
weak.  The disease may be rapidly induced, or years may elapse
before serious trouble exists  or the  eyes are seriously injured.
Scrofula often has much to do with the development of this mal- 
176
SYMPTOMS  OF OPTHALMIA.
ady, or its persistence.   Other causes often excite the diseased
action.
   The symptoms  are, to those  unacquainted with this affliction,
rather obscure and  often varied; in some instances,  weakness
of the eye, dimness of sight, itching of the lids, "blurring" in try-
ing to read; the letters seem to run or mix together; a mist forms
over the eye, which  a little rubbing will temporarily remove.  In
the morning the lids may stick together; a scratching as though
sand  was in the eye, which a little bathing  of the lid removes.
The lid, and sometimes the ball, looks red; or when in the wind,
heat or smoke, the eyes are irritated easily, and tears flow freely.
Some or all these symptoms  are present in the early stages, but
as it  progresses more grave and  serious symptoms supervene.
The ball becomes  red; intolerance of light;  sight declines,  pain
and suffering often attending; the ball becomes more and more
affected; ulcers often form; the cornea  often sloughs,  and the
sight  is lost.   In more simple cases opacity of the cornea (a
"scum"  over the  sight) is  produced,  destroying the sight;
though often not rapid in its course, yet destruction of the eyes
is  inevitable unless proper and  timely  assistance is obtained.
Whenever any of the above symptoms are present, whether you
are subject to  sore eyes or not,  it is a warning to seek  relief at
once, if you wish to  preserve your sight.
  In  ordinary treatment of this affection, more eyes arc lost or
injured  than properly cured.   You ask why is this so ? or, why
not let them alone,  if such are the results of treatment?   We
answer that such is,  we are happy to state, not the result of pro-
per treatment, and if let alone, the sufferer becomes blind.   And
in order to understand why so many go blind under the ordin-
ary treatment, we will first investigate the condition or pathology
of the part affected.   The mucous membrane that covers the vis-
ible part of the ball and lines the lids is similar to  that of the
mouth,  lungs  and intestinal  canal, the  papillae and underlying
glands varying to suit the necessities of the location or organ
dependent  on  or  connected with it.    In the eye it  is quite
smooth, and a portion of it perfectly transparent.  The remain-
ing portion contains the ordinary mucous  follicle  and minute
papillae.   These are abundantly supplied with blood, and often
take upon themselves a  morbid growth, and continue to a size 
TREATMENT.
177
from that of a pin's head  to a grain of wheat,  becoming highly
vascular, the blood-vessels  increasing in size as rapidly as the
granulation, as  it is then  termed.  Fig. 11 shows the blood-
vessels magnified; upon the upper  edge is formed a hard lamel-
lated structure, or layer, and the base is, in bad cases,  a  mere
pedicle compared to the top of the granulations.
  Now, it is a  fact that the more abundantly a part is  supplied
with blood,  the harder it is  to destroy.  (The design of all treat-
ment should be to destroy these granulations, as no other'course
proposes even a hope of relief.) So if medicine be applied to the
whole lid  as it is the sound texture is destroyed, and the  most
of the granulation left.  And it is  a law of nature  that  like pro-
duces like; if bone is broken, bone repairs  the break;  if muscle
is injured, it is replaced in kind;  if it is skin, skin restores  it; if
mucous membrane, it is  repaired  by  the same.  If this was not
so, man would soon cease to be man,  and our whole organization
would be changed.  If a part of a tumor or cancer is removed or
destroyed and not all, the space is refilled with the morbid growth.
So with granulation of the lids; if all  of them are removed entire
at once, the lid is ruined by  a large  cicatrix or scar, producing
entropeon,  or inversion of the lids, a  disease no better than the
first; and if by piecemeal, as it is generally done, the granula-
tions simply fill and refill the place of those  destroyed.   How to
deal with this rebellious difficulty  and make a speedy cure, phy-
sicians admit to be a vexed question;  and the patients  as well as
the physician, by sad  experience, realize that but few, very few,
are-successful in the  cure of such cases.  If a scientific treatment
is ever demanded for  the  cure of any malady, it is in this;  as
those who treat and are treated learn  that the rules laid down in
medical works often  fail.
   Figure  I of the plate  represents granulation of the eye in  an
aggravated form, but  not very uncommon.  The  disease, even
in  the condition as here represented, is amenable to treatment,
and should not be left to produce total  blindness because of  its
discouraging appearance.   Such  cases have been often perfectly
 cured at this institution.
12 
I78                INVERSION OF THE LIDS.
                       STAPHYLOMA.
  Ulcers on the eye-ball are frequent, and may result in stj^iry-
loma—the tumor represented in the cut.  The  deformity can be
easily removed by an operation.

                       ENTROPEON.
  Inversion of the lids as seen in figure 3 is a  most serious and
annoying affection.   It is generally induced by acute or chronic
inflammation of  the lids, or bad treatment for  granulation, pro-
ducing contraction of the membranes and  tissues, inverting the
lid.   The scratching  of the lids upon the balls produces pain,
inflammation and thickening of the membranes that cover the
eye.   Finally, by this thickening, a dull appearance is produced,
with loss of sight.    The  natural appearance  of the ball gives
place  to  a  red or grayish  hue, and the ball  may protrude like
Fig.  10.    The sight is then lost.   Sometimes only one lid is
inverted, and the trouble is not so serious for a long time;  but if
the lashes scratch at all, the eye will become inevitably more and
more  diseased, and be lost.  Many persons, when this trouble
commences, are told that wild hairs are growing out, and at once
the lashes are pulled out with the hope of relief, but the result is
pernicious.    All sensible  people ought to have learned before
this that  there are no such things as wild or tame hairs that grow
in upon the ball, unless the lid rolls them in; and the pulling out
of the lashes always  increases the trouble.   The treatment and
radical cure of the affection  is easy, and completed in a very short
time.   We have restored some  of  the most distressing cases of
this kind, and many who were supposed to be blind have had
good  sight restored.
                       ECTROPEON.
  In this difficulty the lids are turned out and drawn either down
on the cheek  or up on the eyebrows, disfiguring the face badly.
this is very easily relieved by a surgical operation, making a per-
fect lid, and restoring the symmetry of the  face.
  The different malformations of the lids can all be remedied by
an operation.  It is astonishing how the different deformities and
malformations in and about the eye can be so thoroughly  cured
without leaving a perceptible scar. 
OPERATION  EXCEEDINGLY  SIMPLE.
179
                         AMUROSIS,
A disease of the retina and  paralysis  of the  optic nerve, is a
disease of most serious importance, as most cases, if neglected or
improperly treated, result in continual  and total blindness.   Its
causes are various.   The  symptoms are flashes of light; dark
spots floating before  the eyes, sometimes stationary;  pain occa-
sionally; intolerance of light; finally, insensibility to light.  Sight
is useful only in a bright light.   The appearance of the  eye is
not usually  changed.   A minute detail of the symptoms which
may  or may not occur, of the treatment or its results, can not
here  be given for want of space;  but as it is a disease  nearly
alzvays fatal to the sight unless soon arrested, don't try experi-
ments, but seek proper treatment early if at all.  In this disease
a dropsical effusion sometimes follows,  (see figure 9,) which may
increase indefinitely, producing pain and a terrible deformity.
                         PTERYGIUM.
                            (Figure 2.)
   This disease is produced by hypertrophy, or fungoid growth of
the vessels and tissues  of the front portion  of the ball.   (See  fig-
ure 2.) The most common seat of this trouble is the inner corner
of the eye, though it may come upon any part of the ball.   It
commences by an apparent enlargement of the veins and arteries
of the external coats.  Soon a fleshy substance  gradually advances
towards the pupil, thickening and spreading as it advances.  Fi-
nally the pupil is reached, covered, and the sight lost.  This is
not  painful or troublesome  usually, and negligence is thus per-
mitted.   The  treatment should be early,  while it is  small and
simple.   In the treatment of this  affection great errors are com-
mitted.   Some will attempt to relieve it by astringent medicines,
making the trouble worse; others,  with an idea of more thorough
treatment or a radical cure, cut off the  offending portion, thus ex-
pecting to  cure;  but if it is excised it is  reproduced, and even
worse than before.  The same law holds good that like will pro-
duce its kind.   The same vessels that produced it once will again.
You only cut off those small branches, and the granulations pro-
duce the  trouble anew. It should  never be cut off; the operation
for a cure is exceedingly simple, and the philosophy of it appa-
rent  to the most careless  observer;  yet  a  minute description of 
l8o                  CURE  GUARANTEED.
the treatment in  this publication would be tedious; but suffice it
to say,  it requires but a little tact to make nature do her work
over again and correct the trouble.
   This cut represents a pterygium.
CHRONIC INFLAMMATION OF THE  EDGES  OF  THE LIDS.
   The edges  of the lids are red and inflamed,  especially  when
used by artificial light; crusts or scabs collect at the roots of the
lashes;  the  lashes themselves are  observed to fall quite rapidly,
and there is danger of losing  them  entirely.  The treatment is
simple,  and  a  cure can be guaranteed in every instance.
   Tumors of  the lids do not need description, for they are ob-
served as  a small lump in the lid.  They are a deformity; are lia
ble to grow quite rapidly; and seriously injure  the eye.   They
should be removed as soon as observed; the operation is almost
painless.
            DISEASES  OF THE TEAR  PASSAGES.
                    ABSCESS OP TEAR PASSAGES.
   The tears enter the eye at the  upper and outer corner, and,
after flowing over the eye-ball,  pass into  the lower part of the
nose by a narrow passage an inch long, which commences by
two small openings in the edges of the lids at the inner corner of
the eye.   They can be plainly seen  by  turning the lids slightly
out.   An  obstruction at any point causes the tears  to run over
on the cheek.   The  duct may be  seen  (figure 4)  which carries
the tears from the eyes to the  nose.  The  little tubes carrying
the tears from the inner corner of the eye to the duct are called
canuliculi; they often close and produce the same overflowing of
the tears.   Should the  closure of this duct continue, an abscess
will form just below the corner of the eye, (see figure 7) produc-
ing a very disagreeable affection.   Before the  abscess forms a
lump  will often be  found,  which, on  pressure, will  discharge
matter into the inner corner of the eye.   This trouble is curable
if taken in time and properly treated.

                        CATARACT.
                          (Figure 6.)
  This cause of blindness is becoming more prevalent, and many
more are suffering from  incipient cataract than is generally  sup- 
NEVER SPEND YOUR MONEY UPON HUMBUGS.        l8l
posed; but a few words on this subject will suffice.   How shall
the patient decide whether he has  it or not, and  what shall be
done ? are the questions.  Dimness  of sight (and this without
pain,) soreness, spots, flashes of light, and a gradual thickening
of the mist that appears between the eye and the light.   It first
occurs in one eye, then in the other, and not usually in both
simultaneously;  vision is best in the morning or evening, or dur-
ing a cloudy day; a bright day makes  the sight less; the eye
will look as natural as though no difficulty existed, except by
close inspection;  the pupil, which ought to be black, will appear
white or milky, and as sight fails the white appears more appar-
ent.   This disease is curable by a slight operation only.   (See
figure 6, showing the seat  of disease.)  Never spend your money
upon humbugs, who claim that they can drive it away or clear it
up with medicine, electricity, or any external appliance,  or medi-
cine taken internally; for if they are either  so ignorant or deceit-
ful as to impose upon the suffering, then have nothing to do
with them.   The proper treatment is quite simple and generally
successful; and the happiest creatures ever made so by the science
of surgery are those brought  from darkness to again view  na-
ture's grand  and glorious panorama, and again  to enjoy such
blessings, once theirs, lost and reclaimed.   How often have we
seen the tears of joy, uncontrollable,  like  rain, trickle down  the
cheek as light flashes in again upon  the soul, bringing back so
much that was lost, but now doubly dear to their very existence.
To see  the old  mother of seventy-five  summers, who  for  ten
years had not seen a living being, going down to the end of time,
old, decrepit, blind and poor, never again she thought of seeing
those she loved;  the only light to her was memory's retrospect,
and hope beyond the Jordan, when the  curtain  was removed,
and light, with  its sweet  effulgence, cheered  her gloomy  soul
with the thought, as she  said, that it was a sweet interlude be-
tween earth and heaven.
   This  picture represents  a cataract  of  the eye.   It is  noticed
that the pupil of the eye, which ordinarily is black, is in this
case gray or white: that is the cataract.  Not unfrequently no
peculiarity is observed in the eye, and it is then difficult for any
one but the  educated oculist  to recognize the disease.    The
patient  may have a  peculiar groping gait; may see better  in a 
182
EVERY HOUR FRAUGHT WITH DANGER.
cloudy day or in  the  dusk of the  evening than in the bright
light.  He may have  flashes  of light or sparks,  or  steady dark
spots in front of the eye. '
  A case of cataract never gets well without an operation: who-
ever tells you to the contrary either knows' nothing of the  sub-
ject or wishes to rob you of your money by  base quackery.  The
operation for cataract is not painful, but is allowed to  be one of
the most difficult  in the whole range of surgery,  and when  pro-
perly performed is attended with the most brilliant results.  We
can promise success in  ninety-seven cases in a hundred. There are
many thousands groping blindly through life who could receive
that greatest of all  temporal blessings, sight, by the performance
of a single operation.

                     ARTIFICIAL EYES.

  We keep constantly on  hand the best assortment of artificial
eyes, and feel assured that we can satisfy any one in need of them.
We will sell them cheaper than any one else keeping the same
quality.  To those who have never worn them we would say that
there is no pain or surgical operation necessary in the use of an arti-
ficial eye.  They are worn for comfort and the relief of one of the
worst deformities that can befall  us.   If you have an old one,
you can send it as a sample of color and shape, and thus order
what you want without coming; but if you have never worn one
it will be necessary for you to  visit the Institute to have it fitted.

                DELAYS  ARE DANGEROUS.

  If you have any trouble  of the  eye, hasten to a competent op-
thalmic surgeon.  In many  more cases than is generally believed,
every hour is fraught with danger.
  Is your little child born blind?   Have you any blind children,
or any with defective eyes : be sure and have them carefully ex-
amined.   Many in our blind asylums could have  been given
good sight in their youth; and many  adults who are blind,  or
have  even  been blind  from infancy,  can, by a skillful operation,
obtain useful vision.
  In a large majority of cases of partial and total blindness,  the
retina and optic nerve, which lie in the back part of the eye, are in 
                    SAD RESULTS OF NEGLECT.                183
a perfectly healthy condition; the structure in front of these have
from a variety of causes become thickened and opaque.   Light
does not pass through to those regions  where the sensation of
sight is produced, but if light can  be  admitted by an operation,
the patient will receive the great boon of sight, become a useful
citizen, and  bless the advances of modern science which have
made him happy and independent.

                     DISEASES OF  THE EAR.
   Science is  constantly making  new discoveries.   As our knowl-
edge increases, our treatment of disease becomes more rational.
Perhaps  no greater revolution has taken place than in  aural sur-
gery.  It is not generally understood that the ear is fully as deli-
cate an organ as the eye, for many will allow experiments upon
this  organ by an  ignorant pretender who  would recoil, from any-
thing much  less serious proposed  for  the eye.  The mechanism
of the human ear is the most delicate part of the whole body.
Before you allow any  one to prescribe for this organ or operate
upon it, be sure he has made this  his  special study and is thor-
oughly competent.  Until within  a few  years most of the  dis-
eases of the  ear  were  deemed  incurable,  and even  to-day  this
belief is  wide spread.
  Fortunately this is an error.  Nearly all the diseases of the ear
are curable.
  The inner  parts of the ear are so hidden from observation that
the public generally does not appreciate the sad results of neglect.
A discharge from the ear, however slight, is indicative  of a des-
tructive inflammation going on within.  The delicate parts of the
ear are constantly bathed in the foul discharge, and before one is
aware the organ of hearing is totally destroyed.  There is a prev-
alent opinion that the discharge  ought  not to be stopped, that it
will injure the health of the child to do  so.   This is a grave error;
the sooner it is stopped the better chance the child will have to
regain hearing.  The drum may be thickened by chronic disease,
or there  may be  deposits of bony  or  calcareous matter in it, or
there may be a hole in it, or it may be entirely gone.   All these
defects seriously interfere with hearing.  When the drum is thick-
ened, applications can be made to  improve hearing; when there
is a small hole in the drum,  it can  generally be closed by indue- 
184
DICTATED ONLY BY IGNORANCE.
ing a plastic healing process.  When we do not succeed in clos-
ing up openings, we introduce an artificial drum successfully.
  The diseases of the ear are more numerous than is generally
supposed.  In the last report of one of the largest ear hospitals
in the world, tzventy-two distinct diseases of this organ are record-
ed.   Too many apply the same remedy for all aural diseases.   It
is evident to any one that this is wrong, for it endangers the life
and  happiness of the patient, and is dictated only by ignorance.
Manifestly, to any thoughtful person, each disease requires its ap-
propriate and distinct treatment.
  Do not listen to the advice of those who tell you that your
deafness has lasted so long that nothing can be done for it.  Very
many who have been deaf for  years can be entirely cured, and
still many others who are rendered totally unfit to transact busi-
ness or have intercourse with their friends, can receive enough
benefit to make  them useful citizens, and a comfort and blessing
to their homes.
  No one can afford to take the risk of delay or experiments by
those who are not especially skilled in the science of aural sur-
gery. 
ILLUSTRATIONS OF APPARATUS.
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ILLUSTRATIONS OF APPARATUS.
 
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