Chapter 28

DISEASES AND THEIR REMEDIAL TREATMENT.

INTRODUCTION.

Knowledge which is conducive to self-preservation is of _primary_ importance. That great educator, profound thinker, and vigorous writer, Herbert Spencer, has pertinently said that, "As vigorous health and its accompanying high spirits, are larger elements of happiness than any other things whatever, the teaching how to maintain them is a teaching that yields to no other whatever. And therefore we assert that such a course of physiology as is needful for the comprehension of its general truths and their bearings on daily conduct is an all-essential part of a rational education."

Believing that the diffusion of knowledge for the prevention of disease is quite as noble a work as the alleviation of physical suffering by medical skill, we have devoted a large portion of this volume to the subjects of physiology and hygiene. These we have endeavored to present in as familiar a style as possible, that they may be understood by every reader. Freely as we have received light upon these subjects have we endeavored to reflect it again, in hopes that a popular presentation of these matters made plain and easy of comprehension to all people, may lead the masses into greater enjoyment of life--the result of a better preservation of health. This we do in part as a public acknowledgment of our obligations to society, to whom every professional man is a debtor. He belongs to it, is a part of its common stock, and should give as well as receive advantages, return as well as accept benefits. We know of no better way to signify our appreciation of the public confidence and patronage, so generously accorded to us, than to offer this volume to the people at a price less than the actual cost for an edition of ordinary size. This we do as a token of the cordial reciprocation of their good will. In giving to the people wholesome advice, by which they may be enabled to ward off disease and thus preserve the health of multitudes, we believe we shall receive their hearty approval, as well as the approbation of our own conscience, both of which are certainly munificent rewards. We believe that good deeds are always rewarded, and that the physician who prevents sickness manifests a genuine and earnest devotion to the common interests of humanity.

We have no respect for the motives of those medical men who would withhold that information from the people which will direct the masses how to take care of themselves, and thereby prevent much sickness and suffering. Nor is the diffusion of such knowledge antagonistic to the best interests of the true and competent physician. The necessity for his invaluable services can no more be set aside by popularizing physiological, hygienic, and medical truths, than we can dispense with those of the minister and lawyer by the inculcation of the principles of morality in our public schools. The common schools do not lessen the necessity for colleges or universities, but rather contribute to their prosperity. Nor are we so presumptuous as to anticipate that we could possibly make this volume so instructive as to render "every man his own physician." No man can with advantage be his own lawyer, carpenter, tailor, and printer; much less can he hope to artfully repair his own constitution when shattered by grave maladies, which not only impair the physical functions, but weaken and derange the mental faculties. What physician presumes to prescribe for himself, when suddenly prostrated by serious illness? He very sensibly submits to the treatment of another, because he realizes that sickness impairs his judgment, and morbid sensations mislead and unfit him for the exercise of his skill. If this is true of the physician, with how much greater force does it apply to the unprofessional! If a sick sea-captain is unfit to stand at the helm and direct his ship, how utterly incompetent must the raw sailor be when similarly disqualified! Nor is the physician as competent to treat those near and dear to him, when they are suffering from dangerous illness, as another medical man not similarly situated, whose judgment is not liable to be misled by intense anxiety and affectionate sympathy.

Notwithstanding all these facts, however, a knowledge on the part of the unprofessional, of something more than physiology and hygiene, and appertaining more closely to medicine proper, will many times prove valuable.

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

So, likewise, are there numerous, acute diseases of a milder character which are easily and unmistakably recognized without the possession of great medical knowledge, and which readily yield to plain, simple, medical treatment which is within the ready reach of all who strive to acquaint themselves with the rudiments of medical science. But in sudden and painful attacks of acute disease, life may be suddenly and unexpectedly jeopardized, and immediate relief prove necessary. While under these circumstances the prompt application of such domestic treatment as good common-sense may dictate, guided by a knowledge of those first principles of medical learning which we shall hereafter endeavor to make plain, may result in speedy and happy relief, yet at the same time there should be no delay in summoning a competent physician to the bedside of the sufferer.

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

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

The milder forms of uncomplicated, acute diseases, which may be readily and unmistakably recognized, and successfully managed without professional aid, will receive that attention which is necessary to give the reader a correct idea of them, and their proper remedial treatment.

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

We shall devote the largest amount of space to a careful and thorough consideration of those chronic diseases, which, by a little study, may be readily recognized and understood by the masses, and for the cure of which we shall suggest such hygienic treatment and domestic remedies as may be safely employed by all who are in quest of relief. In the more dangerous, obscure, or complicated forms of chronic diseases, the correct diagnosis and successful treatment of which tax all the skill possessed by the experienced specialist, the invalid will not be misled into the dangerous policy of relying upon his own judgment and treatment, but will be counseled not to postpone until too late, the employment of a skillful physician.

The apportionment of space which is made in considering the various diseases and their different stages, as well as the course which the people are advised to pursue under the different circumstances of affliction, is not always in accordance with the plans and recommendations which have been made by others who have written works on domestic medicine. Most of these authors have attempted, by lengthy disquisitions, to teach their readers how to treat themselves without the services of a physician, even in the most hazardous forms of disease. In such dangerous maladies as typhoid, typhus, yellow, and scarlet fevers, typhoid pneumonia, and many others, in which life is imminently imperiled, such instruction and advice is decidedly reprehensible, as it may lead to the most serious consequences. We are confident, therefore, that the manner of disposing of the different subjects which are discussed in the succeeding chapters, and the course of action which is advised, will commend themselves to our readers as being such as are calculated to promote and subserve their best interests.

MEDICAL DIAGNOSIS.

Skill in the art of healing is indicated in three ways: (1.) by ascertaining the _symptoms, seat_, and _nature_ of the disease, which is termed _diagnosis_; (2.) by foretelling the probable termination, which is termed _prognosis_; (3.) by the employment of efficacious and appropriate remedies, which is called _treatment_. Of these three requisites to a prosperous issue, nothing so distinguishes the expert and accomplished physician from the mere pretender as his ready ability to interpret correctly, the location, extent, and character of an affection from its symptoms. By medical diagnosis, then, is understood the discrimination between diseases by certain symptoms which are distinguishing signs. Every malady is accompanied by its characteristic indications, some of which are _diagnostic, i.e._, they particularize the affection and distinguish it from all others.

Medical diagnosis is both a _science_ and an _art_; a science when the causes and symptoms of a disease are understood, and an art when this knowledge can be applied to determine its location and exact nature. Science presents the general principles of practice; art detects among the characteristic symptoms the differential signs, and applies the remedy. Da Costa aptly remarks: "No one aspiring to become a skillful observer can trust exclusively to the light reflected from the writings of others; he must carry the torch in his own hands, and himself look into every recess."

The critical investigation of symptoms, with the view of ascertaining their signs, is essential to successful practice. Without closely observing them, we cannot accurately trace out the diagnosis, and a failure to detect the right disease is apt to be followed by the use of wrong medicines.

General diagnosis considers the surroundings of the patient as well as the actual manifestations of the disease. It takes into account the diathesis, _i.e._, the predisposition to certain diseases in consequence of peculiarities of constitution. We recognize constitutional tendencies, which may be indicated by the contour of the body, its growth, stature, and temperament, since all these facts greatly modify the treatment. Likewise the sex, age, climate, habits, occupation, previous diseases, as well as the present condition, must be taken into account.

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

Percussion consists in striking upon a part with the view of appreciating the sound which results. The part may be struck directly with the tips of the fingers, but more generally one or more fingers of the other hand are interposed between the points of the fingers and the part to be percussed, that they, instead of the naked chest, may receive the blow; or, instead of the fingers, a flat piece of bone or ivory, called a _pleximeter_, is placed upon the chest to receive the blow.

Latterly, improved instruments greatly assist the practitioner of medicine in perfecting this art. The _microscope_ assists the eye, and helps to reveal the appearance and character of the excretions, detecting morbid degenerations; _chemistry_ discloses the composition of the urine, which also indicates the morbid alterations occurring in the system; by percussion we can determine the condition of an internal organ, from the sound given when the external surface is percussed; the ear, with the aid of the _stethoscope_, detects the strange murmurs of respiration, the fainter, more unnatural pulsations of life, and the obscurer workings of disease; with the _spirometer_ we determine the breathing capacity of the lungs, and thus ascertain the extent of the inroads made by disease; the _dynamometer_ records the lifting ability of the patient; the _thermometer_ indicates the morbid variation in the bodily temperature; various instruments inform us of the structural changes causing alterations in the specific gravity of fluids, _e.g_., the _urinometer_ indicates those occurring in the urine; and thus, as the facilities for correct diagnosis increase, the art of distinguishing and classifying diseases becomes more perfect, and their treatment more certain. While physiology treats of all the natural functions, pathology treats of lesions and altered conditions.

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

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

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

INTERPRETATION OF SYMPTOMS.

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

POSITION OF PATIENT. When a patient is disposed to lie upon his back continually during the progress of an acute disease, it is a sign of _muscular debility_. If he manifests no desire to change his position, or cannot do so, and becomes tremulous at the least effort, it indicates _general prostration_. When this position is assumed, during the progress of continued fever, and is accompanied by involuntary twitching of the muscles, picking of the bed-clothes, etc., then danger is imminent and _the patient is sinking_. Fever, resulting from local inflammation, does not produce muscular prostration, and the patient seldom or never assumes the supine position. If this inflammation is in the extremities, those parts are elevated, in order to lessen the pressure of the blood, which a dependent, position increases.

For example, let us change the scene, and introduce a patient with head and shoulders elevated, who prefers to sit up, and who places his hands behind him and leans back, or leans forward resting his arms and head upon a chair. The next week he is worse, and no longer tries to lie in bed, but sits up all the time; note the anxious expression of countenance, the difficult or hurried breathing, the dry and hacking cough, and observe that the least exertion increases the difficulty of respiration and causes palpitation of the heart. These plain symptoms signify thoracic effusion, the collection of water about the lungs.

THE COUNTENANCE displays diagnostic symptoms of disease. In simple, acute fevers, the eyes and face are red and the respiration is hurried; but in acute, sympathetic fever, these signs are wanting. We cannot forget the pale, sharp, contracted, and pinched features of those patients whose nostrils contract and expand alternately with the acts of respiration. How hard it was for them to breathe. The contraction and expansion of the nostrils indicate active congestion of the lungs.

As a general rule, chronic inflammation of the stomach, duodenum, liver, and adjacent organs, imparts a gloomy expression to the countenance, at the same time the eye is dull, the skin dusky or yellow, and the motions are slow. But in lung diseases, the spirits are buoyant, the skin is fair, and the cheeks flushed with fever and distinctly circumscribed with white, for delicacy and contrast, almost exceed the hues of health in beauty. Note, too, the pearly lustre and sparkling light of the eye, the quivering motion of the lips and chin, all signs of pulmonary disease.

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

TONGUE. Much may be learned from the appearance, color, and form of the tongue, and the manner of its protrusion. If pale, moist, and coated white, it indicates a mild, febrile condition of the system. If coated in the center, and the sides look raw, it indicates gastric irritation. If red and raw, or dry and cracked, it is a sign of inflammation of the mucous membrane of the stomach. If the inflammation is in the large intestine, the tip of the tongue presents a deep red color, while the middle is loaded with a dark brown coating. When the tongue is elongated and pointed, quickly protruded and withdrawn, it indicates irritation of the nerve-centers, as well as of the stomach and bowels. If tremulous, it denotes congestion and lack of functional ability; this may be observed in congestive fevers.

PULSE. Usually the pulse beats four times during one respiration, but both in health and disease its frequency may be accelerated or retarded. In adults, there are from sixty-five to seventy-five beats in a minute, and yet in a few instances we have found, in health, only forty pulsations per minute. But when the heart beats from one hundred and twenty to one hundred and forty times a minute, there is reason to apprehend danger, and the case should receive the careful attention of a physician.

Irregularity of the pulse may be caused by disease of the brain, heart, stomach, or liver; by the disordered condition of the nervous system; by lack of muscular nutrition, as in gout, rheumatism, or convulsions; by deficiency of the heart's effective power, when the pulse-wave does not reach the wrist, or when it intermits and then becomes more rapid in consequence of septic changes of the blood, as in diphtheria, erysipelas, and eruptive fevers.

PAIN. The import of pain depends on its seat, intensity, nature, and duration. An acute, intense pain usually indicates inflammation of a nerve as well as the adjacent parts. Sharp, shooting, lancinating pains occur in inflammation of the serous tissues, as in pleurisy. A smarting, stinging pain attends inflammation of the mucous membrane. Acute pain is generally remittent and not fixed to one spot. Dull, heavy pain is more persistent, and is present in congestions, or when the substance of an organ is inflamed, and it often precedes hemorrhage. Burning pain characterizes violent inflammations involving the skin and subjacent cellular tissue, as in case of boils and carbuncles. Deep, perforating pain accompanies inflammation of the bones, or of their enveloping membranes. Gnawing, biting, lancinating pain attends cancers.

The location of pain is not always at the seat of the disease. In hip-disease, the pain is not first felt in the hip, but in the knee-joint. In chronic inflammation of the liver, the pain is generally most severe in the right shoulder and arm. Disease of the kidneys occasionally produces numbness of the thigh and drawing up of the testicle, and commonly causes colicky pains. Inflammation of the meninges of the brain is often indicated by nausea and vomiting before attention is directed to the head. These illustrations are sufficient to show that pain often takes place in some part remote from the disease.

In chronic, abdominal affections, rheumatic fevers, gout, and syphilis, the entire system is thrown into a morbid state, the nervous system is disturbed, and wandering pains manifest themselves in different parts of the body. Fixed pain, which is increased by pressure, indicates inflammation. If it be due only to irritation, pressure will not increase it. Some rheumatic affections and neuralgia not only bear pressure, but the pain diminishes under it. Permanent pain shows that the structures of an organ are inflamed, while intermittent pain is a sign of neuralgia, gout, or rheumatism. Absence of pain in any disease, where ordinarily it should be present, is an unfavorable sign. Internal pain, after a favorable crisis, is a bad omen. Or, if pains cease suddenly without the other symptoms abating, the import is bad. If, however, pain and fever remit simultaneously and the secretions continue, it is a favorable sign.

A dull pain in the head indicates fullness of the blood-vessels from weakness, low blood, or general debility. It may be caused by taking cold, thus producing passive congestion of the brain. It may proceed from gastric disturbance, constipation of the bowels, or derangement of the liver. Heaviness of the head sometimes precedes inflammation of the brain, or chronic disease of its membranes. A dull, oppressive pain in the head indicates softening of the brain, and is generally accompanied by slowness of the pulse and of the speech. A pulsating pain of the head occurs in heart disease, hysteria, and frequently accompanies some forms of insanity.

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

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

The pupil contracts in inflammation of the meninges, when there is increased sensibility and intolerance of light, also in spinal complaints. In some diseases the lustre of the eye increases, as in consumption. But if it decreases with the attack of violent disease, it indicates great debility and prostration.

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

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

MICROSCOPICAL EXAMINATION. This method of examination affords a quicker and more correct idea of a deposit or deposits than any other method. The expert, by simply looking at a specimen, can determine the character of the urine, whether blood, mucus, pus, uric acid, etc., are present or not. But when no deposit is present, then it is necessary to apply chemical tests, and in many cases the quantity of the suspected ingredient must be determined by analysis. As a detailed account, of the various modifications which the urine undergoes in different diseases, would be of no practical use to the masses, since they could not avail themselves of the advantages which it would afford for correct diagnosis, except by the employment of a physician who does not ignore this aid in examining his patients, we shall omit all further details upon the subject. For the same reason we shall not often, in treating of the different diseases in which examinations of the urine furnish such valuable aid in forming a diagnosis, make mention of the changes which are likely to have occurred.

INFLAMMATION.

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

The susceptibility of the body to inflammation maybe _natural_ or _acquired_. It is natural when it is constitutional; that is, when there is an original tendency of the animal economy to manifest itself in some form of inflammation. We may notice that some children are far more subject to boils, croups, and erysipelatous diseases than others. This susceptibility, when innate, may be lessened by careful medication, although it may never be wholly eradicated. When acquired, it is the result of the influence of habits of life, climate, and the state of mind over the constitution

Phlegmonous inflammation is the active inflammation of the cellular membrane, one illustration of which is a common boil. The four principal symptoms are redness, swelling, heat, and pain; and then appears a conical, hard, circumscribed tumor, having its seat in the dermoid texture. At the end of an indefinite period, it becomes pointed, white or yellow, and discharges pus mixed with blood. When it breaks, a small, grayish, fibrous mass sometimes appears, which consists of dead, cellular tissue, and which is called the _core_.

There are certain morbid states of the constitution which lead to local inflammation, subsequent upon slight injury; or, in some cases, without any such provocation, as in gout, rheumatism, and scrofula. One of the first results of the inflammation, in such cases, is a weakening of the forces which distribute the blood to the surface and extremities of the body. It is generally admitted that in scrofulous persons the vascular system is weak, the vessels are small, and because nutrition is faulty, the blood is _imperfectly organized_. The result is failure in the system, for if nutrition fails, there may be lacking earthy matter for the bones, or the unctious secretions of the skin; the sebaceous secretion is albuminous and liable to become dry, producing inflammation of the parts which it ought to protect.

Disorder of the alimentary canal and other mucous surfaces are sometimes reflected upon the skin. We have occasionally observed cutaneous eruptions and erysipelas, when evidently they were distinct signs of internal disorder.

Inflammation may be internal as well as external, as inflammation of the brain, lungs, or stomach, and it is frequently the result of what is called a _cold_. No matter how the body is chilled, the blood retreats from the surface, which becomes pale and shrunken, there is also nervous uneasiness, and frequently a rigor, accompanied with chattering of the teeth. After the cold stage, reaction takes place and fever follows. The sudden change from a dry and heated room to a cool and moist atmosphere is liable to induce a cold. Riding in a carriage until the body is shivering, or sitting in a draft of air when one has been previously heated, or breathing a very cold air during the night when the body is warm, especially when not accustomed to doing so, or exposing the body to a low temperature when insufficiently clothed, are all different ways of producing inflammation.

Inflammation may result in consequence of local injury, caused by a bruise, or by a sharp, cutting instrument, as a knife or an axe, or it may be caused by the puncture of a pin, pen-knife blade or a fork-tine, or from a lacerated wound, as from the bite of a dog, or from a very minute wound poisoned by the bite of a venomous reptile. Local inflammations may arise from scalds, burns, the application of caustics, arsenic, corrosive sublimate, cantharides, powerful acids, abrasions of the surface by injuries, and from the occurrence of accidents.

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

The character of the _pain_ depends upon the tissue involved, and upon the altered or unnatural state of the nerves. Ordinarily, tendon, ligament, cartilage, and bone are not very sensitive, but when inflamed they are exquisitely so.

The heat of the inflamed part is not so great, when measured by the thermometer, as might be supposed from the patient's sensations.

TERMINATION OF INFLAMMATION. Inflammation ends in one of six different ways. Inflammation may terminate in _resolution, i.e_., spontaneous recovery; by _suppuration_, in the formation of matter; by _effusion_, as the inflammation caused by a blister-plaster terminates by effusion of water; by _adhesion_, the part inflamed forming an attachment to some other part; by _induration_, hardening of the organ; or by _gangrene_, that is, death of the part.

Thus, inflammation of the lungs may terminate by recovery, that is, by resolution, by suppuration and raising of "matter," by hardening and solidification of the lung, or by gangrene. Inflammation of the endocardium, the lining membrane of the heart, may cause a thickening of it, and ossification of the valves of the heart, thus impairing its function. Inflammation of the pericardium may terminate in effusion, or dropsy, and inflammation of the liver may result in hardening and adhesion to adjacent parts.

SEVERAL PRINCIPLES FOR TREATMENT OF INFLAMMATION.

Remove the exciting causes as far as practicable. If caused by a splinter or any foreign substance, it should be withdrawn, and if the injury is merely local, apply cold water to the parts to subdue the inflammation. If caused by a rabid animal, the wound should be enlarged and cupped, and the parts cleansed or destroyed by caustic. The patient should remain quiet and not be disturbed. The use of tincture of aconite internally, will be found excellent to prevent the rise of inflammation. A purgative is also advised, and four or five of Dr. Pierce's Pleasant Purgative Pellets will be sufficient to act upon the bowels. If there is pain, an anodyne and diaphoretic is proper. Dr. Pierce's Compound Extract of Smart-weed will fulfill this indication. In local inflammation cold water is a good remedy, yet sometimes hot water, or cloths wrung out of it, will be found to be the appropriate application. When the inflammation is located in an organ within a cavity, as the lungs, hot fomentations will be of great service. Bathing the surface with alkaline water must not be omitted. Whenever the inflammation is serious the family physician should be early summoned.

FEVER.

In fever all the functions are more or less deranged. In every considerable inflammation there is sympathetic fever, but in essential fevers there are generally fewer lesions of structure than in inflammation. Fever occasions great waste of the tissues of the body, and the refuse matter is carried away by the organs of secretion and excretion. The heat of the body in fever is generally diffused, the pulse is quicker, there is dullness, lassitude, chilliness, and disinclination to take food. We propose to give only a general outline of fevers, enough to indicate the principles which should be observed in domestic treatment.

Most fevers are distinctly marked by four stages: 1st, the forming stage; 2d, the cold stage; 3d, the hot stage; 4th, the sweating or declining stage. During the first stage the individual is hardly conscious of being ill, for the attack is so slight that it is hardly perceptible. True, as it progresses, there is a feeling of languor, an indisposition to make any bodily or mental effort, and also a sense of soreness of the muscles, aching of the bones, chilliness, and a disposition to get near the fire. There is restlessness, disturbed sleep, bad dreams, lowness of spirits, all of which are characteristic of the formative stage of fever.

The next is the cold stage, when there is a decided manifestation of the disease, and the patient acknowledges that he is really sick. In typhus and typhoid fever the chills are slight; in other fevers they are more marked; while in ague they are often accompanied by uncontrollable shaking. When the chill is not so distinct the nails look blue and the skin appears shriveled, the eye is sunken and a dark circle circumscribes it, the lips are blue, and there is pain in the back. The pulse is frequent, small, and depressed, the capillary circulation feeble, the respiration increased, and there may be nausea and vomiting. These symptoms vary in duration from a few minutes to more than an hour. They gradually abate, reaction takes place, and the patient begins to throw off the bed-clothes.

Then follows the hot stage, for with the return of the circulation of the blood to the surface of the body, there is greater warmth, freer breathing, and a more comfortable and quiet condition of the system. The veins fill with blood, the countenance brightens, the cheeks are flushed, the intellect is more sprightly, and if the pulse is frequent, it is a good sign; if it sinks, it indicates feeble, vital force, and is not a good symptom. If there is considerable determination of blood to the head it becomes hot, the arteries of the neck pulsate strongly, and delirium may be expected. During the hot stage, if the fever runs high, the patient becomes restless, frequently changes his position, is wakeful, uneasy, and complains of pain in his limbs. In low grades, the sensibility is blunted, smell, taste, and hearing are impaired.

The patient in the hot stage is generally thirsty, and if he is allowed to drink much, it may result in nausea and vomiting. Moderate indulgence in water, however, is permissible. There is aversion to food, and if any is eaten, it remains undigested. The teeth are sometimes covered with dark _sordes_ (foul accumulations) early in the fever, and the appearance of the tongue varies, sometimes being coated a yellowish brown, sometimes red and dry, at other times thickly coated and white. The condition of the bowels varies from constipation to diarrhea, although sometimes they are quite regular. The urine is generally diminished in quantity, but shows higher color.

The sweating stage in some fevers is very marked, while in others there is very little moisture, but an evident decline of the hot stage, the skin becoming more natural and soft. The pulse is more compressible and less frequent, the kidneys act freely, respiration is natural, the pains subside, although there remains languor, lassitude, and weariness, a preternatural sensibility to cold, an easily excited pulse, and a pale and sickly aspect of the countenance. The appetite has failed and the powers of digestion are still impaired.

DOMESTIC MANAGEMENT OF FEVERS. It is proper to make a thorough study of the early, insidious symptoms of fever, in order to understand what ought to be done. If it arises in consequence of malaria, the treatment must be suited to the case. If from irritation of the bowels and improper articles of diet, then a mild cathartic is required. If there is much inflammation, a severe chill, and strong reaction, then the treatment should be active. If the fever is of the congestive variety and the constitution is feeble, the reaction imperfect, a small, weak pulse, a tendency to fainting, a pale countenance, and great pain in the head, apply heat and administer diaphoretics, and procure the services of a good physician.

As a general rule, it is proper to administer a cathartic, unless in typhoid fever, and for this Dr. Pierce's Purgative Pellets answer the purpose, given in doses of from four to six, according to the state of the bowels. If these are not at hand, a tea of sage and senna may be drunk until it produces a purgative effect, or a dose of Rochelle salts taken. In nearly all fevers we have found that a weak, alkaline tea, made from the white ashes of hickory or maple wood, is useful, taken weak, three or four times daily, or if there be considerable thirst, more frequently. Some patients desire lemon juice, which enters the system as an alkali and answers all purposes.

Diaphoretic medicines are also indicated, and the use of Dr. Pierce's Extract of Smart-weed will prove very serviceable. Drinking freely of pleurisy-root tea, or of a strong decoction of boneset is frequently useful. After free sweating has been established, then it is proper to follow by the use of diuretic teas, such as that of spearmint and pumpkin seed combined, or sweet spirits of nitre, in doses of twenty to thirty drops, added to a teaspoonful of the Extract of Smart-weed, diluted with sweetened water.

To lessen the frequency of the pulse, fluid extract or tincture of aconite or veratrum may be given in water, every hour. During the intermission of symptoms, tonic medicines and a sustaining course of treatment should be employed. If the tongue is loaded and the evacuations from the bowels are fetid, a solution of sulphite of soda is proper; or, take equal parts of brewer's yeast and water, mix, and when the yeast settles, give a tablespoonful of the water every hour, as an antiseptic. Administering a warm, alkaline hand-bath to a fever patient every day, is an excellent febrifuge remedy, being careful not to chill or induce fatigue. If there is pain in the head, apply mustard to the feet; if it is in the side, apply hot fomentations.

The symptoms which indicate danger are a tumid and hard abdomen, difficult breathing, offensive and profuse diarrhea, bloody urine, delirium, or insensibility. Favorable symptoms are a natural and soft state of the skin, eruptions on the surface, a natural expression of the countenance, moist tongue, free action of the kidneys, and regular sleep. If the domestic treatment which we have advised does not break the force of the disease and mitigate the urgency of the symptoms, it will be safer to employ a good physician, who will prescribe such a coarse of treatment as the case specially requires. It is our aim to indicate what may be done before the physician is called, for frequently his services cannot be obtained when they are most needed. Besides, if these attacks are early and properly treated with domestic remedies, it will often obviate the necessity of calling upon a physician. If, on the other hand, fevers are neglected and no treatment instituted, they become more serious in character and are more difficult to cure.

To recapitulate, our treatment recommends evacuation through nature's outlets, the skin, kidneys, and bowels, maintaining warmth, neutralizing acidity, using antiseptics, tonics, and the hand-bath, and the fluid extract or tincture of aconite, or veratrum to moderate the pulse by controlling the accelerated and unequal circulation of the blood. It is a simple treatment, but if judiciously followed, it will often abort a fever, or materially modify its intensity and shorten its course.

FEVER AND AGUE. (INTERMITTENT FEVER.)

The description of fever already given applies well to this form of it, only the symptoms in the former stage are rather more distinct than in the other varieties. Weariness, lassitude, yawning, and stretching, a bitter taste in the mouth, nausea, less of appetite, the uneasy state of the stomach and bowels are more marked in the premonitory stages of intermittent fevers. The cold stage commences with a chilliness of the extremities and back, the skin looks pale and shriveled, the blood recedes from the surface, respiration is hurried, the urine is limpid and pale, sometimes there is nausea and vomiting, and towards the conclusion of the stage, the chilly sensations are varied with flushes of heat. The hot stage is distinguished by the heat and dryness of the surface of the body and the redness of the face; there is great thirst, strong, full, and hard pulse, free and hurried respiration and increased pain in the head and back. The sweating stage commences by perspiration appearing upon the forehead, which slowly extends over the whole body, and soon there is an evident intermission of all the symptoms. In the inflammatory variety of intermittent fever, all these symptoms are acute, short, and characterized by strong reaction. Gastric fever, the most frequent variety of intermittent fever, is marked by irritation of the stomach and bowels, and a yellow appearance of the white of the eye.

CAUSES. The cause of the malarial fevers, intermittent, remittent, and congestive, is supposed to be _miasm_, a poisonous, gaseous exhalation from decaying vegetation, which is generally most abundant in swamps and marshes, and which is absorbed into the system through the lungs.

TREATMENT. During the entire paroxysm the patient should be kept in bed, and in the cold stage, covered with blankets and surrounded with bottles of hot water. The Compound Extract of Smart-weed should be administered in some diaphoretic herb-tea. During the hot stage, the extra clothing and the bottles of hot water should be gradually removed and cold drinks taken instead of warm. During the sweating stage the patient should be left alone, but as soon as the perspiration ceases, from two to four of the Purgative Pellets should be administered, as a gentle cathartic. A second paroxysm should, if possible, be prevented. To accomplish this, during the intermission of symptoms, the Golden Medical Discovery should be taken in doses of from two to three teaspoonfuls every four hours in alternation with three-grain doses of the sulphate of quinine. If the attack is very severe, and is not relieved by this treatment, a physician should be summoned to attend the case.

REMITTENT FEVER. (BILIOUS FEVER.)

The distinction between _intermittent_ and _remittent_ fever does not consist in a difference of origin. In the former disease there is a complete intermission of the symptoms, while in the latter there is only a remission.

TREATMENT. The treatment should consist in the employment of those remedial agents advised in intermittent fever, the Golden Medical Discovery and quinine being taken during the remission of symptoms. During the height of the fever, tincture of aconite maybe given and an alkaline sponge-bath administered with advantage. As in intermittent fever, should the course of treatment here advised not promptly arrest the disease, the family physician should be summoned.

CONGESTIVE FEVER. (PERNICIOUS FEVER.)

This is the most severe and dangerous form of malarial fever. It may be either intermittent or remittent in character. In some instances the first paroxysm is so violent as to destroy life in a few hours, while in others it comes on insidiously, the first one or two paroxysms being comparatively mild. It is frequently characterized by stupor, delirium, a marble-like coldness of the surface, vomiting and purging, jaundice, or hemorrhage from the nose and bowels. In America this fever is only met with in the Mississippi valley, and in other localities where the air contains a large quantity of malarial poison.

TREATMENT. This fever is so dangerous that a physician should be summoned as soon as the disease is recognized. For the benefit of those who are unable to obtain medical attendance, we will say that the treatment should be much the same as in intermittent fever, but more energetic. Quinine should be taken in doses of from five to fifteen grains every two or three hours. If it be not retained by the stomach, the following mixture may be administered by injection: sulphate of quinine, one-half drachm; sulphuric acid, five drops; water, one ounce; dissolve, and then add two ounces of starch water.

CONTINUED FEVERS.

The symptoms of these fevers do not intermit and remit, but _continue_ without any marked variation for a certain period. They are usually characterized by great prostration of the system, and are called _putrid_ when they manifest septic changes in the fluids, and _malignant_ when they speedily run to a fatal termination. _Typhoid_ and _typhus_ fevers belong to this class. We shall not advise treatment for these more grave disorders which should always, for the safety of the patient, be attended by the family physician, except to recommend some simple means which may be employed in the initial stage of the disease, or when a physician's services cannot be promptly secured.

TYPHOID FEVER. (ENTERIC FEVER.)

In typhoid fever there is ulceration of the intestines and mesenteric glands. This diseased condition of the bowels distinguishes this fever from all others, and is readily detected by sensitiveness to pressure, especially over the lower part of the abdomen on the right side. The early disposition to diarrhea is another characteristic symptom of it, and there is also no intermission of symptoms as in intermittent fever. The disease comes on insidiously, with loss of appetite, headache, chilliness, and languor. It is usually a week or more before the disease becomes fully developed.

CAUSE. Typhoid fever is a specific form of fever developed from the action of a specific germ upon a susceptible system. The poison of typhoid fever is eliminated mainly through the bowels. The germs of typhoid can maintain life for months in water, and thus it happens that ponds, lakes, rivers and streams which receive sewage can spread the germs of typhoid fever. Well water often swarms with these poisonous germs. In some cases it has been found that privies, though twenty or forty feet away from a well, have yet drained into it--through a clay soil covered with gravel--and carried the germs to those drinking the water from the well. Next to water, milk is the most prominent carrier of contagion. Milk is apt to get infected with the germs if cooled in tanks of water which may receive drainage from outhouses and barns.

TREATMENT. Scientific support has been given the treatment by cold tub baths (70° Fahrenheit) and it is advised by many physicians. Experience has proved that sponge baths and tub baths are of the utmost importance, when the temperature of the patient is at or above 102.5° Fahrenheit. Every three hours the tub bath is given for twenty minutes at 70° Fahrenheit. These may be tepid at first, gradually cooling to 70°. Frictions are applied to patient in the bath, and he is wrapped in blankets when taken out to avoid danger of chill, and then given a warm drink or stimulant. Treatment should be directed by an experienced physician to suit the symptoms. The evacuations from the bowels should be thoroughly disinfected with chloride of lime or carbolic acid, that they may not convey the disease to others. All the sewerage and drain pipes in the house should likewise be disinfected.

SCARLET FEVER. (SCARLATINA.)

This fever takes its name from the scarlet color of the eruption on the surface of the body. Sometimes it is comparatively mild, and is then called _Scarlatina Simplex_; when it is accompanied by a sore throat, it is termed _Scarlatina Anginosa_; and when the disease is of a low, putrid type, it is called _Scarlatina Maligna._ This disease has three distinct stages: (1), the stage of invasion; (2), the stage of eruption; and (3), the stage of desquamation. In the first stage there is pain in the head, increased heat of the skin, redness and soreness of the throat, and sometimes nosebleed, diarrhea, or vomiting. The average duration of this stage is twenty-four hours. The eruptive stage generally begins on the second day, though sometimes it is delayed longer, and the scarlet rash rapidly diffuses itself over the whole body. The redness is vivid and has been compared to the appearance of a boiled lobster. The stage of eruption reaches its maximum of intensity on the third day, and it is important that it does not recede. Redness of the tonsils and throat is one of the early symptoms which precedes any cutaneous eruption. The tongue also is finely spotted with numerous red points which mark its papillae, presenting an appearance which has been compared to that of a strawberry.

The thirst is urgent, there is no appetite, and vomiting and mild delirium are common. This stage continues from four to six days, and sometimes longer. Desquamation (scaling off of the skin) commences at the decline of the eruption, in the form of minute, branny scales. The duration of this stage is indefinite, and may end in five or six or may continue ten or twelve days.

If the inflammation in the throat is very severe, it may terminate in an abscess, which may also occur in the glands of the neck, and sometimes the inflammation extends to the lips, cheeks, and eyelids. Gangrene within the throat occurs in rare instances. The disease is easily communicated, and usually develops in two to five days after exposure. It occurs most frequently in the third and fourth years of life. There is no other disease so simple, and yet so often liable to prove fatal, as scarlet fever; and for this reason we shall advise the attendance of the family physician.

Domestic treatment may be given as follows, until a physician can be obtained: Catnip, pennyroyal, or pleurisy-root tea, containing one teaspoonful of the Extract of Smart-weed, may be given, to drive the rash to the surface. Cold drinks are suitable to allay the thirst, nausea, and fever. The sick-room should be kept at a temperature of about 65° Fahr., and fresh air admitted freely. The patient ought not to be overloaded with bed-clothes; and the skin should be sponged over twice daily with tepid water, different parts being exposed successively, and carefully dried with soft cloths. Soda may be added to the water, but no soap should be used. The diet should consist of milk, extract of beef, and soups. Injections may be employed to relieve constipation, but purgatives should be avoided. We repeat that this disease is one which requires the attendance of the family physician, and great care should be exercised during recovery, that no bad results may follow.

SMALL-POX. (VARIOLA.)

Small-pox is produced by a specific poison, which is reproduced and multiplied during the progress of the disease. It is contained in the pustules, and in the excretions and exhalations of affected individuals. It is established after a period of incubation varying from nine to thirteen days after infection.

There are two varieties of this disease, known as _confluent_ and _distinct_ variola; in the former, the vesicles run together, in the latter, they are separate.

This fever has three stages. The first is that of _invasion_, distinctly marked by a chill or a series of chills, which alternate with flushes of heat. In this stage the tongue becomes coated, there is also nausea and vomiting, pain in the limbs, back, and particularly in the loins, the latter symptom being of diagnostic importance. This stage continues about two days, and if the symptoms are light, it may be expected that the disease will be comparatively mild, and of the _distinct_ variety.

_The stage of eruption._ The eruption begins to appear on the skin, generally on the third day following the attack, though in the throat and mouth may be discovered round, whitish, or ashy spots, several hours previous to the appearance of vesicles on the surface of the body. These are first seen on the face and neck, then on the trunk and upper extremities, and, lastly, on the lower extremities. The eruption at first appears in the form of small, red or purple spots, which change the texture of the skin by becoming more hard, pointed, and elevated. On the fifth day of the eruption they attain their full size, being softened and depressed in the center, and hence are called _umbilicated_. Now a change takes place, and the vesicles fill with "matter" and become pointed, and there is a rise in the fever.

_The stage of suppuration_ commences thus: the pulse quickens, the skin becomes hotter, and in many cases of the confluent variety, swelling of the face, eyelids, and extremities occurs. Frequently there is passive delirium in this stage, and if diarrhea sets in, it is an unfavorable sign. The duration of this stage of the eruption is four or five days.

_The stage of desication_, or of the drying of the pustules, commences between the twelfth and fourteenth day of the disease. In the confluent variety, patches of scab cover all the space occupied by the eruption, and the skin exhales a sickening odor.

THE TREATMENT should have reference to the determination of the eruption to the surface. If there is thirst, allow cold drinks, ice-water, or lemonade. Bathing the surface with cold water, breathing plenty of fresh air, using disinfectants in the room, and taking antiseptic medicine internally, are proper. Add one part of carbolic acid to six parts of glycerine, mix from two to three drops of this with an ounce of water, and of this preparation administer teaspoonful doses frequently. A few drops of carbolic acid and glycerine may be rubbed up with vaseline, and the surface anointed with it to prevent pitting. The malady is so grave that it should be intrusted to the care of the family physician.

VARIOLOID. (MODIFIED SMALL-POX.)

Varioloid is a modified form of small-pox. There is less constitutional disturbance, and very little or no pitting of the skin. Varioloid generally occurs in persons who have not been fully protected by vaccination. A person suffering from this modification of the disease may, by contagion, communicate to another genuine small-pox. The _treatment_ is the same as that recommended in variola.

VACCINIA. (COW-POX.)

The important discovery of vaccination is due to Dr. Jenner, who ascertained that when the cow was affected by this disease and it was then communicated to man, the affection was rendered very mild and devoid of danger, and at the same time it proved a very complete protection against small-pox. Like most other valuable discoveries introduced to the world, it encountered bitter prejudice and the most unfair opposition. Now its inestimable value is generally known and admitted.

In a few cases, in which the quality of the vaccine virus was deteriorated, its effect is only to slightly-modify small-pox, and then the disease resembles that caused by inoculation. The operation of infecting the blood with the _kine virus_ is called _vaccination_. All that we know is that when the cow becomes affected with this disease, and it is then transferred to man, it loses its severity and serves as a protection against small-pox. In a great majority of cases this protection is absolute, and only in a very few does it leave the subject susceptible to small-pox, materially modified. The protection it affords against small-pox is found to diminish after the lapse of an indefinite number of years, and hence it is important to be re-vaccinated once or twice, for instance, after an interval of five years. Between the second and third months of infancy is the best period for vaccination, and the place usually selected is the middle of the arm above the elbow-joint.

CHICKEN-POX. (VARICELLA.)

Chicken-pox is an eruptive disease, which affects children, and occasionally adults. It is attended with only slight constitutional disturbance, and is, therefore, neither a distressing nor dangerous affection. The eruption first appears on the body, afterwards on the neck, the scalp, and lastly on the face. It appears on the second or third day after the attack, and is succeeded by vesicles containing a transparent fluid. These begin to dry on the fifth, sixth, or seventh day. This disease may be distinguished from variola and varioloid by the shortness of the period of invasion, the mildness of the symptoms, and the absence of the deep, funnel-shaped depression of the vesicles, so noticeable in variola.

TREATMENT. Ordinarily very little treatment is required. It is best to use daily an alkaline bath, and, as a drink, the tea of pleurisy-root, catnip, or other diaphoretics, to which may be added from one-half to one teaspoonful of the Extract of Smart-weed. If the fever runs high, a few drops of aconite in water will control it.

MEASLES. (RUBEOLA.)

This is generally a disease of less severity and importance than the other eruptive fevers, but it is sometimes followed by serious complications. The stage of invasion is marked by the symptoms of a common cold, sneezing, watery eyes, a discharge from the nostrils, a dry cough, chilliness, and headache. This stage may last four days. Then follows an eruption of red dots or specks, which momentarily disappear on pressure. On the fourth day of the eruption the redness of the skin fades, the fever diminishes, and the vesicles dry into scales or little flakes. The eyes may be inflamed and the bowels may be quite lax at this stage.

TREATMENT. The great object in the treatment is to bring out the eruption. To effect this, sweating teas are beneficial. The free use of the Extract of Smart-weed is recommended, and the skin should be bathed every day with tepid water. Sometimes when warm drinks fail to bring out the eruption, drinking freely of cold water and keeping warmly covered in bed, will accomplish the desired result.

FALSE MEASLES (_Rose Rash_) is an affection of very little importance and may be treated similarly to a case of ordinary measles.

ERYSIPELAS.

There are few adult persons in this country who have not, by observation or experience, become somewhat familiar with this disease. Its manifestations are both constitutional and local, and their intensity varies exceedingly in different cases. The constitutional symptoms are usually the first to appear, and are of a febrile character. A distinct chill, attended by nausea and general derangement of the stomach is experienced, followed by febrile symptoms more or less severe. There are wandering pains in the body and sometimes a passive delirium exists. Simultaneously with these symptoms the local manifestations of the disease appear. A red spot develops on the face, the ear, or other part of the person. Its boundary is clearly marked and the affected portion slightly raised above the surrounding surface. It is characterized by a burning pain and is very sensitive to the touch. It is not necessary for the benefit of the popular reader that we should draw a distinction between the different varieties of this malady. The distinctions made are founded chiefly upon the _depth_ to which the morbid condition attends, and not on any difference in the _nature of the affection_.

Suppuration of the tissues involved is common in the severer forms. Should the tongue become dark and diarrhea set in, attended with great prostration, the case is very serious, and energetic means must be employed to save life. A retrocession of the inflammation from the surface to a vital organ is an extremely dangerous symptom. The disease is not regarded as contagious, but has been known to become epidemic.

TREATMENT. The treatment during the initial stage of this disease should correspond with the general principles laid down for the treatment of fever. The spirit vapor-bath, with warm, diaphoretic teas, or the Compound Extract of Smart-Weed may be given to favor sweating. The whole person should be frequently bathed in warm water rendered alkaline by the addition of saleratus or soda. The bowels should be moved by a full dose of the Purgative Pellets. Fluid extract of aconite in small and frequent doses will best control the fever. The specific treatment, which should not be omitted, consists in administering doses of ten drops of the tincture of the muriate of iron in alternation with teaspoonful doses of the Golden Medical Discovery, every three hours. As a local application, the inflamed surface may be covered with cloths wet in the mucilage of slippery elm. Equal parts of sweet oil and spirits of turpentine, mixed and painted over the surface, is an application of unsurpassed efficacy.

DIPHTHERIA.

This is an exceedingly grave, constitutional disease characterized by a rapid breaking down of the powers of life, together with a peculiar affection of the throat, in which a disposition to the formation of false membranes is a prominent feature. The formation of these membranes, however, is not limited to the throat, but may occur on mucous surfaces elsewhere.

CAUSE. Infection with the specific germ of the disease by contagion or inoculation. It can be carried in milk or water, and the germs can attach themselves to furniture, walls, clothing, etc. A person with chronic diphtheretic sore throat can infect children or susceptible persons with the disease in its most acute type by kissing. All persons with sore throat should avoid kissing--as this disease is commonly spread in this way.

SYMPTOMS. The symptoms vary in different cases. In some the disease comes on gradually, while in others it is malignant from the first. The throat feels sore, the neck is stiff and a sense of languor, lassitude, and exhaustion pervades the system. Sometimes a chill is experienced at the outset. Febrile disturbance, generally of a low, typhoid character, soon manifests itself. The skin is hot; there is intense thirst; the pulse is quick and feeble, ranging from 120 to 150 per minute. The tongue is generally loaded with a dirty coat, or it may be bright red. The odor of the breath is characteristic, and peculiarly offensive, and there is difficulty in swallowing and sometimes in breathing. Vomiting is sometimes persistent. If we examine the throat, we find more or less swelling of the tonsils and surrounding parts, which are generally bright red, and shining, and covered with a profuse, glairy, tenacious secretion. Sometimes the parts are of a dusky, livid hue, and, in rare instances, pallid. The false membrane, a peculiar tough exudation, soon appears and may be seen in patches, large or small, or covering the entire surface from the gums back as far as can be seen, its color varying from a whitish yellow to a gray or dark ashen tint. When it is thrown off, it sometimes leaves a foul, ulcerating surface beneath. The prostration soon becomes extreme, and small, livid spots may appear on the surface of the body. There may be delirium, which is, in fatal cases, succeeded by stupor, or coma. The extremities become cold; diarrhea, and in some cases convulsions, indicate the approach of death. Sometimes the patient dies before the false membrane forms.

TREATMENT. The extremely dangerous character of this disease demands that the services of a skillful physician be obtained at once; and that his efforts should be aided by the most thorough hygienic precautions, good fresh air, bathing, and a supporting diet. Prior to the arrival of the physician, lose no time in using plenty of good brandy or whiskey to offset the extremely weakening effect of the disease. The employment of alcoholic stimulation in this disease is almost always used by physicians. Control the vomiting and allay the thirst by allowing the patient to suck small pieces of ice every five or ten minutes. Hot fomentations or spirits of turpentine should be applied to the throat. If the physician does not take charge of the patient by this time, the use of permanganate of potash, triturated, in strength of one grain to the ounce, in a mixture of fine sugar of milk and gum acacia, and blown over the parts with an insufflater every few hours, brings the best results if thoroughly carried out; or the throat can be swabbed out with the following mixture: chlorate of potash, four drachms; tincture of muriate of iron, three drachms, syrup of orange, two ounces; water sufficient to make four ounces; administered every two or three hours. Inhaling steam or lime-water from a steam atomizer is especially good. The use of blisters, caustics, active purges, mercurials, or bleeding, should be condemned. Throughout the whole course of the disease the strength must be supported by the most nourishing diet, as well as by tonics and stimulants. Beef tea, milk, milk punch, and brandy should be freely administered. A competent physician should be called in as early as possible. The general results of the treatment with antitoxin, if given on the first, second or third day of the disease, are usually favorable. There are rarely any immediately bad results from the injections, and the published testimony of careful observers would tend to prove that recovery has followed its use in a larger percentage of cases than under former methods of treatment.

QUINSY. (TONSILLITIS.)

This is an acute inflammation of the tonsils, which generally extends to, and involves adjacent strictures, and is attended with general febrile disturbance. Its duration varies from four to twenty days. It sometimes terminates by a gradual return to health (resolution); or by the formation of "matter" within the gland (suppuration.) When this latter is the case, the swelling sometimes becomes so great before it breaks as to require lancing.

CAUSES. It most frequently results from a cold. In some persons there is a predisposition to it, and the individual is liable to recurring attacks. Persons of a scrofulous diathesis are more liable to it than others.

SYMPTOMS. Difficulty of swallowing, soreness, and stiffness of the throat, are the first monitions of its approach. There is fever, quick, full pulse, and dryness of the skin; the tongue is furred, and the breath offensive. The tonsils are intensely red, swollen, and painful, the pain often extending to the ear. Sometimes but one tonsil is affected, though generally both are involved. In severe cases the patient cannot lie down, in consequence of the difficulty of breathing.

TREATMENT. In the early stage of the disease, the spirit vapor-bath is invaluable. The sweating which it produces should be kept up by the use of the Compound Extract of Smart-weed in some diaphoretic infusion. Hot wet-packs to the throat, covered with dry cloths, are useful. The inhalation of the hot vapor of water or vinegar, or peppermint and water, is beneficial. A carthartic should be given at night. When the disease does not show a disposition to yield to this treatment, the services of a physician should be obtained. When pus, or "matter," is formed in the tonsil, which may be known by the increased swelling and the appearance of a yellowish spot, the services of a physician will be required to lance it.

ENLARGED TONSILS.

Chronic enlargement of the tonsils, as shown in Fig. 147, _A A_, is an exceedingly common affection. It is most common to those of a scrofulous habit. It rarely makes its appearance after the thirtieth year, unless it has existed in earlier life, and has been imperfectly cured. Both tonsils are generally, though unequally enlarged. A person affected with this disease is extremely liable to sore throat, and contracts it on the slightest exposure; the contraction of a cold, suppression of perspiration, or derangement of the digestive apparatus being sufficient to provoke inflammation.

CAUSES. Repeated attacks of quinsy, scarlet fever, diphtheria, or scrofula, and general impairment of the system, predispose the individual to this disease.

SYMPTOMS. The voice is often husky, nasal or guttural, and disagreeable. When the patient sleeps, a low moaning is heard, accompanied with snoring and stentorian breathing, and the head is thrown back so as to bring the mouth on a line with the windpipe, and thus facilitate the ingress of air into the lungs. When the affection becomes serious, it interferes with breathing and swallowing. The chest is liable to become flattened in front and arched behind, in consequence of the difficulty of respiration, thus predisposing the patient to pulmonary disease. On looking into the throat, the enlarged tonsils may be seen, as in the figure. Sometimes they are so greatly increased in size that they touch each other.

TREATMENT. The indications to be carried out in the cure of this malady are:

(1.) To remedy the constitutional derangement.

(2.) To remove the enlargement of the tonsil glands.

The successful fulfillment of the first indication may be readily accomplished by attention to hygiene, diet, clothing, and the use of the Golden Medical Discovery, together with small daily doses of the Pleasant Purgative Pellets. This treatment should be persevered in for a considerable length of time after the enlargement has disappeared, to prevent a return.

To fulfill the second indication, astringent gargles may be used. Infusions of witch-hazel or cranesbill should be used during the day. The following mixture is unsurpassed: iodine, one drachm; iodide of potash, four drachms; pure, soft water, two ounces. Apply this preparation to the enlarged tonsils twice a day, with a probang, or soft swab, being careful to paint them each time. A persevering use of these remedies, both internal and local, is necessary to reduce and restore the parts to a healthy condition.

Sometimes the enlarged tonsils undergo calcareous degeneration; in this case, nothing but their removal by a surgical operation is effectual. This can be readily accomplished by any competent surgeon. We have operated in a large number of cases, and have never met with any unfavorable results.

ELONGATION OF THE UVULA.

Chronic enlargement or elongation of the uvula, or palate, as shown at B, Fig. 147, may arise from the same causes as enlargement of the tonsils. It subjects the individual to a great deal of annoyance by dropping into and irritating the throat. It causes tickling and frequent desire to clear the throat, change, weakness, or entire loss of voice, and difficulty of breathing, frequently giving rise to the most persistent and aggravating cough.

TREATMENT. The treatment already laid down for enlarged tonsils, with which affection, elongation of the uvula is so often associated, is generally effectual. When it has existed for a long time and does not yield to this treatment, it may be removed by any competent surgeon.

ANÆMIA.

When the blood contains less than the ordinary number of red corpuscles, the condition is known as _anæmia_, and is characterized by every sign of debility. A copious hemorrhage, in consequence of a cut, or other serious injury, will lessen the quantity of blood and may produce anæmia. After sudden blood-letting, the volume of the circulation is quickly restored by absorption of fluid, but the red corpuscles cannot be so readily replaced, so that the blood is poorer by being more watery. This is only one way in which the blood is impoverished.

The blood may be exhausted by a drain upon the system, in consequence of hard and prolonged study. Severe mental employment consumes the red corpuscles, leaving the blood thin, the skin cool and pale, and the extremities moist and cold.

Anæmia may arise from lack of exercise, or it may be occasioned by mental depression, anxiety, disappointment, trouble, acute excitement of the emotions or passions, spinal irritation; in fact, there are many special relations existing between the red corpuscles of the blood and the various states of the mind and the nervous system. The latter depends directly upon the health and quantity of these red corpuscles for its ability to execute its functions.

Anæmia may arise in consequence of low diet, or because the alimentary organs do not properly digest the food, or when there is not sufficient variety in the diet. No matter how anæmia is occasioned, whether by labor and expenditure, by hemorrhages, lead poisoning, prolonged exposure to miasmatic influences, deprivation of food, indigestion, imperfect assimilation, frequent child-bearing, or lactation, the number of the red corpuscles in the blood is materially diminished.

The diagnostic symptoms of anæmia are pallor of the face, lips, tongue, and general surface, weakness of the vital organs, hurried respiration on slight exercise, swelling or puffiness of the eyes, and a murmur of the heart, resembling the sound of a bellows.

This disorder of the blood tends to develop low inflammation, dropsical effusion, tubercular deposits, Bright's disease, derangements of the liver, diarrhea, leucorrhea, and is a precursor of low, protracted fevers. This condition of the blood predisposes to the development of other affections, providing they are in existence, and often it is found associated with Bright's disease, cancer, and lung difficulties.

TREATMENT. (1.) Prevent all unnecessary waste and vital expenditure.

(2.) Place the patient under favorable circumstances for recovery, by regulating the exercise and clothing entertaining the mind, and furnishing plenty of pure air.

(3.) Prescribe such a nutritious diet as will agree with the enfeebled condition of the patient.

(4.) Regular habits should be established in regard to meals, exercise, recreation, rest, and sleep.

(5.) The use of tonics and stimulants, as much as the stomach will bear, should be encouraged. Bathe the surface with a solution of a drachm of quinine in a pint of whiskey.

(6.) Iron, in some form, is the special internal remedy in anæmia. Meantime, it is proper to treat the patient with gentle, manual friction, rubbing the surface of the body lightly and briskly with the warm, dry hand, which greatly stimulates the circulation of the blood. Anæmia occurs more frequently in the female than in the male, because her functions and duties are more likely to give rise to it.

APNOEA.

Apnoea, or short, hurried, difficult respiration, is occasioned by certain conditions of the blood. When anything interferes with the absorption of oxygen, or the elimination of carbonic acid, the blood is not changed from venous to arterial, and becomes incapable of sustaining life. This morbid condition is termed _asphyxia_. We often read of persons going into wells where there are noxious gases, or remaining in a close room where there are live coals generating carbonic acid gas and thus becoming asphyxiated, dying for want of oxygen.

Deficiency of oxygen is the cause of apnoea, and sometimes the red corpuscles themselves are so few, worn out, or destroyed, that they cannot carry sufficient oxygen, and the consequence is that the patient becomes short of breath, and when a fatal degeneration of the corpuscles ensues, he dies of asphyxia. Many a child grows thin and wan and continues to waste away, the parents little dreaming that the slow consumption of the red corpuscles of the blood is the cause which is undermining the health. Sometimes this disease is the result of starvation, irregular feeding, improper diet, want of care, and, at other times, want of fresh air, proper exercise, and sunlight.

TREATMENT. The first essential to success in the treatment of this disease, is the removal of the exciting cause. Exercise in the outdoor air and sunlight, with good, nutritious food, and well-ventilated sleeping apartments, are of the greatest importance. The bitter tonics, as hydrastin, with pyrophosphate of iron, should be employed to enrich the blood and build up the strength.

LEUCOCYTHÆMIA.

This term is used to designate a condition in which there is an excess of colorless blood-corpuscles. In health, the colorless corpuscles should exist only in the proportion of one, to one or two hundred of the red corpuscles. These colorless corpuscles increase when there is disease of the lymphatic glands, but whether this is the cause of their increase or perversion is not known.

They have been found abundant in the blood in diseases of the spleen and of the liver. Diarrhea usually attends this complaint, together with difficult breathing, loss of strength, gradual decline, fever, diminution of vital forces, and finally death. The recovery of a well-marked case of this disease is very doubtful. Its average duration is about one year.

DROPSIES.

_Transudation_ is the passage of fluid through the tissue of any part of the body without changing its liquid state, while _exudation_ means, medically, the passage of matter which coagulates and gives rise to solid deposits. When transudations are unhealthy, they may accumulate in serous cavities or in cellular structures, and constitute _dropsy_. Exudation is the result of inflammation, and the product effused coagulates and becomes the seat of a new growth of tissue. Exosmosis means the passage of fluid from within outward, and is a process constantly taking place in health; while transudation takes place because the blood is watery and the tissues are feeble and permeable, permitting the serum and watery elements of the blood to pass into certain cavities, where they accumulate.

The cause of dropsies may be low diet, insufficient exercise, indigestion, hemorrhages, wasting diseases, in fact, any thing which impoverishes the blood and increases the relative amount of serum. The tardy circulation of blood in the veins, or its obstruction in any way, is a condition highly favorable to the development of dropsy.

General dropsy is called _anasarca_, and is readily distinguished by bloating or puffiness of the skin all over the body. This condition is also called _oedema_. The skin is pale, yields under the finger without pain, and preserves the impression for some time. The oedema usually appears first in the lower extremities, next in the face, and from thence extends over the body.

General dropsy is commonly due to an impoverished condition of the blood, and this may be the result of _albuminuria_, a disease of the kidneys. Albuminuria is frequently the sequel of scarlatina. Hence, the utmost care should be taken against exposure of a patient recovering from scarlatina, and the same caution should be exercised during convalescence from measles, erysipelas, and rheumatism. Dropsies may be general, as in anasarca, or local, as dropsy of the heart, called _cardiac_ dropsy: dropsy of the peritoneum, the serous membrane which lines the abdominal cavity, called _ascites_; dropsy of the chest, called _hydrothorax_; dropsy of the head, called _hydrocephalus_; dropsy of the scrotum, called _hydrocele_.

Dropsy is not, therefore, of itself a disease, but only the symptom of a morbid condition of the blood, kidneys, liver, or heart. Thus disease of the valves of the heart, may obstruct the free flow of blood and thus retard its circulution. In consequence the pulse grows small and weak, and the patient cannot exercise or labor as usual, and finally the lower limbs begin to swell, then the face and body, the skin looks dusky, the appetite is impaired, the kidneys become diseased, there is difficulty in breathing, and the patient, it is said, dies of dropsy, yet dropsy was the result of a disease of the heart, which retarded the circulation and enfeebled the system, and which was actually the primary cause of death.

TREATMENT. Dropsy being only a symptom of various morbid conditions existing in the system, any treatment to be radically beneficial must, therefore, have reference to the diseased conditions upon which the dropsical effusion, in each individual case, depends. These are so various, and frequently so obscure, as to require the best diagnostic skill possessed by the experienced specialist, to detect them. There are, however, a few general principles which are applicable to the treatment of nearly all cases of dropsy. Nutritious diet, frequent alkaline baths to keep the skin in good condition and favor excretion through its pores, and a general hygienic regulation of the daily habits, are of the greatest importance. There are also a few general remedies which may prove more or less beneficial in nearly all cases. We refer to diuretics and hydragogue cathartics. The object sought in the administration of these is the evacuation of the accumulated fluids through the kidneys and bowels, thus giving relief. Of the diuretics, queen of the meadow, buchu, and digitalis generally operate well. As a cathartic, the Purgative Pellets accompanied with a teaspoonful or two of cream of tartar, will prove serviceable. Beyond these general principles of treatment it would be useless for us to attempt to advise the invalid suffering from any one of the many forms of dropsy. The specialist skilled by large experience in detecting the exact morbid condition which causes the watery effusion and accumulation, can select his remedies to meet the peculiar indications presented by each individual case. Sometimes the removal of the watery accumulation by tapping becomes necessary, in order to afford relief and give time for remedies to act. We have found it necessary to perform this operation very frequently in cases of _hydrocele_, and also quite often in cases of abdominal dropsy. The chest has also been tapped and considerable quantities of fluids drawn off, and this has been followed by prompt improvement and a final cure.

CASES TREATED.

CASE I. A Canadian gentleman, aged 68, applied at the Invalids Hotel and Surgical Institute, for examination and treatment. He had been dropsical for over two years, and had become so badly affected as to be unable to lie down at night. His legs were so filled with water and enlarged as to render it almost impossible for him to walk, and there was a general anasarca. The least exertion was attended with the greatest difficulty of breathing. He had been under the treatment of several eminent general practitioners of medicine in Canada but found no relief. They were unable to discover the real cause of his ailment, but to the specialist who has charge of this class of diseases at our institution, and who annually examines and treats hundreds of such cases, it was at once apparent that the dropsy was caused from a weakened condition of the heart, which rendered it unable to perform its functions. He was put upon a tonic and alterative course of treatment, which also embraced the use of such medicines as have been found to exert a specific, tonic action upon the muscular tissues of the heart. He improved so rapidly that in less than two months he was able to lie down and sleep soundly all night. The bloating disappeared, his strength improved, and in three month's more he was discharged perfectly cured.

CASE II. A man aged 42, consulted us by letter, stating that he was troubled with general bloating which had made its appearance gradually and was attended by general debility and other symptoms which have been enumerated as common to general dropsy. He had been under the treatment of several home physicians without receiving any benefit; he had steadily grown worse until he felt satisfied that if he did not soon get relief he could not live very long. He was requested to send a sample of his urine for examination, as we had suspicions, from the symptoms which he gave, that the cause of his dropsy was _albuminuria_, or Bright's disease of the kidneys. On examination of the urine, albumen in very perceptible quantities was found to be present. We had, about this time, come into possession of a remedy said by very good authority, to be a specific in degeneration of the kidneys when not too far advanced, and we determined to test it upon this well-marked case. We accordingly prescribed it, together with other proper tonics and alteratives, at the same time giving the patient important hygienic advice, which must be complied with if success is attained in the management of this very fatal malady. Our patient gradually improved, and in a few months' time was restored to perfect health, which he has continued to enjoy ever since. From our subsequent experience, embracing the treatment of quite a large number of cases of Bright's disease of the kidneys, we are satisfied that it is, in its early stage, quite amenable to treatment.

CASE III. A man aged 35, single, consulted us for what he supposed to be enlargement of the testicles. The scrotum was as large as his head, and it was with difficulty that he could conceal the deformity from general observation. The disease was immediately recognized by the attending surgeon as hydrocele. The liquid was promptly drawn oft by tapping, and a stimulating injection was made into the scrotum to prevent re-accumulation. We mention this case only because it is one among a very large number who have consulted us supposing that they were suffering from enlargement of the testicles, cancer, or some other morbid growth within the scrotum, when a slight examination has shown the affection to be hydrocele, a disease which is speedily cured by tapping, with a little after treatment. The operation is perfectly safe and almost entirely painless.

CASE IV. A lady, aged 24, consulted us by letter enumerating a long list of symptoms which clearly indicated abdominal dropsy, resulting from suppression of the menses. A well-regulated, hygienic treatment was advised, and medicines to restore the menstrual function by gradually toning up and regulating the whole system, were forwarded to her by express. After four months' treatment, perfect recovery resulted. Cases like this latter are very common and generally yield quite readily to proper management. No harsh or forcing treatment for restoring the menstrual function should be employed, as it will not only fail to accomplish the object sought, but it is also sure to seriously and irreparably injure the system. The most difficult cases which we have had to deal with, have been those which had been subjected by other physicians to the administration of strong emmenagogues in the vain effort to bring on the menses.

RHEUMATISM.

Prominent among constitutional diseases is the one known as _rheumatism_. It is characterized by certain local symptoms or manifestations in fibrous tissues. This term has been applied to neuralgic affections and to _gout_, but it differs from each in several essential particulars. Rheumatism may be divided into (1) _Acute_, (2) _Chronic_, (3) _Muscular_.

ACUTE ARTICULAR RHEUMATISM. Acute articular rheumatism implies an affection of the articulations or joints. It usually commences suddenly; sometimes pain or soreness in the joints precedes the disclosure of the disease. The symptoms are pain in the joints, tenderness, increased heat, swelling and redness of the skin. The pain varies in its intensity in different oases, and is increased by the movement of the affected parts. Swelling of the joints occurs, especially those of the knee, ankle, wrist, elbow, and the smaller joints of the hands and feet. The swelling and redness are generally in proportion to the acuteness of the attack. Acute articular rheumatism is always accompanied with more or less fever. Sweating is generally a prominent symptom, being strongly acid and more profuse during the night. The appetite is impaired, the tongue is coated, the bowels are constipated, or there is diarrhea.

THE DURATION OF THIS DISEASE. Unlike fevers, its course is marked by fluctuations; frequently after a few days the pain subsides, the fever disappears, and convalescence is apparently established, when, suddenly, all the symptoms are renewed with even greater intensity than before. This disease rarely proves fatal, unless the heart is involved.

CAUSES. Rheumatism is frequently supposed to be occasioned by a suppression of the functions of the skin, and is generally attributed to the action of cold upon the surface of the body. But this acts only as an exciting cause. It is a disease of the blood. This form of rheumatism usually occurs between the age of fifteen and thirty, and prevails most extensively in changeable climates. Acute articular rheumatism seldom terminates in the chronic form.

CHRONIC ARTICULAR RHEUMATISM. Articular rheumatism, in the subacute or chronic form, is frequently observed in medical practice. The symptoms are pain and more or less swelling of the joints, although not of as grave a character as in acute rheumatism. There is frequently an absence of increased heat and redness. As in the acute form, the different joints are liable to be affected successively and irregularly, until, after a time, the disease becomes fixed in a single joint, and the fibrous tissues entering into the ligaments and tendons are liable to be affected. The appetite, digestion, and nutrition are often good, and, in mild cases, patients are able to pursue their daily vocations. The disease is supposed to be the same as in the acute form, but milder, and, strange to say, more persistent. A diseased condition of the blood is supposed to be involved in both instances, but this morbid state is less extended, and, at the same time, more obstinate in the chronic than in the acute form. Sub-acute articular rheumatism is not always chronic, and may disappear in a shorter time than in the acute form. Chronic articular rheumatism is not generally fatal, but there is danger of permanent deformities.

MUSCULAR RHEUMATISM. This affection is closely allied to _neuralgia_, and may properly be called _myalgia_. It exists under two forms, acute and chronic. In acute muscular rheumatism, there is at first a dull pain in the muscles, which gradually increases. When the affected muscles are not used the pain is slight, and certain positions may be assumed without inducing it constantly; but in movements which involve contraction of the muscles the pain is very violent. In some cases, the disease is movable, changing from one muscle to another, but usually it remains fixed in the muscle first attacked. The appetite and digestion are not often impaired, and there is no fever. The duration of this form of rheumatism varies from a few hours to a week or more.

In subacute or chronic muscular rheumatism, pain is excited only when the affected muscles are contracted with unusual force, and then it is similar to that experienced in the acute form. The chronic form is more apt to change its position than the acute. The duration of this form is indefinite. In both the acute and chronic forms some particular parts of the body are more subject to the affection than others.

The muscles on the posterior part of the _neck_ are subject to rheumatic affection. It is termed _torticollis_ or _cervical_ rheumatism in such cases, and should be distinguished from ordinary neuralgia. When the muscles of the loins are affected, it is commonly known as _lumbago_. In case the thoracic muscles are affected, it is known as _pleurodynia_. In coughing, sneezing, and the like, the pain produced is not unlike that in pleuritis and intercostal neuralgia.

One of the most marked features of muscular rheumatism, is the cramp-like pain, induced by the movements of the affected muscles, whereas the pain is slight when those muscles are uncontracted. This feature is very serviceable in distinguishing muscular rheumatism, or myalgia, from neuralgic affections. Another trait which distinguishes muscular rheumatism from neuralgia, is that the former is characterized by great soreness, while the latter is not. There is also a distinction between inflammation of the muscles and muscular rheumatism. In the case of the former, there is continued pain, swelling of the parts, occasional redness, and the presence of more or less fever, which conditions do not exist in the latter. Persons subject to rheumatism of the muscles, are apt to suffer from an attack, after exposure of the body to a draught of air during sleep, or when in a state of perspiration.

TREATMENT OF ACUTE RHEUMATISM. Administer the spirit vapor-bath to produce free perspiration, which should be maintained by full doses of the Compound Extract of Smart-weed. The anodyne properties of the latter also prove very valuable in allaying the pain. Tincture or fluid extract of aconite root may also be employed, to assist in equalizing the circulation, and also to secure its anodyne action. Black cohosh seems to exert a specific and salutary influence in this disease, and the tincture or fluid extract of the root of this plant may be advantageously combined with the aconite. Take fluid extract of aconite-root, thirty drops; fluid extract of black cohosh, one drachm; water, fifteen teaspoonfuls; mix. The dose is one teaspoonful every hour. The whole person should be frequently bathed with warm water, rendered alkaline by the addition of saleratus or soda. The painful joints may be packed with wool or with cloths wrung from the hot saleratus water, and the patient kept warm and quiet in bed. The acetate of potash taken in doses of five grains, well diluted with water, every three or four hours, is very valuable in acute rheumatism. Its alkaline qualities tend to neutralize the acid condition of the fluids of the system, and it also possesses diuretic properties which act upon the kidneys, removing the offending blood-poison from the system through these organs. If the joints are very painful, cloths wet with the Compound Extract of Smart-weed and applied to them, and covered with hot fomentations, very frequently relieve the suffering. The majority of cases yield quite promptly to the course of treatment already advised, if it is persevered in. The disease, however, sometimes proves obstinate and resists for many days the best treatment yet known to the medical profession.

TREATMENT OF CHRONIC RHEUMATISM. The general alkaline baths recommended in the acute affection are also valuable in the chronic. The spirit vapor-bath, the Turkish, as well as the sulphur vapor-bath, are all worthy of a trial in this obstinate and painful disease. Alternatives are a very valuable class of agents in chronic rheumatism. The following mixture, in teaspoonful doses three times a day, in alternation with the Golden Medical Discovery, has proved very successful in this disease: acetate of potash, one ounce; fluid extract of black cohosh, one ounce; fluid extract of poison hemlock, two drachms; simple syrup, six ounces. This thorough alterative course, if well persevered in, together with the use of alkaline and vapor-baths, will generally prove very successful. The specialist, however, dealing with chronic diseases exclusively, will occasionally meet with a case which has been the rounds of the home physicians without benefit, that will tax his skill and require the exercise of all his perceptive faculties to determine the exact condition of the patient's system, upon which the obstinacy of the disease depends. When this is ascertained, the remedies will naturally suggest themselves, and the malady will generally yield to them. But, although the treatment of this disease has entered largely into our practice at the Invalid's Hotel, and has been attended by the most happy results, yet the cases have presented so great a diversity of abnormal features, and have required so many variations in the course of treatment, to be met successfully, that we frankly acknowledge our inability to so instruct the unprofessional reader as to enable him to detect the various systemic faults common to this ever-varying disease, and adjust remedies to them, so as to make the treatment uniformly successful. If the several plans of treatment which we have given do not conquer the disease, we can not better advise the invalid than to recommend him to employ a physician of well-known skill in the treatment of chronic diseases. If such a one is not accessible for personal consultation, a careful statement of all the prominent symptoms, in writing, may be forwarded to a specialist of large experience in this disease, who will readily detect the real fault, in which the ailment has its foundation. Particularly easy will it be for him to do so, if he be an expert in the analysis of urine. A vial of that which is first passed in the morning, should be sent with the history of the case, as chronic rheumatism effects characteristic changes in this excretion, which clearly and unmistakably indicate the abnormal condition of the fluids of the body upon which the disease depends.

* * * * *

DISEASES OF THE SKIN.

ECZEMATOUS AFFECTIONS.

Eczematous affections constitute a very important class of skin diseases, the prominent characteristics of which are _eruption_ and _itching_. They are progressive in character, passing through all the successive stages of development, from mere redness of the skin to desquamation, or thickening of the cuticle. The affections belonging to this group are _eczema, psoriasis, pityriasis, lichen, impetigo, gutta rosacea,_ and _scabies_, or _itch_. A careful examination of each of these diseases shows it to be a modified form of eczema, and, therefore, they demand similar treatment.

ECZEMA. (_Humid Tetter, Salt-rheum, Running Scall_, or _Heat Eruption_.) The term _eczema_ is used to designate the commonest kind of skin diseases.

In this disease, the minute blood-vessels are congested causing the skin to be more vascular and redder than in its natural state. There is an itching or smarting in the affected parts. The skin is raised in the form of little pimples or vesicles, and a watery lymph exudes. Sometimes the skin becomes detached and is replaced by a crust of hardened lymph, or it may be partially reproduced, forming _squamæ_, or scales. There are three stages of this disease; the inflammatory, accompanied by swelling, and the formation of pimples or vesicles; that of exudation, which is succeeded by incrustation; and that of desquamation, in which the skin separates in little scales and sometimes becomes thickened. Rarely, if ever, does the disease pass through these successive stages, but it is modified by its location and the temperament of the patient.

The many varieties of eczema are designated according to their predominating characteristics. Thus, when pimples or vesicles are abundant, it is termed, respectively, _eczema papulosum_ and _eczema vesiculosum,_ a fine illustration of which may be seen in Colored Plate I, Fig. 1. Again, when characterized by the eruption of pustules, it is termed _eczema pustulosum_, a representation of which may be seen in Plate I, Fig. 2; and, when the prominent feature is the formation of scales, it is termed _eczema squamosum_.

Eczema may be general or partial; in other words, the eruption may appear in patches or be distributed over the entire surface of the body. The latter form often appears in infants, but rarely occurs in adults. Two or more varieties of the eruption may be associated, or one form may gradually develop into another.

Infants and young children are peculiarly subject to this disorder, and, if the disease be not promptly arrested, it will assume the severest form and eventually become chronic. The muscles are soft, the eyes are dull and expressionless, and the little sufferer experiences the most excruciating torments. Frequently the whole body is covered with patches of eczema, the secretions are arrested, and, where the scales fall off, the skin is left dry and feverish.

Eczema has no symptoms proper, since the morbid feelings are due to constitutional debility, of which eczema is the result. The _signs_ of eczema are redness, heat, an itching or smarting sensation, the formation of pimples or vesicles, exudation, incrustation, the separation of the cuticle into scales and a gradual thickening of the skin.

CAUSES. Three forms of constitutional derangement predispose the system to eczema; nutritive, assimilative, and nervous debility. In the former, there is a diminution of nutritive power, so that the patient becomes weak and emaciated. Assimilative debility is indicated by an impaired digestion and a consequent suppression, or an abnormal state of the secretions. Eczema occasioned by nervous debility, is accompanied by all the morbid conditions incident to irritation and exhaustion of the nervous system. Eczema may be excited by a violation of the rules of hygiene, as undue exposure, or sudden transition from heat to cold, deficient or excessive exercise, impure air, or improper clothing.

PSORIASIS. Psoriasis may be defined as a _chronic form of eczema_. The transition of the last stage of eczema into psoriasis is indicated by a tendency of the inflamed, thickened, scaly skin to become moist when rubbed. It usually appears in patches on various portions of the body. The skin is parched and highly discolored. The hairs are harsh and scanty. The patient is constantly tormented by an unbearable itching sensation and, if the skin is rubbed, it exudes a viscous or sticky fluid. These are the characteristic signs of psoriasis. It generally appears on the flexures, folds and crooks of the joints, the backs and palms of the hands, the arms, and the lower portions of the legs.

PITYRIASIS. (_Branny Tetter_, or _Dandruff_.) This affection is a mild form of psoriasis, from which it may be distinguished by a more superficial congestion or inflammation of the affected parts, the absence of swelling, and the formation of smaller scales, having the form and appearance of _fine bran_. It generally appears on the scalp, sometimes extends over the face, and, in rare instances, affects the entire surface of the body. The signs peculiar to this disease are slight inflammation, itching, and the formation of minute scales.

CAUSES. Pityriasis is caused by nutritive debility, and is often associated with erysipelas, rheumatism, and bronchitis.

LICHEN. (_Papular Rash_.) Lichen is a term used to designate an eruption of minute conical pimples, which are more or less transparent, red, and occasion great annoyance. The eruption is attended with a severe, hot, prickling sensation, as if the flesh were punctured with hot needles. The pimples contain no pus, but if opened, they exude a small quantity of blood and serum. This disease more frequently occurs between the ages of twelve and fifty, but occasionally appears during dentition, when it is called "tooth rash." The lichen pimples are sometimes dispersed singly over the skin and gradually subside, forming a minute scale, corresponding in position with the summit of the pimple. When the pimples appear in clusters, there is a diffused redness in the affected part, and, if they are irritated, minute scabs will be formed. Lichen generally appears on the upper portion of the body, as on the face, arms, hands, back, and chest.

The various forms of lichen are designated according to their causes, signs, location, manner of distribution, and the form of the pimples.

_Lichen Simplex_ is the simplest form of this disorder, and is indicated by the appearance of minute pimples, which, when the distribution is general, are arranged like the blotches of measles. Sometimes the eruption is local and bounded by the limits of an article of clothing, as at the waist. In eight or ten days, the cuticle separates into minute scales, which are detached and thrown off; but a new crop of pimples soon appears and runs the same course, only to be succeeded by another, and thus the affection continues for months and even years.

_Lichen circumscriptus_ is an aggravated form of _lichen simplex_, and is characterized by a circular arrangement of the pimples. The circumference which marks the limit of the patch is sharply defined. This form of lichen usually appears on the chest, hips, or limbs, and is not unfrequently mistaken for ringworm.

_Lichen strophulosus_ is a variety peculiar to infants. Dermatologists recognize several subdivisions of this species, but the general characteristics are the same in all. The pimples are much larger than in the other forms of lichen, of a vivid red color and the duration of the eruption is limited to two or three weeks.

_Lichen urticatus_ is also an infantile affection and begins with inflammation, which is soon succeeded by the eruption. In a few days the pimples shrink, the redness disappears, and the skin has a peculiar bleached appearance. The eruption is attended by an intense itching sensation and, if the skin is ruptured, a small quantity of blood is discharged and a black scab formed. This variety of lichen is very obstinate and of long duration.

_Lichen tropicus_, popularly known as _prickly heat_, is an affection which attacks Europeans in hot climates. It is characterized by the appearance of numerous red pimples of an irregular form, distributed over those portions of the body usually covered by the clothing. It is attended with a fierce, burning, itching sensation, which is aggravated by warm drinks, friction of the clothing, and the heat of the bed. The eruption indicates a healthy condition of the system; its suppression or retrocession is an unfavorable symptom, denoting some internal affection such as deranged nutrition.

In _lichen planus_, as the term indicates, the pimples are flattened. There is no sensation of itching or formation of scabs. The pimples are solitary and have an angular base, and the fresh pimples formed appear on the spaces between the former eruptions. This affection usually attacks some particular region, such as the abdomen, hips, or chest. Instances are recorded in which it has appeared on the tongue and the lining membrane of the mouth. Sometimes it appears in patches, but even then, the margin of each pimple can be discerned.

_Lichen pilaris_ and _lividus_ are modifications of lichen simplex, the former being so named to describe the location of the pimples, _i.e._, surrounding the minute hairs which cover the body, especially the lower limbs. The term _lichen lividus_ indicates the dark purplish hue caused by a torpid circulation and the consequent change of arterial into venous blood before leaving the pimples. _Lichen circinatus_ is a modified form of _lichen circumspectus_. The pimples in the center of the circular patch subside and a ring is formed which gradually increases in size. When the rings become broken or extend in regular forms, the affection is termed _lichen gyratus_.

CAUSES. Constitutional debility predisposes the system to this eruption. The exciting causes are irritation of the skin, strumous diathesis, dentition, and any violation of hygienic rules. Although lichen is not a fatal disease, yet it tends to reduce the vitality of the system.

IMPETIGO. (_Crusted Tetter_ or _Scall_.) Impetigo is a term applied to an inflammation of the skin, more severe and energetic in its character than the preceding affection. We have found the predominating characteristics of eczema and lichen to be the presence of exudation in the former, and the absence of it in the latter.

Impetigo is marked by the formation of yellow pus, which raises the cuticle into pustules. There is a slight swelling, redness, and the pus gradually dries up, forming an amber-colored crust, a representation of which is given in Colored Plate I, Fig. 5. It soon falls, leaving the skin slightly inflammed, but with no scar. The pustules are sometimes surrounded by a cluster of smaller ones.

The varieties of impetigo are designated according to the distribution of the pustules. _Impetigo figurata_, is characterized by the appearance of large clusters upon an inflamed and swollen surface, generally upon the face, but sometimes upon the scalp. This form is represented in Colored Plate I, Fig. 4. In _impetigo sparsa_ the pustules are scattered over the whole body.

CAUSES. The predisposing cause of impetigo is nutritive debility, and the exciting causes are irritation, impure air, and errors of diet.

GUTTA ROSACEA is a _progressive_ disease, and its successive stages of development mark the several varieties, such as _gutta rosacea, erythematosa, papulosa, tuberculosa, pustulosa_, according as they are characterized by redness, pimples, tubercles, or pustules. This affection is attended with heat, itching, and throbbing. The pustules contain serous lymph, which exudes if the cuticle be broken, and forms a crust at the summit of the pustule.

This eruption often appears on the face of persons addicted to intemperate habits, and has thus received the name of "_rum blossom_."

CAUSE. It is essentially a chronic affection, and depends upon constitutional causes.

SCABIES. (_Itch_.) This disease is characterized by a profuse scaliness of the skin, by an eruption of pimples, vesicles, and, in rare instances, of pustules. Its prominent feature is an intense itching, so aggravating that, in many instances, the skin is torn by the nails. Unlike other diseases of the skin, it is not due to inflammation, but is caused by animalculæ, or little parasites, termed by naturalists the _acarus scabiei_. This minute animal burrows in the skin, irritating it, and thus producing the scaliness and itching. The vesicles are comparatively few in number, and contain a transparent fluid. The pustules are only present in the severest forms or when the skin is very thin and tender. It is then termed _pustular itch_.

The parts usually affected are the hands, flexures of the joints, and the genital organs. Cases are recorded, in which scabies appeared upon the face and head, but they are of rare occurrence. The activity of the animalculæ, is modified by the vitality of the victim. In persons of a vigorous constitution, they will rapidly multiply, and, in a few days after their first appearance, will be found in almost every part of the body.

Scabies is not confined to any age or sex, but chiefly affects persons of filthy habits. This disease can only be communicated by contact, or by articles of clothing worn by an infected person. There are certain indications which predispose the system to infection, such as robust health, a hot climate, and uncleanliness.

TREATMENT. In all the varieties of eczematous affections, except scabies, the treatment of which will hereafter be separately considered, remedies employed with a view to the removal of the constitutional fault are of the greatest importance. The eruption upon the skin is but a local manifestation of a functional fault, which must be overcome by alterative remedies. All the excretory organs should be kept active. To open the bowels, administer a full cathartic dose of Dr. Pierce's Pleasant Pellets. Afterwards they should be used in broken doses of one or two daily, in order to obtain their peculiar _alterative_ effects. The use of Dr. Pierce's Golden Medical Discovery is also necessary to secure its constitutional remedial benefits. As a local corrective to relieve the itching and disagreeable dryness of the skin, add half an ounce of blood-root to half a pint of vinegar, steep moderately for two hours, strain and paint the affected parts once or twice daily with the liquid. Every night before retiring, apply glycerine freely to all the affected parts, or dissolve one drachm of oxalic acid in four ounces of glycerine and anoint the skin freely. The white precipitate ointment, obtainable at any drug store, is an excellent application is most forms of eczema. A tea, or infusion, of black walnut leaves, applied as a lotion to the affected parts, has also proved beneficial. The surface of the body should be kept clean by frequent bathing, and thus stimulating its capillary vessels to healthy activity. The eczematous surfaces should not be bathed frequently, and never with harsh or irritating soaps. All varieties of eczematous affections, except scabies, are only temporarily relieved by external applications, while the _radical cure_ depends upon a protracted use of alterative, or blood-cleansing medicines. Therefore, we would again remind the reader of the necessity of keeping the bowels regular, and removing all morbid taints of the blood and faults of the secretory organs by the persistent use of Dr. Pierce's Golden Medical Discovery. _The successful treatment of scabies_, or common itch, generally requires only local applications, for the object to be obtained is simply the destruction of the little insects which cause the eruption. Happily, we possess an _unfailing specific_ for this purpose. Numerous agents have been employed with success, but _Sulphur_ enjoys the greatest reputation for efficacy, and, since it is perfectly harmless, we advise it for this class of disease. Take a quantity of pulverized sulphur and mix with sufficient vaseline or lard to form an ointment. Having first divested the body of clothing, anoint it all over freely, and rub the ointment thoroughly into the pores of the skin while standing before a hot fire. The application should be made at night before retiring, and the patient should wear woolen night-clothes or lie between woolen blankets. In the morning after the application, the patient should take a warm bath, washing the skin thoroughly and using _plenty of soap_. This treatment should be repeated two or three times to be _certain_ of a _perfect eradication_ of the disease. After this course of treatment, the wearing apparel as well as the bed-clothes should be thoroughly cleansed, as a precaution against a return of the disease.

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ERYTHEMATOUS AFFECTIONS.

The prominent features, eruption, and itching of _eczematous_ affections are purely local. _Erythematous_ affections are, however, remarkable for their symptoms of constitutional disorder. Each of these affections is preceded by intense febrile excitement and nervous debility. In brief, the local manifestations are simply signs of general internal disorders; hence, the treatment should be directed to the restoration of the system. This group includes _erythema, erysipelas_, and _urticaria_.

ERYTHEMA. A vivid and partial flushing of the face is produced by a superficial inflammation of the skin, termed _erythema_. There are many stages of this disease, from the instantaneous transient flush caused by emotional excitement, to the protracted inflammation and swelling of _erythema nodosum_.

The affection is characterized by a flush which is at first a bright vivid scarlet, but which changes to a deep purplish tint. There is a slight elevation of the skin, sometimes accompanied by itching. In the second stage of development, the flush subsides, the skin has a yellowish or bruised appearance, and a few minute scales are formed. In _erythema papulosum_, a fine representation of which is given in Colored Plate III, Fig. 18, there is an eruption of red pimples or pustules. The prominent feature of _erythema nodosum_, a variety of erythema which affects those portions of the skin exposed to the sun, is the appearance of a large swelling, usually lasting four or five days and attended by constitutional symptoms, such as nausea, fever, languor, and despondency. The disease is associated with the symptoms incident to a disordered nervous system and sometimes results fatally, in other cases, it terminates in melancholy and mania.

CAUSES. The predisposing causes of erythema are constitutional debility, changes of climate and temperature, and irritating food or medicines. Locally, it may be produced by friction and the heat of the sun.

ERYSIPELAS. There are few adult persons in this country who have not, by observation or experience, become somewhat familiar with this disease. Its manifestations are both constitutional and local, and their intensity varies exceedingly in different cases. The constitutional symptoms are usually the first to appear, and are of a febrile character. A distinct chill, attended by nausea and general derangement of the stomach is experienced, followed by febrile symptoms more or less severe. There are wandering pains in the body and sometimes a passive delirium exists. Simultaneously with these symptoms the local manifestations of the disease appear. A red spot develops on the face the ear, or other part of the person. Its boundary is clearly marked and the affected portion slightly raised above the surrounding surface. It is characterized by a burning pain and is very sensitive to the touch. It is not necessary for the information of the general reader that we should draw a distinction between the different varieties of this malady. The distinctions made are founded chiefly upon the _depth_ to which the morbid condition extends, and not on any difference in the _nature of the affection_.

Suppuration of the tissues involved is common in the severer forms. Should the tongue become dark and diarrhea set in, attended with great prostration, the case is very serious, and energetic means should be employed to save life. A retrocession of the inflammation from the surface to a vital organ is an extremely dangerous symptom.

The disease is not regarded as contagious, but has been known to become epidemic.

URTICARIA. (_Hives, or Nettle-Rash._) This word is derived from _urtica_, signifying a nettle; it is a transient affection of the skin, indicated by a fierce, burning, itching sensation and a development of pustules, or white blotches of various forms. A representation of this eruption is given in Colored Plate III, Fig. 17. It is appropriately named nettle-rash, from its resemblance to the irritation caused by the sting of a nettle. There is the same sharp, tingling sensation and a similar white wheal or blotch, caused by the muscular spasm of the corium, a layer of the skin.

Urticaria may be either acute or chronic. Acute urticaria is always preceded by febrile symptoms and the attack is indicated by a sudden congestion of the skin, followed by a slight swelling or elevation of the affected part. When the congestion subsides, the skin has a bruised appearance. In chronic urticaria, the febrile symptoms are absent.

CAUSES. The exciting causes of urticaria are gastric disorder, irritation of the mucous membrane, or a sudden nervous shock. The predisposing causes are conceded to be assimilative and nervous debility. Hence, it frequently accompanies purpura or land scurvy and rheumatism. The skin in some persons is so susceptible to irritation that urticaria can be kindled at any moment by excitement, as an animated conversation, or by the simple pressure of the hand.

TREATMENT. The proper treatment for simple erythema consists in applying to the affected parts a little lime-water, or sweet-oil, or glycerine, with the use of warm baths and mild cathartics. This is generally sufficient to effect a cure, if followed up with the persistent use of Dr. Pierce's Golden Medical Discovery taken three times a day.

In _erysipelas_ a hot bath, with warm, sweating teas, or, better still. Dr. Pierce's Compound Extract of Smart-weed may be given to favor sweating. The whole person should be frequently bathed with warm water rendered alkaline by the addition of saleratus or soda. The whole should be moved by a full dose of the "Pleasant Pellets." Fluid extract of veratrum viride, in doses of a drop or two every hour will best control the fever. The specific treatment, that which antidotes the poison in the blood, consists in administering fifteen-drop doses of the tincture of the muriate of iron in one teaspoonful of the "Golden Medical Discovery," every three hours. As a local application, the inflamed surface may be covered with cloths wet in the mucilage of slippery elm. A preparation of equal parts of sweet oil and spirits of turpentine, mixed and painted over the surface, is an application of great efficacy.

_For urticaria_, the "Pleasant Pellets" should be administered in sufficient doses to move the bowels, the skin bathed with warm water rendered alkaline by the addition of common baking soda or saleratus, and, if there be any febrile symptoms, a little tincture of aconite or veratrum may be administered in one drop doses once each hour. In the chronic form of the disease, the diet should be light, unstimulating, and easily digested, the skin kept clean by frequent bathing, and fresh air and outdoor exercises freely taken. The somewhat protracted use of Dr. Pierce's Golden Medical Discovery will result in the greatest benefit in this form of disease.

BULLOUS AFFECTIONS.

The distinguishing feature of this group of cutaneous affections is the formation of _bullæ_, or blebs, which are defined as "eminences of the cuticle, containing a fluid."

HERPES is an inflammation of the skin in which the eruption appears in patches of a circular form. On the second day, minute, transparent vesicles appear and gradually develop, becoming opalescent. On the succeeding days, they shrink and produce reddish brown scabs, which soon become hard and fall off, leaving deep, purplish pits. In adults, these vesicles sometimes terminate in painful ulcers, caused by an irritation of the eruption. By some practitioners, herpes is regarded as a purely nervous disorder, from the fact that it is frequently accompanied by severe neuralgic pains. These pains are not _constant_, but _occasional_, and do not appear at any definite stage of the disease. Sometimes they precede and accompany the eruption. Other instances are recorded in which they remained many years after the disease had disappeared. The local and constant pain of herpes is a severe burning, prickling, itching sensation, which remains after the scabs fall.

The three _general_ forms of this disease are _herpes zoster_, _phlyctoenodes_ and _circinatus_.

In _herpes zoster_, or _shingles_, the clusters of vesicles encircle one-half of the body, frequently at the waist; hence, it has received the name of _zona_ or _girdle_. The vesicles often develop into bullæ, and sometimes ulcerate. In _herpes phlyctoenodes_, the vesicles are small, round, and irregularly distributed over the face, neck, arms, and breast. This form is accompanied by febrile symptoms and offensive excretions.

In _herpes circinatus_, or _ringworm_, the vesicles appear in circular patches, or rings. This is the mildest form of herpes, and is not attended by symptoms of constitutional disorder. The various forms of herpes are represented in Colored Plate I, Fig. 3.

CAUSES. Herpes is not contagious. It is caused by vicissitudes of heat and cold, violent emotions, excessive exertion, irritation of the skin, and a general atony of the system.

MILIARIA is the name given to an eruption of vesicles which are larger than those of eczema, but smaller than the bullæ of herpes. At first, the serum contained in the vesicles is perfectly transparent, and reflects the red tint of the underlying skin, hence the name _miliaria rubra._ But gradually it becomes milky and opalescent, hence, the term _miliaria alba_. The vesicles of miliaria are generally solitary, and appear on those portions of the body most liable to become heated and to perspire. The eruption is preceded by chills, languor, slight fever, intense thirst, a sharp prickling sensation of the skin, and profuse perspiration. The vesicles soon desiccate and are replaced by a new crop.

CAUSES. Miliaria is almost universally an accompaniment of febrile disease, and all disorders in which there occurs a profuse perspiration. The causes to which it may be traced in each instance are improper diet, impure air, burdensome clothing, or strong emotions.

PEMPHIGUS is a peculiar eruption which appears upon the limbs and abdomen. The affected part is of a bright red color, and, in a few hours, small vesicles appear containing a transparent fluid. The vesicles soon develop into bullæ, entirely covering the inflamed portion. The fluid becomes opaque and in a few hours escapes. The patch is then covered with a yellow scab. Pemphigus may be either acute or chronic. The acute form is subdivided according to the degree of inflammation, as _pemphigus pompholyx_ in which it is severe, and _pemphigus benignus,_ when it is mild. The bullæ of pemphigus are illustrated in Colored Plate III, Fig. 19.

CAUSE. Pemphigus is always caused by a vitiated state of the system.

RUPIA is indicated by an eruption as large as a chestnut containing a watery fluid, which desiccates into a yellowish-brown crust. A fine representation of rupia vesicles in both stages of development, is given in Colored Plate II, Fig. 13.

TREATMENT. In all forms of herpes, the administration of a small dose of Dr. Pierce's Pleasant Pellets, with the use of his "Golden Medical Discovery" in one to two teaspoonful doses three times a day, will be followed by the happiest results. The skin should be kept clean by the use of the sponge-bath, rendered alkaline by the addition of common baking soda or saleratus. The portion of the body covered by the eruption, should be bathed with a solution of sulphate of zinc, one ounce to a pint of water.

Miliaria is generally associated with certain febrile diseases, and its proper treatment consists in overcoming the febrile and other constitutional symptoms which accompany the disease. A hot foot-bath and small doses of tincture of aconite, say one drop in water each hour, will suffice to remove the fever. If the stomach and bowels are in a vitiated condition, as they are apt to be, a mild cathartic dose of "Pellets" should be given.

_The treatment of pemphigus_ should consist in frequent alkaline sponge-baths, and in covering the affected parts with poultices of slippery elm, which should be kept moist with vinegar, The constitutional treatment should embrace the persistent use of the "Golden Medical Discovery." When the disease occurs in children, it is most generally dependent upon deficient nutrition, and special attention should be given to the diet of the patient, which should be nutritious. Fresh air and outdoor exercise ought not to be neglected.

The proper treatment of rupia does not differ from that suggested for pemphigus.

NERVOUS AFFECTIONS OF THE SKIN.

In nervous affections of the skin, the natural sensibility may be increased, diminished, or perverted. These morbid impressions arise from the nervous system. Although there are several varieties of these affections, yet, being of minor importance, we shall omit their consideration and only speak of one of them in this work.

PRURIGO affects the entire surface of the body and imparts to the skin a parched, yellowish appearance. It is characterized by pimples, and an intense burning, itching sensation. Rubbing and scratching only irritate the skin, which becomes covered with thin black scabs. A good representation of _prurigo_ may be seen in Colored Plate II, Fig. 6. The itching sensations are sometimes caused by chilling the body, by violent exercise, and heat; allowing the mind to dwell upon the affection aggravates it. Prurigo is recognized under two forms; _vulgaris,_ which is a mild form, and _senilis_, which chiefly occurs in old age, and is more severe. The external genital parts of females are frequently affected with this disease, and it is aggravated by menstruation and uncleanliness.

This affection may be due to a vitiated condition of the blood, and is common among those who are greatly debilitated. It is frequently occasioned by uncleanliness, intemperance, the use of unwholesome food, or by an impure atmosphere.

TREATMENT. To allay the itching, take glycerine, one ounce, add to it one drachm of _sulphite_ of soda, and one ounce of rose-water, and apply this to the affected parts. A solution made with borax, two drachms, and morphine, fire grains, dissolved in six ounces of rose-water, makes an excellent lotion to allay the itching. If the disease be severe, it will be necessary to correct the vitiated condition of the blood by a protracted use of Dr. Pierce's Golden Medical Discovery, and to aid its effects, give one "Pleasant Pellet" every day, not to operate as a cathartic, but only to exert an alterative influence.

ALPHOUS AFFECTIONS.

(SCALY SKIN DISEASES.)

Differences of opinion exist with regard to the proper classification of these affections. We shall briefly consider _alphos_, which is sometimes confounded with _lepra_.

ALPHOS, which from its Greek derivation signifies _white_, is characterized by circular, slightly raised white spots. These eruptions vary in size from one line to two inches in diameter, and may be scattered over the entire surface of the body, although they most frequently appear upon the elbows and knees. Alphos may consist of a single tubercle, or of large clusters constituting patches. The scales vary in color and thickness. In Colored Plate III, Figs. 14 and 15, are fine illustrations of alphos. When a person begins to recover from this affection, the scales fall off, leaving a smooth red surface, which gradually returns to its natural color.

This disease is more liable to occur in winter than in summer, although in some cases the reverse holds true. It may disappear for a time, only to return again with renewed vigor. It is not regarded as contagious.

TREATMENT. Thorough and protracted constitutional treatment is required to overcome this disease. Dr. Pierce's Golden Medical Discovery should be taken internally and also applied locally to the affected parts. To every other bottle of the "Discovery" which is taken, one-half ounce of the iodide of potash may be added. One or two of the "Pellets" taken daily will prove a useful adjunct to the "Discovery."

Locally, we have sometimes applied a lotion made of oxide of zinc, one-half drachm; benzoic acid, two drachms; morphine, five grains; glycerine, two ounces. Tincture of the chloride of iron, one drachm in one ounce of glycerine, makes an excellent local application. Whatever the local treatment may be, however, we chiefly rely upon the _persistent_ use of the best alteratives, or blood-cleansing medicines.

AFFECTIONS OF THE HAIR-FOLLICLES.

FAVUS (_Scald Head_) is a disease peculiar to the hair-follicles, and is indicated by the formation of small yellow crusts, having the form of an inverted cup. The eruption has a very offensive odor. When it appears in isolated cups, it is termed _favus dispersus_, but it often occurs in large clusters, as represented in Colored Plate II, Fig. 12, and is then termed _favus confertus_. It generally affects the scalp, but sometimes extends to the face and neck.

CAUSE. Favus is caused by nutritive debility, which results in a perverted cell-growth.

SYCOSIS (_Barber's Itch_) is an inflammatory affection of the hair follicles of the face. The prominent features of the disease are redness and the formation of scales. It is peculiar to males. It has received various names, according to its predominating characteristics, such as _sycosis papulosa, tuberculosa_, and _fungulosa_. Colored Plate II, Fig. 10, is a line illustration of sycosis as it appears on the cheek.

CAUSES. Various causes induce the appearance of sycosis. The general causes are nutritive debility, vicissitudes of heat and cold, and an exhausted state of the nervous system. It may also result from various chronic diseases, such as syphilis and dyspepsia.

COMEDONES, or _grubs_, are due to a retention of the sebaceous matter in the follicles. The sebaceous substance undergoes a change, becoming granular and somewhat hardened. It gradually extends to the mouth of the follicle, where it comes in contact with the atmosphere, and assumes a dark color, as represented in Plate II, Fig. 8. This fact, together with its peculiar form when squeezed out of the skin, has caused it to be termed _grub_. They often appear in great numbers on the face of persons whose circulation is not active, or those who are of a particularly nervous temperament. Stimulating baths and friction will prove very efficacious in removing these cylinders of sebaceous matter. If they are allowed to remain, they will produce an irritation of the skin causing an inflammatory disease known as acne, or stone-pock.

ACNE OR STONE-POCK. In the earliest stage of congestion, acne is characterized by minute hardened elevations of the skin, as shown in Plate II, Fig. 9, and is termed _acne punctata_. As the affection progresses, a bright red pimple, Plate II, Fig. 11, appears, having a conical form, hence the name _acne coniformis_. The pimple develops into a pustule containing yellow "matter," and is then known as _acne pustulosa_. This is followed by a thickening of the tissues, termed _acne tuberculata_. When the thicker skin is removed, it leaves a deep scar, hence the term _acne indurata_.

CAUSES. The remote cause of acne is nutritive debility. The immediate causes are rapid growth, anæmia, improper food, errors of hygiene, mental exhaustion, and various chronic diseases.

TREATMENT. The treatment of favus or scald-head should be commenced by shaving the hair off close to the scalp and washing the head thoroughly with soap and water. In some severe cases, it may be necessary to soften the incrustations with poultices, following these with a free use of soap and water. Having thus exposed the scalp and thoroughly divested it of incrustations, apply to it the ointment of iodide of sulphur, which may be procured at any good drug store. It should be gently rubbed over the parts night and morning. The scalp ought to be kept perfectly clean throughout the treatment. Instead of the foregoing, the following may be applied: Take oxalic acid, ten grains; creosote, twenty drops; water, two ounces; mix. Half an hour after using this lotion, anoint the head freely with butter or lard; it will add greatly to the efficacy of the treatment. But while local applications will relieve many skin diseases and mitigate suffering, we cannot too strongly impress upon the minds of our readers the importance, in this as in all other chronic diseases of the skin, of perseverance in the use of the best alteratives. In this class of agents Dr. Pierce's Golden Medical Discovery stands pre-eminent. Its efficacy may be increased in this disease by adding to each bottle one ounce of the acetate of potash, and, when thus modified, it may be administered in the same manner as if no addition had been made to it.

_The Treatment of Sycosis_ should be essentially the same as that suggested for favus, and it will result in prompt relief and a permanent cure.

_Treatment of Acne._ In the treatment of this, as in that of other diseases, we should seek to ascertain the cause, and, when possible, remove it. Outdoor exercise, a spare, unstimulating diet, and perfect cleanliness are of the first importance. The affected parts should be bathed with warm water and Castile, or, what is better, carbolic soap. Washing the face in cold water generally aggravates the disease. As a local application to the pustules, we have used with good results the following lotion: Oxide of zinc, twenty grains; morphine, five grains; glycerine, two ounces: mix. First having washed the affected parts thoroughly, apply this compound. Our chief reliance, however, as in the preceding diseases, should be upon the persistent use of alteratives and mild cathartics or laxatives.

FURUNCULAR AFFECTIONS. (BOIL-LIKE AFFECTIONS.)

Under this head properly belong boils, carbuncles, and styes.

BOILS. These annoying affections are hard, prominent, circumscribed, inflamed, suppurating tumors, having their seat in the cellular tissue beneath the skin. They vary in size from a pea to a hen's egg, and may occur on any part of the body. The color of a boil varies from deep red to mahogany. It is painful, tender, advances rapidly to maturity, becomes conical, and finally bursts and discharges bloody "matter." Through the opening, and filling the cavity, may be seen a piece of sloughing cellular tissue which is called the _core_. In from four to fifteen days, it is all expelled and the sore rapidly heals. The causes are an impure condition of the blood, which generally arises from imperfect action of the liver or kidneys.

TREATMENT. Spirits of turpentine applied to a boll _in its earliest stage_ will almost always cause it to disappear; but when suppuration has commenced it should be favored by the application of poultices. Next purify the blood to prevent subsequent returns to other parts of the body. For this purpose take Dr. Pierce's Golden Medical Discovery. One or two "Pleasant Pellets" each day will aid in the cure.

CARBUNCLE. (ANTHRAX.)

These are more violent, larger, and more painful than boils, which they resemble. They may spring from several small pimples which extend deep into the tissues, and on the surface frequently several small vesicles appear and break. They may discharge, through one or several openings, a thin acrid, bloody, or dark-colored fluid. They most frequently appear upon the back of the neck, back, back part of the limbs, and under the arms. Their presence is evidence of a depressed condition of vitality. These tumors vary in size from one-half an inch to six inches in diameter, and rapidly proceed to a gangrenous condition, a grayish slough being detached from the healthy tissue.

TREATMENT. Invigorate the system by every possible means. The bitter tonics, such as Golden Seal, Gentian, or Willow, together with quinine and iron should be used. Nutritious diet, pure air, etc., are necessary. Purify the blood to remove the causes of the disease. For this purpose, give the "Golden Medical Discovery" in as large doses as can be borne without acting too freely on the bowels. Anodynes may be necessary to overcome the pain. Poultices are useful to encourage the separation of the dead from the living tissues. Antiseptic dressings are beneficial, of which carbolic acid is to be preferred; yeast, however, may be employed.

Sometimes powerful caustics or free incisions are productive of gratifying results, if followed by appropriate dressings, but these extreme measures should only be resorted to by the direction of a physician.

For a considerable time after the urgent symptoms have subsided, the "Golden Medical Discovery" should be used, to purify and enrich the blood, and the bitter tonics and iron may be alternated with it, or be used conjointly to good advantage.

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SCROFULA.

It is estimated that about one fifth of the human family are afflicted with scrofula. A disease so prevalent and so destructive to life, should enlist universal attention and the best efforts of medical men in devising the most successful treatment for its cure. It varies in the intensity of its manifestation, from the slightest eruption upon the skin (scrofulous eczema), to that most fatal of maladies, pulmonary consumption.

THE SCROFULOUS DIATHESIS. The existence of a certain disposition or habit of body designated as the _scrofulous_ or _strumous diathesis_, is generally recognized by medical practitioners and writers as a constitutional condition predisposing many children to the development of this disease. Enlargement of the head and abdomen, fair, soft and transparent or dark, sallow, greasy or wax-looking skin, and precocious intellect are supposed to indicate this diathesis.

The characteristic feature of this disease, in all the multifarious forms that it assumes, is the formation of tubercle, which, when the malady is fully developed, is an ever-present and distinguishing element.

_Tuberculous_ is therefore almost synonymous with _scrofulous_, and to facilitate an acquaintance with a large list of very prevalent maladies, we may generalize, and classify them all under this generic term. As _tubercle_ is frequently spoken of in works treating on medicine and surgery, playing, as it does, a conspicuous part in an important list of diseases, the reader may very naturally be led to inquire:

WHAT IS TUBERCLE? As employed in pathology, the term is usually applied to a species of degeneration, or morbid development of a pale yellow color, having, in its crude condition, a consistence analogous to that of pretty firm cheese. The physical properties of tubercle are not uniform, however. They vary with age and other circumstances. Some are hard and calcareous, while others are soft and pus-like. The color varies from a light yellow, or almost white, to a dark gray.

It is almost wholly composed of albumen united with a small amount of earthy salts, as phosphate and carbonate of lime, with a trace of the soluble salts of soda.

The existence of tubercular deposits in the tissues of the body, which characterizes scrofula, when fully developed, must not, however, be regarded as the primary affection. Its formation is the result of disordered nutrition. The products of digestion are not fully elaborated, and pass into the blood imperfected, in which condition they are unable to fulfill their normal destiny--the repair of the bodily tissues. Imperfectly formed albuminous matter oozes out from the blood, and infiltrates the tissues, but it has little tendency to take on cell-forms or undergo the vital transformation essential to becoming a part of the tissues. Instead of nutritive energy, which by assimilation produces perfect bodily textures, this function, in the scrofulous diathesis, is deranged by debility, and there is left in the tissues an imperfectly organized particle, incapable of undergoing a complete vital change, around which cluster other particles of tubercular matter, forming little grains, like millet seed, or growing, by new accretions of like particles, to masses of more extensive size. As tubercle is but a semi-organized substance, of deficient vitality, it is very prone to disintegration and suppuration. Being foreign to the tissues in which it is embedded, like a thorn in the flesh, it excites a passive form of inflammation, and from lack of inherent vital energy it is apt to decompose and cause the formation of pus. Hence, infiltration of the muscles, glands, or other soft parts with tuberculous matter, when inflammation is aroused by its presence, and by an exciting cause, give rise to abscesses, as in lumbar or psoas abscesses. When occurring in the joints, tubercles may give rise to chronic suppurative inflammation, as in white swellings and hip-joint disease. Various skin diseases are regarded as local expressions of, or as being materially modified by, the scrofulous diathesis, as eczema, impetigo, and lupus. The disease popularly known as "_fever-sore_" is another form of scrofulous manifestation, affecting the shafts of the bones, and causing disorganization and decay of their structure. Discharges from the ear, bronchitis, chronic inflammation of the intestinal mucous membrane, and chronic diarrhea are frequently due to scrofula, while pulmonary consumption is unanimously regarded as a purely scrofulous affectation. Scrofula shows a strong disposition to manifest itself in the lymphatic glands, particularly in the superficial ones of the neck. The most distinguishing feature of this form of the disease is the appearance of little kernels or tumors about the neck. These often remain about the same size, neither increasing nor diminishing, until finally, without having caused much inconvenience, they disappear. After a time these glands may again enlarge, with more or less pain accompanying the process. As the disease progresses, the pain increases, and the parts become hot and swollen. At length the "matter" which has been forming beneath, finds its way to the surface and is discharged in the form of thin pus, frequently containing little particles or flakes of tubercular matter. During the inflammatory process there may be more or less febrile movement, paleness of the surface, languor, impaired appetite, night sweats, and general feebleness of the system. The resulting open ulcers show little disposition to heal.

SYMPTOMS. There is a train of symptoms characteristic of all scrofulous disease. The appetite may be altogether lost or feeble, or in extreme cases, voracious. In some instances there is an unusual disposition to eat fatty substances. The general derangement of the alimentary functions is indicated by a red, glazed or furrowed appearance of the tongue, flatulent condition of the stomach, and bloated state of the bowels, followed by diarrhea or manifesting obstinate constipation. Thirst and frequent acid eructations accompany the imperfect digestion. The foul breath, early decay of the teeth, the slimy, glairy stools, having the appearance of the white of eggs, and an intolerable fetor, all are indicative of the scrofulous tendencies of the system.

CAUSES. Scrofula may be attributed to various causes. Observation has shown that ill-assorted marriages are a prolific source of scrofula. Both parents may be not only healthy and free from hereditary taints, but robust, well-formed physically, perfectly developed, and yet not one of their children be free from this dire disease. It may present itself in the form of hip disease, white swelling, "fever-sore" suppurating glands, curvature of the spine, rickets, ulcers, pulmonary consumption, or some skin disease, in every case showing the original perversion of the constitution and functions. Scrofula is hereditary when the disease, or the diathesis which predisposes to its development, is transmitted from one or both parents who are affected by it, or who are deficient in constitutional energy, showing feeble nutrition, lack of circulatory force, and a diminished vitality. All these conditions indicate that a few exposures and severe colds are often sufficient to produce a train of symptoms, which terminate in pulmonary or other strumous affections. Whatever deranges the function of nutrition is favorable to the development of scrofula, therefore, irregularities and various excesses tend to inaugurate it. Depletion of the blood by drastic and poisonous medicines, such as antimony and mercurials, hemorrhages and blood-letting, syphilis, excessive mental or physical labor, as well as a too early use and abuse of the sexual organs, all tend to waste the blood, reduce the tone of the system, and develop scrofula.

Scrofula may be the consequence of insufficient nourishment, resulting from subsisting upon poor food, or a too exclusively vegetable diet, with little or no animal food.

Want of exercise and uncleanliness contribute to its production. It is much more prevalent in temperate latitudes, where the climate is variable, than in tropical or frigid regions. The season of the year also greatly influences this disease, for it frequently commences in the winter and spring, and disappears again in the summer and autumn months.

TREATMENT. The skin should be kept clean by means of frequent baths. These assist the functional changes which must take place on the surface of the body, permit the stimulating influence of the light and air and facilitate the aeration of the blood, as well as the transpiration of fluids through the innumerable pores of the skin. All exposure to a low temperature, especially in damp weather, and the wearing of an insufficient amount of clothing should be avoided. Then the food should be generous and of the most nourishing character. Steady habits and regular hours for eating and sleep must be observed, if we would restore tone and regularity to the functions of nutrition. Moderate exercise in the open air is essential, in order that the blood may become well oxygenated, that the vital changes may take place. It is no doubt true that the occasion of the prevalence of scrofula among the lower classes may be ascribed to frequent and severe climatic exposures, irregular and poor diet, or want of due cleanliness. Every well-regulated family can avoid such causes and live with a due regard to the conditions of health. The proper treatment of scrofula is important, because we meet with its symptoms on every side, showing its slow actions upon different parts of the body and its influence upon all the organs. After this disease has been existing for an indefinite length of time, certain glands enlarge, slowly inflame, finally suppurate, and are very difficult to heal. These sores are very liable to degenerate into ulcers. All of these symptoms point to a peculiar taste of the blood, which continually feeds and strengthens this morbid outbreak. All authors agree that the blood is not rich in fibrinous elements, but tends to feebleness and slow inflammation, which ends in maturation. Thus we may trace back this low and morbid condition of the blood to debility of the nutritive organs, defective digestion, which may be induced by irregular habits, a lack of nourishing food, or by the acquirement of some venereal taint.

The matter that is discharged from these glands is not healthy, but is thin, serous, and acrid; a whey-like fluid containing little fragments of tuberculous matter, which resembles curd. The affected glands ulcerate, look blue and indolent, and manifest no disposition to heal. We have thus traced this disorder back to weak, perverted and faulty nutrition, to disordered and vitiated blood, the products of which slowly inflame the glands, which strain out unhealthy, irritating, poisonous matter. The medicines to remedy this perverted condition of the blood and fluids must be alteratives which will act upon the digestive organs and tone the nutritive functions, thus enriching and purifying the blood. As this affection is frequently a complication in chronic diseases, it is eminently proper for us to refer to a few considerations involved in its general treatment.

An alterative medicine belongs to a class which is considered capable of producing a salutary change in a disease without exciting any sensible evacuation. In scrofula, remedies should be employed which will improve digestion and also prevent certain morbid operations in the blood.

It is well known to medical men that nearly all medicines belonging to the class of alteratives, are capable of solution in the gastric and intestinal secretions, and pass without material change, by the process of absorption, through the coats of the stomach and intestines, as do all liquids, and so gain an entrance into the general circulation; that these same alteratives act locally to tone and strengthen the mucous surfaces, and thus promote and rectify the process of digestion before being absorbed; that alterative medicines, when in the blood, must permeate the mass of the circulation, and thus reach the remote parts of the body and influence every function; that these medicines, while in the blood, may combine with it, reconstruct it, and arrest its morbid tendencies to decomposition.

We should use those alteratives which give tone to the digestive and nutritive functions, in order to curtail the constant propagation of scrofula in the system; which alter and purify the blood through the natural functions, thus reconstructing it; and which check the septic, _disorganizing_ changes which are evinced by the irritating and poisonous matter discharged from the ulcers.

These are the three ways in which medicines operate upon the nutritive functions and the blood.

Thus alteratives may be specifics, in so far as they are particularly useful in certain disorders, and the combination which has been made in Dr. Pierce's Golden Medical Discovery, excels all others with which we are acquainted, for scrofulous diseases, particularly in fulfilling the foregoing indications. It works out peculiar processes in the blood, not like food, by supplying merely a natural want, but by strengthening the nutritive functions and counteracting morbid action, after which operations it passes out of the system by excretion.

From what has been said upon the importance of blood medicines and their modes of action, the reader must not infer that we account for all diseases by some fault of the humors of the body, for we do not. But that scrofula, in its varied forms, results from imperfect nutrition and disorders of the blood, is now universally conceded. It is for this reason that neither time nor pains have been spared in perfecting an alterative, tonic, nutritive, restorative, and antiseptic compound, to which Dr. Pierce has given the name of "Golden Medical Discovery." Not only is it an alterative and a nutritive restorative, acting upon the secretions, but it opposes putrefaction and degenerative decay of the fluids and solids. Hence its universal indication in all scrofulous diseases. It will intercept those thin, watery discharges which are the result of weakness, degeneration, and putrescent decay of the blood, perpetuated by a low grade of scrofulous inflammation. By an adult it can be taken in doses of from one to two teaspoonfuls three or four times per day.

The bowels should be properly regulated. When constipation exists one or two of Dr. Pierce's Pleasant Pellets taken daily, will fulfill the indication. The patient ought not to neglect to carry out all the hygienic recommendations heretofore given. The treatment of running sores is very simple. Cleanse them every day with Castile-soap and water, being careful not to rub or touch the surface of the sores. Use a clean sponge or a piece of clean muslin and saturating it with the warm water, hold it a few inches above the affected part, and squeeze out the fluid, allowing the cleansing stream to fall gently upon the open sore. After thoroughly cleansing the sore, apply to it Dr. Pierce's All-Healing Salve. 25 cents in postage stamps sent to us will secure a box by return post if your druggist does not have it in stock.

HIP-JOINT DISEASE.

(COXALGIA.)

_Hip-joint disease_, also known as Coxalgia, is frequently a scrofulous affection of the hip-joint. It usually attacks children, but may occur at any period of life. The causes of this affection are imperfectly understood, yet all the indications point to a scrofulous state of the system. Dampness, cold, improper diet, severe injuries from blows or falls are all numbered among the exciting causes which are conducive to the establishment of this disease.

THE SYMPTOMS are usually developed gradually; at first there is severe pain in the knee, but finally it is located in the hip-joint. Occasionally it is noticed in the hip and knee at the same time. As the disease progresses, the general health becomes impaired, there is wasting of the muscles, wakefulness, disturbed sleep, high fever, profuse and offensive perspiration, the hair falls out, and there is an inability to move the limb without producing excruciating pain. Frequently pus will be formed and discharged at different points, and the limb will become greatly emaciated. Since pain in the knee-joint may mislead as to the location of the disease, to determine the seat of the affection, place the patient in a chair and percuss the knee lightly, by giving it a slight blow with the knuckle; if the hip be affected, the pain will be readily felt in that joint; if it be simply neuralgia of the knee-joint, it will excite no pain whatever. If the disease be allowed to progress and dislocation of the joint takes place, the affected limb becomes shortened.

TREATMENT. The treatment of this disease should consist in rest for the hip-joint, cleanliness of the person and plenty of fresh air and light, a nutritious diet and the use of tonics and sustaining alterative, or blood-cleansing medicines. Dr. Pierce's Golden Medical Discovery has, unaided by other medicines, cured many cases of this disease. This class of medicines should be persistently employed, in order to obtain their full effects. It is a disease which progresses slowly and which is not easily turned from its course, and its fatality should warn the afflicted to employ the best treatment.

Many poor, unfortunate victims know too well, from sad experience, that the course of treatment frequently recommended and employed by physicians and surgeons is ineffectual, and cruel; they deplete the system, apply locally liniments, lotions, iodine, and hot applications; confine the patient in bed and strap his hips down immovably, thus preventing all exercise; then they attach that cruel instrument of torture, the weight and pulley, to the diseased limb.

After many years of practical experience in the treatment of hundreds of cases, we have developed a system of treatment for this terrible malady which is based upon common sense. Instead of depleting, we, by proper constitutional treatment, strengthen and fortify the system. We do not confine the patient in bed, but permit him to go around and take all necessary exercise. We adjust an ingeniously devised and perfectly fitting appliance or apparatus, by which a gentle extension of the limb is maintained, thereby relieving the tension of the muscles, and preventing the friction and wearing of the inflamed surfaces of the joint, which, without the use of our new and improved appliance, are a source of constant irritation. The appliances required in the successful treatment of this disease are numerous and varied in their construction, and require skill and experience on the part of the surgical mechanic as well as on the part of the surgeon, to take accurate and proper measurements of the diseased limb, and to construct the appliances so that they will be adapted to the various requirements of different cases. There are no definite rules for taking these measurements, and only a thorough examination of the case can indicate to the eye of the experienced surgeon what measurements are required, and what kind of an appliance is suitable for each individual case. At the Invalids' Hotel and Surgical Institute these measurements are all taken by the surgeon in person, and each appliance is constructed under his immediate supervision. It is utterly impossible for physicians who have but a limited experience in the treatment of such cases to take correct measurements and send off for an apparatus which fulfills the requirements of the case.

In the light of our vast experience at the Invalids' Hotel and Surgical Institute, we feel that we cannot too strongly urge the employment of a suitable apparatus for supporting the hip-joint, giving it perfect rest, and enabling the patient to exercise and get the outdoor air. As much of the pain in this disease is due to the pressure of the head of the _femur_, or thigh-bone, in the _acetabulum_, or socket, steadily-applied mechanical extension, to relieve the inflamed and sensitive joint of the pressure, is of the greatest importance. By such application the patient is enabled to move about without pain, while the joint is kept perfectly at rest--a condition favorable to the reduction of inflammation within it. The surgeon specialist of the Invalids' Hotel and Surgical Institute is frequently sent for to visit cases of this disease hundreds of miles away and by the employment of suitable apparatus he has been enabled, in scores of cases, to relieve the suffering at once. In cases in which the head of the thigh bone, or the bony socket of the joint has become so diseased as to cause it to ulcerate and break down, all portions of diseased bone should be _thoroughly removed_ by a surgical operation. If this be neglected or delayed, a fatal termination of the disease may be expected. Parents should not put off the employment of a competent specialist in this terrible, distressing, and fatal disease. As treated by general practitioners, it very often proves fatal; or, after causing intense suffering for a series of years, if the active condition of the disease subsides, the patient is left with a ruined and broken constitution, a result which more prompt and earlier relief would have prevented.

The records of practice at the Invalids' Hotel and Surgical Institute abound in reports of cases, demonstrating the fact, that by careful and judicious management, hip-joint disease in its earlier stages, may be promptly arrested, and that cures may be effected even when the bony structure of the joint is seriously diseased.

WHITE SWELLING

White Swelling, otherwise known as _Hydrarthrus_, or _Synovitis_, more frequently affects the knee-joint than any other part. The joints of the elbow, wrist, ankle, or toes, may, however, be affected with this disease, but we shall speak of it in this connection as affecting only the knee-joint. Synovitis may be acute or chronic. The latter form is sometimes induced by blows, sprains, falls, etc., or from exposure to cold; more frequently it is the result of rheumatism or scrofula.

THE SYMPTOMS of this affection are generally slow in their appearance, being sometimes months in manifesting themselves. The joint at first presents only a slight degree of swelling, which gradually increases. Pain is soon felt, mild at first, but augmenting until it becomes severe. The skin has a smooth, glistening appearance, and there is an increased amount of heat in the parts. The affected limb becomes wasted, and is sometimes permanently flexed. There is more or less fever about the body, impairment of the digestive organs, and sleeplessness. The pulse is low but quick, and night-sweats and diarrhea often appear. Under this irritation, the patient is liable to waste away and finally die.

A _post-mortem_ examination reveals the effects of the disease upon the parts attacked. The cartilages of the joint are soft, the synovial membrane is thickened, the ligaments are inflamed and often destroyed, the synovial fluid is increased in amount, sometimes normal in appearance, at others thick and viscous. If the bones be diseased, their articular extremities may be distended and fatty matter deposited in them. The conditions depend upon the form, severity, and duration of the disease.

Synovitis may be considered under three heads; Rheumatic, Scrofulous, and Syphilitic.

_Rheumatic Synovitis_ may arise from exposure to cold, from some injury, or from intemperance in eating. The beginning of the disease may be distinctly marked, or it may come on so gradually that the time of its commencement cannot be noted. The pain is of a dull, steady character, and less severe in the night. This form of the disease sometimes terminates favorably, but in scrofulous systems it is liable to end in the destruction of the joint. It is more common in early life, rarely occurring after the thirtieth year.

_Scrofulous Synovitis_, or _Tuberculosis of the Knee-joint_, when of a chronic character, shows a wasting of the limb, and the swelling is of a pulpy consistence. This form of the disease is more liable to occur in children, though occasionally it is met with in adults. But little pain accompanies this form, although the limb is liable to become permanently affected. In its earlier stages this disease may be checked.

_Syphilitic Synovitis_ is the result of syphilis. The pain is more severe during the night. It, however, generally terminates unfavorably, especially in scrofulous constitutions.

THE TREATMENT of white swelling should be both constitutional and local. Alterative medicines are indicated to purify the blood. Doctor Pierce's Golden Medical Discovery is unequaled for this purpose.

As local treatment, in the active stage of the disease, the knee-joint should be steamed, and hot fomentations applied. This should be followed by applications over the joint of solid extract of stramonium or belladonna, mixed with glycerine. The joint should be wrapped in cotton or wool to keep it uniformly warm. If there are openings about the joint, discharging pus, syringe them out once a day with Castile soap-suds, which may be improved by adding a little bicarbonate of potash (common saleratus). See that the bowels are kept regular, and that the diet is nourishing.

Cases of this disease which have been treated at the Invalids' Hotel and Surgical Institute with uniform success might be cited to the extent of filling a very large number of pages like these. When treated by a skilled specialist, this otherwise formidable and dangerous disease is readily amenable to treatment, and good and serviceable limbs can be promised, even in the extreme cases in which amputation is usually advised by general practitioners and surgeons, who desire the glory that they imagine they will receive by performing a capital operation.

RICKETS. (RACHITIS.)

Rickets is a scrofulous disease, in which there is derangement of the entire system, and it finally manifests itself in disease of the bones. It is characterized by a softening of the bony tissue, due to a deficiency of earthy or calcareous matter in their composition. It appears to be a disease incident to cold, damp places, ill-lighted and imperfectly ventilated rooms, and it especially attacks those who are uncleanly in their habits.

THE SYMPTOMS of rickets are severe pains in the bones, especially during the night, febrile excitement and profuse perspiration, paleness of the face, a sallow and wrinkled appearance of the skin, and derangement of the digestive organs. After a time the body becomes emaciated, the face pale, and the head unusually large. The bones become soft and unable to support the body; various distortions appear; the extremities of the long bones are enlarged, while the limbs between the joints are very slender. Rickets is a disease peculiar to childhood, though it may not be developed until a more advanced period of life. It rarely proves fatal, unless the lungs, heart, or other vital organs, become involved. In some instances the softening and other symptoms continue to increase until every function is affected, and death ensues.

_Post-mortem_ examinations of those who have died of rickets have disclosed morbid changes in the brain, liver, and lymphatic glands. The lungs are often compressed or displaced, and the muscles of the body become pale and wasted. Sometimes the bones are so soft, on account of the deficiency of the calcareous deposit, that they can be easily cut with a knife.

TREATMENT. The use of Dr. Pierce's Golden Medical Discovery is indicated in this affection. It is a disease usually developed during childhood, in consequence of insufficient exercise, deprivation of the sunlight, low, innutritious diet, and lack of cleanliness. Therefore, it is essential to obviate all known causes, and, at the same time supply the patient with food rich in those elements which the system seems to demand. Under any plan of treatment the general directions given for the hygienic management of scrofula should be followed. We might cite many cases that have entirely recovered from this disease, under our advice and the use of "Golden Medical Discovery." We shall merely say, for the encouragement of the afflicted, that this form of scrofula yields readily to this medicine.

OLD SORES. (CHRONIC ULCERS.)

Under this head we may properly consider that class of affections known as Fever-sores, Running-sores, Ulcers, etc. These sores have common characteristics, yet each possesses certain peculiarities, which have led to their division into _irritable, indolent_, and _varicose_. These peculiarities are not constant, one form of ulcer often changing into another. One feature common to all, however, is their slowness in healing, which has sometimes led to the belief that they are incurable. Another popular notion is that their cure is detrimental to the health of the patient. With equal propriety we might say that it is dangerous to cure diarrhea, dysentery, consumption, or cancer. As a result of these erroneous impressions, many people suffer from chronic ulcers for years, and even for a life-time, without attempting to obtain relief. Chronic ulcers usually appear upon the lower extremities. The depth and appearance of the ulcer depend upon its character and the thickness of the tissues where it is situated. Fig. 2 shows a chronic ulcer, or fever-sore, as it appears upon the ankle.

THE IRRITABLE ULCER is painful and tender, the slightest injury causing it to bleed. It is of a dark purplish hue, and filled with spongy, sensitive granulations. It discharges a thin, bloody matter which is sometimes very fetid and acrid, and excoriates the tissues if it comes in contact with them. The edges of this species of ulcer are shelf-like and ragged, and turn inward. The adjacent structures are red and swollen. Very often they are attended by severe constitutional disturbances, such as chills, fever, and great nervous prostration and irritability.

IN THE INDOLENT ULCER the edges are not undermined, but turned outward, and are rounded, thick, glossy, and regular. The granulations are broad, flat, pale, insensible, and covered with a grayish, tenacious matter. The surrounding parts are not very sensitive, but the limb on which it is located is apt to be swollen. This is the commonest form of ulcer, and often remains for years.

VARICOSE ULCER. This species of ulcer occasions a swollen or enlarged condition of the neighboring veins, which are very much enfeebled. It almost invariably appears below the knee, and may be either indolent or irritable. It is generally sensitive to the touch, and sometimes excessively painful. Knots of superficial veins may often be seen beneath the skin.

As we have before remarked, these various species of ulcers are merely modifications of one form of chronic sore. The patient may assert that he enjoys excellent health, but if we question him closely, we find that the sore irritates him, and that there is sufficient constitutional disturbance to prevent the healing powers of nature from effecting a cure.

TREATMENT. The cure of these sores is necessarily slow, and who ever expects to obtain _immediate_ relief will be disappointed.

Constitutional treatment is of the utmost importance, and should, therefore, be thoroughly and persistently applied. The nutritive system, especially the absorbents, should be kept active, as these are the channels by which the broken-down tissue surrounding the sore is replaced by that of a higher grade of vitality. For this purpose, the best alteratives or blood cleansing remedies are required. If secretion and excretion are not normally performed, the blood becomes poisoned by the absorption of unhealthy "matter" from the sore, and various constitutional disturbances occur. If, at any time during treatment, constitutional disturbances are manifested by fullness or disagreeable sensations in the head, nausea, pain, cough, chills, or fever, a thorough cathartic should be given. If the patient be robust, a repetition of the same once a week will be very beneficial. Dr. Pierce's Golden Medical Discovery, and "Pellets" will be productive of the best results.

The local treatment should depend upon the character of the ulcer. If the sore be _irritable_ or painful, soothing applications, such as warm poultices or steaming in a vapor of bitter herbs, as hops, boneset or smart-weed or water pepper, will be found highly beneficial. A poultice of powdered slippery elm is also very soothing, and hence well adapted to this purpose. If the ulcer be _indolent_, a stimulating application is necessary. The hardened, callous state of the edges should be removed by alkaline applications. A strong solution of saleratus, or even a caustic, prepared by boiling the lye from hard-wood ashes to the consistence of syrup, will prove of great utility. One or two applications of the latter are generally sufficient.

The foregoing course of treatment is intended to put the open sore or ulcer in what is known to surgeons as a healthy condition--a condition most favorable for the healing process.

But the open surface of the sore needs something more. It needs the cleansing or antiseptic and soothing influence of such a dressing as is found in Dr. Pierce's All-Healing Salve. If your dealer in medicines does not have this Salve in stock, 25 cents in stamps sent to World's Dispensary Medical Association, Buffalo, N.Y., will secure a box of this unequaled dressing. It will be sent to your address by return post. Therefore, do not allow the dealer to put you off with some inferior preparation. If he has not the All-Healing Salve in stock you can easily obtain it by sending to us as above directed.

No matter how good the local dressing applied to the open sore, or ulcer, do not discontinue the internal use of the "Golden Medical Discovery" until the affected parts are completely healed.

FEVER-SORE. (NECROSIS.)

By the term _necrosis_ we mean mortification, or the state of a bone when it is deprived of life. Dunglison says: "This condition is to the bone what _gangrene_ is to the soft parts." It is popularly known as _fever-sore_, there being no distinction made between this species of sore and those ulcers which affect only the soft tissues of the body. When any part of a bone becomes _necrosed_, it is treated as a foreign body. Nature makes an effort for its removal, and at the same time attempts to replace it with new and healthy materials. In consequence of this process, the dead portion is often inclosed in a case of new, sound bone, termed the _involucrum_; when this is the case the dead portion is termed the _sequestrum_. If, however, it be superficial, and separate from the parts beneath, it is called an _exfoliation_. This healing process, by which the involucrum is formed, cannot be completed while the dead portion remains. Hence, numerous openings are made through the involucrum, to permit the escape of the sequestrum. When a surgical operation is performed for the removal of the necrosed bone it is called _sequestrotomy_. The instruments which our specialists usually employ for this practice are represented in Figs. 3, 4, and 5.

CAUSES. Fever-sore may be due to inflammation, injuries, working in phosphorus, or from the inordinate and protracted use of mercury.

SYMPTOMS. The pain frequently commences in the night, and all the different stages succeed, until, finally, the result is frequently mortification or death. The entire bone, or only a part of it, may be affected; the parts become swollen, "matter" forms, and unless it be artificially evacuated, it will in time work its way out through a fistulous opening. As the disease progresses, the adjacent tissues become thickened and numerous openings are formed, which communicate with the bone, and often with each other, so that a probe may be passed from one to another, as represented in Fig. 6, copied from a drawing by Dr. Howe. The discharge from fever-sores varies in character, and usually has a fetid odor. The surgeon can readily distinguish between healthy and unhealthy bone by the use of a probe. The pus discharged in necrosis contains minute particles of bone, which may be felt by rubbing it between the fingers. Sometimes large pieces present themselves at the openings. The general health is seriously impaired, and the patient becomes debilitated, anæmic, and hectic.

TREATMENT. The process of repair is necessarily tedious, and nature should be assisted to remove the old bone and promote the formation of the new. An alterative course of treatment is indicated and must be persistently followed. Give Dr. Pierce's Golden Medical Discovery and Pleasant Pellets in sufficient doses to keep the bowels regular. However, all efforts to heal the sores, as long as dead bone remains, will prove fruitless. The sores should he throughly cleansed with injections of an alkaline solution, after which bandages, moistened with glycerine, may be applied. If they emit a fetid odor, add a few drops of carbolic acid to the glycerine. The dead bone can be but slowly removed by suppuration, therefore time, and, indeed, sometimes life itself, may be saved by removing it with surgical instruments. In the operation of sequestrotomy, the surgeon must exercise great judgment. Carelessness may prolong the disease and subsequently necessitate another operation, or, perhaps, an amputation.

Usually the dead bone is easily removed by the skilled specialist surgeon, and, when thoroughly taken out, the parts readily heal and the patient rapidly recovers. The removal, therefore, of the dead bone which is a constant source of irritation, and the cause of protracted suffering, should not be delayed, for very rarely indeed can it be removed at all without the assistance of the surgeon. Besides, delay often results in the loss of the limb, and not unfrequently occasions the death of the patient. Under the influence of a reliable local _anæsthetic_, carefully applied, the operation of removing the decayed and offensive bone is speedily and painlessly performed, the use of chloroform or ether not generally being required.

* * * * *

TESTIMONIALS.

If the following letters had been written by your best known and most esteemed neighbors they could be no more worthy of your confidence than they now are, coming, as they do, from well known, intelligent and trustworthy citizens, who, in their several neighborhoods, enjoy the fullest confidence and respect of all who know them.

Out of thousands of similar letters received from former patrons, we have selected these few at random, and have to regret that we can find room only for this comparatively small number in this volume.

BLOOD DISEASE.

RAW SORES FROM KNEE TO ANKLE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Dear Sirs_--My little boy, Amasa Claude Peck, was severely stricken with what the doctors called erysipelas. We had employed two doctors for months without any effect, until he commenced taking your Dr. Pierce's Golden Medical Discovery. Two bottles effected a cure. His leg was raw from his knee to his ankle; it has never broken since, which has been several years. The same medicine also did great things for my now deceased husband in a case of erysipelas of long standing. Respectfully yours,

MRS. A.B. PECK, Ranger, Eastland Co., Texas.

My daughter Mrs. Jennie Rice, was cured of catarrh in her head by using the "Discovery" with Dr. Sage's Catarrh Remedy. She derived great benefit from your medicines and gives the privilege of using her name.

A.B.P.

ANÆMIA--IMPOVERISHED BLOOD.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St.. Buffalo, N.Y.:

_Dear Sirs_--Ten or twelve years ago I had a combination of diseases. Our family physician said I was bloodless and there was no hopes of my recovering. My mother advised me to consult you, which I did. After one month's treatment I was on foot again; it was truly astonishing how speedily I found relief after taking your preparations. I have also used your "Favorite Prescription" and "Golden Medical Discovery," which proved very beneficial.

MRS. ADDIE R. KNIGHT, Carapeake, Gates Ce., North Carolina.

ERYSIPELAS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am glad to say that the use of your medicine has saved me many doctors' bills, as I have for the past eleven years been using it for the erysipelas and also for chronic diarrhea, and am glad to say that it has never failed. I have also recommended it to many of my neighbors, as it is a medicine worth recommending.

I give you the privilege of using my name

Yours truly, JOSEPH SMITH Mineral Point, Tuscarawas Co., O

BLOOD AND KIDNEY DISEASE.

DR. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--I had been an invalid for nineteen years and had all the doctors in our country prescribe for me, but they could not say just what ailed me. When I wrote you giving the history and symptoms, you diagnosed my case as disease of the blood and kidneys, and advised me to try your "Golden Medical Discovery" and "Pellets" and I feel confident your medicines _saved my life_, and I hope all sufferers from kidney and blood diseases will try your valuable medicine.

Respectfully yours, T.H. EDMUNDSON, Postmaster, Home, Marshall Co., Kans.

ECZEMA--SUFFERINGS INTENSE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.

_Gentlemen_--About five years ago I was taken with a discoloration of the skin on my legs and arms, which in a short time terminated in the most aggravated eczema. My sufferings were intense, and no relief did I experience, until I commenced the use of your preparations. I have taken five bottles of the "Golden Medical Discovery," and more than that number of the "Pellets," and believe that I am entirely cured. I never feel the least itching, or burning, which was at one time so unbearable. My appetite and digestion are splendid, and, although I will be seventy years old my next birthday, I am as hearty and strong as most men of fifty.

Very truly yours, JOSEPH P. DELANO, Warsaw, Richmond Co., Va.

Mr. G. MILTON SYDNOR, Druggist, of _Warsaw, Richmond Co., Va._, writes: "My friend, Mr. J.P. Delano, has requested me to write you in confirmation of his statement, which I cheerfully do. I know Mr. Delano well personally, and can testify to the correctness of his statement.

His case of eczema was the worst that I had ever seen. I saw him often during the time he was afflicted, as he came to my store often after medicine. He purchased the "Discovery" and "Pellets" from me, and has been one of the strongest champions of your medicines, and thus aided me very much in their sale. I am quite sure that he has been the means of my selling several dozens of that preparation."

BOILS CURED.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was troubled with boils for thirty years. Four years ago I was so afflicted with them that I could not walk. I bought Dr. Pierce's Pleasant Pellets, and took one "Pellet" after each meal. The boils soon disappeared and have had none since. I have also been troubled with sick headache. When I feel the headache coming on, I take one or two "Pellets," and am relieved of it."

Respectfully yours, WILLIAM RAMICH, Minden, Kearney Co., Neb.

A TERRIBLE SKIN DISEASE.

Jackson, N.C.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Dear Sirs_--I had been troubled with skin disease all my life. As I grew older the disease seemed to be taking a stronger hold upon me. I tried many advertised remedies with no benefit, until I was led to try your "Golden Medical Discovery." When I began taking it my health was very poor; in fact, several persons have since told me that they thought I had the consumption. I weighed only about 125 pounds. The eruption on my skin was accompanied by severe itching. It was first confined to my face, but afterwards spread over the neck and head, and the itching became _simply unbearable_. This was my condition when I began taking the "Discovery." When I would rub the parts affected a kind of branny scale would fall off.

For a while I saw no change or benefit from taking the "Discovery," but I persisted in its use, keeping my bowels open by taking the "Pellets," and taking as much outdoor exercise as was possible, until I begun to gain in flesh, and gradually the disease released its hold. I took during the year somewhere from fifteen to eighteen bottles of the "Discovery." It has now been four years since I first used it, and though not using scarcely any since the first year, my health continues good. My average weight being 155 to 160 pounds, instead of 125, as it was when I began the use of the "Discovery."

Many persons have reminded me of my improved appearance. Some say I look younger than I did six years ago when I was married. I am now forty-eight (48) years old, and stronger, and enjoy better health than I have ever done before in my life. Yours truly,

J.A. Buxton.

BAD CASE OF ECZEMA OR SALT-RHEUM.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was troubled with eczema, or salt-rheum, seven years. I doctored with a number of our home physicians and received no benefit whatever. I also took treatment from physicians in Rochester, New York, Philadelphia, Jersey City, Binghamton, and received no benefit from them. In fact I have paid out hundreds of dollars to the doctors without benefit. My brother came to visit us from the West and he told me to try Dr. Pierce's Golden Medical Discovery. He had taken it and it had cured him. I have taken ten bottles of the "Discovery" and am entirely cured and if there should be any one wishing any information I would gladly correspond with them. If they enclose return stamped envelope.

Very truly yours, MRS. JOHN G. FOSTER, 83 Chapia Street, Canandaigua, N.Y.

ERYSIPELAS AND WOMB DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:

_Gentlemen_--I am forty-eight years old, and have had four children. Three years ago the doctor said I had womb trouble, which was accompanied with backache and a tired and miserable feeling all over; left side hurt me very much, and could not lie on that side, and the doctor said it came from affection of the spleen; had a great deal of headache; was costive, and suffered terribly from erysipelas; it nearly set me crazy, so great was the burning and itching; sometimes experienced severe burning in the stomach. I took twelve bottles of your medicines, six bottles of Dr. Pierce's Golden Medical Discovery and the same amount of his "Favorite Prescription." Was using them for about six months, and can say that they did their work well. I have ever since felt like another person, and do not think I can say enough in their praise. I have no more weakness, and all evidence of erysipelas has disappeared.

Respectfully yours, MRS. SARAH E. WHITE, Kennon, Belmont Co., Ohio.

ECZEMA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--About four years ago my daughter, Helen G. Harris, was afflicted with Eczema in a distressing form. She tried medicines too numerous to mention, but they did no good. I told her that I would write to Dr. Pierce, which I did, and after a few months' use of his medicines she was entirely cured. I believe your medicines unequaled.

MRS. JNO. H. RICHARDSON, a widow living near Wakefield, Va., a few years ago, was in extremely bad health, and used your proprietary medicines with entire success.

Respectfully yours, THOMAS HARRIS, Wakefield Station, Sussex Co., Va.

SALT-RHEUM--FLESH CRACKED OPEN AND BLED.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--It gives me pleasure to express my faith in the virtue of Dr. Pierce's Golden Medical Discovery. Having suffered for three years from salt-rheum and after having been unsuccessfully treated by a good physician, I began the use of the "Discovery." The humor was in my hands. I was obliged to keep a covering on them for months at a time, changing the covering morning and night. The stinging, burning and itching sensation would be so intense that at times it seemed as if I would go crazy. When I bent the fingers the flesh would crack open and bleed. It is impossible for me to describe the intense pain and suffering which I endured night and day. After taking six bottles of the "Discovery" I was entirely cured.

Respectfully yours, MISS LOTTIE CLARK, River Falls, Pierce Co., Wis.

INVETERATE SKIN DISEASE WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:

_Gentlemen_--I desire to state that I am perfectly well and very thankful to you for curing me. The medicines which I used for two months only have effected a perfect and permanent cure of my case. My face looks as well as ever.

I was six weeks under treatment at the Invalids' Hotel and Surgical Institute, and I got first-class accommodation.

The case was a strange one. The pimples did not break out on my chin where I had let my beard grow, they broke out on my cheeks, forehead and nose. A doctor in San Francisco told me it was blood poison and said it was very hard to cure it. I think if it were blood poison it would run all through my system. When I first felt the disease coming on in winter--my face used to be very cold. I worked under the sun fourteen years every summer. I wore no hat--nothing but a skull cap. I thought I was sun-proof. The doctor in San Francisco stopped the disease for one year but it came back again. I had it for five years. It came on from hard work and exposure in the sun.

When my face would break out in the fall it got so itchy, and then little pimples would break out on my face, nose and forehead. I think parasites were in my face. If I would drink a glass of beer, I would feel the effects of it in my face, and tobacco would affect me just the same. My face, nose and forehead would be spotted all over like a "fiddler's note book," every fall for five years. I never saw a case like mine. The doctor said if I would get tanned with the sun I would be all right.

In the kind of work I had to do, I could wear no hat.

Respectfully yours, MICHAEL ALLEN, Oro Fino, Siskiyou Co., Cal.

CURES BROWN SPOTS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.:

_Gentlemen_--I can say that my health is better now than for the last fifteen years. I cannot say what my disease was, but I was as spotted as a leopard with brown spots; I was so miserable and nervous, and could not sleep. I took Dr. Pierce's Golden Medical Discovery one year, and the brown spots all disappeared and I am well. Have not taken any medicine in two years. I think the "Golden Medical Discovery" a splendid medicine for stomach, liver and skin disease. I got no help from the other doctors. I used only the "Golden Medical Discovery."

Yours truly, MRS. WILLIAM JOHNSON, P.O. Box 188, Owosso, Shiawassee Co., Mich.

SCROFULOUS DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, No. 663 Main St., Buffalo, N.Y.:

_Dear Sirs_--I was sick eight long years with the scrofulous humor and I used Dr. Pierce's Golden Medical Discovery and it cured me. I used five bottles and I have used it since for other troubles. It has helped me wonderfully, in fact cured me, and I recommend it to all my friends

Yours most gratefully, MRS. MARY E. NICHOLS Bay Shore, Suffolk Co., N.Y.

"HEART-RENDING TO BEHOLD".

Terrible Suffering from Skin Disease.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--My baby when about three months old began to have little sores come out on his face; did not amount to much until six months old, then they began to spread all over his face and head until his face, head and ears were one solid sore. Our family physician was summoned at the early stages of the disease and tried everything he knew of for the cure of the same, but nothing did him any good. The disease baffled the skill of the doctor in every way, and I was advised by friends to try certain remedies, which I did, with very little effect. The child by this time was a heart-rendering sight to behold, and suffered unknown agonies with the torturing itching and burning of the sores, and so things ran on until my brother, who resides in Buffalo, visited me. As soon as he saw the child he advised me to have him treated at the Invalids' Hotel and Surgical Institute in Buffalo. I wrote to them stating my baby's case, asking them if they could help him, and they thought they could, so began their treatment at once by using salves externally and medicine internally and as soon as they began their treatment the child began to improve and continued so until he was entirely cured in six months' time. He is now two years and six months old and is as tough as any child you ever saw; weighs thirty-five pounds and is perfectly well, thanks to Dr. Pierce and his wonderful medicines.

Yours truly, MRS. A.L. PAYNE, Box 147; Oxbow, Jefferson Co., N.Y.

SCROFULOUS ABSCESSES.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.

_Gentlemen_--About four years ago I took scrofula, and did everything that doctors and others prescribed, but only got worse. Several abscesses formed about my neck and breast, discharging a quantity of matter. I got so weak I could scarcely walk about the house. I read all the medical works I could get hold of, and, among the rest, read some of your works. You described my case, and recommended Dr. Pierce's Golden Medical Discovery with his "Pleasant Pellets." So I procured some and commenced using them and soon began to mend. In six months my sores were all healed up, and in twelve months _I was entirely well_. I am forty-five years old and believe I am as stout as I ever was in my life. I used about one dozen bottles of the "Golden Medical Discovery" with the "Pellets," and used nothing else after I began using your medicines. So I must give your medicine all the praise for curing me, and I am bound to recommend it.

Yours truly MRS. BELLE SWEENEY, Flat Top, Mercer Co., W. Va.

CROSS EYES.

CONVERGENT STRABISMUS. INSTANT AND PAINLESS CURE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am happy to certify to your skill. I had been afflicted with badly crossed eyes from my birth, and my sight was impaired, and I was badly disfigured. By a painless operation my eyes were instantaneously restored to a proper position and my sight much improved.

Your Hotel and skillful surgery merit every recommendation.

Yours truly, DAVID CRANE, Spring Creek, Warren Co. Pa.

SCROFULOUS SORE EYES.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:

_Gentlemen_--When I was two years old my eyes broke out in little white pimples and itching all the time in the mornings; when I awakened my eyes would have to be washed open; I could not see and when they were washed open the corruption would run down my face and drop off. I have tried all of our physicians and their medicine did me no good. A physician attended them from Ellicott City and did them no good. He said it was the running scrofula in the eyelids and could never be cured; it had continued fourteen years, and I had given up all hopes of ever being cured until I saw your advertisement of the "People's Common Sense Medical Adviser," and I sent and got one, and I saw a great deal in it about the eyes. I wrote to you about them and you prescribed for me. Now my eyes are quite well. Some advised me to wear glasses, but you said not. I have been a great sufferer but am glad to say you did me all the good that I have received.

Respectfully yours, MISS VIRGINIA M. GARDNER, Mayo, Anne Arundel Co., Md.

WEAK AND SORE EYES.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--After taking Dr. Pierce's Golden Medical Discovery for four weeks, at a cost of only $1.50, I am more than pleased to announce that my eyes are perfectly well and strong as ever. I doctored and fussed with quack medicines for about one year and a half and found no relief. Finally I consulted your "Medical Adviser" and found a case similar to mine so I wrote and got a speedy reply. I followed directions, which resulted in a speedy cure as above.

Yours truly, JOHN CASSERLY, JR., Westline, Redwood Co., Minn.

RUNNING SCROFULOUS SORES.

DR. R.V. PIERCE: _Dear Sir_--When about three years old I was taken with mumps, also had fever, finally I had that dreaded disease Scrofula. The most eminent physicians in this section treated me to no avail. I had running scrofulous sores on left side of neck and face. I was small and weakly when eight or nine years old, and in fact was nearly a skeleton. Six bottles of Dr. Pierce's Golden Medical Discovery wrought marvelous changes. Although the sores were healed in eight months, I did not quit taking it until I was sure it had been entirely routed from my system. The only signs left of the dreadful disease are the scars which ever remind me of how near death's door I was until rescued by the "Discovery." I am now eighteen years old and weigh 148 pounds; and have not been sick in five years.

Respectfully, HARVEY M. HOLLEMAN, Wilmington, Newbern & Norfolk Railway Co., Wilmington, New Hanover Co., N.C.

"FEVER SORES."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--My daughter who is now 18 years of age was attacked with a severe pain and swelling in her ankle, which soon caused her to have high fever. We employed some of the best physicians in this locality who pronounced it rheumatism, did everything for her they could do, but she kept getting worse from day to day, and in about five weeks after she was first taken sick her ankles and legs came open and discharged a lot of yellow matter and finally slivers of bones came out of the openings in her ankles. All the doctors we consulted said that we would have to have an operation performed on her and have the dead bones taken out, or else she could not get well, with the exception of one of the doctors who said that if her health could be improved the dead bones would come out and be replaced with new ones, for the dead pieces would brake loose from the sound bone and come out through the opening with the matter; but he could not do anything to improve her health.

After doctoring her three months she was reduced to a mere skeleton and had to be tended to like a mere baby and have her feet elevated, or else she would scream with pain. We commenced giving her Dr. Pierce's Golden Medical Discovery. After using it for one month we could see, for the first time, that she was getting no worse, and after using about five bottles her health began to improve a little; but she still suffered with pain and could not have her feet down until she had taken twelve bottles. When she had taken fifteen bottles--she began to walk on crutches, and later with a cane, for about two or three months, when she could walk without a crutch or cane. The diseased bones gradually came out in pieces, some of them an inch to two inches long and one-fourth of an inch thick; the sores healed as soon as the last dead bone was out. She is now a strong healthy young lady as her photograph plainly shows.

Respectfully yours, D.R. SCHROER. Holstein, Warren Co., Mo.

GENERAL DECLINE, RUNNING SORE ON LEG.

Fort Coulonge, Pontiac Co., Quebec.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Thanks be to God, and you, I have the best of health since I have taken your special medicine and one bottle of "Favorite Prescription." I was as weak as any person could be without dying, and I am as healthy as any person can be to-day, and I have gained ten pounds since, and a great many people remark to me how much better I look.

Also, I can mention to you another person who was cured by your "Golden Medical Discovery." His name is John McCoy. For near two years he never walked. He suffered from a running sore on his leg, and after using twelve bottles, he could walk all right and is well to-day The doctors wanted to have it taken off. You say in your letter you would like to have a photograph. I have none and there is no photograph gallery in this village or I would have one taken.

Yours truly, Mrs Isaac Brady

ECZEMA.

DR. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--When I was married I weighed 125 pounds. I was taken sick with a disease which my doctor said was eczema. He failed to do me any good, and I fell away to 90 pounds. I had dyspepsia so bad that I could not eat anything. My husband got me "sarsaparillas" and "cures" and "bitters," and nothing did me any good. Finally he got two bottles of Dr. Pierce's Golden Medical Discovery. I began using it, and, thank God and you, I improved; now I weigh 140 pounds, and my skin is as smooth as a baby's. My husband says I look younger than I did the first time he saw me. I have better health than ever, and I owe it all to you. It is a miracle that I am cured. I cannot say too much about the medicine.

Very respectfully, Rebecca F. Gardner

"FEVER SORES" OR INDOLENT ULCERS--DROPSY AND TORPID LIVER.

Dr. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--I write in regard to your great "Golden Medical Discovery." I cannot be thankful enough to you for what it has done for me. As a result of the grippe I had dropsy, and ulcers formed on my legs with a most intolerable itching at night after going to bed. My circulation was very poor and liver inactive. I feel perfectly well since I took the medicine. The old sores on my legs are all healed up, and I feel like a new man. I highly recommend your "Golden Medical Discovery" to any inquiring person, for it has saved my life.

Yours very truly, FRED. PESTLINE, Alexander, Genesee Co., N.Y.

RUNNING SORE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--It pleases me to state that I had a running sore up on my neck, and had it operated upon three times, and still it was not cured. I was also run down very much. There was a decided change after using Dr. Pierce's Golden Medical Discovery. I took a few bottles and was soon cured Later my husband had a lump behind his ear; he tried your medicine, and one bottle cured him. I shall always recommend your medicines.

Yours respectfully, MRS. L. KOHN, No. 618 E. 16th St., New York City.

"OLD SORES" ON LEGS.

Alexander, N.C.

DR. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--Your "Golden Medical Discovery" has proven a blessing to me. It was recommended to me by Rev. P.A. Kuykendall. I have been a sufferer with old sores on my legs for four years. I used three bottles of it, and my legs are sound and well and my health is better than it has been for some time. I had THE best doctors of this country treat my case and they failed to effect a cure.

Yours respectfully, J.N. Kery Kendall

HIP-JOINT DISEASE.

PHYSICIANS FAIL TO BENEFIT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--At the age of eight years I became afflicted with "Hip-joint Disease." For a year I suffered as much as it was possible for a human being to suffer. My physicians told me I would have to wait patiently, but my father procured me some of Doctor Pierce's Golden Medical Discovery, and I found my falling health restored.

I can cheerfully say that I believe I owe my life to the use of that valuable medicine.

Your true friend, EDWARD J. RUSH, Elizabeth, Harrison Co. Ind.

HIP-JOINT DISEASE CURED.

MISS MARY E. RIDGLEY, of _Gales Creek, Washington Co., Oregon_, when only three years old, had lameness in one of her lower limbs but the use of liniment and Dr. Pierce's Pellets relieved her, and she got better. When six years old the trouble developed into hip-joint disease, so pronounced by her physician. She lost the use of the limb. Was three months under the doctors, but got no better. She complained of great pain in the limb, especially in the knee and hip. The limb wasted away, becoming small and short, and her back became crooked. She had no appetite; was very weak. Hip and knee were very tender to the touch. Physician's treatment not helping her, her mother began to give her "Golden Medical Discovery." Four months afterwards she wrote Dr. Pierce as follows: "She is growing fast, and never complains of any pain or ache. She sleeps well, and eats heartily. Her leg has filled up, and is as big as the other. She plays around all day with the other children. Everybody is astonished to see how she has improved."

In the margin we print Miss Ridgley's picture as she appears twelve years after this treatment, at the age of eighteen. The young lady herself, writes Dr. Pierce as follows: "Your medicines are worth their weight in gold. I was cured of hip-joint disease by the "Golden Medical Discovery" and "Pellets," and I feel sure that they can cure the worst cases if given a chance."

HIP-JOINT DISEASE OF 11 YEARS' STANDING.

P.O. Box 128, Gagetown, Tuscola Co., Mich.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--When I began taking your medicines I was in bed, nothing would relieve me, my hip being swelled seemingly ready to burst. When I began to take Dr. Pierce's Golden Medical Discovery and "Pellets," the swelling gradually decreased; when I had taken one bottle I was able to be up. I don't know how long I will remain well, but I am satisfied that it is the medicine that did the work: I take it right along; as long as I can keep the way I am now, I am satisfied. I have recommended your remedies, and will continue to do so.

Yours truly, H.F. Giron

THICK NECK (GOITRE).

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:

_Gentlemen_--I am willing and pleased to have you publish anything I have written in regard to the cure of my little son of Goitre (that a surgeon of N. Adams said could never be cured).

I do hope that by so doing some little one may escape the misery my little one suffered for over a year until I began the use of the "Golden Medical Discovery." I followed your directions found in the little book around the bottles. Before the first bottle was gone, he could eat and sleep without that coughing and choking that, before the use of the "Discovery," was impossible.

The tumor began to lessen in size, and after the third bottle I would never have known he ever had a tumor there. He is now hearty and healthy. Sleeps as good as any child and is full of life. He does not take anything to prevent a return, and has not for over a year.

I have one of your Common Sense Medical Advisers, and found it worth five times what I gave for it; I have helped others to get it and the "Medical Discovery" and "Favorite Prescription" have brought relief to many through me I use the "Prescription" off and on; it has given me strength; I think I should have been an invalid long ago without it.

Every one here knows the truth of this letter, and I would tell it to the world if I could. Respectfully,

MRS. ANNIE SUMNER, Heartwellville, Bennington Co., Va.

THICK NECK (GOITRE),

NERVOUS DEBILITY AND WEAKNESS CURED.

Miss ELLA A. HOUGHTON, of _Theresa, Jefferson Co., N.Y._, was cured of Thick Neck, Nervous Prostration, Weakness and a complication of ailments by Dr. Pierce's "Discovery" and "Favorite Prescription." She says: "My health is now as good as it was before I was sick. The swelling (goitre) has all gone from my neck. I don't have any bad feelings. My gratitude for the benefit I have received from your treatment has induced me to recommend you to all whom I know to be sick." "I have known of two or three middle aged ladies residing near here, who have been cured by your 'Favorite Prescription.'"

GOITRE CURED.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Dear Sirs_--I can say that your medicine has done its work well in the case of my sister, Miss Rachel Mann. She is entirely well of Goitre and throat trouble. I am glad to say that we can recommend your medicines very highly.

Very truly yours, MARY J. MANN, for sister Rachel Mann, Romola, Center Co., Pa.

CARBUNCLES LARGE AS HEN'S EGGS!

EIGHT OR TEN YEARS AFFLICTED. TWO BOTTLES ONLY, CURE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--For about eight or ten years my father was laid up with carbuncles, the worst that I ever saw. He tried everything he heard of, and his doctor did everything he could for him, but nothing did him any good. Had six or seven carbuncles at a time, as large as a hen's egg; he got so weak and suffered so much he could not walk a step. It was in the summer of '72 or '73 that he had his bed put in the middle of his chamber and got on it to die. No one expected him to get well. Looking over the newspapers, he saw your "Golden Medical Discovery" advertised, and the good it had done. There was not any sold then in the country, so he sent to Richmond--forty-five miles--and got a bottle. When he began to take it he was nearly covered with carbuncles--little and big together. Before he had taken half-a-bottle they began to go away. Before he had taken two bottles he was entirely cured, and he has never been bothered with them since. Every time he sees any sign of them, he gets a bottle of "Golden Medical Discovery" and it cures them. My father, Col. T.U. Fogg, lives in West Point, King William Co., Va. He is now seventy-eight years old, and enjoys good health.

Yours truly, Mrs. NANNIE GOULDMAN, Beulahville, King William Co., Va.

* * * * *

THICK NECK. (GOITRE.)

Thick neck, or goitre, also sometimes called bronchocele, consists of an enlargement of the thyroid gland, which lies over and on each side of the trachea, or windpipe, between the prominence known as "Adam's apple" and the breast bone. The tumor gradually increases in front and laterally, until it produces great deformity, and often interferes with respiration and the act of swallowing. From its pressure on the great blood-vessels running to and from the head, there is a constant liability to engorgement of blood in the brain, and to apoplexy, epilepsy, etc. When the enlargement once makes its appearance, it continues to increase in size as long as the person lives, unless appropriate treatment be resorted to. It never disappears spontaneously. These tumors are much larger than those not familiar with them would suppose from their outward appearance, as they extend under and are bound down by the muscles on each side of the neck, so that they become embedded in the cellular tissues underneath, while the sides of the neck retain, to a considerable extent, their round and even appearance, whereby the real magnitude of the tumor is not apparent. Figure 7 represents the appearance of the neck of a person afflicted with this disease. The form of protuberance varies materially with different persons, that shown in the engraving being the shape which it ordinarily assumes.

The causes of the affection are not well understood. The use of snow-water, or water impregnated with some particular saline or calcareous matter, has been assigned as a cause. It has also been attributed to the use of water in which there is not a trace of iron, iodine, or bromine. A writer in a Swiss journal, _Feuilles d' Hygiene_, states that the disease is often due to an impeded circulation in the large veins of the neck, from pressure of the clothing, or from the head being bent forward, a position which is often seen in school children, when the muscles of the back of the neck have become fatigued.

TREATMENT. We have obtained wonderful results by a new method of treatment, which consists in the employment of electrolysis in conjunction with other therapeutic means. There is scarcely a case in which this treatment, properly carried out, will not effect a radical cure. It is attended with no danger whatever.

Those who are afflicted with this disease and unable to avail themselves of special treatment, cannot do better than to take Dr. Pierce's Alterative Extract, or Golden Medical Discovery, and apply to the skin over and around the tumor, night and morning the following solution which may be prepared at any drug store: iodine, one drachm; iodide of potassium, four drachms; dissolve in three ounces of soft water. Apply to the tumor twice a day, with a feather or hair pencil.

MUMPS. (PAROTITIS.)

This is an inflammation of the parotid glands and generally occurs in childhood. It is often epidemic, and is manifestly contagious. It usually, though not always, appears on both sides of the neck at the same time.

SYMPTOMS. An external, movable swelling, just below and in front of the ear, near the angle of the jaw, is the prominent symptom. The enlargement is not circumscribed, but hard and painful, and attended with more or less fever, derangement of the secretions, and difficulty in swallowing. The swelling increases until the fourth and fifth day, when it gradually diminishes, and by the eighth or tenth is entirely gone. Sometimes the disease is accompanied by swelling of the breasts in the female, or the testicles in the male.

TREATMENT. Usually but little treatment is necessary. Exposure to cold should be avoided. If severe or painful, with febrile symptoms, a hot foot-bath and small doses of the "Compound Extract of Smart-Weed," in some diaphoretic infusion, to induce sweating, together with small doses of aconite, will produce good results. If swelling of the testicles threatens (which seldom happens except on taking cold), resort should be had to mild cathartics, the spirit vapor-bath, stimulating liniments to the neck, and warm fomentations to the part attacked If delirium occurs, a physician should be summoned.

INFLUENZA, OR LA GRIPPE.

This is an infectious disease, characterized by depression, and usually associated with a catarrhal condition of the mucous membrane. It may affect the respiratory organs or the intestinal canal. There is a marked liability to serious complications, of which pneumonia is the most dangerous. The disease is evidently due to a specific virus of great infectiveness, and is more active and contagious at certain seasons and under certain conditions of the atmosphere. By some it has been supposed that it is due to a miasma in the air, but the character of its infection indicates that the true virus is of a germinal nature.

Uncomplicated cases recover, but in the aged and in the delicate we may see fatal results, due usually to the profound depression or the high temperature to which the individual is subjected. There is much redness and swelling of the mucous membranes of the nose and throat--a bronchitis--and a catarrhal state of the stomach and intestines. These may all be present, or the disease may center upon one particular portion of the animal economy, and manifest its ravages there alone.

SYMPTOMS. The attack usually resembles an ordinary catarrh of cold. In some cases the nasal catarrh is absent, or very mild, and the infection invades the general system, with much fever. A very striking manifestation of the disease is the severe nervous troubles which are present at the outset, consisting of headache, pain in the back and legs, and a general soreness of the muscles and bones as if bruised or beaten. The pulse is usually feeble and small--intermittent. The disease may center in the brain, producing delirium. Mental disorders are not uncommon, and there is usually following the disease more or less inaptitude for mental work and a tendency to depression of spirits. In many cases there is a severe diarrhea, and the individual suffers much from pain and discomfort in the abdomen. This is a gastro-intestinal irritation, and apparently favors an early recovery, and usually there are less severe sequels in such cases.

The most dangerous complication is pneumonia. These cases may follow bronchitis, or the grip may begin with well-characterized symptoms of this disease, for which see the chapters upon this trouble. The sputa may not be rusty until after several days. The crisis is usually slow, and a considerable proportion recover, the disease frequently showing a sudden change for the better, and the patient being up and around in a few days. Cases complicated with pneumonia are the most indefinite in their symptoms, and require the closest attention.

TREATMENT. In every case the disease must be regarded as a dangerous one, and the patient be confined to bed and indoors until all fever has disappeared, otherwise sudden and serious manifestations are liable to appear at any time. The patient must be well fed and nourished from the outset. The bowels should be acted upon by mild laxatives, such as castor oil or Dr. Pierce's Pleasant Pellets, using from one to three. It is also of advantage afterward to move them twice each day, by the injection of warm water, to which has been added a teaspoonful of table salt to each pint. This injected into the rectum, using the water slightly tepid, or cool if the patient is feverish, will tend to soften the actions from the bowels and favor the escape of poisonous matter. The cool water has also a soothing effect upon the fever and nervous system. If the fever is high, and there is delirium, small doses of aconite, with water, should be used every half hour or hour, but all depressing agents of this kind must be used with caution, as profound prostration sometimes develops. Warm baths, repeated frequently, and followed by hot lemonade, are of the greatest benefit in reducing the feverish condition and quieting the patient. The bed should be warmed after these are administered and the patient given hot lemonade to bring on free action of the skin, kidneys, and bowels. Where the pulse is weak, the free use of stimulants, as wine, coffee, tea, and brandy or whiskey, are required, as the great danger of the disease is a depression of the heart. In severe bronchitis, pneumonia, and other complications, appropriate treatment should be applied.

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ACUTE NASAL CATARRH.

Acute Nasal Catarrh, or cold in the head, is an acute inflammation of the mucous membrane lining the nasal passage which may confine itself to these parts or extend to the pharynx, larynx, and air-passages below, or affect the auxiliary sinuses or cavities communicating with the nasal passages.

The most frequent cause of cold in the head is exposure to sudden changes in temperature, or draughts of cool air, without taking proper precaution to protect the body so as to prevent the rapid radiation of animal heat. In most cases there is an inherited tendency or acquired weakness, which frequently may be associated with a scrofulous condition of the whole system, that render these points less resistant, and consequently invite the morbid changes which result from exposure and cold. Acute Catarrh also occurs during the initial stage of such eruptive diseases as measles, typhus, typhoid, erysipelas, etc.

Seldom do we meet with an otherwise healthy individual, who is subjected to a frequent cold in the head. Impure blood, inherited scrofulous taints, enfeebled circulation, debility, either general or nervous, are all advance agents, inviting catarrhal disease, and preventing rapid recovery from an acute attack, so that a low grade of Chronic Catarrh is generally the sequence.

SYMPTOMS. The attack is visually ushered in by a chill, or chilly sensation, feeling of lassitude, followed by a slight fever. These symptoms are not as distressing as the sense of fullness about the eyes and frontal region, and prickling dry heat, with more or less obstruction in the nostrils. A few hours later follows a copious, acrid watery discharge, which gradually becomes thick and yellow. Often the inflammatory action may extend to the orifice of the eustachian tube, causing obstruction with temporary deafness, or ringing in the ears. Severe facial neuralgia may be caused by the pressure from the swollen parts upon the branches of sensitive nerves.

TREATMENT. In the mild forms of acute catarrh, or coryza, only simple treatment is required. A hot foot-bath on retiring at night, with a full dose of Dr. Pierce's Compound Extract of Smart-weed, to produce free perspiration will generally break up the attack. Should the discharge from the nostrils continue, Dr. Sage's Catarrh Remedy should be freely used four to six times each day, until the symptoms are controlled. In case the bowels do not act, a full dose of Dr. Pierce's Pleasant Pellets may he taken at bed-time. Avoidance of exposure to cold, and light vegetable diet, are advisable. In the more severe attacks, especially when complicated by laryngeal or bronchial symptoms, the most decisive measures should be employed. The Compound Extract of Smart-weed should be taken freely, together with hot drinks, or a hot general bath. The patient should be warmly covered in bed to encourage a continued perspiration, to equalize the circulation, and subdue the inflammation. Dr. Pierce's Golden Medical Discovery should be taken in teaspoonful doses four times each day in all cases that are complicated or protracted.

Individuals suffering from frequent colds will do wisely to fortify their systems by taking a few bottles of the "Golden Medical Discovery" to improve nutrition, purify the blood, and thus aid nature in overcoming such inherited tendency or required weakness as may be their misfortune to possess. Remember frequent attacks of Acute Catarrh prepare fertile soil for the chronic form which oftentimes is so loathsome and destructive.

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CHRONIC NASAL CATARRH.

OZAENA.

In consequence of repeated attacks of acute catarrh, or "cold in the head," as it is usually termed, the mucous membranes of the nose and the air-passages of the head become permanently thickened, the mucous follicles or glands diseased, and their functions either destroyed or very much deranged. Although chronic catarrh is most commonly brought on in the manner above stated, it sometimes makes its appearance as a sequel of typhoid fever, scarlet fever, measles, or other eruptive fevers, or shows itself as a local manifestation of scrofulous or syphilitic taints in the system.

Injury to the nose may result in a displacement of one or more of the bony structures, setting up a chronic inflammation with catarrh at that point. In the early stages of the disease, the patient may be annoyed with "only a slight dropping into the throat," as many express it, the amount of the discharges from the air-passages of the head at this stage of the disease being only slightly in excess of health. In some cases the discharge is thick, ropy, and tough, requiring frequent and strong efforts in the way of blowing and spitting, to remove it from the throat, in which it frequently lodges. In other cases, or in other stages of the same case, the discharge is thin, watery, acrid, irritating, and profuse. The nose may be "stopped up" from the swollen and thickened condition of the lining mucous membrane, so as to necessitate respiration through the mouth, giving to the voice a disagreeable nasal twang. From the nature of the obstruction in this condition, it is useless for the sufferer to endeavor to clear the passage by blowing the nose; this only tends to render a bad matter worse, by increasing the irritation and swelling of the already thickened lining membrane. The swelling of the mucous membrane does not in all cases become so great as to cause obstruction to respiration through the affected passages. In some cases, the patient suffers from head ache a great portion of the time, or experiences a dull, heavy, disagreeable fullness or pressure in the head, with a confusion of his ideas, which renders him quite unfit for business, especially such as requires deep thought and mental labor. Memory may be more or less affected, and the disposition of those who are otherwise amiable is often rendered irritable or morose and despondent. The mental faculties suffer to such an extent in some cases as to result in insanity. The sense of smell is in many cases impaired, and sometimes entirely lost, and the senses of taste and hearing are not unfrequently more or less affected.

OZÆNA. The ulcerous or more aggravated stage of the disease, from the offensive odor that frequently attends it, is denominated _Ozæna_.

The secretion which is thrown out in the more advanced stages of chronic catarrh becomes so acrid, unhealthy, and poisonous, that it produces severe irritation and inflammation, which are followed by excoriation and ulceration of the delicate membrane which lines the air-passages in the head. Although commencing in this membrane, the ulceration is not confined to it, but gradually extends in depth, until it frequently involves all the component structures of the nose--cartilage and bone, as well as fibrous tissues. As the ulceration extends up among the small bones, the discharge generally becomes profuse and often excessively fetid, requires the frequent use of the handkerchief, and renders the poor sufferer disagreeable to both himself and those with whom he associates. Thick, tough, brownish incrustations, or hardened lumps, are many times formed in the head, by the evaporation of the watery portion of the discharge. These lumps are sometimes so large and tough that it is with great difficulty that they can be removed. They are usually discharged every second, fourth, or fifth day, but only to be succeeded by another crop. Portions of cartilage and bone, or even entire bones, often die, slough away, and are discharged, either in large flakes, or blackened, half-decayed, and crumbly pieces; or, as is much more commonly the case, in the form of numerous minute particles, that escape with the discharge and are unobserved. It is painfully unpleasant to witness the ravages of this terrible disease, and observe the extent to which it sometimes progresses. Holes are eaten through the roof of the mouth, and great cavities excavated into the solid bones of the face; in such cases only the best and most through treatment will check the progress and fatal termination of the disease.

COMPLICATIONS.

Catarrh, or ozaena, is liable to be complicated, not only by the system, blood, and fluids, suffering from scrofulous or other taints, as has already been pointed out, but also by an extension of the diseased conditions to other parts beyond the air-passages of the head.

Occasionally deformities of the septum or other internal structures also polypi or tumors, are sources of constant irritation and accelerate catarrhal disease.

DISEASE OF THE THROAT. The acrid, irritating and poisonous discharge, which, in some stages of disease, almost constantly runs down over the delicate lining membrane of the _pharynx_ (throat), is liable to produce in this sensitive membrane a diseased condition similar to that existing in the air-passages of the head. The throat may feel dry, husky, and at times slightly sore or raw; or, from the muco-purulent discharge that is almost constantly dropping down over its surface, the patient may feel very little inconvenience from the disease of the throat until it is far advanced--the moistening and lubricating effect of the matter that drops on the surface tending to blunt the sensibility of the parts. (_See pharyngitis for symptoms and treatment_.)

THE EXTENSION OF THE DISEASE TO THE LARYNX. The larynx, situated directly below the pharynx (throat), is subjected to the influence of the same irritation from acrid and poisonous discharges dropping into the throat from the head. More or less of it is removed by hawking and spitting, but some remains and is drawn into the larynx, or still lower into the trachea (windpipe), with the inspired air. Thus the disease creeps along the continuous mucous surfaces of the air-passages, the acrid poisonous discharge arousing in its track the irritation, inflammation, ulceration, and thickening of the lining membrane which characterize the disease in other portions of the air-passages. The symptoms and treatment of laryngitis will be found under its appropriate classification.

BRONCHITIS AND CONSUMPTION. We have already detailed the manner in which the throat, larynx, and trachea, in succession, become affected from catarrh, or ozaena. By the same process of extension, the bronchial tubes, and lastly, the _parenchyma_, or substance of the lungs, in their turn, become diseased, and bronchitis and consumption are firmly established. Tightness in the chest, with difficulty of breathing; soreness; darting, sharp, or dull, heavy pain, or a prickly, distressing sensation, accompanied with more or less cough and expectoration--are evidences that the bronchial tubes have become affected, and they should admonish the sufferer _that he is now standing on the stepping-stone to_ CONSUMPTION, over which thousands annually tread, in their slow journey to the grave.

DEAFNESS. By means of a small canal, called the _eustachian tube_, an air-passage and communication between the throat and middle ear is formed. (See Fig. 8.) This passage is lined by a continuation of the mucous membrane which covers the throat and nasal passages. The catarrhal inflammatory process, by continuity of surface, follows the mucous membrane, thickening its structure, until the eustachian tube is closed, and the beautiful mechanism of the internal ear is rendered useless. While the thickening of the mucous membrane is going on, and the passage is gradually becoming closed (and the process sometimes extends through several years), the patient will occasionally, while blowing the nose, experience a crackling in one or both ears, and hearing becomes dull, but returns suddenly, accompanied with a snapping sound. This may be repeated many times, until, finally, hearing does not return, but remains permanently injured. In other cases the hearing is lost so gradually that a considerable degree of deafness may exist before the person is really aware of the fact. Either condition is often accompanied with noises in the head of every conceivable description, increasing the distress of the sufferer. The delicate bones of the ear are sometimes detached from their articulations, the drum is ulcerated and perforated, and through the orifice thus made, the bones or small _spiculæ_ may escape with the thick, purulent, and offensive discharge.

CLOSURE OF THE TEAR DUCT. The lachrymal duct, or passage (tear duct), which, when in a healthy condition, serves to convey the tears from the eye into the nose, may be closed by the same inflammatory and thickening process which we have already explained. This condition is usually attended with watery and weak eyes, the tears escaping over the cheeks, and sometimes producing irritation and excoriation. The nasal branch of the ophthalmic nerve sometimes participates in the ulceration going on in the head, so that the eyes are sympathetically affected. They sometimes become congested or inflamed, and sharp pain in the eyeballs may be experienced.

INDIGESTION, DYSPEPSIA, ETC. A large portion of the acrid, poisonous, purulent discharge, which drops into the throat during sleep, is swallowed. This disturbs the functions of the stomach, causing weakness of that organ, and producing indigestion, dyspepsia, nausea, and loss of appetite. Many sufferers complain of a very distressing "gnawing sensation" in the stomach, or an "all gone," or "faint feelings," as they often express it.

SYMPTOMS. Dull, heavy headaches through the temples and above the eyes; indisposition to exercise; difficulty of thinking or reasoning, or concentrating the mind upon any subject; lassitude; indifference respecting business, lack of ambition or energy; obstruction of nasal passages; discharges voluntarily falling into the throat, sometimes profuse, watery, acrid, thick and tenacious, mucous, purulent, muco-purulent, bloody, concrete blood and pus, putrid, offensive, etc. In others, a dryness of the nasal passages: dry, watery, weak, or inflamed eyes; ringing in the ears, deafness, discharge from the ears, hawking and coughing to clear the throat, ulcerations, death and decay of bones, expectoration of putrid matter, _spiculæ_ of bones, scabs from ulcers leaving surface raw, constant desire to clear the nose and throat, voice altered, nasal twang, offensive breath, impairment or total deprivation of the sense of smell and taste, dizziness, mental depression, loss of appetite, nausea, indigestion, dyspepsia, enlarged tonsils, raw throat, tickling cough, difficulty in speaking plainly, general debility, idiocy, and insanity.

All the above symptoms, as well as some others which have been previously given, and which it is not necessary here to repeat, are common to this disease in some of its stages or complications; yet thousands of cases annually terminate in consumption or chronic bronchitis, and end in the grave, without ever having manifested one-half of the symptoms enumerated.

VARIETIES. People often suppose that there are a great many varieties or species of catarrh. This is an error. The nature of the disease is the same in all cases, the symptoms only varying with the different stages of the disorder, and the various complicated conditions which are liable to arise, and which have already been pointed out.

CAUSES. Anything which debilitates the system, or diminishes its powers of evolving animal heat and withstanding cold or sudden changes of atmospheric temperature, and other disease-producing agencies, renders the individual thus enfeebled very liable to catarrh. Among the most common debilitating agencies are a scrofulous condition of the system, or other impurities of the blood, exhaustive fevers, and other prostrating acute diseases, or those badly treated; exhaustive and unnatural discharges, intemperance, excessive study, self-abuse, adversity, grief, want of sleep, syphilitic taints of the system, which may have been contracted unknowingly, or may have been inherited, having perhaps been handed down even unto the third or fourth generation, to an innocent posterity from infected progenitors; too sudden rest after great and fatiguing exercise, and living in poorly-ventilated apartments. These are among the most fruitful causes of those feeble, deranged, or impure conditions of the system to which catarrh so frequently owes its origin. Although the immediate or exciting cause is generally repeated attacks of "cold in the head," which, being neglected or improperly treated; "go on from bad to worse," yet the predisposing or real cause of the disease is in the majority of cases, an enfeebled, impure, or otherwise faulty condition of the system, which invites the disease, and needs only the irritation produced in the nasal passages by an attack of cold, to kindle the flame and establish the loathsome malady. Some people are convinced with difficulty that there exists in their system a weakness, impurity, or derangement of any kind, which permitted the disease to fasten itself upon them. They may not feel any great weakness, may not have any pimples, blotches, eruptions, swellings, or ulcers, upon their whole person; in fact, nothing about them that would, except to the skilled eye of the practical and experienced physician, indicate that their system is weakened or deranged with bad humors; and yet such a fault may, and GENERALLY DOES, exist. As an ulcer upon the leg, or a "fever-sore," or an eruption upon the skin, may be the only outward sign of a fault in the system, so frequently chronic catarrh is the only sign by which a bad condition of the system manifests itself in a manner that is perceptible to the sufferer himself, or to the non-professional observer. The finely-skilled physician, whose constant practice makes his perceptive faculties perfect in this direction, would detect the constitutional fault, as an experienced banker detects a finely-executed and dangerous bank-note which the unpracticed eye would pronounce genuine.

TREATMENT. If you would remove an evil _strike at its root_. As the predisposing or real cause of catarrh is, in the majority of cases, some weakness, impurity, or otherwise faulty condition of the system, in attempting to cure the disease our chief aim must be directed to the removal of that cause. The more we see of this odious disease, the more so we the importance of combining; with the use of a local, soothing and healing application, a thorough and persistent internal use of blood-cleansing and tonic medicines.

As a local application for healing the diseased condition in the head, Dr. Sage's Catarrh Remedy is beyond all comparison the best preparation ever invented. It is mild and pleasant to use, producing no smarting or pain, and containing no strong, irritating, or caustic drug, or other poison. Its ingredients are simple and harmless, yet when scientifically and skillfully combined, in just the right proportions, they form a most wonderful and valuable healing medicine. Like gunpowder, which is formed of a combination of saltpeter, sulphur, and charcoal, the ingredients are simple, but the product of their combination is wonderful in its effects. The Remedy is a powerful antiseptic, and speedily destroys all bad smell which accompanies so many cases of catarrh, thus affording great comfort to those who suffer from this disease.

The reader's mind cannot be too strongly impressed with the importance of combining thorough constitutional with the local treatment of this disease. Not only will the cure be thus more surely, speedily, and permanently, effected, but you thereby guard against other forms of disease breaking out, as the result of humors in the blood or constitutional derangement or weakness.

In curing catarrh and all the various diseases with which it is so frequently complicated, as throat, bronchial, and lung diseases, weak stomach, catarrhal deafness, weak or inflamed eyes, impure blood, scrofulous and syphilitic taints, the wonderful powers and virtues of the "Golden Medical Discovery" cannot be too strongly extolled. It has a specific effect upon the lining mucous membranes of the nasal and other air passages, promoting the natural secretion of their follicles and glands, thereby softening the diseased and thickened membrane, and restoring it to its natural, thin, delicate, moist, healthy condition. As a blood-purifier, it is unsurpassed. As those diseases which complicate catarrh are diseases of the lining mucous membranes, or of the blood, it will readily be seen why this medicine is so well calculated to cure them.

The "Golden Medical Discovery" is the natural "helpmate" of Dr. Sage's Catarrh Remedy. It not only cleanses, purifies, regulates, and builds up the system to a healthy standard, and conquers throat, bronchial, and lung complications, when any such exist, but, from its specific effects upon the lining membrane of the nasal passages, it aids materially in restoring the diseased, thickened, or ulcerated membrane to a healthy condition, and thus eradicates the disease. When a cure is effected in this manner it is permanent. The system is so purified, regulated, and strengthened, as to be strongly fortified against the encroachments of catarrh and other diseases. The effects of the "Golden Medical Discovery" upon the system will be gradual, and the alterative changes of tissue and function generally somewhat slow. They are with however, less complete, radical, and lasting; and this constitutes its great merit. Under its influence all the secretions are aroused to carry the blood-poisons out of the system, the nutrition is promoted, and the patient finds himself gradually improving in flesh; his strength is built up, his lingering ailments dwindle away, and by and by he finds his whole person has been entirely renovated and repaired he feels like a new man--a perfect being.

THE CLOTHING. With most persons suffering from chronic nasal catarrh, there is a great disposition to take cold, even slight cause being sufficient to produce an acute attack, which greatly aggravates the chronic affection and operates to render it permanent. To obviate the bad effects that are liable to result from this predisposition, great attention should be paid to the clothing, that it thoroughly protects the person from sudden changes of temperature. For more particular and practical suggestions in regard to this matter, the reader is referred to the article on Clothing, in Part Two, Chapter II, of "The People's Common Sense Medical Adviser."

THE DIET has an important influence with this disease, as with consumption and many other chronic ailments. It should be largely composed of those articles rich in the non-nitrogenized or carbonaceous elements. Fat meats, rich, sweet cream, good butter, and other similar articles of food, should comprise a large part of the diet. These elements, which are prolific in the production of animal heat counteract the predisposition to take cold, and thus become most valuable remedial agents--not less essential than the medical treatment that has been advised. The patient, suffering from chronic catarrh, should study well the hygienic teachings to be found in Part Two of "The People's Common Sense Medical Adviser," and govern himself accordingly.

TREATMENT OF COMPLICATIONS. There are various complications of this disease that require modifications of the treatment to meet them successfully. The rules cannot be made that would enable non-professional readers to vary the treatment to suit peculiarities of constitution, or complications of the disease. When consulted, either the person or by letter, we have been able to so modify the treatment as to be adopt it to peculiar individuals which rejected the ordinary treatment, and have thus cured hundreds who had otherwise failed to find relief.

TIME REQUIRED IN EFFECTING A CURE. Reader, if you suffer from chronic nasal catarrh, do not expect to be very speedily cured, especially if your case is one of long standing. Unprincipled quacks and charlatans, who possess no knowledge of disease, or medicine either, and whose sole design is to palm off upon you a bottle or two of some worse than worthless strong, caustic solution, irritating snuff, or drying "fumigator," "dry up," "annihilator," "carbolated catarrh cure," "catarrh specific," or other strong preparation, will tell you that the worst cases can be _speedily_ cured by these unreasonable means. It is true that such strong, irritating, and drying preparations will many times suddenly arrest the discharge from the nose, but the thickened or ulcerated condition of the lining mucous membrane, which really constitutes the disease, is not removed by such treatment, and the discharge soon comes on again. Besides, there is danger attending the employment of such strong, irritating, or drying preparations. The disease, by their use, is frequently driven to the throat, bronchial tubes, lungs, or brain, and thus a bad matter is made worse. Not less irrational and unsuccessful is the plan of treating the disease with inhalations of "carbolized iodine," and other drags, administered through variously-devised pocket and other inhalers. Such treatment may mask or cover up catarrh for a time; but, by reason of the constitutional nature of the disease, it cannot effect a perfect and permanent cure. Dr. Sage's Catarrh Remedy, on the other hand, cures the disease on common-sense, rational, and scientific principles, by its mild, soothing, and healing properties, to which the disease gradually yields, when the system has been put in perfect order by the use of "Golden Medical Discovery." This is the only perfectly safe, scientific, and successful mode of acting upon and healing it. Without, we trust, being considered egotistical, we can say that this opinion is based upon a large experience and a perfect familiarity with the nature and curability of the disease. For many years our whole time and attention has been given to the study and cure of catarrh and other chronic diseases treated of in "The People's Common Sense Medical Adviser." Cases of catarrh have been treated by thousands, and our medicines for the cure of this loathsome disease, and of other chronic diseases, have met with an extensive sale in all parts of the United States, and have found their way into many foreign countries. The universal satisfaction with which their use has been attended, and the grateful manifestations received from the cured, have afforded one of the greatest pleasures of our lives. Scarcely a mail arrives that does not bring new testimony of cures effected by the treatment here recommended.

DIRECTIONS FOR USING DR. SAGE'S CATARRH REMEDY.

To prepare the medicine ready for use, put the whole quantity of powder contained in the package, as put up for sale, into a bottle; pour into it one pint of cool, soft water. Rain water or melted snow is good. Ordinary lake, river, well or spring water will do if only _slightly_ hard. Cork the bottle tightly and shake it thoroughly, after which allow it to stand six or eight hours to settle. Two of the ingredients of which the remedy is composed do not entirely dissolve, but their medicinal properties are completely and speedily extracted and taken up by the water. These settlings have lost their medicinal properties and should not be allowed to enter the nasal cavity. It should be kept tightly corked, not allowing it to freeze in winter, or be kept where it is very warm in summer. This we term the "Catarrh Remedy Fluid."

Use the fluid, prepared according to the above directions, not less than three or four times a day, the last time just before retiring, in the following manner: Without shaking the bottle to roll the fluid, pour out a teaspoonful or more into the hollow of the hand, hold it there until warmed; first gently, and afterwards forcibly, snuff the fluid up one nostril and then the other, until the nose is well filled and it passes back into the throat. No fears need be entertained that it will produce strangling or any unpleasant effect in thus using it, for, unlike any other fluids (simple tepid water not excepted), it does not produce the slightest pain or disagreeable feeling, but, on the contrary, leaves such a cooling, pleasant sensation that its use soon becomes a pleasure rather than a task. In a few minutes after thus using the remedy, it should be blown out gently (never forcibly), to clear the nose and throat of all hardened crusts and offensive accumulations, if any such exist. Never blow the nose violently, as it irritates the passages and counteracts, to some extent, the curative effects of the remedy. This process should be repeated until the remedy has been thoroughly applied two or three times, not blowing it out the last time of using it, but retaining the medicine in contact with the affected parts for a considerable length of time. No harm can result if the fluid be swallowed, as it contains nothing poisonous or injurious.

A BETTER WAY. The manner of using Dr. Sage's Catarrh Remedy, advised above, is somewhat imperfect and not nearly so thorough a mode as the one to which the reader's attention will now be directed.

In a very large number of bad cases of catarrh, or those of long standing, the disease has crept along and extended high up in the nasal passages, and into the various sinuses or cavities, and tubes communicating therewith. The act of snuffing the fluid _carries it along the floor of the nose and into the throat_, but does not carry it _high enough_, or fill the passages _full enough_, to reach all the chambers, tubes, and surfaces, that are affected with the disease.

The fluid may seem, from the sensation produced, to pass high up between the eyes, or even above them, but it does not. It is only a sensation transmitted to these parts by nerves, the filaments of which are distributed to that portion of the mucous membrane which the fluid does not reach, just as a sensation is transmitted to the little finger by a blow upon the elbow.

Now, in order to be most successful in the treatment of catarrh, it is necessary that _the remedy should reach and be thoroughly applied to all the affected parts_. This can be accomplished in only one way, which is by _hydrostatic pressure_. The anatomy of the nasal passages, and the various chambers and tubes that communicate therewith, is such that they cannot be reached with fluid administered with any kind of syringe or inhaling tube, or with any instrument, except one constructed to apply it upon the principle above stated. Such an instrument is Dr. Pierce's Nasal Douche.

By the use of this instrument, the fluid enters every portion of the air-passages of the head by its own weight, no snuffing being required.

DIRECTIONS FOR USING DR. SAGE'S CATARRH REMEDY WITH THIS INSTRUMENT.

To cleanse out the passages previous to applying the Catarrh Remedy fluid, take one quart of soft water, add to it two large tablespoonfuls of common salt, and shake it up occasionally until all is dissolved. Before use heat it until blood warm, or, in other words, until it gives a pleasant, mild warmth to the inserted finger. Put the reservoir on a shelf, or hang it up, so that it will be a little higher than the head: fill the reservoir with salt and water, pressing the tube between the thumb and finger so as to prevent the fluid from escaping through it; introduce the nozzle at the end of the tube into one nostril, pressing it in far enough to close the entrance of the passage so that no fluid can escape by the side of the tube, breathe through the mouth, avoid swallowing, and allow the fluid to flow. The soft palate, by the act of breathing through the mouth, is elevated so as to completely close the passage into the throat, and thus the fluid is made to flow up one nostril in a gentle stream, to pass into and thoroughly cleanse all the sinuses, or cavities, connected with the nasal passages, and to flow out of the other nostril. The douche should not be employed unless both nostrils are open and the flow is free. If the head is "stopped up," snuff up the warm liquid from the hand occasionally, until the passages are open and you can breathe freely through both nostrils.

Do not forget that the instrument will not work properly unless you _breathe through the mouth and avoid swallowing_ while the fluid flows.

Fill the reservoir a second time with the simple salt and water, and, inserting the nozzle into the nostril out of which the fluid flowed on using it the first time, pass the current through in the opposite direction; that is, so that it will flow out of the nostril into which it flowed the first time of using it.

After having thus thoroughly cleansed the passages, fill the instrument half full or more with the "Catarrh Remedy Fluid," prepared as heretofore directed, and warmed to a moderate temperature, and pass this through the nose in the same manner as directed for the salt water. The salt water is not curative, but is milder than simple water, and is, therefore, preferable for cleansing the passages.

On first commencing the use of the instrument, it is best to hang it only a very little higher than the forehead, but after using it a few times, put it up about as high as the length of the tube will admit.

Let no one entertain any feeling of timidity on commencing the use of this instrument, as its operation is perfectly simple and harmless, and, with the fluids which we recommend, is never attended with any strangling, choking, pain, or other disagreeable sensations. The medicine should be applied with the Douche at least twice a day, in the morning and at night on retiring. There is no advantage in using the medicine oftener than three times a day, when used with the instrument, but a _sufficient_ quantity should be used each time to medicate all the diseased parts. If any remains in the Douche it may be poured back into the stock solution for subsequent use, but a liquid that has once passed through the nasal cavity contains the germs of the disease and must not be used a second time.

* * * * *

NASAL POLYPUS.

The term Nasal Polypus is usually given to a variety of growths which are met with in the nasal passages far more frequently than any other tumors. They are thus designated because of their fancied resemblance to the aquatic polypus. They occur singly, or in clusters, as illustrated in Fig. 13. In the early stages the mucous membrane is swollen and irregularly dilated, presenting a rough and mottled appearance not unlike chronic catarrh with which they are usually associated. Gradually these mound-like tumors enlarge, usually becoming pendulant, and presenting a grayish opaque glistening surface, similar to the pulp of a grape. Occasionally they become massive at the point of attachment, and assimilate a warty or cauliflower growth. The latter variety is better supplied with blood vessels and presents a red or dark pink surface and may bleed on slight irritation. The favorite location is beneath or behind the middle or superior turbinated bodies, oftentimes nearly or quite concealed. However, no portion of the mucous membrane lining the upper air passages is exempt. Sometimes they grow from the roof of the nostril and pharnyx in pendulous masses, assuming the shape of the cavities, filling the entire nostril and upper portion of pharnyx. The mucous membrane covering the turbinated bodies may become dilated and swollen, finally developing by catarrhal processes into a polypus at that point. (See _H_, Fig. 13.)

CAUSES. Nothing definitely is known regarding their causation. They are generally supposed to originate in some constitutional derangement, impairing the nutrition of the mucous membranes. Other cases are closely associated with chronic nasal catarrh, and frequent attacks of cold in the head.

SYMPTOMS. These may vary considerably in different cases due to the character and location of the polypus. In the early stages before the tumor is well developed, the symptoms may be those of nasal catarrh, and the diagnosis of polypus be possible only after a personal examination by a skillful specialist. Neither is the size of the polypus always in proportion to the severity of the symptoms. The nasal discharge is generally increased and of a variable character. As the tumors enlarge they cause a sense of fullness and weight between and below the eyes, with more or less headache and facial neuralgia. There is partial or complete obstruction of one or both nostrils. In some cases the obstruction changes from one nostril to the other when lying down; the stoppage generally being on the side toward the pillow. A polypus located at the junction of the nasal passages and throat by force of gravity always causes obstruction to the lower nasal cavity when lying down. Polypi often attain considerable size and by pressure upon and displacement of the surrounding structures occasion hideous facial deformity. Changes in the weather often aggravate the symptoms. By blowing the nostril the tumor sometimes may be forced forward, so that it may be seen a short distance from the anterior opening of the nostril. The _voice_ is often affected, being muffled or harsh in tone, similar to that which accompanies a cold in the head. _Respiration_ may be considerably embarrassed, due to the obstruction in the nasal passages, and the patient necessarily resorts to mouth breathing. In advanced cases the Larnyx is usually much congested, being constantly irritated, not only reflexly through the nervous system, but directly by the inspired air, and excoriating discharges dropping in the throat from behind the palate. Thus it is plain to understand how chronic Pharyngitis, Laryngitis, Bronchitis, and Asthma may result from a small polypus in the nasal cavity.

TREATMENT. In mild cases correcting the constitutional derangement may check the morbid process in the nostrils and cause absorption of the polypus growth. For this purpose Dr. Pierce's Golden Medical Discovery is unequaled. The removal of the polypus may sometimes be accomplished by snuffing powdered blood-root. When these measures fail it is necessary to seek surgical assistance. After the removal of the polypus Dr. Sage's Catarrh Remedy should be used to prevent a recurrence.

OUR OPERATION FOR NASAL TUMORS.

Having operated with unvarying success upon a very large number and variety of nasal tumors at the Invalids' Hotel and Surgical Institute we are positively assured that the means and methods which we employ are neither severe or dangerous; _no pain_, consequently _no shock_; recovery rapid and permanent. Many forms of injection and local treatment are in use for the removal of nasal polypi, none of which have proven to be curative; recurrence of the tumor many times following such treatment. Many cases have presented themselves after having been treated by the heroic method of seizing the polypus with a pair of forceps and forcibly tearing it loose, bringing with it segments of healthy tissue, leaving bone exposed, and a ragged, uneven surface of diseased membrane. It is much easier to properly treat a case from the beginning than to undertake it in such a rendition.

Owing to the fact that these nasal tumors grow directly from the lining membranes it is necessary not only to thoroughly remove the tumor but to treat the diseased membrane at the point from which the polypus springs; otherwise another tumor may develop at the same point. The nasal passage having been thoroughly anæsthetized, or benumbed, by the use of cocaine, the nasal speculum is introduced, and by means of reflected light from the head mirror worn by the operator, the interior of the nostril is brought into view. (See Fig. 9, p. 479.)

Often the attachment of the growth is entirely hidden behind the irregular bony structures of the nostril so that it requires the skill of an expert specialist, deft in the manipulation of these parts, to operate properly.

Many styles and shapes of delicately devised instruments are necessary to completely remove the growth without doing injury to the adjacent structures. By our newly devised operation the tumor is at once removed, without pain, and with the loss of only a few drops of blood. Further, because the tumor is entirely removed and the base properly treated there is not the offensive discharge for a long time afterward and the danger from infection and blood-poison to which the patient is subjected in other forms of treatment.

In conclusion we would say that we claim for our operation the following points that are worthy of the careful consideration of every one who may be so unfortunate as to require the services of a specialist for the removal of growths in the nasal or upper air passages.

1st. Our operation is absolutely painless.

2d. No chloroform or ether is required.

3d. We insure perfect removal of growth.

4th. There is no injury to other adjacent structures.

5th. The operation is bloodless.

6th. The recovery is rapid.

7th. There is no slough to produce pus that may be absorbed and cause blood-poisoning.

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DEFORMITY OF THE NASAL SEPTUM.

In health the nasal septum is a bony or cartilaginous plate, as shown in _A_, Fig. 14, dividing the nasal passages into two cavities of the same size and shape. This plate or partition is also a support to which the flexible structures which form the tip of the nose are attached. In early life the septum is flexible and may be bent or doubled by injury to the nose; but owing to its elasticity usually resumes its natural position and shape. After maturity any dislocation or change in this bony plate usually remains permanent unless some means are employed for its correction. In a limited number of cases supposed to be chronic nasal catarrh, we have found upon examination that one or both nasal cavities were more or less obliterated and obstructed by the deformed and thickened septum. (See _A_, Fig. 15.) Many of these cases date from an injury to the external parts, causing only bleeding from the nose and a slight pain for a short time. Chronic inflammation develops at the point where the bone is bent or cracked, resulting in thickening, often producing nodules or spur-like projections which not only interfere with nasal breathing, but also act as irritants to the adjacent delicate membranes and produce many of the symptoms common to nasal catarrh.

Among other common causes are unequal or imperfect development of the nasal bones, due to an inherited strumous tendency and local ulcerative disease, weakening or destroying the bone.

SYMPTOMS. The location and extent of the deformity of the nasal septum necessarily gives opportunity for a variety of symptoms. In aggravated cases the nose appears to be bent toward one side. In the earlier stages there is an excess of mucous secretion, often dropping into the throat from behind the palate. The discharge is variable as in nasal catarrh with more or less difficult nasal breathing, the stoppage changing from one nostril to the other. Sneezing and frequent attacks of nose bleed are often common symptoms. The tendency of the disease is to extend backward often causing headache, deafness, roaring in the ears and post-nasal disease which results in a chronic sore throat, the latter disease often being the one for which the patient seeks advice. If allowed to progress uninterruptedly the throat gradually becomes more irritable, associated with an annoying cough, and the voice becomes harsh and has a nasal tone. The general health is impaired, the nervous system excitable; laryngitis, asthma, and lung disease become complications, which render the existence of the individual miserable.

TREATMENT. In mild cases where the deformity is slight, and the obstruction is not a constant symptom, the nasal cavities should be cleansed (See treatment of nasal catarrh) after inhaling dust, and special attention given to the prompt treatment of cold in the head. Should there be irritability, sneezing, or a constant discharge, it is advisable to use Dr. Sage's Catarrh Remedy as directed on p. 483 to soothe the excitability and lessen the inflammatory action in and about the thickened and deformed septum. As an auxiliary to promote the absorption of the thickened tissues and restore them to a healthy activity, a number of bottles of the "Golden Medical Discovery" should be taken while using the local treatment. Any dormant condition of the liver or digestive tract may be corrected by taking Dr. Pierce's Pleasant Purgative Pellets. In advanced cases after the structures are so diseased and thickened that it renders local treatment hopeless, only surgical interference can prove curative.

OUR PAINLESS OPERATION.

By the application of a few drops of a solution of cocaine in the nostril, at the point to be treated, we are now able to produce such local anæsthesia as to render the operation entirely painless without the administration of either chloroform or ether. This is an important consideration as many are adverse to taking chloroform or ether, and now that we possess an agent that produces, locally, complete insensibility to pain, we are very glad to dispense with their use in all such minor operations. There is no pain caused even by the application of the cocaine to deaden the sensibility of the part. Many examinations of the upper air-passages heretofore very annoying and even painful to the patient and sometimes unsatisfactory, are rendered entirely painless, and carried out with a thoroughness that would be impossible without the use of this wonderful agent. Not only in surgery of the nose and throat, but alike in other departments, our surgeon-specialists employ the same local anæsthetic in all minor operations, none of which are attended with the least pain.

Our specialists were among the first surgeons in this country to employ this newly-discovered anæsthetic. We regard it as a great boon to our patients, and never withhold it in any case where it can be employed to prevent suffering. Its use is attended with no danger, nor is it followed by bad or disagreeable results.

OUR OPERATION.

The nostrils being the entrance to and the beginning of the air passages no dexterity and skill can be spared in treating and properly correcting any deformity that may exist. Mutilation of these sensitive structures is sure to be followed by serious reflex symptoms in adjacent parts.

Consequently cases of this nature should only be entrusted to the care of a competent and experienced specialist. Our resources and appliances are unlimited and seldom do we use the surgeon's knife in a case of this nature.

As in the treatment of other pathological growths in the upper air passages the rhinoscope is indispensable. The parts can only be brought into the view of the operator by means of this instrument and sets of mirrors to reflect light on all sides of the deformed and hidden parts.

By our operation both nasal cavities are restored to their normal size and contour (compare Figs. 14, 15), unhealthy and diseased tissues are removed, and free nasal respiration established.

All treatments are carried out under strict aseptic precautions, thus reducing the danger from absorption of poisonous secretions to the minimum. By our skillful and ingenious management of these cases we never have had a single patient manifest any serious symptoms after operation. In such cases we consider this the only safe, practical, and permanent cure. Every year hundreds pass out of existence the victims of incurable disease of the air-passages resulting from morbid nasal conditions, who might be saved by proper and timely treatment.

* * * * *

PHARYNGITIS AND POST-NASAL CATARRH.

Simple chronic pharyngitis seldom exists alone and uncomplicated; most cases being the result of previous existing disease of the nasal or post-nasal passages. Many cases are associated with hypertrophy, or enlargement, of the tonsils. Usually the disease is located in the upper part of the pharynx, or throat, behind and above the uvula and soft palate, and is thus hidden from view when looking into the throat through the mouth. When not associated with nasal catarrh the common symptoms are dropping of tenacious mucous in the throat, causing a constant desire to hawk and spit; sense of dryness in this region; cough and expectoration on rising in the morning, which is due to the irritability of the throat, and may invade the lower air-passages. The throat may be studded with red and thickened patches of its mucous membrane. Respiration may be embarrassed, the voice affected and the general health gradually decline. The membrane above and behind the palate is angry, reddened, thickened and roughened, as represented in _G_, Fig. 16.

TREATMENT To rationally treat a disease, attack the cause. Therefore, in an uncomplicated case of post-nasal disease of the pharynx the medicine should be applied at this point. For this purpose we recommend the regular and continuous use of Dr. Sage's Catarrh Remedy administered preferably by means of the post-nasal syringe as illustrated in Fig. 16.

The efficacy of Dr. Sage's Catarrh Remedy as a curative agent in catarrh of mucous membranes is unequaled if the medicine be properly and thoroughly applied. The Catarrh Remedy fluid should be prepared as directed in the pamphlet which accompanies the medicine. Warm enough of the medicine to fill the syringe twice. After the syringe is filled with the warm medicine, introduce the curved tip behind the soft palate, holding the syringe as seen in Fig. 16, then incline the head forward over a wash bowl and empty the syringe by pressing the plunger quickly. The medicine will immediately come in contact with the diseased surfaces and pass out through the nostrils, thoroughly medicating, disinfecting and cleansing the upper part of the throat and the posterior region of the nostrils. Two syringes of the medicine should be used for each treatment, and two or more applications made every day until a cure is effected.

At the same time the local treatment is being used, Dr. Pierce's Golden Medical Discovery should be taken to act through the blood upon the diseased tissues.

The Catarrh Remedy may be administered by means of the Nasal Douche, if the case is complicated by nasal catarrh. Should tumors or deformities exist, it is advisable to consult a specialist.

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ENLARGED TONSILS.

Chronic enlargement of the tonsils, as shown in Fig. 17, _A A_, is an exceedingly common affection. It is most common to those of a scrofulous habit. It rarely makes its appearance after the thirtieth year, unless it has been imperfectly cured. Both tonsils are generally, though unequally enlarged. A person affected with this disease is extremely liable to sore throat, and contracts it on the slightest exposure; the contraction of a cold, suppression of perspiration, or derangement of the digestive apparatus being sufficient to provoke inflammation.

CAUSES. Repeated attacks of quinsy, scarlet fever, diphtheria, or scrofula, and general impairment of the system, predispose the individual to this disease.

SYMPTOMS. The voice is often husky, nasal or guttural, and disagreeable. When the patient sleeps, a low moaning is heard, accompanied with snoring and stentorian breathing, and the head is thrown back so as to bring the mouth on a line with the windpipe, and thus facilitate the ingress of air into the lungs. When the affection becomes serious it interferes with breathing and swallowing. The chest is liable to become flattened in front and arched behind, in consequence of the difficulty of respiration, thus predisposing the patient to pulmonary disease. On looking into the throat, the enlarged tonsils may be seen, as in the Fig. 17. Sometimes they are so greatly increased in size that they touch each other.

TREATMENT. The indications to be carried out in the cure of this malady are:

(1.) To remedy the constitutional derangement.

(2.) To remove the enlargement of the tonsilar glands.

The successful fulfillment of the first indication may be readily accomplished by attention to hygiene, diet, clothing, and the use of Dr. Pierce's Golden Medical Discovery, together with small daily doses of his "Pleasant Pellets." This treatment should be persevered in for a considerable length of time after the enlargement has disappeared, to prevent a return.

To fulfill the second indication, astringent gargles may be used. Infusions of witch-hazel or cranesbill should be used during the day. The following mixture is unsurpassed: iodine, one drachm; iodide of potash, four drachms; pure, soft water, two ounces. Apply this preparation to the enlarged tonsils twice a day, with a probang, or soft swab, being careful to paint them each time. A persevering use of these remedies, both internal and local, is necessary to reduce and restore the parts to a healthy condition.

Sometimes the enlarged tonsils undergo calcareous degeneration; in this case, nothing but their removal by a surgical operation is effectual. This can be readily accomplished by any competent surgeon. We have operated in a large number of cases, and have never met with my unfavorable results.

The method we adopt at the Invalids' Hotel and Surgical Institute for the removal of diseased tonsils is, like other minor operations, painless. The patient is not required to take chloroform or ether. When the enlarged gland is once thoroughly removed the disease seldom returns.

ELONGATION OF THE UVULA.

Chronic enlargement, or elongation of the uvula or soft palate, as shown at _B_ in Fig. 17, may arise from the same causes as enlargement of the tonsils. It subjects the individual to a great deal of annoyance by dropping into or irritating the throat. It causes tickling and frequent desire to clear the throat, also change, weakness and loss of voice, and often gives rise to a very persistent and aggravating cough. Constriction of the throat, cough and difficult breathing are more prominent symptoms in complicated cases.

TREATMENT. The treatment already laid down for enlarged tonsils, with which affection, elongation of the uvula is so often associated, is generally effectual. When it has existed for a long time, and does not yield to this treatment it may be removed by any competent surgeon.

* * * * *

CHRONIC LARYNGITIS.

This is of much more frequent occurrence than the acute form, and is often associated with tubercular affections, and constitutional syphilis. It is characterized by an inflammatory condition, ulceration, or hardening of the mucous membrane of the larynx, most frequently the latter. There is also a chronic form, known as _follicular laryngitis_, or _clergymen's sore throat_, to which public speakers are subject.

THE CAUSES of chronic laryngitis are various, as prolonged use of the vocal organs in reading or speaking; using them too long on one pitch or key, without regard to their modulation; improper treatment of acute diseases of the throat; neglected nasal catarrh; the inordinate use of mercury; syphilis; repeated colds which directly cause sore throat, injuries, etc. It is also frequently due to tubercular deposits, and in these cases it generally terminates in consumption.

SYMPTOMS. The affection often comes on insidiously. There is soreness of the throat, noticeable particularly when speaking, and immediately thereafter; a "raw" and constricted feeling, leading to frequent attempts to clear the throat, in order to relieve the uneasy sensation. The voice becomes altered, hoarse, and husky, and there is a slight, peculiar cough, with but little expectoration. At first, the matter expectorated is mucus, but as the disease advances, and ulceration progresses, it becomes muco-purulent, perhaps lumpy, bloody, or is almost wholly pure pus. The voice becomes more and more impaired, and is finally lost. In the latter stages, it resembles consumption, being attended with hectic fever, night-sweats, emaciation, cough, profuse expectoration, and sometimes hemorrhage.

TREATMENT. The patient should avoid using his voice as much as possible. At the same time, attention should be paid to the diet, the bathing, and the clothing. Every thing should be done that is calculated to build up and improve the general health. Dr. Pierce's Golden Medical Discovery is well adapted to remove morbid states of the disease, in consequence of its direct action on the mucous membranes of the air-passages, and its efficacy in allaying irritation of the laryngeal, pharyngeal, and pneumogastric nerves. It should be perseveringly employed. Iodine inhalations, administered with the pocket inhaler, illustrated by Fig. 3, and the application of tincture of iodine to the forepart of the neck, are efficacious in many cases. Inhalations of chloride of ammonia, administered with a steam-atomizer, Fig. 11, in the form of spray, are frequently of great benefit. _Perseverance_ is necessary, and the afflicted are cautioned against discontinuing the treatment too soon, for the disease is very liable to return.

* * * * *

CONSUMPTION.

PHTHISIS PULMONALIS.

By this we understand a constitutional affection, characterized by a wasting away of the body, attended by the deposition of tubercular matter into the lung tissue. Hence the appellations, _Phthisis Pulmonalis; Pulmonary Tuberculosis; Tubercular Consumption_. Tubercles may form in other organs and result in a breaking down of their tissues, but the employment of the term _Consumption_ in this article is restricted to the lungs. The general prevalence, the insidious attack, and the distressing fatality of this disease, demand the special attention and investigation of every thinking person. It preys upon all classes of society. Rich and poor alike furnish its victims.

Some idea of its prevalence may be formed when we consider that, of the entire population of the globe, one in every three hundred and twenty-three persons annually dies of consumption. It may not be definitely known just what proportion of all the deaths in this country and Europe occurs from this one disease. Those who have gathered statistics differ somewhat, some claiming one-fourth, while others put the ratio at one-sixth, one-seventh, and even as low as one-ninth. A fair estimate, and one probably very near the truth, would be one-sixth or one-seventh of the whole number. In New York City, for five consecutive years, the proportion was three in twenty. In New England, about twenty thousand annually succumb to this destroyer, and in the State of New York as many more. These figures may appear to be exaggerations, but investigations of the subject prove them to be the simple truth. Epidemics of cholera, yellow fever, and other diseases of similar character, so terrible in their results, occasion wide-spread alarm, and receive the most careful considerations for their prevention and cure, while consumption receives scarcely a thought. Yet the number of their victims sinks into insignificance when compared with those of consumption. Like the thief in the night, it steals upon its victim unawares. In a large proportion of cases, its approach is so insidious that the early symptoms are almost wholly disregarded; indeed, they excite but little, if any, attention, and perhaps for a time disappear altogether. Thus the patient's suspicions, if they have been aroused, are allayed and appropriate measures for his relief are discontinued. This may be the case until renewed attacks firmly establish the disease, and before the patient is fully aware of the fatal tendency of his malady, he is progressing rapidly towards that "bourne from which no traveler returns."

As has already been stated, consumption is a constitutional disease, manifested by feeble vitality, loss of strength, emaciation--symptoms which are too often classed under the name of _general debility_, until local symptoms develop, as _cough, difficult breathing_, or _hemorrhage_, when examination of the chest reveals the startling fact that tubercular deposits have been formed in the lungs. Invalids are seldom willing to believe that they have consumption, until it is so far advanced that all medicine can do is to smooth the pathway to the grave. Another characteristic of this disease is _hope_, which remains active until the very last, flattering the patient into expectation of recovery. To the influence of this emotion, the prolongation of the patient's life may often be attributed.

NATURE OF THE DISEASE. It is an error to suppose that the disease under consideration is confined to the lungs. "Pulmonary Consumption," as has been remarked, "is but a _fragment_ of a great constitutional malady." The lungs are merely the stage where it plays its most conspicuous part. Every part of the system is more or less involved, every vital operation more or less deranged; especially is the _nutritive_ function vitiated and imperfect. The circulation is also involved in the general morbid condition. Tubercles, which constitute a marked feature of the disease, are composed of unorganized matter, deposited from the blood in the tissue of the lungs. They are small globules of a yellow, opaque, friable substance, of about the consistency of cheese. After their deposition, they are increased in size by the accretion of fresh matter of the same kind. They are characteristic of all forms of scrofulous disease.

The most plausible theory in regard to them is, that they are the result of imperfect nutrition. Such a substance cannot be produced in the blood when this fluid is perfectly formed. It is an unorganized particle of matter, resulting from the imperfect elaboration of the products of digestion, which is not, therefore, properly fitted for assimilation with the tissues. The system being unable to appropriate it, and powerless to cast in off through the excretory channels, deposits it in the lungs or other parts of the body. There it remains as a foreign substance, like a splinter or thorn in the flesh, until ejected by suppuration and sloughing of the surrounding parts. It might be supposed by some that when the offending matter was thus eliminated from the lungs, they would heal and the patient recover; but, unfortunately, the deposition of tubercular matter does no cease. Owing to the morbid action of the vital forces, it is formed and deposited as fast or faster than it can be thrown off by expectoration. Hence arises the remarkable fatality of pulmonary consumption.

CAUSES. The causes of consumption are numerous and varied, but may all be classed under two heads, viz: _Constitutional_, or _predisposing_, and _local_, or _exciting_. Of just what tubercular matter consists, is still a subject of controversy, but that its existence depends upon certain conditions, either _congenital_ or _acquired_, is generally conceded; and one of these conditions is impaired vitality. Constitutional predisposition must first give rise to conditions which will admit of the formation of tubercular matter, before any cause whatever can occasion its local deposition. It must modify the vitality of the whole system, when other causes may determine in the system thus impaired, the peculiar morbid action of which tubercular matter is the product. The general division of causes into predisposing and exciting, must ever be more or less arbitrary. Individuals subject to predisposing causes may live the natural term of life and finally die of other disease. Indeed, when predisposing causes are known to exist, they should constitute a warning for the avoidance of other causes. Again, among the so-called exciting causes, some may operate in such a manner, with some individuals, as to predispose them to consumption, and the result will be the same as if the disposition had been congenital. The causes which in one individual are _exciting_, under other circumstances and in other individuals, would be _predisposing_, because they act so as to depress the vitality and impair the nutritive processes.

THE PREDISPOSING CAUSES, then, are hereditary predisposition, scrofula, debility of the parents, climatic influences, sedentary habits, depressing emotions, in fact, _anything_ which impairs the vital forces and interferes with the perfect elaboration of nutritive material.

THE EXCITING CAUSES are those which are capable of arousing the predisposing ones into activity, and which, in some instances, may themselves induce predisposition; as dyspepsia, nasal catarrh, colds, suppressed menstruation, bronchitis, retrocession of cutaneous affections, measles, scarlatina, malaria, whooping-cough, small-pox, continued fevers, pleurisy, pneumonia, long-continued influence of cold, sudden prolonged exposure to cold, sudden suspension of long-continued discharges, masturbation, excessive venery, wastes from excessive mental activity, insufficient diet, both as regards quantity and quality, exposure to impure air, atmospheric vicissitudes, dark dwellings, dampness, prolonged lactation, depressing mental emotions, insufficient clothing, improper treatment of other diseases, exhaustive discharges, tight lacing, fast life in fashionable society, and impurity and impoverishment of blood from any cause. This list might be greatly extended, but the other causes are generally in some manner allied to those already named.

SYMPTOMS. The symptoms of consumption vary with the progress of the disease. Writers generally recognize three stages, which so gradually change from one to the other that a dividing line cannot be drawn. As the disease progresses, new conditions develop, which are manifested by new symptoms. Prior to the advent of pulmonary symptoms, is the latent period, which may extend over a variable length of time, from a few months to several years; and, indeed, may never be developed any farther. Until sufficient tubercular matter has been deposited in the lungs to alter the sounds observed on auscultation and percussion, a definite diagnosis of tubercular consumption cannot be made, even though there may have been hemorrhage. Nevertheless, when we find _paleness, emaciation, accelerated and difficult breathing, increased frequency of the pulse, an increase of temperature_, and _general debility_ coming on gradually without any apparent cause, we have sufficient grounds for grave suspicions. These are increased if tenderness under the collar-bone, with a slight, hacking cough is present. These symptoms should be sufficient to warn any individual who has the slightest reason to believe that he is disposed to consumption, to lose no time in instituting the appropriate hygienic and medical treatment, for it is at this stage that remedies will be found most effective. Unfortunately, this period is too apt to pass unheeded, or receive but trifling attention; the patient finds some trivial excuse for his present condition, and believes that he will soon be well. But, alas for his anticipations! The disease goes onward and onward, gradually gaining ground, from which it will be with great difficulty dislodged.

The cough now becomes sufficiently harassing to attract attention, and is generally worse in the morning. The expectoration is slight and frothy; the pulse varies from ninety to one hundred and twenty beats in a minute, and sometimes even exceeds this. Flushes of heat and a burning sensation on the soles of the feet and palms of the hands are experienced. A circumscribed redness of one or both cheeks is apparent. These symptoms increase in the afternoon, and in the evening are followed by a sense of chilliness more or less severe. The appetite may be good, even voracious; but the patient remarks that his food "does not seem to do him any good," and, to use a popular expression, "he is going into a decline." As the strength wanes the cough becomes more and more severe, as if occasioned by a fresh cold, in which way the patient vainly tries to account for it. Expectoration increases, becomes more opaque, and, perhaps, yellow, with occasionally slight dots or streaks of blood. The fever increases, and there is more pain and oppression of the chest, particularly during deep respiration after exercise. Palpitation is more severe. There may now be night-sweats, tire patient waking in the morning to find himself drenched in perspiration, exhausted, and haggard. Bleeding from the lungs occurs, and creates alarm and astonishment, often coming on suddenly without warning. The hemorrhage usually ceases spontaneously, or on the administration of proper remedies, and in a few days the patient feels better than he has felt for some time previously. The cough is less severe, and the breathing less difficult. Indeed, a complete remission sometimes occurs, and both patient and friends deceive themselves with the belief that the afflicted one is getting well.

After an indefinite length of time, the symptoms return with greater severity. These remissions and aggravations may be repeated several times, each successive remission being less perfect, each recurrence more severe, carrying the patient further down the road toward the "dark valley." Now the cough increases, the paroxysms become more severe, the expectoration more copious and purulent, as the tubercular deposits soften and break down. The voice is hollow and reverberating, the chest is flattened, and loses its mobility; the collar-bones are prominent, with marked depression above and below. Auscultation reveals a bubbling, gurgling sound, as the air passes through the matter in the bronchi, with the click, to the air cells beyond. Percussion gives a dull sound or if there are large cavities, it is hollow, and auscultation elicits the amphoric sound, as of blowing into a bottle. Hectic fever is now fully established; the eye is unusually bright and pearly, with dilated pupils, which gives a peculiar expression; the paroxysms of coughing exhaust the patient, and he gasps and pants for breath. The tongue now becomes furred, the patient thirsty, the bowels constipated, and all the functions are irregularly performed. Another remission may now occur, and the patient be able to resume light employment, for an indefinite length of time, which we have known to extend over three or four years, when the symptoms again return.

If the patient is a female, and deranged or suppressed menstruation has not marked the accession of pulmonary symptoms, the flow now becomes profuse and clotted, or is scanty and colorless, sometimes ceasing altogether. In the male, the sexual powers diminish, and copulation is followed by excessive and long-continued prostration. From this time onward, the progress of the disease is more rapid. The liver and kidneys are implicated. In addition to the pallor, the complexion becomes jaundiced, giving the patient, who is now wasting to a mere skeleton, a ghastly look. The urine is generally copious and limpid, though occasionally scanty and yellow. The pulse increases to one hundred and thirty or one hundred and forty beats in the minute, and is feeble and thread-like. The cough harasses the patient so that he does not sleep, or his rest is fitful and unrefreshing; whenever sleep does occur, the patient wakes to find himself drenched with a cold, clammy perspiration. The throat, mouth, and tongue now become tender, and occasionally ulcerate. Expectoration is profuse, purulent, and viscid, clinging tenaciously to the throat and mouth, and the patient no longer has strength to eject it. The hair now falls off, the nails become livid, and the breathing difficult and gasping; the patient has no longer strength to move himself in bed and has to be propped up with pillows, and suffocates on assuming the recumbent position. Drinks are swallowed with difficulty. Diarrhea takes the place of constipation. The extremities are cold, swollen, and dropsical; the voice feeble, hollow, grating, husky, the patient gasping between each word; the respiration is short and quick. A slight remission of these symptoms occurs. The patient is more comfortable, lively, cheerful, and perhaps forms plans for the future. But it is the last effort of expiring vitality, the last flicker of the lamp of life, the candle burns brilliantly for a moment, and with one last effort goes out, and death closes the scene.

The duration of the active stage of consumption varies from a few weeks to several years, the average time being about eighteen months.

_Cough_ is always a prominent symptom throughout the entire course of the disease, varying with its progress.

_Expectoration_, at first scanty, then slightly increased, colorless, frothy, and mucous, is also a characteristic. After a time it becomes opaque, yellow, and more or less watery; then muco-purulent and finally purulent, copious, and viscid. When tubercular matter is freely expectorated, with but little mucus, it sinks in water. This symptom continues to the very last.

_Haemoptysis_ (bleeding from the lungs) may occur at any stage of the disease, often being the first pulmonary symptom noticed, again being delayed until late; and there are cases in which it does not happen at all. It seldom occurs in any other disease.

_Night-sweats_ may occur at any stage, though they are rarely experienced until the disease is pretty well established, and are very exhausting.

_Hectic Fever_ generally occurs soon after the pulmonary symptoms are developed, and increases in intensity with the progress of the disease. There are usually two paroxysms in twenty-four hours, one of which occurs towards evening and is followed by night-sweats.

_Dyspnoea_ (difficult breathing) is at first slight, except after exertion, amounting to only a sense of oppression; but it becomes more and more severe as the disease advances, until the very last, when it is agonizing in the extreme.

_Aphthæ_, sometimes extending to the pharynx and larynx, generally occurs towards the last. The mouth and throat become so very sore and tender that nourishment and medicine are taken with difficulty.

_Emaciation and Debility_ are characteristic of the disease. They fluctuate as the disease advances or is retarded, increasing to the very last.

_Auscultation and Percussion_ constitute valuable means of diagnosis from the time tubercular matter begins to be deposited to the very last, and, when correctly practiced, reveal the extent and progress of the disease. As a knowledge of the sounds elicited can only be acquired by practical experience with proper instruments, they will not be described here. The only diseases with which consumption is likely to be confounded are general debility in the early stage, bronchitis, chronic pleurisy, chronic pneumonia, and abscess in the lungs, after the advent of pulmonary symptoms.

CURABILITY. Notwithstanding the prevailing opinion that consumption is incurable, there exists ample, incontrovertible evidence to the contrary. Its curability is established beyond the shadow of a doubt. Individuals have recovered in whom there was extensive destruction of pulmonary tissue, and, indeed, entire destruction of one lung. Numerous instances are on record in which persons have suffered from all the symptoms of confirmed consumption, and have regained their health and subsequently died of other diseases. The case of the late Dr. Joseph Parish, of Philadelphia, affords a striking example of this kind. In early life, he manifested all the symptoms of confirmed consumption, including frequent hemorrhages, yet he fully regained his health, and, after a very useful life, died at an advanced age of another disease. Post-mortem examination revealed the existence of cicatrices, or scars, in his lungs where tubercular matter had been deposited. Dr. Wood, in his Practice of Medicine, mentions another instance of a medical gentleman in Philadelphia, who in early life suffered from consumption with hæmoptysis, from which he recovered, and afterwards died, at an advanced age, of typhoid fever, when the knife revealed the presence of cicatrices. Post-mortem examinations of individuals who have died of other diseases, have revealed, in numerous instances, the presence of consumption at some period of their existence. In these cases the lungs were perfectly healed by cicatrization, or by the deposit of a chalky material. A French physician made post-mortem examinations of one hundred women, all of whom were over sixty years of age, and who had died of other diseases, and in fifty of them he found evidences of the previous existence of consumption.

Professor Flint says that consumption sometimes terminates in recovery, and that his observations lead him to the conclusion that the prospect of recovery is more favorable in cases characterized by frequent hemorrhages. Drs. Ware and Walshe are also led to the same conclusion.

Professor J. Hughes Bennett, of Edinburgh, has thoroughly investigated the subject, and adds his testimony to that of others, citing numerous cases that have resulted in perfect recovery. If such testimony is not sufficient, we may mention the following, whose names are well known and respected in professional circles, and all of whom declare that consumption is a curable disease. The list includes Laennec, Andral, Cruveilhier, Kingston, Presat, Rogée, Boudet, and a host of others.

No farther back than 1866, on page 145, of the proceedings of the Connecticut Medical Society, we find "Observations, Ante-mortem and Post-mortem, upon the case of the late President Day by Prof. S.G. Hubbard, M.D., New Haven," from which we learn that Jeremiah Day, LL. D., who was for twenty-nine years President of Yale College, was, while a mere youth, a victim of pulmonary consumption. During his infancy and boyhood his vitality was feeble. He entered Yale College as a student in 1789, "but was soon obliged to leave the institution on account of pulmonary difficulty, which was doubtless the incipient stage of the organic disease of the lungs which subsequently developed itself." He remained in feeble health for two years, but returned to college, and graduated in 1797. For the next six years his lung difficulties were quite severe, and he repeatedly bled in large quantities, but he had so far recovered in 1803, as to accept a Professorship. He was afterwards chosen President of the college, which office he held for many years, in the enjoyment of good health. He died from "old age," as we are told, in 1867, aged 94 years.

Statistics show that under the improved methods of treating this disease, the mortality, as compared with previous years, has been greatly reduced. Clinical observation proves that injuries to the lungs are not so fatal as was once supposed.

TREATMENT. The earlier the treatment of this disease is undertaken, the greater is the probability of success. The reason of this is obvious; at first the disease is general or constitutional, but as it advances, by the deposit of _tubercular matter_, it becomes both constitutional and local. Hence the treatment must be both _general_ and _local_. The occurrence of certain prominent and distressing symptoms, either from the natural progress of the disease, or from complications with other affections, often renders it difficult, even for physicians, to determine how far their treatment should be general and how far local.

Treating the symptoms instead of the general disease, or treating the constitutional disease without regard to the symptoms which arise from it, is an error into which many physicians have fallen. The constitutional affection, the local manifestations and complications, and the circumstances and individual peculiarities of the patient, must all be carefully considered; bearing in mind all the while, that tubercular matter is the product of a morbid action, which, in every case, must exist before its deposition in the lungs, or any other tissue, can take place.

In every case in which curative treatment is to be instituted, the hearty and persistent co-operation of both patient and friends is absolutely necessary; and the treatment, which is both hygienic and medical in character, should have in view the following aims:

(1.) The avoidance of the causes concerned in the production and perpetuation of the disease.

(2.) The restoration of healthy nutrition, in order to stop the formation of tuberculous matter.

(3.) The arrest of the abnormal breaking down of the tissues, and the prevention of emaciation.

(4.) The relief of local symptoms, and the complications arising from other diseases.

The fulfillment of the first indication, the avoidance of causes, is of the utmost importance, for if they have been sufficient to _produce_ the disease, their continued operation must certainly be sufficient to _perpetuate_ it. A single individual is very often subjected to the operation of several of the causes already enumerated, some of which, in consequence of circumstances and surroundings, are unavoidable. Of these, the one most difficult to overcome is climate; _i.e._ the frequent variations of temperature.

Upon the subject of climate much has been written. But that which is best adapted to the cure of consumption, is that which will enable the patient to pass a certain number of hours every day in the pure open air, without exposure to sudden alterations of temperature. There are very few persons who change their place of residence, except as a last resort, when the disease is in the last stage. It is then productive of little or no good. This is one reason why so many people having consumption die in Florida, and other warm countries. If a change of climate is to be effected at all, it should be made early.

The most powerful stimulant to health is well-regulated exercise. It assists the performance of every function, and is of paramount importance to promote good digestion and proper assimilation, conditions essential for recovery. It should not, however, be carried beyond the powers of endurance of the individual, so as to exhaust or fatigue. Everything that can invigorate should be adopted; everything that exhausts should be shunned.

To fulfill the second indication, to restore healthy nutrition, requires not only a proper diet, both as regards quantity and quality, but demands that the integrity of the organs concerned in the process of digestion and assimilation, shall be maintained at the highest standard of perfection possible.

That the diet be sufficient in quantity should be obvious to all. It is also necessary that it be nutritious, and that it should contain carbonaceous elements. Food of a starchy or saccharine character is apt to increase acidity, and interfere with the assimilation of other elements, therefore, articles, rich in fatty matters, should enter largely into the diet. The articles of food best adapted to the consumptive invalid are milk, rich cream, eggs, bread made from unbolted wheat-flour, and raised with yeast, cracked wheat, oatmeal, good butter, beef, game, and fowls. These contain the necessary elements for assimilation. Oily food is of great importance, and the beef eaten should contain a good proportion of fat. Plenty of salt should always be eaten with the food, and a desire for it is often experienced. Over-eating should be avoided, lest the stomach be induced to rebel against articles of diet rich in important elements.

Derangement of the process of nutrition requires careful attention, and, if necessary, correction. For this purpose, nothing can excel Dr. Pierce's Golden Medical Discovery. It increases the appetite, favors the nutritive transformation of the food, enriches the blood, and thus retards the deposition of tubercular matter. It is so combined that, while it meets all these indications, it relieves or prevents the development of those distressing symptoms so common in this disease.

The "Golden Medical Discovery" is adapted to fulfill the third indication in the management of this disease, which is to check the abnormal breaking down and waste of tissues, which constitute such a prominent feature in this malady. The antiseptic properties of the "Discovery" are unmistakably manifested in preventing such abnormal decomposition. The emaciation, excessive expectoration, profuse perspiration, diarrhea, and hectic fever, common to consumption, are all due to a too rapid disintegration and waste of the tissues. It is in this condition of the system that this medicine, by its powerful antiseptic properties, manifests its most wonderful curative ability. When, as in this disease, the vital forces of the system have, in a degree, lost their restraining influence over the processes of disintegration, waste, and decay, which goes on so rapidly that nutrition cannot compensate for the loss to the system, then it is that the "Golden Medical Discovery," by its antiseptic influence, checks this rapid waste of the tissues, and thus arrests the disease. To the lack of employment of such a remedy in the treatment of consumption, the unparalleled fatality of the disease is largely due. In their anxiety to improve digestion and nutrition, and thus build up the tissues, physicians often lose sight of the no less important indication of restraining the destructive waste going on in the system, which overbalances the supplies furnished by absorption. The gradually increasing emaciation and loss of strength render perpetuity of the organism impossible.

The fulfillment of the fourth indication, to relieve local symptoms, and the complications with other diseases, is often attended with no little difficulty.

_The Cough_ is a secondary symptom, arising from the irritation caused by the tubercular deposits. Medicated inhalations may give temporary relief, but cannot cure it. They strike at the branches of the disease, while the root is left to flourish and develop new branches.

Expectorants have been employed to a great extent, and the theories, which have been advanced in favor of their use, are sometimes very ingenious. That they modify the cough, we do not attempt to deny; but it is usually at a great expense, for they derange the stomach and interfere with digestion and assimilation.

Improvement of the general health is always attended with amelioration of the cough. If the patient did not cough at all, the lungs would soon fill up with broken-down tissue, and death from suffocation would result. Irritation of the nerves supplying the lungs sometimes occurs, and causes the patient to cough immoderately, when it is not necessary for the purpose of expectoration. This condition is readily controlled by Dr. Pierce's Golden Medical Discovery, which exerts a decidedly quieting and tonic influence upon the pneumogastric nerve, which, with its ramifications, is the one involved. An infusion of the common red clover, in tablespoonful doses, will also be found a valuable adjunct in overcoming this condition.

_Hoemoptysis_. Hemorrhage from the lungs is generally sudden and unexpected in its attack, though sometimes preceded by difficulty of breathing, and a salty taste in the mouth. Although it _very rarely_ destroys life, it often occasions alarm. Common table salt, given in one-fourth to one-half teaspoonful doses, repeated every ten or fifteen minutes, is generally sufficient to control it. Ligatures applied to the thighs and arms, sufficiently tight to arrest the circulation of blood in the veins, but not tight enough to impede it in the arteries, is a useful proceeding. Ergot, in teaspoonful doses of the fluid extract, hamamelis, and gallic acid, all are valuable for this purpose.

_Night-sweats_ can only be regarded as a symptom of weakness, and are to be remedied by an improvement of the general health. Bathing in salt water is sometimes attended with good results. The practice of giving acids for this symptom can only be regarded as irrational. It may arrest the sweating, but it will do harm in other ways. Belladonna, given at bed-time, is an effectual remedy.

_Frequency of the pulse_ is generally a prominent symptom in this disease. It sometimes points to a condition of sufficient importance to require a remedy. Although the "Golden Medical Discovery" is combined to meet this condition, its value may be greatly enhanced by adding one-half to one teaspoonful, according to the urgency of the case and the frequency of the pulse, of the fluid extract of _Veratrum Viride_ to each bottle. The benefit of this, when persisted in, will be apparent in the amelioration of all the symptoms, and in the general improvement. This fluid extract can be had at any drug store.

_Diarrhea_ is sometimes a troublesome symptom, and particularly so in the latter stages of the disease. It is generally due to acidity of the alimentary canal, to which the treatment must be directed. Great care should be taken in the selection of the diet to improve the quality and avoid everything which disagrees with the patient. Improve digestion by every possible means. Carbonate of soda and rhubarb, in the form of a syrup, are sometimes excellent. The Compound Extract of Smart-weed, in small doses, will generally diminish the frequency of the discharges.

_Derangement of the Liver_ is often a complication requiring attention, and the timely relief of which goes very far in ameliorating the general condition of the patient. The "Golden Medical Discovery" is generally sufficient to relieve this complication. Its influence, however, may be considerably increased in this direction by the use of Dr. Pierce's Pleasant Pellets, according to the directions which accompany them. They should only be taken in the smallest doses, one or two "Pellets "every day, just enough to produce a natural movement of the bowels each day.

_Uterine Derangements_. In the female, derangement of the menstrual function is generally an early complication of consumption, if indeed it does not occur at the outset. It deserves early attention, and, in addition to the remedies already advised, Dr. Pierce's Favorite Prescription is so compounded as to meet the requirements of this condition, and at the same time exert a favorable influence upon the constitutional disease.

The numerous reports of cures of well-developed cases of Consumption to be found in the back portion of this little treatise must be sufficient, it seems to us, to convince the most skeptical of the wonderful power which Dr. Pierce's Golden Medical Discovery exercises over this terribly fatal malady. As will be noted, many of the cases there reported had long been unsuccessfully treated with cod liver oil emulsion and all the other usual remedies employed by the profession and were fast running down. "Golden Medical Discovery" aroused the stomach and liver, and started all the nutritive functions into action, whereby digestion and nutrition were promoted and both the strength and flesh steadily built up. The reader will bear in mind, that most of the cases hereinafter reported, were pronounced Consumption by their attending physicians as well as by us. It cannot be said, therefore, that we exaggerate the malady and that the cases were merely bad, lingering coughs. Thousands, whose maladies have been pronounced genuine Tubercular Pulmonary Consumption, (Phthisis Pulmonalis) by eminent physicians have been _perfectly_ and _permanently_ cured by the use of Dr. Pierce's Golden Medical Discovery. It can, therefore, no longer be doubted that this wonderful compound is far superior as a remedy for Consumption to cod liver oil, compound Hypophosphites, and the many other agents so highly extolled, and so generally prescribed for this fatal malady by even the more progressive and advanced of the medical profession of our day. Read the letters received from grateful patients who have been cured and note how many commend the use of "Golden Medical Discovery," as a "last resort," after their home physicians had exhausted all their skill and resources in vain.

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CHRONIC BRONCHITIS.

This is a subacute or chronic form of inflammation of the mucous membrane of the bronchial tubes, of a very persistent character and variable intensity. There are few diseases which manifest a greater variety of modifications than this.

SYMPTOMS. The symptoms of this disease vary greatly with its violence and progress. Cough is always present, and is very often the first symptom to attract the patient's attention. It is usually increased by every slight cold, and with each fresh accession becomes more and more severe, and is arrested with greater difficulty. The cough is always persistent, sometimes short and hacking, at other times deep, prolonged, and harsh. Sometimes it is spasmodic and irritating and particularly so when it is associated with affections of the larynx, or with asthma, involving irritation of the branches or the filaments of the pneumogastric nerve.

When the chronic follows the acute form of the disease, or follows inflammation of the lungs, the expectoration may be profuse from the first, and of a yellowish color and tenacious character. When the disease arises from other causes, the expectoration is generally slight at first, and the cough dry or hacking. This may continue some time before much expectoration occurs. The expectorated matter is at first whitish, opaque, and tenacious, mixed sometimes with a frothy mucus, requiring considerable coughing to loosen it and throw it off. As the disease progresses, it becomes thicker, more sticky, of a yellowish or greenish color, mixed with pus, and sometimes streaked with blood. In the latter stages, it becomes profuse and fetid, and severe hemorrhage may occur. Sometimes the cough and expectoration disappear when the weather becomes warm, to appear again with the return of winter, which has gained for it the appellation of _winter cough_. The sufferers feel as if something was bound tightly round them, rendering inhalation difficult. Soreness throughout the chest is often a persistent symptom, especially when the cough is dry and hard. Behind the breast-bone there is experienced a sense of uneasiness, in some cases amounting to pain, more or less severe.

As the disease progresses, the loss of strength is more and more marked, the patient can no longer follow his usual employment, his spirits are depressed, and he gradually sinks, or tubercular matter is deposited in the lungs, and consumption is developed.

TREATMENT. Thorough attention to hygiene, with the avoidance of the causes concerned in the production and perpetuation of the disease, is necessary. The patient must be protected from the vicissitudes of the weather by plenty of clothing; flannel should be worn next to the skin, with a pad of flannel or buckskin over the chest, and the feet should be kept warm and dry. Exercise in the open air is essential. When the weather is so cold as to excite coughing, something should be worn over the mouth, as a thin cloth, handkerchief, muffler, or anything which will modify the temperature of the atmosphere before it comes into contact with the mucous lining of the lungs. Good ventilation of sleeping-rooms is all-important; not that the air should be cold, but that it should be as pure as possible.

The diet must be nutritious, cabonaceous, and of sufficient quantity. Beef, milk, rich cream, plenty of good butter, eggs, fish, wheat bread from unbolted flour, supply the appropriate alimentary substances for perfect nutrition and the maintenance of animal heat.

To overcome the modified form of inflammation in the bronchial tubes, all sources of irritation should be avoided, as the inhalation of dust, or excessively cold air. It is in the cure of severe and obstinate cases of this disease that Dr. Pierce's Golden Medical Discovery has achieved unparalleled success, and won the highest praise from those who have used it. Its value will generally be enhanced in treating this complaint by adding one-half a teaspoonful of the fluid extract of _Veratrum Viride_ to each bottle. This can be added by any respectable druggist. Especially should it be thus modified if the pulse be accelerated so as to beat ninety or a hundred times in a minute. The "Golden Medical Discovery" should be taken in teaspoonful doses, repeated every two hours. When the cough is dry and hard, with no expectoration, it arises from irritation of some of the branches of the pneumogastric nerve, which this remedy will relieve. It may, however, be aided by inhaling the hot vapor of vinegar and water, or vapor from a decoction of hops, to which vinegar has been added.

The use of Dr. Pierce's Golden Medical Discovery should be _persisted_ in, taking it in frequent doses, every two or three hours, and keeping up its use until the disease yields and is perfectly stamped out. Do not expect a formidable disease of perhaps weeks' or months' duration to be _speedily_ cured. Chronic diseases are generally slow in their inception and development and can only be cured by gradual stages. Perseverance in treatment is required. Many invalids do not possess the strength of purpose--the will power--to continue the use of the "Golden Medical Discovery" long enough to receive its full benefits. It is worse than useless for such to commence its use, for without persistency it cannot be expected to cure such obstinate maladies as chronic bronchitis.

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ASTHMA.

PHTHISIC.

One of the most distressing ailments with which the human family is afflicted is asthma. Its symptoms are not to be mistaken. Suddenly and without apparent provocation the patient experiences the greatest difficulty in breathing. When warning is given, there is usually a sense of fullness in the stomach, flatulence, languor, and general nervous irritability. The countenance is a picture of anxiety and horror. The difficulty of breathing increases and the struggle for air commences. Windows and doors are thrown open, fans used, and, utterly regardless of consequences, the sufferer passes the whole night in exposure and torture, even though the temperature be below zero. Fearing suffocation, the patient dare not lie down; he rushes to the window for air, rests his head upon a table or chair, or upon his hands, with the elbows upon the knees, jumps up suddenly and gasps and struggles for air. The eyes are prominent and the veins of the forehead distended with blood; sometimes the bowels are relaxed. The urine is colorless and is passed in copious quantities. This symptom indicates great excitement of the nervous system. The voice is hoarse, articulation difficult, breathing limited, noisy and wheezy. The _wheezing_ is pathognomonic of the disease. It can only be confounded with croup, and then only in the young. In croup there is pain and difficulty in swallowing, fever and cough, which are usually absent in asthma. A severe paroxysm of asthma is very distressing to witness, and one unused to it might well suppose the sufferer to be in his last agonies. No definite limit can be assigned to the duration of the attack or of the disease. It may last but a few minutes, may endure for hours, or with slight remission continue for days. The condition of the patient may be for years as changeable as the pointings of the weather-vane. In fact, the atmosphere has much to do with the disease. With every approaching storm, with every cloud of dust, even the dust from sweeping a room, with every foul odor, and, in some more sensitive organizations, with even the perfume of flowers, a paroxysm is provoked. Truly he is a "child of circumstances," a veritable football upon the toes of every atmospheric disturbance.

UNPARALLELED SUCCESS.

Persons affected with asthma or phthisic are numerous. With such an amount of suffering in our midst is it not a marvel, if not a disgrace, that the medical profession of to-day endorse the opinions of a half century ago and pronounce it incurable, rather than make stupendous and laudable efforts to discover plans of medication that will result in certain and permanent cure? Almost single handed we undertook this field of investigation, and we take pleasure in reporting that our labors have been crowned with success. The large experience furnished us has led to the discovery of remedies for this distressing malady of more than ordinary efficacy. Through the agency of these means we have been enabled to cure hundreds, who had suffered untold tortures for twelve, fifteen, or twenty-five years. Some whom we have been successful in curing had suffered from childhood to middle and even old age. The treatment of asthma, or phthisic, still continues to be a prominent specialty at the Invalids' Hotel and Surgical Institute.

NATURE OF THE DISEASE.

As to the exact pathological condition in this malady, opinions differ. Some physicians consider it a disease of the nervous system, others, of the blood, others, of the bronchial tubes, while not a few believe it to be dependent upon some disease of the stomach, heart, liver, kidneys, or due to urinary affections, or "female weakness." Respecting all these diseases of special organs, it is evident that any complication, and particularly one that is debilitating or causes irritation of the nervous system will increase its severity. This important fact we keep constantly in view in our treatment, and prescribe remedies to remove all complications.

In heart disease there is often dyspnoea, or difficult breathing, but this is not of the nature of asthma, or phthisic. The condition of the lungs is readily understood. There being an obstruction to the free passage of the blood through the heart, any excessive muscular exertion, or anything, in fact, which increases the action of the heart, is very apt to produce congestion of the lungs, and then the blood becomes surcharged with carbonic acid, which causes increased efforts to take more air into the lungs.

A NERVOUS DISEASE. A sudden fright, unfavorable news, grief, loss of property, etc., circumstances which affect the mind and nervous system, almost invariably throw the phthisical into a paroxysm. Nervines are demanded, particularly if the case be a chronic one, and we see that they are carefully and properly prepared and supplied, and in such a form as to be exactly fitted to the temperament and constitution.

POPULAR REMEDIES USED FOR SELF-TREATMENT OF ASTHMA.

There are numerous remedies that may be used to _relieve paroxysms_ of asthma. Among them we will notice a few that are most frequently employed by the profession. They can be easily and inexpensively prepared by any patient or druggist:

1. Equal parts of the tinctures of lobalis capsicum and skunk cabbage root. _Dose_.--Take a half teaspoonful in a little water every ten or fifteen minutes until relieved.

NOTE.--This is an antispasmodic and relaxant. In considerable quantities it will produce sickness at the stomach and perhaps vomiting. It should not be used when there is disease of the heart.

2. Chloroform. _Dose_.--A small quantity (say thirty drops), may be poured upon a handkerchief or napkin, held about one inch from the nostrils and the vapor inhaled. It is quite unnecessary to use this until insensibility follows; in fact, such an effect would be hazardous to life in the hands of the inexperienced.

3. Sulphuric ether. _Dose_.--The same as No. 2, and with the same precaution. Either of them should be used promptly upon the beginning of the paroxysm.

4. Take four ounces of stramonium leaves and strip from the stems, rubbing between the hands to partly pulverize. To this add one ounce of saltpetre, finely powdered. _Dose_.--Place a half teaspoonful upon a very hot shovel. Inhale the rising smoke. If the first few inspirations cause coughing, the smoke should not be evaded as the coughing incites deeper inspiration.

5. Stramonium and saltpetre as in No. 4. Dampen with water and make into balls or cones. These are more easily handled and are fired in the same way as the powder and used in the same way.

6. Take of sunflower leaves, stramonium leaves, mullein leaves, one ounce each; of lobelia leaves, half an ounce; of powdered nitre, one ounce; and benzoic acid, two drams. Mix thoroughly. _Dose_.--A pipeful, to be smoked the same as tobacco.

7. A cup of hot coffee or several of hot water. This is especially effective in cases arising from checked perspiration, from rheumatism, etc.

These recipes are given to the public as being the principal agents employed by the medical profession throughout the world. It must be distinctly understood that they are not _curative_ but merely _palliative_, and used to relieve paroxysms. We object to them wholly and unqualifiedly because they contain NARCOTICS. It is a fundamental principle in our treatment not to use this class of remedies. They stupefy the brain, debilitate the nervous system, and have, in not a few instances, formed an unfortunate appetite and habit, most difficult to overcome. We are of the opinion that one of the chief reasons why this malady has been considered incurable is the fact that physicians have almost universally relied upon narcotic drugs. With such medication a cure is the exception. A cure can only be effected under such circumstances when the _powers of nature are sufficient to overcome both the_ NARCOTIC _and the_ DISEASE. That they will _relieve_ we do not deny, but _they will never cure_. It reminds us of an old country doctor who advised a lady to smoke tobacco to cure acid dyspepsia. She followed the prescription for over thirty years and at last accounts was not cured yet. In all seriousness we ask would any other remedy except a narcotic or stimulant be used with such persistency for anything like this length of time? Is it not apparent that such agents form a habit which is often worse than the disease, and yet fail to effect a cure? We appreciate the necessity for relief, and do not blame sufferers for availing themselves of any means for this purpose. But they should not be satisfied with relief only, but should look about for such a system of medication as will rid them of the disease completely and permanently. If a week's or a month's exemption is a "foretaste of heaven," how incomparable are the comforts and happiness to be derived from a life-time immunity?

MILLIONS OF DOLLARS

are annually spent upon the advice of physicians, in traveling expenses, and hotel bills, by sufferers from asthma, or phthisic, in seeking a change of climate that will be advantageous. It is the last expedient of the doctor who is annoyed by the continued complaint of his unrelieved patient, and can only be made available by the wealthy. In some instances the change is beneficial, but to be effectually so a permanent change of residence is required. Most patients are unable or unwilling to do this. In some cases change only affords temporary relief, the attacks returning after a few months. Even the wealthy dislike to take such chances. The less opulent cannot think of such methods, and hence are compelled to bear their sufferings as best they can. In the majority of instances the "change of climate" is only an illusion, or only temporarily beneficial at best. We can tell them a better way, and if they are wise they will follow it.

* * * * *

HAY ASTHMA, OR HAY FEVER.

This affection, known also as Hay Catarrh, Hay Fever, or Rose Cold differs but little in its manifestations, from coryza, or cold in the head, save in its _inciting cause_, and in its element of periodicity. In this latitude there are persons who, during summer or early fall, are invariably attacked with acute congestion or inflammation of the upper air-passages, giving rise to sneezing, watery discharges from the nose and eyes, difficult respiration, fever, and general prostration. These symptoms are supposed to be induced by the inhalation of pollen or odors from grasses or flowers, which at that time are supposed to give off certain exhalations of an Irritating character. Unless arrested by medical treatment, the disease lasts until cool weather, or the occurrence of a hard frost rids the atmosphere of the exciting influence.

Some feather beds give off an odor which excites all the aggravated symptoms of this disease. Thus it appears that certain emanations have the power of inciting these inflammatory conditions in certain sensitive constitutions. In all individuals suffering from this disease there is an over sensitiveness of the nervous system which admits of the appearance of such sudden and severe manifestations. Many cases suffering only mild symptoms for the first few seasons, annually become aggravated until severe spasmodic asthma is a regular, and sometimes continuous complication. A case or two are on record in which the odor from the body of a horse so induced these symptoms that the individual could never ride or drive him.

TREATMENT. In mild cases, or when the attack first appears, the daily use of Dr. Sage's Catarrh Remedy fluid will neutralize and wash away the poisonous particles which have found lodgment in the nasal passages. The Remedy is best applied with Dr. Pierce's Nasal Douche. When the disease has existed the previous season it is necessary that the patient begin both constitutional and local treatment four or six weeks prior to an expected return of the disease. The nervous system should be strengthened, and the resistance of the patient to the irritating influence of these pollens and odors so increased, that even though he may be exposed, no severe symptoms will follow.

Dr. Pierce's Golden Medical Discovery will be found invaluable as an alterative, blood purifier, and nerve tonic, and should be taken regularly while Dr. Sage's Catarrh Remedy is being used locally for its antiseptic and curative properties. The action of the "Discovery" is especially desired in cases that are so far advanced as to be attended with asthmatic symptoms, such as difficult breathing, headache, and a feeling of lassitude and prostration.

In very obstinate or distressing cases our specialists have been able to prescribe and send, by mail or express, special courses of treatment which have proven so effective as to cure the disease _permanently_, so that it has not reappeared the following season. The treatment seems to have produced such an impression upon the system as to have fortified the individual against a return of the disease.

In rare cases morbid growths in the upper air-passages are of such a nature as in themselves to be a source of sufficient excitement to unbalance the nervous equilibrium so that the individual is thus rendered more susceptible to this disease. In such, or exceedingly obstinate cases a personal examination by our specialist is desirable, and often results in the use of such measures as give permanent relief.

* * * * *

TESTIMONIALS.

If the following letters had been written by your best known and most esteemed neighbors they could be no more worthy of your confidence than they now are, coming, as they do, from well known, intelligent, and trustworthy citizens, who, in their several neighborhoods, enjoy the fullest confidence and respect of all who know them.

Out of thousands of similar letters received from former patrons, we have selected these few at random, and have to regret that we can find room only for this comparatively small number in this volume.

BLEEDING FROM LUNGS, CONSUMPTION

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I wish to say to you that Doctor Pierce's Golden Medical Discovery saved my life and has made me a man; my home-physician says I am good for forty years yet. You will remember that my case was a case just between life and death, and all of my friends were sure it was a case of death, until I commenced taking a second bottle of "Golden Medical Discovery," when I was able to sit up and the cough was very much better, and the bleeding from my lungs stopped, and before I had taken six bottles of the "Golden Medical Discovery" my cough ceased and I was a new man and ready for business.

And now I feel that it is a duty that I owe to my fellow-men to recommend to them the "Golden Medical Discovery" and Dr. Sage's Catarrh Remedy, which saved my life when doctors and all kinds of medicines failed to do me any good.

I will send to you with this letter two of my photographs; one was taken a few weeks before I was taken down sick in bed, and the other was taken after I was well.

Yours respectfully, C.H. HARRIS, No. 1622 Second Avenue, Rock Island, Ill.

SEVERE CHRONIC COUGH.

Wilbar, Wilkes Co., N.C.

DR. R.V. PIERCE, 663 Main Street, Buffalo, N.Y.:

_Dear Sir_--I cannot recommend your "Golden Medical Discovery" too highly. I had a severe chronic cough and I began to use that medicine and took only one bottle, and I have not been sick a day since. When I began to use your "Golden Medical Discovery" my weight was 104 pounds, and now I weigh 125 pounds.

Yours very truly, Mrs. Anna Parsons

SPITTING OF BLOOD. LUNG DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I can gladly recommend Dr. Pierce's Golden Medical Discovery to all suffering from diseases for which you recommend it. In the summer of 1888 I took a severe cold, which settled on my lungs and chest, and I suffered intensely with it. I tried several of our best physicians here and they gave up all hopes of my recovery, and my friends thought I would have to die, and I thought so myself, as the doctors did not know what was the matter with me. In the morning, on rising, I would cough and spit blood for two hours, and I was pale and weak and not able to work any. I then ran across Dr. Pierce's advertisement and I came to the conclusion I would try the "Golden Medical Discovery," as it was so highly recommended. I was greatly discouraged when I began the use of the "Discovery," but after I had taken four or five bottles I then noticed I was getting better, and I could stand it to work some, and kept on taking it till I took about twenty or twenty-five bottles. It has been five years since I took it and have had no return of that trouble since. I gladly recommend your medicine for I know it saved my life.

Yours respectfully, JOHN M. HITE, Audubon, Audubon Co., Iowa.

LUNG DISEASE.

Blue Rock, Muskingum Co., Ohio.

DR. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--I feel like taking you by the hand and saying, "thank God, you have saved my wife," for we had given her up. We had sat by her, when the doctor said she could not live till morning; so bad was her lung disease. Dr. Pierce's Golden Medical Discovery cured her.

MR. THOMAS McGILL.

When her case was reported to the specialist of the Invalids' Hotel, Mrs. McGill was suffering from pain in the chest, struggling for breath, hard dry cough; jarring hurt the chest; short breath, backache; uterine disease, leucorrhea, menstruation scanty and painful; feet and ankles swollen; was confined to house most of the time; was given up by her home physician. Her disease began six years before with "lung disease" which was followed by bleeding from lungs.

CURES WHEN COD LIVER OIL FAILS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--My wife a few years ago had hemorrhages of the lungs, and we summoned our home physician. He checked the hemorrhage but failed to cure her. She had also a terrible cough and expectorated a great deal. She wanted to see another doctor so I called one and he examined her. She asked him whether she had consumption, and his answer was, "Madam, it is very near consumption." He advised her to use cod liver oil, but this gave but little relief. I happened to get hold of one of your little books that comes with each bottle of Dr. Pierce's medicines and I read some cases about like my wife's. I went to the drug store and procured a bottle of Dr. Pierce's Golden Medical Discovery and my wife commenced using it according to directions. She began to get better right away and her cough has left her. She used about ten bottles. She is in her fifty-fifth year and can walk ten or twelve miles without any trouble. We are satisfied that her life and health have been saved by the use of "Golden Medical Discovery." As soon as she takes any cold she insists upon having a bottle of her medicine, as she calls it, and that is the last we hear of her cold.

Yours respectfully, Joseph D. Wiles West Point Street, Frederick, Md.

MALARIA, CHILLS, AND LUNG DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--It has been about eight months since I quit using Dr. Pierce's Golden Medical Discovery. When I commenced using it I only weighed 130 pounds. I had been suffering with malarial fever, chills, and lung disease for four years. I took treatment from many doctors, and tried many different kinds of patent medicines and all seemed to do no good. Since I have used four bottles of "Golden Medical Discovery" and one bottle of Dr. Pierce's Pleasant Pellets I feel well in every respect _and weigh 160 pounds instead of only 130_, my weight when I began its use.

Yours truly, ROBERT WILLIAMS, Hazelton, Barber Co., Kas.

CONSUMPTION.

ALMOST RAISED FROM THE GRAVE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I have long felt it my duty to acknowledge to you what your "Golden Medical Discovery "and "Pleasant Pellets" have done for me. They almost raised me from the grave. I had three brothers and one sister die of consumption, and I was speedily following after them. I had severe cough, pain, copious expectoration, and other alarming symptoms, and my friends all thought I had but a few months to live. At this time I was persuaded to try your "Discovery," and the first bottle acted like magic. Of course I continued on with the medicine, and as a result I gained rapidly in strength. My friends were astonished. When I commenced the use of your medicines, six years ago, I weighed but 120 and was sinking rapidly. I now weigh 135, and my health continues perfect. I have a copy of your "People's Common Sense Medical Adviser," and neither money nor friends could ever induce me to part with it.

Twelve years later, Mrs. Vansicklin writes: "My health still continues _perfect_. I now weigh 148 pounds. Your book--the Common Sense Medical Adviser is a treasure in our home." Yours truly,

MRS. H.H. VANSICKLIN, Brighton, Ont.

CONSUMPTION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Two years ago I thought I had consumption, and was continually coughing day and night, and not able to work. I bought six bottles of Dr. Pierce's Golden Medical Discovery and it did me more good than all the other medicine I ever took, and now I am feeling all O.K., and I weigh 165 pounds. Two years ago I weighed 145 pounds. I can fully recommend Dr. Pierce's Golden Medical Discovery to any person that has consumption. I remain, Yours truly,

JOHN A. HENSON, South Bosque, McLennan Co., Texas.

IT "FILLS THE BILL." LUNG DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--In 1872, when living in New York State, my health was very poor. I was clear "run down." Pain in my lungs, right side and in my bowels; had been ailing for nearly two years; my feet swelled during the day so I could hardly stand it till night, as I was on my feet the most of the time.

I wrote you and you sent me special medicines, which brought me around all right. I have weak lungs, and when I get run down I usually take a few bottles of Dr. Pierce's Golden Medical Discovery, which always builds me up. We have used your "Discovery" in our family with the best results.

When living at Blue Mound I was very sick with inflammation of the lungs from taking cold. When I took cold I was at Clinton, Missouri. Was confined to my bed for a few days. I said to the doctor that I must go home; he advised me to stay where I was, but I started for Blue Mound with my pulse at 140. When I arrived home I was glad to get in bed, and called in Dr. ----. He said my lungs were in a bad condition. Well, I was very sick for three weeks or more, and when I got around I was not well, and at that time Dr. ---- came to Blue Mound, stopped there two weeks, gave free lectures and had lots of patients. He examined me and said I needed treatment, and he could cure me.

I was suffering all the time with pain in my right lung. He wanted $50.00 for treatment, and would cure. So I let him pass along and wrote to your Association for advice, which was to take the "Discovery," and I took one-half dozen bottles which "filled the bill." Yours respectfully,

A.D. SIMMONS, Emporia, Lyon Co., Kansas.

CONSUMPTION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--It is my pleasant duty to you and to suffering humanity to acknowledge the benefit I received from Dr. Pierce's Golden Medical Discovery. About seven years ago I became troubled with my lungs--consumption in its first stage. Some of my friends in Ontario had been using your medicine before I knew anything of it; and after coming to this country, I commenced taking it, and I think it has done wonders for me. I am positive, that if any one will persist in taking it, it will do all you say. It has done so much for me that I feel it my duty to testify to its wonderful curative properties. Respectfully,

MRS. JESSE K. SMITH, Baldur, Selkirk Co., Manitoba.

DYSPEPSIA AND NASAL CATARRH.

DR. PIERCE, Buffalo, N.Y.:

_Dear Sir_--I had been very badly troubled for many years with dyspepsia, also nasal catarrh, and got so bad and weak that I could not work. I could hardly eat anything without vomiting; had a pain in the stomach and a burning sensation coming into the throat. I took Dr. Pierce's Golden Medical Discovery and "Pleasant Pellets," and can truly say these medicines have helped me wonderfully. I improved right along from the very beginning. I stopped taking medicine in the latter part of May and then felt as well as ever in my life. I am pretty well now, for a man of sixty-three years. I can eat all kinds of food and it doesn't cause me any pain in the stomach as it always did before I took Dr. Pierce's medicines. I can cheerfully say to the public that they need not hesitate in taking Dr. Pierce's Golden Medical Discovery for dyspepsia; it will eradicate and cure the disease if anything will.

Yours truly, JOHN LARSON, Ashby, Grant Co., Minn.

LUNG DISEASE.

Dr. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--I cheerfully make the following statement: In February, 1893, I was attacked with a severe illness. It came on very gradually, and was attended with a severe cough and expectoration; also had pain in the lungs; had chills and night-sweats; was much reduced in strength. After trying for relief in different directions without success, I was induced to apply to your eminent Staff of Physicians at 603 Main St., Buffalo, N.Y., and I am happy to say that my improvement began as soon as I began the use of the medicines which were prescribed for me at that time. The improvement has been continuous, until I now feel my lungs are entirely cured; have no cough, no expectoration in the last month, and my usual weight of 183 pounds has been restored. Have been able to do a fair day's work any time during the past two mouths without unusual fatigue. I can cheerfully recommend your Institution to persons similarly affected, and will authorize you to refer any one making inquiry to me.

Yours respectfully, J.J. HUME, Corfu, Genesee Co., N.Y.

A BAD COUGH.

Vanburen, Kalkaska Co., Mich.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Your medicine is the best I have ever taken, I was not able to do hardly any work at all; had pain in my left side and back, and had headache all the time. I tried your medicine and it helped me. Last spring I had a bad cough; got so bad I had to be in bed all the time. My husband thought I had consumption. He wanted me to get a doctor, but I told him if it was consumption they could not help me. We thought we would try Dr. Pierce's Golden Medical Discovery and before I had taken one bottle the cough was stopped and I have had no more of it returning.

Respectfully yours, Jennie Dingman

SEVERE COUGH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I want to say a word in favor of your medicine. I can not do it justice by mere words.

I was taken sick the 5th of July; I called a doctor but did not receive any benefit from him. I was going into quick consumption. Had a terrible cough, raised a great deal of phlegm; had pain through chest, was very weak and all run-down." I told my husband to get a bottle of "Golden Medical Discovery;" he did so; I commenced taking it and I began to get better. I was not outside of the door yard, from July 5th, until August 22d. I only took two bottles, and the first of September I was able to do the work for boarders, and have had boarders ever since. It is the grandest medicine ever invented.

Respectfully, Mrs. CHARLES JEWELL, (P.O. Box 89), Rockford, Kent Co., Mich.

SPITTING OF BLOOD.

Olanta, Clearfield Co., Pa.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I can truly say that your "Golden Medical Discovery" and "Pleasant Pellets" have been the means of saving my life. When I began taking your medicines I thought my time was short. I have not spit up blood now for about four months, and am feeling much better. Our home doctor says my temperature and pulse are all right now; and that I do not need further medicine, and that I will get all right again. I feel that your medicine has done wonders for me. I would have written sooner, but I was waiting to see if the improvement Would be permanent.

Yours truly, D.Y. Rowles

DESPONDENCY.

NERVOUS PROSTRATION--THREATENED WITH CONSUMPTION.

WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I have felt inclined to say to you, and your whole staff of physicians, and now do convey to you, my heart-felt gratitude for your able and skillful assistance rendered me in my afflictions. I had been for years a sufferer, and at times nearly despondent. I had been treated by the most able and skillful physicians that this north-western country could provide. I had paid them large sums of money and was finally given to understand that there was no hope for my cure. Your advertisements fell into my hands, which treated upon my case. I read and compared my case with the insight you so ably explained, so I was satisfied you understood your profession well. I started full of hope and as I reached Buffalo, after three days' travel by rail, some 1,500 miles, there was something that cheered me on. I made my way to your Invalids' Hotel. I was examined and pronounced curable. I was operated upon for a local affection that caused much of my suffering, the same day I arrived, and in ten days was discharged permanently cured. I have felt perfectly well ever since. I was nicely treated by the able nurses and attendants who were always gentle and kind.

I can cheerfully say to the public, that they need not hesitate in throwing themselves into your kind care in every case that is curable by the hand of man, and you will treat them honestly.

Hoping this may be of some benefit to some afflicted persons who may feel some diffidence in trusting themselves in your hands.

Yours respectfully, H. CUMMINS, Eagle Lake, Blue Earth Co., Minn.

LUNG DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am much better, and believe it was through your medicine and advice that I am as well as I am. I might have been entirely well if I had been able to have kept the medicine to take as directed. I have taken only four bottles, and it would be four or five months from the time I would take one bottle till I could get another one. I can talk better, and feel almost like a new person to what I did two years ago. I weigh more and can do any kind of work. Dr. Pierce's Golden Medical Discovery is the only medicine that did me any good.

Your friend, MRS. RACHEL D. FISHER, Silver Point, Putnam Co., Tenn.

CHILLS AND LINGERING COUGH

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--In 1879 I wrote you after suffering eighteen months. I had tried three doctors--took over one dozen bottles of patent medicines, without relief.

I had chills with hacking cough; my friends said I had consumption; was reduced in flesh and nerve till the least work or exercise would exhaust me completely.

Thanks for the day I wrote you, for I sent you ten dollars, and received four bottles of medicine which I took, and have been able to do hard work. I have never had any symptoms of those dreaded chills since. My weight got as low as 135 pounds; now I weigh 175 pounds. I would advise any one affected with chronic disease to consult you, as your treatment is genuine.

Yours truly, HENRY DIETZEL, P.M. Ernst, Clark Co., Ill.

HEREDITARY CONSUMPTION.

HOME DOCTORS OPPOSED HIS COMING TO US (THEY OFTEN DO) ALTHOUGH UNABLE TO HELP HIM THEMSELVES.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--For the benefit of the afflicted, I wish to say, that I visited your Institution in 1889, completely broken down in health and suffering, as I thought, from heart disease and consumption. I had spent money with many of our home physicians, but they only gave me partial relief and I would soon be worse than ever. When I spoke of coming to you, the doctors here cried "humbug," but I told them I had been humbugged at home and if I staid I would surely die, and if I went could do no worse. I spent thirty days at your Invalids' Hotel and Surgical Institute, and came away like a new man, comparatively speaking. I found the Institution all it had been represented, and I may truthfully say, that the time spent there was to me as an oasis in a desert to a weary and thirsty traveler; for those were among the happiest days of my life. No pains were spared to make each patient comfortable and at home. I cannot recommend your Institution too highly, for I feel that to your treatment I owe my life. I have sold a great deal of your medicines, and recommend them with the same faith I would water to the thirsty. They, the "Pellets," "Golden Medical Discovery" and "Favorite Prescription," give universal satisfaction. You are at liberty to use this as you desire, for my only motive in writing is to benefit the afflicted, by pointing out to them a place of cure; for, no matter what their disease, I am confident that if medical skill can avail, they can be cured at the Invalids' Hotel and Surgical Institute.

Yours truly, J.F. JONES, Raleigh C.H., Raleigh Co., W. Va.

ABSCESS OF LUNG. REDUCED ALMOST TO A SKELETON.

Bisbee, Cochise Co., Ariz.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I had been confined to my bed four months, had tried the skill of four doctors and all the patent medicines that were recommended for my case, which was an abscess on the lung. My physicians and friends had given me up to die; I was reduced to a perfect skeleton; my strength was gone; my eyesight was so dim I could scarcely see at all, and I had no appetite--could not eat anything at all when I commenced using Doctor Pierce's Family Medicines. I have taken sixteen bottles of the "Golden Medical Discovery," twelve bottles of "Pellets" and three bottles of "Favorite Prescription," and to-day I am well and strong and weigh 128 pounds--two pounds more than I ever before weighed in my life.

Your true friend, Mrs. Sarah A. Kelly

LUNG DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--My daughter had pneumonia and it left her with a horrible cough and one lung was almost gone; our doctor seemed to think there could be nothing more done, and said to go South; but not having the means at that time, I began giving her Dr. Pierce's Golden Medical Discovery, which she took steadily for two years. During that time she gained rapidly in strength; the lungs became normal, the cough leaving her entirely. We are never without this medicine in the house, and have recommended it to all our friends, and I am positively certain that if Dr. Pierce's medicine is used in time, it will cure in other cases as well as in this one.

Yours respectfully, MRS. RUTH A. SICKLES, Ocean Port, Monmouth Co., N.J. (Box 33.)

REDUCED TO A SKELETON.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Having felt it a duty to write of the good I received by taking your medicine, I now would say, that one year ago I was given up by my family physician and friends; all said I must die. My lungs were badly affected, and body reduced to a skeleton. My people commenced to give me your "Medical Discovery" and I soon began to mend. It was not long before I became well enough to take charge of my household duties again. I owe my recovery to Dr. Pierce's Golden Medical Discovery.

Respectfully yours, MRS. MIRA MILLS, Sardis, Big Stone Co., Minn.

COUGH AND NIGHT SWEATS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--In regard to your medicines I will say that they are always in the house. I shall never forget those nights when I was down with pneumonia. Had it not been for Dr. Pierce's Golden Medical Discovery I would not be a well man to-day. One bottle stopped the cough and night sweats.

My wife was troubled with leucorrhea so bad that we did not know what to do until Dr. Pierce's Favorite Prescription was brought into the house and gave her rest.

Yours truly, H.M. DETELS, Traver, Tulare Co., Cal.

PULMONARY DISEASE. A WONDERFUL CURE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am 29 years old. During the winter of '84 I contracted a severe cold, which settled on my lungs. Each succeeding winter my cough grew worse, and in the winter of '85 I had chicken-pox, and taking cold, drove them in causing me a severe spell of sickness. The following summer I had congestion of the lungs and hemorrhage and a severe spell of fever. My physician advised me to go West in search of health. My friends thought I had consumption of the lungs, I coughed so much. In September, 1889, I left Carthage, Mo. (where I then lived), for Phoenix, Ariz. After I had been there about four months I had a severe attack of "_La Grippe_" and with this I coughed myself almost (I thought), to death; and to add to my distress I had an almost intolerable attack of pleurisy. A doctor was summoned and after an examination said I had Empyemia, and said he could do me but very little good until he removed the pus. He and his partner came and by the use of an aspirator drew off nine pints of pus; after about a week he drew off two pints. After a few days I told my doctor I could hear the pus gurgle as I had before he drew it off. Strange to say, but nevertheless true, my heart was crowded over on the opposite side for three months. I knew it was there for I could feel the pulsations there, and I was so short of breath for a long time I could not stoop down to tie my shoes.

The doctor told me it would be useless again to use the aspirator, but that he would be obliged to make an incision in my side and treat it till I got well. On the 28th day of March. 1890, my doctor and his partner and three other doctors undertook the operation, and, after removing about two inches of one of my ribs, withdrew 16 pints of pus. This came near being too much for me though I slowly recovered and in three months the doctors thought I was able to come home. I arrived home in June and was very poorly all summer, and did not sit up but _very little_, and had fever every day. In the latter part of the summer of '90 I commenced to take "Golden Medical Discovery" and although my side had been discharging for TWENTY-THREE MONTHS it healed up sound and well. I am now able to do considerable hard work. I would advise all who are afflicted as I was, to give your medicine a trial. I am glad I have out-lived my friends' expectations.

Yours truly, CHARLES E. LEES, P.O. Box 2, Winslow, Washington Co., Ark.

THROAT AND LUNG DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was troubled with throat and lung disease for about two years and lost strength so that I was unable to do much work. I took four bottles of Dr. Pierce's Golden Medical Discovery, and can say that it did more good than any other medicine that I ever took. I am now able to do my work, and enjoy good health.

Yours truly, MRS. JULIA WHITE, Willow Creek, Blue Earth Co., Minn.

WEAK LUNGS, COUGH, PROFUSE EXPECTORATION AND CATARRH.

MR. ANTON KRATZ, of _Crawford, Dawes Co., Neb._, had weak lungs, cough and catarrh, with profuse expectoration; difficult breathing, lasting from one to eight hours. He writes:

"I took sick and went to the doctors. They gave me medicine, but it did not help me, so I got two or three bottles of 'Golden Medical Discovery' and some 'Pellets.' After awhile I got better, until three winters ago I got sick again so I could not do anything, and I wrote to you giving my symptoms on one of your question blanks, and asked you about my case. You told me to take your 'Golden Medical Discovery.' I took four bottles and got well and have been well ever since."

LUNG DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: Buffalo, N.Y.:

_Gentlemen_--Before taking the "Discovery" I would have four or five bad coughing spells every day and would cough up mouthfuls of solid white froth, and before I took one bottle it stopped it. I could not walk across the room with the pain in my back and sides; but soon the pain was all gone, and I could sleep well at night. My general health is much better since I have taken the "Golden Medical Discovery" although I have been obliged to work hard on a farm.

Respectfully yours, MRS. JOHN LINCOLN, Glen Annan, Huron Co., Ont.

CONSUMPTION AND GENERAL DEBILITY.

CURED BY SPECIAL HOME TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I had pain in lungs and across the chest; had been spitting blood for the past six years. Menstruation was scant and caused great prostration. Suffered from constipation; cutting pains about the stomach and rumbling in the bowels; exceedingly nervous; indigestion. She writes as follows: "I wish to inform you that I am well. I never can praise you or your ways of treatment enough. I shall bring you all the patients that I can. I feel so rich to get my health back. I can eat well and sleep well, and work all day. I suppose you will think it took a long time to pull me up, but I was very low, much worse than I ever told you of at the time. I was not able even to feed myself any more. My husband had to undress me. I could not wash my own face, or stand alone. I did not lie down to sleep for eleven months; I always had to sit up, because I would choke if I laid my head down. _I have not raised a drop of blood since your treatment_, and I did it always for five years before. Our minister said this spring that he had never thought I could live, and says that he advises every one that is sick to go to you. He was so surprised to see how strong and well I was. My relatives all think that you ought to write my case up for the papers in Chicago. I can never repay you for what you have done for me. A thousand thanks is but empty words. My husband was telling a man just last week, "do not spend all your money in Chicago, as we did, and then write to Buffalo, but go and write now, and your wife will soon be well." My father was saying that he wished the doctors that gave me up could see me now. I think they could not believe their own eyes. I am astonished when I think back how I was six years ago; I could not walk across the room alone for three years, and after taking your treatment for eighteen months, I am _completely_ well. I can hardly believe it myself when I read over those letters that I received from you. I work hard every day. There is never a day that you are not remembered. I hope that you may live many years to do for others what you have done for me. I had this taken so that you might have my picture as I am now; I wish you could have seen me as I was then, and I wish to thank you for those little notes of inquiry that you used to send to find out how I was getting along, which showed that I was remembered not only while the money lasted, but that you cared for me after that."

Respectfully yours, MRS. F. NIENHUIS, Crawford, Cook Co., Ill.

"COMPLETELY WRECKED."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Last August I was taken sick of a fever and was confined to bed for nearly six months. I had four doctors to see me, but it just seemed to me that they could relieve me for only a short while. I had a bad cough and all thought I was going into consumption. After being sick for so long, my nerves were nearly exhausted and my stomach, liver and bowels refused to act, in fact, my whole system was completely wrecked. I could not rest nor sleep, unless influenced by some drug and at last, mother concluded to try your medicines on me. She had taken them about a year before and had been greatly benefited by their use, so she said I will try the last resort--for I had been given up to die.

I began taking your "Golden Medical Discovery" and "Pleasant Pellets." I improved rapidly--was soon able to be up in my room, and to my surprise, I could eat a little of nearly everything I desired. Before I began the use of your medicines, I could eat nothing in peace; I would almost cramp to death, even when I took a little cold water.

But after the use of four and a half bottles of your "Golden Medical Discovery," and two vials of "Pellets," with God's help, I have almost risen from the dead.

I will cheerfully recommend your remedies to my afflicted friends, for I am to-day, well and strong as ever. You can use this among your testimonials, if you choose, with my greatest approval.

Very Respectfully yours, Miss LOULA LINDSEY, Ringgold, Pittsylvania Co., Va.

BRONCHITIS OF TWENTY YEARS' STANDING.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I had bronchitis for twenty years and over, and I could not work without coughing so hard as to take all my strength away. I took five bottles of Dr. Pierce's Golden Medical Discovery, and give you my word and honor that I can do any work that there is to do on my "ranch" without coughing. Sometimes in the winter when exposed to the change in the weather, I have a slight attack of coughing. Remember, I have not taken any of the "Golden Medical Discovery" for a year.

Yours, B.F. WILEY, Box Elder, Converse Co., Wyo.

BRONCHITIS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was troubled with bronchitis for over two years, had severe cough and great difficulty in breathing; appetite was poor and suffered from indigestion, became very weak and despondent. My age (I am now 71) was against me. I was treated by two physicians but they did me no good. I then used four bottles of your "Golden Medical Discovery" and was entirely cured, for which I am very thankful.

Yours truly, M.M. ALEXANDER, Hedrick, Alexander Co., N.C.

LUNG DISEASE.

Schuylersville, Saratoga Co., N.Y. (P.O. Box 396).

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Something over a year ago I wrote to you about my lungs. I used Dr. Pierce's Golden Medical Discovery besides using Iodine and mustard paste.

That pain in my lung entirely left me, and I have not felt it at all since last August. The doctor who lives here and who has always treated me thinks it is a great cure. Words cannot express my gratitude to you. I am now able to do a good day's work.

Yours gratefully, Lulu E. Baugs

CHRONIC SORE THROAT, COUGH HOARSENESS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am feeling well at the present time; I took fourteen bottles of Dr. Pierce's Golden Medical Discovery. I had chronic sore throat, hoarseness, sore chest, rheumatism in my arms, and was very much run down. The doctor here at home said one lung was affected and that I had symptoms of consumption. I know that your "Golden Medical Discovery" was the cause of regaining my health. I remain,

Respectfully yours, MRS. MARY TRAPHAGEN, NO. 6 Front Street, Poughkeepsie, N.Y.

CONSUMPTION. BAD COUGH, SPIT UP BLOOD.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--When I commenced taking your "Discovery" I was very low with a cough, and at times spit up much blood. I was not able to do the least work, but most of the time was in bed. I was all run-down, very weak, my head was dizzy, and I was extremely despondent. The first bottle I took did not seem to do me much good, but I had faith in it and continued using it until I had taken fifteen bottles, and now I do not look nor feel like the same man I was one year ago. People are astonished, and say, "well, last year this time I would not have thought that you would be living now." I can thankfully say I am entirely cured of a disease which, but for your wonderful "Discovery," would have resulted in my death.

Yours truly, K.C. McLIN, Kempsville, Princess Anne Co., Va.

LUNG DISEASE.

COUGHED DAY AND NIGHT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Three years ago I was so sick I could not eat, sleep or walk, for I coughed all day and night. My weight was reduced from 150 to 127 pounds. The first night that I slept four hours at one time, was after I had taken three doses of Dr. Pierce's Golden Medical Discovery. The offensive matter expectorated grew less every day and when I had taken the whole of one bottle I could sleep all night without coughing, and have been well ever since and weigh 178 pounds.

Respectfully yours, MRS. LOUISA STEINMANN, 67th St., near 15th Ave., Lefferts Park, Brooklyn, N.Y.

BILIOUSNESS, CONSTIPATION, BAD COUGH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Some twenty-five years since I was feeling very miserable all summer; I was very bilious; sometimes my bowels would not move once in sixty or seventy hours, and then almost impossible. I would take some bitters, which would help to move the matter, but as soon as the bitters were gone, I had to buy more or I would be as bad as before, and sometimes worse; but none of them appeared to do me any good except to move the bowels, until thirty years since a druggist called my attention to Dr. Pierce's Golden Medical Discovery, and before I had taken half a bottle of the "Golden Medical Discovery" I felt much better and by the time I had taken all, I could eat three hearty meals per day and had not felt so well for a long time. Soon after I was called to do a job some miles from home, and one night the old lady there was speaking about her daughter, (Mrs. Brooks) who had been under the doctor's care for five months and did not get any better, and I learned by asking a few questions that she had no appetite, and no ambition to do anything. Then I told her what the "Golden Medical Discovery" had done for me. The next day the old lady drove down to her daughter's, and got Mr. Brooks to send to Rutland--ten miles away--for two bottles of the "Golden Medical Discovery," and the next day the doctor came, and when about to take leave, Mr. Brooks told the doctor he did not want him any more at present and would send for him if necessary. I saw the old lady about ten days later and her daughter was improving, and Mr. Brooks had great faith in the "Golden Medical Discovery," and had not sent for the doctor, but had gone to Rutland for more of the "G.M.D."

When I commenced taking the "Golden Medical Discovery." I thought I was going into consumption as had a cough for three years or more and my weight decreasing. My weight before taking the "G.M.D." was 133 pounds; last March it was 147 pounds, and I give the credit to the "Discovery."

Yours respectfully, GEORGE I. WILDER, East Wallingford, Rutland Co., Vt.

THROAT AND LUNG DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I had complicated chronic disease for several years--throat and lung and other affections, which almost resulted in consumption. Our doctors could do me no good. I happened to get hold of some of Doctor Pierce's books, and was induced to try his treatment. To the surprise of myself and family, I was, in a short time, changed almost to a new person--from pale sallow complexion to the bloom of health again. Many thanks for restoring me from an untimely grave. I will say to the public it is not always necessary to go to the Institute; I was treated at home with success. I cannot speak in too high praise of Dr. Pierce's Golden Medical Discovery, "Pellets" and "Favorite Prescription." I think they will do all that is claimed for them.

Respectfully, MRS. ALMEDA BRIGNER, Oxford, Furnas Co. Neb,.

SEVERE LUNG AND BRONCHIAL DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--For some time I have been troubled with a severe lung and bronchial disease, following a severe attack of pneumonia. Was raising a great amount of pus, had severe night-sweats and was very much prostrated, when I was induced to visit Dr. Pierce's Invalid's Hotel and Surgical Institute for examination. After having a full statement of my case, I paid for one month's treatment in the Sanitarium and during that time was fully restored to health. I can not speak too highly of the physicians, and this famous Institution.

I take great pleasure in making my cure public and in highly recommending this Institution to all afflicted. The Staff of Physicians and Surgeons is skillful and of large experience, and I feel confident that all the benefit that can possibly be obtained from medical treatment, can be obtained at the Invalids' Hotel and Surgical Institute.

Yours truly, EUGENE CAMPBELL, New Cumberland, Hancock Co., W. Va.

DYSPEPSIA AND CONSUMPTION.

DR. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--I was not able to do my work for nearly two years, and I tried four different doctors and grew worse all the time. Then I began on your medicine and took twelve bottles of "Golden Medical Discovery" and one of "Favorite Prescription," and am able to do my work and feel as well as I have felt in years. Physicians called my disease Dyspepsia and Consumption.

Respectfully yours, MRS. R. FERGUSON, Ink, Shannon Co., Mo.

LUNG DISEASE CURED.

Will you please accept a few lines from me thanking you for your skill in preparing your medicines and placing them within reach of the suffering. I have a daughter, Miss M.H. Snead, who has been very low, was almost given up by two physicians, who treated her with their best skill, and did not receive much benefit. She was first attacked with pneumonia and pleurisy in very bad form and was then taken with a very bad cough, which kept growing worse and worse, until finally it seemed as though she had consumption very bad. The physicians prescribed Cod liver oil, but to no benefit. Mrs. Miller, a neighbor of ours, recommended Dr. Pierce's Golden Medical Discovery to me with very strong faith, as she had been in the same condition and was cured by its use. I procured two bottles and she grew better. She hasn't felt any return of lung disease in over twelve months. She was nothing but a skeleton when she took the first dose, and to-day she weighs 135 pounds. I thought it my duty to write to you in regard to her case, as so many other medicines had failed, and it has acted like a charm.

Respectfully yours, MRS. SARAH E. SNEAD. Clio, Iredell Co., N.C.

DISEASE OF LUNGS AND STOMACH.

Locust Lane, Scott County, Va.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am happy to inform you that after consulting you by letter and two months' trial of Dr. Pierce's Golden Medical Discovery, I am enjoying a better state of health than I have for some time. I have had weak lungs for several years--at times spit up blood. In January, 1893, I took a severe cold, which settled on my lungs--had a very bad cough, it seemed as if my lungs were swollen; could not expectorate much at a time, very hard to get up; suffered much with pains in my chest; was reduced in flesh and became very weak.

Physicians prescribed for me but I found no relief until I consulted you. It seemed I was going into consumption very fast. I have as good health now as could be expected. I am fifty-seven years of age and able to work on my farm, and feel under many obligations for your kind advice. Also my stomach was out of order, suffered with burning in my stomach and chest. I have no burning nor pains in my stomach and chest now.

Yours truly, Milton Ramry

DOCTORS ENDORSE IT.

AN EMINENT PHYSICIAN OF ARKANSAS TELLS OF SOME REMARKABLE CURES OF CONSUMPTION.

Dr. PIERCE:--I will say this to you, that Consumption is hereditary in my wife's family; some have already died with the disease. My wife has a sister, Mrs. E.A. Cleary, that was taken with consumption. She used your "Golden Medical Discovery," and, to the surprise of her many friends, she got well. My wife has also had hemorrhages from the lungs, and her sister insisted on her using the 'Golden Medical Discovery." I consented to her using it, and it relieved her. She has had no symptoms of consumption for the past six years. People having this disease can take no better remedy.

Yours truly. W.C. Rogers, M.D. Stamps, La Fayette Co., Ark.

CHRONIC BRONCHITIS AND DYSPEPSIA.

WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Several years ago I spent many dollars for medicine, but in vain, and expected to die with consumption. But hearing of your Invalids' Hotel and Surgical Institute, I visited you.

To your advice and treatment I owe my life and present good health.

Hoping that you and your eminent faculty may be spared many years to cure the afflicted, I send you my best wishes.

Yours truly, ALBERT ROSENBERGER, Laotto, Noble Co., Ind.

"SORE THROAT."

Palatka, Putnam Co., Florida.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--About seven years ago I was taken with sore throat and tried some home remedies, and it grew worse; and then I went to a doctor here in town, and after trying his remedies for three or four months, which did me no good, then I tried Dr. ---- remedies; and still I grew worse for two years when I wrote you about it. You advised me to take Dr. Pierce's Golden Medical Discovery and his "Pellets," according to directions, and they would cure me, and so they did after taking eight bottles of the "Discovery," and the "Pellets" to keep my bowels regular. We now take the "Discovery" and "Pellets" for all our aches and pains, and think there are no medicines half so good. We use no other.

Yours Truly, Mrs. Ellen Calvert

LUNG AND WOMB DISEASE, DROPSY, SICK HEADACHE, DYSPEPSIA AND BLOODY PILES.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--In the winter of 1881, I became irregular in my monthly courses. Of course at first I paid but little attention to it, hoping it would amount to nothing and probably wear away. But I slowly but surely grew worse, and at last resolved to apply to the doctors for help. My water came often, and in small quantities, and with great pain, and with red brick-dust deposit. I was attacked with severe womb trouble, bloody piles and dropsy of the ovary. I was treated by five different doctors. I was compelled to wear an inside support for a year, but it still seemed impossible for me to get well and I began to feel exceedingly alarmed and very uneasy, not knowing what course to pursue, or what the consequences might be. I had heard of Dr. Pierce, and concluded to make one more trial, so I sat down and wrote a letter to him, stating matters as near as I could, and in due time I received a favorable reply; then I commenced with his medicine. I commenced somewhere in February 1891 with the "Golden Medical Discovery" and "Favorite Prescription," in alternate doses. A strange occurrence followed. My limbs felt like what we call "asleep," and I felt as if I were in a strange land and wondered what was going to take place. I kept on till I took nine bottles. The first relief I felt was from sick headache, which I had been troubled with for many years; I was also cured of a very bad cough which I had been troubled with for many years, and of dyspepsia of long standing. I was entirely cured of a very singular and severe itching on my back, between my shoulders, which our doctor's called winter itch and which they pronounced incurable. I had suffered with this for twenty years; it would come in the winter and go away in the summer. I was also cured of the worst form of bloody piles and of womb disease. At present I feel like a new person.

When I first commenced with Dr. Pierce's medicines, I could not walk half a mile without a pain. The other day I walked to Mercersburgh post-office, a distance of twelve miles, and the next day walked back again, and felt no bad results from the Journey. I am now 51 years old.

Mrs. Knavel further writes, that "To any person desiring to know more concerning my case and its wonderful cure, and who will enclose to me a return self-addressed and stamped envelope for reply, I will be pleased to write further information."

Yours respectfully, SARAH A. KNAVEL, Indian Springs, Washington Co. Md.

BRONCHITIS AND LUNG DISEASE.

Mrs. Neal, of Crockett Mills, Tenn., had an attack of measles, followed by _bronchitis_ and _pneumonia_. Her husband writes: "I feel gratified with the effect of your wonderful medicine. I can recommend it to anybody, and feel I am doing them justice. My wife was not able to perform her household duties for six months. She has used two bottles of 'Golden Medical Discovery,' and is now able to do all her work. I think it the finest medicine in the world, and I am, gratefully,

Your life-long friend, J.B. NEAL."

BLEEDING FROM LUNGS; CHRONIC CATARRH; VERY LOW.

CURED BY SPECIAL HOME-TREATMENT

WORLD'S DISPENSARY MEDICAL ASSOCIATION: Buffalo, N.Y.:

_Gentlemen_--I was very low--almost given up by two physicians who treated me with their very best skill and did not receive much benefit. I was attacked with "La Grippe" in December, 1891, and pleurisy, and was taken with a very bad cough, which kept growing worse. The physicians prescribed Emulsion of Cod Liver Oil, but no benefit. In June, 1892, I bled from the lungs; everybody thought I would die. A friend told me to try Dr. Pierce's medicines. I did so, and after taking six months' home-treatment I was cured. When I commenced taking his treatment I only weighed 130 pounds, now I weigh 175, and can do as good a day's work as I ever could. I can cheerfully say that I believe I owe my life to his valuable medicines.

Yours truly, G. RILEY SPRINKLE, California Creek, Madison Co., N.C.

LUNG DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was troubled with my lungs and stomach for five years. I could do no work hardly until I used Dr. Pierce's Golden Medical Discovery. After using five bottles of the "Golden Medical Discovery" and three vials of the "Pleasant Pellets" I was cured, and now I am doing the work for a family of nine. I tried other medicines and nothing would do me any good, and if I had not gotten your medicine I would have been in my grave. I could not recommend it too highly for the good it did me; it is the best medicine I ever got hold of.

MRS. E.C. VAN BOSKIRK, Selin's Grove, Snyder Co.,Penn.

"COMPLETELY BROKEN DOWN"

FROM DYSPEPSIA, CATARRH, SPINAL DISEASE--NERVOUS PROSTRATION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I wish to express my heartfelt thanks to you for the wonderful cure that your special remedies performed in my case. In the Spring of 1891, I had a severe attack of La Grippe, which left me in bad shape. I consulted as good a physician as there was in the county, and he told me that I was suffering from enlargement of the heart and that I must be very careful about taking: any violent exercise, and I must not allow myself to get excited, as excitement of any kind might prove fatal. He gave me remedies for my trouble which made me feel some better; but being a farmer I was obliged to work hard and soon began to run down. I began to have spells of a terribly deathly sinking feeling at my stomach and a terrible pressure at the heart--in the region of the heart, and sometimes I would fall prostrate and although I was conscious all the time I could not speak aloud.

The last of October, 1891, while doing my chores in the morning, I had one of those bad spells and upset my lantern, which resulted in my losing my buildings by fire.

My wife was out of health at that time--she, too, was suffering from the effects of La Grippe. Having lost everything eatable for ourselves and stock, I was forced to work very hard to get through the winter. The next February, 1892, we had another attack of La Grippe, which resulted in the death of my beloved wife. The next May, this terrible affliction together with hard work completely broke me down and although I was doctoring all the time I kept steadily growing worse. I got so bad that I could not sleep more than two or three hours any night and very often I would go all night without closing my eyes at all.

The last of September, I had to give up work almost entirely. I got so that I _could not walk one-fourth of a mile without being completely exhausted_. One physician whom I consulted said I was suffering with nervous prostration and gave me medicine for it, but I got no better. My food distressed me terribly and after eating, it would sour and I would have to vomit up the most that I had eaten. At last, I got so I had to live on bread made of wheat middlings and for about three months I could not eat anything else, although it seemed as though I should starve to death. I thought I would give anything if I could eat a hearty meal of anything that I wanted, but did not dare to because every kind of food distressed me so. My bowels became badly constipated and for three months I did not have a natural operation of the bowels; and I suffered very much with catarrh, and there was such a pressure across my forehead that it seemed sometimes as though it would burst. I became very despondent. I did not want to go anywhere, neither did I want to see any one, everything looked dark and gloomy to me. When well, I was naturally or a lively disposition and a great hand to joke with my friends, but no one could say anything funny enough to get a smile out of me then. I was always very fond of music too, but I could not bear to hear a bit of music, neither vocal nor instrumental. About the first of February, 1893, some of my friends prevailed upon me to consult a physician who made a specialty of treating chronic nervous troubles; he said I had no organic trouble of the heart and that it was caused by my stomach being out of order; he said that I had a bad kidney trouble and that my spine was affected, and that unless I got help it would end in "Locomotor Ataxia." He said he could help me but it would probably take a year to cure me. He let me have a month's treatment and gave me advice in regard to diet, etc. I thought for awhile that it was helping me but soon I began to go down hill again, and as a last resort I began to take some of the cure-alls (patent) with which the country is flooded; but I soon became disgusted with them and made up my mind there was no help for me. I had to use about all the strength I had to walk; I could not lift my left foot up to step over anything--had to draw it after me; I could hardly sleep; neither could I transact any business, in fact I did not take any interest in any of my affairs. It seemed to me as though I did not have a friend on earth, and I longed for death to come to put me out of my misery.

My son, with whom I was living, had been trying for a long time to get me to send to you for treatment, but I had paid out so much money and received no benefit from it, that I did not believe there was any help for me.

At last I thought I would write you what I could of my symptoms, and get your opinion of my case, but it took me about two days to write the letter. My head felt so bad that I could not collect myself enough to describe my feelings. You wrote me that my trouble was caused by indigestion, dyspepsia, catarrh, and spinal affection, and that you could cure me, and in fact, make a new man of me if I would send for your special treatment and follow your advice. My son sent for the medicine for me. I took it and followed your directions as near as I could; the first week I could not see much of any change--the second week I could see that I was improving some, the third week I could look back and see that I had gained considerable. I could sleep better; the bloating in my bowels did not trouble me so bad; my stomach did not distress me so much and I could eat different kinds of food and my digestion seemed to be improving fast; and by using your Special Catarrh Remedy my nose began to run (it had been nearly six months that my nose was perfectly dry) and one day it felt as though something gave way in my head--it seemed to be back, in behind my eyes, and I blowed a large amount of filth out of my head that looked like the yolk of an egg, and it was nearly as thick as jelly; after that my head began to improve rapidly and I began to gain in flesh and strength, and the best of all is, I have kept right on gaining until at the present time _I feel as well as I ever did in my life_. Sleep well, can eat three hearty meals every day and digest them too, and eat anything I want, and seven days in a week.

To look back now I don't see why I did not apply to you when I was first taken sick. For about ten years ago. I had treatment of you for catarrh, liver and kidney trouble, and you helped me then; also, about eight years ago my wife had two months' treatment from you which helped her of the troubles from which she was suffering at that time. All the reasons that I can give, is, that owing to financial troubles and having to pay out so much for sickness, I could not seem to get the money (that I could spare) to pay for the treatment.

Gentlemen, I wish I could express my thanks to you for what you have done for me, but I cannot do it. I am a poor hand to express myself, but I consider my restoration to health almost a miracle, and I firmly believe that I owe my life to you, for I do not believe that I should have lived till the present time had it not been for your Special Treatment. Now, if there is any part of this letter that you would wish to publish, you are at liberty to do so: and if it would be the means of directing any suffering fellow being to a place where they can get relief, I shall be very thankful.

Respectfully, C.M. NILES, East New Portland, Somerset Co., Maine.

CATARRH, INDIGESTION, AND NERVOUSNESS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--For a long time I was suffering from indigestion, catarrh and nervousness. I was so run down that I could not go to school, and, as the various remedies I tried did me no good, I applied to you, and was advised to try a course of special treatment. After taking only two months' medicines from your noble institution, I feel perfectly restored to health. I have, moreover, recovered my lost flesh, and I am pleased to say need no further medicines.

Yours truly, E.A. BALDWIN, Proctorsville, Windsor Co., Vermont.

NASAL CATARRH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--My daughter had for many months severe nasal catarrh with sores forming on the inside of nose; if not attended promptly the sores would come out on bridge of nose and also in the corner of nose and upper lip. We had several physicians attending her, but they gave her only temporary relief. We were advised by a friend who had used your remedies to try them. After using thirteen bottles of Doctor Sage's Catarrh Remedy, and at the same time two bottles of Doctor Pierce's Golden Medical Discovery my daughter was completely cured of the dreaded disease and in the past three years has had no symptoms of the disease ever coming back. I am satisfied the above medicines will cure any kind of catarrh.

Yours truly, JOSEPH POLLAK, McPherson, McPherson Co., Kan.

CHRONIC NASAL CATARRH

RESULTED IN LUNG DISEASE. DESPAIRED OF OBTAINING RELIEF.

DR. R.V. PIERCE, 663 Main Street, Buffalo N.Y.:

_Dear Sir_--Without solicitation from you, I feel it my duty to suffering humanity, to make known the virtues of your medicine in curing catarrh. About ten years ago, I first began to realize that I was the victim of nasal catarrh; I tried every known remedy, but gradually grew worse. My ears would gather and break; nights of restlessness would succeed days of agony. The disease finally attacked my left lung, and I despaired of obtaining relief. About six years since I began the use of Dr. Sage's Catarrh Remedy, in connection with the "Golden Medical Discovery," and by the persistent use of the above remedies I feel that I am completely cured of this loathsome disease.

For attacks of biliousness, coughs and colds, I think there is nothing equal to the "Discovery," and I bless the day that I first began the use of your remedies.

Very respectfully, HOWARD J. CONVERSE, Civil Engineer, Plain City, Madison Co., Ohio.

A TERRIBLE CASE OF CATARRH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I suffered for two years with catarrh in the head, having very severe pains in the top of my head. A hunch came on the side and back of my head--my whole head and face were so sore and sensitive that a pillow of down felt hard, and I was obliged to change my position often. I could not breathe through my nose at all and was obliged to keep my bed fully one half of the time, and could not collect my thoughts to think steadily on any subject--I was really afraid of losing my reason. I got all run-down and was "out of sorts" in general; then I commenced using Dr. Sage's Catarrh Remedy and Dr. Pierce's Golden Medical Discovery. To-day my health is good and I have no catarrh.

Yours truly, MRS. JAMES LANSING, Fort Edward, Washington Co., N.Y.

CATARRH AND GENERAL DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Being an invalid for many years and trying home physicians without benefit, I went to the Invalids' Hotel and Surgical Institute, and can most highly recommend this place to all sufferers. I had a severe attack of catarrh and general debility, and after a short stay at this Institute, my whole system was toned up and I was soon enjoying perfect health.

I can truthfully say that this institution fully merits all the praise that could be given it. I never lose an opportunity to recommend all my suffering friends to the Faculty of this Association, for I believe it is in advance of its kind in the world. The physicians and surgeons are skillful and of wide experience, the nurses kind and thoughtful, the rooms large and pleasant, and everything is done to make the visit of any one pleasant as well as beneficial in the highest degree.

I do not hesitate to urge all invalids, no matter what their trouble, to place themselves under the care of the eminent physicians of this institution, being confident that they can give them all the relief that possibly can be obtained from medical treatment and skill.

Truly yours, THOMAS LEWIS, Kamas, Summit County, Utah.

CATARRH AND LIVER COMPLAINT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Dear Sirs_--After suffering for several years with nasal catarrh and liver complaint, and having become greatly reduced in health, as a last resort I placed myself in your hands for treatment My improvement began almost immediately after entering your institution. I was enabled to leave at the end of one month, having experienced great benefit. The treatment was continued at home for a few months, after which my cure was complete. At the present time, I am able for office work, and feel that I am completely cured of the catarrh and have but little if any trouble with my liver. I shall lose no opportunity to recommend your institution or your medicines to the afflicted. I do most unhesitatingly recommend chronic sufferers to visit your institution or take your remedies at home.

Sincerely yours, WILLIAM KING, Rose Bud, Pope Co., Ills.

CATARRH, BRONCHITIS, LIVER COMPLAINT AND DYSPEPSIA.

Ely, White Pine Co., Nevada.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--For ten years I was greatly afflicted with Catarrh, Bronchitis, Liver Complaint, and Dyspepsia. I tried many doctors and remedies to see if I could not obtain relief, but I grew constantly worse instead of better.

I heard much concerning the Invalids' Hotel and Surgical Institute at Buffalo. I concluded to go there and try and obtain some benefit. I staid a month in this famous Institution, and during that time made fine improvement, and when I left felt like another man.

I can truthfully recommend this world-renowned Institution to all the afflicted. The Institution itself, in all its appointments, is far in advance of the age. It is more like a home than a hospital; the rooms are large and pleasant; the table the very best; the nurses kind and considerate, and the doctors skillful and of wide experience. While there I saw and talked with a great number of people who had come to this Institution as a last resort, and they were all unanimous in their praise.

I cannot say too much in favor of the World's Dispensary Medical Association and its Staff of skilled attendants, nor can I too strongly urge all sufferers to go there, being confident that all within the power of medical science and skill can be done for them there. Would send you my photograph as requested, but there is not a photograph gallery within a hundred miles of here. Yours truly,

D.D. Phillips

BRONCHITIS; CATARRH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:

_Gentlemen_--I was troubled for several years with bronchial disease, having a severe cough a good share of the time. Some of my friends thought I had consumption; I got so weak I could scarcely walk across the floor, and raised a good deal. I commenced taking Dr. Pierce's Golden Medical Discovery and my cough soon got better, and I have not been troubled with it since. That was four years ago; I took only three bottles. I would recommend it to all having throat or lung trouble. I have also used Dr. Sage's Catarrh Remedy with equally good results. I believe that no one need suffer long with chronic catarrh who is within reach of this remedy.

Yours respectfully, MRS. LENA OSBORNE, Ripley, Chautauqua Co., N.Y.

NASAL CATARRH, LUNG DISEASE, INDIGESTION, ETC.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Five years since my family physician pronounced my case Pulmonary Consumption. Since that time I nave taken various treatments, some of which have given relief. One treatment that was administered for nasal catarrh, from which I continued to be affected, caused erosion of the mucous membrane, and destruction of the bony septum which separates the two nostrils. Took cold quite easily, suffered from considerable nasal catarrh, with discharges passing posteriorly dropping into the throat; occasional cough with some shortness of breath on exertion. A deep inspiration caused a dizzy sensation in the head; eyesight was impaired as well as the memory. After sitting for a time, and then quickly rising I suffered from blindness as well as a dizzy feeling in the head. I never felt that I was entirely cured of my lung trouble, having many of the symptoms which are common to those in the incipient stage of consumption. I also suffered from indigestion, torpidity of the liver, and constipation of the bowels.

Upon consulting at your Institution, was advised at once to begin the course of specially prepared medicines as indicated in my case. In all, I have only taken two months' special treatment, and it has now been six months since I have required any medicine; all symptoms of disease have entirely disappeared, and I desire to thank you for the interest you have taken in my case, and the treatment prescribed. I have no objection to your publishing my testimony, if by so doing others may be induced to place themselves under your care for treatment at your Institution, or have medicines sent to their homes.

Respectfully yours, H.A. MILNE, Mekinock, Grand Forks Co., North Dakota.

CONSUMPTION.

Ashland, Middlesex Co., Mass., (Box 171).

DR. E.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--It is now eight years since I took Dr. Pierce's Golden Medical Discovery. I had a very bad cough, also night-sweats, and was almost in my grave, as we thought, with consumption, when a friend of mine who died with consumption came to me in a dream and told me to take Dr. Pierce's Golden Medical Discovery, and, thank the Lord, I did so. By the time I had taken half of the first bottle I felt so much better, I kept on till I had taken three bottles, that was all I needed. I got well and strong again.

Sincerely yours, Clura McIntyre

CHRONIC NASAL CATARRH.

DR. R.V. PIERCE, NO. 663 Main St., Buffalo, N.Y.:

_Dear Sir_--I had been troubled with chronic nasal catarrh for a year; could not sleep at night or rest in the day, because I could not breathe through my nose. I tried everything I was told of, and all failed to cure. I read about Dr. Pierce's remedies and thought I would try them. I used three bottles of Dr. Pierce's Golden Medical Discovery, four of Dr. Sage's Catarrh Remedy, and I was relieved within two weeks. I continued these medicines for four weeks, and am perfectly cured. I would advise any one who is troubled with catarrh to use Dr. Pierce's medicines. I am very thankful for the remedies."

Yours respectfully, MRS. M. FLEMMING, 698 17th Ave., Milwaukee, Wis.

NASAL CATARRH AND DYSPEPSIA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Twenty years ago I was nearly dead with nasal catarrh. I had it several years before I knew what it was, then I read Dr. Pierce's description of catarrh. I felt as he described. No one else had ever been able to tell me anything of the symptoms he described. I simply concluded that if he could so minutely describe, he could also relieve, and I immediately placed myself under his treatment--by correspondence. In a few months I was entirely relieved and have not suffered from it since.

At the time I placed myself under his care I could not breathe with my mouth closed. My friends thought I could live only a few months more. I have had no return of catarrh and enjoy good health. I believe Dr. Pierce's treatment will cure any case of catarrh.

Nine years ago I was under Dr. Pierce's treatment (by correspondence) for dyspepsia. After a few months' treatment I was entirely cured of that terrible disease.

Yours respectfully, MRS. HENRY NUCKOLLS, Rockville, Hanover County, Va.

CATARRH OF TWENTY YEARS' STANDING.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--My catarrh was of about twenty years' standing; my left nostril closed, I could not breathe through it; had a constant pain above my left eye night and day. I commenced using Dr. Sage's Catarrh Remedy, at the same time using the "Golden Medical Discovery"; I used one package and one bottle of "Golden Medical Discovery" and I found great relief; after using the second I thought all was right, but I began to feel the effects of it again, so I got the third and fourth packages, and I am satisfied I am rid of it. Since I commenced using your medicines, I have taken six bottles of Dr. Pierce's Golden Medical Discovery.

Yours respectfully, JOHN WEAVER, West Carrollton, Montgomery Co., Ohio.

CHRONIC NASAL CATARRH CAUSES GREAT SUFFERING.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I had been a great sufferer from nasal catarrh for a number of years which greatly debilitated my system, and in consequence, have been in poor health for the last five years.

Slight exposure would cause bronchial trouble, but kept up under it until a little more than two years ago when I was taken with "La Grippe," which greatly aggravated my other troubles; and for more than six months before consulting you was scarcely able to do anything; _could not breathe through my nostrils_ only a little while at a time either day or night; I suffered _dreadfully_, having at times _terrible pains in my head_ being unable to sleep some nights more than two hours and then not without dreaming, and when I awoke my head felt worse then when I retired. Had indigestion, chronic constipation and stomach trouble.

A little more than a year ago, while reading in one of your Memorandum Books I decided to try your Dr. Pierce's Golden Medical Discovery, "Favorite Prescription" and "Pellets;" and after using several bottles, I began to get better and to get some strength, but my catarrh remained about the same until I consulted you by letter and the remedy prescribed proved effectual; after three months' treatment, I am able to do most of my house work.

Yours respectfully, MRS. SARA M. CROCKER. P.O. Box 332. Niantic, New London Co., Ct.

CHRONIC NASAL CATARRH.

THOUGHT HIS CASE HOPELESS--TWO BOTTLES CURE.

WORLD'S DISPENSARY-MEDICAL ASSOCIATION, Buffalo, N.Y.:

It gives me great pleasure to testify to the merits of Dr. Sage's Catarrh Remedy. I can say honestly and candidly that it is the grandest medicine ever compounded for catarrh. I suffered terribly with that dreadful disease and thought my case a hopeless one. I have expended on my case about forty dollars for different remedies guaranteed to cure catarrh in its worst form, but received no benefit therefrom. I also received treatment from two physicians, but they did me no good. Having read a great deal about Dr. Sage's Catarrh Remedy, I concluded to try it. The first bottle gave the most pleasing results, and the second bottle completely cured my case, which I considered hopeless. I most heartily recommend Dr. Sage's Catarrh Remedy to all suffering from catarrh, with the assurance that it will surely cure. It is a great boon to suffering humanity. Hoping that this humble testimony may be the means of leading many sufferers to try your most valuable medicine with the same happy results as I experienced, and wishing you the best of success, I am,

Yours sincerely, AUGUST G. MEISE, Vincennes, Ind.

NASAL CATARRH.

Naples, Uinta Co., Utah.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I have been using Dr. Sage's Catarrh Remedy and have been taking "Golden Medical Discovery" since I last wrote to you. I am well pleased with the result. I feel better than I have for years. The "Golden Medical Discovery" caused a very unpleasant sensation to pass through my body at first but I do not feel it much now. I have recommended it to others and the only complaint I hear now is that our druggist cannot keep a supply on hand.

I take pleasure in reporting my case to you, and I feel that the interest you have taken in my case has been a blessing unto me.

My mother has suffered with bad legs for over twenty years and last fall they got so bad she was unable to walk. She has taken "Golden Medical Discovery" all winter and is now able to walk a little. She says she feels better in body than she has for years. She has spent the most of her life among the sick and speaks very highly of your medicines.

Yours truly, Geo A. Slough

IMPURE BLOOD AND CATARRH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:

_Gentlemen_--My health is better now than it has been in ten years. I used six bottles of "Golden Medical Discovery," and three bottles Doctor Sage's Catarrh Remedy, and since using your medicines I have been able to do more work than before. I have been teaching school since my health got better and last year I was able to travel and preach fifty-nine sermons, besides my work of teaching.

For four years I suffered with catarrh in my head, and impure blood, until my health was very feeble. Dr. Pierce's Golden Medical Discovery I found to be the best blood-purifier I ever used. Had I not used your remedies I believe that I would have been dead to-day, or at least not able to say anything. But instead of that I am able to walk one and one-half miles and teach school every day.

Yours truly, REV. J.H. TATE, Wahoo, Sullivan Co., Tenn.

CATARRH AND DYSPEPSIA

CURED BY SPECIAL HOME-TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am happy to inform you that my catarrh and dyspeptic symptoms have all vanished. I am no longer troubled with headache and stoppage of the nose, my stomach is in good order, and I enjoy three hearty meals daily without any bad feelings.

I have gained in almost every respect, particularly in weight and strength, since beginning the use of your specially prepared medicines. By continuing to follow your special hygienic rules, I believe no relapse will occur.

Yours respectfully, BERTHOLD EBERHARDT, N.E. Cor. 10th and Callowhill Streets, Philadelphia, Pa.

NASAL CATARRH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I have used your Dr. Sage's Catarrh Remedy and Dr. R.V. Pierce's Golden Medical Discovery and they cured me of a severe Catarrh in the Head. I can honestly recommend them to all who may suffer from that distressing disease.

Yours truly. M.D. INGRAM, Ingram, Bell Co., Ky.

Mr. Ingram had suffered for many years from the most distressing symptoms, such as profuse offensive discharge from nose, stopping up of nose, sneezing, weak eyes and frequent headache.

CHRONIC NASAL CATARRH AND LUNG DISEASE.

Marlow, Baldwin Co., Ala.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I had catarrh in the head for years, and trouble with my left lung at the same time. You put so much faith in your remedies that I concluded to try one bottle or two, and I derived much benefit therefrom. I used up three bottles of Dr. Sage's Catarrh Remedy, five bottles of your "Golden Medical Discovery," and in four months I was myself again. I could not sleep on my left side, and now I can sleep and eat heartily. So long as I have your medicines on hand I have no need of a doctor; I do not think my house in order without them.

Yours truly, A.H. Heard

A DEBT OF GRATITUDE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Some ten years ago I suffered untold agony from chronic nasal catarrh. My family physician gave me up as incurable, and said I must die. At this time I weighed 110 pounds. My case was such a bad one, that every day, towards sunset, my voice would become so hoarse I could barely speak above a whisper. In the morning my coughing and clearing of my throat would almost strangle me. By the use of Dr. Sage's Catarrh Remedy in three months I was a well man; the cure has been permanent, and I now weigh 148 pounds.

Yours truly, PROF. W. HAUSNER, Ithaca, Tompkins Co., N.Y.

CATARRH, DEAFNESS AND OTHER COMPLICATIONS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I take pleasure in announcing to you that I have been greatly benefited by your medicines; my trouble began with nasal catarrh and extended to my throat and ears; my bowels were inactive and my general health became impaired; my worst trouble, however, was dullness of hearing. I had an uncomfortable, bad feeling in my ears--akin to earache; I had a watery discharge from the nose; I had to hawk and spit a great deal at times; my mind was greatly affected also and had a great deal of pain in the head. Upon advice of friends to try your medicines I resolved to do so. Have used six bottles of your "Golden Medical Discovery" and two bottles of Sage's Catarrh Remedy. The pain in my head is gone and my health is greatly improved and am working every day, something I could not do before. My appetite is good.

Yours truly, MORRIS C. WEAVER, No. 171 E. Genesee St., Buffalo, N.Y.

BRONCHIAL DISEASE.

Clifford, Susquehanna Co., Penna.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--The doctors said I had bronchitis, and I doctored with five different physicians before taking your medicines. My throat would bleed from three to five times a day--half a dozen mouthfuls perhaps--as fresh as if you had cut your finger, and I was in a generally weakened state although able to be about the house, but the least exertion would make me tremble. Finally I purchased one of Dr. Pierce's Common Sense Medical Advisers, and read it a good deal, and so was induced to take your medicines. I took in all seven bottles of the "Golden Medical Discovery," one of the "Favorite Prescription," and one bottle of Dr. Sage's Catarrh Remedy, and some of the "Pellets," and they did everything for me--more than anything else I ever tried. In about six months' time I was well. Now, my throat does not trouble me unless I take cold. It has been about six years since I took your medicines, and I think they cured me.

I think there are no medicines equal to your medicines, and would recommend them to all suffering ones.

Yours truly, Mrs. Lewis Johnson

CATARRH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I had the catarrh in the head for about fifteen years; my head was always stopped up and I had pains almost constantly. My nose would run, and stuff would fall into my throat whenever I would lie down, and at other times it seemed dry and crusty, and then my head would become stopped up and I would suffer again.

I used cubebs and glycerine for a long time; they only relieved me while I was using them. I used several other kinds of stuff, but I received no benefit from them. I had nearly given up in despair. At last I came across one of your advertisements of Dr. Sage's Catarrh Remedy in one of your Memorandum Books, and I thought I would try it. It is the grandest thing on earth. I was thankful to God I found something at last to stop my suffering. May God bless you, dear friends, for saving my life.

I used your medicine about eight weeks: it only took two bottles to cure me sound and well after all the rest had failed.

Yours truly, DAVID MINER, Bridgeport, Marion Co., Ind.

CHRONIC NASAL CATARRH.

HALF A DOZEN BOTTLES OF DR. SAGE'S CATARRH REMEDY WITH DR. PIERCE'S GOLDEN MEDICAL DISCOVERY CURES PERMANENTLY A BAD CASE OF CHRONIC NASAL CATARRH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.:

_Gentlemen_--I was suffering from chronic catarrh, and bought a half-dozen bottles of your Dr. Sage's Catarrh Remedy, also some of Dr. Pierce's Golden Medical Discovery to purify my blood and I am happy to say I am permanently cured of that disease.

Years after this letter was written Mr. Hodges informs us that his cure has remained permanent.

Yours truly, N.M. HODGES, Laketown, Rich Co., Utah.

CHRONIC NASAL CATARRH. STARTED WITH LA GRIPPE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I think it is time I reported my case to you, as it is five months since I began using your medicines. I have taken five bottles of Dr. Sage's Catarrh Remedy, and used it with Dr. Pierce's Golden Medical Discovery. I have no signs of catarrh now, and can say I never felt better in my life, then while taking your medicine. Two years later Mr. Thomas says: I nave not been troubled with catarrh since taking the "Catarrh Remedy." I am a tenor singer and my voice almost left me when I had the catarrh but now my voice has come back. Yours respectfully,

E.W. THOMAS, Box 18, Garden City, Miss.

CATARRH AND OTHER COMPLICATIONS.

North Berne, Fairfield Co., Ohio.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--My health is good. I am restored from weak eyes, weak stomach, catarrh, also female trouble. I took two bottles of Dr. Pierce's Golden Medical Discovery, one bottle of Dr. Sage's Catarrh Remedy. It took wonderful effect. I have recommended your medicines a great deal, and have done a great deal of work for you. I have been the cause of selling quite a quantity of medicine in this county, and I will do all I can for you.

Yours truly, Sarah Campfield

CATARRH OF EIGHT YEARS' STANDING.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I write this to let you know that I am well of that disease called catarrh of the head. Three years ago this fall I had catarrh in its worst form, till from three gills to one and one-half pints of corruption would be expectorated in twenty-four hours.

Then I noticed your advertisement. Six months after taking your medicines I thought it too soon to tell you, but I can now say that my money was well spent in buying your medicine, for it resulted in a permanent cure. The catarrh was of eight years' standing.

Yours respectfully, EDWARD M. BAILEY, Taggart, Harrison Co., Mo.

DREADFUL COUGH. ABSCESS OF LUNG.

Brookeland, Sabine Co., Texas.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Seven years ago I was on the verge of the grave, with what the physician pronounced an abscess of the right lung. It lingered on for three years. During that time my side discharged large quantities of pus and I had a dreadful cough. I was so weak that I could not walk fifty yards without being completely exhausted. I had taken every kind of medicine that was recommended for similar maladies, such as cod liver oil, sarsaparillas, iron tonic and syrup of hypophosphites, without any relief. I was about discouraged when I commenced taking Dr. Pierce's Golden Medical Discovery. I took six bottles and it completely restored me to health. The discharge stopped from my side, and the cough has ceased. I am now able to follow my profession, which is a teacher of penmanship. I can walk ten miles any day without the least worry. If any one doubts this statement they can write me and I will verify the above statement.

Trusting that this may be the means of assisting some one else who is suffering untold miseries, as I did before using the "G.M.D."

I am, fraternally thine, F. Berryman, Jr.

CATARRHAL DEAFNESS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was nearly deaf on the right side of my head. I used three or four bottles of Dr. Pierce's Golden Medical Discovery and four bottles of Dr. Sage's Catarrh Remedy with the Nasal Douche, in the first trial. Cold weather coming on I had to stop, as I could not use the Injector in freezing weather, but I was greatly benefited. Along towards spring I found it was coming back, from taking cold, and, after several trials of other remedies, I again began the use of your medicines, taking two bottles of the "Golden Medical Discovery" and three bottles of Dr. Sage's Catarrh Remedy, and I feel safe in believing I am cured as I feel no signs of its return. My health is very good for a man of 74 years of age and I am satisfied that Dr. Pierce's Medicines did it. I recommend them whenever I have a chance.

Yours respectfully, S.P. GRAY, Graham, Nodaway Co., Mo.

BRONCHITIS. LIVER COMPLAINT.

318 E. 83rd St., New York City, N.Y.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am extremely sorry not to have informed you sooner of the magnificent result I obtained from your most valuable medicines. When, sometime ago, I consulted you in regard to my affliction, bronchitis, I was indeed fearing the worst. But I had so much confidence in your medicines, which I had previously used for colds and liver complaint with good results, that I strictly followed your kind advice and continued taking it until I was assured of perfect health. I took five bottles of your Dr. Pierce's Golden Medical Discovery, using the "Pellets" combined as directed, and _the effect was magical_. I am now healthy and hearty. Heartily thanking you for your kind advice and assistance, I remain, gentlemen.

Yours most respectfully, Paolo Bedesing

LINGERING COUGH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.

_Gentlemen_--I contracted a cough during the winter of 1889 and tried many different kinds of cough medicines, but none did me any good. I at last became alarmed, and wrote to Dr. R.V. Pierce to know if he could prepare a medicine that would cure me, and I was advised to try his "Golden Medical Discovery," which I did, and am glad to say that only two bottles cured me after letting the cough run on from the winter of 1889 until the spring of 1893.

Yours respectfully, MORGAN. C. LILLY, Holston, Washington Co., Va.

NERVOUS DEBILITY AND CATARRH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I have enjoyed good health since I took your treatment. I suffered intense agony for five months, and after taking one month's medicine I found very much relief--so much I was surprised.

Many thanks for the good your medicines have done me, and my prayers are that God may help you in your good work, and that you may live long and prosper.

Yours respectfully, MRS. ALICE HOFFMAN, Box 183, Clarksville, Butler Co., Iowa.

NERVOUS DEBILITY AND CATARRH.

Big Piney, Pulaski Co., Mo.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was treated by you eleven years ago for nervous debility and chronic catarrh of eight years' standing and of a very aggravated nature. I was considered near my grave by many of my friends when I commenced treatment.

I used eight months' special treatment, after while I used some 12 or 15 bottles of your Sage's Catarrh Remedy, and have had excellent health ever since.

Yours truly, B.P. Dake.

CURE OF DEAFNESS DUE TO CATARRH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--For several years I was troubled with catarrh and deafness of the right ear--the hearing becoming more and more defective until I could scarcely hear at all. There was a constant ringing, roaring noise in my ear, and finally the disease assumed a very painful form.

The ear became very sensitive to the touch, and the pain and inflammation extended into the eustachian tube and down into the throat. I could scarcely sleep at night, and during the day I suffered constantly.

I finally decided to consult Dr. Pierce, and acting under his advice, I began the use of "Golden Medical Discovery" and Sage's Catarrh Remedy by means of Dr. Pierce's Nasal Douche.

I soon began to improve and after using three bottles each of the above named remedies the pain and soreness left my ear, my hearing returned and I considered myself completely cured, and indeed there has been no recurrence of the trouble since.

Sincerely yours, T.J. WILLIAMS, Byrneville, Harrison Co., Ind.

ASTHMA AND CATARRH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--For some months I suffered from a shortness of breath and dryness in the throat which usually came on at night, and these symptoms gradually became aggravated until it was impossible for me to procure enough sleep so that I could perform my daily duties about the farm. Deriving no relief from such treatment as I was taking I came to your Institution, was examined by your specialist, who pronounced my case asthma, complicated with nasal catarrh. After using the special medicines which he prepared for me for a few days I commenced to feel better, the shortness of breath gradually disappearing; the paroxysms of asthma were less frequent and not so severe.

After taking only two months' treatment I was completely restored to my previous good health, and for five months it has not been necessary for me to use any medicine, and I feel that I am perfectly well. I give you this testimonial in order that others who are similarly afflicted may know of your skill in treating cases of this nature, and seek relief from your Institution.

Respectfully, GOTTLIEB BERNER, Cheektowaga, Erie Co., N.Y.

ASTHMA COMPLICATED WITH BRONCHITIS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--It is five weeks to-day since I was at your place for medical treatment for a bronchial and asthmatic difficulty; it had got so bad that it was hard work for me to breathe if I moved around any; I have sat up many a night for when I laid down I could not get my breath. I had six different doctors to aid me--all the good they did me was to get my money. Can say, of a truth, that you have done mo more good than all other doctors. One doctor said I would not live two years; that is four years ago and I am yet alive. I am sure I am now on the safe road to recovery with your treatment.

Yours, etc., T.E. STANTON, Manlius, Onondaga Co., N.Y.

ASTHMA, OR PHTHISIC.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--In gratitude to yourselves as well as to give my fellow sufferers the benefit of my experience I wish to say, that immediately after receiving your courteous reply to my letter, describing the difficulty in breathing after any extra exertion, I began taking Dr. Pierce's Golden Medical Discovery, and before I had finished the first bottle I was greatly relieved.

I have taken less than one-half dozen bottles, and although the disease was of about three years' standing, I can now do as big a day's work as any of my neighbors and as many of them, for all of which I am indebted to the "Golden Medical Discovery."

Yours respectfully, AVERY F. BUTTLES. Norden, Keyapaha County, Nebr.

NASAL POLYPI.

WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--It is with pleasure that I can testify to your skillful operation in removing a number of nasal tumors.

I had been a great sufferer from acute headaches, caused by the tumors, for years.

I cannot speak too highly of the benefit I received at your Institution the two months I stayed with you. I feel sure of a permanent cure as I do not have the headaches as formerly.

Yours respectfully, GEORGE H. BAILEY, Hinsdale, Cheshire Co., N.H.

ASTHMA CURED.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

Gentlemen--My wife was afflicted with asthma for twenty years: as she grew older she grew worse. Her case was treated by three eminent doctors, but all failed; they told me there was no cure for it. Discouraged as I was, I resolved to try Dr. Pierce's Golden Medical Discovery; she used five bottles and two vials of your "Pleasant Pellets," which has made a permanent cure. She has gained twenty pounds in weight since the cure was effected.

Yours truly, D.R. KYKER, English, Cocke Co., Tenn.

COMPLICATION OF DISEASES.

A GRATEFUL PATIENT'S WORDS OF PRAISE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main Street, Buffalo, N.Y.

_Gentlemen_--Having been in your Institution as a sufferer from two distinct chronic diseases of years' standing, and having been placed under the charge of your specialists, I was speedily relieved of my afflictions. The Invalids' Hotel is a place as much like home as it is possible for such an institution to be. The physicians and surgeons are all expert specialists and thoroughly efficient; the nurses are very competent, attentive and kind; and, in fact, the whole _personnel_ of the Invalids' Hotel endeavor to do their best to make the patients feel like being at home. I always felt while there as if I was one of the family. I gladly recommend your Institution to all persons who are afflicted with any kind of chronic disease, for from my own experience I _know_ the professional staff will do all which they promise to do. Please accept my thanks for the speedy benefits and perfect cure of my diseases, and I think your Institution is worthy of the highest endorsement.

Yours truly, WILLIAM HENKEL, No. 1917 Congress Street, St. Louis, Mo.

LUNG TROUBLE.

WORLD'S DISPENSARY MEDICAL ASS'N, Buffalo, N.Y.:

_Gentlemen_--When I commenced taking your medicines, eighteen months ago, my health was completely broken down. At times I could not even walk across the room, without pains in my chest. The doctor who attended me said I had lung-trouble and that I would never be well again. At last I concluded to try Dr. Pierce's medicines. I bought a bottle of "Golden Medical Discovery," took it and soon commenced to feel a little better, then you directed me to take both the "Golden Medical Discovery" and the "Favorite Prescription," which I did. Altogether I have taken eighteen bottles of "Golden Medical Discovery," twelve of the "Favorite Prescription" and five vials of "Pellets." I am now almost entirely well and do all my work without any pain whatever, and can _run_ with more ease than I could formerly _walk_.

Yours truly, MRS. CORA L. SUNDERLAND, Chaneyville, Calvert Co., Md.

ASTHMA, OR PHTHISIC.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--For six or seven years I have been a great sufferer from asthma, being for weeks so I had to sit in my chair night and day; and to all people suffering with the disease, I am glad to recommend your medicines of which I have taken only a few bottles. I now call myself cured, for I have not had asthma for a long time.

Yours respectfully, MRS. EMILY OWEN, Hinsdale, Cheshire Co., N.H.

NERVOUS PROSTRATION FOLLOWING GRIP.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--In January of '90 took the "grippe," went to work before I was well, was caught in a rain which gave me a very bad relapse, resulting in lung fever and complete prostration; was on my bed two months, and when I did get out, the strength to walk any more than just a few rods did not come back. My family doctor and two prominent physicians of Sioux City, did me no good. Late in the fall I got a bottle of Dr. Pierce's Golden Medical Discovery, which quieted my trembling nerves and gave me an appetite to eat. I then concluded to try the Doctor, personally. Up to this time I was in a pitiable condition. Sometimes I could not sleep until I felt almost wild, then sleep so much I would be stupefied. I could not digest any food and my whole system was wasting and failing fast. I doubt if any one who saw me expected me to get well. I took the treatment sent me by the World's Dispensary Medical Association for more than a year. The medicine never gave me any distress as other medicines had done before. I began to improve from the start, but the change from one extreme to the other was like the growth of a child.

To any one suffering from nervous prostration I would say, "don't be impatient." It takes a long time for weakened nerves to grow strong. I have at last become strong and well, thanks to the Giver of all good and the grand Institution at Buffalo. I nave since married a noble-hearted young woman, and when I am playing with our sweet, healthy, baby girl, I give way to the thought that at last the long, Bad chapter of my life is ended; at such times her merry laugh sounds like a song of triumph of life over death.

Gratefully yours, W.S. NICHOLSON, Willow Creek, Clay Co., Iowa.

* * * * *

DISEASES OF THE HEART.

Diseases of the heart are classified as either _functional_ or _organic_ We shall dwell only briefly upon purely _functional_ derangements of the heart; as _increased_, or excited action, _defective_, or enfeebled action, and _irregular_ action.

Increased action of the heart, indicated by palpitation, or increased number of the beats, may be caused _mechanically_, as by distention of the stomach, which, by preventing the descent of the diaphragm, excites the action of this organ. Or it may be a _sympathetic_ disturbance produced through the nervous system; thus the emotions and passions may suddenly arouse the heart to excessive action; or the presence of worms in the intestines, improper food, and masturbation, may be the cause. The use of tea, tobacco, and alcoholic drinks excites the heart. We have found that the excessive use of tobacco is very frequently the cause of functional derangement of this organ. Deficiency of the blood, as in anæmia, may be the cause of palpitation of the heart.

Functional disturbance of the heart's action is manifested by palpitation, irregularity, intermissions, a rolling or tumbling movement, and a feeling as if the heart were in the throat. These symptoms often give rise to great apprehension, anxiety, fear, and depression of mind.

TREATMENT. The curative treatment of functional derangement of the heart must have reference to the causes producing it. If it is in consequence of indigestion, the appetite and digestion should be improved by observing regularity in the time of taking the meals, and eating very easily-digested food. The use of strong tea, coffee, tobacco, and spirits, should be interdicted, and regular exercise, rest, and sleep should be enjoined.

In all cases, the domestic management should include daily bathing, exercise in the open air, regular habits, and the avoidance of all causes which tend to excite the heart's irregularity.

_The remedial treatment_ of these functional affections ought to be confided to some experienced physician, as the remedies are not within the ordinary reach of all families, nor if they were, would they have sufficient experience and knowledge to select and properly administer them.

ORGANIC DISEASE OF THE HEART.

By organic disease we mean disease pertaining to the structure of the heart itself, in contradistinction to _functional_ disease, which has reference merely to the _action_ of the heart. The heart is subject to various organic diseases, but we have only space to consider, in the briefest manner, those which are the most common. It is essential that the reader should have some knowledge of the anatomy and functions of the various parts of the heart in order that its diseases and their effects may be comprehended; therefore the anatomy and physiology of this organ, given in Part I, Chapter VII, of this work, should be carefully studied.

It is very evident that any disease which affects the structure and function of any part of the heart must, necessarily, give rise to certain modifications of the pulse, sounds, etc. It is through the observation and study of these modifications and changes that we arrive at a correct diagnosis as to the precise location and character of the disease.

Until within comparatively recent years, physicians were very much in the dark regarding diseases of the heart. Now, however, with a thorough knowledge of the anatomy, physiology, and pathology of the heart and the parts surrounding it, and with the aid of instruments which modern ingenuity has given us, we are able to diagnosticate with precision the slightest lesions of any part of this important organ, and, knowing their nature, to map out an appropriate course of treatment. With the aid of the stethoscope, invented by Laennec and improved upon by Camman, we are able to distinguish the slightest deviation from the normal sounds, and, by noting the character of the sound, the time when it occurs, the area over which It is heard most distinctly, and the direction in which it is transmitted, to locate the lesion which produces it. By the aid of the sphygmograph, first invented by Herrisson, and afterward improved upon by Ludwig, Vierordt, Marey, and lastly by Pond, of our own country, the pulsations at the wrist are registered, and thus made perceptible to the eye.

We herewith give a cut, Fig. 1, of Pond's instrument, and two tracings made by it. The first is a healthy tracing, and the second indicates enlargement, technically called hypertrophy, of the heart

PERICARDITIS, or inflammation of the membranous sac which surrounds the heart, may be either acute or chronic. The symptoms in acute pericarditis are made up from co-existing affections, and are frequently associated with articular rheumatism, Bright's disease of the kidneys, or pleuritis The intensity of the pain varies in different individuals. The action of the heart is increased, the pulse is quick, and vomiting sometimes takes place. When this disease is developed in the course of rheumatism, it is known as rheumatic pericarditis, and is almost always associated with endocarditis. In some cases acute pericarditis is very distressing, in others it is mild. The fatality is not due so much to the disease itself, as to co-existing affections. When it does not prove fatal, it sometimes becomes chronic.

In chronic pericarditis, pain is seldom present. The heart is generally more or less enlarged, its sounds are feeble, the first being weaker than the second.

ENDOCARDITIS, or inflammation of the membrane lining the cavities of the heart, is one of the most frequent forms of heart disease. It is almost invariably associated with acute rheumatism, or some of the eruptive fevers, as small-pox, scarlet fever, etc., and is due to the irritation of the unhealthy blood passing through the heart. The disease is generally attended with little or no pain, and, consequently, if the attending physician be not on the alert, it will escape his observation. When associated with acute rheumatism, the disease is only in rare instances directly fatal, but in the great majority of cases it leaves permanent organic changes, which sooner or later develop into valvular affections, and these may eventually destroy life. When the disease occurs, however, as the result of pyæmia (blood-poisoning produced by the absorption of decomposing pus or "matter") or of diphtheria, or when it is associated with any other septic conditions, it constitutes a very grave element. Collections of matter formed on the membrane lining the heart and covering its valves, are liable to be detached and carried by the circulation to the brain, spleen, or liver, where they plug up some artery, and thus cause death of the parts which it supplies with blood.

Chronic endocarditis generally occurs in rheumatic subjects, unassociated with any acute disease, It may exist without any marked symptoms, except, perhaps, a sense of oppression and uneasiness in the chest, with palpitation. It produces a thickening and hardening of the membrane lining the heart, and generally causes a retraction, adhesion, and degeneration of some of the valves of the heart, thus bringing on valvular disease.

VALVULAR LESIONS are, as we have seen, very frequently the result of endocarditis. They are of two kinds. First, those which prevent the valves from flapping back close to the walls of the ventricles, or arteries, thus diminishing, to a greater or lesser extent, the size of the valvular orifices, and offering an obstruction to the free flow of blood through them; and which consist of a thickening and retraction, or adhesion of the valves, chalky deposits, morbid growths, etc. Secondly, those which prevent complete closure of the valves, and thus permit a return of the blood into the cavity from which it has just been expelled. These latter consist of retractions, perforations, and partial detachments of the valves, chalky deposits around the base of the valves and in them, and rupture of the chordæ tendineæ.

These two forms of lesions are usually co-existent, one generally being more extensive than the other. Thus, the regurgitation may be slight, and the obstruction great, or _vice versa_. The symptoms and disturbance of the circulation are altogether dependent upon the location and form of the lesion, or lesions. Each valvular lesion has its characteristic sound, or murmur, which is heard at a particular period in the cycle of the heart's action, and it is, as before stated, from these sounds, from tracings of the pulse, and from the many other indications, that we arrive at a diagnosis. Thus, in obstruction of the orifice at the junction of the aorta with the left ventricle, one of the most frequent of valvular lesions, a murmur, generally harsh in character, is heard with the first sound of the heart, with greatest intensity directly over the normal position or the aortic semilunar valves. This is conveyed along the large arteries, and may be heard, less distinctly, over the carotids. In the sphygmographic tracing, the line of ascent is less abrupt than in the normal tracing (Fig. 2), and not nearly so high, and it is rounded at the top. In aortic regurgitation, the line of ascent is similar to that of the healthy tracing, but the line of descent is very sudden. The left side of the heart is almost invariably the primary seat of these affections, but in the latter stages of their course, the right side also is liable to become involved, and, as a consequence, there then exists great disturbance of the venous circulation, with a damming back of the blood in the veins, and passive congestion of the liver, kidneys and brain, followed by dropsy, albumen in the urine, etc.

HYPERTROPHY OF THE HEART consists of a thickening of the muscular walls of this organ. It may be confined to one portion of the heart, or it may affect the entire organ. The affection has been divided into the following three forms: _Simple hypertrophy_, in which there is an increase in the thickness of the walls of the heart, without any augmentation in the capacity of the cavities, and which is usually the result of chronic Bright's disease, or great intemperance; _eccentric hypertrophy_, in which there is an increase in the thickness of the walls of the heart, together with increase in the capacity of the cavities, and which is generally the result of some valvular lesion; and _concentric hypertrophy_, in which there is an increase in the thickness of the walls of the heart, with a decrease in the capacity of the cavities. Valvular lesions, obstructions in the large arteries, or, in fact, any thing which calls upon the heart to constantly perform an undue amount of labor must, necessarily, produce hypertrophy of its muscular walls, just as the undue amount of labor which the blacksmith's arm is called upon to perform produces hypertrophy of its muscles. With this condition, the pulse is hard and incompressible, and the line of ascent in the sphygmographic tracing (Fig. 3) is higher than in health.

DILATATION OF THE HEART is a condition which is closely allied to hypertrophy of the heart, and which consists of an increase in the capacity of the cavities of the heart, with diminished contractile power. In simple dilatation, there is an increase in the capacities of the cavities, without any marked change in the walls of the organ. It is usually the result of some disease which has produced great muscular prostration, and which has interfered materially with nutrition. More frequently, however, dilatation is the result of valvular lesions, and is associated with hypertrophy, there being an increase in the thickness of the walls with a diminution of the contractile power. The hypertrophy from valvular lesions goes on increasing until it reaches a certain stage, when dilatation commences, the two conditions then being associated.

ATROPHY of the heart is the opposite to hypertrophy, and signifies a wasting away of the muscular substance, and a diminution in the thickness of the walls of the heart. Its power is diminished in proportion to the degree of atrophy.

FATTY DEGENERATION of the heart consists in the deposition of particles of fat within the _sarcolemma_ (the sheath which invests the fibrils), which are substituted for the proper muscular tissue. If the fatty degeneration exists to any extent the muscular walls present a yellowish color, and the heart is soft and flabby. This may be confined to one ventricle, or it may affect the inner layer of fibres, the outer layer remaining unchanged. Degeneration of the left ventricle occasions feebleness of the pulse. Difficulty in breathing is one symptom of this disease, especially when the right ventricle is affected. There is pallor, feeble circulation, cold extremities, and frequently dropsy. Fatty degeneration is more liable to occur in corpulent persons, and between the ages of forty and fifty years.

ANGINA PECTORIS, also termed _neuralgia of the heart_, might be included among the diseases of the nervous system, but as it is usually associated with a derangement in the action of the heart, it may be properly considered in this connection. The pain varies in intensity, sometimes being very acute, at others assuming a milder form. The action of the heart is more or less disturbed. The beats are irregular, at times being strong, while again they are feeble. A feeling of numbness is experienced in those parts to which the pain penetrates. These paroxysms _usually_ continue but a few minutes, although they sometimes last several hours. Persons suffering from angina pectoris are liable to sudden death. It is connected with ossification, or other organic changes of the heart. Usually these paroxysms, if the life of the patient continues, become more and more frequent. The danger is not to be measured by the intensity of the pain, but by the co-existing organic disease. Although it is not absolutely certain that organic disease is present in all cases of angina pectoris, yet the exceptions are so rare that when the signs of organic disease cannot be detected, it may be inferred that angina is not the real affection, or that the existing lesions escape observation. Those who suffer from this disease are, in the great majority of cases, of the male sex, and rarely under the age of forty.

TREATMENT. In the foregoing consideration of organic diseases of the heart, we have omitted to speak of their remedial management, for the obvious reason that unprofessional readers are unable to correctly distinguish between the various diseases of this vital organ; and it would, therefore, be useless for us to attempt to instruct them as to the medicinal treatment of the different cardiac affections.

In the vast majority of instances, diseases of the heart are not necessarily speedily fatal. Persons have been known to live twenty years or more with very extensive organic disease of this organ.

It is _very important_, however, that a correct diagnosis be made in the early stages of these diseases, in order that an appropriate course of hygiene and treatment may be adopted, which will check their progress. While we cannot cure extensive organic diseases of the heart, we _can_ check their progress, and prolong life, and render the condition of the subject comparatively comfortable. Since we are able to diagnosticate with the utmost precision the various affections of the heart, and since the discovery of certain specific medicines which exert most beneficial effects, we are enabled to treat this class of maladies with the most gratifying results. Thus we have seen a case in a very advanced stage of the disease, with the breathing so difficult that the subject had been compelled to remain almost constantly in the sitting posture, in the greatest agony, for so long a time that immense bed sores had formed on the seat; in which the dropsy had become so extensive that the skin of the legs had burst open; and yet this patient, through the influence of a specific course of treatment, was speedily relieved, and enabled to live in a comparatively comfortable condition for many months.

One afflicted with heart disease should abstain from the use of all kinds of stimulants, tobacco, and whatever tends to lower vitality. His life should be an even one, free from all excitement of any kind whatsoever. He should avoid severe physical exertion, and everything which causes the heart to beat with undue frequency.

There are certain symptoms, the result of _chlorosis_ (the green sickness), a deficiency of blood, dyspepsia, uterine disease, and certain nervous affections, which may simulate those of real organic disease, but the physician of education and experience, with a trained ear, is able to detect the difference speedily.

SORE MOUTH. (STOMATITIS.)

Stomatitis, or inflammation of the mucous membrane of the mouth, may include the entire surface of the gums, tongue, and cheeks, or appear only in spots. Vesicles are formed, having swollen edges and a white or yellow center, which finally ulcerate. When mild, the affection is confined to these parts.

If the inflammation is acute, the mouth is dry and parched, or as is more frequently the case, the flow of saliva is abundant and acrid, and, when swallowed, irritates the stomach and bowels, producing fever, diarrhea, griping pains, and flatulency. The tongue is either coated white or red, and is glossy, and the sense of taste is considerably impaired. Digestion and nutrition are then disturbed, and the patient becomes rapidly emaciated.

THRUSH, OR CANKER, is that form of stomatitis in which white ulcers locate on the inner side of the upper lip, the tongue, or roof of the mouth; the irritation which they cause not only interferes with eating, but produces fever, together with the symptoms previously mentioned.

APTHÆ, or follicular inflammation, is distinguished by very painful little ulcers, single or in clusters, scattered over the surface of the tongue and lining of the mouth. Sometimes it is complicated with little lumps in the tongue. These form ulcers and denote scrofulous inflammation. Fissures and cracks in the tongue indicate derangement of the stomach.

THE CAUSES of stomatitis, in nursing infants, are unhealthy milk, or effete matter, which, for lack of proper care and cleanliness, accumulates upon the nipple. In older children, improper diet, irritants, debility of the digestive functions, or hereditary syphilitic taint, disorder the blood and induce local inflammation.

TREATMENT. Locally, use a wash of golden seal or gold thread sweetened with maple-sugar, and rendered slightly alkaline with borax or saleratus. Also use a very weak, alkaline tea, or one of slippery-elm flour, to obviate the acridity of the secretions. If the sores do not heal, constitutional treatment may be required, as the use of the Golden Medical Discovery. The family physician should be consulted if the sore mouth resists all these remedial measures.

NURSING SORE MOUTH. (STOMATITIS MATERNA.)

During the period of nursing, and sometimes in the latter months of pregnancy, women are liable to a peculiar variety of sore mouth. The soreness is sometimes so great that, although the appetite may be ravenous, the patient cannot eat. When this condition extends to the stomach and bowels, symptoms of a very grave character appear, and the disease, by interfering with the process of nutrition, causes emaciation and debility, and in extreme cases, death. It is a strange affection, nearly always disappearing upon weaning the child, though this course is not absolutely necessary. It appears to depend upon a hepatic, or gastric derangement, in connection with a vitiated condition of the blood, but how this is brought about is unknown.

SYMPTOMS. The disease sometimes comes on suddenly, at others more slowly. The fact that the woman is either pregnant or nursing, is of importance in forming a diagnosis. At first there is a severe, scalding sensation of the tongue, mouth, and fauces, with pain, which is sometimes intense. The color of the tongue is often pink, or a light red, while the mouth is generally of a deeper hue. This stinging, biting sensation is accompanied by a profuse, watery discharge from the mouth, which seems extremely hot and acrid, causing excoriation whenever it comes in contract with the face or chin. The appetite is good, sometimes ravenous, but food or drinks, except of the blandest character, occasion such intense pain that the patient avoids their use. Ulceration occurs after a little time. The bowels are generally constipated, but when the disease extends to the stomach or intestines, diarrhea occurs. There is generally anæmia, debility, and impairment of the vital powers.

TREATMENT. The indications for treatment in this affection are to overcome the vitiated condition of the blood, and to sustain the vital powers. The remedies for this purpose are alteratives, antiseptics, and tonics. Give the Golden Medical Discovery, the value of which may be greatly enhanced by adding one-half ounce of the fluid extract of baptisia to each bottle, in doses of a teaspoonful four times a day. Chlorate of potash, half an ounce in a pint of water, used as a wash and gargle, is of great value. A teaspoonful of the same may be swallowed several times a day. This will not interfere with other medicines. As a tonic, the tincture of the muriate of iron, in five to ten-drop doses, diluted with water, may be taken three or four times daily. Quinine, in one or two-gram doses, should be given with the iron if the debility be extreme. When there is great acidity of the stomach, which may be known by heart burn, saleratus may be taken in water, to neutralize it, but should not be drunk within an hour of the time for taking other medicines. If constipation exists, use the Pleasant Pellets. This course of treatment, thoroughly carried out, will seldom fail to effect a perfect cure, without weaning the child, yet this latter course may sometimes become advisable to promote the recovery of the patient. Should the treatment advised not produce the desired result, a skillful physician's services should be secured, as he may, in individual cases, distinguish other important indications which may enable him to modify the treatment to advantage.

DIARRHEA, CHOLERA INFANTUM, OR SUMMER COMPLAINT, AND DYSENTERY.

These diseases are usually considered separately by medical writers but, as they are closely related, a simple diarrhea not unfrequently running into a _cholera infantum_ or a dysentery, we shall consider them together.

DIARRHEA is an affection characterized by unnaturally frequent evacuations from the bowels of a liquid of morbidly soft consistency. It may be simple or inflammatory, and acute or chronic.

A diarrhea is said to be bilious when the discharges are composed principally of serum, highly colored with yellow or green bile; catarrhal, when they are of a semi-transparent, mucous character; serous, when the dejections are thin and watery, sometimes mixed with blood, bile, or ingesta.

The symptoms of the affection are usually at first those of indigestion, a fullness of the stomach, flatulency, and colicky pains. The pains, which precede each evacuation, are intermittent in character. There may be an unpleasant sinking sensation in the abdomen, and, with the discharge, exhaustion, a feeble pulse, and a cool skin. In the inflammatory variety, there is more or less fever.

CHOLERA INFANTUM, or summer complaint, is a disease peculiar to the warm season, and more prevalent in cities, and among those children who do not nurse at the breast. It is characterized by great irritability of the stomach, and persistent vomiting and purging, the discharges from the bowels being copious and watery, and sometimes containing specks of curd, yellowish-green matter, and mucus. The limbs of the little sufferer are usually drawn up, indicating pain in the bowels, and there is great prostration with cold extremities. The invasion may be so sudden, and the disease so violent as to destroy life in a few hours.

DYSENTERY, also known as _bloody-flux,_ consists of an inflammation of the mucous membrane of the large intestine, with ulceration of the affected surfaces. The disease is accompanied with much nervous prostration, and is distinguished by severe pains in the abdomen of a griping nature, followed by frequent scanty and bloody stools, and much straining. Occasionally the attack is ushered in with a chill and aching pains in various parts of the body, with copious fecal dejections. In other cases the attack is preceded by loss of appetite, a sense of uneasiness with dull pains in the abdomen, and weariness. The disease, like diarrhea, may be either acute or chronic.

THE CAUSES of these affections of the bowels are many and varied. They may be brought on by exposure to cold and wet, or by improper and indigestible articles of food, such as unripe fruits, salads, pastries, and, in fact, anything which interferes with the normal operations of the digestive apparatus. One of the most fertile sources of diarrhea in infants, and of _cholera infantum_, is the administration of unsuitable food, the ill effects of which are greatly increased by exposure to heat or cold. Uncleanliness, and the inhalation of impure air, are prolific causes Of these diseases. Epidemics have been supposed to be due to some peculiarity in the condition of the atmosphere, or to some impalpable germ of a vegetable or animal nature.

TREATMENT. In the treatment of these diseases, one should first endeavor to ascertain the cause of the trouble, and then, if possible, effect its removal. Attention should be given to the hygienic surroundings of the individual afflicted; if he reside in a miasmatic district, or in a location in which the atmosphere is contaminated by the decomposition of animal or vegetable matter, or filled with noxious gases, his abode should be changed. A pure, dry air is most beneficial in these cases.

Only the least irritating and most easily digestible articles of food should be taken. Healthy cow's milk is slightly alkaline, but that of cows fed on slops is usually acid, and unfit for infants. It is, therefore, well to test all milk with blue litmus paper before feeding it to young children. If found to be strongly acid, that is if it turns the paper red, it should be rejected, but if only slightly so, sufficient lime water may be added to render it slightly alkaline. For adults and older children, the diet should consist of such starchy foods as arrow-root, sago, corn starch, and rice, and of ripe grapes, freed from the skins and seeds, peaches, and boiled milk, or milk and lime water. In some cases the animal broths are beneficial, especially mutton broth. To quench the thirst, crust coffee, rice coffee, and lemonade, in small quantities, may be taken.

Rest is important in these diseases. In severe cases, the patient should be kept in bed.

At the onset of an attack of diarrhea or dysentery, if there be reason to believe that the intestinal tract contains irritating matter, a dose of castor oil, with a few drops of anise oil added to render it palatable, should be administered. After all irritating ingesta have been removed, Dr. Pierce's Compound Extract of Smart-weed should be given in doses proportionate to the age of the patient, and the severity of the case. Being composed of the extract of smart-weed, or water pepper, Jamaica ginger, camphor, and genuine French grape brandy, it exerts a most wonderful effect not only in those diseases but in cholera morbus and intestinal colic. It allays the irritation and inflammation of the affected mucous surfaces, and soothes the nervous system. In the great majority of cases, the above course of treatment will be found sufficient, but in the more severe forms of these diseases additional remedies may be required.

In dysentery, accompanied with severe pain and straining, injections of starch water and laudanum, from two to four ounces of the former to from twenty to fifty drops of the latter should be used.

Hot fomentations applied to the abdomen are beneficial. If the discharges contain much blood, a flannel cloth moistened with the spirits of turpentine should be laid over the lower part of the abdomen, and kept there until slight irritation is produced.

Lime water, bicarbonate of soda, bicarbonate of potash (saleratus), chalk, and the subnitrate of bismuth are valuable agents to correct the secretions, and allay irritation of the diseased mucous surface. The above-named preparations of soda, potash, and bismuth may be taken in doses of from five to twenty grains every few hours.

Blackberry root and cranesbill (_Geranium Maculatum_), in the form of fluid extract or infusion, are beneficial in acute cases in which the discharges are profuse and watery, and in the chronic forms of these affections.

In _cholera infantum_ subnitrate of bismuth should be given in doses of from five to ten grains at intervals of from two to four hours. If the discharges are very profuse, the fluid extract of cranesbill may be administered in from two to ten-drop doses alternately with the bismuth. The camphorated tincture of opium (paregoric) is required in doses of from two to twenty drops, depending upon the age of the child and the severity of the case, if there is much pain, but great caution should be exercised in administering the preparations of opium to children. A single drop of laudanum given to a young infant has caused convulsions, coma, and death in more than one instance. To check the vomiting of _cholera infantum_, mild irritation over the stomach is sometimes effectual. For this purpose a weak mustard plaster, or a cloth moistened with turpentine, may be laid over the stomach for a few minutes at a time. If the child is old enough to suck pellets of ice, these are beneficial, or a piece can be wrapped in a cloth and sucked.

COLIC.

_Colic_ is a term applied to griping pains in the abdomen, which are sometimes accompanied with nausea and vomiting. The derangement is recognized in several forms, some of which we shall briefly describe.

BILIOUS COLIC. This may be the result of a morbid condition of the liver.

SYMPTOMS. It is characterized by severe pain occurring in paroxysms, which may be relieved by pressure upon the bowels. The pulse is quick, the tongue coated, and the skin harsh and dry; there is headache, impaired appetite, acrid taste in the mouth, thirst, nausea, attended with vomiting and general chilliness, followed by febrile symptoms.

CAUSE. It may be induced by exposure to cold, in consequence of which the circulation is impeded, the pores of the skin obstructed, and all of the vitiated matters having to be expelled through the liver, stomach, and intestines. It may also be due to malaria in the atmosphere. It most commonly occurs during the autumn, after a season of hot weather.

FLATULENT COLIC. Flatulent or "wind" colic is one of the results of indigestion.

SYMPTOMS. A sense of fullness in the pit of the stomach, attended with pain, which is transferred from one part of the bowels to another. There is fever, a quick pulse, nausea, and the presence of gas; by the latter feature it may be detected from the other forms.

CAUSES. Cold or atmospheric changes, the eating of unripe fruits, uncooked vegetables and those articles of diet which ferment easily, are the principle causes.

PAINTER'S COLIC. This form is also known by various names, such as _colica pictonum, saturnine_, or _lead colic_. Those persons who are engaged in the manufacture of lead, and painters, are the most frequent victims of this affection.

SYMPTOMS. Impaired appetite, fetid breath, thickly coated tongue, obstinate constipation, a dry skin, scanty urine, languor, severe pain in the umbilical region, and general derangement of the functions of the system.

CAUSES. From the term applied to this form, the cause may be inferred. It is induced by the absorption of lead through the lungs, stomach, and skin.

TREATMENT. The indication to be fulfilled in _bilious_ colic is to relieve the intestinal spasm. This may be done by drinking freely of a decoction of yam-root, or _dioscorea villosa_, which is an effectual remedy in this affection. If this be not at hand, the spasm may be relieved by administering freely of Dr. Pierce's Extract of Smart-Weed. If the stomach be irritable, a tablespoonful of laudanum and one of tincture of lobelia, in four ounces of starch water, administered as an injection, is effectual. If simple means do not promptly arrest the attack, no time should be lost in summoning the family physician.

In _flatulent_ colic, the treatment should depend upon the cause. If it be occasioned by cold, a teaspoonful or two of the Extract of Smart-weed, in warm water or catnip tea, repeated a few times, will be sufficient. If it result from overloading the stomach, a dose of the Pleasant Pellets will answer the purpose. If the pain in the abdomen is severe, apply hot fomentations. Assist the action of physic, by giving an injection of senna and catnip tea, or if the stomach is very sour, take internally some mild alkali, such as common saleratus.

In _painters'_ colic, the following cathartic mixture is an effectual remedy: sulphate of magnesia (epsom salts), twelve ounces; nitrate of potassa (saltpeter), half an ounce; sulphuric acid, one drachm; boiling water, one quart. Of this remedy give a teaspoonful every thirty minutes or every hour, until the bowels move. An injection of some diaphoretic tea, or of alum water, is a good remedy. Castor oil and molasses, containing a teaspoonful of spirits of turpentine, will add to the efficiency of an injection. If the colic be not promptly relieved, a physician should be employed. To eliminate the lead from the system, and thus prevent a return of the colic, or other injurious effects, two drachms of iodide of potassium should be added to a bottle of the Golden Medical Discovery, and a teaspoonful of this taken four times a day.

JAUNDICE. (ICTERUS.)

This affection is generally regarded as a symptom of disordered liver, since it frequently occurs during the progress of diseases of that organ. When the disease imparts a greenish tinge to the skin, it is termed _green jaundice,_ and, when it imparts a blackish color, it is known as _black jaundice._ Jaundice is undoubtedly due to the presence of biliary elements in the blood.

CAUSES. In consequence of the varied conditions from which it arises, Professor Da Costa has aptly remarked: "With the _recognition_ of jaundice, the difficulty in diagnosis may be said to begin." He considers the causes of jaundice to be (1) diseases of the liver; (2) disease or the bile ducts; (3) diseases remote from the liver, or general disease leading to a disorder of that viscus; (4) certain causes acting upon the blood.

SYMPTOMS. It is characterized by a yellowish color of the skin and of the white of the eyes. The skin is usually dry and harsh; if it be moist, the linen will be tinged yellow from the perspiration. The tongue is coated yellow, the mouth is dry, and the appetite impaired; there is headache, nausea, and sometimes vomiting; there is pain in the abdomen after eating, and in the region of the liver, and it is also felt in the right shoulder, and between the shoulder-blades. In severe cases, there is fever, accompanied with chills, despondency and loss of flesh. The stools are generally of a light clay color, and very offensive; the urine is thick and yellow. When the disease terminates fatally, there is delirium followed by stupor.

TREATMENT. The first step should be to eliminate from the system, as speedily as possible, all noxious materials. For this purpose, the spirit-vapor bath should be used. If the urine is scanty or voided with difficulty, take acetate of potash or queen of the meadow. These may be taken in connection with the Golden Medical Discovery and Purgative Pellets, the efficacy of which has already been described in the treatment of chronic inflammation of the liver. They are indeed valuable agents in this disease, since they increase the action of all the excretory glands, and rapidly remove those matters, which, if retained, would poison the system.

In some cases, acids are of great value; good hard cider or hydrochloric acid and the acid bath are frequently valuable agents.

In other cases the employment, both internally and externally, of alkalies in addition to the Golden Medical Discovery answers the purpose much better.

Again, there are persons who, in addition to alteratives and baths, require tonics. In the treatment or this affection, whatever may be the nature of the case, the use of _alteratives_ must not be forgotten, for _without_ them, the auxiliary treatment with acids, alkalies, and tonics, will not produce the desired effect.

The employment of drastic remedies is sometimes resorted to; but, although they may give temporary relief, the patient soon relapses into his former condition, while if the treatment above given be adopted, the recovery will be permanent.

GALL-STONES. (BILIARY CALCULI.)

These are concretions found in the gall-bladder or bile duct, and vary from the size of a pea to that of a hen's egg. There may be no indication of their existence in the gall-bladder until they begin to pass through the duct.

CAUSES. The formation of gall-stones is undoubtedly due to an unhealthy condition of the bile. Corpulent persons, and those indulging in over-stimulating diet, or in the habitual use of fermented drinks, are most liable to be troubled by them.

SYMPTOMS. The patient is suddenly seized with excruciating pain in the right side. After a time it subsides, but is again renewed with as great severity as before. There is nausea, with vomiting, which is often excessive and severe. The pulse is sometimes slower than is natural, the extremities are cold, there is great exhaustion, together with perspiration and spasmodic contraction of the abdominal muscles. As soon as one stone has passed through the duct into the intestine, immediate relief is experienced until another commences to pass, and the larger the concretion, the greater is the pain. If the stools be washed, the gall-stones may be seen floating on top of the water.

TREATMENT. This consists chiefly in relieving the patient of pain and vomiting during the passage of the gall-stones. Hot fomentations made with stramonium leaves and lobelia, and applied over the painful parts, are beneficial. Small doses of lobelia may be taken, but not in sufficient quantities to produce vomiting. Doses of opium should also be taken; this anodyne must, however, be used with care. Gelseminum is often useful. Chloroform, ether, or the spirit vapor-bath generally allays the pain. Carbonate of soda, dissolved in water, often relieves the vomiting.

These distressing symptoms are apt to recur until the removal of all the gall-stones is effected. To aid in removing them, take the Golden Medical Discovery rather freely for a day or two, and continue its use with lobelia, in doses sufficiently large to produce nausea, but not vomiting. From four to eight ounces of sweet oil may be given, and, if the bowels do not respond within three hours, repeat the dose, and the gall-stones will generally be evacuated. To prevent the formation of these concretions take the Golden Medical Discovery, together with alkaline drinks made with carbonate of soda. Tone and energy will thereby be imparted to the liver, the free flow of bile will be insured and the subsequent formation of gall-stones prevented.

INTESTINAL WORMS.

We have not the space to discuss the numerous theories which have been offered to account for the presence of these parasites in the human body. We shall enumerate the principal species, describe the symptoms indicating their presence, and indicate the proper remedies.

There are five species of intestinal worms, sufficiently common to merit a description.

(1.) The round worm, termed by naturalists, _ascaris lumbricoides_, varies from six inches to a foot in length, and resembles the common earth-worm. It infests the small intestines, and seldom migrates into the stomach or large bowel. Instances are recorded, however, in which it has crept upward in the esophagus, larynx, nostrils, and eustachian tube; but their presence in these parts is of comparatively rare occurrence, and is generally caused by some local irritation which compels their migration. The fact that they have been found in the peritoneal sac, gave rise to the opinion that they perforate the intestine; but careful observations have proved that they can only escape through openings made by ulcers.

This species has been found in adults, but is more common in children from three to twelve years of age. The number of this species existing in a human body is variable. Sometimes only two or three are found. At other times a hundred, and even twice that number, are voided in a few days.

(2.) The _ascaris vermicularis_, thread, pin, or seat-worm, is round, very slender, and about half an inch in length. The habitation of this species is the rectum, and they are often found matted together in the excrement. They are very active, even after ejection, and have been known to cause great local irritation by entering the vagina and urethra. Their presence is an occasional cause of masturbation. It is impossible to estimate the number of these parasites that may exist in the human rectum. Great numbers, sometimes, are voided at a single evacuation.

(3.) The _tricocephalus dispar_ is a third variety of the round worm, and is said to infest the bodies of almost every species of mammalia. As its name indicates, the upper portion of its body is slender, hair-like, and terminates at the lower extremity in a thick, spiral portion. It is from one to two inches in length, and is found attached by its head to the mucous membrane of the cæcum, and, in rare instances, in the colon and small intestine. They are rarely numerous.

_Tæceniæ_ or _tape-worms,_ are hermaphrodites, of a flat, ribbon-like form, and are composed of numerous segments, each of which is provided with a complete set of generative organs, and contains ova for the production of thousands of individuals. Some authors have supposed that each segment, or joint, is a distinct individual, but the existence of one head for the whole precludes this theory. There are two species of _tæniæ_ developed in the human intestine; the _tænia solium_ and the _tænia lata_.

(4.) The _tænia solium_ is the species commonly found in America and all the countries of Europe, except France, Russia, and Switzerland. In France, both species are found, but the tænia lata seems to be indigenous to Russia and Switzerland.

The _tænia solium_ varies in length from four or five to thirty, thirty-five, or even forty feet. The head is hemispherical and armed with a double row of twenty or thirty hooklets. The genital organs are alternate and placed upon the outer edges of each segment. It inhabits the small intestine, and is usually solitary.

(5.) The _tænia lata_, or broad tape-worm, is distinguished by the greater breadth of its segments, and the location of the genital organs, which are found in the centre of each segment. Its small elongated head is unarmed, and has a longitudinal fissure on each side. It usually attains a greater length than the _tænia solium_.

SYMPTOMS. The symptoms which the long worms occasion, are frequently somewhat obscure. Thirst, irregular appetite, colicky pains, excessive flow of saliva, enlargement of the abdomen, itching of the nose, pallor of the face, offensive breath, disturbed sleep, and grinding of the teeth, all are common symptoms. Occasionally, convulsions and other nervous affections are produced by the presence of the _ascaris lumbricoides,_ but generally they produce less constitutional disturbance than the other varieties. The passage of this species of worms from the bowels, or their ejection from the stomach, is the only positive evidence of their presence. The _ascaris vermicularis_, thread, pin, or seat-worm, gives rise to most of the symptoms produced by the long worms, but in addition produces intense itching at the anus, and, not unfrequently, an eruption upon that part. The itching is particularly distressing at night. When the little sufferer is well covered, the warmth occasioned by the bed-clothes causes these little parasites to crawl out upon the anus, and produces such paroxysms of itching and pain as to cause the child to kick the covering oft and lie naked. The persistent manifestations of a disposition to lie naked, should excite the parents' suspicions of seat-worms, and lead them to investigate all the symptoms. By examining the child's stools the worms may he found adhering to the feces, and they may also be seen on the anus. Thousands of children suffer untold agony from these little seat-worms, which are left unmolested to torment them, because the parents are unfamiliar with the meaning of the symptoms manifested, and therefore pay no heed to them. We have been thus particular in describing the symptoms indicating the presence of these pestiferous parasites, in order that they may be readily detected.

_The Symptoms_ produced by the tape-worm are dizziness, ringing in the ears, increased secretion of saliva, indigestion, ravenous appetite, sharp abdominal pains, and emaciation. The only positive sign of the presence of these parasites, is the passage of pieces of them in the feces. The nervous and other symptoms produced by the ordinary long worms are also caused by the tape-worm.

CAUSES. Careful observations have proved that there are certain causes which favor the generation or development of intestinal worms. Among others, we may mention fatty or farinaceous articles of food, gormandizing, constant exposure to a moist atmosphere, and sedentary habits.

It is now generally conceded that the development of tape-worms is due to the swallowing of an egg or germ-cell, which is contained in many kinds of animal food, and which the process of cooking has failed to destroy. People living near low marshes, lakes, or the seacoast, are liable to _tæniæ_.

TREATMENT. The expulsion of the _ascaris lumbricoides_ may be very easily and pleasantly effected. Santonin is an effectual remedy for this variety of worms. For a child three years old, take santonin, six grains; podophyllin, one grain; white sugar, thirty grains; mix, triturate, and divide into twelve powders, and give one every three or four hours, until they act upon the bowels; or take santonin, ten grains; white sugar, twenty grains; mix, triturate, and divide into ten powders, and give one every night at bed-time, and after giving two or three in this way, administer a mild cathartic. As santonin is almost entirely tasteless, if not combined with other medicines which are unpalatable, no difficulty will be experienced in administering it to children. By reference to the article on anthelmintics in this volume, other valuable vermifuges may be selected, and directions found for their employment.

In the removal of thread or pin-worms, anthelmintic medicines taken into the stomach are of little or no value. An injection of a strong solution of salt, is a very efficient remedy. A teaspoonful of turpentine in half a pint of milk makes a good injection. Strong coffee has been recommended as an injection. The anus should be well anointed with vaseline, lard, oil, or fresh butter, after each movement of the bowels. Whatever injection or remedy is used, it should be followed by the application of some ointment to the anus, otherwise they will continue to deposit their eggs about that orifice and multiply there.

Various remedies have been used to destroy tape-worms. Among others we may mention the old and time-honored remedy, which consists of two or three ounces of the oil of turpentine, taken in castor oil or some aromatic tincture.

A decoction made by boiling two or three ounces of freshly powdered pomegranate bark in a pint of water was used by the ancients, and is now highly recommended as a remedy.

Some American physicians have used an emulsion of pumpkin seeds with marked success.

Twenty or thirty grains of the extract of male fern, followed by a cathartic is highly recommended for the destruction and removal of tæniæ.

TRICHINA SPIRALIS.

In 1835, Owen discovered a peculiar parasite, which sometimes infests the human body, and is termed the _trichina spiralis_. The presence of these parasites has given rise to morbid conditions of the system, followed by the most serious results. They are developed in the alimentary canal, and then perforate its tissues and enter the muscles. Twelve trichinæ have been found in a section of human muscle only one-twelfth of an inch square and one-fifth of an inch in thickness.

The early symptoms of trichinæ are very uncertain, being the same as those of some other disease. The patient complains of severe pain in the abdomen and is troubled with diarrhea. When the trichinæ pass into the muscles, they occasion great suffering. There are sharp pains in the muscles, the perspiration is profuse, and the patient becomes exhausted.

CAUSE. Nearly every case of trichinæ, which has been brought to the notice of the profession, has been attributed to the eating of raw or improperly cooked pork. The parasites can only be detected with a microscope.

TREATMENT. The impossibility of removing the trichinæ after they have passed into the muscles is apparent; and, as yet, no special remedy has been recommended to remove them from the alimentary canal. The only safety lies in prevention. Hence raw or imperfectly cooked pork should never be eaten.

* * * * *

DYSPEPSIA.

It is generally conceded that a multitude of human ailments arise from _indigestion_, and in its various forms it taxes the skill of the physician to prescribe the proper remedies. It is undeniable that the closest intimacy exists between happiness and good digestion. A healthy digestion aids materially in making a cheerful disposition, and the "feast of reason and flow of soul" is due as much to the functional integrity of the stomach as to a strong and generous mental organization. Dr. Johnson severely said: "_Every man is a rascal as soon as he is sick._" We all know that a morbid condition irritates the individual and excites sarcastic and disagreeable remarks. And, likewise, an irritable temper and, suddenly aroused passions may not only turn and disturb the stomach, but even poison the secretions. Anxiety, excitability, fear, and irritability frequently cause the perversion of physiological processes.

The slightest functional disturbance of the stomach deranges, more or less, all the succeeding operations of digestion and tends to the vitiation and impairment of the delicate processes of nutrition. Dyspepsia may commence and proceed so insidiously as not to excite the suspicion of friends, although the patient generally desires active treatment, such as cathartics, emetics, and medicines to act upon the liver. When the disease becomes confirmed, it presents some of the following symptoms: Weight, uneasiness, and fullness in the region of the stomach, attended by impatience, irritability, sluggishness, anxiety, and melancholy; there is impairment of the appetite and taste, also sourness, flatulency, and, perhaps, frequent attacks of colic, loss of hope, courage, and energy; apathy, drowsiness, and frightful dreams are also symptoms common in the different stages of this disease. There are, furthermore, the accompanying symptoms of a coated tongue, bitter taste in the mouth, unpleasant eructations, scalding of the throat from regurgitation, offensive breath, sick headache, giddiness, disturbed sleep, sallow countenance, heart-burn, morbid craving after food, constant anxiety and apprehension, fancied impotency, and fickleness. The subjects of dyspepsia frequently imagine that they require medicines to act upon the liver, desire active treatment, are endlessly experimenting in diet, daily rehearse their symptoms, and are morbidly sensitive.

CAUSES. Overtasking the body or mind, overloading the stomach, the use of improper food, such as stale vegetables and meat, unripe fruits, indigestible articles, improperly prepared food, irregular meals, disorderly habits, the use of alcoholic stimulants, loss of sleep, masturbation irritability of temper, anxiety, or grief may all give rise to indigestion. If the functions performed by the skin are embarrassed by cold, tight clothing, or lack of cleanliness, the nutritive changes cannot properly take place throughout the body, and consequently the digestive functions are embarrassed, as the revolutions of a water-wheel are impeded by the backset of the water. When food is not thoroughly masticated, it is not properly mixed with saliva of the glands of the mouth, and is not prepared for digestion by the acids of the stomach.

Whatever diminishes the general strength, impairs the health, or encroaches upon the functions of life, also hinders the perfect solution of food and disturbs in a measure the function of digestion. Whatever diminishes the normal amount of the digestive secretions or perverts their quality, deteriorating their solvent properties, is a cause of dyspepsia. This should be borne in mind in selecting remedies.

TREATMENT. The hygienic treatment consists in the regulation of the daily habits, proper selection and preparation of the food, cultivation of cheerfulness, diversion of the mind, and cleanliness of person. We cannot give particular directions as to the kind of diet, as there are no established rules for guidance. Generally, a dyspeptic knows best, from experience, what articles of diet can be taken with the least injury. The directions applicable to the condition of one patient, are not suited to those of another. In dyspepsia, animal food is, as a rule, preferable. Foods rich in starchy matter often ferment and produce distress. Sometimes alkalies may be given with beneficial effect, when there seems to be an excess of acid in the gastric secretions.

In some cases, the digestive fluids are weak and fermentation results, giving rise to flatulency and belching. An antiseptic, which may be prepared by mixing a teaspoonful of hydrochloric acid with four ounces of water, of which a teaspoonful may be taken after each meal, will prove beneficial to check the fermentation and aid digestion. The addition of one or two drops of a mixture of one part of carbolic acid and six of glycerine, to the above solution of hydrochloric acid improves its antiseptic properties. Or, Dr. Pierce's Golden Medical Discovery will stop undue fermentation, and from its tonic and invigorating effect upon the lining membranes of the stomach will generally overcome the indigestion. Some people are afraid to take it, when suffering from indigestion, because it has a sweet taste. But the sweet is not saccharine, or sugar sweet, but an entirely different sweet principle which prevents fermentation instead of promoting it.

Acidity of the stomach and the attendant irritation may be allayed by the following mixture: Calcined magnesia, one drachm; refined sugar, one drachm; subnitrate of bismuth, one-half drachm; oil of cajeput, ten drops. The dose is half a teaspoonful an hour after every meal. Any dispensing druggist can put it up.

It is frequently difficult to prevent the patient from over-distending the stomach, and thus impairing the tone of the muscular coats and prolonging the process of digestion.

In consequence of debility, over-exertion, anxiety, or chronic inflammation of the stomach, there is not a proper secretion, in quantity or quality, of digestive solvents, and it matters not whether it be a deficiency of the fluids of the stomach, or of the intestines, or of the pancreas and liver, the result is indigestion. The question of what important agent is lacking, naturally presents itself to the physician. Is it _pepsin_, the active principle of the gastric juice, which converts proteids into peptone, that is wanting, or is there a deficiency of _pancreatin_? Of course the principle which is lacking should be supplied; but has the physician the remedial agents properly prepared, and ready for prescribing? The specialist, having more cases of dyspepsia to treat than the general practitioner, is more likely to have the latest and most approved remedies applicable to loss of appetite, indigestion, impoverished blood, imperfect assimilation, and all diseases arising from faulty nutrition. In ordinary practice, the physician's time is divided in his consideration of acute, chronic, surgical, and obstetrical cases; in fact, much of it is occupied in riding to reach his patients. His attention is continually diverted from one class of cases to another, effectually preventing investigation in any particular direction. His patronage does not warrant him in the outlay of time required for the investigation of particular diseases, and the expense necessary to obtain the latest and best remedial agents for their treatment. In the multiplicity of his cares and arduous duties by night and by day, obstinate chronic cases become an annoyance to him, and whenever he can be otherwise professionally employed, he avoids them, disliking to undertake their treatment.

With plenty of time for scientific investigation, ample facilities to meet the demands upon his skill, and each succeeding case presenting some new phase, the treatment becomes a matter of absorbing interest to the specialist, and each success inspires greater confidence. We not only use in the treatment of indigestion, solvent remedies, like pepsin, which act only upon proteids, but also other remedies of recent discovery, which exert a remarkable curative influence in diseases of the digestive organs.

The chemistry of digestion and of life is becoming better understood. Any of the free acids may serve to dissolve a precipitated phosphate; but it is only the investigating therapeutist and experienced practitioner who understands which of them is the _most_ and which is the _least_ efficacious. Alkalies may dissolve lithic deposits, but who, unless he be an experienced physician, can detect the fault of nutrition which leads to their formation, or rightly interpret the symptoms indicating it? These simple illustrations of the complications which attend dyspepsia, are mentioned merely to show that they must be anticipated and taken into account in the treatment.

The number of cases of dyspeptic invalids treated by the staff of the Invalids' Hotel and Surgical Institute within file past few years, is so large as scarcely to be credited by those unacquainted with the prevalence of this disease. For this reason we have taken unusual pains to investigate the causes of the disease, and have spared no expense to provide the most approved digestive solvents, and stomachic tonics, which invigorate the mucous membrane of the stomach, and materially assist in reducing the food to a liquid condition. Some of these, without being purgative, increase the activity of the liver, and stimulate the intestinal secretions, two very important indications which should be fulfilled by remedies which cause no real depression. The recent important discoveries made in obtaining the active principles from indigenous plants, has opened the way to the use of a few of the most important of these remedial agents, hitherto almost wholly unknown to the medical profession, and the encouraging results attending our practice have amply repaid us for the investigation and originality in our treatment of this affection.

A careful chemical and microscopical examination of the urine often discloses the actual morbid conditions which perpetuate this functional disease.

CHRONIC DIARRHEA.

On account of the frequency and importance of chronic diarrhea, we deem it worthy of special consideration. It is frequently the sequel of the acute form of the affection. The urgent and severe symptoms of acute diarrhea are often abated, but the disease is not completely cured. The bowels are left in an irritable condition, perhaps in a state of chronic ulceration, which perpetuates morbid discharges.

The most noticeable symptom is the tendency to frequent and unhealthy discharges from the intestines. The evacuated matter varies much in appearance and character in different cases. The precise location of the morbid conditions which give rise to the discharges, as well as to their extent, modifies the color, consistency, and ingredients of the stools. Most frequently they are dark colored and of very offensive odor. They are of a more liquid character than is natural, except when, as is sometimes the case, periods of constipation alternate with periods of unnatural looseness. Tormina, or griping, is usually present, but not so severe as in the acute affection. Tenesmus, or straining, often accompanies it. The appetite is impaired, there is general debility, and the patient is nervous and irritable. The complexion becomes sallow, the skin dry and rough, the tongue dark colored, and the body emaciated.

The affection may be the sequel of neglected or badly treated acute diarrhea, may arise from the injudicious use of powerful purgative medicines, may result from dissipation, unwholesome food, bad air, absence of light, long continued exposure to dampness and cold, overwork, and extreme mental anxiety. Sometimes it is associated with other diseases, such as Bright's disease of the kidneys, scurvy, or some of the various forms of scrofulous disease.

The more prominent symptoms are so apparent and so characteristic that the most unskilled may be able to decide whether the patient has chronic diarrhea; but to determine in what portion of the intestinal canal the affection is chiefly seated, to decide upon the extent of its ravages, to ascertain what peculiar shade or type the affection has taken on, to investigate its complications and modifications, to ferret out its producing or aggravating causes, and above all, to nicely and skillfully adjust remedies to meet the depraved conditions, is by no means an easy task, even for the educated and experienced physician. It should be borne in mind that this is a dangerous malady, and one which should not be trifled with or neglected. Its tendency is to corrode and destroy the bowels, a process which if unchecked, must sooner or latter result in death. There is little tendency to spontaneous recovery, nor is a removal of the exciting cause often followed by recovery. The disease becomes so firmly seated, and the powers of life so debilitated, that nature cannot rally.

TREATMENT. A warm, salt bath, several times a week, taken at bed-time, is beneficial. Flannel should be worn next to the skin, and the sleeping-room should be warm and well ventilated.

As will be seen from testimonials hereinafter inserted, Dr. Pierce's Golden Medical Discovery has achieved great success in curing chronic diarrhea. Its use should be persisted in for a considerable time to strengthen and tone up the bowels. To relieve the discharges, take Dr. Pierce's Compound Extract of Smart Weed, as needed from time to time.

CHRONIC INFLAMMATION OF THE LIVER.

(CHRONIC HEPATITIS.)

This is what is ordinarily termed _liver complaint, torpid liver, and bilious disorder_.

Under this head may be considered all those chronic affections known as congestion, induration, and enlargement of the liver, and which result in deficient action, functional derangement, morbid secretion of bile, and various chronic affections.

SYMPTOMS. Owing to the liability of other organs to become diseased during the progress of chronic affections of the liver, great precision in diagnosis is required to determine, by the symptoms, the organ which is _primarily_ diseased and those secondarily affected. This requires not only familiarity with the signs of a complicated disease, but also thorough anatomical knowledge of the diseased organ, of the morbid changes which occur in its structure, and their influence on its own functions, as well as on those of other organs.

The symptoms may differ according to the circumstances, temperament, sex, age, or constitution of the individual, and the complications of the disease. The local indications are fullness of the right side, thus denoting congestion of the liver; a dull, heavy pain, which is increased by pressure or by lying on the left side; a sense of fullness, weight, and oppression about the stomach; an aching in the right shoulder-blade; a dull, disagreeable pain in the shoulder-joint, which may extend down the arm, and which is sometimes felt in the wrist and joints of the hand Not unfrequently the complexion becomes pale and sallow, and there is puffiness under the eye, headache, a bitter taste in the mouth, tongue coated white or covered with a brown fur, and hardness of the gums; there is frequent sighing, a hacking cough, fever, restlessness, and loss of sleep; sometimes an unnatural, greasy appearance of the skin, at others, it is dry and harsh, has scaly or branny eruptions, pimples, dark blotches, and troublesome itching. The urine is frequently scanty and high-colored, but variable as to quantity and appearance; it often produces a scalding sensation when voided, and, if allowed to stand, deposits a sediment which sometimes contains albumen. The pulse is very slow, particularly when the elements of the bile are not eliminated from the blood. The pulsations of the heart are easily quickened, and palpitation is excited if the subject be low and anæmic. There is depression of spirits, and a decided tendency to be discouraged and despondent. The functional powers of the stomach are impaired; there is loss of appetite, or it becomes capricious; uneasiness is felt in the region of the stomach, oppression, sometimes nausea and water-brash, or there is indigestion, flatulency, and acid eructations; the bowels become irregular, usually constipated, and occasionally subject to obstinate diarrhea attended with colicky pains; the stools are of a light clay color, sometimes hard and dark, again thin and very offensive, and occasionally green or black. As the disease progresses, during the day the circulation is sluggish, the feet and hands are cold, but at night the pulse is accelerated, and a burning sensation is felt in the palms of the hands and the soles of the feet.

The foregoing symptoms are not all present in one case, nor are any two cases alike in every respect. They vary according to the organs most implicated in the hepatic derangement. Thus, when chronic inflammation of the liver is associated with _heart_ disease, the subject may have palpitation, excessive or defective action of the heart, attended with more or less pain and shortness of breath. If the _lungs_ be specially influenced, then, in addition to the ordinary hepatic symptoms, there may be a dry cough, asthma, hurried respiration, bronchitis, hoarseness, and pain in the chest. If the _stomach_ be the sympathizing organ, the tongue is coated white or brown, there is nausea, loss of appetite, flatulency, acidity, dyspepsia, fullness, and oppression, amounting, sometimes, to pain in the stomach after taking food; the food ferments and gives rise to eructations and various other manifestations of disorder. If the _bowels_ are morbidly influenced by this affection, there is constipation or diarrhea, griping pain, distension of the abdomen, piles, and pain just within the points of the hips, thus indicating irritation of The colon. If the _brain_ or _nervous system_ sensitively responds, there is headache, dizziness, disturbed sleep, depression of spirits, peevishness, capriciousness, lack of energy, irritability, and congestive symptoms. When the _skin_ is involved the surface is dry, harsh, and scaly, displaying dark "moth-spots," blotches, or numerous little sores, and the countenance has a dull, tawny look. If the _kidneys_ be disturbed by it, there may be pain and a sensation of weight in the back, while the urine may be scanty and high-colored, or abundant, pale, and limpid, frequently charged with sedimentary products of disease, and voided with difficulty. If the _womb_ be implicated in this chronic affection, the menstrual function may be deranged, and result in an excessive or a deficient monthly flow, and be followed by profuse leucorrhea.

The preceding allusion to the complications of chronic inflammation of the liver shows the necessity of clearly distinguishing between the symptoms of this disorder and those reflected by the organs which sympathetically respond. To discriminate more effectually, and place the correctness of the diagnosis beyond doubt, we make a chemical and microscopical examination of the urine, and thereby detect the morbid products which it contains, and direct our attention to the diseased organs furnishing them. These examinations together with a complete history of the case, enable us to make a correct and definite diagnosis of the disease, and the extent to which it has affected the other organs.

Before entering upon the consideration of treatment, let us briefly enumerate the functions of the liver: _First_, it removes matter, which, if allowed to remain in the blood, would become noxious and unfit it for the further support of the body. _Secondly_, by secreting bile, it furnishes to the digestive organs a fluid which assists in converting the food into chyle, stimulates the intestine to action, and then is itself transformed and absorbed with the chylous products, after which it circulates with the blood and assists in nutrition until, becoming injurious and pernicious, it is re-secreted and re-elaborated to serve again, as described.

For its growth and nourishment, the liver is furnished with blood by the hepatic artery; but for the purpose of secretion and depuration, it is abundantly supplied with venous blood by the portal system, which is made up of veins from the spleen, stomach, pancreas, and intestines. This impure, venous blood, surcharged with biliary elements, which must be withdrawn from it, is freely poured into the minute network of this glandular organ. In a healthy condition of the liver, the carbonaceous elements of the blood are converted into sugar, and the constituents of the bile are liberated by the liver, and set apart for further duties. When it fails to eliminate these noxious elements from the blood, it is itself thoroughly vitiated by them.

TREATMENT. Food must be rich in carbon in order that it may build up the tissues and keep the body warm, but carbonic acid, the result of the combustion, must be removed from the blood, or death will ensue. So bile is necessary to digestion, nutrition, and life; yet, if it be not separated from the blood by the secreting action of the liver, it will as surely poison the system and destroy life as carbonic acid. Although the constituents of the bile exist in the blood, they must be removed in order that the blood may be rendered more fit to support the body, while the secreted bile is destined to assist in digestion, and the mysterious process of nutrition. Therefore, we should induce a secretion of bile, and restore the normal activity of the liver. This should be done, not by administering stimulants, but by relieving it of all contingent embarrassments as far as possible. Would any one think of giving to a weak, debilitated man large portions of brandy to enable him to work? Does not every one know that, when the unnatural stimulus is removed, he fails? Apply this principle in the treatment of the liver. When harsh, unnatural stimulants and "bile-driving" medicines are administered for a time and then withheld, the liver relapses into a more torpid and debilitated condition than before treatment was begun. Is not this true of nine-tenths of all who suffer from this malady, and have recourse to this class of remedies?

Then how can we remedially fulfill the preceding indications? We answer in the language of a distinguished author and standard medical writer, "by using a class of agents which should never be overlooked in the treatment of long-standing liver diseases, chiefly addressed to the blood and denominated '_alteratives._'"

_Alteratives, tonics_, and _restorative catalytics_ are required not only in diseases of the liver, but in a large number of ailments in which the blood becomes charged with morbid materials. The active remedial properties of the most efficient agents of the above classes of medicine now known, are scientifically combined in the "Golden Medical Discovery," which acts _especially_ upon the blood, and hence influences the system generally. It is also powerful in eliminating those morbid humors which are afterwards subjected to excretion through various organs.

Its action is radically different from most medicines employed in chronic diseases, for the reason, that what is usually prescribed, is something corrosive. Unless the disease be temporary, it may return with increased violence.

We have been very minute in the description of the remedial properties of the "Golden Medical Discovery," and have relied upon the reason and intelligence of our patrons, believing that they can, in a degree, understand why we deem it so applicable to the system. It does not debilitate the liver by over-stimulation, nor irritate the stomach and bowels by disturbing the delicate processes of digestion, neither does it act with severity upon the blood, but it operates so gently, insensibly, and yet with so much certainty, that it excites the surprise and admiration of the patient.

From the careful detail of its various properties, there is abundant reason for its favorable action upon all of the excretory organs, which co-operate in the removal of morbid materials from the system. If, however, the bowels are unusually sluggish or obstinately constipated, it is advisable, in conjunction with the "Golden Medical Discovery," to use the "Pleasant Pellets," which are also powerfully alterative, besides being mild and unirritating in their operation. They are the natural assistants of the "Discovery," working harmoniously together. They should be taken in small doses, and their use perseveringly followed, until the bowels are properly regulated by the use of the "Discovery" alone.

It has been customary to resort to powerful drastic cathartics, followed by bitters prepared in dilute alcohol. The habit is unscientific, for it is well known that alcohol deranges the functions of the digestive organs and depraves the blood, besides creating a morbid appetite. It has been repeatedly demonstrated that the use of such bitters has led to a life of drunkenness, with all the woe and untold misery which attend it.

Medicines to be strictly remedial, should exert a tonic influence upon all the vital processes. Those organs which are contiguous to the liver, or connected by sympathy with it, should be assisted in the performance of their functions. Persons who are habitually subject to "bilious" attacks are pleased to find that the use of the "Discovery" and "Pellets" furnishes immunity from such onsets, and prevents their usual recurrence. Thus these remedies are _preventive_ as well as _curative_.

What we have thus far recommended for the treatment of this chronic affection is within the reach of every family. Patients laboring under this disease, when complicated with other affections, require special consideration and treatment, and all such are counseled to employ only those physicians whose experience and success entitle them to confidence. Health is one of the greatest of blessings, and how to restore it when lost, is a question of vital importance.

Having successfully treated thousands of invalids who have suffered from this chronic affection, we possess abundant evidence of the curability of the disease, but we have only space to publish a few letters from persons who have been under our care, or who have used our medicines, purchased from druggists.

CONSTIPATION. (COSTIVENESS.)

Health depends very largely upon the regularity of the bowels. There should be proper alvine evacuations every day. There are few persons who have not suffered at some period of their lives from constipation of the bowels. Inattentive to the calls of nature, or a neglect to regularly attend to this important duty, sooner or later, produces disastrous results. Furthermore, it is essential to the comfort of every individual, for, when this function is not performed, there is derangement of the mental as well as of the bodily organs.

Constipation, or _costiveness_, as it is sometimes termed, is a functional derangement of the large intestine. This intestine is about five feet in length, and consists of the cæcum, colon, and rectum. It serves as a temporary reservoir for the excrementitial residue of alimentary matter, and for the effete materials excreted by the glands contained in its mucous coats. It is distinguished as the _large_ intestine, because of its great size.

Habitual constipation produces many derangements, resulting from _sympathy, irritation_, or _mechanical obstruction_. By referring to Figs. 4 and 9, the reader may observe the anatomical relations which the large intestine sustains to the other abdominal organs. The ascending colon arises in the cæcum (Fig. 4), at the lower part of the abdomen, and passes over the kidney on the right side, where it begins a circuitous route around the abdominal cavity, comes in contact with the inferior surface of the liver, proceeds behind and below the large curvature of the stomach, emerges on the left side, and passes downward in front of the left kidney, where it dips into the pelvic cavity, and ends in the rectum.

If fecal matters are retained until they are decomposed, great injury follows, since the fluid portions are absorbed, conveyed into the blood, and, of necessity, corrupt it with their impurities. In this way, constipation may be the source of general derangement, but _such_ disorder is seldom attributed to the torpid state of this intestine. There is little doubt but that it thereby imposes a great tax upon the functions of the liver, and, frequently, the fault is attributed to that organ instead of the large intestine. Sometimes the blood becomes so charged with fecal matter that its odor can be detected in the breath of the subject.

An overloaded condition of the large intestine may cause inflammation of the liver or dropsy of the abdomen. When the colon is distended, it becomes a mechanical impediment to the free circulation of the blood in other organs, and causes congestion of the portal system, predisposing to chronic inflammation or cirrhosis of the liver. This latter is a structural affection, and may, in turn, give rise to abdominal dropsy. In a word, the accumulation of feces in the colon irritates both the large and small intestines, thus causing congestion of the bowels, liver, or stomach.

The protracted presence of feculent matter deadens the sensibility of the intestine, so that great stimulation is required to provoke it to action. The contents become dry, solid, knotty, and hard, and very difficult to evacuate. If drastic, irritating physic be taken, only _temporary_ relief is afforded, and it must be repeatedly resorted to, and the dose increased, to obtain the desired effect.

SYMPTOMS. One diagnostic symptom of a loaded state of the colon, is an abundant secretion of urine, as limpid as water. The direct symptoms relate to the hardness of the feces and the great difficulty of voiding them. The influence of constipation upon the functions of the liver, is indicated by the sympathy displayed between that organ and the mind. The patient manifests apprehension, mental depression, taciturnity, and melancholy, all indicative of hypochondriac dejection, induced by constipation.

We have treated patients, who, from this cause, had renounced their bright hopes, lost their buoyant spirits, and, becoming subject to superstitious fears, had given themselves up, night and day, to devotions and penance. It often happens that the victims of this deep dejection and morbid feeling of self-abasement, are persons not only of good moral character, but of high religious attainments, and their painful exhibitions of fear, distrust, and gloom, originate in _physical_ rather than in spiritual causes. It is interesting to witness this strange perversion of the imagination, this morbid debasement of the religious faculties, and dejection of mind, due to causes disturbing the functions of the liver and other vital organs.

Young girls, as they approach the age of puberty, seem possessed with the idea that the unfrequent action of the bowels is a desirable habit. They do not associate with the duty a proper regard for health, but consider it as an inelegant and repugnant practice. The consequence is, that at this susceptible period, constipation, induced by neglect, arouses a latent hepatic or pulmonary disease which has been lurking in the system.

How many girls illustrate the truth of this statement by their complaints of dizziness, throbbing pain in the forehead and temples, flushing of the face, transient flushes of heat over the body, while at the same time the extremities are cold. At other times, they manifest the evils of such a course by their stupor, drowsiness, and deep sleep, although upon arising in the morning, they are still tired and unrefreshed.

The constipated condition of the bowels, often leads to congestion of the uterus and leucorrhea, followed by uterine debility, prolapsus, excessive menstruation, anteversion or retroversion of that organ. The infrequency of the habit, incorrectly supposed to be desirable by a young woman, becomes nearly, if not quite disastrous to all her desires and bright prospects. Complications arise, and neither the inexperienced girl nor her solicitous and afflicted parents know where to look for remedial aid. If they seek an asylum from these sufferings, they find many private institutions, where flattering expectations of speedy recovery are aroused. At such institutions, these uterine disorders are generally treated merely as local diseases, while the causes are overlooked, and, consequently, a permanent cure is not effected. Having spent nearly all the money at her command, the patient returns home utterly disheartened. After such failures, many of these unfortunate individuals have applied to us and received treatment, and by persistently following our directions, have in due time been restored to health, amid all the comforts of home, and among friends, who rejoiced with them in the unexpectedly favorable turn of affairs, accomplished at a comparatively trifling expense.

We have seen infants, and also young children, in whom constipation was obstinate. It therefore seems that it is often hereditary. In some persons, this affection continues from childhood, with but little variation, until bleeding pile tumors are developed. Habitual constipation of the bowels for a long period of years will generate a class of diseases, which are often very serious in their results.

CAUSES. We have already alluded to a sense of false modesty which prevents a response to the calls of nature, and we may mention other reasons, equally trifling, which deter many from fulfilling its demands. Some are in the habit of temporarily postponing their visits to the water closet, until, when they do go, they find themselves unable to evacuate the bowels. Sometimes the closet is a damp, uncomfortable out-house, situated at a distance from the dwelling, or the access is too public, and, hence, there is an unwillingness to visit it at the proper time. Some appear to be too indolent to attend to this duty. Others are too energetic, and think they cannot take the time, until they have finished some self-imposed task or attended to a pressing engagement.

Inactive life and sedentary occupations are also causes of constipation. Active exercise promotes all the bodily functions, and helps to regulate the bowels. Those who are engaged in literary pursuits, find that mental occupation determines the blood to the brain, thus drawing it from the extremities; the temperature falls below the natural standard, and there is almost invariably congestion of the bowels. The inmates of boarding-schools, factory girls, seamstresses, milliners, employés in manufacturing establishments, and all who sit and toil almost unremittingly twelve hours in the day, do not get sufficient exercise of all the muscles of the body, and are often troubled with obstinate constipation.

Food prepared according to the modern modes of cookery, is one of the causes which favors the developement of this derangement. People live too exclusively upon bolted wheat flour. The branny portion of a kernel of wheat consists of various nutritive elements, with more than five times the amount of phosphate of lime contained in fine bolted flour. Those who daily use boiled cracked wheat are not troubled by constipation. There is no dryness or hardness of the feces, and the bowels are evacuated without discomfort.

TREATMENT. Prevention is always better than cure; hence, a few hygienic directions may not be amiss. Do not disregard the intimations of nature, but promptly respond to her calls. If there is constipation, overcome it by establishing the habit of making daily efforts to effect a movement of the bowels. Taking regular exercise by walking, and lightly percussing or kneading the bowels for five minutes daily, help to increase their activity. The habit of early rising favors the natural action of the bowels. Drinking a glass of water on rising exerts a beneficial influence. The food should be such as will excite the mucous secretion of the large intestines, and arouse its muscles to action. For this purpose, there is no one article that excels coarsely-cracked boiled wheat. Graham bread, mush, cakes, gems, and all articles of diet made from unbolted wheat flour are valuable auxiliaries, and may be prepared to suit the taste. Take the meals at stated hours; be punctual in attendance, regular in eating, and thoroughly masticate your food. Irregularity in the intervals between eating, disturbs the functions of the intestine. The use of ripe fruits, such as apples, pears, grapes, figs, and prunes, in proper quantities, is sometimes very beneficial. Trivial or unimportant as these hygienic suggestions may appear, yet were they observed, constipation, as well as most of the diseases incident to it, would be obviated. A large proportion of the cases will yield to the foregoing hygienic treatment without the employment of medicines. Should it be necessary, however, to employ an aperient to relieve the constipation, Dr. Pierce's Golden Medical Discovery will act most congenially, and will be followed by no constipating reaction, which invariably occurs when drastic cathartics are employed. Its operation is mild, bringing about a healthy action by promoting the biliary and other secretions, thus aiding nature in establishing normal functional activity in the bowels. Recourse should be had to it before employing any thing more strongly cathartic. However, should it prove too mild in its aperient effects, small doses of Dr. Pierce's Pleasant Pellets may be employed daily to assist it. Unlike other cathartics, they produce a secondary tonic effect upon the bowels, which renders their influence more lasting than that of other purgatives. We cannot too strongly discourage the injurious custom which many people have of frequently _scouring_ out their bowels with strong cathartics. It is a bad practice, and cannot fail to do injury. The greatest benefit is derived, not from cathartic doses, but from taking only one or two of the "Pellets" per day, or enough to keep the bowels regular, and continuing their use for several weeks, in connection with Dr. Pierce's Golden Medical Discovery, strictly carrying out the hygienic treatment heretofore advised.

The medical treatment of individual cases sometimes involves many considerations relative to the particular circumstances and complications presented. The peculiar susceptibility of the constitution, as well as the diseases incident to constipation, must be taken into account. Symptomatic derangement should not be treated as primary, although it is by inexperienced physicians. If the patient be afflicted with uterine disease, piles, nervous affections, falling of the lower bowel, or fistula, they should be treated in connection with this disease. For these reasons, we would advise our readers to submit all complicated cases, or those that do not yield to the course heretofore advised, to a physician of large experience in the management of chronic diseases, and not assume the great responsibility and the dire consequences which are very liable to arise from the improper treatment of such cases. We have been called upon to treat thousands of cases of this troublesome affection, and as a result of our vast experience, and in consequence of our original and improved methods of diagnosis, it is not generally necessary that we should see and examine the patient in person. We can almost always determine the exact nature of the patient's malady, and its stage of advancement, without seeing the subject in person.

PILES. (HEMORRHOIDS.)

There are few maladies more common than this, and few which are more annoying. Piles consist of tumors formed within the rectum and about the anus, by dilatation of the hemorrhoidal veins and thickening of their walls. Sometimes, when attended by considerable inflammation, or when the attacks are very frequent, there is thickening of the adjacent cellular and mucous tissues.

There are two general forms of this disease, the external or blind piles, in which the tumors are outside the anus, and the internal or bleeding piles, in which the tumors are formed within the sphincters, although after their formation they may protrude. The external piles are commonly made up of thick tissues; upon one side, the skin forms the covering, while on the inner surface is the mucous membrane of the bowel. It is this surface which is most tender and irritable and liable to inflammation. The internal form of the disease is situated from a half an inch to two and a half inches above the sphincter muscle of the anus. The tumors are usually round, oval or cylindrical in form. They may be scattered over the surface of the bowel, or clustered together. The illustrations (Figs. 1 and 2) show the two forms of the disease. The two protruding tumors in Fig. 2, illustrate the usual form of prolapsing internal piles, whilst the one highest up in the bowel shows the form most commonly met with. It is seldom that one pile tumor is found alone, there usually being two or three, and sometimes as many as five or six, in a cluster. Fig. 3 shows the manner of distribution of the veins in the rectal region. The small venous loops, or bulb-like terminations of the veins H. _i_., are the points at which the piles most frequently occur.

CAUSES. Whatever tends to favor an undue accumulation of blood in the hemorrhoidal veins predisposes to piles. For this reason the affection is frequently a result of diseases of the heart and liver, which cause an obstruction in the circulation of the blood through the portal vein. Mechanical pressure from tumors in the abdomen, pregnancy, or an enlarged or misplaced uterus, is not infrequently a cause of the disease, by keeping the hemorrhoidal veins over-distended. Those diseases which provoke much straining, as stricture, inflammation or enlargement of the prostate gland, and stone in the bladder are also active causative agents. The most common cause of all, however, is constipation; and persons of indolent, sedentary and luxurious habits of life are the ones most frequently affected with this derangement. The following are also prolific causes of piles, viz.: pelvic tumors, violent horseback exercise, indigestion, pregnancy, habitual use of drastic cathartics, diarrhea, dysentery, sitting on heated cushions, long-continued standing posture, diseases of the liver, worms, the wearing of tight corsets, eating highly seasoned or indigestible food, and the use of alcoholic stimulants. No age is exempt from piles, nor is the disease peculiar to either sex. Aside from the serious inconvenience and pain which are experienced with most forms of piles, there is a tendency to fistula, and to cancer in the rectal region. It is important, therefore, that the disease should not be allowed to run on unchecked.

SYMPTOMS. The most common symptoms at first are slight uneasiness, such as a little soreness or itching at the verge of the anus, and at times lancinating pains. These sensations are more severe as a rule if the bowels are constipated. If the piles are external they frequently become inflamed, swollen and painful, and in some instances they suppurate, which usually results in relief. When internal piles have increased to any considerable extent, or have become inflamed, they produce not only itching at the extremity of the bowel, pain in the back, etc., but also a sensation of fullness in the rectum, as though some foreign body were present, and, on action of the bowels, there is a sensation as though a portion of the fæces had not been expelled. When the internal piles become large, they frequently come down with fæcal matter from the bowel, as illustrated in Fig. 2, and this prolapsus becomes more and more marked with the progress of the disease, until, in many cases, the tumors are forced down at each action of the bowels, causing excruciating pain until they are properly replaced. Usually, in the early stages, they recede spontaneously; however, after a time it becomes necessary for the sufferer to press them back, but in some instances this is impossible. Frequently during the protrusion one of the hemorrhoidal veins gives away, and this is followed by a free escape of blood, and ulceration may ensue. Not infrequently with this disease the patient loses strength and flesh, and the face becomes pale and puffy, assuming a waxy appearance. Many times there is nausea, with vertigo. Is consequence of the relaxation, the bowel may descend when on the feet, or with some extra muscular effort, especially when stooping. These symptoms may not all be present in one person, and, indeed, sometimes are somewhat obscure; when such is the case, an examination by a competent physician will always determine the true character of the complaint at once.

TREATMENT. Notwithstanding the well established fact that piles are readily cured by the appropriate treatment, hundreds of thousands of people suffer untold tortures from them because of the popular impression that they cannot be cured. All cases are not, however, amenable to the same form of treatment, for various unhealthy conditions of the system are often concerned in their production and perpetuation, and must, of necessity, be remedied by appropriate treatment, before a cure of the piles can be expected. It will, therefore, become apparent that the avoidance of causes is of paramount importance. Some of these causes are external, and wholly under the control of the patient, while others depend upon diseases that are curable; it frequently happens that while other diseases are being remedied, the piles disappear Without any special attention.

Diseases of the urinary apparatus, as stricture of the urethra, enlargement of the prostate gland, and stone in the bladder, dysentery, diarrhea, and constipation,--all cause piles, by the irritation, and determination of blood, which they induce; these difficulties must be removed by appropriate treatment.

Some years since, we ascertained that we were using in our practice remedies which, in addition to other virtues, possessed a direct specific influence upon the vessels concerned in the formation of piles. These agents enter into the composition of Dr. Pierce's Golden Medical Discovery, which, consequently, will be found exceedingly efficacious in the treatment of this disease. This remedy, therefore, in removing the disease upon which the piles depend, as a congested or torpid liver, constipation, etc., and in exciting a direct curative control over the piles themselves, exerts a double influence. It may be aided, when the bowels are badly constipated, by the use of Dr. Pierce's Pleasant Pellets, taken in the morning, to secure a regular and easy evacuation of the bowels each day. All stimulating food and alcoholic drinks should be abstained from. The cold bath is beneficial in these cases, provided there is not great debility. The affected parts should be bathed frequently with cold water, and, if prolapsus exists, it is well to inject a little cool water into the rectum, and allow it to remain a few minutes. As a soothing, astringing and healing application to the affected parts we prepare an Ointment that has acquired great fame for the prompt relief which it affords in all ordinary cases. This we do not sell through druggists but can send by mail, on receipt of price, $1.00 per large box, postage prepaid. The persistent use of this Ointment, at the same time keeping the bowels regular by the use of "Golden Medical Discovery," with an occasional laxative dose of "Pellets," will generally cure all ordinary cases of piles.

THE RADICAL CURE OF LARGE PILE TUMORS. In cases in which the tumors have become indurated and very large it is impossible to effect cures by the foregoing or any other medical treatment. Various methods have been in use by the profession for the relief of the most severe cases. The most common is excision with the knife or scissors. Reference to the large vessels, shown in Fig. 3, which are affected in this disease, will at once show the sufferer the dangers of this method. The sudden removal of a tumor, which is connected with one or more of the large hemorrhoidal veins, is sure to be followed by severe hemorrhage, and many times painful ulceration, and a fatal result. To avoid this it has been the practice of many physicians to apply caustics or to burn off the base of the tumors with a red-hot iron. A more barbarous and painful method could not be devised. When it is considered that in many cases, this severe and painful treatment is followed by ulceration, and occasionally by the developement of cancer, the matter should be carefully weighed before any such dangerous procedure is attempted. Another common method of treatment is to crush the base of the pile with a clamp, and then cut off the tumors with scissors. After this it is also necessary to apply the hot iron to prevent hemorrhage. Formerly, applications of nitric acid were in common use by physicians as a means of cure, but it was found that while this treatment would give temporary relief, yet in no severe case would it effect a cure. By what we term palliative treatment alone more cures are effected than by the old process of treatment with nitric acid. Still another form of treatment is strangulation of the pile by means of a ligature, and this is often more painful than the application of hot irons, inasmuch as in cutting off the return flow of blood from the piles, a large tumor is left for days fully distended and extremely painful. It does not slough off for a considerable time, and we have seen the strongest men suffer intensely, to whom the use of scissors in removing the tumors was a positive relief in comparison with the torture of the ligature. A treatment that has been highly recommended by some physicians and condemned by others, is the process of injection with carbolic acid. This method of treatment is not very painful but, unfortunately, it is dangerous. The injection of the tumors with a fluid which causes coagulation of the blood, and which does not completely shut off the return current of the circulation through the tumors, has proved fatal in a small percentage of cases. The clots which are formed by this treatment become detached and are carried into the general circulation and conveyed to the liver, lungs and even to the brain, where, by plugging up the vessels of those organs, they cause abscesses which terminate life. Serious inflammation of the veins is another accident which often follows the injection of carbolic acid. This treatment is, therefore, now seldom resorted to except by physicians who do not appreciate its dangers.

A MORE SUCCESSFUL METHOD. Fortunately for suffering humanity, a method of treatment has been perfected and thoroughly tested in our institution, in which all such trouble and danger as above described are avoided. This consists in bringing down the tumors, cleansing them and making application, of certain chemical preparations, that cause the tumors to speedily shrivel up, and in a very short time, say ten to fourteen days, disappear entirely. These treatments and applications cause _no pain whatever_, for by first applying a weak solution of cocaine to the parts they are speedily rendered entirely insensible, so that the most sensitive, nervous lady experiences not the slightest suffering from the application of our remedies.

Having now at our command means so positively certain in their action upon pile tumors, we do not hesitate to say that the very worst cases, no matter of how long standing, can be promptly cured, if we can only have the patient for a few days under our personal care. Considering the very distressing character of pile tumors, it is a great boon that we have at last found safe, painless, and positively certain means for their cure. The news will be hailed with joy by a large class of sufferers.

Probably no other discovery in modern science is destined to be the means of conferring greater blessings on a large class of sufferers than that of a painless and positive method of curing the largest pile tumors in the brief time required by our system of treating them.

It seems to us that there is no longer an excuse for any one to endure the tortures inflicted by pile tumors, provided the afflicted one can command the little time and moderate amount of means necessary to secure the treatment indicated. Piles are not only in and of themselves very painful and annoying, but often greatly aggravate and even cause other grave and painful affections, and should, therefore, not be neglected. When large, they never get well without proper treatment. We have seen many cases in which the long train of diverse and distressing symptoms caused by piles led the sufferer, and even the family physician, to suppose that other diseases existed, but all of which annoying symptoms were speedily dispelled by the cure of the piles. We have no doubt that neglected piles, fistulæ, and other morbid conditions of the lower bowels, frequently degenerate into cancerous disease. We have the eminent authority of J. Hughes Bennett, of Edinburg, and many other close observers, for saying that benign or ordinary tumors often degenerate into real cancerous disease, and our own extensive observation convinces us that this is not infrequently a result of neglected rectal disease, as piles, fistulæ and fissures. How important, then, to give prompt attention and skillful treatment to disease of these parts. When the ordinary palliative treatment, with ointments and with laxative agents to keep the bowels soluble, does not _completely and perfectly_ subdue the malady, lose no time in securing the most skillful appliances, that every vestige of the affection may be promptly removed. We have treated many thousands of cases with uniform success, and our patients write to us expressing the greatest degree of satisfaction, and recommending our method most highly.

Reports of a few cases, selected at random from the large number which we have cured, are given below to illustrate our success in curing them.

ANAL FISTULA. (FISTULA IN ANO.)

This disease is _more dangerous_ than piles, though, after once formed, not so painful. It sometimes commences with intense itching about the anus, accompanied with a little discharge; or the first symptom may be a painful abscess, like a boil, which finally breaks. The soreness then in a measure subsides, leaving a fistulous opening, with a continuous discharge of matter. This unnatural opening, with its constant drain upon the system, sooner or later is certain to ruin the health or develop consumption or other maladies, and destroy life.

Fistula in Ano may exist in three conditions: First, complete fistula--when the opening is continuous from the cavity of the rectum or bowel to the surface of the skin, so that liquids, gases, etc., escape; secondly, internal incomplete fistula, when the opening extends from the inside of the rectum into the tissues surrounding it, but not through the skin. A few cases of this kind exist, while the sufferers are unconscious of the nature of the difficulty, supposing it to be piles or some trouble--they know not what. Thirdly, external, incomplete fistula, when the opening extends through the skin into the tissues around the rectum, but does not enter the bowel.

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. Sometimes only a small external opening is seen, while a large abscess exists internally. In any case, the discharge is not only reducing to the system, but it is disgusting and offensive.

CAUSES The causes are a constitutional predisposition, constipation, piles, or the presence of foreign bodies in the rectum, causing an abscess or ulcer. Some authors have contended that fistula always originates from an ulcer in the rectum, which gradually makes its way through the cellular tissue to the surface. Others contend that the cause of this disease consists in an abscess, which burrows in the tissues and makes its exit into the rectum, or through the skin, or both. No doubt it may originate in both ways. It can readily be seen that when an internal opening is once established, the _foeces_ which enter into it must sooner or later work their way to the surface, burrowing through those parts which offer the least resistance, until a place of exit is reached.

DIAGNOSIS. The disease may be suspected, if there has been an abscess in the parts involved, or if the patient has been subject to pain in the rectum, and the parts are tender, tumid, or indurated. When the fistula opens externally, the linen will be moistened and soiled with pus, or a bloody fluid, and when the tract is large, the _foeces_ may pass through it. A careful exploration with a probe, passed into the external opening while the finger is in the rectum, generally reveals the direction of the tract; but, sometimes, in consequence of the tortuous course of the canal, the probe cannot he made to follow it. When the fistula is incomplete, and opens internally, the probe is passed into the rectum and directed outwards, when it may be felt externally. In such cases, a tumor, caused by the contents of the fistula, may generally be seen protruding near the anus, and the pain will be considerably increased during defecation, by the _foeces_ passing into it and disturbing its walls. The examination should be made with the greatest possible care, for it is attended with more or less pain.

TREATMENT. When constitutional derangement exists, it must be rectified, or any treatment will be liable to result in failure. The comfort of the patient may be greatly promoted by attention to the bowels, keeping their contents in a soluble condition, and the liver active, so as to prevent congestion of the rectum and adjacent structures. This can best be done by careful attention to hygiene, and the use of "Golden Medical Discovery" and "Pellets," in sufficient quantities to produce the above named effects.

A _radical cure_, however, cannot be accomplished except by surgical means, for which we have the _knife, ligature, caustic, stimulating injections, etc.,_ which may be varied to suit the emergency, but which should never be employed except by a competent surgeon. Constitutional conditions materially influence the cure, no matter what procedure is adopted; the greater the constitutional derangement and the poorer the general health, the longer is the cure delayed. The great secret of our success in treating this disease consists in applying appropriate constitutional treatment at the same time.

The use of the knife is becoming obsolete, and has, to a great extent, given way to other measures which are equally successful. Indeed, other means will succeed in cases in which the knife fails or is for any reason inapplicable. One great objection to the knife is not only the dread which patients entertain of it, but the great liability of its use to result in paralysis of the sphincters of the anus, the consequence of which is loss of control over the bowels; and another is that it sometimes entirely fails to result in cure. By the means which we employ, these objections are entirely overcome, and, while the general system is being renovated, the fistula is healed, without any complications.

Fistula is much more common than has generally been supposed. It is apt to be associated with pulmonary diseases. Heretofore, it has been supposed that to heal the fistula, during the progress of the lung affection, would result in fatal consequences, and the patient has been left to suffer and die under the combined influence, of the _two_ diseases. Observation, based upon an extensive experience in the management of such diseases, has proved that supposition to be fallacious in every respect, and we would urge all persons afflicted with fistula to have the affliction cured, no matter what complications may exist. The fact underlying this erroneous opinion is, that when grave constitutional troubles have co-existed the use of the knife has resulted in failure, and the fistula has refused to heal.

Having had ample facilities for observing the relative merits of the various methods of treating this complaint, in hundreds of eases, in our own practice and that of others, we feel justified in saying that the plan which we have adopted is far superior to that in general use. The local treatment which we employ depends upon the nature of the fistula; in some instances the ligature is best, in others caustics, and again injection, etc., while still others require a combination of two or more methods, or a modification of them.

In cases in which it is impossible for the patient to come to our hotel for a radical and speedy cure of the fistula, we employ constitutional treatment, with, the use of a medicated crayon, which is similar in shape to a small slate pencil. This crayon is made of gelatine with the remedial agents thoroughly incorporated through it, and in an easily soluble form. They are very flexible and readily used, and where the fistulous track is sufficiently large to admit of their insertion, the most decided improvement invariable follows their application. One is oiled and gently introduced into the track every two or three days, and by its solution the unhealthy tissues which line the track are removed. They are thrown off, and a healthy action is induced. With careful constitutional treatment, decided improvement soon follows, and the discharge is gradually lessened. The most satisfactory improvement occurs in the general health and strength of the patient, and gradually the fistula closes. Sometimes it is necessary to pursue this course of treatment for many months, but the result obtained is sufficient reward for the trouble. A large percentage of cures follow this treatment, and we recommend it when it is impossible for the patient to leave home, or when the general health is greatly reduced by severe constitutional disease.

* * * * *

TESTIMONIALS.

While we have a great cloud of witnesses testifying to the efficacy of our treatment of the diseases described in this volume, yet for lack of space we can here introduce only the few following:

"LIVER COMPLAINT."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--In the year 1889 I was taken with disease which the doctors called "liver complaint." I tried three different doctors. They did me no good. They tried about one year; I was not able to work for two years. At last I thought I would try Dr. Pierce's medicines, and I wrote to Dr. Pierce, and he wrote to me to take his "Golden Medical Discovery," and I bought two bottles, and when I took it, I saw it was improving me, and I got five more, and before I had taken all I was well, and I haven't felt the symptoms since. I had a continued hurting in my bowels for about two years. I feel as if the cure is worth thousands of dollars to me.

Yours truly, J.H. MAY, Potts' Station, Pope Co., Ark.

DYSPEPSIA AND WOMB DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Dear Sirs_--When first taking Dr. Pierce's Favorite Prescription I was nervous and would have sour stomach and distress after eating, and when I would rise after stooping over everything would turn dark before me and I would feel dizzy. I suffered a great deal of pain at each monthly period. I took one bottle and a half of the "Favorite Prescription," one teaspoonful three times a day, and the "Pellets" as directions called for. I gained in health and strength so rapidly that I have been able to work very hard the past summer, and my back never troubles me; and when I have my monthly periods I never feel the least bit of pain. In fact I consider myself in excellent health.

Very truly yours, MRS. INEZ V. CARR RANSOM, Panama, Chaut. Co., N.Y.

INFLAMMATION OF LIVER.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was taken sick with inflammation of the liver and could get no relief from the doctors of this place--Randolph, N.Y. I was induced to use Dr. Pierce's Golden Medical Discovery, and "Pleasant Pellets," and after using five bottles of the medicine, I regained my health, and now I am a well man. I weighed 185 pounds before taken sick, and I was reduced to 135 pounds in sixty days' time. I suffered greatly from headache, pain in my right shoulder, poor appetite, constipation and a sleepy feeling all the time. My health is now very good, and I weigh 170 pounds, and I am able to do a good day's work without any trouble at all. Thanks to these valuable medicines.

Yours truly, THOMAS J. BENTLEY, Randolph, Catt. Co., N.Y.

LIVER DISEASE AND DYSPEPSIA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Dear Sirs_--I am enjoying excellent health. After taking a bottle of Dr. Pierce's Golden Medical Discovery and several bottles of "Pellets," I am a different person. Only weighed 119 pounds when I began taking your medicine, now weigh 160. My symptoms were pain under the left shoulder, distress after eating, headache, dizziness, constipation, and, in fact, my system was "out of sorts generally." I tell every one your medicine has done more for me than any other.

I remain, yours truly, MRS. CHARLES H. HART, San Ardo, Monterey Co., California.

LIVER COMPLAINT AND CATARRH.

_Dear Sirs_--After suffering for several years with nasal catarrh and liver complaint, and having become greatly reduced in health, as a last resort I placed myself in your hands for treatment. My improvement began almost immediately after entering your institution. I was enabled to leave at the end of one month, having experienced great benefit. The treatment was continued at home for a few months, after which my cure was complete. At the present time, I am able for office work, and feel that I am completely cured of the catarrh and have but little if any trouble with my liver. I shall lose no opportunity to recommend your institution or your medicines to the afflicted. I do most unhesitatingly recommend chronic sufferers to visit your institution or take your remedies at home.

Sincerely yours, WILLIAM KING, Rose Bud, Pope Co., Ills.

A COMPLICATED CASE OF STOMACH, LUNG, AND UTERINE DISEASE.

_Dear Sirs_--Some six years ago I was taken sick with chills; I would have a very bad chill and then I would begin to sweat and vomit; I had no appetite; I had the catarrh very bad; I had inward troubles of different kinds; my back ached all the time; I had sores gather and break inside; I had a lung trouble; I was very bad off; I could sit up only long enough to have my bed made; my husband sent for our family doctor; he came three times a week for three months; I was not so well at the end of three months as when he first came, but kept growing worse; he gave me up to die, and said I had consumption. I had heard of Dr. Pierce's medicines doing a good deal of good, so I made up my mind to try them. I sent and got one bottle of "Favorite Prescription" and one bottle of "Golden Medical Discovery"; also one bottle of "Pellets," and commenced taking them. In a few days I commenced to gain, and In two weeks' time I could sit up most all day, and in five weeks' time I could do my work with the help of two small girls. After taking four bottles of "Favorite Prescription," six bottles of "Discovery," and three of "Pellets," I was well enough to get along without any medicine. I can do a good day's work, and I owe my life to Dr. Pierce. With God's will and the use of Dr. Pierce's medicine I am still alive and well.

Yours respectfully, Mrs. CLARA A. RADEMAKER, Addison Point, Washington Co., Me.

LIVER COMPLAINT AND DROPSY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION. Buffalo, N.Y.:

_Gentlemen_--About two years ago I was confined to my bed for several weeks with liver complaint. I became dropsical, my limbs swelled to twice their usual size and I could scarcely move them. I commenced using Dr. Pierce's Golden Medical Discovery; one bottle helped me so I could sit up; two bottles gave me strength enough to be able to do part of my household work; six bottles cured me, and to-day I am enjoying good health. The "Medical Discovery" should be in every household, and in gratitude for what it has done for me I have recommended it to many friends. For nine years I have suffered from deafness, and while taking the "Discovery" my hearing became much improved.

Very truly yours, MRS. I.C. DENNIS, Burson. Calaveras Co., Cal.

INDIGESTION, CONSTIPATION, VARICOCELE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Dear Sirs_--In regard to my condition of health, will say, although I am not entirely well, yet I have received much and lasting good from your treatment. My digestion was improved greatly, so that little trouble is experienced after eating; my liver seems to act reasonable well, and my bowels are much better. My varicocele I consider entirely cured, as I have not used the bandage for one half day for more than six months, and do not experience any inconvenience from that source.

Yours truly, HARLAN HODGES, Keota, Keokuk Co., Is.

CASE OF CHRONIC DIARRHEA CURED BY HOME TREATMENT.

At the time the case was first submitted to us the bowels were moving six or eight times a day. In addition to the diarrhea, the patient had suffered from indigestion and womb trouble for eight years. There was almost continual pain from the top of the head to the hips and through the shoulders. There was weakness, soreness and numbness in the arms, hands, back and hips; the bladder was irritable, urine being passed frequently, or occasionally scanty, dark, thick, with a brick-dust deposit. There was a dragging sensation in the region of the womb. Menstruation was irregular, and she had frequent trembling spells lasting for hours. There was difficulty in fixing the attention, even for a sufficient length of time to write a brief letter. In fact, she was so weak and nervous she could scarcely write at all. Sleeplessness was a prominent feature of the case. The principal diet consisted of light bread and hot milk; could not use Graham bread. A course of special treatment was supplied to her about the first of January, 1890, but soon after commencing the treatment she had an attack of pneumonia. In due time the treatment was resumed, and then followed an attack of the epidemic influenza, or grip, so that, although the treatment was carried on at intervals during a year, there were but few occasions when our specialist had what he considered full control of the case. A year after the case was discharged the following communication was received:

February 15, 1893.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I should have written sooner, but I waited to see if there would be any return of my old disease. After suffering over eight years with severe chronic diarrhea, you have cured me; I have had no return of it for over a year. It is with gratitude I write to you to tell you the great good you have done me, for I am sure I would have been in my grave before this had it not been for your treatment; My stomach troubles me very little any more. Occasionally I use a bottle of "Golden Medical Discovery" and a bottle of "Pellets." Hoping that the kind Father may spare your lives for many years to do good to suffering humanity,

I am, Very gratefully yours, MRS. R.S. GWIN, Peck's Run, Upshur Co., W. Va.

LIVER COMPLAINT, DYSPEPSIA, AND CONSTIPATION.

CURED BY HOME TREATMENT.

Received his first disability in the war; complains of getting very weak; bowels move only in three or tour days; stomach so painful that nothing passes through it digested; back so weak cannot sit up; had the first attack of dyspepsia fifteen years ago, and has spent hundreds of dollars trying to get well; kidneys badly affected, urine highly colored, and burns in passing; has pains around the heart and fluttering sensations at times, says: "I am not able to travel; all the doctors have given me up as beyond medical aid.

Reports after two months' treatment: "I am happy to say that I am almost well; suffer with no pain in my stomach after eating; my appetite is good; my bowels move once a day and very often twice a day, and the urine is natural; do not have that dizziness in the head any more: rest well at night and feel rested in the morning Have gained flesh all the time; weigh 178 pounds, and work every day on the farm. Have taken no medicine from any other physician, and give you and your medicine all the credit for the health I now enjoy. My wife has taken your "Golden Medical Discovery" for goitre (thick neck). She has taken it for about six weeks and she is getting better."

JOHN FLEENER, Brooklyn, Indiana.

DYSPEPSIA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Your letter was received, and I am glad to say that I am perfectly well, and have been since I took your last medicine. I think I am better than I ever was, if such a thing could be. I am twenty pounds heavier than I ever was before, weighing 155 pounds. I have not had a pain or an ache since, for which fact I am thankful to you for looking after my case as promptly as you did, as, in looking over your catalogue of diseases, I thought that I had every thing ailing me that was in the book. I have told dozens if they were sick to call on you. With my best wishes, and hoping that all of your patients will receive as much benefit as I did, I remain,

Very truly yours, GEORGE R. KENYON Batavia, Ill.

DYSPEPSIA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--"A few of my symptoms were: Heartburn and fullness after eating, sometimes pain in my bowels, headache, poor appetite and bad taste in my mouth. At night I was feverish, with hot flushes over skin. After taking Dr. Pierce's Golden Medical Discovery I was relieved of all these symptoms, and I feel perfectly well to-day."

Very truly yours, J.P. MCADAMS, Elon College, North Carolina.

OBSTINATE AND COMPLICATED DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Yours of July 12th to hand. I am only too glad to comply with your request. Having suffered for many years with a complication of diseases and feeling conscious that they were rapidly making serious inroads upon my constitution, and that I was speedily becoming unable and incapacitated to attend to my ordinary business. I resolved, after reading a number of testimonials from your patients, to place myself under your treatment at the Invalids' Hotel and Surgical Institute. With heart-felt gratitude I can truthfully say I am relieved of my trouble. I most cheerfully and earnestly recommend this Institution to all who are afflicted with chronic and painful diseases, no matter of what nature. During my stay there I saw some wonderful cures and surgical operations.

Yours truly, JOHN H. SMITH, Deckertown, Sussex Co., N.J.

COMPLICATION OF DISEASES.

Without solicitude or hope of pecuniary reward, with heart-felt gratitude and a desire to aid my fellow-man to health and happiness, allow me to state, that as an inmate for more than a month of the Invalids' Hotel and Surgical Institute at No. 663 Main Street, Buffalo, N.Y., I feel warranted in its highest recommendation. While there I saw and talked with a great number of people who came there as a last resort, to be cured of almost every chronic disease to which flesh is heir, and they were unanimous in their praise of the Institution and the skilled specialists who constitute its professional staff.

ANDREW HOLES, Moorhead, Minn.

NERVOUS DEBILITY, DYSPEPSIA, KIDNEY AND LIVER DISEASE--CURED.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

Gentlemen--I take pleasure in informing you that the treatment you gave me for the relief of an affection of the spine and nervous system, disease of the digestive organs, kidneys and liver, has been entirely successful. I had feared that my health was gradually being undermined, prior to entering your institution, and I can testify to the perfect appointment that you have, the excellent apparatus for the administration of electrical and other massage treatment and baths. My relief was most satisfactory, and the cure has remained permanent.

I take pleasure in recommending your institution to the afflicted, believing that you have the very best treatment for chronic diseases known, and I have had an opportunity to satisfy myself, from conversation with other invalids in your Institution, of the care and skillful treatment that you administer, and its excellent effects. I believe that it is fully abreast of the times, and equal to any institution in the world. With many good wishes and thanks for my cure, I remain,

Yours truly, B.V. WRIGHT, Graniteville, Middlesex Co., Mass.

PROLAPSING PILES (HEMORRHOIDS), ASTHMA, TORPID LIVER AND CONSTIPATION.

CURED AT THE AGE OF 62--NOW 73 YEARS OF AGE--AND CONTINUES IN GOOD HEALTH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Dear Doctors_--It is with the greatest pleasure that I add my own experience to that of the many that you have cured. I am now seventy-three years of age, and enjoy very good health for my years, and as you can see by the photograph I send you, time has dealt very considerately with me so far as my activity and enjoyment of life are concerned. To this I feel that in large measure my thanks are due to you, for eleven years ago when I was sixty-two years of age you treated the pile tumors so successfully. They had been the source of greatest discomfort. I think that they were caused first by chronic diarrhea, which had troubled me many years prior to their appearance. I was also afflicted with asthma, torpid liver and constipation. These conditions produced in time some pile tumors that were the source of much suffering, and seemed to continually annoy me. As is usual with such difficulties, I believe, I would be free from discomfort for a time, and then the piles would get sensitive and irritable, come down at stool, and gave rise to severe pain that seemed to affect my general health. The nervous symptoms that resulted from their presence were such as to lead me to fear that I would break down in health unless they were relieved. From information obtained from others who had been relieved at your hands, I applied to your institution, and can thankfully assert that the tumors were permanently cured, as it has been eleven years since your specialist treated me, and I have had no trouble of the kind, and for an old lady I am pretty well. I had such good treatment and nice care at your institution that I cannot express in my testimony the thanks that I owe you. Wishing you every success in the treatment of others, and that you may be able to relieve the sufferings of many hundreds as you have mine,

I remain. Very respectfully and thankfully yours, MRS. MOSES PLUMMER, Groton, Caledonia Co., Vt.

BILIOUSNESS, CONSTIPATION, BAD COUGH.

WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Some twenty-five years since I was feeling very miserable all summer; I was very bilious; sometimes my bowels would not move once in sixty to seventy hours, and then almost impossible. I would take some bitters, which would help to move the matter, but as soon as the bitters were gone, I had to buy more or I would be as bad as before, and sometimes worse; but none of them appeared to do me any good except to move the bowels, until thirty years since a druggist called my attention to your "Golden Medical Discovery," and before I had taken half a bottle of the "Golden Medical Discovery," I felt much better, and by the time I had taken all, I could eat three hearty meals per day and had not felt so well for a long time. Soon after I was called to do a job some miles from home, and one night the old lady there was speaking about her daughter (Mrs. Brooks) who had been under the doctor's care for about five months and did not get any better, and I learned by asking a few questions that she had no appetite and no ambition to do anything. Then I told her what the "Golden Medical Discovery" had done for me. The next day the old lady drove down to her daughter's and got Mr. Brooks to send to Rutland, ten miles away, for two bottles of the "Golden Medical Discovery," and the next day when the doctor came and was about to take his leave, Mr. Brooks told the doctor he did not want him any more at present, and would send for him, if necessary. I saw the old lady about ten days later and her daughter was improving, and Mr. Brooks had great faith in the "Golden Medical Discovery," and had not sent for the doctor, but had gone to Rutland for more of the "Golden Medical Discovery." When I commenced taking the "Golden Medical Discovery" I thought I was going into consumption, as I had a cough for three years or more and my weight decreasing. My weight before taking the "Golden Medical Discovery" was 133 pounds; last March it was 147 pounds, and I give the credit to the "Discovery,"

GEORGE I. WILDER, East Wallingford, Rutland Co., Vt.

LIVER DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I suffered greatly for thirteen years. Not one moment during that time had I rest from pain or weakness. I consulted six of our best physicians, taking medicines from each for a good long time. I became completely discouraged, as I had been many times before. A letter from the World's Dispensary Medical Association with questions to be answered, fell into my hands; these I carefully answered. As soon as a letter could go and come I received another saying I had the Liver Disease. I could hardly believe it, for it had never entered my mind that that was my trouble. I read the pamphlet sent me in the next mail, describing my feelings much better than I could myself. I accepted their advice, strictly followed it. I found complete relief in taking the "Golden Medical Discovery." For years I could not ride a mile nor walk to my nearest neighbor's without feeling worse for it, and most of the time could not go at all. The day this picture was taken I rode eighteen miles, walking up and down two long hills. To the afflicted and discouraged I would say consult the World's Dispensary Medical Association; accept their advice, strictly follow it, and if there be help for you I believe you will find it in so doing.

Respectfully yours, MRS. HELEN C. BOSWORTH, Money Creek, Houston Co., Minn.

DYSPEPSIA,

AND OTHER COMPLICATIONS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--In reply to yours of the 7th instant, I would say that I can cheerfully recommend your medicines, as I have tried them and found them just as represented. I am enjoying splendid health at the present time.

Yours truly, STEPHEN OGDEN, Twin Mound, Douglas Co., Kansas.

DYSPEPSIA AND CONSTIPATION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I have been troubled with dyspepsia and constipation for the last six years, and have tried all medicines that I could think of; and I got so low in health that I thought I would once more try the "Golden Medical Discovery" and Dr. Pierce's Pleasant Pellets. After taking it for three months I began to feel better, especially the gas and sour rising off my stomach at night. Formerly it was a terrible distressed feeling, could not rest nor sleep. I am very thankful to the World's Dispensary Medical Association, and thankful to God who put the great _power_ in your medicine that cured me. I will say a good word for your medicines to all friends I meet. With many thanks, I remain,

Respectfully. Miss M.A. ELIZABETH HELFER, Moreton Farm, Monroe Co., N.Y.

COMPLICATION OF DISEASES.

A GRATEFUL PATIENT'S WORDS OF PRAISE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Having been in your Institution as a sufferer from two distinct chronic diseases of years' standing, and having been placed under the charge of your specialists, I was speedily relieved of my afflictions. The Invalids' Hotel is a place as much like home as it is possible for such an institution to be. The physicians and surgeons are all expert specialists and thoroughly efficient; the nurses are very competent, attentive and kind; and, in fact, the whole _personnel_ of the Invalids' Hotel endeavor to do their best to make the patients feel like being at home. I always felt while there as if I was one of the family. I gladly recommend your Institution to all persons who are afflicted with any kind of chronic disease, for from my own experience I _know_ the professional staff will do all which they promise to do. Please accept my thanks for the speedy benefits and perfect cure of my diseases, and I think your Institution is worthy of the highest endorsement.

Yours truly, WILLIAM HENKEL, No. 1917 Congress Street, St. Louis, Mo.

DYSPEPSIA AND GENERAL DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Having suffered for a number of years with dyspepsia, torpid liver and general debility, and having tried several physicians with little or no benefit, I resolved, as a last resort, to consult your specialists at the World's Dispensary. Being advised by them to use Dr. Pierce's Golden Medical Discovery, I did so, and after using several bottles, I feel entirely restored to health. Now, I take great pleasure in recommending your medicines to suffering humanity everywhere.

Yours very gratefully, REV. A.H. MEVS, Friar's Point, Coahoma Co., Mississippi.

"LIVER COMPLAINT."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--When I commenced taking "Golden Medical Discovery," I was suffering badly from "Liver Complaint." I had been out of health for three years. I suffered terribly from "heart-burn," had bad coat on tongue, and was often troubled with diarrhea. Three bottles of the "Discovery" cured me. Had I not commenced taking it when I did, I should have been dead long ago. You have my heartfelt gratitude for my cure.

Yours truly, JAMES GAUGHAN, Braidwood, Will Co., Ill.

P.S.--There are lots of people here whom I have recommended to use your Golden Medical Discovery," and each and every one says it is a good medicine. One woman in particular, told me she was getting better every day by the use of your medicines.

J.G.

NERVOUS DYSPEPSIA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I had a dead aching in my head and down the back of my neck and in my left ear, and my tongue was so stiff at night and dry, and I had no taste, or appetite to eat anything. I also had such a dead aching in the small of my back; it just felt as if I would break, and such aching between my hips. I had been having the "change of life," and if I worked hard I got a pain between my shoulders and a kind of aching in the abdomen. I doctored a good deal and never got any relief. I was very nervous. I took two bottles of Dr. Pierce's Golden Medical Discovery and two of his "Favorite Prescription," and I am perfectly cured.

MRS. ELLEN TAYLOR, Clarion, Clarion Co., Pennsylvania.

DYSPEPSIA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Dear Sirs_--I was a great sufferer from dyspepsia, and I had suffered so long that I was a wreck; life was rendered undesirable and it seemed death was near! but I came in contact with Dr. Pierce's Golden Medical Discovery and "Pellets." I took twelve bottles of the "Discovery," and several bottles of the "Pellets," and followed the hygienic advice of Dr. Pierce, and I am happy to say it was indeed a cure, for life is worth living now. A thousand thanks for your treatment. I enclose my photo.

Yours respectfully, REV. CHAS. PROSSER, Mount Carmel, Northumberland Co. Pa.

LIVER DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Dear Sirs_--It is with pleasure that I tell you what your "Discovery" has done for my mother. She was in poor health for a long time, coughing and weak, and thought she had consumption; she had such palpitation of the heart and could not rest at night because of the palpitation sometimes, and then the right arm pained her so at times that she hardly knew what to do; If we would put on hot applications, it would drive it to the heart, and the doctor did her no good; so finally, as a last resort, we happened to get hold of some of Dr. Pierce's pamphlets and were constrained to write to him and send a small bottle of urine for examination. He immediately wrote back, saying it was liver trouble, and to take the "Golden Medical Discovery" according to directions. She took it for two months, when the pain in her arm gradually left her and she could comb her own hair, and began to be more cheerful, for she was melancholy before. The palpitation grew less and less, and she rested at night, and is now doing her own work for a family of five, and is sixty-one years old.

I have taken delight in recommending to others this wonderful medicine for heart and liver trouble; she took a dozen bottles to effect the desired end.

Respectfully yours, Miss LU WINTER, Dakota, Winona Co., Minn.

TORPID LIVER, SUPPRESSED MENSTRUATION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I had suffered so much for years from "Liver Complaint" that I did not care whether I got well or not, but my husband urged me to take your "Golden Medical Discovery." I had not had my courses for six months; after I had taken your medicine about two months, I was well.

When one of my daughters with a baby two weeks old was in so much pain that she could not rest day or night, I went to her as quickly as I could, and commenced giving her your "Favorite Prescription." The next morning the pains were all gone. She said, "oh, mother, I would have died if you had not come. I do feel so good." Your medicine makes people feel like they wanted to live. There is a woman at Verdi who had several children who died with consumption of the bowels and _chronic diarrhea_. She had another one who was going the same way. The doctor said it was bound to die. I went there and gave it five drops of Dr. Pierce's Extract of Smart-Weed, and increased the dose every time its bowels moved, until I got to a half teaspoonful. The next morning the child was almost well. That woman says I saved her baby's life.

I could write a week and not tell half the good your medicines have done through my hands. Two weeks ago, a young man at my house was taken with _cholera morbus_. He thought he was surely going to die, but as quickly as I could get some hot water, I put hot applications on his stomach and bowels, and gave him a few doses of your Extract of Smart-Weed. He got well immediately. MRS. MARY ISABELL FITZGERALD. Reno, Washoe Co., Nev.

LIVER DISEASE AND NERVOUS DYSPEPSIA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was weak, nervous, dizzy, with a fainting sensation when walking; could not walk any distance, always feeling hungry but always felt bad; after eating felt as though my victuals were sticking in my throat; could not rest well at night; I was not well all winter. In 1891 took sick and quit work; in March doctored with three different doctors with very little benefit for a good deal over a year, then began taking your "Golden Medical Discovery." Took ten bottles of that, and one bottle of your "Pleasant Pellets," and steadily improved all the time I was taking your medicine and have worked all this summer; did not work for two years.

My case was liver disease and nervous dyspepsia of which your medicine has cured me, for which receive my sincere thanks.

Respectfully yours, ISRAEL RHUE, Morrisdale Mines, Clearfleld Co., Pa.

TORPID LIVER.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--From early childhood I have suffered from a sluggish liver with all the disorders accompanying such a condition. Doctors' prescriptions and patent medicines I have used in abundance; they only afforded temporary relief. I was recommended to try Dr. Pierce's Pleasant Pellets. I did so, taking three at night and two after dinner every day for two weeks. I then reduced the dose to one 'Pellet' every day and continued this practice for two months. I have in six months increased in solid flesh, twenty-six pounds. I am in better health than I have been since childhood. Drowsiness and unpleasant feelings after meals have completely disappeared.

Respectfully yours, U.S. Inspector of Immigration, Buffalo, N.Y. John H.M. Berry

LIVER DISEASE, CONSTIPATION.

DR. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--I enclose you my photograph as you requested; also, state that I have taken your "Pellets" and "Golden Medical Discovery" for chronic "liver complaint" attended with constipation of the bowels, and after using six bottles of "Discovery" and same of "Pellets," I am greatly benefited. You can use my name in advertising your medicines and I can warrant them to do all you claim for them.

Respectfully yours, Mrs. M.F. McDANIEL, Bee Branch, Van Buren Co., Ark.

TORPID LIVER, DYSPEPSIA, NERVOUS AND GENERAL DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Dear Sirs_--Having suffered severely, for a long time, from a torpid liver, indigestion, constipation, nervousness and general debility, and finding no relief in my efforts to regain my health, I was induced to try your "Golden Medical Discovery" and "Pleasant Pellets."

Under this treatment I improved very much, and in a few months was able to attend to my professional duties.

I now feel very grateful for the benefits I have received from the use of your valuable medicines, and recommended them to many of my friends and neighbors.

Respectfully yours, J.F. HUDSON, Witcherville, Sebastian Co., Ark.

"TROUBLESOME COMPLAINTS."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 683 Main Street, Buffalo, N.Y.:

_Gentlemen_--After using five bottles of Dr. Pierce's Golden Medical Discovery, four bottles of Dr. Pierce's Favorite Prescription, and about half-a-dozen packages of his "Pellets," I am convinced that I am thoroughly cured of that dread disease, known as dyspepsia, and other troublesome complaints.

Very sincerely yours, MISS HATTIE L. CHENEY, Sac City, Sac County, Iowa.

LIVER AND KIDNEY DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Your kindness to me I can never forget, I cannot express half my feelings of gratefulness to you. I had despaired of ever getting well.

I had been in bad health twenty years--liver and kidneys, all out of order and aches all through me; numb hands and cold feet. Everything I ate distressed me, bowels constipated, was very nervous, depressed and despondent; in fact I can't express half my bad feelings to you. When I first wrote to you, I thought I would not live to get an answer from you.

I have taken twenty bottles of "Golden Medical Discovery" and "Pellets." My health is now very good. You have my honest recommendations to all sufferers.

Thankfully yours, MRS. REBECCA RAY, DeAnn, Hempstead Co., Ark.

LIVER AND KIDNEY DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was for years hardly able to go about. I suffered from liver and kidney trouble, six different Doctors treated me during that time but could do me no good. I give your "Medical Discovery" the praise for my cure.

Then, too, my wife had a bad case of Asthma which was cured by the use of that wonderful blood-purifier.

Yours truly, GEO. W. SWEENEY, Haydentown, Pa.

TORPID LIVER.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I can truthfully say that I believe your "Golden Medical Discovery" saved my life. When I began your treatment two years ago, I had been given up by the Doctor, and my friends had lost all hope of my recovery. I had suffered for years with torpid liver; I had chronic pleurisy and catarrh in a very bad form, attended with hemorrhages--was confined to my bed two months. In a few days after beginning your medicine I could perceive a slight change for the better; in three months I felt almost like a new person.

Yours very gratefully, MRS. MAGGIE E. BRANSFORD, Williamsburg, W. Va.

DYSPEPSIA, UTERINE DISEASE.

MRS. J.A. MARTIN, of _Cleburne, Texas_, had not had good health since the birth of her child, eight years before; had a headache with burning and throbbing sensations; and a hurting in her stomach; there was a dead aching and gnawing or drawing of the stomach as she described it; sharp pain in the stomach extending to her right breast and shoulder. Weighed in health 125 pounds, but was reduced to 95 pounds; was weak; could scarcely walk at all, was sick at stomach a great deal; when her monthly sickness came on had much pain and the sickness of the stomach remained until menstruation stopped. She writes:

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--"I have taken about six bottles of your 'Golden Medical Discovery' and 'Favorite Prescription,' and am glad to say that I feel better and stouter than I have felt in a long time. I can work all day now and not be tired at night. My head don't trouble me now. When I commenced the use of the medicine I weighed 89 pounds, and to-day I weigh 98 pounds. I feel better than I have for months."

DYSPEPSIA AND CONSUMPTION.

DR. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--I was not able to do my work for nearly two years, and I tried four different doctors and grew worse all the time. Then I began on your medicine and took twelve bottles of "Golden Medical Discovery" and one of "Favorite Prescription," and am able to do my work and feel as well as I have felt in years. Physicians called my disease Dyspepsia and Consumption.

Respectfully yours, MRS. R. FERGUSON, Ink. Shannon Co., Mo.

DYSPEPSIA, COSTIVENESS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I suffered a great deal with headache and dizziness in my head and costiveness. My food would sour on my stomach and I would spit it up. I also suffered with my back a great deal; in fact, I was entirely broken down. Had different doctors but none seemed to do me any good and I began to take your medicine--the "Golden Medical Discovery."

I have been enjoying better health since I have taken your medicine than I had for years before. I have recommended it to my friends; I believe it to be the best medicine in the world. My sister has taken more of your medicine than I have; her husband has also taken it; she thinks there is no medicine in the world so good as Dr. Pierce's.

Yours truly, MRS. MAGGIE WICKLINE, Box 95, Pulaski City, Pulaski Co., Va.

DYSPEPSIA OF FIFTEEN YEARS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Dr. Pierce's Golden Medical Discovery and "Favorite Prescription" cured me of dyspepsia after fifteen years' suffering. I doctored a great deal without receiving any benefit. About four years ago my attention was called to Dr. Pierce's Favorite Prescription, which was highly recommended for dyspepsia and I used three bottles of "Prescription" and eight bottles of "Golden Medical Discovery," and they have done me more good than all other medicines I ever used.

Yours truly, MRS. ANGELINE STRAWDERMAN, Philippi, Barbour Co., W. Va.

DYSPEPSIA, SHORTNESS OF BREATH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was in bad health when I commenced your treatment; I was troubled with my stomach, and with shortness of breath. Everything I ate distressed me. I lost flesh and strength and became very nervous and despondent. I took eight bottles of "Golden Medical Discovery," and six bottles of "Pellets," and they cured me.

I would advise all suffering people to go under your treatment.

Respectfully yours, WRIGHT GOODWIN, Gaylord, Beaufort Co., N.C.

DYSPEPSIA IN ITS WORST FORM.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Only those who have had dyspepsia in its worst forms know what it really can be. What such a case needs I have found in your kindly encouragement, and your "Golden Medical Discovery."

Although I can now claim, if any one can, that I have a cast iron stomach, I always keep your "Golden Medical Discovery" and the "Pellets" on hand when settling down from an active summer's vacation, to quiet student life.

I heartily recommend these medicines to every one whose suffering is of the nature that mine was.

Yours truly, ERVIN DIETERLY, Gettysburgh, Pa.

DYSPEPSIA AND "FEMALE WEAKNESS."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Words fail to describe my sufferings before I took your "Golden Medical Discovery" and "Favorite Prescription." I could not walk across the room without great suffering, but now I am able to do my own work, thanks to your wonderful medicines, I am a well woman. I suffered all the time with a weight in the bottom of my stomach, and the most severe bearing-down pains, low down, across me, with every step I attempted to take. I also suffered intense pain in my back and right hip. At times I could not turn myself in bed. My complexion was yellow, my eyes blood-shot, and my whole system was a complete wreck. I suffered greatly from headaches, and the thought of food would sicken me. Now I can eat anything, and at anytime. My friends are all surprised at the great change in me. Every one thought I would not live through the month of August. Two of my neighbors are using your medicines, and say they feel like new beings.

Truly yours, MRS. ANNIE HUTCHINSON, Cambridge, Dorchester Co, Md.

INDIGESTION AND NERVOUSNESS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am a woman of fifty-six years of age. Had been troubled with Indigestion for three years, which, I think, resulted from "change of life" and overwork. An eminent physician informed me I had no organic disease. But I had distress after eating and was troubled with gas in parts affected, an unpleasant taste in my mouth in the morning. I was weak and nervous and had to live on a very light diet. After taking your "Golden Medical Discovery" I was relieved of these symptoms. I believe the results warrant me in recommending it to others.

Yours respectfully, MRS. CHARLES LIVINGSTON, Livingston, Grant Co., Wis.

INDIGESTION AND TORPID LIVER.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I can heartily recommend your "Golden Medical Discovery" to any one who is troubled with indigestion and torpid liver; I was that bad it was about chronic with me. All the other medicines could give me no relief; but at last, what came to my relief was that wonderful medicine, the "Golden Medical Discovery." I could scarcely eat anything--it would put me in terrible distress in my stomach; I had a dull aching and grinding pain in my stomach with pain in my right side and back, and headache, bad taste in my mouth; at night I was feverish and the soles of my feet burned.

I took four bottles of the "Discovery" and two vials of the "Pellets." I am well and hearty and can eat as well as any body can,--thanks to your "Discovery."

Yours truly, E.M. SEAVOLT, No. 427 Sandusky St., Mount Vernon, Knox Co., Ohio.

DISEASE OF STOMACH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Yours of the 4th instant was duly received. I take great pleasure in recommending to the public your system of home-treatment for chronic diseases. I am thankful to say I am in perfect health and have worked every day since I last wrote to you and have not taken a particle of medicine of any kind and am weighing about one hundred and eighty pounds. I have taken your "Golden Medical Discovery" with very satisfactory results, and "Pleasant Pellets" also.

Yours respectfully, ARTHUR LEWIS, Schoharie, Schoharie Co., N.Y.

RHEUMATISM.

WHAT A MINISTER SAYS. CURED FOR $4.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--In the fall of last year I suffered from rheumatism in my left shoulder and elbow. I tried a great many remedies, recommended to me by friends, but they all failed to afford relief. From that time I began Dr. Pierce's Golden Medical Discovery, until I felt that I was cured, was a period covering four or five months. While the attack lasted, I suffered a great deal, and could not dress or undress myself. Although I am 73 years old, I now regard my health as splendid. I had spent a great deal of money previously, in various kinds of medicine, but the "Discovery," from the day I commenced until I was well, cost only FOUR DOLLARS.

Accept my gratitude, and I beg to subscribe myself,

Sincerely yours, Rev. WILSON WILLIAMS, Trinity Station, Morgan Co., Ala.

HEADACHE AND CONSTIPATION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I suffered from loss of appetite, constipation, neuralgia, and great weakness, and had terrible attacks of sick headache very frequently; also nose bleed. My health was so poor that I was not able to go to school for two years. I took Doctor Pierce's Pleasant Pellets and "Golden Medical Discovery," and in a short time I was strong and well. Many friends are taking your medicines seeing what they have done for me.

Respectfully yours, Miss BERTHA WOLFE, Markham, Cattaraugus Co., N.Y.

AS LIVER PILLS,

NOTHING CAN COMPARE WITH DR. PIERCE'S PLEASANT PELLETS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

There is nothing that can compare with Dr. Pierce's Pleasant Pellets, as Liver Pills, They have done me more good than any other medicine I have ever taken.

Respectfully yours, SAMUEL BAKER, No. 161 Summit Ave., Phillipsburg. N.J.

ULCERATION OF BOWELS.

SEVERE BLEEDING.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--My friends said I would never be any better, for I had ulceration of the bowels. By the time I had taken a bottle and a half of Dr. Pierce's Golden Medical Discovery, the bleeding had almost stopped. My appetite was good, nothing seemed to hurt me that I ate. My improvement was wonderful. Several years have passed and my cure is permanent.

Yours respectfully, Mrs. AURELIA VANZILE, Hamilton, Ind.

BILIOUS ATTACKS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Nine years ago I was taken with severe pains in my stomach and bowels which the usual home remedies failed to relieve; after several days it passed off, leaving me very sore and weak but in the course of a few weeks it came on again. I called in a doctor--he treated me for biliousness; I occasionally went several months without any attack and then it would come more severe than ever; I could scarcely bear the weight of my clothes on my stomach and bowels. I grew thin, weak and despondent,--could do no work without bringing on terrible pain. Doctors treated me for catarrh of the head and stomach, indigestion, dyspepsia, but all was of no avail; the suffering gradually increased in severity and I despaired of any relief.

In 1892 I had a spell that was so severe I cramped from feet to neck. The Doctor said I must die--he couldn't do any thing for me. After about five weeks in bed I could again sit up, but the pain had settled in my right groin and limb. Relatives persuaded me to try "Golden Medical Discovery." Two thirds of the bottle was gone when I felt a change for the better; I had one very light attack after the first bottle; that has been seventeen months ago and I have had no more trouble. I have taken ten bottles of Dr. Pierce's Golden Medical Discovery and I am now well and able to support my family.

To any one with stomach and bowel trouble I will recommend Dr. Pierce's Medicine. I am never without it in the house.

I remain, yours, I.C. SEELY, Lindsborg, McPherson Co., Kans.

DYSPEPSIA--CONSTIPATION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 653 Main St., Buffalo, N.Y.:

_Gentlemen_--Three years ago I was suffering from constipation, distress in the stomach, bowels, feet and ankles bloated, kidney and heart trouble, loss of appetite, bad taste in the mouth, sour risings in the stomach, and indigestion. I was under the treatment of three physicians seven months. One gave me up to die. This was my condition when I was prevailed upon to take Dr. Pierce's Golden Medical Discovery and "Pleasant Pellets." I am well, your medicines have cured me permanently. Had I the power and language to herald to the whole world the good qualities of your medicines, I would most gladly do so, as they have saved my life and brought health and happiness to me.

Yours most sincerely, MRS. A.L. PIERCE, Stillwater, Penobscot Co., Me.

SORES IN MOUTH DUE TO INDIGESTION.

CHAS. KELLOGG TURNEY, ESQ., a prominent contractor and builder, also well known as one of the accomplished singers at the Chautauqua Assembly, and who does business at _Room 6, Bernard Block, Collinwood, Cuyahoga County, Ohio_, writes:

"I was troubled with little watery blisters which would form on the under side of my tongue, and which proved very sore and troublesome. Becoming alarmed at the frequency of their appearance, and having much faith in Dr. Pierce and his associates, I wrote to them for advice. They recommended me to take Dr. Pierce's Golden Medical Discovery, which I did, and after using two bottles my trouble entirely disappeared."

GAINED THIRTEEN POUNDS; CATARRH OF STOMACH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Two years ago I was pale and emaciated, food fermented in my stomach. A physician pronounced my case "Catarrh of the Stomach," but he could not help me. I lived a month without solid food and when I tried to eat I would vomit. At this time I began taking Dr. Pierce's Pleasant Pellets, and in two weeks I was decidedly better. I am now in good health, and never felt better in my life. I have a better color, eat more, and have no distress after eating--having gained thirteen pounds since I began taking them.

Yours respectfully, MRS. MARY POWELL, Glen Eaton, Marshall Co., W. Va.

CHRONIC DIARRHEA--DYSPEPSIA.

THOMAS L. HALL, of _Creek, Westmoreland County, Pa.,_ had chronic diarrhea, which his physician called dysentery. He had been troubled more or less for five years; had very severe attack fifteen months before writing us; had not been able to work steadily for twelve months. Food sometimes passed undigested; some days had three to six passages; had watery and sour risings from the stomach; backache; was drowsy upon rising in the morning; pain about the heart; itching all over body and limbs. He had three months' treatment at home--the special medicines being sent him by express. He writes that he "was greatly benefited by first week's treatment," but continued and "in three months was entirely well."

DYSPEPSIA--LOSS OF FLESH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main Street, Buffalo, N.Y.:

_Gentlemen_--Three years ago I commenced taking Dr. Pierce's Golden Medical Discovery; I weighed 140 pounds, and now I weigh 175 pounds, so you see how I have gained in health and weight. Dr. Pierce's Pellets are the best pills I ever took for the liver. All my friends say they do them the most good.

Respectfully yours, ROBERT MANSON, West Rye, Rockingham Co., N.H.

TERRIBLE DYSPEPSIA CURED.

Mrs. LUKE COOK, of _Grove, Newaygo Co., Michigan_, writes:

"I had been ill for five years. My symptoms were pain in the stomach and bowels; could eat nothing but stale bread and tea or coffee. Meat and vegetables passed through the bowels undigested in about two hours, causing great pain. I was all "run-down." Tongue looked like a piece of raw meat. One doctor pronounced my case cancer of the stomach. I took treatment from five different physicians with but very little benefit--only temporary relief. I got so weak I could scarcely walk around, and suffered terrible agony. After taking fifteen bottles of Dr. Pierce's Golden Medical Discovery, I am well and able to do my own work, and frequently walk two miles and back the same day. I am now sixty-eight years old."

INDIGESTION, CATARRH, AND NERVOUSNESS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.:

_Gentlemen_--For a long time I was suffering from indigestion, catarrh and nervousness. I was so run down that I could not go to school, and, as the various remedies I tried did me no good, I applied to you, and was advised to try a course of special treatment. After taking only two months' medicines from your noble institution, I feel perfectly restored to health. I have, moreover, recovered my lost flesh, and I am pleased to say need no further medicines.

Yours truly, E.A. BALDWIN, Proctorsville, Windsor Co., Vermont.

GENERAL DEBILITY, MALARIA, SICK HEADACHE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am happy to say that your valuable medicine has been a great benefit to me. I was suffering from general debility, malaria and nervous sick headaches, and after my third child was born (a beautiful baby boy of ten pounds) I only recovered after a long illness; I barely gained strength enough in two years' time so that I was able to crawl about to accomplish the little housework that I had, by lying down to read many times each day; had sick headaches very often; and many pains and aches, all the time complaining of getting no better. I finally asked my husband to get a bottle of Dr. Pierce's Favorite Prescription, which he promptly did. After I had taken one bottle I could see a great change in my strength, and fewer sick headaches.

I continued taking the medicine until I had taken eight bottles--seven of the "Favorite Prescription" and one of the "Golden Medical Discovery." For some time past I have not used it, but I am now able to do the housework for myself, husband and two children (aged nine and five years). I also take in dressmaking, and enjoy walking a mile at a time, and I think it is all due to the medicine, for I know I was only failing fast before I commenced to take it. I take great pleasure in recommending the "Favorite Prescription" to all women who suffer from debility and sick headache.

Respectfully yours, MRS. J.H. LANSING, Fort Edward, Washington Co., N.Y.

MALARIAL FEVER.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--My little girl, eleven years old, took malarial fever and lay 22 days in fever. Our family doctor was tending her twice a day; she got no better; I sent unbeknown to the doctor and got one bottle of Dr. Pierce's Pellets, and one bottle of his "Golden Medical Discovery," and commenced to give them to her as directed; after taking the medicine three days, the fever began to go down, and the doctor came in and said: "what's the matter?" "Ida, you have no fever this morning," and laughed. Then I told him I had been giving Dr. Pierce's medicines. He didn't say a word--he was beaten. My oldest daughter is improving by taking Dr. Pierce's Favorite Prescription.

Yours respectfully, MRS. ELIZABETH McCONELL, Payne, Paulding Co., O.

GENERAL DROPSY.

TAPPING AND MEDICATION CONQUERS THE DISEASE AFTER IT HAD RUN 22 YEARS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I wish to acknowledge that you have cured me of the worst dropsy that ever came within my knowledge, it having afflicted me twenty-two years. After I had suffered much from other surgeons without any cure being effected, and with only relief for a short time, you performed a not only painless but very scientific operation, and with medicine completed the cure. It is now five years since you treated me and no symptoms of the disease have shown themselves. I will also add that while with you at the Invalids' Hotel I received the best of care and attention from the well trained nurses in your employ, for all of which I feel grateful.

With respect and best wishes, EDWIN L. WATERS, ATHOL CENTRE, MASS.

REDUCED TO A SKELETON.

CHRONIC DIARRHEA--DYSPEPSIA CURED BY TWO MONTHS' SPECIAL HOME-TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--To all sufferers from chronic diseases I want to say that I suffered for six years, and was under fourteen different doctors in city and country. They could not reach my case; I was given up to die; my sufferings were _indescribable_; I could not retain food on my stomach; could not control my bowels at times; suffered great pain; could not sleep at night; I was reduced to a _skeleton_; in health I weighed 180; then only 111; I now weigh as much as I did before I was sick. I am sixty years old, but feel young and active; I owe it to the medicines you sent to me. After taking it two months I was out of bed attending to my work; my friends could hardly believe it was I when they would meet me out away from home. I consider my cure as almost miraculous.

Respectfully, JOS. T. YERBY, White Stone, Lancaster Co., Va.

CHRONIC DIARRHEA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--It is now nine years since I was afflicted with the above disease, which reduced me to a mere skeleton, and my friends had very little hope of my recovery. After trying different doctors, and many other remedies for a year, from which I received little or no benefit, I was advised to try Dr. Pierce's special treatment, which I did, and after two months I was a well, strong, healthy man, and have been ever since.

Yours, etc., ISAAC G. HAMILTON, Baie Verte, Westmoreland Co., N.H.

DYSPEPSIA OR INDIGESTION.

KIDNEY DISEASE AND RUPTURE.

The following is from the widely-known and popular proprietor of the Kingsley House at Ashuelot, N.H.: "It may seem useless to add testimony to the overwhelming mass already given of the many remarkable cures performed at your Institution, but I deem it a pleasure and a duty to add mine to your long list as _very remarkable_. I had a rupture of twenty-seven years' standing, with hemorrhage of the kidney for six months, preceding my visit to your Institute, and was also troubled badly with indigestion, all of which ailments had reduced me in strength and flesh to a mere skeleton. Had been treated by many local physicians, who failed to do me any good. I could walk but a very short distance when I left my home on the 8th of July, 1892, for treatment at your Institution, with but little faith or hope of ever being any better. But through your skillful treatment I was able to return to my home on the 9th of August, 1892, and consider myself permanently cured, having had to take no medicine since. Considering my case _almost a miracle_, I cannot speak too highly of your Institute and skillful treatment, to which I feel that I am indebted for my continued existence. You are at liberty to refer to me, and to use this as you see fit.

Very respectfully, A.N. KINGSLEY, Ashuelot, Cheshire Co., N.H."

DYSPEPSIA, RHEUMATISM, NERVOUS PROSTRATION, SLEEPLESSNESS.

Mr. J.T. TOWNSEND, of _Noah, Coffee County, Tenn_., consulted us by letter. He was suffering from great nervous prostration; could not walk without tottering; was troubled greatly with inability to sleep; poor appetite; did not relish food; suffered much pain and stiffness in the joints; was overcome with neat working on a thresher, followed by persistent nausea, confusion of ideas, his memory being very defective.

After taking a single course of treatment, the medicines being sent by express, he writes as follows: "The medicine you sent me lasted me five weeks, and proved very beneficial indeed. I believe it, under God, was the means of saving me from a premature grave. When I received the medicine, I had just gotten rid of an attack of bilious fever, which left me in a deplorable condition. I was very week and nervous, but my improvement commenced with the first dose of your medicine, so by the time my medicine was out I felt better than I had for years, and now have no indication of a return of my trouble." A month later he writes: "I continue to enjoy the most perfect health. Every organ of my body, and every faculty of my mind, is in splendid condition, which makes life worth living. I have gained twenty-one pounds since I have been able to attend to business. Please accept my profound thanks for your promptness in sending me my medicines."

NERVOUS DEBILITY.

PILES, CATARRH, HEART SYMPTOMS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--The effect of your remedies is little short of a miracle. My general make-up and appearance are astonishing; my cheeks rosy, eyes bright, circles nearly all gone from under eyes; am fleshier, stronger, more active, and an entirely different man. No piles, catarrh, heart trouble; no chills and fever; no despondency, no anything.

Yours truly, JOHN TALBOTT, Pennsylvania Agricultural Works, York, York Co., Penn.

DYSPEPSIA AND CATARRH

CURED BY SPECIAL HOME-TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am happy to inform you that my catarrh and dyspeptic symptoms have all vanished. I am no longer troubled with headache and stoppage of the nose, my stomach is in good order, and I enjoy three hearty meals daily without any bad feelings.

I have gained in almost every respect, particularly in weight and strength, since beginning the use of your specially prepared medicines. By continuing to follow your special hygienic rules, I believe no relapse will occur.

Yours respectfully, BERTHOLD EBERHARDT, N.E. Cor. 10th, and Callowhill Streets, Philadelphia, Pa.

INDIGESTION, CONSTIPATION, AND UTERINE DISEASE.

WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Some months ago I consulted your specialist concerning my health, which had at that time become very much impaired from the effects of uterine disease, indigestion and chronic constipation. I was also troubled with frequent attacks of nervous headache which rendered me very miserable.

A line of treatment was outlined by your specialist, which I followed closely, and I immediately began to improve under the use of the medicine advised. The benefits wore so marked that within two or three months I was able to discontinue the use of the medicine, and have since that time been enjoying good health. I attribute my cure to the use of your medicines, and I heartily thank you for the benefits received, as well as for the kind attention given me by your specialist.

Respectfully yours, IDA M. JOSLYN, Groton, Conn.

CHRONIC BRONCHITIS AND DYSPEPSIA.

WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Several years ago I spent many dollars for medicine, but in vain, and expected to die with consumption. But hearing of your Invalids' Hotel and Surgical Institute, I visited you.

To your advice and treatment I owe my life and present good health.

Hoping-that you and your eminent faculty may be spared many years to cure the afflicted, I send you my best wishes.

Yours truly, ALBERT ROSENBERGER, La Otto, Noble Co., Ind.

A COMPLETE COLLAPSE.

STOMACH TROUBLES

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:

_Gentlemen_--Fifteen years ago I felt the first effect of a diseased stomach. It was very light at first, but as time went on it gradually grew worse. I did not suffer much at first--say for the first five years; but after that it was continual suffering all the time (and growing worse all the time), until just two years ago, when I completely collapsed, and had to give up all thoughts of work. I have not done a day's work since, but am now ready to go to work again. During the last five years I have been doctoring with as many as six different doctors here and in San Francisco. I was with one specialist here in my city five months, but none of the doctors gave me even temporary relief. The main symptoms of my disease were that my food would sour on my stomach and give me an awful heart-burn. I would bloat and have sour risings, and an awful burning sensation in my chest which would bring the tears. I have felt many times that I would like to leave this world. In looking over the ads. in the San Francisco Examiner, I ran across yours--stating that any one who would send twenty-one one-cent stamps to the address given would receive The People's Common Sense Medical Adviser I did as requested, and read a copy, and I now owe my life and present good health to Dr. Pierce and his noble staff of physicians. I have now taken fourteen bottles of the "Golden Medical Discovery" and four bottles of the "Pleasant Pellets," and will say that I am entirely well of all my stomach troubles. Can sleep nine hours every night.

A word to those who are taking or contemplating taking this grand remedy. Do not give up with one or two bottles, but continue on, and it will cure you as sure as the sun shines above.

Gratefully yours, J.L. WARNER, 1005 Fourth Street, Sacramento, Cal.

NERVOUS DYSPEPSIA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--For over twelve years I was a great sufferer from nervous indigestion and acidity of the stomach. I tried some of the best doctors, both in England and this country, but did not find permanent relief until I went to the Invalids' Hotel and Surgical Institute. The medicine prepared for me by the specialist at this famous institution was so effectual that I feel that I am perfectly cured.

I cannot speak in too high praise of the Invalids' Hotel and Surgical Institute. The Staff of Physicians is skillful and of large experience, and the institution itself, in all its appointments, excellent and in advance of the age. I highly recommend it to all the afflicted, feeling confident that all the benefit to be derived from medical or surgical treatment can be had at that institution.

JOSEPH SMITH, No. 200 Eighth Street, Olean, N.Y.

BAD CASE OF DYSPEPSIA,

CURED BY SPECIAL HOME-TREATMENT.

Mrs. JOHANNA JOHNSON, of _Big Springs, Union Co., South Dak_., forty-six years old. A pain began in the stomach, a sort of cramp; extended to the chest, shoulders and arms, also affecting the spinal column opposite the location of pain; had a hard lump that felt like lead in the pit of her stomach. Pain was brought on sometimes by eating something that at other times she could eat with impunity. Attacks of pain lasted usually about three days. After the pain would leave, she was weak and sore. Sometimes attacks would come on every day.

Had two months' special treatment.

Reports five months afterwards as follows: "Since taking your medicine, I am a new person; at least I feel so. I have used only one-half of the last set of medicines, and think I will not need to continue. A lady similarly afflicted is trying some of my medicine, and will order from you direct. I am glad to know where to direct the sick, and where the most good can be had for one's money. I am feeling well, and can work as formerly."

INDIGESTION AND CONSTIPATION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was troubled with chronic indigestion and constipation. Had to be constantly taking physic, and finally was compelled to resort to hot water injections regularly to move my bowels. This got to be a great drudge to me. I took treatment from the leading physicians of this part of the country for my stomach and bowel troubles, and spent over one hundred dollars in this way, but they did me no good whatever. I got so bad that I began to think my time on earth was short, and did not care if I lived or died. I had to stop work; everything was a burden to me, until at last I tried your Institution. I went there, and you said you could help me, and those words sounded so good to me, as I thought I never could get well again. After taking your special home-treatment for five months, I was in the enjoyment of perfect health. This was two years ago, and ever since my bowels have moved regularly, and I have not taken any medicine to make them move. I cannot find words in which to express my sincere thanks for the almost immediate relief. I received from your specialists, and will say I am now enjoying the very best of health.

Yours with respect, ORWIG F. SINIGAR, No. 71 Feather St., Canton, Ohio.

FISTULA IN ANO, PILES, PROLAPSE OF RECTUM.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--For more than twelve years I have been a sufferer with a complication of rectal troubles; pile tumors, prolapsus and fistula in Ano. I have been under the treatment of our most skilled practitioners, by ligature, carbolic acid, constitutional treatment, change of climate and the celebrated Brinkerhoff treatment, and also tried all of the local guaranteed nostrums, from all of which I have been only temporarily relieved. The old troubles would in a short time return, and with seemingly renewed vigor. With fast failing health and terrible nerve prostration, I left home the 1st day of October last, to take a two weeks' trip, hoping for some temporary relief. On the trip I stopped over at Buffalo, and having several years before been in correspondence with the Infirmary, concluded to consult you. I did so with little hope of a beneficial result. From the manner in which I was received and the satisfactory diagnosis of my case, I placed myself under your treatment. On the 16th day of October you operated upon me with such complete and satisfactory success, that I am now a sound and happy man, and am confident that had I been treated by you ten years ago that I would now be twenty years younger in feeling and thousands of dollars better off. It affords me pleasure, doctors, to recommend the Invalids' Hotel and Surgical Institute to all of the afflicted, and to assure them of the most skillful treatment, honest and polite attention, and with the assurance of my kindest and most grateful remembrance,

I am, Yours truly, N.T. ROBERTS, Pine Bluff, Ark.

RECTAL FISTULA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Having been a great sufferer for years and receiving little or no benefit from other physicians, I determined to try your Institution, and with grateful results.

Having a successful operation for a fistula (of five years' standing) without the knife, while other home-physicians advised me there were no other means. And my troubles are yielding slowly but surely; my general health is better than for twelve years--all of which I owe to Dr. Pierce, and his skillful physicians and surgeons.

Please accept my sincere thanks for the kindness shown me while an inmate by all connected with the Invalids' Hotel. I shall heartily recommend your Institution to all sufferers.

Yours gratefully, MRS. M.B. LOTHROP, Villa Park, Orange Co., Cal.

UTERINE AND RECTAL DISEASE.

HOME PHYSICIANS FAILED.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_To whom it may concern_--I was greatly afflicted with Uterine and Rectal disease. My disease was of very long standing and had baffled the skill of our home physicians. I went to the Invalids' Hotel and Surgical Institute, and received treatment of their specialist. Under his skillful care and kind attention I soon regained my strength and felt that my former life and ambition were again restored to me. I cannot speak in too high praise of this famous Institution; the rooms are large and cheerful, the food of the very best, the nurses kind and attentive, and the staff of physicians and surgeons skillful and of large experience.

Yours respectfully, MRS. CHAS. CLAWSON, Middlesex, Yates Co, N.Y.

RECTAL FISTULA

WITH BLOOD-POISONING, CURED BY A SAFE AND PAINLESS METHOD. A PROMINENT MERCHANT TESTIFIES TO THE SUPERIOR METHODS EMPLOYED AT THE INVALIDS' HOTEL AND SURGICAL INSTITUTE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

It is with pleasure that I testify to the cure of the Fistula, for which you treated me. I had suffered from it for a long time, and felt that it was likely to seriously undermine my health and poison my system. I had deterred having it treated from the fears of the cutting operation in common use by physicians in the large hospitals and by surgeons in general practice. My fears were grounded on the fatal results that had followed in cases in my knowledge. I am thankful that I placed my case in the hands of your experienced specialists for treatment. The result has been a perfect cure. The treatment of the blood-poison that you gave me was successful in eliminating it all from my system, and I have since enjoyed perfect health, and no recurrence whatever of the fistula. It has been now many years since I was cured, and I thank you most sincerely for the good results that were brought about in my case.

I can recommend your institution as one in which all the requirements of an invalid are fully met.

Yours truly, J.F. EATON, Auburn, Mo., Box 806.

RECTAL FISTULA AND NERVOUS PROSTRATION-RUPTURE.

_To the afflicted public_:

It becomes my pleasant duty to recommend the Invalids' Hotel, Buffalo, N.Y., as an Institution for the successful treatment of surgical cases and chronic ailments of every description. It is with especial pleasure that I recommend the surgeon-in-chief of the Hotel, who is a skilled surgeon, one who stands at the head of the profession. The appointments of the Hotel are excellent. I was afflicted with an Anal Fistula (a very bad one it proved to be). I went to the Invalids' Hotel for treatment. Was placed under the care of your surgeon, who treated my case with such skill, that the parts are healed soundly. I recommended a friend of mine, who had a rupture, to go to you for treatment. He did so and was soundly healed of his trouble. I will cheerfully answer all communications relative to my stay at the Invalids' Hotel, provided a stamp is enclosed for return postage.

Yours truly, M.L. STIGERS, Menlo, Iowa.

ANAL FISTULA.

COMPLICATED CASE OF HEART DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:

_Gentlemen_--I feel that it is my duty to suffering humanity to let them know of your great success with me. I had a chronic disease that I had suffered with for sixteen years, and last November, owing to a fall, the disease doubled on me. I was confined to my bed for months, and the best surgeons of our city attended me daily. I continually grew worse. After consultation they decided that the knife must be used, which is attended with great pain and danger. I wrote you and stated my case; you said you could entirely cure me without pain, also without the use of the knife. I determined to go to Buffalo. Arrived there the 18th of March, and on the 20th of April I was at home entirely cured, and have enjoyed better health than for years. You also treated my wife for heart trouble, and greatly benefited her. The thoroughness of your methods, preparing the system, etc., greatly adds to your success, as well as your skillful treatment. I shall ever hold the surgeons at the Invalids' Hotel and Surgical Institute as a green spot in my memory.

Yours respectfully, N.S. JOHNSON, Bloomfield, Iowa.

HERNIA AND PILES CURED WITHOUT PAIN.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I have been successfully treated at your institution for piles and also rupture of the left side.

Your institution is all it claims to be, and the treatment of my case was accomplished without pain and apparently any risk. Your method of using locally cocaine as an anæsthetic is such a decided improvement. I did not have to take any dangerous ether or chloroform, but had a small quantity of medicine injected that made the operation as painless as though it was being done on some one else. At the same time I knew everything and could see what was being done.

You have my kindest thanks for the good care and many attentions given me. Your nurses and physicians all give kind and skillful care.

Yours very truly, J.J. APP, Bolivar, Tuscarawas Co., Ohio.

LARGE PILE TUMORS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was afflicted with piles for many years, brought on by heavy lifting during the war. My suffering was extreme, and the pile tumors gradually increased in size, notwithstanding the fact that I tried many different kinds of treatment. After becoming physically incapacitated and unable to do any work at all, and after much hesitation, I visited your institution as the last resort. I am happy to state that my visit there has resulted in a complete and permanent cure. A year or more has now elapsed since I placed myself under the care of your specialist, and I wish to thank you most heartily, for the attention which I received while there, and for the cure which has been accomplished in my case. I cannot say enough in favor of you and your staff of physicians who gave every attention, and whose treatment has been so successful. All suffering has entirely vanished, and I have gained about 35 pounds in flesh.

Respectfully yours, J.C. BAGLEY, Watts Flats, Chaut. Co., N.Y.

LARGE PILE TUMORS; CHRONIC INFLAMMATION OF BLADDER.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

I was troubled with piles for thirty years. These were very mild at first but gradually increased in severity, and I was unable to get anything which would relieve them. They gradually increased in size, and for a good many years past have caused me a great amount of pain. The tumors became of large size and protruded whenever I lifted anything heavy or strained in the least; also bled copiously at times. This, together with chronic inflammation of the bladder, with which I have also suffered for some years, rendered my life miserable. Physicians at home gave up my case as hopeless, and said that they did not think I could be benefited, and certainly not cured. I visited your Institution, hoping to obtain relief, but with very little faith, and am happy to say that the treatment which I obtained there has resulted in a permanent cure of the piles, and the inflammation of the bladder has been so greatly relieved that at present I have no suffering of any kind. The cure is complete and I feel like a new person. In fact I have not experienced such comfort in many years. I shall always appreciate the kindness and attention shown me by your staff of physicians, and also by the nurses in your Institution, and shall advise my afflicted friends to make you a visit.

Very respectfully, PETER CRUMP, Dennison, Goodhue Co., Minn.

PILE TUMORS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

Since the spring of 1872, I have been troubled with pains in head, the result of sun-stroke while in the U.S. army, and pile tumor growth. For the last named disease I was treated at the Invalids' Hotel and Surgical Institute, in June of 1887, and the growth, as I believe, is killed, and the result has been a great benefit to my general health. I am quite comfortable and with strength to look after my little work and superintend the same, much better than before treatment, for which benefit please accept my thanks.

Yours respectfully, S.H. CROSBY, Manito, Mason Co., Ill.

BAD CASE OF PILES CURED BY HOME-TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I received a few days ago a communication from you requesting a photo, of myself. I will say that I am sorry, but I have had no photograph of myself taken since I was a child, but will gladly give you a testimonial and I will answer by letter any skeptical ones that you refer to me, provided they send a return addressed and stamped envelope for reply.

Just one year ago, I was suffering untold agonies from internal piles and prolapsus of the rectum: my bodily pain was so great that the mental strain was almost more than I could stand. I was useless to myself and family and had about persuaded myself it would be better to take my life, and I think I should have done so had not a copy of the Common Sense Medical Adviser happened to fall into my hands. I was not certain just what my trouble was, at least what to call it. I began the Chapter treating on Pile Tumors, and then I realized just what my trouble was. I wrote you and received encouragement. I sent for a month's treatment and it was certainly the best investment I ever made. I received the medicines at noon--read the directions carefully and commenced at once to carry them out. I seemed better the next day. I suffered less, and in a few days there was a decided change for the better. I continued the medicine until I had taken all of it; I have not taken any since, except occasionally a few of Dr. Pierce's Pellets, just enough to act as a mild laxative. I am perfectly well. I was always more or less constipated all my life. I now understand that by keeping the bowels open and in good order, I could have avoided all of the suffering that I have gone through; my friends all think my recovery almost a miracle. I feel, Oh, so grateful to you, I shall never fail to speak a word in your favor to suffering humanity.

Respectfully, Mrs. J.W. Heist Fayette, Howard Co., Mo.

PILES AND CHRONIC DIARRHEA.

DR. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--I was a great sufferer for thirty years from piles, and take great pleasure in bearing testimony to the fact, that since you treated me, seven years since, I _have not had a symptom of piles_.

At the above stated period I had also been a sufferer from diarrhea, in its most aggravating form, for three and a half years, and I was completely and radically cured of that, also.

I beg to assure you, and your noble associates, of my lasting gratitude, and feel no hesitancy in expressing the opinion that but for your great skill in treating me, I should have been in my grave. I state for the benefit of all those who may be similarly afflicted that if they will place themselves in your hands, you will goon effect radical cures.

JOHN J. BRADFORD, Augusta, Perry Co., Miss.

LARGE PILE TUMORS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Allow me to thank you for the kind attention and skillful treatment I received while at your Institution for five weeks' treatment. I cannot speak too favorably of your Institution.

You have my best wishes for your continued success.

Respectfully yours, L.H. ESTEY, Hinsdale, Cheshire Co., N.H.

HEADACHE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I have used your medicines for a number of years, and know that they do for me all that is claimed for them. I am employed mostly at my desk, and not infrequently have an attack of the headache. It usually comes on in the forenoon. At my dinner I eat my regular meal, and take one or two of Doctor Pierce's Pleasant Pellets immediately after, and in the course of an hour my headache is cured and no bad effects. I feel better every way for having taken them--not worse, as is usual after taking other kinds of pills. Your "Pleasant Pellets" are worth more than their weight in gold, if for nothing else than to cure headache.

Very respectfully, E. VARGASON, Otter Lake, Lapeer Co., Mich.

DYSPEPSIA, NEURALGIA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Before using your medicines, my food would not digest; then neuralgia set in, and I suffered severe pain through my sides, shoulders, breast and stomach. Bilious attacks were frequent; then my flesh began stinging and my heart began beating badly and making me so that I could not lift a chair, and all together threw me into a cramp and a numbness, and the family thought I was dying, and sent for another doctor who said it was hard to do anything for me; he visited me almost six years and did not help me; the pain was so great I had to scream; I said to my doctor, "can you give me something" and he said, "yes, but it will not do you any good." I told him he had not done me any good in six years, and I would quit him. I saw I was almost gone, very pale and weak and did not eat anything.

I began your "Golden Medical Discovery," and one-half bottle helped me so much I began work and improved fast; it helped me so I got 10 bottles. While using them my friends said when I quit I would be just as bad as ever. It has been five years and no need of a doctor yet, and I will say that I think it cannot be beat, and I will still believe in it, for if it had not been for the "Golden Medical Discovery" I would have been in my grave. Your medicines have helped my brother, and father is using it now and it is helping him.

I remain. Your true friend, Miss C.B. GWIN, Cowardin, Bath Co., Va.

BLOATING OF BOWELS, CAUSED BY LIVER DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--My son, aged fourteen years, was taken with bloating of the abdomen; this would go down leaving the parts so sore he could scarcely stand. We had three different doctors to treat him, but he grew steadily worse. We then commenced giving him Dr. Pierre's Golden Medical Discovery, and after using it three days he commenced to improve. Last summer he had so fully recovered his health as to make a full hand in the harvest field. He took, in all, only six bottles of the "Golden Medical Discovery," and it saved his life.

Respectfully yours, J.B. WATRING, Lead Mine, Tucker Co., W. Va.

NERVOUS DYSPEPSIA; UTERINE AND SPINAL WEAKNESS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo. N.Y.:

_Gentlemen_--I had nervous dyspepsia for twenty years, followed by uterine and spinal weakness with irritation of the same. In the Spring of 1890 I became so exhausted that I was compelled to keep to my bed with symptoms of paralysis in the lower limbs, and many other distressing symptoms. I accidentally obtained one of Dr. Pierce's Medical Advisers from a friend, and finding my ailments so well described therein, I wrote to Dr. Pierce for his advice, which he sent by return mail. For my recovery he requested me to use his "Golden Medical Discovery," his "Favorite Prescription," and his "Pleasant Pellets." He also gave me some directions for every-day living. These means accomplished my complete cure. I am thankful that we can have such reliable medicines brought into our homes without great expense.

Yours truly, MRS. AMERICA NAY, Volga, Jefferson Co., Ind.

DYSPEPSIA, TORPID LIVER--TERRIBLE SUFFERING.

DR. R.V. PIERCE: _Dear Sir_--When I commenced your medicines, had headache all the time, indigestion, pain in my back and loins, soreness and stiffness in my joints, my limbs ached so I could not sleep at night: I could not lie in bed more than two or three hours any night; when I would lie my head on the pillow I would have to rise immediately to get breath, sit up and walk the floor very near all night. I could not eat anything that would digest; I would do the cooking for the family, but I was in so much pain the tears were in my eyes all the time I would get a meal ready. I would take one mouthful of bread and then go off and sit down and cry with hunger, but dare not eat any more, and then would have to vomit from that one mouthful of bread--I would have such weak spells I could not stand on my feet.

I had tried five doctors, they had done me no good; I had given up--never to take anything more, only to lull the pain. I had given up to die when I received a pamphlet and some papers from you. I decided to try once more and I have been improving ever since I commenced your treatment; my health is better than it has been for fifteen years; I weighed one hundred pounds when I began taking your medicines; now I weigh one hundred and thirty, as much as I ever weighed. I have taken ten bottles of "Favorite Prescription" and still more of "Golden Medical Discovery," and several vials of the "Pellets."

Your sincere friend, MRS. M.H. O'BANNON, Lameta, Leake Co., Miss.

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THE NERVOUS SYSTEM.

The nerves of the human body are not unlike the vast telegraph system of this continent.

The millions of nerve filaments are similar to the network of wires that keep all the cities in close sympathy and communion. The nerves have to deal with organs instead of villages, and with cells in place of individuals.

Commerce is regulated and train loads of food supplies dispatched here and there by telegraph, while in the body the nerves send their analogue, increased blood and nourishment, where it is required.

The various organs of sense receive manifold impressions of conditions to be met, food required and dangers to be avoided and the nerves transmit these impressions telegraphically to the brain.

The structure of the brain, spinal cord and sympathetic nerves, is not unlike a gigantic and complicated galvanic battery. The number of cells in the brain and spine are more numerous, by many millions, than those supplying any telegraph system.

As the blood supplies each cell with its necessary nourishment and removes its used up or waste materials, so does the workman give each cell of his battery fresh chemicals from time to time, and removes the used up waste.

The wires that lead from this battery to every part of the country are like the nerve filaments that go to each part of the human body and make them all--no matter how minute--perform their functions in a proper manner, and, when done, permit them to retire to rest.

With the complicated human structure, when disease takes hold, we have the same troubles that would be presented were the telegraph operators suddenly to become ill. What confusion and discord would prevail! If the sickness is severe enough to cause delirium, it would be as though madmen were at the telegraph keys dispatching trains of passenger cars which could hardly fail to bring injury and destruction to unwary travelers.

In health, we are unaware of the work of the nerves. The wheels of life move without noise. Few realize that the cavities of the heart (auricles and ventricles) are contracting steadily and alternately under the guidance of nerve cells. By this means the stream of blood, laden with nourishment, is sent to every part of the body.

Silently the stomach pours out, under nerve influence, its juices that dissolve and change parts of the food, that it may pass into the blood in condition to nourish. In a similar way, the pancreas pours out a fluid that digests the fats.

The muscular fibres of the intestines are caused to contract rhythmically and force along the bolus of digested food, so that its soluble parts may be taken up by the minute absorbent vessels to enrich the blood.

All these things of most vital importance we know least about. They go on, from day to day, without our being aware of the work done.

Let something interfere with the process, and how quickly is the sensation changed. Few there are who have not felt the agony of colic pain, due to stoppage of digestion. What suffering is greater than the sense of awful suffocation from a heart that is not acting well?

These are only familiar illustrations of a thousand and one distressing derangements and symptoms that come from exhaustion and prostration of the nervous system.

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NERVOUS DEBILITY OR EXHAUSTION.

This affection, also popularly known as Nervous Prostration, or Nervous Weakness, and, to the medical profession, as Neurasthenia, or Nervous Asthenia, is becoming alarmingly prevalent.

The wear, tear and strain of modern life are concentrated upon the nervous system. The care and consequent fret, worry and labor of this age are greater than ever before known.

The result of this extreme activity, is exhaustion and weakness. Physical bankruptcy is the result of drawing incessantly upon the reserve capital of nerve force.

We extract the following from an article which recently appeared In the New York _Tribune_:

AN AGE OF NERVOUSNESS.

The stone age, the bronze age and the iron age, we have heard of; likewise of the Dark Ages, and other self-marking eras in human history. As for the present, it might with fitness be known as the age of engineering, or of electricity, both of which proud titles it has won by its achievements. Yet there is also a less roseate view to be taken of it, and another title to be given to it, based upon its too-evident frailties; namely, that it is an age of nervousness.

Such is the view taken by the famous psychologist, Dr. William Erb, of the University of Heidelberg. Nervousness, he says, meaning nervous excitement, nervous weakness, is the growing malady of the day, the physiological feature of the age. Hysteria, hypochondria and neurasthenia are increasing with fearful rapidity among both sexes. They begin in childhood, if not indeed inherited. Minds are overburdened in school, with too much teaching or misdirected teaching. The pleasures of social life follow, overexerting the already enfeebled nervous system. Business life is made up of hurry and worry and shocks and excitements. Society, science, business, art, literature, even religion, are all pervaded by a spirit of unrest, and by a competitive zeal which urges its victims on remorselessly. No man knows repose. The result is, wreckage. The pharmacopoeia is overcrowded with nerve tonics, nerve stimulants, nerve sedatives. The medical profession devotes its best energies to the treatment of neuropaths. And as a people we are, or are becoming, excitable, irritable, morbid, prone to sudden collapse through snapping of the overtense chord of the nervous vitality.

Nowhere are the rush and hurry and overstrain of life more marked than in this much-achieving Nation. The comparative youth and freshness and vigor of the American people enable them to do and to endure what would be beyond the power of an older and more worn-out community. Yet there is no disguising the fact that the pace tells even here, and often tells to kill. True, all the tendencies of the age are in that direction. Inventions, discoveries, achievements of science, all add to the sum of that which is to be learned, and widen the field in which there is work to be done. What we need to learn is, however, that all these things are for man, not man for them. If knowledge has increased, we should take more time for acquiring it, knowing that, with the consequent increase of power, we shall be able to achieve as much afterward in the shorter time as our predecessors did in the longer time their briefer study afforded. Greater ability should mean not only greater results wrought, but fuller repose as well. For it would be a sorry ending of this splendid age of learning and of labor to be known as an age of unsettled brains and shattered nerves.

A distinguished medical authority says:

"It is proved beyond any dispute that nervousness is the characteristic malady of the American Nation, growing upon them in a frightfully accelerated ratio every year, and threatening them with disasters at no distant date which the mind shrinks from contemplating."

He continues as follows: "The number of deaths from this cause is already appalling and is steadily and rapidly increasing. In some of the busy centres the tables of mortality show that the proportion of nerve deaths has multiplied more than twenty times in the last forty years, and that now the nerve deaths number more than one-fourth of all the deaths recorded. What is most shocking in these returns, this fearful loss of life occurs mainly among young people of both sexes."

"This means that the Americans are fast becoming a very short-lived people; and that if they were shut in on themselves for only a few years, without any influx of vitality by immigration, the publication of the census would send a pang of horror and alarm throughout the land."

The annual report of the State Board of Charities of the State of New York for 1894, shows that while the increase in the State's population from 1880 to 1892 was 28 per cent., the increase of the insane in State institutions for the same period was 83 per cent.!

The enjoyment of the fruits of fortune, earned at the expense of the nerve cells, is an impossibility. The quiet and harmony of the nerve centres and nervous system are gone. Rest is impossible, continuance of work only causes increased jarring and discord of that many stringed and wonderful mechanism.

SYMPTOMS. It is well nigh impossible to give the symptoms of this disease in an orderly manner, as the affection gives rise to a thousand and one varying and ofttimes vague symptoms. The particular part of the nervous system affected, and also the cause and character of the attacks modify the symptoms. The eminent Dr. Wood says: "Nervous exhaustion may, in the beginning, affect the whole of the nervous system, or it may be at first purely local, and co-exist with lack of general nervous strength."

SPERMATORRHEA furnishes many examples of the local form of neurasthenia, or exhaustion, the sexual centres being primarily affected. In these cases, however, sooner or later, the whole nervous system becomes Involved. So in other forms of the disorder, the exhaustion at first local, finally, if neglected, implicates the whole organism. Often, in brain exhaustion, the symptoms are at first purely local. Almost always the cause of a local neurasthenia, or exhaustion, is excessive use of the part. Thus, cerebral or brain exhaustion, or debility, is usually the result of mental overwork, while sexual asthenia, or weakness is generally due to abuse of the sexual organs or to sexual excesses. When to the brain fatigue, or exhaustion, are added the depressing effects of excessive anxiety, or allied emotions, the symptoms from the first are more general, and the exhaustion may effect chiefly a single function of the brain. In pure brain exhaustion, the loss of a disposition to work, is usually the first symptom, the sufferer finding that it constantly requires a more and more painful effort of the will to perform the allotted task. At first, there is loss of the power of fixing the attention, and this, by and by, is accompanied by a weakness of the memory; disturbances of sleep are frequent; various abnormal sensations in the head are complained of. In most cases there is not absolute headache, but a feeling of weight or fullness, or an indescribable distress, usually aggravated by mental effort. It is true that in some cases of very dangerous brain tire, mental labor is performed with extraordinary vigor and ease; the power of work, is, for the time, markedly increased, and even the quality of the product may be raised. The patient may glory in a wild intellectual exaltation, a sense of mental power, with an almost uncontrollable brain activity. It is probable, however, that these cases are not instances of pure neurasthenia, or brain exhaustion, but that there is active congestion of the gray matter of the brain. In these cases the disease is very prone to end in serious organic affection of the brain.

Severe brain exhaustion may be associated with good spirits, but usually there is marked depression, and this perversion of function generally goes on, if the disease be not checked, to decided melancholy. The will power, like all the other functional activities of the brain, is prone to be weakened, morbid fears may finally develop, and at last, that which was at the beginning a single brain exhaustion, may end in persistent hypochondria, followed by insanity.

Peculiar sensations are common in neurasthenia, such as chilliness, unnatural itching, a feeling as though ants or other insects were crawling on the skin. Eruptions are common. Attacks of neuralgia are often frequent and sometimes severe, being usually worse in those persons of nervous ancestry. In some cases there is a lack of proper sensation, in others an unnatural sensitiveness. There is also in many cases a peculiar tenderness over some portion of the spinal column, especially in women.

IN WOMEN, with nervous disturbance of the sexual organs, there is frequently great pain felt during menstruation; in others, ovarian irritation and a so-called "irritable," or sensitive uterus, giving rise to manifold nervous and hysterical symptoms, sometimes culminating in convulsions or "fits." In not a small proportion of the uterine diseases which are generally only locally treated by physicians, the local disease is largely and sometimes solely the expression of a general weakness of nervous origin.

SELF-ABUSE AND EXCESSES.

It is well known that Onanism, or masturbation, as well as sexual excesses, produce an exhaustion of the nerve centres presiding over the sexual functions. This is the common history of spermatorrhea or loss of the virile fluid by nightly emissions, accompanied by lascivious dreams.

GENERAL NEURASTHENIA, or nervous exhaustion, may also produce a local weakness of the sexual centres of the brain and spinal cord, with symptoms at least resembling those of partial impotency and great irritability of the sexual organs, or a complete impotence, with premature seminal discharge whenever coition is attempted. Many times this condition results from excessive intellectual labor, even with no sexual excesses or abuses. Nocturnal, or nightly emissions, are not always experienced in these cases. When they do occur, the debilitating losses of vital fluid react upon the brain, robbing the victim of courage and manliness and exciting various phases of morbid fear and sensitiveness.

Many cases of nervous debility, or exhaustion, are the result of long continued malarial poisoning, diarrhea, Bright's disease, exhausting fevers or other debilitating affections. Numerous are the cases in which the patient is able to trace the origin of the malady back to an attack of influenza, or grip. An epidemic of the latter disease is sure to be followed by numerous cases of nervous prostration, or exhaustion.

CARE SHOULD BE EXERCISED.

In all cases, it is necessary to make careful examinations in order to detect any obscure chronic disease which may exist. In women, nervous prostration often develops without perceptible cause at the age of puberty or at the "change of life." Overwork, especially overwork combined with worry, are fruitful causes of nervous exhaustion in both sexes.

AN OVERWORKED NERVOUS SYSTEM

is always an exhausted nervous system. The nerve cells have been robbed of their vital forces. All the nutritive organs of the body suffer from the lack of nerve control, and the blood-vessels that supply the nerve centres are not in proper tone. Hence the supply of blood and the action of the heart are greatly interfered with. Many times, the most troublesome symptom, early in the disease, is an excessive perspiration of the hands and feet.

IMPOVERISHED OR POOR BLOOD.

A badly nourished nervous system is irritable. Many of the symptoms of weakness and lack of nutrition resemble those found in congestion, or stimulation from excess of blood. Then, too, we find sometimes that poor, thin, watery blood, not suitable for nourishment although sent in large amount to the brain, does not properly nourish that organ. There will still be brain exhaustion, as the nervous structures have lost their power of absorbing the nutrient materials from the blood which, being poor in quality, does not vitalize and strengthen the nerve centres as it should. In such cases thought is an effort and sustained mental exertion is impossible; the memory is uncertain, and the patient drowsy. Occasionally, after rest, there may be flashes of brilliancy, but generally they are brief.

DANGER OF CONTRACTING INTEMPERANCE.

The patient often learns that a small amount of wine or spirits is a temporary aid, and sometimes its habitual use is begun in this way. Stimulants only make a bad matter worse when their use is continued for any considerable length of time. The sufferer becomes more and more dependent upon them and the nervous exhaustion is much aggravated as large quantities are taken to satisfy the morbid craving that has been acquired.

WAKEFULNESS, OR INSOMNIA, is present in many cases; in others, there is unusual drowsiness but sleep gives neither rest nor strength; often it is disturbed by dreams that exhaust the vitality and leave the patient more tired than when rest was sought.

HEADACHE is one of the most annoying symptoms and sometimes is very persistent. It may incapacitate the patient for the ordinary duties of life. After laying down awhile and being quiet, the headache may be relieved, but recurs on attempting to go about.

FRETFULNESS. Sometimes, owing to the discomfort experienced, there is likely to be a change of disposition, irritability of temper, fretfulness and peevishness; a tendency to an irascibility all out of proportion to the real provocation. In many cases there is dizziness, and frequently noises in the head, ringing in the ears, spots before the eyes, twitching of the muscles, eyelids or eye muscles, and at times dimness of vision, or sudden spells when the sight is not satisfactory. At times there is a feeling of discomfort, as if the quantity of good air were not sufficient to aerate the blood, and there is sighing or a desire to sit in an open window, or a strong desire to be fanned. The pulse and temperature are usually normal, or a little below, but may rise if any local irritation exists. At times the face is flushed and at others pale. The skin may be dry, or in other cases bathed in perspiration on slight exertion or mental worry. When there is weakness of the nervous system, the disease manifests itself through various organs. Hence, the palpitation of the heart, dyspepsia or acute attacks of indigestion, with colicky pains and heaviness after meals, with eructations or belchings of gas, or local discomfort and unnatural action affecting, at different times, almost every organ of the body. It is well known that insanity may result from the loss of sleep and constant brooding over the symptoms that the patient fails to properly understand.

TREATMENT.

In no class of diseases is greater care, scientific knowledge and skill more necessary than in the treatment of nervous affections. Almost every case is a law unto itself, and must receive careful consideration, pains-taking advice and specially prescribed treatment suited to the peculiarities of the individual. Hereditary influences, causes of the disease and constitutional peculiarities of the patient must all be taken into account.

VALUE OF EXPERIENCE.

Only through extensive experience can the medical practitioner become expert at detecting and successfully meeting, by rational scientific and carefully adapted treatment, the many phases and complications incident to the different forms and stages of this very prevalent malady.

For more than a quarter of a century, the Specialists of the Invalids Hotel and Surgical Institute having charge of this department of practice, have been actively engaged battling with diseases of the nervous system. As a result of this long time and vast experience, they have naturally developed and thoroughly tested many valuable remedial agencies for the relief and cure of this class of sufferers. Many of these can be successfully prescribed and used at the patients' homes without a personal consultation; while others can only be brought into use at our Institution.

TREATMENT AT HOME.

Many cases, especially when the exciting cause of the malady can be easily ascertained, as in spermatorrhea from self-abuse, or sexual excesses, or in women when arising from uterine affections, can be very successfully managed and cured at home. This is also true when the disease is due to the excessive use of tobacco, opium and other narcotics.

CONSULTATION BY LETTER.

The patient has thought over his symptoms hundreds of times. The location of every discomfort has been carefully noted. These matters are stated with accuracy, common sense and good judgment when writing to us. The people are far more intelligent in these matters than physicians are generally willing to admit. A patient is often confused while being personally examined by a physician and gives imperfect or incorrect answers. After he has left the presence of the physician, he finds that he has failed to enumerate many of the most important symptoms. In consulting by letter, the patient is not embarrassed, states the exact symptoms and carefully reads over the letter, to see if it is a complete and accurate description of his sufferings. In this way he often conveys a much better idea of the case than if present in person, and subject to the most thorough questioning and "cross-examination." The timid lady and nervous young man write just as they feel and one reason why we have had such success in treating intricate and delicate diseases, is because we have obtained such true and natural statements of the cases from these letters, many of which are perfect pen pictures of disease. As bank tellers and cashiers, who daily handle large quantities of currency, can unmistakably detect spurious money by a glance at the engraving or touch of the paper, so the experienced physician, by his great familiarity with disease, becomes equally skilled in detecting the nature and extent of a chronic malady, from a written description of its symptoms. To aid the patient in giving a clear and intelligible history of his case we send, when requested, a very complete question blank.

EXAMINATION OF THE URINE.

A careful, microscopical examination and chemical analysis of the urine is a valuable aid in determining the nature of these diseases of the nervous system. This important fact is not overlooked at the Invalids' Hotel and Surgical Institute, where experienced chemists are employed to make such examinations and report the result to the attending physicians. Persons consulting us and desiring to avail themselves of the advantages afforded by these examinations, can send a sample of their urine by express. The bottle should be thoroughly cleansed and should contain from two to four ounces of that first passed after arising in the morning. It should be carefully packed in saw-dust or paper and inclosed in a light wooden box. All express charges must be prepaid through and a complete history of the case, including the age and sex of the patient, should accompany every package, or it will receive no attention. This saves valuable time by directing the examination into the channels indicated and thus avoiding a lengthy series of experiments. As we are daily receiving numerous bottles of urine, every sample, to prevent confusion, should be labeled with the patient's name. By the postal regulations, all liquids are excluded from the mails, unless packed in accordance with our printed directions, which will be sent free on request being received for them.

WE AIM TO CURE,

not merely to palliate as is so often done by practitioners in dealing with these distressing maladies. We do not prescribe coca mixtures, whiskey, malt extracts, so-called celery compounds or other nerve stimulants, which only spur the already weakened nervous system on as a man would urge his jaded horse to renewed efforts when the animal should be refreshed by proper food and rest. Neither have we any faith, in lasting good resulting from prescribing such nerve sedatives as put the nerves to sleep and so, by simply blunting sensibility, delude the patient into the false belief that he is being benefited.

To effect a radical cure of the weakness, the nerve centres must be restored to a normal condition by improving the nutrition of the nerve cells. To do this the causes of the difficulty must be understood and any local weakness or disease of any organ, be it the liver, kidneys, lungs, stomach, rectum, bladder, or generative organs, must be understood, properly treated and overcome. The desire for alcoholic stimulants is a most common and dangerous tendency of the disease. To gratify the morbid appetite for stimulants is to do the patient lasting injury.

IMPOVERISHED BLOOD.

In some cases the nervous affection is the result of an impure, or impoverished, condition of the blood. In such cases the use of Dr. Pierce's Golden Medical Discovery has, in the great majority of cases, resulted in an immediate benefit and gradually in a permanent restoration of the nerve centres to a normal condition. This remedy, particularly if assisted by the use of Dr. Pierce's Pleasant Pellets, when constipation is present, unloads the liver, and their combined action tends to remove from the blood the poisons which it is the function of the liver to take from that fluid. The cells of the brain, after performing their function, throw into the blood certain poisonous materials which it is the function of the liver to remove. If this is not done, the cells become clogged, and can only be restored to a natural and healthful condition by increasing the activity of the liver. This treatment gives rise to an immediate improvement, and a continuance of the remedies results in a gradual toning up of the nervous system and relief from the unpleasant symptoms.

"FEMALE WEAKNESS."

Many women suffer from nervous prostration, or exhaustion, owing to congestion of the uterus and ovaries, caused by over-indulgence; again by overwork, the strain of too many household cares, or too frequent childbirths. In these cases, the use of Dr. Pierce's Favorite Prescription is of the greatest benefit, tending to restore the uterus and ovaries to a normal condition. Its wonderful restorative effects, tonic and nerve invigorating properties, especially adapt it to the cure of these cases. Digestion and assimilation of food are promoted by its use. When the liver or blood is not in healthful condition, as previously referred to, the "Golden Medical Discovery" should be used in conjunction with the "Prescription." If menstruation be scanty, Dr. Pierce's Pellets will have a beneficial influence in increasing the flow, and overcoming the headache and congestion of internal organs that is the result of scanty menstruation, especially if their use be accompanied with full doses of Dr. Pierce's Compound Extract of Smart-Weed.

LOCAL CAUSES.

In the great majority of cases, when nervous prostration has made its appearance at intervals, with periods of prolonged good health intervening, but in which, as a rule, slight excesses, over-exertion or the attacks of some acute disease, produces a nervous exhaustion, we have found that local derangement is the cause of the whole trouble. This cause may often be readily removed and a perfect and permanent restoration of the health will follow.

IN MEN, we have often found a varicocele to be the cause of nervous prostration. In others rupture, or urethral stricture, sometimes of a character so mild as hardly to give serious inconvenience, has been the cause.

IN WOMEN,, ulceration of the uterus, stricture of the cervix, congestion or other diseases of the ovaries, such as cysts, abscesses, etc., inflammation of the Fallopian tubes, characterized with more or less periodical discomfort and attacks of leucorrhea, or "whites," are common causes.

In all cases in which the nervous disease depends upon local causes, we find that the relief of the local source of irritation, which tends to reduce the general health and interfere with perfect nervous tone, is all that is necessary to give the invalid a perfect restoration to health, vigor and activity. It is like removing the burden from a tired horse who has fallen prostrate under an excessive load. The removal of the burden puts the individual under a favorable condition for the immediate restoration to health and strength, and permanent relief is only a matter of a few days' or weeks' time, with appropriate nourishment and restorative nerve tonics.

ALCOHOL, OPIUM AND TOBACCO

affect different individuals according to their several susceptibilities. Some are able to withstand, with apparent impunity, an amount of these that can not be tolerated by others without great injury. No one, however, is wholly proof against these unwholesome agents which are in such common use. The sad results of their excessive use are seen in thousands of cases of shattered nerves and wasted vigor. The excessive use of tea and coffee is also a prolific cause of nervous affections.

Happily, we have now at our command remedies which exercise a most potent controlling influence over the acquired, morbid appetite for these narcotics and stimulants. Of course we have to depend, to some extent, upon the will power of the patient, but where this is not wholly lost, we have in all our later experience, been able to realize a degree of success which has been alike gratifying to both physician and patient.

THE INVALIDS' HOTEL AND SURGICAL INSTITUTE SPECIALLY EQUIPPED FOR THE CURE OF NERVOUS AFFECTIONS.

Private institutions, well supplied with the numerous and costly aids to the work of the specialist treating nervous diseases, are now a recognized necessity. Physicians and sufferers alike appreciate this fact.

Public hospitals do not answer this purpose, owing to the fact that they are more especially intended for the alleviation of the sufferings of the poor, and the greater part of the work done is in affording relief from acute diseases and emergencies requiring surgical aid. Attention is thus detracted from delicate nervous affections and is almost wholly engrossed in caring for sufferers from other diseases and injuries. Besides, association with the charity cases that abound in such places and the evidences of suffering present on every hand, are enough to prevent all improvement in sensitive and sympathetic invalids.

Perfect equipment is an important part of the battle in the cure of nervous affections.

ELECTRICITY IN NERVOUS AFFECTIONS.

Electrical applications, to be beneficial, require, on the part of the attendant, a technical knowledge of the highest character with costly apparatus and special appliances. There can be little doubt that electricity is convertible into nerve force.

In treating cases in the Invalids' Hotel, a large variety of batteries, dynamos and other electrical appliances are brought into use. These consist of cell batteries, such as is illustrated by Fig. 4, dynamos, operated by power, Franklin, or static electrical machines illustrated in Fig. 5, and other electrical apparatus, the choice of the particular machine or battery being determined by the nature of the case.

CARE AND SKILL REQUIRED.

Electricity, like other powerful agencies, in order to prove remedial must be used of proper strength and in proper quantity. The potential, or strength, as well as the volume, or amount, of current has to be carefully measured for that purpose. To accomplish this, we employ an instrument called a galvanometer, or amperemeter, illustrated in Fig. 6, which indicates the exact amount of current being applied. For the want of such instruments to measure the current, physicians often fail to get beneficial results, as they are not able to administer either the proper quantity or quality of current. Ofttimes, for like reasons, their hap-hazard way of employing this powerful agent does positive injury to the patient.

Of course, in treating cases at a distance, we cannot avail ourselves of all the great variety of apparatus brought into use at our Invalids Hotel, yet we have some forms of machines well adapted for home use, and so simple that, by sending plain printed directions with the machines, our patients are able to use them effectively without the aid of the physician. Especially is this true in the milder forms of nervous disease, and when great exactness and nicety of application is not so important. We show in Fig. 7 and Fig. 8, two forms of such batteries which are often furnished our patients for use at their homes. Many times, after cases are under treatment here for a while, we are able to educate them in the use of the battery so that by taking one of these home with them they can continue the treatment with good results after leaving the Institution.

ORGANIC, OR ANIMAL, EXTRACTS AS REMEDIES.

The experience of Pasteur, Brown-Sequard, and our own specialists, in the use of extracts of nerve substance and of certain glands and organs by hypodermic or subcutaneous injection of these fluids, has, in a vast number of cases, been most gratifying to both physicians and patients. Many wonderful cures have thus been obtained. Injected subcutaneously these animal extracts are immediately assimilated and we are often able to stop, at once, the progress of disease and turn the tide towards recovery. Thus the cells receive the special stimulants upon which their life and activity depend.

The animal extracts employed in our Institution are all scientifically and carefully produced in our chemical laboratory under the direct supervision of an experienced chemist, and are believed to be superior in quality. They are turned out fresh, as wanted, which is important, as all such preparations, no matter how carefully made and put up, deteriorate with age.

These extracts are made from the glands and organs of the lower animals, as from the brain, spinal cord, heart, testicles, ovaries and some other organs and parts of bullocks, rabbits, guinea pigs and other animals. That they possess properties which exert most potent tonic, or invigorating, influences upon those organs and parts of the human system corresponding to the organs and parts of the lower animals from which they have been extracted, no longer admits of doubt. In cases of partial and even complete impotency, especially in elderly men, attended with nervous exhaustion, most astonishingly favorable results are obtained by our specialists through the administration of our extracts obtained from the nerve tissue of the spinal cord, associated with the use of the expressed juices from animal testes. We do not, however, prescribe these extracts to the exclusion of other well tested remedial agents, but do regard them, especially in the more confirmed and obstinate cases, as among our most positive curative agents.

We must confess that when first proclaimed by Brown-Sequard as Valuable remedial agents, we regarded the use of these extracts with good deal of skepticism, but experience is, after all, the best teacher and we were forced, after numerous successful tests, to admit their great efficacy. We have always endeavored to keep up with the vanguard of the army of medical reform, and so took early occasion to introduce these agents into our practice and made preparations to produce them in our laboratory.

From an article written by an eminent specialist in nervous diseases, and recently published in the New York _Medical Journal_, we extract the following:

"Organic beings possess the power of assimilating from the nutritious matters they absorb the peculiar pabulum which each organ of the body demands for the development and sustenance. The brain, for instance, selects that part which it requires, the heart the material necessary for its growth and preservation, and so on with the liver, the lungs, the muscles, and the various other organs of the body. No mistake is ever committed. The brain never takes liver nutriment, nor the liver brain nutriment; but each selects that which it requires. There are, however, diseased conditions of the various organs in which this power is lost or impaired, and, as a consequence, disturbance of function, or even death itself, is the result."

"Now, if we can obtain the peculiar matter that an organ of the body requires and inject it directly into the blood, we do away with the performance of many vital processes which are accomplished only by the expenditure of a large amount of vital force."

"Let us suppose a person suffering from an exhausted brain, the result of excessive brain-work. Three hearty meals are eaten every day, but, no matter how judiciously the food may be arranged, the condition continues. Now, if we inject into that person's blood a concentrated extract of the brain of a healthy animal, we supply at once the pabulum which the organ requires. Then, if under this treatment the morbid symptoms disappear, we are justified in concluding that we have successfully aided Nature in doing that which, unassisted, she could not accomplish."

"That is the system. I believe it is applicable not only to the brain, but to all the other organs of the body."

The writer of the above is, very probably, a little over sanguine in his opinion that the plan of treatment will prove efficacious in all organic diseases, but certainly, from our experience, we can endorse his belief as to its great efficacy in many forms of organic weakness, especially those of the generative organs, nervous system, heart and some other parts of the body. We believe that we are placing a conservative estimate upon the remedial value of these animal juices, or extracts, when we say that they are destined to fill an important place in the curative resources of the specialist in chronic diseases.

Under the head of epilepsy, also in connection with our consideration of locomotor ataxia, we shall have occasion to refer to the use of these extracts as applicable to the cure of those maladies.

Most cases of nervous diseases that come to us, for examination and treatment, do so after having tried, without success, treatment by baths, enforced seclusion, as well as unskillfully applied electrical treatment and massage. Prolonged medication has frequently aroused digestive disorders and made the patient hate the sight of the medicine bottle. In such cases our improved methods, as applied in the Institution and also prescribed for patients at a distance, enable our specialists to give relief and effect cures with a minimum of medicine. They also enable us to treat many cases of nervous diseases heretofore regarded as almost hopeless, such as locomotor ataxia, paralysis, epilepsy and spinal affections, with a degree of success which has been very gratifying alike to physicians and patients.

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HEADACHE AND NEURALGIA.

There is no ill to which flesh is heir that is the source of a greater degree of discomfort to the human race than headache. The farmer, housewife, banker, merchant and laborer seem to be equally prone to the affliction and all who suffer have a great number of days rendered uncomfortable and unhappy by the presence of this most unpleasant affection. Pain is the warning finger of disease--the threatening indication of coming trouble. In headache, we have an indication that the system is subjected to some strain or injurious impression. It may be that the eyes have been overworked or the brain unnaturally taxed; or that the nervous and physical systems have not been properly refreshed by sufficient sleep, and have used up the residue of reserve power. Many suffer from headache only after they have been subjected to sudden changes of temperature and have taken cold; others only when the bowels have become inactive, the liver torpid and the blood vitiated with retained poisons.

All appreciate the discomfort that results from this malady and earnestly seek for permanent relief.

Headaches may be divided in two classes: (1) those due to the presence of poisons in the blood, and (2) those due to irritation of various organs, as of the eyes, stomach, liver, and intestines.

Of the first form, or variety, of headache, influenza, or grip, and acute "cold in the head," are the most common causes. These give rise to most excruciating pain. There is congestion, followed by inflammation in the nasal passages and cavities communicating therewith. The membranes of these passages throw out a thin, watery, irritating discharge, which gradually thickens and becomes pus-like and offensive in character, if the disease continues.

Poisonous matters are absorbed from the affected surfaces into the blood. These poisons, circulating in the blood, produce great irritation of the nerve cells, so much so, that the severity of the attack is felt in the nervous centres, the brain and spinal cord, with pain varying from the most acute and sharp, to a dull, numb ache. The temples, eyes, neck and small of the back, are in their order, the usual locations of greatest pain. Such attacks vary in frequency and severity. One attack is usually followed by an early recurrence, which may be more or less severe, while the period of active pain varies from a few hours to several days. Such attacks leave an exhausted state of the nerve centres and general weakness of the system that often lasts for weeks and may permanently impair the system, except such results be prevented by appropriate treatment. Every recurrence of the attack leaves the system in a worse condition, until profound nervous prostration; ensues.

Malarial headache, sometimes termed "brow ague," is a common form of the malady with those residing in malarial regions. The pain rapidly develops, usually over one eye. It lasts from five to ten hours, and is often of frightful intensity.

Other forms are rheumatic and gouty headache; usually a heavy aching pain appearing on the approach of storms, but at times almost continuous, made worse by improper diet.

Uræmic headache is due to kidney disease, and alcoholic to direct irritation of the brain membranes from the use of alcoholic beverages. The latter is accompanied with much irritation of the stomach and intestines.

Headaches of a similar character result from the presence in the blood of an excess of the active principles of coffee and tea.

Overindulgence in these agents, as with alcohol, affects the nerve cells and membranes, often causing severe attacks of headache.

Nervous headache is another common affliction. This seems to arise from several causes, such as impoverished blood and exhaustion from overwork of the brain. Hysterical headache is not uncommon. There is a severe kind of headache, the attacks of which appear first at early puberty and continue at intervals more or less frequent in women up to the change of life and in men to about the fortieth year.

The periodical headache is usually preceded by yawning, chilliness, languid, exhausted feelings, in others by peculiar emotional or mental activity. This is followed by unusual drowsiness, in which the night's rest is broken by dreams, and from which the patient awakes tired. Gradually, during the day, the headache develops, beginning in the eyes or bones over them. It gets more and more severe, shooting into the jaws and neck or extending to the back of the head and spine. As the pains get most severe, nausea or vomiting, often repeated, follow, in which the contents of the stomach, with mucus and bile, is ejected. The whole paroxysm lasts from five hours to two or even three days.

NEURALGIC HEADACHE is a common variety; often the pain is not confined to the head, in fact neuralgia may affect almost any part of the system.

NEURALGIA.

Neuralgia is an affection of the nerves, of which the chief symptom is pain. This is of variable intensity and character. It follows the course of the affected nerve and its branches, and occurs in paroxysms, of agonizing pain with periods of intermission during which the pain may be very slight, and cause but little discomfort.

The severe pain is described as lancinating, cutting, tearing, burning, boring and pressing. Patients use different words in describing the attacks, and there is probably a difference in the character of the pain, though in a severe paroxysm one is scarcely able to make a very nice distinction. We have known cases in which the pain occurred suddenly and overwhelmed the patient's fortitude by its severity and unexpected onset. Between the paroxysms there may be less severe pain, which is then more frequently of an aching, burning or pricking character. In some, paroxysm after paroxysm succeed each other with almost lightening-like rapidity, and even in the intervals the pain is very intense. At another time there is only one sharp sting of pain, which attacks recur several times an hour or day, or may be absent for days or months. An extended freedom from all pain is rare in a patient very much affected. The first attacks in all forms of neuralgia are often comparatively light, and the severity of the pain gradually increases as the attacks multiply. We have frequently had patients unacquainted with anatomy, map out the distribution of a nerve very perfectly, simply describing the portion of the body in which the pain was experienced. For convenience, the neuralgia has been named with reference to the nerve most seriously attacked; lumbago to the spasms of pain affecting the small of the back; tic-douloureux is a term applied to neuralgia of the fifth nerve, that supplying the side of the face, with branches to the eyes, jaw, and teeth. Neuralgia of the testicles, ovaries, stomach, heart, are frequently met with. That affecting the large nerve supplying the thigh and leg is termed sciatica. These nerve affections often prove a most grave disorder, rendering the life of the sufferer a burden.

TREATMENT. Contrary to opinions frequently expressed by members of the medical profession, we find that most cases present some removable, or remediable, cause for attacks of headache and neuralgia. The temporary relief that is obtained by the use of "headache powders," various bromide combinations, caffeine and other anodyne and narcotic medicines, is sometimes necessary in order that the excruciating sufferings may be borne for the time, but as a rule such remedies only react unfavorably by interfering still further with the natural restoration of the affected organs, or protract the removal of the cause of the disease. Hence, the next attack is usually earlier in its appearance and more severe and lasting when such agents are employed.

The great majority of headaches and neuralgias are due to the presence of poisons in the blood. This may be due to affections of the blood-making, or blood-purifying organs.

For the correction of inactive blood-making glands, or a lack of purification of the blood, due to such cause, the use of Dr. Pierce's Golden Medical Discovery is particularly beneficial. It has no equal in its direct effect upon the liver, the great purifying organ of the body. Through this natural gateway, it removes from the system poisonous materials which are the waste from the nerve cells. The accumulation of these waste materials irritates the cells and causes them to cry out with pain. The blood, being properly purified by the use of "Golden Medical Discovery" supplies to the nerves, and to the nerve cells, what they crave--a healthy and rich blood that furnishes proper nourishment. Hence the headache disappears, and the neuralgic pains are overcome.

When the liver is engorged and torpid, the intestines become overloaded with fecal matters that putrefy and give rise to gases and consequent distention. Deleterious poisons are formed and absorbed by the blood from such hardened and irritating lumps in the intestines. When the bowels are thus constipated, Dr. Pierce's Pleasant Pellets are necessary as an adjunct to the "Golden Medical Discovery." The "Pellets" remove from the intestinal canal all irritating materials and thus enhance the alterative, or blood-cleansing, action of the "Golden Medical Discovery."

In women, when there is a nervous affection, dependent upon some unnatural state of the ovaries or uterus, and complicated with an imperfect or unnatural circulation in those parts, we have noted that most satisfactory results invariably follow the use of Dr. Pierce's Favorite Prescription. This agent improves the tone of the nervous system, and by its direct restorative tonic effects, lessens, or overcomes, any congestion of the womb or its appendages, regulates menstruation and promotes a condition of health and vigor.

In a vast experience, our specialists have thoroughly tested a great many specific remedies which we prescribe for home-treatment, sending the necessary remedies to our patients by express or mail, carefully adapting them to each individual case. Many sufferers have been, by a brief course of our home-treatment, relieved permanently from excruciating sufferings that had been a source of annoyance and loss of time for many years prior to the use of our remedies.

Our treatment is intended to effect permanent cures. We do not use those narcotics and compounds of antipyrine and other similar agents which are very depressing in their effects, and, like morphine and other preparations of opium, give only temporary relief, and interfere with the action of the heart, but we use treatment that builds up the system, removes the cause of the difficulty and restores the nervous system and all the organs of the body to a normal and healthful condition.

In some cases we advise treatment in our Institution, where we have every facility in the way of electrical appliances and many other aids that can only be employed by the personal attention of a skillful physician. These aids are more fully described under the head of nervous exhaustion and a reference is also suggested to what we have to say under the heads of paralysis and locomotor ataxia.

Headaches or neuralgic pains, due to local irritations, as uterine disease, stricture, neurotic or nerve tumors, pressure of trusses, eye strain from weakened eye muscles, or lenses that need the help of proper spectacles, require for a permanent cure the removal of the cause. Sciatic neuralgia, one of the most common and painful forms of nerve irritation, is particularly amenable to treatment by the modern means of cure used in our practice at the Invalids' Hotel.

We find, as a rule, that severe headaches and neuralgias are but the forerunners of more serious conditions, and are therefore deserving of special attention. They should be corrected as early as possible, before any organic changes have occurred.

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PARALYSIS OR PALSY;

LOCOMOTOR ATAXIA AND KINDRED AFFECTIONS.

Paralysis is an affection characterized by loss of muscular power or by the sense of touch, taste, sight or smell becoming impaired from injury to a nerve by accident or disease.

The disease is sometimes due to simple lack of nerve force or power. This may come from interference with the blood supply of the nerve centres, as in hysterical palsy and reflex paralysis. Frequently the power of speech is affected in this way, ability to remember and difficulty in pronunciation of certain words being the most common. Certain affections of the womb and its appendages, in women, and, in men, stricture of the urethra, adherent prepuce, or foreskin, with wounds and injuries, many times of nerves and organs remote from the paralyzed points, cause the loss of power.

THE CAUSES OF PARALYSIS are very numerous. Whatever destroys, or impairs the natural structure of nervous matter, or whatever interferes materially with the conducting power of nerve-fibre, or the generating power of the nerve-centres, will produce a paralysis, the extent of which will depend upon the amount of nervous matter affected. Thus paralysis may be due to disease of the brain arising from apoplexy; to abscess, softening, syphilitic or other tumors, or epilepsy; to disease of the spinal cord, or marrow; to disease of the structures which surround the spinal cord, producing pressure upon it; to injury or compression of a nerve, by which its conducting power it impaired; to the effects of diphtheria, hysteria, or rheumatism. It may also be due to poisoning of nervous matter with opium, lead, arsenic, or mercury; or to the retention of poisonous substances which are generated in the living body and which should pass off through the excretory organs, as the elements of the urine and bile.

Members of consumptive families are very prone to paralysis.

We also find that the disease is often the result of some nervous strain, or over excitement The over indulgence of the passions is particularly a fruitful source of injury to the brain and spinal centres. An angry man or woman uses up more nerve energy in a few minutes than would be sufficient to serve the muscles with stimulus through hours of toil.

The young, in unnatural indulgence of the sexual passions, waste the vigor and energy of maturity. Sexual excesses must be put down as among the most prolific causes of this terrible malady. Ignorance shields no one from the consequences of violations of the laws of health.

The passion for wealth with its ceaseless toil, continuous strain, and rapid exhaustion of the nerve forces, usually brings its devotee into the same condition of discord as does the abuse of a stimulant. For a time the system will repair and bolster up the weakness, but the longer the day of reckoning is postponed, the more serious and terrible is the collapse.

Such individuals need only an exposure to cold, or an over indulgence of some kind, to suddenly precipitate a paralysis.

GENERAL PARALYSIS. This term is applied to paralysis affecting the arms and legs. In this form of paralysis there is generally more loss of motion than of sensation, and the mind is usually more or less affected.

HEMIPLEGIA, or paralysis of one side of the body, is generally spoken of as a "stroke of palsy." Sometimes only one extremity, the arm, is affected. Only occasionally is the face involved. In the majority of cases the mind is affected, the memory being poor, the sufferer becoming melancholy, peevish, and fretful.

In paralysis of the right side, there is sometimes a curious forgetfulness or misplacement of language, the patient being unable to think of words to express his thoughts. This condition is called _aphasia_. It is usually the result of some injury or disease of the brain, almost invariably the side of the brain opposite the affected half of the body. In some cases it is due to a wasting, or softening, of the brain substance, on account of insufficient nourishment, a deficient supply of blood; whilst in others, it is due to just the opposite condition, an excess of blood, producing rupture of some blood-vessel, transudations, and pressure.

PARAPLEGIA, or paralysis of the lower half of the body, is the result of disease of the spinal marrow. The paralysis may occur suddenly, but, in the majority of cases, it comes on slowly and insidiously, with weakness and numbness of the feet and legs, or with tingling and a sensation resembling that produced by ants creeping on the surface of the skin. By degrees the weakness increases, until there is complete loss of both motion and sensation in the feet and legs. The lower bowel and bladder are generally involved, and as a result, the patient suffers from constipation, and retention and dribbling of urine. Although completely paralyzed, the patient is often tormented with involuntary movements and cramps in the affected muscles.

Paraplegia may be caused by various injuries of the spinal cord; by congestion, degeneration, or hemorrhage; by pressure from thickening of the sheath of the cord, or from tumors, or from disease of the bones and cartilages of the spinal column. Paraplegia may also be produced through reflex action, by an irritation, or injury to some organ or part of the body distant from the spinal cord; thus, irritation of the skin, or of the bowels from the presence of worms, or disease of the bladder or of the womb, may produce paraplegia.

LOCOMOTOR ATAXIA.

Locomotor ataxia, or creeping palsy, is also called progressive paralysis. This affection consists of a disease of the nervous matter in the posterior columns of the spinal cord. It usually affects first the lower part of the cord, and those portions of the nerve matter that supply the muscles of the legs. In other cases it first affects the portions of the spinal cord that supply the arms. In most cases of this disease there is an early stage in which the patient suffers from "lightning pains," as they are called. These are of a severe, stabbing, boring character, very sudden in their onset, and at times so serious as to have induced suicide. These paroxysms, in the milder form of the disease, are not so severe, and are readily controlled by anodynes. They may affect the stomach, and be mistaken for dyspepsia, or the rectum, and be taken for fissure or piles. At times they affect the bladder, when the symptoms are not unlike those of stone or cancer. In many cases we find the patient has been treated for a long period of years for rheumatism, sciatica, or neuralgia, when the real disease has been this progressive paralysis in its earlier stage. Sometimes the disease takes the form of spermatorrhea or impotency; in other cases it is manifested in weak eyes, disturbances of vision, or cross-eyes. Sooner or later, there appears the peculiar paralysis of the disease, which consists of more or less numbness of the feet and legs, and, in the later stages, of the hands and arms, sometimes of the face. As a rule, however, the patient finds difficulty in properly maintaining his balance, and in walking his movements are tottering, like a man partially intoxicated. It is difficult for him to maintain his balance and walk with his eyes closed. If the arms are affected, their movements are uncertain. In guiding a needle or in buttoning or unbuttoning the clothing, there is an inability to move the hand with rapidity and certainty, or to any portion of the face or body if the eyes be closed. The eyes and attention must be constantly directed to the motion that is about to be performed, or it is imperfectly done. The brain centres in this case supply the weakened action of the spinal cord, and the stimulus to the muscles is directed by the intelligence instead of being automatic, as in health, and due to spinal action. Still later, the voluntary movements become spasmodic or jerking. The neuralgic pains often become very distressing; there is often a sense of constriction around the limbs or body, as if they were encircled with tight cords. In extreme cases locomotion becomes impossible, the patient is unable to bring the hand to the mouth, and the speech may become impaired, articulation being difficult and imperfect. In all cases there is more or less loss of sensation in the lower limbs, the patient generally being usable to distinguish between two points and one, even when the two, are a considerable distance apart. The inability to feel the contact of the ground or floor with the feet occasions the difficulty in walking. THE CAUSES of this disease are somewhat obscure, but unquestionably exposure to cold and dampness, and over-mental work, are largely instrumental in its production. Scrofula and syphilis favor its development, while abuse of the nervous system, such as results from over-indulgence of the animal and reproductive instincts, are frequent sources of the nervous changes that lead to ataxia.

SHAKING PALSY.

_Shaking Palsy, or Paralysis Agitans_, is an affection dependent upon degenerative changes in the nervous centres. It is characterized by a tremulous agitation, or continual shaking, beginning in the hands, arms or head, and gradually extending itself over the entire body. The disease progresses slowly, but when far advanced the agitation is violent, and the patient swallows and masticates his food with great difficulty. In an advanced stage of the disease, the body becomes bent forward, and the chin almost touches the breast-bone. The tremor, which early in the disease only occurred during the time the patient was awake, now continues during sleep, and not infrequently the agitation becomes so violent as to waken the sufferer.

GENERAL TREATMENT OF PARALYSIS.

The indications of treatment for the various forms of paralysis are to remove the causes, if these can be determined, and rouse the functions of the paralyzed parts. Measures should be adopted to remedy the morbid conditions upon which this affection depends. Keep the skin clean and healthy, promote the circulation of the blood, especially in the paralyzed limbs, and encourage healthy nutrition. These ends may be best attained by the daily employment of stimulating baths and frictions upon the surface. As much regular exercise as the patient can bear without fatigue should be taken in order to favor the preservation of the appetite and strength. Care should also be taken that the bowels are evacuated regularly every day. The circulation through, and consequently the nutrition of, the palsied muscles may be aided by having a strong healthy person knead and manipulate them. These manual movements upon the surface of the body will often excite muscular sensibility, similar to that awakened by a weak Faradic current. The internal medicines should be such as to regulate the general functions of the system. The use of these remedies must be directed by the skill and experience of those who are professionally qualified to administer hem.

When the patient has been able to be under our personal care at the Invalids' Hotel, we have found the employment of mechanical movements and manipulations, applied by means of a variety of machinery, employed in this Institution, together with the use of the equalizer, or large dry cupping, or vacuum apparatus, to be of the greatest benefit. These several machines and apparatus furnish a perfect system of physical training, thus rendering valuable aid in the cure of many forms of obstinate chronic diseases. A few of these machines are shown in Figs. 9, 10, 11, 12, 13, and 14; also see page 32 of Appendix.

The general practitioner often endeavors to overcome the inertia of the nerve-centers and nerves by means of specific irritants, with the view of exciting the power-producing function, of compelling the weakened and disabled centers to evolve more power. By such stimulation and forcing, he places a burden on the weakest parts. The compulsory and ineffectual endeavor of the weak parts to act in response to such stimulation is very liable to make undue drafts upon the capacity to act, which only end in exhaustion of the little remaining power instead of its re-enforcement. Cases which were previously curable by direct and appropriate means, are thus forever placed beyond the reach of remedies. No powerful stimulating or depressing medicines are indicated in any of the various forms of the affection. In paralysis it should be our aim to improve local and general nutrition, to relieve local congestions and inflammations, to produce absorption of deposited matters, and to force an abundance of blood through palsied muscles, from which they may derive a proper supply of nutriment, and to which they may give up the products of waste. All this can be accomplished by massage, mechanical movements, regulation of the atmospheric pressure on the body, baths, and proper physical culture.

In paralysis, there is a diminution or total loss of the contractile property of the muscles to which the affected nerve fibers are distributed; consequently the capillaries and small veins are not compressed, as in health, and the blood is not forced on through them towards the heart; hence there is a backing-up of the circulation, passive congestion, and all the evils incident to that condition ensue.

_Mechanical movements_ properly applied to the affected limbs, or parts of the body, accomplish the same results as contraction of the muscles. They compress the capillaries and veins and thus force the blood on through these vessels towards the heart. There is a constant pressure in the arteries, hence the flow of blood in the capillaries is always towards the veins, and, when it gets into the veins, it is prevented from flowing back by the valves in those vessels.

A proper circulation of the blood through the disordered parts is thus effected, and, as the result, they receive an abundance of nutriment, and their waste products are promptly carried away to the excretory organs, by which they are separated from the body; the deposits of fatty matter between the muscular fibers are absorbed, and the agglutinated fibers are separated.

As proof of these statements, it has been found by experiment and observation that there is an increase of temperature in the parts subjected to this action, which _must_ be due mainly to an increase in the chemico-vital changes that are superinduced by the nutritious elements of the arterial blood, particularly that element which is supplied to it by the inspired air, oxygen. All the products of waste are increased. The skin becomes more soft and moist, showing that the amount of matter eliminated by it is increased. The urine becomes more abundant, and the relative amount of urea, its most important constituent, becomes greatly increased. The amount of carbonic acid gas exhaled is increased, and further evidence in the same direction is furnished by the very marked increase in the inspiratory acts, necessitated by the increased demands for oxygen.

The local increase of the circulation incident to properly applied mechanical movements, must produce a corresponding diminution of blood in other, even in remote, regions of the body. Thus this treatment, by its revulsive effects, is capable of relieving various disorders of the head, chest, digestive organs, and pelvis. Nowhere, however, is the effect more satisfactory than in affections of the brain and spinal cord, whether characterized by loss of power, of sensation, or by neuralgic pain. Any portion of these nerve centres suffering from congestion, will find prompt relief in mechanical vibratory movements.

THE MOVEMENT CURE which we advocate is not a "Swedish Movement Cure," nor anything akin to it. It is the application of remedial forces by complex structures, which combine a variety of mechanical powers. The inventions are solely American.

By means of this machinery, which is driven by steam power with great velocity, we are able to apply _soft, pleasant, rapid vibrating movements_ over the surface of the body, and thereby increase the circulation of blood through the parts, raise the temperature, and excite pleasant sensations. The movements can be applied by our ingeniously-devised machinery to any part of the body through the clothing and _without the least exposure of the person._ They can be administered in a great variety of ways, by light, quiet persuasions, by gentle frictions, by rubbing, by oscillations, by kneadings, by circular movements, in fact, by an almost _endless variety_ of reciprocating and alternating motions, which, if described, would convey to the mind of the reader but a faint conception of their remedial value.

VIBRATORY MOTION not only establishes activity of the circulation through the skin and muscles, but it also affects profoundly the circulation in the important and vital organs of the body; it is thus capable of overcoming torpidity or congestion of the liver, spleen, and other deep-seated organs, without the depressing effects which sometimes follow the administration of powerful medicines.

It has not been our purpose to literally explain, in detail, the methods of applying vibratory motion in the treatment of paralysis for popular experiment, since to be successful one should become an expert, not only in this mechanical treatment, but also in the diagnosis of the various forms of paralysis, as well as familiar with their causes, pathology, and remedial requirements. Thus, to be successful in the treatment of paralysis and other nervous diseases, by the application of motor forces with our ingeniously-contrived machinery, the cost of which is beyond the means of most invalids, one must exercise great discretion.

GRATIFYING SUCCESS. Not only is vibratory motion as a remedial agent rational and philosophical, but our experience has fully demonstrated its marvelous effects in the treatment of paralysis in its various forms, and also in the cure of other chronic diseases. We have cured cases of infantile paralysis which had resisted the skill of the most renowned physicians in our country. We have treated those who could not stand or bear the weight of the body, but who have been so far restored as to be able to walk and run without assistance. Writer's and telegraph operator's paralysis, or cramp, we have cured in a few weeks' time. Club-feet, spinal curvature, and other deformities resulting from paralysis, have been successfully treated in our Institution. In short, our success has been most flattering in all curable cases of paralysis, and it is such experience that induces us to hold out encouragement to those who are afflicted with paralysis and other nervous affections.

Vibratory motion is a desideratum of priceless value to those who are afflicted with diseases of the nervous system, as well as to all others who need a gentle stimulus to call forth their latent energies and improve their physical condition.

RECAPITULATION.

Motion, properly transmitted to the human system by mechanical apparatus, is transformed into other forms of force identical with vital energy, by which the ordinary processes of the system are greatly promoted.

It increases animal heat and nervous and muscular power to the normal standard.

It removes engorgement or local impediments to the circulation.

The electrical induction produced, renders it a most efficacious remedy for paralysis of all kinds.

It removes interstitial fluids and causes rapid absorption and disappearance of solid and fluid accumulations.

It is a powerful alterative, or blood-purifier, increasing oxidation and stimulating excretion.

It diminishes chronic nervous irritability and promotes sleep.

It hardens the flesh by increasing muscular development and improves digestion and nutrition.

ANIMAL JUICES, OR EXTRACTS.

The use of animal, nerve and gland extracts has proven of surprising efficiency in the treatment of paralysis and locomotor ataxia. They furnish a pabulum in concentrated form for the nourishment and restoration of the weakened nerve cells and fibres.

In the vast majority of cases, we have been able, by the use of these recently discovered curative agents, when assisted by other means at our command at the Invalids' Hotel and Surgical Institute, to arrest the progress of these nervous affections, hitherto so generally considered incurable, and bring about restoration of the paralysed functions and a renewal of lost power.

These comparatively new remedial agents have been very thoroughly tested by us. Their merits are more fully considered in a preceding chapter of this treatise, under the head of treatment for Nervous Exhaustion, or Debility.

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EPILEPSY ("FITS").

Epilepsy, or falling sickness, is a disease which is characterized by attacks of sudden loss of consciousness, together with convulsive movements of the muscles. The paroxysms occur at irregular intervals, the periods between them, in some cases, being only a few minutes or hours, while in others, several months elapse.

There are two classes of Epilepsy: 1st. The general form, with a convulsion that usually involves all the muscles of the body simultaneously. It begins suddenly with little or no warning, commonly with a cry or scream. The convulsion may last several minutes and is followed by a deep sleep for some hours.

2nd. The local or Jacksonian form in which the attack begins with a peculiar sensation in some particular region of the body, either in one extremity or one half of the face. This sensation is followed by a twitching of the muscles of the part. The sensation and spasm extend or advance gradually to other parts. Consciousness is not usually lost, though it may be when the spasms culminate in a general convulsion.

Great weakness generally follows in the parts convulsed, gradually passing away. When the attack begins on the right side of the face it is associated with an immediate inability to speak.

SYMPTOMS. In the severe forms of the disease, the subject suddenly loses consciousness and falls; there is rigidity of the muscles, which causes a twitching of the face and limbs; the eyes are turned up, and there is foaming at the mouth. In the severe form of the disease, the respiration is arrested, while in the milder attacks, the breathing is difficult, slow, deep, and snoring. With the commencement of the spasm, the tongue is sometimes caught between the teeth and severely bitten. During the paroxysm, the countenance changes from a livid hue to dark purple. The convulsion continues from one to three minutes, and is followed by a deep, sighing inspiration; the subject then sinks into a deep sleep, which continues for half an hour or longer. When consciousness is first regained, the subject appears confused, stupid, and usually complains of headache. He has no recollection of what has occurred during the attack, he pronounces words indistinctly, and if he attempts to walk, he staggers like a drunken man. Sometimes, several attacks occur so closely together that there is no interval of consciousness between them.

In some cases, there are premonitory symptoms, such as giddiness, drowsiness, headache, and irritability of temper, which warn the subject of an approaching paroxysm. Occasionally, a wave of cold commencing at the feet and proceeding to the head, is experienced. This is called an _aura_. When it reaches the brain, the subject becomes unconscious, falls, and the convulsion commences. If the disease be allowed to proceed unchecked, it almost invariably leads to great impairment of mind, insanity, or paralysis.

CAUSES. The _predisposing causes_ are an hereditary tendency to the disease, and everything which impairs the constitution and produces nervous prostration and irritability. Syphilis, phimosis, sexual abuses, uterine disease, and the use of alcoholic liquors are prominent predisposing causes. Many of the causes treated by us have been brought on by masturbation. Others are the results of injury to the head. Often fracture of the skull is followed by epileptic attacks.

_The exciting causes_ include everything which disturbs the equilibrium of the nervous system. Indigestible articles of food, intestinal worms, loss of sleep, great exhaustion, grief, anger, constipation of the bowels, piles, and uterine irritation may be enumerated among such causes. Convulsions of an epileptic character may also be induced by a poisoned condition of the blood, from malaria and disease of the kidneys or liver.

TREATMENT. When the time of an expected paroxysm approaches, great care should be exercised that the patient be not suddenly attacked while carrying a lighted lamp, or that he does not fall in some dangerous place, strike upon a heated stove, or in some similar way inflict great injury. If there be warning symptoms before the attack, the subject should carry a vial of the _nitrite of amyl_ in the pocket, and, when the premonitory symptoms are felt, two or three drops should be poured on a handkerchief and held about an inch from the nose and inhaled, until flushing is produced, or a burning sensation is felt in the face.

During the paroxysm, the subject should be laid on the back, with the head slightly elevated, and the clothing about the neck and waist, if tight, should be loosened. If there be sufficient warning, a folded napkin, or a soft pine stick covered with a handkerchief or cloth, should be placed between the double teeth, to prevent the tongue from being bitten. During the fit, the head may be bathed with cold water.

A person who suffers from this disease should avoid everything which tends to excite the nervous system, or increase to any great extent the action of the heart. The sufferer should go to bed at regular hours, and take at least eight hours sleep. The sleeping-room should be large and well ventilated, and the patient should lie with the head elevated. All indigestible articles of food should be avoided and the diet should consist principally of bread, vegetables, milk, and fruits. Meat should be taken but once a day, and then in very small quantities. The use of alcoholic liquors and coffee should be avoided, and tea only taken in small quantities. The bowels should be regulated with Dr. Pierce's Pleasant Pellets and injections, if necessary. A thorough bath should be taken once or twice a week. If the attacks occur at night, the body should be sponged before going to bed with tepid water, to which should be added sufficient tincture or infusion of capsicum, or red-pepper, to render it stimulating to the skin.

The causes, if they can be determined, should be removed, and those remedies administered which relieve nervous irritability and cerebral congestion. If due to worms, the proper remedies should be given; if to phimosis, the subject should be circumcised; if to pressure on the brain, from fracture of the skull, trephining should be practiced, and the depressed bone raised. There are no _specifics_ for this disease; each individual case must be treated according to the condition presented. The nostrums advertised extensively over the country as specifics for this disease, while they may, in some instances, prevent the attacks for a short time, irritate the stomach, impair digestion, lower vitality, and permanently injure the system, often rendering the disease incurable. They deceive the sufferer, leading him to think that his disease is being cured, until it progresses so far that he is beyond the reach of any treatment. As a rule, the longer the disease progresses, the more difficult it is to cure.

Epilepsy has by many physicians been regarded as incurable, but our extensive experience has convinced us that by an appropriate course of treatment, the _vast majority_ of cases can be cured. The animal extracts, or juices, herein more fully described under the head of treatment for Nervous Exhaustion, have proven curative in some cases that have resisted other remedies. This treatment requires the personal attention of a physician skilled in its employment. It is also of first importance that the extracts be properly made. We have discovered several new remedies, which undoubtedly exert a powerful curative influence over this disease, but it is necessary to vary the treatment so much in different cases, that it would be useless to enter further into details in this treatise.

SURGICAL TREATMENT. A considerable proportion of those cases of epilepsy, termed Jacksonian, have been found to be caused by new growth upon, or in, the substance of the brain. Sometimes cysts form as a result of small hemorrhages, or of spots of softening from clots in the cerebral arteries. Other cases are due to a small spot of hardened tissue or an inflamed centre of irritation in the outer gray matter of the brain.

The majority of these forms of disease can be exactly localized in a small area of the brain, and may usually be traced to a blow or fall on the head, or to fracture of the skull without depression. The discovery of the fact that such results of injury will produce localized spasm has naturally lead to the conclusion that similar products anywhere in the brain may give rise to epilepsy. In these cases trephining of the skull and the removal of irritation from the brain has been followed by the most successful results. It is seldom a serious or dangerous operation, but very few deaths having resulted in the practice of good surgeons in many hundreds of cases, and these were individuals who were not favorable for operation, and in whom it was undertaken as a last resort

In these cases of epilepsy, due to injury, the operation is fairly safe, and in carefully selected cases that have not been allowed to run so long as to bring upon the brain a general epileptic tendency, the results of operation are good and the procedure warrantable.

SEE TESTIMONIALS FROM A FEW OF THE MANY CURES EFFECTED BY OUR SPECIALISTS.

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CHOREA (ST. VITUS'S DANCE).

This disease is an affection of the nervous system, which is characterized by spasmodic contractions of certain muscles. It may affect the entire body, although it is usually confined to the left side, or to a special group of muscles.

SYMPTOMS. Twitchings of the muscles of the face are the most conspicuous symptoms. They are at first comparatively slight, but as the disease progresses, these spasms become more decided, and the face is twisted into various shapes and forms. The head, in some cases, is constantly jerking. It is with great difficulty that the tongue is thrust out of the mouth, and then, with a sudden jerk, it is quickly withdrawn.

These spasms or contortions, may affect the extremities in a similar manner, the hands and arms cannot be kept quiet, the gait may be unsteady, and one foot is merely dragged after the other. If one limb be forcibly held, to keep it quiet, some other limb will involuntarily move. Strange as it may appear, these contractions, which cannot be controlled by the will during wakefulness, are very much lessened or arrested by sleep.

Prior to the development of the spasmodic affection, there is usually a period in which the sufferer notes a want of appetite, languidness, with disinclination towards mental or bodily pursuits, headache, restlessness, pains in the limbs and joints, with irritable temper and weakness of memory. There are many other symptoms in special cases. As the disease develops, the patient gradually begins to exhibit an awkwardness of movement in the extremities, and objects frequently fall from the grasp. Children thus afflicted, spill their food while eating, and it becomes difficult for them to stand still. Attempts to write, sew, or draw are imperfectly performed. Such children are very often punished for supposed ill-behavior or careless habits. Later on the symptoms become more unmistakable, and the presence of the disease is readily recognized. The patient may become incapable of dressing, and the limbs and face are no longer under the control of the will. Uncontrollable movements of the fingers, hands, shrugging of the shoulders, dancing of the legs, grimaces of the face, and distortions of the body, become more or less constant. Speech and swallowing may be seriously embarrassed. Any unusual excitement of the mind or body is apt to intensify the muscular twitchings. Severe mental application, the reading of exciting books, the witnessing of entertainments, and excessive indulgence in sports, have to be discontinued.

THE MOST COMMON CAUSES seem to be exhaustion of the nerve centres, due to the appearance of the second teeth in children and the development common to the age of puberty. Other causes may be briefly mentioned as follows: rheumatic affections, constipation, a morbid state of the blood, suppression of the menstrual function, uterine difficulties, masturbation, or self-abuse, blows, injuries, or any cause which would give rise to nervous debility. Sometimes it is caused by obstruction in the alimentary canal, or by intestinal worms.

TREATMENT. The disease is one in which there is a debility of the nerve centres, complicated with a lack of assimilation and digestion. There is no affection more amenable to treatment in its early stages than this. We are daily in receipt of correspondence from sufferers, or their parents, or friends, in which the most gratifying relief and a cure has resulted from the use of Dr. Pierce's Favorite Prescription used in conjunction with Dr. Pierce's Golden Medical Discovery. These two remedies should be used alternately, the dose being suited to the age of the patient.

A large majority of the cases of chorea occur in females and at the period of life when the nervous system is subjected to unusual requirements. In these cases the "Favorite Prescription" effects a gradual restoration of nervous energy, and improvement in the tone of the nerve centres, and by its direct effect upon the circulation in the ovarian region, eliminates the most potent causes of debility. In young people, we usually advise a dose of three drops for each year of the age. For instance, children of eight years of age should take twenty-four drops; those of twelve, thirty-six drops; those of fifteen, forty-five drops, which is about two-thirds of a teaspoonful. A similar dose of Dr. Pierce's Golden Medical Discovery should be administered, taking it before meals, and the "Prescription" after meals. Under their administration the patient will rapidly improve in health and strength; the circulation is materially bettered, the blood is purified, enriched, vitalized. The remedies effect a complete removal, from the blood, of the impurities that represent nerve waste, and as a consequence the nerve cells are properly nourished. The disease is gradually controlled, and when the favorable influences of quiet, nourishing food, with plenty of outdoor air, and not too active exercise is added, the progress is most gratifying. The patients, in a few weeks, are able to control much of the spasmodic movements, and gradually their restoration to a normal condition is accomplished.

In occasional cases, where there is some complication, as rheumatism or other severe affection, complicating and preventing their recovery, special treatment is required. We are always ready to advise in regard to such cases when consulted either by mail or in person.

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TESTIMONIALS.

If the following letters had been written by your best known and most esteemed neighbors they could be no more worthy of your confidence than they are now, coming, as they do, from well known, intelligent and trustworthy citizens, who, in their several neighborhoods, enjoy the fullest confidence and respect of all who know them.

Out of thousands of similar letters received from former patrons, we have selected these few at random, and have to regret that we can find room only for this comparatively small number in this volume.

NERVOUS AND GENERAL DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:

_Gentlemen_--I am thankful to-day that I can honestly say, that as a result of your few weeks' treatment, I feel better now in both body and mind than I have for fifteen years. Before I consulted you I felt more like taking my own life to end my miserable feelings than I felt like living; I had given up all hopes of ever being any good to myself or anybody else, but, thank God, your encouragement, and kind words, and skillful treatment have made a different man of me.

Before I consulted you, I took no interest in business nor any thing else in the world, which the wise Creator has placed in this world for all mankind to enjoy; but now my mind is clear, and I take an interest in business and enjoy life better than I ever did before.

Now, may God bless you for your good and skillful treatment of me; and, also, may this be the means of inducing others who are to-day suffering from the same complaint to at once consult you, as I can assure them that they will receive full benefit of your kind attention, for moderate charges.

Yours respectfully, T.M. CARSON, P.O. Box 145, Swissvale, Allegheny Co., Pa.

NERVOUS DEBILITY.

SPECIAL TREATMENT, FOLLOWED BY USE OF "GOLDEN MEDICAL DISCOVERY."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Ltd., 3, New Oxford Street, London, W.C.:

_Gentlemen_--I now write to describe the benefit which I have received from your treatment. For some time I had been suffering from nervous debility, and before placing myself under your treatment my trouble was very severe; and not understanding the nature of my disease, I did not know what to do until I saw a few testimonials of your wonderful cures, when I was led to at once communicate with you; and after two months' special treatment from you, I was greatly relieved, and was advised to then use Dr. Pierce's Golden Medical Discovery, which I did for a time, and am happy to say that I now feel like another man, and am troubled no longer with the old symptoms, and I thank God, and also the kind gentlemen that have been conducting my case, for the treatment and advice which I have received. I also think the "Golden Medical Discovery" is a most wonderful medicine, and I shall feel it my duty to speak well of your medicines and treatment to all fellow sufferers I may meet. I am,

Yours truly, F. MACEY, Faversham, Kent, England.

NERVOUS DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:

_Gentlemen_--Two and a half years ago, after seeking in vain for health at the hands of local doctors, I began treatment with you for "Nervous Debility of a complicated nature. Ag a result thereof I now give this testimonial, having been changed from a person of rapidly declining health--often despondent and with no inclination to work of any kind, to one of sound constitution who enjoys life and is once more able to battle his way to success in life; and it is now about two years since the change occurred, showing it to be permanent.

I cannot say too much in praise of your methods, and careful, courteous attention which myself and others have enjoyed at your hands; and that the good work may go on to an unlimited extent is my earnest wish.

Yours sincerely. A.E. NORCROSS, (General Delivery), Detroit, Mich.

NERVOUS DEBILITY, DYSPEPSIA, HEART DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I feel very grateful to you, and to our all-wise Creator for restoring my health. When I first wrote to you I was a miserable sufferer with nervous debility, dyspepsia, heart disease, also female weakness. I was so nervous and low-spirited I could not sleep, in fact I was just about as weak and low as I could be, and could scarcely drag around; but, after persevering for about twelve months, occasionally with the help of your kind treatment and advice, I once more begin to feel like myself again. Words cannot tell how I do appreciate my health.

Thank you, gentlemen! I shall never forget the kind business-like manner in which you have treated me. May God bless you, inasmuch as your heart's desire is to do good to suffering humanity.

Very truly, Miss K. GREENWELL, No. 253 Twenty-second St., Ogden, Utah.

NERVOUS DEBILITY--RESULT OF INDISCRETION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--For the last year and a half I was troubled with Nervous Debility. I tried some medicine that I bought from the druggist, which did me little or no good; so, hearing of the World's Dispensary Medical Association, of Buffalo, I wrote them about my case, and in reply, they said they were sure they could cure me. At that time I was weak in my arms and legs, had poor sight and, worst of all, I was very nervous and bashful. I could not sleep at night and feel refreshed in the morning. I could not look any one in the eye without feeling ashamed.

I have now taken two months' treatment and I feel sound in mind and body; but to be sure I am going to take another month's treatment from these same doctors in Buffalo.

I recommend all men who are afflicted with any disease similar to the one of which I have just been cured to apply to the World's Dispensary Medical Association, and if they take treatment from these doctors they will surely be cured. I cannot praise them too much for what they have done for me.

Yours truly, C.H. GOODSELL, No. 151 S.W. Temple St. Salt Lake City, Utah.

NERVOUS AND GENERAL DEBILITY.

WORLD'S DISPENSARY MEDICAL, ASSOCIATION, 663 Main St., Buffalo, N.Y.:

_Gentlemen_--I had been out of health for a period of about three years. Suffered with pains in the head, catarrh, chills, fever, nervousness, and general debility. Spent about all the money I had in order to obtain relief, but received little, if any good. I was scarcely able to work, when in July, 1887, I wrote to your Association, describing my case. You replied, advising me, and prescribing a course of treatment, which you sent to me. After taking but a part of these medicines I began to feel a great deal better; could sleep very much better and was able to resume work as usual, but still suffered some pain in head, and my buck was lame and weak. I continued treatment for some three or four months, until all remaining symptoms of distress and weakness had disappeared. At the end of about eight months I found I felt as well as I ever did. My weight had increased fully twenty pounds, and I could safely say that you had effected a perfect cure in my case.

Respectfully yours, THOMAS WESLEY KNAPP, Myhart, Allen Co., Ind.

NERVOUS AND UTERINE DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:

_Gentlemen_--I was sick for over three years with nervous complaint, with blind dizzy spells, palpitation of the heart, pain in the back and head, and at times would have such a weak tired feeling when I first got up in the morning, and at times nervous chills. At other times, I would feel as if there were a tight bandage around my forehead.

The first physician I went to said I had nervous dyspepsia; the next one did not say what he thought ailed me; the third said I had dyspepsia, but none of them did me any good. As soon as I commenced taking Dr. Pierce's Favorite Prescription, I began to get better; could sleep well nights, and that bad nervous feeling and the pain in my back soon left me. I can walk several miles without getting tired. I took in all, three bottles of the "Favorite Prescription" and two of Dr. Pierce's Golden Medical Discovery.

Yours truly, MRS. JENNIE WILLIAMS, Mohawk, Lane Co., Oregon.

NERVOUS AND GENERAL DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.:

_Gentlemen_--When I applied to you for medical treatment I was in a very bad state. Your suggestion that I use Dr. Pierce's Golden Medical Discovery was followed with good results, and I can say I felt the effects of it before the first bottle was finished. The dull pains in my back were leaving me very fast. I used three bottles of the "Golden Medical Discovery." I had a dull pain in the back, restless sleep followed by very trying dreams, appetite poor, weakness, consequently very easily tired. Now I can go about my work, walk twelve or fifteen miles a day and not feel tired. When I commenced to use your "Golden Medical Discovery" I only weighed 125 pounds; now have increased to 150.

Yours respectfully, W.C. DILLON, Box 63, Woburn, Middlesex Co., Mara.

NERVOUS DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:

_Gentlemen_--I had been ailing for months and did not know what was the matter. I had a heavy and languid feeling; dimness of sight, spots and flashes before my eyes; an "all gone" feeling in my stomach as if the bottom had fallen out; was nervous and irritable and felt like sinking down when at work. I could hardly get up in the morning; it seemed as if I were more tired then I was when I went to bed. My appetite at times was ravenous, and at other times the smell of food made me sick; I would often go from the dinner table and vomit. I would have spells when it seemed that every man was my foe and would be melancholy, and think that something was going to happen to me; was easily upset, could not get my mind to stay on anything long at a time. When I read about your remedies, I made up my mind to try them. After taking one month's treatment I felt better, and kept on until I had taken three months' treatment and was made a new man. I would advise any one who is in bad health to do the same, and will assure them that Dr. Pierce is a gentleman, and will do Just what he says, as he did in my case.

Yours truly, MARIS H. MOORE, Ocean City, Cape May Co., N.J.

NERVOUS AND GENERAL DEBILITY.

Dr. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--My case was a complication of diseases--a general break-down, lasting three years. I placed myself under the treatment of four different physicians. At last, giving up all hope of recovery at home, I was making arrangements to go to a Sanitarium in Michigan for special treatment. One of your small books with blank enclosed was handed to me; I filled out the blank, and thought I would try rather than leave home and little ones,--"Happy decision;" two months' special treatment and I was well and happy, and to-day, I have the very best of health.

Yours respectfully, MRS. LOMA LINN, Ladoga, Montgomery Co., Ind.

NERVOUS AND GENERAL DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Had vertigo, or dizziness. Pain over right eye. Vomiting sometimes, severe pains in arms, from elbows to shoulders, pain in left side. Numbness of the fingers. His home physician said "will run into paralysis." Analysis of the urine shows phosphatic deposits. Began treatment with specialists of Invalids' Hotel and Surgical Institute, in August, '87; used the remedies interruptedly for about six months. Writes May 11th, '89, "have not had a dizzy spell for a year." In October,'90, writes, "the dizzy spells have gone for good, I hope." November 9th, '93, reports, "I most willingly recommend your medicines for they cured me of those dizzy spells of long standing, after four doctors in this county had treated my case for three years, without benefit."

Respectfully yours, JASPER THOMAS, Alamosa, Conejos Co., Col.

IRRITABILITY AND EXHAUSTION OF THE NERVOUS SYSTEM, RHEUMATISM AND HEART DISEASE.

CURED BY SIX BOTTLES OF THE "GOLDEN MEDICAL DISCOVERY."

Mr. C. Allison Roberts, of Cassville, White Co., Tenn., suffered a great deal from rheumatism, he says: "Legs ached more like toothache than anything I can think of, the thigh bones throbbing and paining; had pains in hips, back, arms and shoulders." His symptoms also showed that the heart was affected. Had chills, headache often and sometimes sick headache. Bowels were costive and irregular. Food distressed and could not eat meat; urine milky; coughed in early part of night, and feet and legs would become numb. Had difficulty in getting to sleep before midnight, and was restless through the night and dreamed much. Had sinking spells which lasted for thirty minutes. Turned pale, became trembly and sometimes vomited his food.

Almost immediately after beginning the use of the "Golden Medical Discovery" the headache ceased. After using four bottles, reported that he had been benefited by the remedy. Later he reported: "I have been in reasonable health for some time. I took six bottles of the 'Golden Medical Discovery' and it cured the rheumatism entirely. I had suffered with it for several years and found no relief until I used your medicine. Have no weak nor nervous symptoms now, and no spells of turning sick at the stomach, or of bad action of the heart, palpitation, etc."

NERVOUSNESS, "FEMALE WEAKNESS," NASAL CATARRH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--My health was utterly gone. Was suffering from nervousness, female troubles and nasal catarrh; life was almost a burden to me, but a glorious change came, due solely to Dr. Pierce's Favorite Prescription and Dr. Sage's Catarrh Remedy. I have suffered more than tongue can ever tell. I have been treated by good physicians but they only help me temporarily. I have taken a great many patent medicines with the same result. In 1890, I began taking Dr. Pierce's Favorite Prescription and Dr. Sage's Catarrh Remedy, which gave me immediate relief and a permanent cure.

Respectfully, MRS. BELLE SANDERSON, Sprout, Nicholas Co., Ky.

NERVOUS DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 603 Main St., Buffalo, N.Y.:

_Gentlemen_--It is now about six months since I discontinued your treatment, and as I have had no return of the old symptoms, I consider it unnecessary to take more medicine. When I visited your Institution some two years ago, I had but faint hopes of ever being restored to health, as I was suffering from a complication of diseases. My case was an unusually obstinate one, yet I am satisfied that a cure could have been accomplished in half the time, had I been able to follow your directions in regard to diet more closely. I hereby tender you my sincerest thanks for the kind treatment received while at your Institution. Those days will always be the happiest in my memory. I will close by giving your faculty my sincere thanks, and hope success will crown your business.

Yours very gratefully, J.F. RITTER, Medford, Jackson Co., Oreg.

NERVOUS DEBILITY. SPECIAL TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Ltd., 3, New Oxford Street, London, W.C.:

_Dear Sirs_--In reply to your kind inquiries regarding my health, I am only too glad to say that I am better than I ever was. Before taking your medicines, I experienced great nervousness, loss of appetite, restless nights, taking no interest in my work; had pale complexion, with hollow checks, sunken eyes and loss of memory. I only took your special treatment for about two months, and received great benefit from taking it, but still go on taking your "Pellets" when required. I am sorry to say that I have not got a photograph before taking your medicines, or I should have been glad to send it to let you have seen them both before taking your medicines and after. I remain

Yours sincerely, W. TRUMBETTA, 84, Essex Street, South Heigham, Norwich, Eng.

NERVOUS PROSTRATION.

WORLD'S DISPENSARY MEDICAL, ASSOCIATION, 663 Main St., Buffalo, N.Y.:

_Gentlemen_--It is now sixteen years since I suffered from that terrible disease, nervous prostration. I suffered untold agony and thought I would go insane. Had a terrible burning sensation across my shoulders, and my head felt large as two, and as if there was a hole from one ear to the other and all sounds passed right through. I could not see, nor sleep, nor scarcely eat, and was that nervous the least thing made me angry. I was treated by our home physician and given up as incurable. At that time I saw your Memorandum Book and thought I would write you, and the result of it was you took my case.

After one month of your valuable remedies I felt like a new person, and after six months was restored to good health again after suffering nearly one year of untold agony.

I would heartily recommend all and every one suffering from any chronic disease to place their case in the hands of the World's Dispensary Medical Association, of Buffalo, N.Y., as I cannot praise your treatment too highly. Words are inadequate to express the gratitude I owe you in so successfully treating my case.

Respectfully yours, MRS. E.A. NORTHROP, South Main Street, Newark, Wayne Co., N.Y.

GENERAL AND NERVOUS DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_My Dear Sirs_--I believe that I am free from all the troubles that you have been treating me for. The pain in my back is gone--my digestion is good. In all truth I can say _I am a man again_!

I can stoop without pain--can labor without that weak and tired feeling. I am truly grateful to you for the good that you have done me, and may you reap a rich reward for the good you have done for suffering humanity, is my sincere wish.

Truly yours, J.W. STOCKING, Panama. Lancaster County, Nebr.

NERVOUS DEBILITY AND VARICOCELE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I commenced treatment, I think, in July or August, of 1888, and continued four months. My case was nervous debility of fifteen years' standing.

I tried home doctors but found they were only aggravating my case. I also tried the Remedy Company, then of St. Louis, who claimed to perform wonderful cures with their "Pastiles," but they proved utterly worthless. Having come in possession of Dr. Pierce's little book and circulars, a perusal of the same convinced me that my health would not be trifled with at his Institution.

I was a poor man and could not afford much experimenting. I ordered one month's treatment, and at the end of this first month, I found, to my surprise, that I was feeling different. The second month, still more surprised at my returning health. Third month thought I was cured, and engaged myself to a young lady, and wrote you to that effect, and you advised me with your congratulations to marry, and to order another month's treatment; and at the end of the fourth month I was a _man_, something I did not know what it would be like to be before.

I have now been married five years, and have two healthy children--a boy and a girl. I would never have dared to marry had it not been for your medicines. I must add that during this treatment I was troubled with varicocele on left side. I wrote you this at third month of treatment, and you sent without extra charge, a Suspensory and Lotion, and two months' treatment cured me sound and well of this distressing malady; I have not felt the least symptoms of its return.

I want the world to know what a competent and honorable firm the World's Dispensary Medical Association is. I would love to shake you by the hand. May God let you continue to be a help to mankind is my prayer.

Yours truly, D.A. WALTON, Marion, Grant County, Ind.

NERVOUS DEBILITY AND VARICOCELE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I can bear testimony to the removal of varicocele, for which you treated me. I had been in the habit of getting out with the boys and trying to see which could kick the highest with one foot on the ground, and it caused me to have varicocele. I went to my home doctor and he treated me with no success. It was getting worse all the time and I got out of shape all over. My health got bad and I thought my case hopeless. I had tried two doctors and received no benefit.

I had one of your little Memorandum Books in my pocket, and one day, looking through it I saw you treated such cases, and wrote you and received word in a few days that you would treat me, so I sent off for one month's treatment; and in five months I had gained my weight back, and that was eight years ago and I feel sound and well and my health has been good ever since.

You are at liberty to use my testimony in whatever way it may be of most benefit to you.

I also enclose a photograph of myself that was taken soon after your treatment.

With feelings of much gratefulness, I am.

Very truly yours, J.L. RIDINGS, Clarence, Shelby County, Missouri.

NERVOUS DEBILITY. INDIGESTION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION. Buffalo, N.Y.:

_Gentlemen_--It is now about thirteen months since I discontinued your treatment, and I have no return of the old symptoms, I consider it unnecessary to continue treatment. When I commenced taking your medicine I was suffering from nervous debility, indigestion, dyspepsia, etc. After using your medicine one month I am perfectly healthy, and cheerfully recommend your Institution to suffering humanity.

Yours truly, R.M. BASCOM, Sunfield, Eaton County, Mich.

NERVOUS DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION. Buffalo, N.Y.:

_Gentlemen_--It is now about five years since I received a two months' treatment for my case and I have had no return of the symptoms, I consider it unnecessary to take more medicines because I am gaining strength every day. I am healthier than I have been in fifteen years, and I thank you for the kind favor you have done me in my case, and I wish that all sufferers would send to you for treatment.

Yours respectfully, FRANKLIN ZERBE, De Turksville, Schuylkill Co., Penna.

NERVOUS DEBILITY, DYSPEPSIA, CONSTIPATION.

Blackstone, Nottoway Co., Va.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Dr. Pierce's Golden Medical Discovery and "Pleasant Pellets" made a perfect cure of me. I increased in weight from 120 pounds to 150 pounds and my strength increased in proportion. It improved me so rapidly that my friends inquired what produced such a change in my general appearance and health. Some accused me of dissipation. When I told them it was your medicine, the drug stores found a ready market for it, and continue to sell it with increased sales.

Yours truly, R.E. Jones

NERVOUS AND GENERAL DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was a great sufferer from nervous and general debility. I applied to you by letter for advice and received from you medical treatment for three months, which completely restored me to health; the course of treatment did not interfere with my usual vocation and was not difficult to follow. I am a well man to-day and take pleasure in advising all the afflicted to consult you at once, and feel sure they will, like myself, be well pleased with your treatment.

Yours truly, O.A. CONKLIN, Ravenna, Muskegon Co., Mich.

NERVOUS DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--After taking the two months' treatment which you sent me by mail for that broken-down condition, usually styled "Nervous Debility," attended by the usual symptoms such as headache, sleeplessness, confusion of ideas, etc., the above symptoms have so entirely disappeared that I do not consider it necessary to continue the treatment longer. I would say further that I am satisfied that you understand your business, and would advise anybody suffering from any chronic disease to avail themselves of your skill in preference to resorting to any other source known to me.

Yours respectfully, HERMAN CULVER, Port Angeles, Clallam Co., Wash.

GENERAL AND NERVOUS DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am very thankful for what you have done for me. The treatment which you furnished me a year ago gave me great relief. I had been suffering for many months with general and nervous debility, with headache, languor, sleeplessness, indigestion, constipation, etc., which were increasing upon me. One month's treatment gave me perfect relief, and I am now like a new person. I can heartily recommend all young men to consult your staff when in need of medical advice.

Respectfully yours, WM. H. COON, Medina, N.Y.

NERVOUS DEBILITY AND CATARRH.

Big Piney, Pulaski Co., Mo.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was treated by you eleven years ago for nervous debility and chronic catarrh of eight years' standing and of a very aggravated nature. I was considered near my grave by many of my friends when I commenced treatment.

I used eight months' special treatment, after which I used some 13 or 15 bottles of your Sage's Catarrh Remedy, and have had excellent health ever since.

Yours truely B.P. Dake.

NERVOUS DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--For about five years I was troubled with Nervous Debility. I was weak and nervous, and my appetite poor. I saw your advertisement in a newspaper and concluded to write to you. I took your medicine for nine months, and at the end of that time, I had gained thirteen pounds, was much stronger, my nervousness had left me and I felt well and strong. I am sincerely thankful for the great help I received from you.

Yours very truly, GEORGE RANKIN, New Castle, Lawrence Co., Pa.

NERVOUS DEBILITY.

Richville, St. Lawrence Co., N.Y.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--After two years of perfect health I write to you thanking you for your treatment.

I had suffered several years from Nervous Debility, and had tried various remedies, and been treated by different physicians, but received no benefit from them. I ventured to write to you, and after taking a month's treatment and following your Hygienic rules, I am now fully recovered and never felt better in my life.

May God spare you for many more years, for the sake of suffering humanity.

Yours respectfully, Evan P. Jones.

NERVOUS DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--In 1887, I had occasion to visit your Invalids' Hotel and Surgical Institute for a course of treatment. I am happy to state that my case was cured to my entire satisfaction, and that I always think with gratitude of the kind treatment received from the hands of doctors and nurses. While there I became acquainted with many undergoing treatment for various chronic and surgical diseases, and all were unanimous in their praise of the Institution.

Respectfully yours, EDWARD UELBRICK, White Oaks, N.M.

NERVOUS PROSTRATION; RHEUMATISM; CONSTIPATION.

Colebrook, Litchneld Co., Ct.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I desire to express my heartfelt thanks for the great benefit you have done me. About ten years ago I contracted rheumatism, from which I suffered dreadfully at times. Was also troubled with chronic constipation; had been from boyhood. Had doctored more or less for years without any great benefit until I consulted you and commenced taking your Special Remedies. After taking three courses of your medicines I was so far improved in health and strength that I considered it unnecessary to continue it longer.

Wishing you much success in your great work.

Yours truly, W.H. LOVELAND

NERVOUS DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--So much of my good health is due to the excellent treatment I received from the Invalids' Hotel and Surgical Institute, that I take the greatest pleasure in recommending all the afflicted to this famous Institution.

I was run down and a great sufferer from nervous debility. The remedies put up by the specialist of this Institute so suited my case, and so improved my health, that I soon felt like a new man. My gratitude is so heartfelt that I cannot speak to my friends and to all the afflicted in too high praise of the skill of the physicians of the World's Dispensary Medical Association and of the great benefit to be derived from their treatment.

Yours, truly, LEVI RAKES, Plattemouth, Cans Co., Neb.

NERVOUS DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was suffering with a very severe nervous debility and general weakness, and after using your splendid treatment for four months, I find myself perfectly cured.

Respectfully yours, T.J. CARDER, Pacific Grove, Monterey Co., Cal.

NERVOUS PROSTRATION.

Severe Palpitation of the Heart.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am feeling quite well. I have taken Dr. Pierce's Golden Medical Discovery and "Pellets," and I can truly say they have done me more good than anything I have ever taken. I keep the "Pellets" in the house all the time.

Respectfully, MRS. LAURA E. MOORE, Wolfborough, Carroll County, N.H.

NERVOUS DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--My health had been gradually failing for years. I could not sleep nights and was very nervous, and I was depressed in spirits and was entirely unfit for business. The principal cause was over-work. Through the influence of friends I began your treatment and continued it three months, and at the end of that time I felt so much better that I did not continue it longer.

And I can cheerfully recommend your mode of treatment to every sufferer.

Sincerely yours, GEORGE POSSON, Middleburgh, Schobarie Co., N.Y.

NERVOUS DEBILITY AND CATARRH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y,:

_Gentlemen_--I have enjoyed good health since I took your treatment I suffered intense agony for five months, and after taking one month's medicine I found very much relief--so much I was surprised.

Many thanks for the good your medicines have done me, and my prayers are that God may help you in your good work, and that you may live long and prosper.

Yours respectfully, MRS. ALICE HOFFMAN, Box 183, Clarksville, Butler Co., Iowa.

"A NERVOUS WRECK."

NERVOUS DEBILITY, EXHAUSTION, THREATENED INSANITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--About six years ago, I had tried all the doctors in my part of the country with no satisfactory benefit. They did not understand my case.

I was a nervous wreck--unable to sleep--could not eat, and underwent the usual horrors that one endures where there is loss of control of the nerves. A few months more would have made me insane.

My cure has remained permanent. The relief was something that I cannot describe. It has enabled me to pursue my work steadily ever since, and I am more than happy to testify to the excellent skill and honorable dealings of your faculty and the fine appointments of your Institution.

Respectfully yours, FAYETTE MOFFATT, Hendrum, Norman Co., Minn.

NERVOUS DEBILITY,

KIDNEY DISEASE, NIGHT-EMISSIONS, SEVERE HEADACHES, INDIGESTION, RHEUMATISM, COULD NOT SLEEP NOR REST. FOUND RELIEF AFTER FIVE OR MORE YEARS OF AGONY.

Elstonville, Lancaster Co., Pa.

WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am not able to express my thanks to you for the benefit of your special treatment. I had no hope of ever being restored to health again, having tried several home physicians, and having found no relief. I had little faith of ever being relieved of the dizzy spells and black spots before my eyes. Some of my friends told me it was nothing but a fake and a humbug. Thank God I did not listen to them. The first month's special treatment gave me such relief that I continued five months, and to-day can do heavy work without that troublesome pain in my back, and can stoop down without dizziness in my head. I would advise any one that is afflicted with any of these diseases to at once consult the practical and skillful physicians at the World's Dispensary Medical Association, at Buffalo, N.Y. I cannot think of words that will half express my gratitude. Thanks to God that he has granted you such skill. I am.

Yours truly, John M. Ellinger.

GENERAL DEBILITY

OF FIFTEEN YEARS' STANDING. CURED BY SPECIAL HOME-TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Lt'd:

_Gentlemen_--After being a sufferer from debility and general weakness for fifteen years, I found a radical cure in the treatment I received from you at my own home. The first supply of medicine seemed to start me on the road, and the wheel was kept turning till I reached the happy condition of health.

I hope this will meet the eyes of some of my old comrades, who have been to the eastern countries, and there lost their health, as I did, and as many others do.

Gentlemen, I wish again to thank you most kindly for your good treatment and thoughtful attention. I will enclose my photograph. I am,

Yours truly, G.W. WHITROD, Rockland, St. Andrews, Attleboro, Norfolk, Eng.

NERVOUS DEBILITY.

WORLDS DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--About a year ago I found myself a victim of Nervous Debility. For some time I hardly knew what course to pursue, nearly every paper I might pick up contained some advertisement that would cure me. But believing in the old adage, "never expect to get something for nothing," I decided to write to an Association that _I knew_ was reliable.

Acting accordingly, I took a course of four months' treatment, which I am pleased to state has given me in return a perfect cure. Thanks to the medical skill of your Faculty.

Yours truly, C.M. GATES, Girard, Macoupin Co., Ill.

NERVOUS AND GENERAL DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--After taking your second months' treatment I feel as though I am entirely cured. The trouble with my back is entirely removed; have gained in strength right along and have been working hard for the last two months. I cannot fully express my appreciation of your kindness and beneficial treatment.

Yours truly, A. CROWL, Oneida Mills, Carroll Co., Ohio.

NERVOUS DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Your letter inquiring about my health, came duly to hand a few days ago. In answer permit me to say that the three months' course of treatment effected a cure. Now my general health is good, body strengthened, mind clear, memory revived, and energy to work restored; cheerfulness and bright hopes, once lost, are now fully regained. My case was a complicated one of Liver disease and general effects of bad habits and usage, yet I was not too far gone to be restored by your wonderful treatment. My prayer is that you will ever prove a blessing to mankind.

Yours respectfully, T.M. HUTCHISON, Forest Hill, Summers Co., W. Va.

NERVOUS DEBILITY.

PILES, CATARRH, HEART SYMPTOMS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--The effect of your remedies is little short of a miracle. My general make-up and appearance are astonishing; my cheeks rosy, eyes bright, circles nearly all gone from under eyes; am fleshier, stronger, more active, and an entirely different man. No piles, catarrh, heart trouble; no chills and fever; no despondency, no anything.

Yours truly, JOHN TALBOTT, Pennsylvania Agricultural Works, York, York Co., Pens.

NERVOUS DEBILITY

RESULTING FROM INJURY TO SPINE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I take pleasure in saying that the Invalids' Hotel is the best institution in the world for the cure and treatment of all kinds of chronic diseases. I was afflicted for a long time before I went to your Institution for treatment, and I tried many doctors, but without avail. After being in your Institution two months, I was restored to health, and I am a well man to-day, and take pleasure in giving you many thanks. My difficulty was the result of injury received early in life, and it has been permanently and perfectly cured. With many good wishes and highest recommendations.

Respectfully yours, GEORGE W. BENHAM, P.O. Box 227, Seymour, Conn.

NERVOUS DEBILITY, DYSPEPSIA, AND OTHER COMPLICATIONS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, No. 663 Main St., Buffalo, N.Y.:

_Gentlemen_--I am now through with your last month's treatment. I have taken in all three months' treatment. When I first wrote to you I thought I was gone beyond the reach of recovery, but, thanks to God, I am to-day a sound man, heartier than I have been for years, and your Institution deserves the credit of it. I will forever remember you, and want you to publish this testimonial for the benefit of others, as there are thousands in the same fix that I was in.

Yours truly, D.H. POFF, Raleigh, Raleigh Co., W. Va.

NERVOUS PROSTRATION.

Everson, Whatcom Co., Wash.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--As regards your medicines I can truthfully say that I consider them good. Three years ago, I was much run-down with indigestion and nervous prostration. I purchased about four bottles of "Golden Medical Discovery" and "Favorite Prescription," and after taking them along with the "Pellets", I felt much improved. Indeed, my friends told me I looked like another woman.

Yours truly, Mrs. Rob't Burns

NERVOUS DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am pleased to send you a testimonial regarding the perfect and permanent cure which you have effected in my case.

I suffered from Nervous Debility. The symptoms were prostration, sleeplessness, exhaustion, over-fatigue from mental trouble, overstudy and anxiety, indigestion, dyspepsia, constipation, headache, inability to concentrate the mind, general lassitude, melancholia, backache and pains from the top of my head to the sole of my feet. You treated me about twelve months and effected a _perfect cure_.

Yours respectfully, WILLIAM SLATTERY, Garden City, Finney Co., Kan.

HERNIA--LEFT INGUINAL--PRESENT EIGHT YEARS WITH NERVOUS PROSTRATION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:

_Gentlemen_--I take greatest pleasure in making public the most wonderful cure I received at the Invalids' Hotel and Surgical Institute of Buffalo.

I had suffered severely for eight years with a left inguinal hernia; had tried many physicians and medicines, but found only temporary relief. I was greatly run-down, and my nervous system considerably shattered. My friends persuaded me to go to the Invalids' Hotel and Surgical Institute. While there I was operated on by their specialist, and in a few weeks began to gain strength and energy so that I could return home, and have since felt entirely well.

Words could not do justice to my feeling in regard to this institution. There is no place like it for medical aid, and I would urge all invalids to go there, feeling confident that they could no where receive more skillful treatment or more kind attention and care.

Respectfully, A.J. KIDDER, North Yam Hill, Yamhill Co., Oreg.

THICK NECK (GOITRE),

NERVOUS DEBILITY AND WEAKNESS CURED.

Miss ELLA A. HOUGHTON, of _Theresa, Jefferson Co., N.Y._, was cured of Thick Neck, Nervous Prostration, Weakness and a complication of ailments by Dr. Pierce's '"Discovery" and "Favorite Prescription." She says: "My health is now as good as it was before I was sick. The swelling (goitre) has all gone from my neck. I don't have any bad feelings. My gratitude for the benefit I have received from your treatment has induced me to recommend you to all whom I know to be sick." "I have known of two or three middle aged ladies residing near here, who have been cured by your 'Favorite Prescription.'"

NERVOUS DEBILITY,

CURED BY SPECIAL HOME-TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Lt'd, 3, New Oxford Street, London, W.C.:

_Dear Sirs_--It is now over two years since I first began to feel something the matter with me. I gradually got worse, with a nervous and despondent feeling. I went to a doctor, who said I was suffering from debility and ordered me away. I got a little better and returned to work, but only to get worse again. I then had very restless nights with terrible dreams, and would wake up all in a perspiration. I often wished I was dead. At last, I had to give up work again, and thought that I should never return to it. I was then under several doctors, but they did me no good. I then came across a little book from your Association, and seeing cases like mine cured, I determined to come to London and see you. I was then under your treatment for three months at my home, taking your medicines and adhering to your rules. I felt a change the first week, and after three months' treatment I was restored to health. It is now four months since I took any of your medicine, and have not had any symptoms return. I am now at work again, and enjoying life the same as anyone else. I thank you very much for your kind attention. I remain,

Yours truly, G. DANCY, 25, Merton Road, Stanford Road, Kensington, W. London.

"LIFE MISERABLE AT TIMES."

NERVOUS EXHAUSTION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:

_Gentlemen_--For several years I was a sufferer from some constitutional disease, or combination of diseases, which rendered life miserable at times. Dyspepsia, headache, dizziness, irritability and gloomy forebodings were among the symptoms I suffered. By chance, one of the pamphlets you publish fell into my hands, and I was induced to write you, describing my condition as best I could, and consequently I was treated by your Specialists.

When I had been treated for two months I felt so well and the symptoms were so far gone that I felt I was cured and quit taking medicine. As this was more than two years ago time has proved that I was correct, for I am a healthy, robust man to-day--thanks to you and to your associates in the noble Institution which you have established for suffering humanity.

Yours respectfully, J.W. DURHAM, Parkland, Jefferson County, Ky.

NERVOUS AND GENERAL PROSTRATION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--It is with pleasure that I add my testimony to your list, hoping it may contribute to your success and induce others to avail themselves of the benefit of your invaluable medicines. In June, 1890, I took typhoid fever of malignant type; for two months I hovered between life and death; at length the fever left me in a prostrated condition. Then I was taken with a severe pain in my back and general nervous prostration; could not move myself in bed nor bear to be moved by the most careful nurses without experiencing excruciating pain. I had the best medical attention in the community, but they failed to give relief. My friends wrote to Dr. Pierce, stating my condition and requesting treatment for me. He treated me for two months; by that time I had so much improved that I did not think it worth while to continue the treatment longer, and my health has been such that I have not had occasion to lie in bed two days together since. I feel under lasting obligations to Dr. Pierce, and thank God for blessing the world with so able a physician.

Very respectfully, MISS MAGNOLIA MORRISON, Abernethy, Iredell Co., N.C.

NERVOUSNESS, CATARRH, AND INDIGESTION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 683 Main St., Buffalo, N.Y.:

_Gentlemen_--For a long time I was suffering from indigestion, catarrh and nervousness. I was so run down that I could not go to school, and, as the various remedies I tried did me no good, I applied to you, and was advised to try a course of special treatment. After taking only two months' medicines from your noble institution, I feel perfectly restored to health. I have, moreover, recovered my lost flesh, and I am pleased to say need no further medicines.

Yours truly, E.A. BALDWIN, Proctorsville, Windsor Co., Vermont.

LOSS OF FLESH AND STRENGTH.

NERVOUS PROSTRATION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was run down entirely, losing my flesh and getting weak and nervous, and had hard work to draw a long breath; could hardly breathe at all, and came nearly dying once or twice. Had tried many kinds of patent medicines--many doctors, all in vain.

One day I saw an advertisement in a newspaper, about "If you are run down and losing flesh, use 'Golden Medical Discovery.'" I, like a drowning man, would grab at anything on sight. So I went to my druggist and asked him for "Golden Medical Discovery," and he had it and I bought one bottle and followed the directions and it did me good at first start; so I bought two bottles every month until I had used about six bottles, then I had my strength back and could draw my breath and felt like a new man.

Yours truly, CHARLES HOLMSTEDT, Newtonville, Baraga County, Mich.

NERVOUS EXHAUSTION.

A PROMINENT NURSE AND STUDENT IN DISEASES OF FEMALES.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--One could scarcely discharge a more pleasant duty to a suffering fellow being than to direct them to a place of relief. Hence, I desire to state that a short time ago, life was almost a burden to mo until I began taking treatment for nervous exhaustion from Dr. Pierce of the Invalids' Hotel and Surgical Institute, at Buffalo, N.Y., and can conscientiously say at the end of six weeks, I feel like another being.

I have also consulted Dr. Pierce on numerous occasions during the past eight years, and at no time whatever have I known his remedies to fail, more especially, his "Favorite Prescription," (which I have used in my practice), and the "Golden Medical Discovery," when taken according to directions.

These remedies will in no event disappoint. I am now In the enjoyment of perfect health--a blessing which I attribute to the kind Providence which directed me to the World's Dispensary Medical Association.

Yours gratefully, SARAH BARNHARDT, Grand Rapids, Mich.

NERVOUS EXHAUSTION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:

_Gentlemen_--It is over a year now since I applied to you for help and it is more than six months since I reported myself as well. I have worked very hard since then, and still have continued well all the time.

When I called upon you for treatment I was in a terrible condition. I was subject to severe headaches; was troubled with a tired, an almost lifeless feeling, and although I slept, _I could not get rest_. I was nervous and fretful, and could not do as much work as I wanted to do. To tell it all in a few words _I was all run down_. I had never wholly recovered from the grip, which left me in a very poor condition; and that, together with over-work and insufficient physical exercise, had put me in such a condition that I was almost unfit to teach my school.

After five months' treatment (one month intervening in which I received none) I considered myself well, and I think that I was right. I feel very grateful to you for your treatment of me, and shall ever be willing to speak a good word for you.

Yours respectfully, WILLIAM E. DIXON, Harwich Port, Barnstable County, Mass.

NERVOUS EXHAUSTION.

DR. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--After being troubled with my head for two years and taking treatment with ten different doctors and getting no help, I started for your city, but allowed myself to be talked out of seeing you by a man on the train; stopped off at Lancaster and saw Dr. ----, took one month's treatment with no benefit--grew worse.

After that, started once more, did not tell where I was going. I was a complete wreck--had to be helped on board of the cars. You looked me over carefully--you seemed to know just what the trouble was. Gave me medicine for a month's treatment. I came back homo and took the medicine. Well, I was surprised the first week and have been ever since--gained right along. Have been well ever since and all for one month's treatment, for which I thank you very much.

Respectfully, GEO. S. WILSON, Perry, Wyoming Co., N.Y.

NERVOUS EXHAUSTION.

Cayuga, Vermilion Co., Ind.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--It is now about eighteen months since I discontinued the use of your medicines. I can truly say I feel like a new man. I have none of that wakefulness at night, or the tired feeling when I get up of a morning. Now, I can work hard all day, go to bed at night tired, wake up the next morning rested and refreshed, though I took but two months' treatment; its value to me I am not able to estimate; before and during treatment I weighed about 160 pounds, and now I weigh 185 pounds. With many thanks and good wishes, I am,

Yours truly, Geo. F. Howard

SEVERE NERVOUS PROSTRATION.

"OUT OF DARKNESS INTO LIGHT."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main Street, Buffalo, N.Y.:

_Gentlemen_--About eighteen years ago, after the birth of one of my children I was left in a weak, run-down condition; it seemed to me that my nerves were unstrung very bad: I did not suffer much pain, but I think I suffered everything any one could suffer with nervousness; my life was a misery to me. I doctored with seven different doctors and got no relief; then I took almost all kinds of patent medicines and got no relief from them, but got worse all the time, when I chanced to get one of your little pamphlets.

I thought I would write to you, and waited as I thought to hear that there was no help for me; when my answer came and you said you could cure me great was my joy. I had taken your medicine about a month when I began to improve and in a few months was entirely cured.

My recovery was like coming out of the dark into the light, so great was the change. I will advise all sufferers to go to you for relief--I don't think they will be disappointed. When I commenced taking your medicine I weighed 94 pounds, now I weigh 125 pounds.

I do not know how to thank you for all the good your remedies did me, With heart-felt thanks I am.

Sincerely yours, MRS. AMANDA C. AUSTIN, Burden, Cowley Co., Kansas.

P.S.--I have a lady friend who is taking Dr. Pierce's Favorite Prescription now, and last summer every one thought she was going with consumption; four of her father's family had died with it in five years: she has taken one bottle of "Favorite Prescription," and now she is better in health than she has been in three years. Her address is Mrs. Laura Paugh, Burden, Cowley Co., Kas. A.C.A.

NERVOUS EXHAUSTION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.:

_Gentlemen_--For the last five years I have tried many leading doctors in this country but without avail. I gave up every hope. Your advertisement fell into my hands; at the time I did not know what to do because all my money had gone for medicine, but money was no object to me. I could not rest till I was cured.

Your treatment, which I received, cured me in a short time, and I am just as good as ever. I come before the public to advise anyone in need of treatment to give you the first chance, and he will find relief for I believe that nowhere can one obtain more skillful care or more kindly attention. Hoping that success will crown your business, I am,

Very truly yours, CHARLES GAUL, Muskegon, Muskegon Co., Mich, care of "Warwick House."

NERVOUS PROSTRATION, SLEEPLESSNESS, DYSPEPSIA, AND RHEUMATISM.

Mr. J.T. TOWNSEND, of _Noah, Coffee County, Tenn_., consulted us by letter. He was suffering from great nervous prostration; could not walk without tottering: was troubled greatly with inability to sleep; poor appetite; did not relish food; suffered much pain and stiffness in the joints; was overcome with heat working on a thresher, followed by persistent nausea, confusion of ideas, his memory being very defective.

After taking a single course of treatment, the medicines being sent by express, he writes as follows: "The medicine you sent me lasted me five weeks, and proved very beneficial indeed. I believe it, under God, was the means of saving me from a premature grave. When I received the medicine, I had just gotten rid of an attack of bilious fever, which left me in a deplorable condition. I was very week and nervous, but my improvement commenced with the first dose of your medicine, so by the time my medicine was out felt better than I had for years, and now have no indication of a return of my trouble." A month later he writes: "I continue to enjoy the most perfect health. Every organ of my body, and every faculty of my mind, is in splendid condition, which makes life worth living. I have gained twenty-one pounds since I have been able to attend to business. Please accept my profound thanks for your promptness in sending me my medicines."

NERVOUS PROSTRATION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.:

_Gentlemen_--It gives me pleasure to testify to your skill in the treatment of my case. When I applied to you last June, I was suffering all the horrors of nervous prostration, which was brought on by over-work and constant anxiety. I had no energy and no interest in business; rather an aversion to anything like work. My appetite was poor, indeed food seemed to distress rather than nourish. I felt tired and drowsy mornings; irritable and despondent; suspicious of every body and everything. After two months' treatment these unpleasant symptoms disappeared, and my health is better than it has been for twenty years.

I can never express to you my gratitude for your kindness, and would cheerfully recommend your Institution to all sufferers.

Yours truly, GEORGE W. COLQUITT, Palmetto, Campbell Co., Ga.

BAD CASE OF UTERINE DISEASE AND NERVOUS PROSTRATION,

CURED BY HOME TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--It is with pleasure that I write to let you know the great benefit I have received from your medicines and self-treatment at home, which you kindly sent me, advising me to take your Dr. Pierce's Favorite Prescription and "Pleasant Pellets" and "Golden Medical Discovery" for my troubles. I did take your advice as near as I could; when I wrote my first letter to you, I had been treated by different doctors for twelve months and received but very little or no benefit, but had spent one hundred dollars for treatment and medicines.

My husband, and little boy twelve years old, did all the family sewing and washing and work in general, and I could not walk across the room without help or stand on my feet one minute at a time; at night I could not sleep, nor day time either; nothing I ate tasted well--I had no desire to eat anything; my bowels were costive all the time, and after following your advice and using about fourteen dollars worth of your medicines altogether, I now feel like a new person. I am not bothered with that nervousness, where it used to be that I could not stand a sudden rush of horses feet, or a quick halloo from one's boys, or a sudden sound of anything would cause me to take sudden nervous spells of some kind, as if I were smothering or dying, or something of the kind--I can't tell just how I did feel. Now I do all my washing, sewing and house work in general for a family of seven--five children, my husband and self, and help my husband in the field some besides. I can truthfully say, ii it had not been for Dr. Pierce's medicines and the kind advice to me, with self-treatment at home, I would have been dead long ago, and I never can feel that I can say enough for his skill and medicine nor thank him enough for the good he has done me.

I use no other medicines in my family but these and never will, for they do all that is claimed for them and more too. I have one of the "Advisers," and I would not be without it for fifty times its cost. May God be with you throughout your life is my prayer.

Respectfully yours, MRS. ADDIE GLASS, Bandera, Bandera Co., Texas.

NERVOUS PROSTRATION FOLLOWING GRIP.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--In January of '90 I took the "grippe," went to work before I was well, was caught in a rain which gave me a very bad relapse, resulting in lung fever and complete prostration; was on my bed two months, and when I did get out, the strength to walk any more than just a few rods did not come back. My family doctor and two prominent physicians of Sioux City, did me no good. Late in the fall I got a bottle of Dr. Pierce's Golden Medical Discovery, which quieted my trembling nerves and gave me an appetite to eat. I then concluded to try the Doctor, personally. Up to this time I was in a pitiable condition. Sometimes I could not sleep until I felt almost wild, then sleep so much I would be stupefied. I could not digest any food and my whole system was wasting and failing fast. I doubt if any one who saw me expected me to get well. I took the treatment sent me by the World's Dispensary Medical Association for more than a year. The medicine never gave me any distress as other medicines had done before. I began to improve from the start, but the change from one extreme to the other was like the growth of a child.

To any one suffering from nervous prostration I would say, "don't be impatient." It takes a long time for weakened nerves to grow strong. I have at last become strong and well, thanks to the Giver of all good and the grand Institution at Buffalo. I have since married a noble-hearted young woman, and when I am playing with our sweet, healthy, baby girl, I give way to the thought that at last the long, sad chapter of my life is ended; at such times her merry laugh sounds like a song of triumph of life over death.

Gratefully yours, W.S. NICHOLSON, Willow Creek, Clay Co., Iowa.

NERVOUS PROSTRATION COMPLICATED WITH KIDNEY AND BLADDER DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Having been a patient in your Invalids' Hotel for several weeks, I take great pleasure in telling other sufferers of my treatment which I received under your efficient staff of physicians, surgeons and nurses, and I will say with clear conscience that every care and comfort was given me that I wished for. I am sure that your Institution is far in advance of the age, and would wish that every invalid could avail himself of the treatment that I received in your most, excellently kept Invalids' Hotel. I cheerfully give this as my testimonial to individuals, friends and sufferers. My health is so fully restored that I look upon life with pleasure and comfort, whereas before I was a suffering nervous invalid, unable to sleep and much of the time in torment. Wishing you success I am your friend and well wisher,

M. MANHEIM, Georgetown, S.C.

NERVOUS EXHAUSTION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.:

_Gentlemen_--I was troubled with nervous exhaustion; my legs and back ached, and I could not sleep hardly any, and could not rest at night for about three months, and, reading in one of your Memorandum Books a case that suited mine and having taken medicines without any good results, I concluded to try your medicines. I explained my case carefully and got one month's medicines, of which I did not take all as I thought I did not need it, as I felt like another man--could sleep well and work without having that "all-gone feeling."

Yours respectfully, A.D. CHRISTIE, Maple Creek, Forest Co., Penn.

NERVOUS AND GENERAL PROSTRATION.

"LIFE IS NOW SWEET."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Six years ago I had an attack of measles, which left my health in a precarious condition. I was placed under the treatment of a good physician who did all in his power to restore my health, but all in vain. I had dyspepsia and could not eat meat, vegetables nor fruit of any kind. I suffered alternately from cold and heat. At times my feet and knees would feel like ice to the touch, and at other times I would suffer the most excruciating torture, seeming as though every nerve in my body was being seared with a hot iron. My left hip and knee would become so affected that I could scarcely walk across the room. I slept very little. On one occasion I remained awake four days and four nights, and then was put to sleep by repeated doses of morphine. My nervous system became so shattered that words spoken by any person in my room fell like pebbles on my brain; and nights I would often have to be raised in bed to prevent smothering to death. It is impossible for me to describe my sufferings at that time but I know that if it had not been for Dr. Pierce's Favorite Prescription I would to-day have been in my grave.

I began the use of the "Favorite Prescription" in March--three years ago, as well as I can remember. Continued till summer when I wrote to you--received your advice and a few simple prescriptions which I had filled at the drug store. I also began the use of the "Golden Medical Discovery." My nerves became quiet: I slept well; my stomach began to heal; my strength returned and I began to feel like a new person. And, to-day, while I am not as strong as the strongest, I can do any kind of work that other women do, and each season I can say I am stronger than I was the last. I used thirty bottles of your medicines. Some may say that was a great deal, but I will never regret the money and patience it took to cure me. It has enabled me to once more enter school where I am trying to make up for those lost years of my life, and as I join the girls in their romps, I can say that "life is now sweet."

Any one desiring particulars may address me.

Respectfully, MISS LUCY MOYERS, Kelso, Lincoln Co., Tenn.

NERVOUS EXHAUSTION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was thought to be beyond all help and had but very little hope myself, but at the urgent entreaty of my wife I let her write to you for me and began taking special treatment from you. I could eat but very little and could keep nothing on my stomach, and was vomiting up bile once or twice every day; muscles all gone and too weak to get about. But to-day I think I am a sound healthy man. I owe it all to your treatment, and a loving Saviour who blessed the means in your hands to the healing of this body of mine. And I gladly recommend the sick and suffering to try Dr. Pierce, and pray God to bless you and your work.

Yours respectfully, W.H. KEESLER, P.O. Box 185, Harriman, Roane Co., Tenn.

NERVOUS EXHAUSTION.

Farina, Fayette Co., Ill.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--It gives me great pleasure to add my testimony to that of many others in behalf of the great success of your Institution. I had been breaking in general health for years and had got so that I could not properly attend to my business. Was very forgetful and easily irritated and excited, and was unable to attend to my business a good part of my time. I doctored with country and city M.D.'s., and took patent medicine, but without any permanent good. I was induced to write to you, which resulted in my taking about one and one-half months' treatment from you, when I felt so much better that I discontinued the treatment. For the last six months I have felt like my old natural self again, and am able to attend strictly to business all the time for which I am very thankful.

Yours truly, C.H. West.

KIND WORDS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Having spent four weeks in your Institution, it gives me great pleasure to state that during that time I received the most courteous and faithful care and treatment, and I bear willing testimony to the skill and ability of the surgeons and the faithful care of the nurses.

Wishing you continued success, I recommend all persons suffering from chronic diseases to give you a trial.

Respectfully yours, JOHN HURST, Marquette, Bighorn Co., Wyo.

SICK HEADACHE, GENERAL DEBILITY, MALARIA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am happy to say that your valuable medicine has been a great benefit to me. I was suffering from general debility, malaria and nervous sick headaches, and after my third child was born (a beautiful baby boy of ten pounds) I only recovered after a long illness; I barely gained strength enough in two years time so that I was able to crawl about to accomplish the little housework that I had, by lying down to read many times each day; had sick headaches very often; and many pains and aches, all the time complaining of getting no better. I finally asked my husband to get a bottle of Dr. Pierce's Favorite Prescription, which he promptly did. After I had taken one bottle I could see a great change in my strength, and fewer sick headaches.

I continued taking the medicine until I had taken eight bottles--seven of the "Favorite Prescription" and one of the "Golden Medical Discovery." For some time past I have not used it, but I am now able to do the housework for myself, husband and two children (aged nine and five years). I also take in dressmaking, and enjoy walking a mile at a time, and I think it Is all due to the medicine, for I know I was only failing fast before I commenced to take it. I take great pleasure in recommending the "Favorite Prescription" to all women who suffer from debility and sick headache.

Respectfully yours, MRS. J.H. LANSING, Fort Edward, Washington Co., N.Y.

HEADACHE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I have used your medicines for a number of years, and know that they do for me all that is claimed for them. I am employed mostly at my desk, and not infrequently have an attack of the headache. It usually comes on in the forenoon. At my dinner I eat my regular meal, and take one or two of Doctor Pierce's Pleasant Pellets immediately after, and in the course of an hour my headache is cured and no bad effects. I feel better every way for having taken them--not worse, as is usual after taking other kinds of pills. Your "Pleasant Pellets" are worth more than their weight in gold, if for nothing else than to cure headache.

Very respectfully, E. VARGASON, Otter Lake, Lapeer Co., Mich.

HEADACHE AND CONSTIPATION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I suffered from loss of appetite, constipation, neuralgia, and great weakness, and had terrible attacks of sick headache very frequently; also nose bleed. My health was so poor that I was not able to go to school for two years. I took Dr. Pierce's Pleasant Pellets and "Golden Medical Discovery," and in a short time I was strong and well. Many friends are taking your medicines seeing what they have done for me.

Respectfully yours, Miss BERTHA WOLFE, Markham, Cattaraugus Co., N.Y.

TERRIBLE PAIN IN HEAD AND FAINTING SPELLS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--When I commenced taking your medicine I was very sickly. I had frequent spells of fainting, terrible pain in my head, and life was a burden to me. I was attended by one of the best physicians in our town, but with no good results. At last a neighbor advised me to try Dr. Pierce's Favorite Prescription, which I did, and after taking one bottle I felt greatly benefited. I would advise all ladies similarly afflicted to try "Favorite Prescription."

Yours truly, MRS. SAMUEL A. JACOBS, Mechanicsburgh, Cumberland Co., Penn.

SICK HEADACHE, BOILS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.:

_Gentlemen_--I was troubled with boils for thirty years. Four years ago I was so afflicted with them that I could not walk. I bought Dr. Pierce's Pleasant Pellets, and took one "Pellet" after each meal. The boils soon disappeared and have had none since. I have also been troubled with sick headache. When I feel the headache coming on, I take one or two "Pellets," and am relieved of it.

Respectfully yours, WILLIAM RAMICH, Minden, Kearney Co., Neb.

SICK HEADACHE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION. Lt'd:

_Gentlemen_--Having suffered several years with very bad bilious attacks and all kinds of headaches, I tried different kinds of medicines but found nothing to cure me. Having read about Dr. Pierce's Pleasant Pellets, I commenced taking them. Before I had finished one phial I found benefit; they have done me great good. I have recommended them to all my friends and will continue to do so where I have the chance.

Yours truly, MRS. JAMES BAKER, Furneaux, Pelham, Nr. Buntingford, Herts.

OBSTINATE NEURALGIA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.:

_Gentlemen_--This is to certify that I had the neuralgia several years, and was not able to perform labor nor attend to business. I was induced to try your medicines, which I took and they effected a permanent cure. I am now well and hearty, and able to do a good day's work, and weigh one hundred and eighty pounds,--and thanks to you for it. I used your medicines three months and was cured.

Yours truly, AUGUST HABENICHT, Fort Pierce, Brevard Co., Fla.

PARALYSIS AND UTERINE DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 603 Main St., Buffalo, N.Y.:

_Gentlemen_--I will say that your Institute is all that you claim for it, and more too. The Doctors are courteous gentlemen and the best Physicians I have ever met with in my life. My treatment while at the Institute did me more good in one month than all the doctors everywhere else combined. My ailment was Paralysis and Female Weakness. Your treatment did me good while at the Institute, and I have also been greatly benefited by the home-treatment I have received from you since. I am much better than I was; I am able to do considerable work now. When I came to you I could not do anything.

I herewith send you my heartfelt thanks for all you have done for me, and should I need more treatment I will write you as before. I would advise all people who have chronic diseases to go to the Invalids' Hotel and Surgical Institute for help, for it is a grand place and prices are reasonable. We use your Family Medicines--your "Pellets" and Golden Medical Discovery--and find they are all you claim for them.

Again I thank you and remain, your friend,

MRS. S.B. MANN, Sutton, Clay Co., Neb.

PARTIAL PARALYSIS FROM UTERINE DISEASE.

Buffalo, La Rue County, Ky.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am still having very good health. I value Dr. Pierce's Golden Medical Discovery and his "Favorite Prescription" very highly and often recommend them to others. I do not think I would ever have got well if it had not been for your medicines. I was in a sad condition. My bowels and half of my body (the left side), was nearly paralyzed, besides nearly my whole system was out of order. I suffered all the time; but after taking six bottles of "Golden Medical Discovery" and the same of "Favorite Prescription," and using two bottles of Sage's Catarrh Remedy as an injection, I felt like a new person. I have never seen anyone suffering in the same way as I did. If anyone with female trouble of any kind will use your medicines I am satisfied they will help them.

Yours truly, Mary A. Sallee.

LOCOMOTOR ATAXIA. SPECIAL TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Ltd., No. 3 New Oxford Street, London, W.C.:

_Gentlemen_--In the latter part of 1890, I was struck down with that terrible--and by many members of the medical profession pronounced to be, incurable disease, locomotor ataxia. My family doctor declared that nothing could be done for me, but for the sake of satisfaction advised me to go to London, and see an expert, whom he named. I did so, with the result of being told as above. This was in November, 1890. The symptoms were first numbness in hands and feet, which soon extended as far as the thighs, joined with the most intense feeling of cold that it can be possible to imagine. For six months I felt as though I had stood in ice up to my thighs. I soon became unable to walk or to stand, and crawled up stairs on my hands and knees, I thought for the last time, as I then thought I should die. Stomach troubles then set in, and for more than three months, I endured the utmost agony. Night and day sweats absorbed my little remaining strength, and I became helpless. I had taken leave of my family, not expecting to last the day out, when I was seen by a young doctor, who is fast becoming an eminent man, who said he thought he could alleviate my sufferings--though he did not expect to cure me. He commenced to treat me, and in about one month I began to improve, though very slowly. This was in February, 1891, and before the end of the year I was able to walk down stairs again. It was in March, 1892, that I began taking Dr. Pierce's Golden Medical Discovery, and on sending to you for a bottle in reply to your inquiry, I began your special treatment, with the happy result that I gradually improved in health and strength; and on the 26th of October, 1892, I was able to call on you in London, and you advised me to continue your treatment, and use a battery as well, which I did until April, 1893, when I could walk about quite nicely, and I now enjoy better health than for the past eight years. I am thankful too, that my eldest daughter has derived the greatest benefit from Dr. Pierce's Favorite Prescription. She took it for painful menstruation, and is now well and healthy. I am

Yours very truly, C.F. GOODWIN CASTLEMAN, Bursledon, Southampton, England.

PARALYSIS, NERVOUS PROSTRATION, ETC.

From the records of the WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

This gentlemen had a severe attack of grip in January, 1890. His health gradually declined until June, at which time he was taken very much worse. Had nervous shocks three or four times a day. Slight paralysis of lower limbs. Respiration and pulse slow and irregular. Bowels constipated and tongue coated. Indigestion. Ringing in the ears. Legs wasting. Dimness of vision. Lost flesh rapidly and reduced to "skin I and bones." Chills and sweats; dizzy. Had great distress in bowels. Pain about the heart. Had been confined to his bed 46 days, at the time the case was submitted to us. We sent only one month's course of special medicines. He writes us afterwards:

"I am at regular farm work, after my doctor here having told me that I must die and that Dr. Pierce was a gigantic humbug."

Yours truly, F.M. BRASHER, Homer, Logan Co., Ky.

EPILEPTIC "FITS."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, No. 663 Main St., Buffalo, N.Y.:

_Gentlemen_--My daughter, Sadie, is eighteen years old; has been afflicted with that dreaded disease, Epilepsy, for fourteen years. She received treatment from seven different doctors without any material benefit. She has only had one spasm after commencing with your treatment, now almost two years. Three boxes of epilepsy medicine, followed up with your "Favorite Prescription" cured her. She took about six months' treatment in all.

This places us under a world of obligation to you as the instrument of our great relief under a kind Providence. Should there be any signs of it returning we would with unshaken faith send for more medicine. You can use her or my signature as you wish.

Yours truly, GEORGE SWINEHART, Lake, Stark Co., Ohio.

EPILEPSY.

CURED BY SPECIAL TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Ltd., No. 3 New Oxford St., London.:

_Gentlemen_--I have great pleasure in announcing to you my heartfelt thanks for the benefit derived from your treatment, having suffered from epileptic fits for six years. I have experienced as many as five and seven fits a day, some lasting two hours at a time. I am glad to say since trying your medicine which is now five months, I have not had one. Thanking you for your kindness.

Gratefully yours, GEO. HERBERT PLUMSTEAD, 67 Fishgate Street, St. Edmunds, Norwich, England.

SPASMS OR FITS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:

_Gentlemen_--I desire to express my gratitude for the wonderful results of your treatment with my little son John. He was very bad, as we thought, for the physician could do nothing for him any more, and I got discouraged and went to my daughter, Mrs. D.T. Knappenberger, of Jeannette, Pa., (who has been a terrible invalid and was cured at your Institute), for advice. 'Oh, father,' she said, 'don't doctor here, but go to Dr. Pierce. So the result was I gave her money and she sent for medicines. You sent two bottles of medicine and he never has taken a drop since and is perfectly well and never had a spell since. I do not know what you call the disease, but we called it spasms or fits. With my experience I can heartily recommend the Invalids' Hotel, and think if a case can be cured at all, you can cure it. And unless they can cure or greatly benefit the patient, they will not undertake it; this is my experience with the World's Dispensary. My daughter, Mrs. D.T. Knappenberger, and my son Johnnie, feel very grateful toward the Dispensary for their cure.

Yours truly, D.A. MAXWELL, Greensburgh, Westmorland Co., Pa.

EPILEPSY, "FITS."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--My little girl was delicate from birth, nervous and irritable. When three and one-half years old we discovered she had that terrible disease "epilepsy," inherited from her father's family; she had spasms or fits once in two or three days, and grew worse so rapidly that in four months she had from four to eight fits in twenty-four hours. Home physicians did no good, and just then one of your little pamphlets came to me as they had come often before. As my need was great I wrote a description of her case, and though your answer did not seem very encouraging, I did not dare to lose any chance of saving my child, so I commenced the treatment. On November 6, 1891, she had seven fits; November 7th gave her your medicines; she had four fits that day, and never one since. She took your medicines less than four months. She is nearly six years old, a strong, hearty, bright child, attending school every day.

What more can I say than that I thank Dr. Pierce and the Faculty of the World's Dispensary Medical Association for having saved the life of my child, and I thank God that he gave them the knowledge and skill to do so.

Respectfully yours, MRS. J. MCCARTY, Gouldsville, Washington Co., Vt.

ST. VITUS'S DANCE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--My boy had been in bad health for a long time. We called our home doctor, but he got no better. Finally he had the St. Vitus's Dance, and our doctor did not know what to do. So I wrote to you and did as you told me; I got two bottles of your "Favorite Prescription," and one bottle and a half did the work all right. At that time, eighteen months ago, his weight was 85 pounds, now it is 135 to 140; he is fourteen years old.

Yours truly, JEREMIAH PONSLER, Zenas, Jennings County, Ind.

EPILEPSY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--My daughter, Josephine E. Thulin, is now six and a half years old. She had been afflicted with epilepsy for three and a half years, and received treatment from three different doctors, and from one especially, for the space of two years steady, without any benefit. Before taking your treatment she had as many as six or seven spells a day. The child could not have stood it much longer. After taking your treatment one month the spells stopped. With four months' special treatment from you, and two months' use of Dr. Pierce's Favorite Prescription she was entirely cured. In one year and three months she has not had a drop of medicine, and she is in the best of health and vigor.

I would say to any sufferer from obstinate or chronic disease, and especially epilepsy, that we have a living witness. You can come and see for yourself that the doctors connected with the World's Dispensary Medical Association _do_ understand how to prescribe.

You can use this as a testimonial from me, of what you have done for us. I remain,

Yours truly, JOHN THULIN, (for daughter,) Kearney, Buffalo Co., Nebr.

A STRONG ENDORSEMENT.

_To whom it may concern_:

This is to certify that I took treatment at the Invalids' Hotel and Surgical Institute, Buffalo, N.Y., and I was cured of a chronic trouble that had been maltreated by other physicians. While there I saw a man who had been cured by the specialists, who had before been given up to die by the best doctors in Troy, N.Y. Of course, the case must have been a very stubborn one. I afterwards saw a man here, in Georgia, die, who, if he had been in Pierce's Surgical Institute under the treatment and care of his skilled doctors and nurses, I know would have most assuredly got well. Why? Because it was only a case of _stone in the bladder_, and they are easily cured at Dr. Pierce's Surgical Institute. I think almost any chronic disease can be cured there, if taken in time, judging from my observations while an inmate of that Institution.

H.E. BANKSTON, Barnesville, Pike Co., Ga.

COMPLICATION OF DISEASES.

Without solicitude or hope of pecuniary reward, with heart-felt gratitude and a desire to aid my fellow-man to health and happiness, allow me to state, that as an inmate for more than a month of the Invalids' Hotel and Surgical Institute at No. 663 Main Street, Buffalo, N.Y., I feel warranted in its highest recommendation. While there I saw and talked with a groat number of people who came there as a last resort, to be cured of almost every chronic disease to which flesh is heir, and they were unanimous in their praise of the Institution and the skilled specialists who constitute its professional staff.

ANDREW HOLES, Moorhead, Minn.

* * * * *

THE DOOR OF LIFE.

The fear of pain and the dangers of childbirth fill many a woman's breast with dismay. In the olden days of leeches and witchcraft, it was considered sacrilegious to lessen the pains of labor. Latterly, anæsthetics have been used at the time of parturition, and now people are beginning to find out that pain and danger can be almost wholly avoided.

Proper preparation during gestation will make both as rare as they used to be common. There is no reason why childbirth should be fraught with danger and distress. It is a perfectly natural function, and should be performed in a natural way without undue suffering. Nature never intended that women should be tortured when doing the one thing which makes them wholly womanly. The perversion of nature's laws has brought this suffering about, and a return to right living will stop it.

Nine out of ten women are troubled more or less by weakness and diseases peculiar to their sex. It is so because they do not take proper care of themselves--because they neglect little ills and little precautions. A woman in perfectly hearty health goes through her time of trial with comparative ease. The thing to do then, is to make all pregnant women healthy--to strengthen them generally and locally. The medicine and tonic to do it with is Dr. Pierce's Favorite Prescription.

It is a powerful invigorant and nervine. It soothes and strengthens the nerves and acts directly on the feminine organism in a way which fits it for the proper and regular performance of all its functions at ill times.

Taken during gestation it robs childbirth of its dangers to both mother and child, by preparing the system for delivery, thereby shortening labor, lessening pain and abbreviating the period of confinement. The Favorite Prescription also promotes the secretion of an abundance of nourishment for the child, if taken after confinement, besides building up the mother's strength and making her recovery more perfect.

ABORTION. (MISCARRIAGE.)

The term _abortion_ is used to denote the premature expulsion of the foetus. If the expulsion takes place within four months after impregnation, it is termed _abortion_; if between the fourth and seventh month, _miscarriage_; if after the seventh month, but before the completion of the full period of gestation, _premature labor_.

Abortion may be due to those agents which act directly upon the uterus and cause the expulsion of the foetus; to those which occasion the death of the foetus, thereby effecting its ejection; and it may be _criminal_, that is, produced intentionally by direct agencies intended for that purpose.

SYMPTOMS. The premonitory symptoms are pain in the loins and lower part of the back, a dull pain in the abdomen and thighs, nausea, chills, and palpitation. The membranes and blood-vessels of the uterus become lacerated, causing profuse hemorrhage. The discharge of blood from the vagina is sometimes attended with excessive pain.

THE CAUSES which act directly upon the uterus to produce abortion may be violent exercise, lifting, accidents, or injuries from blows or falls. Nervous susceptibilities, a plethoric condition of the system, anæmia, exhaustive discharges, use of improper food, uterine displacements, congestion caused by excessive sexual excitement, general debility or muscular irritability, which is sometimes so great as to produce contractility of the uterus before the term of pregnancy is completed, inflammation of the cervix, ulcerations of the uterus, or any previously existing disease may produce abortion. When it has once taken place, it is apt to recur at about the same time in subsequent pregnancies.

The death of the foetus may be occasioned by a diseased condition of the embryo, amnion, or placenta, and also by convulsions or peritoneal inflammation.

CRIMINAL ABORTION is secretly practiced by women who desire to rid themselves of the evidence of immorality, and by those in wedlock who wish to avoid the care and responsibility of rearing offspring. Statistics show that it is very prevalent, undermining the health of women and corrupting the morals of society. We cannot pass over this subject in silence. Those who frustrate the processes of nature by violating the laws of life incur just penalties. All the functions of life and body are vitally concerned in reproduction. Any infraction of the Divine law, "Thou shalt not kill," is inevitably followed by punishment. The obligations to nature cannot be evaded without inevitable penal effects. Furthermore, all such transgressors carry with them the consciousness of guilt and the feeling of secret woe.

"O God! that horrid, horrid dream Besets me now awake! Again, again, with dizzy brain. The human life I take, And my red right hand grows raging hot, Like Cranmer's at the stake."--HOOD.

What shall we say concerning abortionists, men and women who are willing to engage in the murder of innocents for pay? True, there may be circumstances in which it is not right to continue in the pregnant condition, such as when the children of an unfortunate marriage are idiots, or the pelvis of the woman is so deformed that she cannot bear a living child. All such cases should be submitted to the _family_ physician, who ought to be made acquainted with all the circumstances and facts relating to the case, when he can summon other physicians for counsel, and their deliberations may determine the propriety or necessity of bringing on an abortion.

Parties have written to us and others have made personal application under circumstances when it might have been right for their _family physician_ to have induced abortion. We wish to have it distinctly understood that we will not under any circumstances prescribe medicines or perform any operation to relieve women of pregnancy.

Mechanical means are resorted to by abortionists, and many women produce abortion upon themselves. It always terminates in lasting injury and sometimes in speedy death. Certain medicines will sometimes produce abortion but they are very unsafe. An opinion is very prevalent that if abortion be produced before the movements of the foetus are felt, there is no crime committed. It should be remembered that _life begins with conception_, and, at whatever period of pregnancy abortion is committed, _life is destroyed_. Whoever disobeys the Divine injunction cannot escape his own consciousness of the deed, and the anguish and bitter remorse which ever after disturb the soul.

TREATMENT. In threatened abortion, there is pain in the back or lower part of the abdomen, and later some flow of blood. The first object is to obtain perfect rest and quiet, and assume the recumbent position. By lying down, the blood will be more easily diverted to the surface of the body. Gallic acid, in doses of five grains every two or three hours, is often a valuable agent to arrest the hemorrhage, but opium in some form should be relied upon principally. A Dover's powder, ten grains, may be administered, to assist in determining the blood to the surface and extremities of the body and to allay irritation. The room should be cool, the patient should lie on a hard bed, and all company should be avoided, for excitement favors abortion. If the flow of blood equals a gill in amount, there is little hope of preventing abortion, and the treatment of the case should be entrusted to the family physician.

* * * * *

WOMAN AND HER DISEASES.

An imaginative poet avers that woman is the link connecting Heaven and earth. True it is, we see in her the embodiment of purity and heavenly graces, the most perfect combination of modesty, devotion, patience, affection, gratitude and loveliness, and the perfection of physical beauty. We watch with deep interest the steady and gradual development from girlhood to womanhood, when the whole person improves in grace and elegance, the voice becomes more sonorous and melodious, and the angles and curvatures of her contour become more rounded and amplified, preparatory for her high and holy mission.

The uterus, or womb, and ovaries, with which her whole system is in intimate sympathy, render her doubly susceptible to injurious influences and a resulting series of diseases, from which the other sex is entirely exempt. By their sympathetic connections they wield a modifying influence over all the other functions of the system. Physically and mentally, woman is man modified, perfected,--the last and crowning handiwork of God. When, therefore, this structure so wonderfully endowed, so exquisitely wrought, and performing the most delicate and sacred functions which God has ever entrusted to a created being, is disturbed by disease, when the nicely-adjusted balance of her complex nature deviates from its true and intended poise, the most efficient aid should be extended, in order that the normal equilibrium may be regained, her health restored, and her divine mission, on which human welfare so largely depends, be fulfilled. Its importance should elicit the best efforts of the highest type of mind, the ripe development of genius, and the most scientific administration of the choicest, rarest, and purest medicinal elements in the whole range of nature.

A VAST EXPERIENCE. As the remedial management of diseases of women has, for many years, entered very largely into our practice at the Invalids' Hotel and Surgical Institute, located at 663 Main Street, Buffalo, N.Y., comprising the treatment of many thousands of cases annually, we have been afforded great experience in perfecting and adapting remedies for their cure, enabling us to meet their requirements with increased _certainty_ and _exactness_.

TREATING THE WRONG DISEASE. Our improved and perfected system of diagnosing, or determining, the _exact_ nature and extent of chronic affections, which, in most cases, we are able to do at a distance, and without a personal examination of the patient, as will be more particularly explained in the appendix, or latter part of this little book, has enabled us to avoid the blunders so often committed by the general practitioner, who not infrequently treats those afflicted with chronic ailments peculiar to women, for long weeks, and perhaps months, without ever discovering their real and true disease, or condition. Thus, invalid women are often uselessly subjected to treatment for dyspepsia, heart disease, liver or kidney affections, sick headaches, and various aches and pains, as if they were _primary_ diseases, when in reality, they are only so many local manifestations, or _symptoms_, of some overlooked derangement, or disease, of the womb. For, as we have already intimated, every organ of the system is in _intimate_ sympathy with the uterus, or womb. Any disease, either functional or organic, of this organ, is at once manifest through several, if not all, the sympathizing organs of the system. When we receive a sharp blow upon the elbow, the pain is felt most keenly in our little finger. Just so in diseases of the womb; often the most distress is felt in organs or parts of the system quite distant from the real seat of disease. On this account, thoughtless, easy-going and ignorant physicians are misled, and very commonly mistake the invalid's disease for some affection of the stomach, heart, liver, kidneys, or other organ, when really it is located in the uterus. Cure the disease of the womb, and all these disagreeable manifestations, or symptoms, vanish. Their cause being removed, the various dependent derangements, and disagreeable nervous sensations and sufferings rapidly give way, and vigorous health is firmly re-established.

TIME AND PERSEVERANCE IN TREATMENT REQUIRED TO CURE. Most chronic diseases of women are slow in their inception, or development, and their removal or cure must necessarily be gradual. Disease that has been progressing and becoming more firmly established for months, or perhaps years, cannot, except in rare cases, be hastily dislodged, and the system restored to perfect health. The process of cure, like the development and progress of the disease, must be a gradual one, accomplished step by step. Often, too, the use of medicines that, if _persisted_ in, will prove beneficial and curative, will, for a considerable time, arouse in the system very disagreeable sensations, and many times this leads unthinking persons to become frightened or discouraged, and to quit the treatment best adapted to their cases if only faithfully carried out. In many forms of womb disease, their are organic lesions or changes, that can be repaired only by a gradual process, just as an external wound would heal,--not suddenly, but by a constant, slow filling in and building up, or by the gradual development or growth of one cell upon another. Just as a great breach in a wall would be repaired by filling in brick upon brick, until the defect is effaced, so must these lesion's be removed by gradual processes. When fully repaired, the dependent, sympathetic derangements, disagreeable sensations, and all the long train of consequential symptoms are, one by one, abolished.

NOT LIMITED IN OUR REMEDIAL RESOURCES. It should be borne in mind that, while we recommend, in this little volume, certain courses of treatment for ordinary cases, the remedies mentioned do not by any means embrace all our resources in the way of medicines and other curative agencies, especially for complicated, difficult, or very obstinate cases. In many of the latter class we can send medicines that are exactly adapted to the case, if the invalid will fill out one of our "Applications for Treatment," which may be found folded in the latter part of this book, or which will be sent to any address, on application, by mail. In most womb diseases, the chemical and microscopical examination of the urine also furnishes valuable aid in determining the exact condition of the patient, as well as the precise stage of the local organic disease. Full directions for putting up and sending such samples may be found in the "Appendix" of this little volume. Every case submitted to us, either by letter or in person, receives the careful and deliberate consideration of a full Council of specialists before a decision as to the nature of the malady, or the proper course of treatment to be employed, is determined upon. The great advantage of this system of practice must be obvious to every intelligent, thoughtful person. No experimenting is ever resorted to. The treatment is _specially_ and _exactly_ adapted to each individual case, which requires such judgment, skill, and nicety of discrimination, as has only been acquired by our specialists through long and diligent study, and an experience embracing the treatment annually of many thousands of cases of those chronic diseases which are peculiar to women.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main Street, Buffalo, N.Y.

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MENSTRUATION AND ITS DISORDERS.

The function of the ovaries is to furnish ova or germs, and the functions of the uterus or womb are to secrete mucus; to exude the menses; to secrete the decidua; to contain and nourish the foetus and to effect its expulsion.

Menstruation, or the menses, monthly visitation, catamenia, menstrual flow, courses, or periods, usually makes its appearance in the female between the twelfth and fifteenth years, at which time the reproductive system undergoes remarkable changes. A marked characteristic of menstruation is its regular return about every twenty-eight days. The menstrual flow usually continues from three to six days, and the discharge seems to be ordinary blood, which, during its vaginal passage, becomes mixed with mucus, and is thereby deprived of the power of coagulation. The quantity exuded varies from two to eight ounces, but the amount consistent with the health of one person, may be excessive and weakening in another. This function is regarded as "being regular when its effect upon the system is favorable, for whatever organic process directly contributes to the health should be considered as normal. It occurs at regular intervals for about thirty years, when menstruation and the aptitude for conception simultaneously cease.

The departures from healthy menstruation are numerous. The most important of these are _amenorrhea, dysmenorrhea_, and _menorrhagia_.

AMENORRHEA.

The term _amenorrhea_ signifies the absence of menstruation when it should occur. It may be considered under two general heads: when it fails to be established at the proper age, and when, after having made its appearance, it ceases to return at the usual periods. The term _retention_ has been applied to the first, and that of _suppression_ to the latter. Menstruation may fail to be established in consequence of organic defects, or from some abnormal condition of the blood and nervous system.

MALFORMATION OF THE VAGINA. Retention of the menses may result from malformation of the vaginal canal, which sometimes terminates before it reaches the womb, being simply a short, closed sac. If the uterus and ovaries are perfect, all the feminine characteristics are manifest, and a vaginal exploration discloses the nature of the difficulty. If, however, the sides of this passage adhere in consequence of previous inflammation, they may be carefully separated by a surgical operation, and this function restored.

ABSENCE OR MALFORMATION OF THE WOMB. The uterus may be deformed or entirely absent, and yet there be an inclination, or symptoms indicative of an effort, to establish this function. The individual may be delicate in organization, graceful in bearing, refined and attractive in all feminine ways, and yet this organ may be so defective as to preclude the establishment of the menstrual function. Sometimes there is merely an occlusion of the _mouth_ of the uterus, the perforation of which removes all difficulty. In others, the _neck_ of the womb is filled with a morbid growth, or the walls of its canal are adherent, as the result of inflammation, and may be separated by a small silver or ivory probe, and the menses be thus liberated.

IMPERFORATE HYMEN. The hymen is a circular, or semilunar membrane, which imperfectly closes the outer orifice of the vagina in the virgin. When of a semilunar shape, it usually occupies the lower or posterior portion of the canal, leaving an opening in the upper or anterior portion, varying from the size of a quill to that of a thimble, through which the menstrual fluid exudes. This membrane is usually ruptured and destroyed by the first sexual intercourse, and, hence, its presence has been considered evidence of virginity. Its absence, however, must not be considered a conclusive evidence of sexual intercourse, for, as Dr. Dunglison says, "many circumstances of an innocent character may occasion a rupture or destruction of this membrane. It is often absent in children soon after birth; while it may remain entire after copulation. Hence, the presence of the hymen does not _absolutely_ prove virginity; nor does its absence prove incontinence, although its presence would be _prima facie_ evidence of continence."

Sometimes this membrane, when not imperforate, is so thick and strong as to render sexual intercourse impossible, and requires a cutting operation to open the vagina. Several such cases have been operated upon at the Invalids' Hotel and Surgical Institute.

It occasionally happens that the hymen is entire, or imperforate, at birth. This may not be discovered before puberty. But when this period arrives and the menstrual discharge takes place into the vagina, the female will suffer from the retention and accumulation of this secretion, and ultimately a tumor or a protrusion of the membrane which closes the vagina will occur, giving rise to severe pain and other serious symptoms. The retained menstrual fluid, increasing in quantity at every monthly period, dilates the womb as well as the vagina, and even the Fallopian tubes become distended, presenting at length an urgent necessity for relief.

TREATMENT. This condition admits of relief only by operative surgery. The operation consists in dividing the hymen by a crucial incision, thus allowing the accumulated fluid to be discharged, after which the vagina is cleansed by syringing it with warm water.

ABSENCE OF THE OVARIES. Let us suppose the case of a young woman who has fully reached the period of puberty without having menstruated. All the organs which we have described, are manifestly developed, she is healthy, vigorous, robust, and able to exercise freely or to engage in laborious occupations. But we notice that her voice is not sweetly feminine, nor is her presence timid, tender, and winning; there is wanting that diffident sexual consciousness, which gently woos, and, at the same time, modestly repels, and tends to awaken interest, curiosity, and desire. Considering also that she has never manifested any inclination to menstruate, we are irresistibly led to the conclusion that the ovaries are wanting; the delicate mustache upon the upper lip, the undeveloped breasts, the coarse features, and her taste for masculine pursuits, all concur in this diagnosis. Thus we account for the harshness of the voice, fitted for command rather than to express the mellow, persuasive cadences of love. Such a malformation cannot be remedied.

RETENTION AND SUPPRESSION FROM MORBID CONDITIONS OF THE BLOOD. Non-appearance, as well as suppression of the menses, may result from an abnormal state of the blood. The first condition which demands our attention under this head is _plethora_. In robust, plethoric females the menses are sometimes very tardy in their appearance, and every month the attempt to establish this function is attended with pain in the head, loins, and back, chilliness, nausea, and bloating of the abdomen. Sometimes there is intolerance of light or sound, and cerebral congestion, amounting almost to apoplectic symptoms. The pulse is full and strong, the blood abundant and surcharged with red corpuscles. Such persons may be accustomed to luxurious living, and there is evidently a predisposition to abnormal activity of the alimentary functions.

TREATMENT. We may briefly suggest that such subjects should engage in laborious physical exercise in order to expend the surplus of vitality, and should lessen the daily amount of food taken, and use that which is light and unstimulating. We should also prevent the determination of blood to the head, by keeping it cool and the feet warm, and by increasing the flow of blood to the extremities. The volume of the circulation may be diminished by acting upon the natural outlets, such as the skin, kidneys, and bowels. The proper means and appliances for quickening the circulation of the blood are indicated, and friction upon the surface, bathing, the daily use of such cathartics as Dr. Pierce's Pleasant Pellets, and, finally, the use of some general uterine stimulant, such as Dr. Pierce's Favorite Prescription, will generally prove successful in cases of amenorrhea resulting from plethora.

RETENTION AND SUPPRESSION FROM ANÆMIA. To describe the condition of the patient whose blood is low and deprived of the richness, warmth, and bloom, it once possessed when it kindled admiration and enthusiasm in others, is but to give a picture of a numerous class of female invalids. It is sad to see beauty fading, vigor waning, and Bright's disease or consumption slowly wasting the blood and consuming the vital cells, until the spirit can no longer dwell in its earthly abode and death claims the skeleton for dust.

CHRONIC DECLINE, with its attendant anæmia, may be induced by bad habits, destitution, or constitutional depravity. Sickly forms, wrecks of health, address our senses on every side. All these subjects evidently once had a capital in life, sufficient, if properly and carefully husbanded, to comfortably afford them vital stamina and length of days. Alas! they have squandered their estate, perchance in idleness and luxurious living, or have wasted it in vanities or misdirected ambition. Having become bankrupts in health, there is necessarily a failure of the menstrual function, and then follows a _panic_. All the blame of the insolvency and general derangement, is unjustly attributed to the non-performance of the duties of the uterus. Thus, this organ is altogether _dependent_ Upon the general health for its functional ability, yet frequently treatment is instituted to compel menstruation, regardless of the condition of the system. Thus the enfeebled uterus is wrongfully held responsible for general disorder, because it ceases to act, when _by acting_ it would further deplete the blood and thus materially contribute to the already existing chronic decline.

No matter what are the causes of this decline, whether they are the follies of fashion, the effect of indolence, debility in consequence of insufficient food, perversion of nutrition by irregular habits, lack of exercise, or the taking of drastic medicines, the result is anæmia and amenorrhea.

TREATMENT. We would suggest in such cases a nutritious diet, increased exercise, cleanliness, regular habits, hard beds, and useful employment. The diet may be improved by animal broths, roasted meats, fresh beef, mutton, chicken, or eggs, and the dress should be comfortable, warm, and permit freedom of motion. The patient should indulge in amusing exercises, walking, swinging, riding, games of croquet, traveling, singing, percussing the expanded chest, or engage in healthful calisthenic exercises. The hygienic treatment of this form of amenorrhea, then, consists in physical culture, regular bathing, and the regulation of the bowels, if constipated, as suggested in this volume under the head of constipation.

The _medical treatment_ should be directed to enriching the blood, improving nutrition, toning up the generative organs, and the health of the whole system. This requires the employment of uterine and general tonics, and Dr. Pierce's Favorite Prescription, which is sold by druggists, happily combines the properties required. It improves digestion, enriches the blood, exercises a tonic and gently stimulating effect upon the uterus and ovaries, and thus promotes the function of menstruation. It is not a strong emmenagogue, but operates slowly, yet surely, and in accordance with physiological laws, being eminently congenial in its effects upon the female system, and, hence, not liable to do harm. There is danger in employing active driving medicines, besides, no emmenagogue, however powerful, can establish the menstrual function so long as the system is in a debilitated condition and the blood reduced. The restorative effects of the "Favorite Prescription" should be secured by administering it regularly, in from one to two teaspoonful doses, three or four times a day, for several weeks, and as the system is built up and those symptoms appear which indicate a return of the menses, their visitation may be encouraged by the use of hot foot and sitz-baths, and free doses of Dr. Pierce's Compound Extract of Smart-weed. But the latter should only be used when symptoms of approaching menstruation are manifested. By following out this course of treatment, a soft flush will gradually take the place of the pallor of the cheeks, the appetite will return and the health will be restored.

ACUTE SUPPRESSION OF THE MENSES may be caused by _strong emotions,_ as excessive joy, or by violent _excitement_ of the _propensities_, as intense anger, sudden fright, fear, or anxiety. Suppression may result from sudden exposure to cold, immersion of the hands or feet in cold water, drinking cold water when the body is heated, sitting on the cold ground or damp grass, or from a burn or wound. It is not uncommon for women to labor in the heated wash-room, pounding, rubbing, and wringing soiled linen, thereby overtaxing the delicate physical system. While feeling tired and jaded, all reeking in perspiration, they rinse and wring the clothes out of cold water and hang them upon the line with arms bare, when the atmosphere is so freezing that the garments stiffen before they finish this part of the task. Is it any wonder that acute suppressions occur or that inflammations set in?

The symptoms which naturally follow are a quick pulse, hot skin, thirst, fever, headache, and dizziness, and the inflammation may locate in the ovaries, uterus, lungs, bowels, brain, or other parts. No matter what organs are attacked the menses are suppressed. The suppression can generally be attributed to an adequate cause, resulting in constitutional disturbance. The severity and duration of the attack and the power of the constitution to resist it, must determine the gravity of the consequences.

TREATMENT. As acute suppression of the menses is due to derangement of the circulation of the blood, caused by taking cold, by violent excitement of the propensities or excessively strong emotional experience, the prominent indication is to secure its speedy equalization. Give a hot foot, a warm sitz, or the spirit vapor-bath and administer full doses of Dr. Pierce's Compound Extract of Smart-weed, to produce free perspiration. Dr. Eberle, a very celebrated medical author, says that he used the Extract of Smart-weed in twenty cases of amenorrhea, and affirms, "with no other remedy or mode of treatment have I been so successful as with this." Our experience in the use of the Extract has been equally satisfactory. Should this treatment not establish the function, Dr. Pierce's Favorite Prescription should be given three times a day until the system is invigorated, say for twenty-eight days, when the above course may be repeated, and generally with success. Should the case be complicated with inflammation of the lungs, brain, or other vital organs, manifesting alarming symptoms, the family physician should be called. The treatment should be active and suited to the indications of each particular case. When the disease becomes chronic, the active stage of symptoms having passed, and it continues to linger without making the desired improvement, all the means suggested for the treatment of suppression from anæmia should be employed. Their use will be followed by the most gratifying results. It should be borne in mind, however, that when we have suggested any treatment in this volume, it is generally such as the family may institute and apply, and does not, by any means, represent the variety or extent of the remedial resources which we employ when consulted in person or by letter. We refer our readers to only a few of the safe and reliable remedies which we have prepared and placed within their reach, and give them just such hygienic advice as we think will best serve their interests.

* * * * *

DYSMENORRHEA.

(PAINFUL MENSTRUATION.)

_Dysmenorrhea_, from its Greek derivation, signifies a _difficult monthly flow,_ and is applied to menstruation when that function becomes painful and difficult. Menstruation, like other healthy operations of the body, should be painless, but too frequently it is the case, that discomfort and distress commence twenty-four hours before the flow appears, and continue with increasing pain, sickness at the stomach, and vomiting, until the patient has to take to the bed. When the discharge does occur, speedy relief is sometimes obtained, and the patient suffers no more during that menstrual period. With others, the commencement of the function is painless, but from six to twenty-four hours after, the flow is arrested and the patient then experiences acute suffering. Pain may be felt in the back, loins, and down the thighs. Sometimes it is of a lancinating, neuralgic kind, at others, it is more like colic. Frequently the distress causes lassitude, fever, general uneasiness, and a sense of lethargy. There are those who suffer more or less during the entire period of the flow, while the distress of others terminates at the time when a membranous cast is expelled. For convenience of description, dysmenorrhea has been divided into the following varieties: _neuralgic, congestive, inflammatory, membranous_, and _obstructive_.

_The neuralgic variety_ of dysmenorrhea, sometimes called _spasmodic_ or _idiopathic_, occurs when there is excessive sensibility of the ovaries and uterine nerves, which sympathetically _respond_, especially to cutaneous, biliary, and sexual irritation, and when ovarian or uterine irritation is communicated to distant nerve-centres. In the first class, usually comprising lean persons of an encephalic temperament, whatever disorders the functions of the general system, instantaneously reflects upon the ovaries and uterine nerves, and the menstrual function Is correspondingly disturbed, and, instead of being painless, the flow becomes spasmodic, with paroxysms of distress. In the second class, which includes those persons who are plethoric, the ovarian and uterine nerves seem to be the origin and centre of irritation, which is sometimes so severe as to cause indescribable pain. We have known women who affirmed that the severity of labor pains was not so great as that from this cause. In one instance, the subject suffered thus for eleven years, and then became a mother, and has ever asserted that her periodic suffering was far more intense than the pain experienced during her confinement. These neuralgic pains fly along the tracks of nerves to different organs, and capriciously dart from point to point with marvelous celerity, producing nausea, headache, and sometimes delirium.

IN THE CONGESTIVE VARIETY of dysmenorrhea, the menstrual period may be ushered in without pain; after a few hours, the pulse becomes stronger and more rapid, the skin grows hot and dry, the menses stop, there is uneasiness, restlessness, and severe pelvic pains. Evidently, the mucous membranes of the Fallopian tubes and uterus have become congested, and the pain results from the arrest of the functional process, the exudation of blood.

THE CAUSES are plethora, exposure to cold, excitement of the emotions or passions, and a morbid condition of the blood. Sometimes congestion arises in consequence of a displacement of the uterus.

IN THE INFLAMMATORY VARIETY, the mucous membrane of the uterus is the seat of irritation. The blood flows into the capillary vessels in greater abundance than is natural, and those vessels become over-dilated and enfeebled and so altered in their sensibility as to produce local excitement and pain. It may be associated with inflammation of the ovaries, peritoneum, or bladder. Upon the return of the menses, there is a dull, heavy, fixed pain in the pelvis, which continues until the period is completed. There is generally tenderness of the uterus, and also leucorrhea during the intervals between each monthly flow.

IN THE MEMBRANOUS VARIETY of dysmenorrhea, the entire mucous membrane which lines the cavity of the uterus, in consequence of some morbid process, is gradually detached and expelled at the menstrual period.

SYMPTOMS. There are steady pains at the commencement of the menstrual flow, and they increase in violence and become decidedly expulsive. The mouth of the uterus gradually dilates, and finally, the membrane is forced out of the uterus, attended with a slight flow of blood and an entire subsidence of the pain.

THE TREATMENT, in all the preceding varieties of dysmenorrhea, should consist of measures to determine the circulation of the blood to the surface, and increase the perspiratory functions. Congestion and inflammation of the internal organs are generally induced by exposure to cold or from insufficient clothing. Sometimes they follow from neglect of the skin, which is not kept clean and its excretory function encouraged by warm clothing. The domestic treatment at the monthly crisis should be commenced by the administration of hot foot, and sitz-baths, after which the patient should be warmly covered in bed, and bottles of hot water applied to the extremities, back, and thighs. Dr. Pierce's Compound Extract of Smart-weed should be given in full doses, frequently repeated, to secure its diaphoretic, emmenagogue, and anodyne effects, which, for this painful affection, is unsurpassed. For the radical cure of this disease, whether of a congestive, inflammatory, or neuralgic character, Dr. Pierce's Favorite Prescription, which is sold by druggists, is a pleasant and specific remedy, which will most speedily correct the abnormal condition that produces the trouble, and thereby obviate the necessity of passing this terrible ordeal at every monthly period. The patient should take two teaspoonfuls of the medicine three times a day, and keep up its use in these doses for weeks. Frequently, one month will suffice to cure, but in most cases, a longer season is required. In the end, the suffering patient will not be disappointed, but will become a new being, ready for the enjoyment and duties of life. The bowels should be kept regular throughout the treatment by the use of Dr. Pierce's Pleasant Pellets, if necessary. A hand or sponge-bath should be used daily to keep the skin active, and be followed by a brisk rubbing of the surface with a rough towel or flesh-brush. A wet sheet pack will cleanse the pores of the skin and invite the blood into the minute capillaries of the surface, and thus prove of great benefit. It should be repeated after an interval of seven days, but ought to be omitted if near the approach of a menstrual period. The clothing should be warm, to protect the system against changes of temperature; especially should every precaution be taken to keep the feet dry and warm. The patient should walk in the open air, and the distance should be regularly lengthened at each succeeding walk. If the course of treatment which we have suggested be faithfully pursued, a permanent cure will be effected.

IN THE OBSTRUCTIVE VARIETY of dysmenorrhea, some organic impediment hinders the exit of the menstrual blood from the uterus, which, consequently, becomes distended and painful. The pain may be constant, but is most acute when the uterus makes spasmodic efforts to discharge the menstrual blood. If these efforts prove successful, there is an interval of relief. Flexion or version of the womb may produce partial occlusion of the canal of the neck of the uterus, thus preventing the free flow of the menstrual fluid through it. Tumors located in the body or neck of the uterus often cause obstruction to the free discharge of the menses. Imperforate hymen and vaginal stricture also sometimes cause obstruction and give rise to painful menstruation. As these several abnormal conditions and diseases will be treated of elsewhere in this volume, we omit their further consideration here.

Partial adhesion of the walls of the neck of the womb may result from inflammation of the mucous lining, and prevent a free and easy exit of the menstrual fluid. In many cases, the contracted and narrowed condition of the canal of the cervix seems to be a congenital deformity, for we can trace it to no perceptible cause. It is also true that contraction and partial, or even complete, stricture of the cervix, or neck of the womb, often results from the improper application of strong caustics to this passage by incompetent and ignorant surgeons. Every person has observed the contraction of tissue caused by a severe burn, which often produces such a distortion of the injured part as to disfigure the body for life. A similar result is produced when the neck of the womb is burned with strong caustics. The tissues are destroyed, and, as the parts heal, the deeper-seated tissues firmly contract, forming a hard, unyielding cicatrix, thus constricting the neck of the womb, through which the menses pass into the vagina.

TREATMENT. From the nature of this malady, it will readily be seen that no medical treatment can effect a radical cure. We must therefore resort to surgery. In a small proportion of cases, the stricture may be cured by repeated dilations of the constricted part of the cervical canal. This may be accomplished by using a very smooth probe which is fine at the point, but increases in size, so that its introduction will widen and expand the orifice and canal. The stricture may be overcome in many cases by using different sized probes. In some instances, we have employed the uterine dilator, represented by Fig. 3. We have also introduced sea-tangle and sponge tents into the neck of the womb, and allowed them to remain until they expanded by absorbing moisture from the surrounding tissues. The latter process is simple, and in many cases preferable. By means of a speculum (see Figs. 15 and 16), the mouth of the womb is brought into view, and the surgeon seizes a small tent with a pair of forceps and gently presses it into the neck of the womb, where it is left to expand and thus dilate the passage. If there seems to be a persistent disposition of the circular fibers of the cervix to contract, and thus close the canal, a surgical operation will be necessary to insure permanent relief. In performing this operation, we use a cutting instrument called the hysterotome (see Figs. 4 and 5). By the use of this instrument, the cervical canal is enlarged by an incision on either side. The operation is but slightly painful, and, in the hands of a competent surgeon, is perfectly safe. We have operated in a very large number of cases and have never known any alarming or dangerous symptoms to result. After the incision, a small roll of cotton, thoroughly saturated with glycerine, is applied to the incised parts, and a larger roll is introduced into the vagina. The second day after the operation, the cotton is removed, the edges of the wound separated by a uterine sound or probe, and a cotton tent introduced into the cervix, and allowed to remain, so that it will expand and thus open the wound to its full extent. This treatment must be thoroughly applied, and repeated every alternate day, until the incised parts are perfectly healed.

Many times patients cannot understand why it is that the operation of cutting the constricted cervix causes no pain; they often being entirely unconscious of the making of the incision. The explanation is easy. The cervix uteri, or neck of the womb, is supplied with but few nerves of sensation, and is almost as destitute of sensation as the finger or toe nails, the paring of which causes not the slightest pain. On this account we never find it necessary to administer chloroform or any other anæsthetic when undertaking this operation. If the patient be extremely sensitive the application to the cervix of a weak solution of cocaine is quite sufficient to completely benumb or anesthetize the parts so as to entirely avoid all pain from the operation.

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MENORRHAGIA.

(PROFUSE MENSTRUATION.)

The word _Menorrhagia_, which is of Greek derivation, literally means _monthly breaking away_, and is employed to designate profuse menstruation. This disorder must not be confounded with those hemorrhages which are not periodical, and which are due to other causes. The term _menhorrhagia_ is restricted to an immoderate monthly flow. The menstrual flow may occur too often, continue too long, or be too profuse. It induces a feeble pulse, cold extremities, weak respiration, general debility, and may occur in opposite states of the system, _i.e._, in women who have a plethoric and robust habit, or in those of flaccid muscles and bloodless features. When the menstrual discharge is natural, it is so gradual that by mixing with the vaginal secretions it is prevented from coagulating, while in this disease, clots are often formed.

SYMPTOMS. In women of a _plethoric_ habit, it is ushered in by itching and heat in the vagina, pain and a feeling of weight in the loins and lower part of the abdomen, and, at times, the breasts become hot and painful. There is considerable thirst, headache, and giddiness. At last, the blood appears and flows profusely, and all the violent symptoms at once subside. The rest of the period is marked by an inordinate flow, leaving the system weak from the loss of blood. It oftener occurs, however, in persons who are naturally weak and delicate, in which case the periods are more frequent and continue longer, and after a time they are renewed by any bodily exertion or mental emotion, so that a constant drain exists. If the flow of blood is not continuous, leucorrhea intervenes. The patient gradually loses strength and becomes languid, her face is pale and usually bloated, livid circles appear around the eyes, the appetite is impaired, the bowels are constipated, and the feet and ankles swollen. Lack of blood in the brain is indicated by headache, ringing in the ears, and dizziness. The patient is nervous and irritable, being disturbed by the slightest noise, and the heart palpitates after the least exertion.

CAUSES. The _first_ form is caused by eating too much rich and highly-seasoned food, drinking wine, porter, ale, or beer, want of exercise, in brief, whatever induces plethora; the _second_ results from an insufficient or poor diet, leucorrhea, frequent abortions, want of ventilation, inherent feebleness, and whatever depresses the vital powers. Either form may be due to syphilitic taints, excessive sexual indulgence, accidents of pregnancy, or organic diseases of the womb. The morbid affections of the womb most likely to induce menorrhagia, are granular ulceration of its mouth and neck, fungous degeneration of its lining membrane, and tumors within that organ. As these subjects will be severally considered hereafter, we shall here dismiss them with this brief notice.

Profuse menstruation is very prone to occur in young women of a lymphatic temperament, whose organs are sleazy in texture.

TREATMENT. To control the excessive flow, the patient should remain in her bed, and assume the recumbent position until the period is passed. If circumstances prevent strict compliance with this rule, it should be observed as nearly as possible. Warmth should be applied to the feet, and cold cloths, which ought to be removed as soon as they become warm by the heat of the body, should be repeatedly placed upon the back and abdomen. A strong tea made from cinnamon bark, or witch-hazel leaves or bark, taken freely, will prove very efficacious in checking the flow. The fluid extract of ergot, in doses of from half a teaspoonful to a teaspoonful, in a little water or cinnamon tea, is one of the most effectual remedies in this affection. Another valuable remedy for arresting menorrhagia is an infusion of Canada fleabane; or the oil of this plant may be administered in doses of from five to ten drops on sugar. Gallic acid is also a good styptic to employ in these cases. If there is febrile excitement, a hard pulse, frequent and throbbing, and if there is headache, thirst, parched lips, hot and dry skin, as is sometimes the case, then menorrhagia is due to an augmented action of the heart and arteries, and the indication of treatment is to diminish vascular action. This may be temporarily accomplished by the use of veratrum viride, which should be continued until the flow is sufficiently diminished.

The means already suggested will generally prove effective in controlling the inordinate flow at the time. Treatment that will produce permanent relief should then be adopted. The condition of the skin, kidneys, and bowels, requires attention for noxious elements should not be retained in the system. To give tone to weakened pelvic organs we know of nothing more specific in its effects than Dr. Pierce's Favorite Prescription, which is sold by druggists. It should be taken continuously for weeks, in order to fully correct the extremely weakened condition of that organ. It also aids nutrition, and thus tones up the general system, so that in the form of profuse menstruation, resulting from debility, the patient is strengthened, her blood enriched, and her nervousness quieted, which constitutes the necessary treatment to make the cure permanent.

As women approach the critical age, and menstruation ceases, if they are anæmic, their condition is pitiable. This period is popularly denominated the _turn of life_. Under favorable circumstances, the vitality is decidedly enhanced, and the decline of this function is attended with a revival of the bodily powers. But when this crisis has been preceded by excessive labor, when intemperance or excesses of any kind have deranged the bodily functions and perverted nutrition, when the mind has been long and deeply depressed, or when the insidious progress of disease of the heart, liver, or other Important organs, occurs in consequence of irregularities of living, then there is danger of congestion of the uterus and a protracted and profuse menstrual flow, which favors a decline.

The treatment of this form of menorrhagia does not differ from that already suggested. The diet should be light and nourishing, and daily exercise, such as walking, riding, change of air and scenery, all will contribute to restoration. Especial attention should be directed to the condition of the bowels and liver. If the latter be deranged, Dr. Pierce's Golden Medical Discovery will be a most efficacious remedy. When there is a diminution of vital force, resulting in impaired nutrition and disorders of blood, an alterative is required which will insensibly and gradually restore activity by removing the causes of derangement. Impairment of nutrition is very frequently associated with functional or organic disease of the liver, and curative measures consist of the use of alteratives, friction baths, exercise, nutritive diet, and diversion of the mind. Whenever innutrition depends upon deprivation of the blood or torpor of any of the secretory organs, the "Golden Medical Discovery" will prove to be an invaluable remedial agent, for it is an alterative and at the same time a blood restorative. If the bowels be costive small laxative doses of Dr. Pierce's Pleasant Pellets should be employed. The "Favorite Prescription" regulates the menstrual function by toning up the tissues of the uterus and restraining the escape of the menses from the orifices of the blood-vessels. While the diet should be nourishing, consisting of wild game, mutton, chicken, and wine, the patient ought not to debilitate the stomach by the use of strong tea or coffee. The circulation of the blood should be quickened by riding, walking, exposure to sunlight, and fresh air. The patient ought to engage in some light occupation, in which the mind will be constantly as well as agreeably employed, but not overtaxed. By pursuing the course of treatment, invalids suffering from menorrhagia may be permanently restored to health.

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THE TURN OF LIFE.

(CESSATION OF THE MENSES.)

Menstruation commonly occurs at regular monthly intervals, during a period of about thirty years. The time for its cessation depends somewhat upon the date of its first appearance. In the temperate zones it commences at about the fifteenth year, and, consequently should terminate at the forty-fifth year. Instances are common, however, in which it has been prolonged until the fiftieth and even to the fifty-fifth year. In warm climates it commences and terminates at an earlier age.

As women approach the critical period of life, if the general health and habits be good, the discharge may gradually diminish, and, at length, totally disappear, without producing any particular inconvenience, but this seldom happens. More frequently, the discharge is entirely absent for six or seven weeks, and when it does return, it is more copious than usual. In some cases, the flow is not only too profuse, but too frequent. Many months may elapse before the menses return, and, even then, they are apt to be very pale and deficient in quantity.

The fluctuations of this function occasion irregularities and disturbances of the general health. When the flow of blood is diverted from the uterus, it is liable to be directed to the head or some other part of the body. In fact, there appears to be constitutional agitation, and disorders of all the organs. Perhaps one reason for calling this a critical period is, that if there is a morbid tendency in the system, a disposition to develop tumors of the breast or uterus, these are very liable to make rapid progress at this time, since they are not relieved by the customary, local exudation of blood. It is a time favorable to the awakening of latent disorder and morbid growths, for, at the decline of the menstrual function, the uterus is not so capable of resisting vitiating influences.

There is greater liability to irritation of the bladder and rectum, and the menstrual flow may be superseded by a white, acrid discharge, caused by an inflammation of the mucous membrane of the vagina. Even if the system be not enfeebled by excessive losses of blood, debility may result from a continued irritation of the uterine organs, and cause the morbid discharge. The nervous system sympathetically responds, becoming exceedingly irritable, and thus implicating in this derangement every bodily organ. In some constitutions, the change of any habit is almost impossible, particularly if it is improperly acquired, or detrimental to health; and so we have sometimes thought respecting this function, that the more it has been abused and perverted during the time of Its natural activity, the greater is the disturbance occasioned when it ceases.

TREATMENT. There should be regularity in all the habits of life. Women are too apt to approach this important period without due care and consideration. When the physical system is about to suspend a function, it is folly to endeavor to perform the labor or assume the responsibilities which were permissible when the constitution was more robust.

How the duties of each day and hour weigh upon the energies of the mother! What intense solicitude and yearning she experiences! How unselfish is that mother who each day works steadily and faithfully for others, and who is conscious of the hidden dangers that lurk around her pathway! With confiding faith and love, she commends the interests of her children to Him who doeth all things well. She anticipates the wants of her family and strives to supply the desired comforts, thus wasting her strength in the labors prompted by her loving nature. Would it not be a greater comfort to those children to have the counsel of their dear mother in later years, than to have the bitter reflection that she sacrificed her health and life for their gratification?

Unconsciously, perhaps, but none the less certainly, do women enter upon this period regardless of the care they ought to bestow upon themselves. Without sufficient forethought or an understanding of the functional changes taking place, they over-tax their strength, until, by continuous exertion, they break down under those labors which, to persons of their age, are excessive and injurious. Is it strange, when woman has thus exhausted her energies, when her body trembles with fatigue and her mind is agitated with responsibilities, that the menses capriciously return, or the uterus is unable to withstand congestion, and capillary hemorrhage becomes excessive? If the physical system had not been thus exhausted, it would have exercised its powers for the conservation of health and strength. It is better to be forewarned of the ills to which we are liable, and fortify ourselves against them, rather than squander the strength intended for personal preservation. Let every woman, and especially every _mother_, consider her situation and properly prepare for that grand climacteric, which so materially influences her future health and life.

The general health should be carefully preserved by those exercises which will equalize the circulation of the blood, and the regular action of the bowels should be promoted by the use of those articles of diet which contribute to this end. Relieve the mind of responsibility, keep the skin clean, and enrich the blood with tonics and alteratives. For the latter purpose, use Dr. Pierce's Favorite Prescription and "Golden Medical Discovery." If these remedies fail, seek professional advice. A careful regulation of the habits, strict attention to the requirements of the system, and the use of tonic medicines, will very frequently render the employment of a physician unnecessary

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LEUCORRHEA.

("WHITES.")

Leucorrhea is the symptomatic manifestation of some uterine or vaginal affection, vulgarly called "whites." We say _symptomatic_, for the white or yellowish discharge, which we term leucorrhea, is not a disease, but a symptom of some uterine or vaginal disorder. We call it a _white_ discharge to distinguish it from the menses and uterine hemorrhages. It varies, however, in color and consistency from a white, glairy mucus to a yellow or greenish, purulent, fetid matter. Sometimes it has a curdled appearance, at others, it is of the consistency of cream. Leucorrhea is the most common symptom of uterine derangement, and there are few females who are not affected by it at some period of life. It may originate either in the vagina or uterus, and it is accordingly termed either vaginal or uterine leucorrhea. The nature of leucorrhea is analogous to that of nasal catarrh. In a healthy state, the lining membrane of the genital organs secretes sufficient mucus to moisten them; but, if the mucous membrane is temporarily congested or inflamed, the secretion becomes profuse, irritating, and offensive. Vaginal and uterine leucorrhea are essentially different in character, the former being an acid, and the latter an alkaline secretion, and, while the first is a creamy, purulent fluid, the latter is thick and ropy, like the white of an egg. In fact, the latter discharge is rich in albuminous matter and blood-corpuscles, hence, its great debilitating effect upon the system, and, if not promptly arrested it is likely to produce _vaginitis, pruritus vulvce_, or _vulvitis_.

VAGINITIS is indicated by intense inflammation of the mucous membrane of the vagina. When this affection is present the patient experiences a sense of burning heat, aching and weight in the region of the vagina, violent and throbbing pains in the pelvis, and the discharge is profuse and very offensive. There is also a frequent desire to urinate, and the passage of the urine causes a sensation of scalding.

PRURITUS VULVAE. The discharge irritates the nerves of the external genital parts, thus producing an almost unendurable itching. Scratching or rubbing the parts only aggravates the affection. The patient is tormented night and day, is deprived of sleep, and naturally becomes despondent. Pruritus vulvae, in its severest forms, is often developed when the discharge is scarcely noticeable. It is the most common result or accompaniment of leucorrhea.

VULVITIS. This term indicates an inflammation of the lining membrane of the external genital parts. Sometimes the inflammation extends to the deeper tissues, causing great pain, and even suppuration, resulting in the formation of an abscess. The attack is indicated by redness, swelling, and a feverish state of the affected parts, which is quickly followed by a profuse flow of yellow pus, and, in some instances, small ulcers are formed on the affected parts.

SYMPTOMS. The sufferer from leucorrhea becomes pale and emaciated, the eyes dull and heavy, the functions of the skin, stomach and bowels become deranged, more or less pain in the head is experienced, sometimes accompanied with dizziness, palpitation is common, and, as the disease progresses, the blood becomes impoverished, the feet and ankles are swollen, the mind is apprehensive and melancholy, and very frequently the function of generation is injured, resulting in complete sterility. Exercise produces pain in the small of the back and the lower portion of the spine, and, owing to a relation of the vaginal walls, the womb falls far below its natural position, or turns in various directions, according to the manner in which the weight above rests upon it. Ulcers are apt to appear upon the mouth of the womb, the matter from which tinges the discharge and stains the linen. Hysteria is often an attendant of this disease.

CAUSES. The immediate cause of leucorrhea is either congestion, or inflammation of the mucous membrane of the vagina or womb, or both. The exciting causes are numerous. Among others, deranged menstruation, prolonged nursing of children, pregnancy, abortions, excessive indulgence in sexual intercourse, uncleanliness, piles, uterine ulcers, and displacement of the womb, are the most common. In brief, it usually accompanies every uterine disorder which vitiates and reduces the system. During childhood, particularly in scrofulous children, discharges from the vagina are not unfrequent, owing to worms or other intestinal irritation.

Among the organic causes of leucorrhea, are ulceration of the mouth or neck of the womb and tumors. These will be considered hereafter.

TREATMENT. We have dwelt upon leucorrhea because of its prevalence and in order to exhibit the various forms it may assume. These reasons long ago prompted us to investigate it; and, ascertaining the derangement to consist in a relaxation of the walls of the vagina, attendant upon depressed vitality, for many years we experimented with various medicines to find those that would exercise specific properties in restoring the tissues involved to a natural condition, thereby arresting the abnormal discharge. Our efforts in that direction have been very successful, and our expectations more than realized. The treatment which we shall recommend is rational, based upon the pathological conditions of the disease, and has been attended with the greatest success.

It embraces the use of those general restoratives and specific uterine tonics, so harmoniously combined in Dr. Pierce's Favorite Prescription, a remedy which has achieved unparalleled success in the cure of this affection and won the highest praise from thousands of grateful women. It many cases, it is well to accompany its use with alterative treatment, for which the "Golden Medical Discovery" will be found especially effective. It is an absurd practice to arrest the discharge with astringent injections _alone_. The weak and lax walls of the vagina, as well as the other tissues of the system, require strength, and this can be gained only by the use of general and special tonics. Appropriate injections as _auxiliary_ treatment will very much _assist_ in the cure. The "Favorite Prescription" is a special tonic for the affected parts, and the "Golden Medical Discovery" is the best general alterative of which we have any knowledge. They may be taken in alternate doses every day. If the patient is very pale and anæmic, one drachm of the carbonate, or two drachms of the citrate or pyrophosphate of iron, may be advantageously added to each bottle of the "Favorite Prescription." If the carbonate be employed, as it is insoluble, the bottle should be well shaken every time before using. The functions of the skin should be kept active by frequent baths, and the patient, if able, should walk or ride in the open air, and freely expose herself to the sunshine. If the invalid be too weak to exercise much, she should go out in warm weather and sit in the open air. Sunshine is no less important in maintaining animal, than in supporting vegetable growth and health. The human being, like the plant, sickens and grows pale, weak and tender, if secluded from the sunlight. The apartments occupied should be thoroughly ventilated. Many women are sickly and feeble because they live in badly ventilated rooms.

We cannot too strongly urge in this, as in all other chronic diseases peculiar to women, that the bowels be kept regular. Frequent, but small doses of Dr. Pierce's Pleasant Pellets will prove most beneficial. If the vaginal passage is tender and irritable, an infusion, or tea of slippery-elm bark is very soothing, and may be used freely with a vaginal syringe. Whatever injection is employed, should be preceded by the free use of Castile soap and warm water, to thoroughly cleanse the parts. One part of glycerine to six parts of water is a soothing lotion when there is much tenderness, heat, and pain in the vagina. If there be no great tenderness in the vagina, or if the acute, inflammatory symptoms have yielded to the lotions already suggested, then a tonic and astringent injection should be employed.

For this purpose a wash made by dissolving one of DR. PIERCE'S PURIFYING AND STRENGTHENING LOTION TABLETS, in one pint of hot water is a superior application and will not fail to be of great benefit in controlling the disagreeable drain. If your medicine dealer is not supplied with these, mail 25 cents in one-cent stamps to us and we will forward a box of the Lotion Tablets by return post.

These Lotion Tablets have for many years been used in the treatment of obstinate cases of leucorrhea at the Invalids' Hotel and Surgical Institute, and their efficiency has been alike gratifying to both patient and physician.

If _pruritus_ or severe itching, be also a symptom, the itching will readily yield if the parts be cleansed with Castile or other fine soap and warm water, followed by the application of a compound composed of two ounces of glycerine, one ounce of rose-water, and one drachm of sulphite of soda; or, for the sulphite of soda, two drachms of borax may be substituted. The following lotion is a good one to relieve pruritus: sugar of lead, two drachms; carbolic acid, half a drachm; laudanum, four ounces; glycerine, four ounces; water, four pints; mix. This may be applied to the itching parts, and also injected into the vagina.

HOW TO USE VAGINAL INJECTIONS. We usually recommend the Fountain Syringe illustrated in Fig. 6, as the most convenient instrument for administering vaginal injections. The fountains supplied by us are of soft rubber, and have extra nozzles, with which to make rectal, nasal or ear irrigations. There is also a large, long nozzle for vaginal injections.

It is channeled so is to permit the free clearing away of the secretions as the Douche is employed. The Fountain Syringe can he used without assistance, the flow of fluid is gradual, and with a force that can be varied, by raising or lowering the reservoir, yet is never so great as to be liable to produce injurious effects.

The syringes usually sold with small nozzles or pipes are of little or no value for vaginal injections. In many instances so small a tube will pass readily into the canal of the uterus, and hence there has frequently resulted an injection of a portion of the fluid into the uterus itself, producing severe pain. It is important, therefore, in using the Vaginal Douche to employ only a large tube that has grooves in its surface for the free clearing away of the fluid as it runs from the fountain.

Where it is desired to obtain relief from a congested, inflamed or sensitive and irritable state of the mucous surface, the employment of a large quantity of water as hot as it can be borne, is of the greatest remedial value. It rapidly diminishes the size of the blood vessels, and aids in bringing about a normal circulation in the parts.

As a rule, in taking the Douche with the Fountain Syringe the rubber bag is filled, and suspended from a nail or hook at a height of from two to five feet above the patient, and the fluid passes through the tube by force of gravity, thus requiring no muscular exercise. The force of the stream depends upon the height of the fountain above the outlet nozzle. It is only necessary that the patient should assume a comfortable position where the fluid which comes from the vaginal canal can flow into a water closet, or any convenient vessel.

After a thorough cleansing of the vaginal surfaces of mucus, by means of the warm or hot water, it is sometimes advisable to inject remedial fluids. These injections may readily be made with the fountain or bulb syringe, introducing not less than from two to four ounces. This may be retained sufficiently long to exert its remedial effects upon the mucous surface, which usually takes from five to eight minutes. The hips should be elevated, and the nozzle of the syringe surrounded by a napkin or other similar material, upon which moderate compression can be made so as to retain the fluid in the vagina for the necessary period.

When suffering from any uterine trouble, it is necessary to avoid severe fatigue. The amount and character of exercise should be suited to the condition of the patient; while, most important of all, the strictest abstinence from sexual intercourse should be observed.

To those who are unable readily to obtain the Fountain Syringe above recommended we can send by mail, post-paid, one of these instruments on receipt of $2.00.

A Soft Rubber-bulb, or Pump Syringe (illustrated in Fig. 7), not so good for making vaginal injections, can be sent by us, post-paid, for from 75cts. to $1.50, the price varying with the quality and size.

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STERILITY.

(BARRENNESS.)

Real sentiment and interest center in fecundity, since the desires and happiness of mankind are consummated in marriage and procreation. How dreary would life be without love, companionship, and the family! How precious are the ties that bind our hearts to father, mother, daughter, and son! The love of children is innate in the heart of every true man and woman. Each child born supplements the lives of its parents with new interest, awakens tender concern, and unites their sympathies with its young life.

How dreary is the thought that one may attain a ripe old age with neither son nor daughter to smooth the decline of life, or sorrow for his or her departure! How many women desire a _first-born_ of love, the idol of their waiting hearts, a soul, which shall be begotten within, clothed with their own nature, and yet immortal! It is a natural instinct, this yearning of the heart for offspring; and yet little is said upon this subject, in which so much is experienced. All that is beautiful and lovely in woman, finds its climax in motherhood. What earthly being do we love so devotedly as our mother?

Men and women exhibit but little concern, mere idle curiosity, perhaps, on this subject, unless, perchance, there is no evidence of their own reproductive powers. If, however, these appear to be deficient, then few topics are more deeply interesting or investigated with greater personal solicitude. Such persons will seldom submit their condition to the family physician, for it is a delicate subject, involving personal considerations, and, therefor, they prefer to consult with one who cannot connect their unfortunate situation with any of the incidents which enter into the history of their lives. This is very natural, and sometimes is the only way to keep private matters profoundly secret. Being widely known as specialists, devoting our undivided attention to chronic affections, and having unusual facilities for the investigation and management of such cases, we have been applied to in innumerable instances, to ascertain the causes of barrenness and effect its removal.

It is admitted that the question of a woman's sterility is practically decided in the first three years of married life, for statistics show that less than ten out of a hundred women who do not indicate their fertility in the first three years of wedlock ever bear children. We have treated many who gave no evidence of fertility for a much longer period of married life, and who afterwards gave birth to children. We are unable to state the proper ratio of the number of the married who are childless; much less have we the right to assume that all who decline the responsibilities of motherhood are necessarily barren.

CAUSES. The causes of barrenness may be obliteration of the canal of the neck of the womb, sealing up of its mouth, or inflammation resulting in adhesion of the walls of the vagina, thus obstructing the passage to the uterus. In the latter case, the vagina forms a short, closed sac. In some instances, the vaginal passage cannot be entered in consequence of an imperforate hymen. Again, the cause of barrenness may either be a diseased condition of the ovaries, preventing them from maturing healthy germs, or chronic inflammation of the mucous membrane of the neck of the uterus, which does not render conception impossible, but improbable. It is one of the most common causes of unfruitfulness, because the female seldom, if ever, recovers from it spontaneously. It has been known to exist for twenty or thirty years.

Chronic inflammation of the vagina also gives rise to acrid secretions, which destroy the vitality of the spermatozoa. Suppression of the menses, or any disorder of the uterine functions, may disqualify the female for reproduction. Flexions of the uterus, displacements, congestions, and local debility, may likewise prevent fertility. Sterility may result from impaired ovarian innervation or undue excitement of the nerves, either of which deranges the process of ovulation. Even too frequent indulgence in marital pleasures sometimes defeats conception. Prostitutes who indulge in excessive and promiscuous sexual intercourse, seldom become pregnant. Any thing that enfeebles the functional powers of the system is liable to disqualify the female for reproduction.

TREATMENT. An extensive observation and experience in the treatment of sterility, convinces us that, in the majority of cases, barrenness is due to some form of disease which can be easily remedied. If the passages through the neck of the uterus be closed or contracted, and this is the most frequent cause of sterility, a very delicate surgical operation, which causes little if any pain or inconvenience to the patient, will remove the impediment to fertility. In many of these cases, we have succeeded in removing the contraction and stricture of the neck of the womb by dilatation. When the vaginal walls are so firmly united as to prevent copulation, a surgical operation may be necessary to overcome their adhesion. When the hymen obstructs the vaginal orifice, a similar operation may be necessary to divide it. Vaginismus, which will be treated elsewhere, sometimes causes sterility.

It is proper that we should suggest to the barren, that if sexual intercourse be indulged in only very abstemiously, conception will be more likely to occur than if moderation be not exercised. We may also very properly allude to the fact that there is greater aptitude to fecundation immediately before and soon after the menstrual periods than at other times. In fact, many medical men believe that it is impossible for conception to occur from the twelfth day following menstruation up to within two or three days of the return of the menses.

ELONGATION OF THE NECK OF THE WOMB. An elongated condition of the neck of the womb, illustrated by Fig. 9, is frequently a cause of sterility. If this part is elongated, slim and pointed, as shown in the illustration, it is apt to curve or bend upon itself, thus constricting the passage through it and preventing the transit of seminal fluid into the womb. An eminent author says, "Even a slight degree of elongation, in which the cervix, or neck, has a conical shape, has been observed to be frequently followed by that condition [sterility]." Our own observations, embracing the examination of hundreds of sterile women annually, lead us to believe that this condition is among the common causes of barrenness. But, fortunately, it is one of those most easily overcome.

TREATMENT. If the neck is only slightly elongated, this consists in dividing the slim projecting part, by the use of the _hysterotome_, If it be a more aggravated case, a portion of the womb must be removed. This operation is perfectly safe and simple, and, strange as it may seem to those who are not familiar with operations upon the womb, is not painful. We have never seen any bad results follow it, but have known it to be the means of rendering numerous barren women fruitful.

FLEXIONS AND VERSIONS OF THE WOMB. Flexion of the uterus, in which it is bent upon itself, as illustrated in Fig. 10, produces a bending of the cervical canal, constricting or obliterating it, and thus preventing the passage of spermatozoa through it. Version of the uterus in which its top, or _fundus_, falls either forward against the bladder (anteversion), as illustrated in Fig. 11, or backward against the rectum (retroversion), may close the mouth of the uterus by firmly pressing it against the wall of the vaginal canal, and thus prevent the passage of spermatozoa into the womb. 'The treatment of these several displacements will be considered hereafter. We may here remark, however, that they can be remedied by proper treatment. Our mechanical movements, manipulations, and kneadings are invaluable aids in correcting these displacements.

DISEASE OF THE OVARIES. Sterility may be due to disease of the ovaries. Chronic inflammation of the ovaries may result from uterine disorders or peritonitis, and is commonly attended with a sense of fullness and tenderness, and pain in the ovarian region. These symptoms are more apparent upon slight pressure, or during menstruation. This disease is curable, although it may require considerable time to perfectly restore the health. When this chronic affection is the result of other derangements, the indications are to restore health in the contiguous organs, and to relieve excessive congestion and nervous excitement in the ovaries. The patient should be very quiet during the menstrual period and avoid severe exercise or fatiguing occupations, not only at those periods, but during the intervals. All measures calculated to improve the general health should be adopted. Use injections of warm water, medicated with borax, soda, and glycerine, in the vagina every night and morning. The surface of the body should be kept clean by the daily employment of hand-baths, followed by brisk friction. The bowels, if constipated, should be regulated as suggested for constipation. The system should be strengthened by Dr. Pierce's Favorite Prescription, and, if the blood be disordered, no better alterative can be found for domestic use than Dr. Pierce's Golden Medical Discovery. If the patient does not in a few months improve under this treatment, the case should be placed under the immediate care of some physician well qualified by education and experience to critically examine and successfully treat this affection.

CHRONIC INFLAMMATION AND ULCERATION OF THE UTERUS, A CAUSE OF STERILITY. When enumerating the causes of barrenness we mentioned that chronic inflammation of the mucous membrane of the mouth and neck of the womb was the most common affection that defeats conception. Of all diseases of female organs, this is, without doubt, the most common, and, since it does not at first produce great inconvenience or immediately endanger life, it does not excite the attention which its importance demands. It is overlooked, and, when the attention is directed to the existence of this long-neglected disease it appears so trivial that it is not regarded as being the real cause of infertility in the patient.

When this disease has existed for a long time, the very structure of the parts involved becomes changed. The glands of the cervical membrane secrete a glairy mucus, resembling the white, or albuminous part of an egg. The secretion is thick and ropy, and fills the entire mouth and neck of the uterus, thus preventing the entrance of the spermatozoa. The mucous membrane becomes thickened, the inflammation extends to the deeper structures, and, on examination through the speculum, we find the mouth of the uterus inflamed, hardened, and enlarged, as represented in Fig. 22, Colored Plate IV, or in Fig. 23 of same plate. Fig. 25, Plate IV, shows the mucous follicles just as they are found all along the neck of the womb, in a state of inflammation and enlargement, and filled with a fluid resembling honey, giving rise to ulceration and a thick discharge, as illustrated in Fig. 23, Colored Plate IV.

Feebleness of the constitution, impoverishment of the blood, a scrofulous diathesis, want of exercise, uncleanliness, tight lacing, disappointment, excessive excitement of the passions, the use of pessaries for displacement of the uterus, overwork, and taking cold, all predispose the cervical membrane to chronic ulceration.

The inflammation may be so mild, and the discharge so trifling in quantity, as scarcely to attract attention. But after it obtains a firmer hold, and, in most cases, it is aggravated by exposure or neglect, the patient experiences dragging sensations about the pelvis, and pain in back and loins, accompanied with a bearing-down sensation and numbness or pain extending to the thighs.

The discharge is thick, starch-like, and generally irritating. The patient becomes irascible, capricious, querulous, and sometimes moody and hysterical. She is easily discouraged, her appetite and digestion become impaired, and she grows thin and does not look or act as when in health.

TREATMENT. In offering a few hints for the domestic management of these abnormal conditions, we would at the same time remark, that, while health may be regained by skillful treatment, recovery will be gradual. We especially wish to guard the patient against entertaining too strong expectations of a speedy recovery. Although she may employ the best treatment known, yet from three to five months may elapse before a perfect cure can be effected. In persons of scrofulous diathesis, in whom the recuperative forces are weakened, it is very difficult to effect a radical cure. It is equally true, however, that under domestic management alone, thousands have been restored to perfect health and fruitfulness.

Hygienic management consists in toning the functions of the skin by daily bathing the surface of the body, and quickening the circulation by brisk friction. The patient should rise early in the morning, and exercise in the fresh and invigorating air. Those who sleep in warm rooms, or spend much of their time in bed, will continue to have congestion of the uterus, and habitual discharges from this enfeebled organ. The patient should take daily walks, increasing the length of the excursion from time to time, but not to the extent of producing fatigue. The bowels, if constipated, should be regulated. Strengthen the system by using Dr. Pierce's Favorite Prescription, to each bottle of which add two drachms of citrate or pyrophosphate of iron. The mouth and neck of the uterus should be thoroughly cleansed by the use of the syringe, as suggested for the treatment of leucorrhea. The use of the solution of Dr. Pierce's Purifying and Strengthening Lotion Tablets there advised will also be beneficial, if thoroughly applied.

A most valuable course of local treatment, which may be adopted by any intelligent lady without the aid of a physician, and one that will result in the greatest benefit when there is morbid sensibility, congestion, inflammation, or ulceration about the mouth or neck of the womb, consists in applying to those parts a roll of medicated cotton or soft sponge, allowing it to remain there for twelve hours at a time. A piece of fine, soft, compressible sponge, as large as a hen's egg, or a roll of cotton batting of two-thirds that size, is thoroughly saturated with pure glycerine. Securely fasten to it a stout cord a few inches long. The vagina and affected parts having been thoroughly cleansed with warm water and Castile soap, as advised in the treatment of leucorrhea, the sponge or cotton should be passed up the vagina with the finger, and pressed rather firmly against the mouth and neck of the womb, which, being enlarged, and, consequently falling below its natural position, will generally be low down in the vagina, and so hardened as to be unmistakably distinguished from the surrounding parts by the sense of touch. The glycerine, having a very strong affinity for water, will absorb large quantities of the _serum_, which has been effused into the affected tissues in consequence of their congestion and inflammation, and thus reduce the inflammation and enlargement. This is the cause of the profuse, watery discharge which follows the application. In twelve hours after the sponge or cotton has been applied, it should be removed by means of the attached thread, one end of which has been purposely left hanging out of the vagina. Then thoroughly cleanse the vagina with warm water, use the solution of Dr. Pierce's Lotion Tablets as suggested for the treatment of leucorrhea, and repeat the glycerine application the following day or every other day.

If there is no irritation or tenderness of the vagina, add one drachm of tincture of iodine to each ounce of the glycerine, alternating the use of this with that of pure glycerine; or, the iodine and glycerine may be used every third day, and the glycerine alone on the two intervening days. As the iodine will color the finger somewhat, it is well to know that this unpleasant effect may be almost or entirely avoided by coating that member with lard, sweet oil, or vaseline. The stain may be readily removed with a solution of iodide of potassium. The use of Dr. Pierce's Antiseptic and Healing Suppositories as advised on an other page under the head of Ulceration of the Uterus will aid greatly in effecting a cure.

If your medicine dealer does not have these Suppositories in stock, mail 25 cents in stamps to Dr. R.V. Pierce, Buffalo, N.Y., and a box will be sent you by return post.

It is well to alternate Dr. Pierce's Golden Medical Discovery with Dr. Pierce's Favorite Prescription, taking of each three times a day. By persevering in this course of treatment, nine-tenths of those who are thus afflicted will improve and be fully restored to health, fruitfulness and happiness. If barrenness continue, the case should be unreservedly submitted, either in person or by letter, to a physician skilled in the diagnosis and treatment of these affections.

From the foregoing remarks, the reader will perceive that there are a variety of diseased conditions, any one of which may produce sterility. It is equally true that nearly all these conditions may be easily cured by proper medical or surgical treatment. A frequent cause of barrenness is stricture of the neck of the uterus. No medicine that a woman can take or have applied will remove this unnatural condition. Fortunately, however, the means to be employed cause no pain, are perfectly safe, and the time required to effect a cure is short, rarely over twenty or thirty days.

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DISPLACEMENTS OF THE WOMB.

The relative positions of the womb and surrounding organs, when in a state of health, are well illustrated by Fig. 1, page 680. The womb is supported in its place by resting upon the vaginal walls, and by a broad ligament on either side, as well as by other connective tissues. By general debility of the system, the supports of the womb, like the other tissues of the body, become weakened and inadequate to perfectly perform their duty, thus permitting various displacements of that organ.

PROLAPSUS, OR FALLING OF THE UTERUS, is a common form of displacement. It has been erroneously regarded as a local uterine disease, requiring only local treatment instead of being considered as a symptom of general derangement, and, therefore, requiring constitutional treatment. Hence, variously devised supporters have been invented to retain the womb in position after its replacement. It is a law of physiology, that the muscular system is strengthened by use, and that want of exercise weakens it. The blacksmith's arm is strengthened and developed by daily exercise. Support his arm in a sling, and the muscles will be greatly weakened and wasted. So when artificial supports are used to retain the womb in position, thereby relieving the supporting ligaments and tissues of their normal function, the _natural_ supports of the uterus are still further weakened, and the prolapsus will be worse than before when the artificial support is removed. Besides, all these mechanical contrivances are irritating to the tissues of the womb and vagina, and frequently produce congestion, inflammation, and even ulceration, thus rendering the patient's condition much worse than before their employment. These worse than useless appliances should never be resorted to for the temporary relief which they sometimes afford. Constitutional treatment together with appropriate applications is the only effectual method of remedying this morbid condition.

SYMPTOMS. When the displacement is sufficient to cause any serious disturbance, the prominent symptoms are a sensation of dragging and weight in the region of the womb, pain in the back and loins, inability to lift weights, great fatigue from walking, leucorrhea, a frequent desire to urinate, irritation of the lower bowel, and derangement of the stomach. The womb may protrude from the vaginal orifice; in very rare cases, wholly protrudes, and may be inverted.

CAUSES. As we have already stated, general debility favors prolapsus of the womb, but various general and local circumstances and conditions also favor its occurrence. Wearing heavy garments supported only by the hips, compressing the waist and abdomen with tight clothing, thus forcing the abdominal organs down upon the womb, are fruitful causes of this affection. Excesses in sexual intercourse give rise to leucorrhea, producing a relaxed condition of the vagina, upon which the womb rests, and, in this way, one of its supports is weakened. Enlargement of the uterus from congestion, and inflammation or tumors also favor prolapsus. Abortion may leave the womb enlarged, its supports weakened, and result in this displacement.

FLEXIONS AND VERSIONS. Instead of sliding down into the vagina, as in prolapsus, the uterus is liable to fall or be forced into other unnatural positions. When the uterus is bent upon itself, it is called _flexion_. If the bending is backward, it is called _retroflexion_; if forward, _anteflexion._ Fig. 12, represents the former condition, the uterus being flexed backward so that the fundus, or upper part of the womb, is pressed against the rectum, while the neck of the uterus remains in its natural position. This is a common form of displacement, and generally occurs between the ages of fourteen and fifty.

SYMPTOMS. The prominent symptoms of retroflexion of the uterus are a sense of weight in the region of the rectum, difficulty in evacuating the bowels, and, sometimes a retention of the feces. There may be suppression of the urine and the menses may be diminished in quantity. If retroflexion is due to a chronic enlargement of the uterus, caused by abortion or parturition, the patient suffers from an immoderate menstrual flow.

CAUSES. The principal causes of retroflexion are congestion, enlargement and tumors of the uterus. Congestion is liable to occur in women possessing an extremely active temperament, as well as in those of sedentary and indolent habits. Retroflexion is a common displacement in both married and unmarried women; it is a secondary affection, and, when it is caused by congestion, the menses are painful and reduced in quantity, and there is pain in the back and a sense of weight in the region of the rectum. In some instances, there is a reflex irritation of the mammary glands, and a consequent secretion of milk. There may also be nausea and vomiting, which often lead to the erroneous opinion that the patient is pregnant.

_Anteflexion_ of the uterus denotes a bending forward of the body and fundus of the uterus, while the neck remains in its natural position.

In versions of the uterus, neither the body nor the neck of the womb is bent upon itself, but the whole organ is completely turned backward or forward.

_Retroversion_ of the uterus, illustrated by Fig. 13, signifies a change in the position of the womb, so that the upper, or fundal portion of the organ drops back toward the concavity of the sacrum, while the neck preserves a straight line in the opposite direction. The fundus presses forcibly against the rectum, while the upper part of the vagina bends abruptly and forms an acute angle near the mouth of the uterus.

SYMPTOMS. Retroversion is indicated by bearing-down pains in the loins and difficulty in evacuating the bowels. The feces may accumulate in the rectum, because they cannot pass this obstruction.

CAUSES. Jumping, falling, or undue pressure from the contents of the abdomen, may suddenly cause retroversion of the uterus. Sometimes retroversion results from obstinate constipation.

_Anteversion_. This term designates another unnatural position of the uterus, in which the fundus, or upper part of the organ, falls forward, as illustrated by Fig. 14, while the neck points towards the hollow of the sacrum. This position of the womb is the reverse of that of retroversion. In its natural position, the fundus of the uterus is slightly inclined forward, and any pressure, or forward traction, is liable to cause it to fall still further in that direction.

SYMPTOMS. One of the most common symptoms of anteversion is a frequent desire to urinate, in consequence of the pressure of the uterus upon the bladder. The free flow of the menses is sometimes obstructed.

CAUSES. The causes are tight lacing, prolapse of the abdominal organs, weakness of the supporting ligaments, and enervating habits.

TREATMENT. In treating all the various displacements of the uterus, the prominent indication is to tone up the general system, for by so doing we also strengthen the uterine supports.

Digestion should be improved, the blood enriched, and nutrition increased, so that the muscles and ligaments which retain the womb in position may become firm and strong. The womb will thus be gradually drawn into position by their normal action and firmly supported. It is a great mistake, made by physicians as well as patients, to consider a displacement of the uterus a _local_ disease, requiring only local treatment. A restoration of the general health will result in the cure of these displacements, the uterus will regain its tone and muscular power, and the local derangement, with its attendant pain and morbid symptoms, will disappear.

It is true that displacements of the womb may be associated with inflammation and ulcers, which require local treatment, as elsewhere suggested; but simple displacement of the uterus may be remedied by pursuing the following course of sanitary and medical treatment. Sleep on a hard bed, rise early, bathe, and take a short walk before breakfast. Dress the body warmly and allow sufficient space for the easy and full expansion of the lungs. Eat moderately three meals a day, of those articles which are nutritious and readily digested. Keep the bowels regular by the use of proper food. If they are constipated, use Dr. Pierce's Pellets to keep them open and regular. Avoid retaining the standing position too long at a time, especially when the symptoms are aggravated by it. Many energetic women disregard their increasing pains, and keep upon their feet as long as possible. Such a course is extremely injurious and should be avoided.

As a general restorative and uterine tonic, nothing surpasses Dr. Pierce's Favorite Prescription, which is sold by druggists and accompanied with full directions for use. If leucorrhea is an attendant symptom, the treatment suggested for that condition should be employed. The use of Dr. Pierce's Antiseptic and Healing Suppositories, applying one every third night After having first cleansed the vagina and neck of the womb thoroughly by the use of warm water and soap as an injection, will prove of great benefit in giving strength to the supports of the womb and its appendages.

By persevering in the rational treatment which we have suggested for the various displacements of the womb, nearly all who suffer from such derangements may be fully restored to health. The patient should not expect _speedy_ relief. Considerable time will be necessary to bring the general system up to a perfect standard of health, and, until this is accomplished, no great improvement in the distressing symptoms can be expected. Mechanical movements are especially effective in this class of cases. We have successfully treated many obstinate cases in which the displacements were very serious.

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ULCERATION OF THE UTERUS.

Ulceration is the process by which ulcers, or sores, are produced. It is characterized by the secretion of pus or some fetid discharge, and is continued as a local disease through the operation of constitutional causes. Ulcers are generally symptoms of other morbid conditions.

Ulcers may form in the _mouth_ or _neck_ of the uterus, and, omitting cancerous ulcers and those of a syphilitic character, which are considered elsewhere, may be classified as _Granular_ and _Follicular_.

GRANULAR ULCER. This variety of ulcerative degeneration is the most frequent, and may exist for some time without exciting any suspicion in the mind of the patient that she is afflicted with any such morbid condition. There is local inflammation, and the mouth of the uterus is uneven, rough, and granular. If an examination be made with the speculum, the mouth of the uterus is often found in the condition represented in Fig. 22, Colored Plate IV.

Figs 15 and 16 represent two different forms of specula. The one represented by Fig. 15 consists of a tube of glass coated with quicksilver and covered with India rubber, which is thoroughly varnished. That represented by Fig. 18 is made of metal and plated. By using one of these instruments, the condition of the mouth of the womb can be distinctly seen.

FOLLICULAR ULCER. When the mucous follicles of the neck of the uterus are inflamed they enlarge and become filled with a fluid having the color and consistency of honey, presenting the appearance illustrated by Fig. 25, Colored Plato IV. This secretion, because of the presence of the Inflammation, is not discharged. The follicles, therefore, continue to enlarge until they burst, and we then see in their place the red, elevated, angry-looking eminence, which is called a _follicular ulcer_.

SYMPTOMS. The severity of the symptoms depends upon the character of the ulceration. It may be simple or associated with purulent leucorrhea and hemorrhage. If ulceration be slight and local, few symptoms will be present; but if it be associated with uterine debility, congestion and inflammation of the mucous membrane of the uterus, the discharge will be profuse, and there will be fixed pain in the back and loins, a bearing-down sensation, and great difficulty in walking. The discharge is weakening, as it impoverishes the blood, and thus reduces the strength.

CAUSES. Ulceration may be induced by any thing that excites inflammation of the lining membrane of the mouth and neck of the uterus. The use of pessaries, excessive sexual indulgence, injuries occasioned by giving birth to children, congestions, enlargements and displacements, may all operate as causes.

TREATMENT. We cannot too strongly condemn the practice so popular at the present time with physicians generally, of indiscriminately burning all uterine ulcers with strong caustics, such as nitrate of silver, chromate of potassium, and other similar escharotics, regardless of the condition of the general system. Ulcers of the womb must be healed in the same manner as those upon any other part of the body. It is an irrational practice to repeatedly cauterize them, expecting thereby to promote healing, while the system is vitiated and the vitality far below the standard of health. Enrich the blood, tone up the system, keep the ulcers cleansed by the frequent use of lotions, and they will generally heal. Caustics often aggravate the irritability and interfere with the healing processes of nature. Ladies should not unnecessarily submit to the exposure of their persons. If they perseveringly employ the treatment which we shall suggest, other local treatment will _very rarely_ be found necessary. This modern warfare which physicians are waging upon the unoffending womb is a most irrational practice. Our grandmothers got along very well without exposing themselves to the humiliation and tortures of this new-born empiricism. We do not wish to be understood as undervaluing or denying the necessity, in rare cases, of examinations of the uterus, or as being unappreciative of the aid afforded in such investigations by the speculum, and the beneficial effects of local applications made directly to the womb through that instrument. What we affirm is, that such examinations and applications are, in the practice of most modern physicians, made unnecessarily frequent, resulting many times in lasting injury to the patient.

GENERAL MEANS. As has already been indicated, constitutional treatment should be principally relied upon to cure ulceration of the neck of the womb. Put the system in perfect order and the local ulceration cannot fail to heal. If you have a sore or ulcer upon the leg you very naturally reason that there is a fault in the system at large or in the blood. You do not apply caustics to the sore, but you go to work to restore the blood and system to a normal or healthy condition and as soon as this is accomplished the open and rebellious sore, or ulcer, heals of its own accord. All you have to do locally, to stimulate the ulcer to heal, is to keep it well cleansed by the use of Castile soap and warm water. Just so with ulceration of the womb. Thoroughly cleanse the vagina and neck of the womb once a day by the use of warm water and a little soap, applying this _thoroughly_, as directed on page 704, under the head of treatment for leucorrhea, and using a solution of Dr. Pierce's Purifying and Strengthening Lotion Tablets as there directed. After thus thoroughly cleansing and purifying the parts, a piece of soft sponge as large as a hen's egg, to which a bit of cord or strong thread is attached to facilitate removing it, may be thoroughly wet in pure glycerine and introduced into the vagina, pressed against the mouth of the womb, and allowed to remain there for twelve hours, when it should be gently removed by pulling on the attached string. The cleansing lotion of soap and warm water should be used daily and followed by the glycerine application.

Every third night instead of the glycerine tampon apply one of Dr. Pierce's Antiseptic and Healing Suppositories, pressing it well up against the mouth of the womb, and letting it remain there to slowly dissolve. This will give far better curative results than the application of nitrate of silver or other caustics so generally used by physicians. Besides it has the great advantage of being entirely harmless in any condition of the parts to which it is applied. These Suppositories are powerfully antiseptic, destroying all offensive odors and have a soothing and at the same time tonic or strengthening effect upon the neck of the womb and the vagina.

In cases where there is prolapsus or falling of the womb, or Anteversion or Retroversion, or other displacements the use of the Antiseptic and Healing Suppositories will be found to be of great benefit in giving strength to the supports of the womb and its appendages.

If your dealer is not supplied with the Suppositories, inclose 25 cents in one-cent stamps to us at Buffalo, N.Y., and a package will be sent you, post-paid.

We are fully aware that this thorough and _systematic_ course of treatment is slightly troublesome in its application, but what system of treatment that can promise similar success is not?

This course of treatment must be _rigidly_ adhered to for several weeks before we can expect a complete cure of the ulcers and the arrest of the consequent leucorrheal discharge.

THE SHEET ANCHOR OF HOPE. Do not fail to bear in mind that no difference how good the lotions and other local applications may be, your _chief_ reliance in all cases of ulceration of the womb, as well as in those of simple leucorrhea, must be upon _thorough constitutional_ treatment. To this end Dr. Pierce's Golden Medical Discovery should be taken three times a day in doses of from one to one-and-a-half teaspoonfuls one hour before each meal, and in the middle of the forenoon, in the middle of the afternoon, and just before retiring for the night, a like amount of Dr. Pierce's Favorite Prescription should be taken. The use of these blood cleansing and invigorating tonic medicines should be kept up _persistently_ for several weeks; for you must not expect a perfect cure too soon in a malady that has become chronic and seated. The disease does not become established hastily, but is slow in its inception and progress, and will only gradually and slowly yield to the best of treatment, which we believe we have already pointed out. Followed _earnestly, faithfully_ and _persistently_, the use of the means which we have suggested will rarely, if ever, fail.

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URINARY FISTULA.

A fistula, or false passage, is sometimes formed between the bladder and the vagina, between the bladder and the uterus, or between the urethra and the vagina. This passage allows the urine to escape through it into the vagina, and is a source of great annoyance and suffering. This affection is most commonly due to sloughing, caused by severe and long-continued pressure upon the parts during child-labor. It is also sometimes produced by the unskillful use of forceps and other instruments employed by midwives. Syphilitic and other ulcerations may so destroy the tissues as to form a urinary fistula.

TREATMENT. The treatment is purely surgical, and consists in paring the edges of the opening so as to make them raw, bringing them together and holding the parts thus by means of stitches until they heal. By the aid of a speculum, properly curved scissors, needles with long handles, fine silver wire, and a few other instruments and appliances, the skillful surgeon can close a urinary fistula with almost as much ease as he can close a wound on the surface of the body.

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DISORDERS INCIDENT TO PREGNANCY.

While some women pass through the whole period of pregnancy without inconvenience, others suffer from various sympathetic disturbances, as "morning sickness," impaired appetite, constipation, diarrhea, headache, "heart-burn," fainting fits, difficult breathing, and sometimes convulsions. A strong nervous sympathy exists between the uterus and every part of the system and this sympathy is greatly intensified by pregnancy, causing the distressing symptoms above mentioned.

TREATMENT. By proper treatment, most of these evils can be obviated and the patient made comfortable. By the moderate use of such a nervine and uterine tonic as Dr. Pierce's Favorite Prescription, this nervous irritability may be controlled or subdued, and the disagreeable symptoms thus avoided.

While the female is pregnant, she should avoid all compression of the waist and abdomen. For this reason tight clothing, stays, or corsets must be discarded. She should also carefully regulate her diet, selecting that which is most nutritious and easily digested.

The nausea which occurs in the morning may generally be avoided by partaking of a little light food and a cup of tea or coffee before leaving the bed. If vomiting occurs, and the ejected matter be very acid, carbonate of magnesia, taken in tablespoonful doses, or some alkali with aromatics, or pulverized charcoal, which can be obtained at any drug store, will afford relief. If constipation or diarrhea be experienced, small doses of Dr. Pierce's Pellets should be employed--one or two only at a time. Want of appetite, headache, or a tendency to convulsions, can be generally overcome by a persistent use of Dr. Pierce's Favorite Prescription, which should be taken in teaspoonful doses three or four times each day. Indeed, this valuable medicine not only relieves the distressing symptoms which frequently attend the pregnant state, but also prepares the system for the ordeal of parturition (delivery). One or two bottles of this nervine and tonic used previous to confinement, will, in many cases, save hours of terrible suffering, besides regulating the system, and thus insuring a speedy recovery. We have received the heartfelt thanks of hundreds of grateful mothers for the inestimable benefit thus conferred. The Favorite Prescription is perfectly safe and harmless to use _at all times_ and under all circumstances in the doses above prescribed.

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OVARIAN AND UTERINE TUMORS.

We have space only to give a brief outline of the characteristics and treatment of the most frequent classes of tumors which affect the ovaries and uterus.

OVARIAN TUMORS generally consist of one or more cysts or sacs, developed within the ovary, and filled with a fluid, or semi-fluid matter, which is formed in their interior. The cysts vary in size, in some instances being not larger than a pea, while in others they are capable of containing many quarts of fluid. In one case operated upon at the Invalids' Hotel and Surgical Institute, thirty-five pints of fluid were taken from three cysts.

The effect of ovarian tumors on the duration of life is shown by the statistics of Stafford Lee. Of 123 cases, nearly a third died within a year, more than one-half within two years from the first development of reliable symptoms, while only seventeen lived for nine years or upwards.

FIBROID TUMORS of the uterus are composed of fibrous tissue, identical in structure with that of the uterine walls. They are met with in all sizes, from that of a small shot to that of a mass capable of filling the entire cavity of the abdomen. Cases are on record in which these tumors have attained the weight of seventy pounds.

The manner in which fibroid tumors terminate life is generally by prostration and debility produced by pressure on, and consequently, interference with, the function of some one or more of the organs essential to life; or by anæmia and debility, produced by the severe hemorrhages, which the intra-uterine or sub-mucous form not infrequently induces.

POLYPI OR POLYPOID TUMORS of the uterus are of three kinds, cystic, mucous and fibrous. They vary greatly in size, sometimes being as large as a tea-cup; and their point of attachment may be extensive or consist only of a small pedicle. The cystic and mucous varieties may spring from any portion of the mucous surface of the uterus, but they are more frequently met with growing from the mucous membrane lining the cervical canal, and pendent from the mouth of the womb, as represented in Fig. 21 and in Fig. 26, Colored Plate IV; while the fibrous variety generally grows from the sub-mucous tissue at or near the fundus, or upper portion, of the uterus.

The most prominent symptoms of polypoid growths are hemorrhage, which is almost invariably present, leucorrhea, pain, backache, and a sense of weight and dragging in the pelvis.

The best method of treatment, and, in fact, the only effectual one, is removal with the _écraseur_, polypus forceps, or galvano-cautery. The operation is usually attended with little or no pain.

FOR MORE THAN TWENTY-FIVE YEARS the physicians of the Invalids' Hotel and Surgical Institute, have been successfully treating tumors by means of electricity. More recently, the medical profession has quite generally adopted electrical applications in response to the advice of Apostoli, of Paris. The plan used however is crude. It does not compare in results with the successful and safe procedure that our surgeons have invented and pursued.

Electrical treatment will destroy the life of ovarian and fibroid tumors if applied early and after the improved methods so long used at our Institution. The destructive effect of electricity is modified by the introduction of certain electro-chemical applications so that it attacks and kills only the cells of the tumor.

THE VERY LARGE OVARIAN TUMORS, however, are not amenable to treatment by this process. The walls of their cysts become so thin and weak, while the pressure of the fluid from within is so great, that sudden and spontaneous rupture is liable to occur at any time and produce death. Removal by a cutting operation is necessary in such cases. Fortunately this procedure, as skillfully modified and perfected by experience, has, in the hands of our surgeons, proven free from the dangers and hazard common to Ovariotomy. This is due to skillful operation and to the fact that in our Institution the sanitary arrangements are as perfect as it is possible to make them. Everything is at hand in the way of instruments and appliances likely to be required, and the entire procedure is conducted upon the principles of perfect cleanliness and antisepsis, which obviate the risk of inflammation and blood-poisoning.

Furthermore, our nurses have had such fine training and such a vast experience in their attendance upon such cases, that wants are anticipated, and details, that would escape those not so well qualified, are looked after so thoughtfully and vigilantly that the convalescence is rapid, as well as being in every way comfortable and safe. Under such conditions

OUR SURGEONS HAVE COMPLETED A LONG LIST OF REMOVALS OF OVARIAN TUMORS WITHOUT A SINGLE DEATH!

We are, therefore, _warranted_ in stating that

THE DANGERS DUE TO THE PRESENCE OF THESE TUMORS ARE FAR GREATER THAN THE SLIGHT RISKS OF REMOVAL BY THE SKILLFUL METHODS EMPLOYED BY OUR SURGEONS.

Owing to a change made in the anæsthetic used, the painful and persistent vomiting that often follows abdominal operations is prevented. This does away with the greatest of all the dangers attendant upon the operation of Ovariotomy, and favors speedy recovery. Food, as administered in the form of artificially digested and concentrated nourishment, is readily retained. The strength is thus rapidly restored, and the healing process hastened.

It is generally supposed that the size of the opening made through the abdominal walls is large, proportionate to the size of these tumors. This is an error. Even in the largest cystic tumors where the development is immense, a small incision only, is made--simply sufficient to bring the walls of the tumor in view and admit, perhaps, two or three fingers. The tumor is then rapidly emptied of its contents by means of a powerful suction apparatus. Adhesions, if any exist, are then carefully removed, and hemorrhage therefrom prevented; after which the large sac of the tumor, which when collapsed is like a thin bag, is readily drawn out through the small opening in the abdomen and removed. The small pedicle or cord-like mass of vessels that supplies the tumor, are then carefully treated after a plan invented by, and peculiar to, ourselves, which effectually prevents any bleeding, and, at the same time, does not leave any irritating substance, such as burned and charred flesh, rubber, silk, or any other unabsorbable material, within the abdomen. The parts are left unbruised and without any poisonous germs in contact.

Our surgeons have met with phenomenal success in removing Ovarian Tumors, by the operation of Ovariotomy. Thus far, in a career extending over a long period of time and embracing the removal of a long list of these morbid growths, they have not had a single fatal case.

The following cases illustrate our method of treatment in a few of the many cases that have been under our care. Each case is typical of a class:

CASE I A married woman, aged 38. Had never given birth to a child. About four years before coming under our observation, she discovered a small bunch, as she expressed it, in the left ovarian region, which gradually increased in size until, when she consulted us, it caused considerable pain in the region of the liver from pressure, and interfered with respiration. Her general health was becoming much impaired. She stated that she had consulted a prominent gynecologist in this city, who had told her that the attachments of the tumor were so extensive that ovariotomy (removal with the knife) was out of the question, and that, therefore, he could only give her palliative treatment. This unfavorable prognosis only added mental anguish and despair to her physical suffering. On examination, we found a large multilocular cystic tumor, represented by Fig. 17, with very thick walls, extending from the left ovarian region obliquely upwards and to the right, so that it pressed more upon the short ribs on the right side than it did upon the left, but which filled the entire cavity of the abdomen. The attachments, as the doctor whom she had previously consulted had stated, were so extensive that its removal with the knife could not be thought of. We were not disposed, however, to give the case up as hopeless. We told her that we would do what we could for her, but as to what the result of our treatment would be, we could not definitely say. She placed her case in our hands, and we resorted to the above described treatment. She was treated two and three times per week for more than two months, at the end of which time, the tumor had decreased in size fully two-thirds. It has ever since remained stationary, and has given her no trouble or inconvenience whatever. It is now seven years since we treated her.

CASE II. A young lady of 23; unmarried. About six months previous to consulting us, she had discovered a tumor of about the size of an egg, In the region of the left ovary, which had been gradually increasing in size. On examination, we found the morbid growth to be about the size of a quart bowl, and evidently composed of several cysts with thick walls. She experienced no pain, and but slight inconvenience from its presence, but she was in great mental distress. She was an only daughter, and her mother had died a few years previously from the shock and hemorrhage resulting from an operation for the removal of a large ovarian tumor, performed by the late lamented Dr. Peaslee, of New York. The same course was pursued in this case, and at the end of six weeks' treatment, the tumor was reduced to the size of an egg, and has remained so ever since, now more than three years.

CASE III. A woman,37 years of age; married six years; no children. She had suffered for eight years from profuse menstruation and dysmenorrhea, with a membranous discharge, and, for several months before consulting us, she had experienced severe pain and a soreness in the pelvic organs. Her bowels were obstinately constipated, it being next to impossible for her to have an evacuation, and she possessed a pale and careworn countenance. Upon examination, we discovered a hard, incompressible tumor, represented in Fig. 18, attached to the posterior wall of the uterus, which caused anteversion of the womb, and which pressed upon the rectum so as to produce great obstruction. She was treated by means of electrolysis, with injections into the substance of the growth, for one month, at the end of which she resumed home, with the tumor reduced from the size of a pint bowl to the size of an egg, and her health greatly improved. After going home the tumor continued to grow less until, at the end of a few months, her home physicians could detect no trace of it, and she has remained well since, for more than five years.

CASE IV. A lady aged 36: married 13 years; no children. She complained of severe pain in the back and a frequent desire to urinate. Menstruation was profuse, and the bowels were constipated. On examination, we found an inter-mural fibroid tumor, represented in Figs. 19, developed in the anterior wall of the uterus, and pressing upon the bladder. The womb was enlarged, measuring three inches in depth, and was slightly anteflected. A month's treatment, with electrolysis and injections into the tumor, arrested the growth and diminished the size more than one-half, and caused the unpleasant symptoms to disappear.

CASE V. A married lady, 26 years of age; had borne no children, but had had several abortions, brought about intentionally. Six months before consulting us, a tumor, about the size of an egg, was discovered by her home physician. It grew steadily from the time of its discovery until, when we made an examination, it was found to be about the size of an ordinary tea-cup. It was developed in the posterior wall of the womb, as represented in Fig. 20. Three weeks' treatment reduced the tumor two thirds.

CASE VI. A widow lady, aged 52. She was examined ten years ago by two of the most distinguished physicians of New Haven, Conn., who pronounced her sufferings due to cancer of the uterus. She was then suffering from repeated hemorrhages, and other symptoms. They gave her palliative treatment, and told her that to interfere with the morbid growth would only shorten her life, and that by leaving it alone she might live several years. By and by the hemorrhages ceased and she passed the change of life, but she continued to be troubled with a sensation of fullness in the pelvis, pains in the back, and frequent headaches. On examination we found not a cancer, but a large polypus, as represented in Fig. 21, which had caused all the trouble. It was quickly removed, without pain, and her health restored. Thus, through an error of diagnosis, she was made to suffer physically and mentally for ten, long years of her life, in constant dread of a horrible death.

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TESTIMONIALS.

While we have a great cloud of witnesses testifying to the efficacy of our treatment of the diseases described in this volume, yet for lack of space we can here introduce only the following:

LARGE FIBRO-CYSTIC TUMOR.

PRONOUNCED INCURABLE BY MANY EMINENT SURGEONS. HEALTH RESTORED AND TUMOR REMOVED WITHOUT CUTTING.

WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I cheerfully send you the following testimonial, and hope it may induce some sick person to seek relief where it is sure to be found.

We never truly appreciate health until it forsakes us.

For six years, I suffered all the tortures and fears attendant on the growth and development of a fibro-cystic tumor. I tried to have the tumor removed, but found it impossible. I had the very best medical advice the South affords, but every physician rendered the same verdict, 'incurable.' How that word, for months, rang in my ears--'INCURABLE.' It seemed stamped on my mind in letters of fire. What I suffered, both in mind and body, cannot be imagined. But for my unbounded faith in God's goodness and mercy, I doubt not, I would have given up and died. But I trusted in Him to direct me in the way to find relief. One hope stood out before me like a beacon light; and that was to find the means to go to Buffalo, N.Y., to Dr. Pierce's famous Invalids' Hotel and Surgical Institute. At last the opportunity came, and I bid my loved ones a sad farewell, (not one of them ever expected to see me again, alive) and with a sister to relieve me of every care on the journey, we started for the Institute.

On arriving at the Invalids' Hotel, I was too sick and fatigued to treat with civility the sweet-faced, lady-like housekeeper who received me, or the gentle nurses who tried so patiently and kindly to minister to my wants.

I had read a good deal about the Invalids' Hotel, and expected to see wonderful things; but like Sheba's Queen, I could truthfully say, 'the half had never been told.' The many ways, means, and appliances, for the relief of poor sufferers surpassed a thousand fold anything I had ever imagined could come within the scope of human skill. The skilled physicians were not only able and attentive, but on meeting one, if it were every day, they always had a ready smile, a warm hand clasp, and an encouraging word, which alone, would make one feel better and at home. The trained nurses were attentive and kind.

Every department was cleanliness itself, and kept at such an even temperature, even to the halls, that during my four months' stay, I never had the slightest cold. Not only the comforts of life, but every luxury that the most exacting could demand, were fully supplied. I saw many poor sufferers, from various diseases, made well and happy, and I too, with the other happy ones, found relief, and that without the use of the knife or an anæsthetic of any kind. I would urge all poor chronic sufferers, it matters not what the trouble may be, to go to Dr. Pierce's Institute and be cured. If any one similarly afflicted cares to know more of my case, I will gladly answer any questions, if she will only write me, and enclose addressed and stamped envelope in which to reply. During my stay at the Invalids' Hotel I never lacked for anything that willing hands and warm hearts could supply, and I came away feeling that I was leaving a sweet, luxurious home and many warm friends, but with a new lease of life and perfect confidence in the ability of the physicians, for I know I could not possibly have lived two months longer, had I not found relief. To-day I am well, rosy and happy, with a heart full of lasting gratitude for the kind treatment and cure which I received at the Invalids' Hotel and Surgical Institute.

Yours truly. Miss DELAINE DUKE, Clanton, Chilton Co., Ala.

POLYPOID TUMOR OF UTERUS WEIGHING OVER FIVE POUNDS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--After many trials my doctors here had given up all efforts to cure me. A tumor that had existed almost from my childhood was gradually killing me. From frequent hemorrhages, I had become as pale and bloodless as a ghost, and so weak as to be scarcely able to stand or walk. Frequently the loss of blood was so great as to cause such long fainting spells that my family thought me past mortal help. How I lived to get to your place is yet a matter of wonder.

We appreciated the fact that in the skill of your surgeon lay my last and only hope. The result proved his abilities. The restoration of my health, when it was so generally and for so long despaired of, was miraculous, and I cannot sufficiently express my gratitude and thanks.

The comfort that was given by the kindly attention of your nurses is one of the very agreeable memories of your home-like and pleasant Institution. With much gratitude, I am,

Respectfully yours, Miss ANNIE BOLIN, Leon, Kan.

NOTE--The above case had been pronounced cancer of the womb by home physicians.

FIBROID TUMOR. CURED WITHOUT CUTTING.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I cheerfully give a testimonial of my treatment at your Institution, hoping it may induce others to avail themselves of your skill. In December, 1890, I went to you, after suffering five years with two fibroid tumors of the uterus. The tumors had grown rapidly for six months prior to my going to you for treatment, and had become quite painful. Under your treatment they entirely disappeared and my health was entirely restored. The treatment I received from your able corps of physicians and nurses was all that could be desired, and I would further state that your Hotel and Surgical Institute possess all the requirements for making invalids comfortable and happy.

Yours truly, VANIA E. DRENNEN, Nelson, Portage Co., O.

OVARIAN TUMOR OF 62 POUNDS WEIGHT REMOVED.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I hereby certify that I had safely removed, without realizing any pain, a large cyst, or Multilocular Tumor (ovarian) weighing 62 pounds, by your surgeons. Then, with kind and watchful treatment, the care of good and faithful nurses, and by the blessing of an all-wise Providence, I was sitting up in twelve days from that time; had no inflammation or fever, kept gaining, and in five weeks returned home. I am feeling better than I have for two or three years. I cheerfully and truthfully recommend the Invalids' Hotel and Surgical Institute to all afflicted as I was--with tumors, or any chronic disease. The rooms are large and pleasant, the best of food is served, and everything possible is done by the physicians, nurses, and attendants connected with the Institution, to render the visits of the afflicted pleasant and desirable.

Accept the grateful thanks of my husband and myself for your good care and great kindness to me during my stay at your Hotel, and I wish you all great success.

Very respectfully, MRS. ELISHA MATSON, Watte Flats, Chautauqua Co., N.Y.

UTERINE FIBROID TUMOR.

THE FOLLOWING IS FROM THE EMINENT LADY PHYSICIAN AND POPULAR LECTURER, MRS. JENNIE V.S. WILCOX, MD

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--The _least_ return one can render for an invaluable service, the saving of a life, is an acknowledgment of the same. Mine was a long-standing, stubborn, constitutional difficulty; chronic, and defying _all_ previous treatment. Under the care of the doctors of the elegantly appointed Invalids' Hotel and Surgical Institute the disease yielded. Could I persuade some of my fashionable friends to spend a summer or winter at Dr. Pierce's rather than at "resorts" more or less unsuited to weary or sick people, there might rise up an improved generation. The electrical appliances at the Invalids' Hotel are probably the finest in the world. With them the administration of electricity for the absorption and removal of all abnormal growths, especially in my sex, is an _assured science_, and no experiment. I cordially commend all my fellow sufferers to the tender care of the Invalids' Hotel.

Yours very respectfully, JENNIE V.S. WILCOX, M.D. Saratoga Springs, N.Y.

OVARIAN ABSCESS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--It is with pleasure that I can testify to the skillful treatment received at the hands of your surgeon specialists. I had been given up to die, with an abdominal tumor and abscess. My case was not understood, before coming to you. Although operated upon twice unsuccessfully by others, my life was despaired of. I am happy to state that after a few weeks' stay in your Institution, with a skillful operation which owing to my extreme feebleness, was performed without any Chloroform or Ether (local anæsthesia only being employed), and which resulted in the removal of the tumor and abscess, I was perfectly cured, and have since enjoyed excellent health. I am now restored to my children and family, and have much to thank you for. The kindness and attention received from your physicians and nurses while in the hotel could not be better, and I wish to praise them all highly.

Very truly yours, MRS. ANNA KEACH, 60 Bissell Ave., Buffalo.

SUFFERED FOR 20 YEARS.

OVARIAN DISEASE WITH INFLAMMATION OF ABDOMINAL ORGANS AND GREAT NERVOUS PROSTRATION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I most gladly express my appreciation of the treatment I received at the Invalids' Hotel and Surgical Institute at Buffalo. When I first applied to you for treatment I could sit up but a few minutes each day, and my physician had told me I never could be any better. I began to improve very soon after receiving and commencing to use your medicines. I continued to use them for some months, following the special instructions faithfully as I could, and steadily improved in health. My trouble was of such a nature that it was necessary for me to receive personal treatment, and I spent six weeks at your Institute. The kindness of physicians and attendants is everything that can be wished. It is now two years since I have had any of your medicines, and I have taken no others since, and my health is very good indeed. I can hardly realize that I am the same person that used to suffer so much for twenty years or more.

Very respectfully, MRS. M. GIBBONS, Franklin, Delaware Co., N.Y.

DISEASED OVARY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 683 Main St., Buffalo, N.Y.:

_Gentlemen_--In the Autumn of '88, I had an ovary removed at the Invalids' Hotel and Surgical Institute, Buffalo. The operation was performed with consummate skill. The Hotel is first-class in every respect, being at once a Christian Hospital and Home. The skill of man, as exercised there, seems all that God designed it to be.

I cheerfully add my testimonial as I consider the Institution first class in every respect.

Yours truly, MRS. ELLEN F. TANNER, Leavenworth, Kans.

FIBROID TUMOR OF UTERUS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--There is no endorsement that the faculty of your Institute could ask that I would not willingly give. I fully realize that I owe not only my good health, but my life to the wonderful treatment received at the Invalids' Hotel and Surgical Institute, and would earnestly recommend any person needing the best medical or surgical attention to go for relief and cure to your Institution at Buffalo, N.Y. Words are inadequate to express the gratitude I owe you in so successfully treating my case.

Very truly yours, Mrs. C.B. SLEEPER. Brainerd, Minn.

OVARIAN TUMOR MADE UP OF SMALL CYSTS (MULTILOCULAR).

It grew to enormous size in but five months. The patient, a young unmarried woman, left home expecting to die. She had several physicians. None of them could give her any definite information as to the nature of the growth or other than unfavorable expectations as to its probable effects.

It was successfully removed. The patient being able to be up and around in about two weeks with no unfavorable symptoms. Cure perfect. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_My Dear Doctors_--Many months have passed since I have written you concerning my health. I have remained perfectly well, and, in fact, my health was never better than since the tumor was removed.

You will remember my case: The tumor had only grown about five months, but it was of immense size, and I had despaired of life, and my family thought that I would not return alive from your Institution. Your skillful operation and removal of the tumor, which weighed over thirty pounds, with the kind nursing and good attention given me afterwards, brought me through sound and well. To you I feel that I owe all thanks. My prayer is for the success of the World's Dispensary Medical Association. You saved my life after I had given up all hope. The kind care that all gave me was something that could not be paid for with money. It was like being at home. I send you my picture, which will give you some idea of the change for the better in my looks. I am now married and am very happy.

Very respectfully, MRS. P.S. CRISSMAN. Montrose, Henry Co., Mo.

OVARIAN TUMOR.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am pleased to inform you that I have had no trouble since the removal of the tumor five years ago--that my general health is perfectly restored, and I grow stronger and stronger. And since that time I have two boys, healthy, and growing as strong as can be, and I feel very well satisfied with the care of the good and faithful nurses and physicians.

I cheerfully and truthfully recommend the Invalids' Hotel and Surgical Institute to all afflicted as I was with tumors, or any chronic disease. I send you my picture which will give you some idea of the change for the better in my looks.

Accept the grateful thanks of my husband and myself for your good care and great kindness to me during my stay at your hotel and our wishes for your best success. Respectfully,

MRS. J. NESTOR ORTIZ, Ortiz, Conejos Co., Colo.

FIBROUS TUMOR.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_My Dear Doctors_--My husband had to carry me into your place but in thirty days I walked out of the Invalids' Hotel sound and well. The tumor that caused my sufferings had gradually developed during a period of several years. The trouble induced an inflammation of the bladder and I had to endure that torment in addition. There were times when I could not touch my feet to the floor. Walking was an agony that I could hardly bear. I faithfully tried good physicians and the various remedies and treatments that were recommended to me without any satisfactory relief. So I made up my mind to go to your institution. I am now very thankful. Every one I met with in your place seemed to help me to get well.

You have got not only the most skillful physicians and nurses but they are also the kindest and most agreeable that I have ever met. Your hotel is comfortable, home-like and perfectly clean.

The treatment was wonderfully successful in my case. The removal of the tumor was accomplished without pain. I can highly endorse local anesthesia instead of using chloroform or ether. My recovery was rapid and I continue in good health and think of you all with thanks and good wishes.

Very truly yours, MRS. ADELAIDE DEAN, 246 Garden Street, Lockport, N.Y.

FIBROID TUMOR OF THE UTERUS

INVOLVING BOTH BODY AND NECK OF THE WOMB.

The tumor was of many years' standing; had grown within a few months till it was about the size of a child's head.

From anxiety and worry, the patient had grown nervous and generally miserable. It was successfully removed by electrolysis, no knife nor other cutting instrument being employed. In ten days the patient was able to be about and to return home.

_Yanceyville, N.G_.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I have thought of you and prayed for your welfare ever since I left your Institution. I am perfectly well and enjoying as good health as ever I did. The treatment you so skillfully applied has completely restored my health, and I feel that I owe you a debt of gratitude that I can never repay. I am constantly sounding your praise among my friends, and know that I can never speak of you in too high terms. I once despaired of ever feeling well,--to-day, I am jolly and like another being. May you long be spared to minster to the afflicted.

Very respectfully, MRS. HANNAH JOHNSON.

NERVOUS PROSTRATION; DEBILITY; DYSPEPSIA; "FEMALE WEAKNESSES," CURED BY SPECIAL HOME-TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--For a number of years I suffered with a complication of female troubles; I tried various remedies from physicians but nothing seemed to do me any permanent good.

About three years ago, I suffered an attack of nervous prostration, being the result of repeated miscarriages; this was a severe shock to my nervous system, resulting in a complication of other troubles among which was nervous dyspepsia. Words fail to express what I endured at this time. Only those who have passed through a similar experience can imagine the distressing symptoms accompanying this disease; I could neither eat nor sleep, was growing very thin in flesh and life seemed a burden to me.

This was my condition when I wrote to your Institution for help. I received a very encouraging letter and commenced treatment at once. I had not used their remedies a week before I began to feel better, and as I continued the treatment my health gradually improved. All the distressing symptoms have disappeared and my general health is restored. Accept my sincere thanks for the interest manifested in my case and the happy results obtained. I am now the mother of a fine baby girl, and I shall ever remember to whom I owe my present health and good fortune.

Yours truly, MRS. J.D. NICHOLSON, La Hoyt, Henry Co., Iowa.

BED FAST FROM WOMB DISEASE AND URINARY TROUBLES.

DR. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--When I began your treatment, I was unable to be up any at all, being troubled with womb and urinary diseases; but I can gladly say that had it not been for your medicine I could not have lived a great while longer.

I hereby give your medicine a high recommendation for the marvelous work it has wrought.

Yours respectfully, MRS. PHEBE MCCLAIN, Earnest, Jefferson Co., Ala.

UTERINE AND RECTAL DISEASE.

HOME PHYSICIANS FAILED.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_To whom it may concern_--I was greatly afflicted with Uterine and Rectal disease. My disease was of very long standing and had baffled the skill of our home physicians. I went to the Invalids' Hotel and Surgical Institute, and received treatment of their specialist. Under his skillful care and kind attention I soon regained my strength and felt that my former life and ambition were again restored to me. I cannot speak in too high praise of this famous Institution; the rooms are large and cheerful, the food of the very best, the nurses kind and attentive, and the staff of physicians and surgeons skillful and of large experience.

Yours respectfully, MRS. CHAS. CLAWSON, Middlesex, Yates Co., N.Y.

FALLING OF THE WOMB, LEUCORRHEA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was sick two years with "Falling of the Womb" and leucorrhoea or whites, previous to taking your medicines. I took six bottles of your "Favorite Prescription," and was entirely cured of both in six months; it is four years this month, since I was entirely well of both those diseases and have never had any signs of their appearance since, and I am satisfied the "Favorite Prescription" saved my life, for I could hardly walk around, when I commenced taking your medicine, and I think it is a God's blessing to me, and a great credit to you that I ever took your medicine, for had I not taken it, I think I would have been in the grave now, and I can highly recommend it to all who suffer from these two complaints.

I was pronounced incurable by the best doctors here in the West. I gave up all hopes and made up my mind that I was to be taken away from my husband and baby of two years old. I was sick all of the time--could not eat anything at all. In one week, after beginning the use of your medicine, my stomach was so much better that I could eat anything; I could see that I was gaining all over, and my husband then went and got me six bottles: I took three of them and my stomach did not bother me any more.

We sent to you and got the People's Common Sense Medical Adviser, and found my case described just as I was; we did what the book told us, in every way; in one month's time I could see I was much better than I had been; we still kept on just as the book told us, and in three months I stopped taking medicine, only three times a day, and continued for some time in that way, and to-day, I can proudly say I am a well woman. Yes, am well, strong and healthy. I am so glad and thankful to you, Doctor, for my good health, for well do I know you are the one that cured me.

When I began to take your medicine my face was poor and eyes looked dead. I could not enjoy myself any where, I was tired and sick all the time. I could hardly do my housework, but now I do that and tend a big garden, help my husband and take in sewing.

Yours respectfully, MRS. MARY F. COVELL, Scotland, Bon Homme Co., So. Dak.

SEVERE NERVOUS PROSTRATION.

"OUT OF DARKNESS INTO LIGHT."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--About eighteen years ago, after the birth of one of my children I was left in a weak, run-down condition; it seemed to me that my nerves were unstrung very bad: I did not suffer much pain, but I think I suffered everything any one could suffer with nervousness; my life was a misery to me. I doctored with seven different doctors and got no relief; then I took almost all kinds of patent medicines and got no relief from them, but got worse all the time, when I chanced to get one of your little pamphlets.

I thought I would write to you, and waited as I thought to hear that there was no help for me; when my answer came and you said you could cure me great was my joy. I had taken your medicine about a month when I began to improve and in a few months was entirely cured.

My recovery was like coming out of the dark into the light, so great was the change. I will advise all sufferers to go to you for relief--I don't think they will be disappointed. When I commenced taking your medicine I weighed 94 pounds, now I weigh 125 pounds.

I do not know how to thank you for all the good your remedies did me, With heart-felt thanks I am,

Sincerely yours, MRS. AMANDA C. AUSTIN, Burden, Cowley Co., Kansas.

P.S.--I have a lady friend who is taking Dr. Pierce's Favorite Prescription now, and last summer every one thought she was going with consumption; four of her father's family had died with it in five years: she has taken one bottle of "Favorite Prescription," and now she is better in health than she has been in three years. Her address is Mrs. Laura Paugh, Burden, Cowley Co., Kas. A.C.A.

MONTHS OF SUFFERING AND TORTURE.

"LEFT TO DIE A HOPELESS WRECK."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--A grateful heart and an appreciation of your medical skill prompts me to make a statement of my case.

At the birth of my last baby (a boy weighing 14 pounds at his birth), I contracted womb disease. And for three years previous to treatment, I had been a great sufferer from prolapsus. Owing to a more serious injury than prolapsus, received at childbirth, my physicians told me that "I could never hope for recovery."

After delivery, I kept my bed for seven weeks. At the expiration of that time I tried to walk. I found that I could not even stand straight; there seemed to be a "tight cord" or "drawing" from my left side extending down into my groin, accompanied by great soreness.

After repeated attempts, with my body inclined to that side and yielding to the drawing, I finally succeeded in walking--a violent trembling all the while in the parts affected.

Three months after the birth of my baby, I tried to take hold of my household duties--then my troubles increased, and with them came a series of "Doctors' bills."

I consulted two of the best physicians, besides trying all the medicines I heard tell of, that were recommended for such diseases; but failed in obtaining a cure from any of them; my relief was only temporary. My condition was growing worse each day; the womb was so low and the "bearing down" weight so great that I could scarcely stand on my feet at all. I was irritable and nervous with a dull headache and constipation; hands and feet cold and clammy, except the palms and soles; a burning on top of my head. At this stage of my disease my bladder was badly affected--the "neck" becoming enlarged and the water collecting there caused a protrusion to over half the size of a tea cup, leaving it so dry and harsh, that it was with the greatest difficulty I could walk at all; a sudden jar, sneeze, or even the slightest pressure, would force the water out, leaving me in a spasm of pain. At this stage (22 months after confinement) menstruation returned for the first time since the birth of my baby. I had already suffered as much as I thought it possible to bear, and live, but my sufferings were even greater after this; my womb was ulcerated and inflamed; nervousness increased to violent shaking, over which I had no control; circulation so feeble that the extremities were scarcely supplied with blood, they were constantly cold and clammy. My sleep broken and disturbed, life was fast becoming a burden to me, For months, however, I endured this torture; I had abandoned work altogether; I could be up but a few moments at a time and could not walk across the floor without excruciating pain. There was no sleep, no rest, and after a week and even more, would pass during which I would never close my eyes in sleep, even when morphine, opium and chloral, were administered. My body seemed a dead weight, while my mind was alive to all my sufferings. There seemed to be a burning pressure about my head all the while.

I would have shaking spells frequently, leaving me perfectly exhausted, my heart the while beating so rapidly, I could not count the pulsations; it seemed to cease altogether after that, with a sinking, fainting feeling over me, making it difficult to breathe at all. During my menstrual periods I suffered a "thousand deaths." My appetite was gone, mind and sight impaired, strength and flesh all gone. I was a pitiable object to look at, divested of all that made life endurable for me. I had baffled the skill of two physicians, and was left, after three years of agony, to die, a "hopeless wreck," worse than death.

Such was my condition when I applied to you for treatment. After using medicines only six days I began to improve; my nerves were steadier; circulation better, hands and feet warm. Nine days after taking your medicines they restored the function again. I will confess I expected to suffer death again--I did not think the medicines had had time to effect a change within so short a time. Imagine my joy and surprise upon waking next morning to find it had "stolen like a thief upon me in the night," I knew not when. I spent the day in grateful tears--how could I help it? It passed off as quietly as it came, leaving my head clear of that _dreadful, burning pressure_! My nerves were steady; indeed, my improvement was so remarkable, that it seemed almost a delusion. My appetite had returned, and I was hungry for the first time in over a year. I slept well--awoke refreshed and feeling stronger. After two weeks, I was able to walk around the house and yard without support; a day or two after that I walked a hundred yards, visiting and spent the day. In three weeks time I went home (I had gone to my mother's before treatment, as I and many others thought, to die).

At the end of one month there was no symptom, nor sign, of the old disease. I was able to be up all day, resting a short time at noon. To be sure of permanent results I continued treatment for one month longer, and have never had a return of the disease nor any symptom of it since. Before the end of the second month, I was able to be about the house, helping the children with the cooking, and milking. My weight increased fourteen pounds in five months after treatment. I have taken no medicine since except one bottle of Dr. Pierce's Favorite Prescription, four years ago. At this time (nine years after treatment), I find my health still good, having no aches nor pains, a splendid appetite, sleep well, no headache, no backache and no womb trouble. I am able to do my house work and everything; can do a day's work with less fatigue than I have for years before treatment. I feel sure that I would have been in the grave years ago if it had not been for your medicines. I advise all other ladies who are troubled with the same disease to apply to you for treatment.

Be assured, that whenever I have it in my power I shall recommend your invaluable remedies. I thank you a thousand times for what you have done for me, and for the kindness which you have extended to me throughout.

Wishing you long life and continued success, I am, with much gratitude,

Very truly yours, Mrs. JENNIE S. MOODY, Isney, Choctaw Co., Ala.

COMPLICATED CASE OF WOMB DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--When I went to the Invalids' Hotel for treatment I was in a very critical condition. I could scarcely walk for inward troubles--but I cannot stop to speak of one disease, for I had such a complication of diseases. Now I am doing my own housework and in the past four weeks I have entertained forty-seven people, and I think I certainly am doing well. It is with the greatest pleasure that I recommend all who are afflicted to go to the Invalids' Hotel and Surgical Institute. The Surgeons are honorable, trustworthy gentlemen, who will do all they promise; and, being men of large experience, they know just what course of treatment to pursue from first to last, so that an invalid can rest assured that no experimenting will be done.

For seventeen years I was an invalid and never had better health than at the present day, for which I am grateful to your Institute.

Yours respectfully, Mrs. D.T. KNAPPENBERGER, Jeannette, Westmoreland Co., Pa.

UTERINE DISEASE.

_Gentlemen_--For eight years I was a sufferer from female derangements. I have been permanently cured by your specialist, and with only thirty days' treatment. I am happy to say there is no return of the old trouble, and all my friends were so surprised to see me so well after being an invalid so long. I shall never regret the day I went to the Invalids' Hotel. You ought to see me now--I am so healthy, I shall never forget your kind treatment of me, and the nurses too were so kind and attentive--I cannot say too much in their praise.

Respectfully, MRS. J.W. REEL, Idaho City, Boise Co., Idaho.

PAINFUL MENSTRUATION AND CONSTIPATION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--In April, 1891 I came to your Invalids' Hotel for examination and treatment. I was at that time suffering from profuse and painful menstruation, complicated with obstinate constipation, from which I had suffered many years. I cannot speak too highly of your treatment of my case, as it was both prompt and thorough and resulted in a radical cure of the above named diseases, and I desire to recommend all who are thus afflicted to apply to your eminent staff of physicians for relief, as they cure when others fail. My advice to all who are afflicted is, if you wish to get well, go where they make such diseases a specialty. I hope that many others may be as thoroughly cured as I have been.

Yours truly, Miss ELLA DORAN, Tiffin, Seneca Co., O.

COMPLICATION OF DISEASES CURED BY SPECIAL HOME-TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I suffered from female complaint; my kidneys, stomach and nerves were also affected. My physician told me I had Bright's Disease of the Kidneys. I suffered a great deal in various ways, at times. I felt as if life were a burden to me; about that time Dr. Pierce's Common Sense Medical Adviser came into my possession. I read it carefully, and I thought if Dr. Pierce can not cure me perhaps he can give me some relief. I wrote to him, describing my symptoms and feelings as well as I could, and asked him if he could cure me. He said he thought he could, but it would take a long time for my disease was deep seated. He sent me a box of medicines enough to last one month, especially prepared for my case.

I continued taking his medicines for about thirteen months, and at the end of that time I felt like a new woman; that has been almost seven years now and my health is still good.

The benefits derived from Dr. Pierce's Medicines are lasting, and I advise all women suffering as I did, to give his medicines a fair trial.

Gratefully yours, MRS. MARY SHEEN, Council Bluffs, Iowa.

PARALYSIS AND UTERINE DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I will say that your Institute is all that you claim for it, and more to. The Doctors are courteous gentlemen and the best Physicians I have ever met with in my life. My treatment while at the Institute did me more good in one month than all the doctors everywhere else combined. My ailment was Paralysis and Female Weakness. Your treatment did me good while at the Institute, and I have also been greatly benefited by the home-treatment I have received from you since. I am much better than I was; I am able to do considerable work now. When I came to you I could not do anything.

I herewith send you my heartfelt thanks for all you have done for me, and should I need more treatment I will write you as before. I would advise all people who have chronic diseases to go to the Invalids' Hotel and Surgical Institute for help, for it is a grand place and prices are reasonable. We use your Family Medicines--your "Pellets" and "Golden Medical Discovery"--and find they are all you claim for them.

Again I thank you and remain, your friend,

MRS. S.B. MANN, Sutton, Clay Co., Neb.

BARRENNESS CURED.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--With pleasure I can recommend your medicines and treatment. At the time of my treatment I was barren, and had no signs of ever having any children until after the time of your treatment.

We now have two little boys, and we are happy. This picture shows my husband, myself and our eldest child.

I pray for your continued success, and thank you for your skill.

Very truly yours, MRS. A.H. BAIN, Cozad, Dawson Co., Neb.

INDIGESTION, CONSTIPATION, AND UTERINE DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Some months ago I consulted your specialist concerning my health, which had at that time become very much impaired from the effects of uterine disease, indigestion and chronic constipation. I was also troubled with frequent attacks of nervous headache which rendered me very miserable.

A line of treatment was outlined by your specialist, which I followed closely, and I immediately began to improve under the use of the medicine advised. The benefits were so marked that within two or three months I was able to discontinue the use of the medicine, and have since that time been enjoying good health. I attribute my cure to the use of your medicines, and I heartily thank you for the benefits received, as well as for the kind attention given me by your specialist.

Respectfully yours, IDA M. JOSLYN, Groton, Conn.

NERVOUS AND GENERAL PROSTRATION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--It is with pleasure that I add my testimony to your list, hoping it may contribute to your success and induce others to avail themselves of the benefit of your invaluable medicines. In June, 1890, I took typhoid fever of malignant type; for two months I hovered between life and death; at length the fever left me in a prostrated condition. Then I was taken with a severe pain in my back and general nervous prostration; could not move myself in bed nor bear to be moved by the most careful nurses without experiencing excruciating pain. I had the best medical attention in the community, but they failed to give relief. My friends wrote to Dr. Pierce, stating my condition and requesting treatment for me. He treated me for two months; by that time I had so much improved that I did not think it worth while to continue the treatment longer, and my health has been such that I have not had occasion to lie in bed two days together since. I feel under lasting obligations to Dr. Pierce, and thank God for blessing the world with so able a physician.

Very respectfully. MISS MAGNOLIA MORRISON, Abernethy, Iredell Co. N.C.

GENERAL DECLINE.

"FEMALE WEAKNESS," HEART DISEASE AND RHEUMATISM.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--For years I had been a great sufferer from general declining health--female weakness, heart disease and rheumatism--and despaired of ever getting well. Physicians afforded me only temporary relief. It was not until I commenced doctoring with Dr. R.V. Pierce that I experienced any decided benefit. My health has gradually improved until now I feel like a new being. Language fails to express my gratitude for this cure, which is due wholly to your life-saving and life-giving medicines.

Respectfully, MRS. CALEB ASHMAN, Du Bois, Clearfleld Co., Pa.

NERVOUS AND GENERAL DEBILITY.

DR. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--My case was a complication of diseases--a general break-down, lasting three years. I placed myself under the treatment of four different physicians. At last, giving up all hope of recovery at home, I was making arrangements to go to a Sanitarium in Michigan for special treatment. One of your small books with blank enclosed was handed to me; I filled out the blank, and thought I would try rather than leave home and little ones,--"Happy decision;" two months' special treatment and I was well and happy, and to-day, I have the very best of health.

Yours respectfully, MRS. LOMA LINN, Ladoga, Montgomery Co., Ind

FEMALE WEAKNESS; LEUCORRHEA.

DR. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--I was troubled with "female weakness" and leucorrhea for three years before I applied to you. I had tried several doctors but they did me no good, and I grew worse all the time. Finally I wrote to you for special treatment, and thanks to Dr. Pierce for being the means of my recovery. I am forty-five years old and do all my housework.

I remain, MRS. MARTIN J. MCCLURE, Thomasville, Oregon Co., Mo.

"FEMALE WEAKNESS."

Dr. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--Having been treated by one of your associate physicians, at the Invalids' Hotel and Surgical Institute, and greatly benefited, I do not hesitate to recommend you and your Faculty to all who may need the services of honest and skillful physicians.

Yours truly, MRS. D.S. MOSES, Fremont, Ohio.

"FEMALE WEAKNESS."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I have been taking Dr. Pierce's Favorite Prescription--three bottles of it and am getting well fast; I can do my own work, which I have not done for almost two years; I do my own washing and all of my house work; I have gained about six pounds taking your remedy. You cannot know how glad I am that I tried your "Favorite Prescription."

Yours truly, MRS. ANNIE B. FITCH, Johnstown, Cambria Co., Pa.

WOMB DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I enjoy good health thanks to Dr. Pierce's Favorite Prescription and "Golden Medical Discovery." I was under doctors' care for two years with womb disease, and gradually wasting in strength all the time. I was so weak that I could sit up in bed only a few moments, for two years. I commenced taking Dr. Pierce's Favorite Prescription and his "Golden Medical Discovery," and by the time I had taken one-half dozen bottles I was up and going wherever I pleased, and have had good health and been very strong ever since--that was two years and a half ago.

Yours truly, MRS. ANNA ULRICH, Elm Creek, Buffalo Co., Neb.

A MOST WONDERFUL CURE.

TERRIBLE ULCERATION AND FALLING OF WOMB. DROPSY AND OTHER COMPLICATIONS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am a farmer's wife. My husband hired hands to work on his farm--I had them to cook for--to wait upon, and my family to care for. I worked very hard till my health and strength gave way. Six years ago the "turn-of-life" began in the worst form with other disease which I knew not; I had a severe misery in my back, pain in my head; the monthly flow became so excessive--came on too often; lasted eleven days. When the flow would stop then there would be yellow discharge of thick mattery appearance. I had bearing down in the lower portion of the womb--great pain all through my body: the pain in my womb was more like "labor-pain" than anything I can compare it to; I had palpitation of the heart, light chills, hay fever; had pain in my stomach like colic. My womb was very low down; the mouth was a large hard knot--was so sore I was compelled to have a soft seat to sit on; severe pains in my thighs; pain down the sides of the abdomen; pain in my breast, pain between my shoulders; my bowels costive; my nervous system prostrated; my digestion impaired; I had a desire to urinate all the time, could not pass only a few drops at a time; on standing a few hours, it would form a crust on the chamber--red, grainy substance; I was bloated all over my body. My feet and legs were swelled tight, and I was in so much pain day and night I could not sleep; I could not eat any food only a little sweet milk and a little corn-bread; I lived in this way for four years; I could not walk across the room. I was treated by four of the best doctors in the land; the first three gave me no relief--the fourth built up my health to some extent; none of them could cure me--none of the four could regulate the menstrual flow, they could not cure those offensive discharges. I was given up to die by all four of them; my family and friends expected every day I would die.

I got one of your Memorandum Books; I read it carefully, and I was hoping all this time for some relief--I hoped all the time for relief. My husband decided to write to you--ask your advice, believing you could give me relief; though I felt ashamed to tell a gentleman, a doctor I never saw, those things concerning my afflictions; but I was suffering terribly. I hoped for relief and I found it. I am happy to tell you I am well. I was spared to be cured by your good advice and good medicine and to spread your fame.

When I received the book you sent me and a letter telling me what to take, and what it would do for me, I was very feeble; I had just got up from one of those bad spells--so weak that I could not sit up for more than an hour at a time. My husband went and got the medicine and a syringe. I began its use, as you advised, and took the medicine as you directed; I have taken your medicine seven months; the first month my improvement was slow; I began to have strength; my pain began to banish; my appetite began to come; I commenced to sleep sound and the bloating began to go down; the pain in my head was gone; palpitation of the heart, also the misery in my back disappeared; the pain in my womb began to banish; the first time the monthly flow appeared, it was controlled--it was regulated--it went so light with me that I could go all the time without a cane. I have not had one spell to confine me to bed in seven months; I have done all the cooking for my family all the year; the pain in my stomach disappeared; the yellow discharge also--the bearing down banished. I have no pain, no aches, no bad feelings. I feel better to day, than I have in ten years. I now enjoy life, enjoy my family, enjoy my friends. I enjoy the pleasure of telling my friends who cured me, and what medicine it was that cured me; he should have the honor. It is Dr. Pierce!

I was at death's door when I began to take his medicine, and followed his advice. It was his "Favorite Prescription," "Golden Medical Discovery" and the "Pleasant Pellets" that cured me. I also used the lotion, or wash advised, with a syringe.

Now, I wish you to accept my best wishes, and hearty thanks for what you have done for me.

Last winter I gave my sick friends the pamphlets which were around the bottles of medicine; some of them are going to take it; it gives great satisfaction here; I will take no other myself; it will come the nearest to raising the dead of any medicine I ever saw in my life; it saved my life, when four doctors gave me up to die. My God bless you in your work, as He has done in my case.

Yours truly, MRS. MARY SMITH, Oakfuskee, Cleburne Co., Ala.

SEVERE FLOWING.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I suffered terribly with leucorrhea, my monthlies would nearly always send me to bed; I would lose from two to four quarts of blood. I had womb trouble pretty bad and my bladder would trouble me nearly all the time, by continually wanting to urinate, with smarting, burning pains. My husband got me a bottle of Dr. Pierce's Favorite Prescription. I took nineteen bottles and now feel very well indeed.

Your friend, MRS. LULU CLARK, No. 208 West 3d Street, Sioux City, Ia.

Mr. Homer Clark, the husband, writes: "My wife was troubled with leucorrhea and female weakness, and ulcers of the womb. She has been doctoring with every doctor of any good reputation, and has spent lots of money in hospitals, but to no purpose. She continued to get worse. She was greatly prejudiced against patent medicines, but as a last resort we tried a bottle of Dr. Pierce's Favorite Prescription. We had seen some of your advertisements, and Mr. Cummings, a west-side druggist, advised us to try a bottle. We tried it with the following results: The first bottle did her so much good that we bought another, and have continued until she has been cured."

INFLAMMATION AND "FALLING OF WOMB."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I deem it my duty to express my deep, heart-felt gratitude to you for having been the means, under Providence, of restoring me to health, for I have been by spells unable to walk. My troubles were of the womb--inflammatory and bearing down sensations and the doctors all said they could not cure me.

Twelve bottles of Dr. Pierce's wonderful Favorite Prescription has cured me.

Yours, MRS. FRANK CAMFIELD, East Dickinson, Franklin Co., N.Y.

GENERAL DECLINE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I believe I owe my life to Doctor Pierce's remedies. Six or seven years ago, my health began to gradually fail; some of my friends as well as myself thought I was going into consumption. I began taking Dr. Pierce's Favorite Prescription, "Golden Medical Discovery" and his "Pellets," and was greatly benefited; took half a dozen bottles at that time, did not take any more for several years, when I began to go down again. I was married November, 1889. The next September had a miscarriage. The summer following my health was very bad; I then got one dozen bottles and took as directed. My health was much improved and am now the proud mother of a healthy boy 22 months old. My health is now much better than I thought it ever would be.

Yours truly, MRS. ALICE V. DUNCAN, Rees Tannery, Mineral Co., W. Va.

ERYSIPELAS AND WOMB DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_ I am forty-eight years old, and have had four children. Three years ago the doctor said I had womb trouble, which was accompanied with backache and a tired and miserable feeling all over; left side hurt me very much, and could not lie on that side, and the doctor said it came from affection of the spleen; had a great deal of headache; was costive, and suffered terribly from erysipelas; it nearly set me crazy, so great was the burning and itching; sometimes experienced severe burning in the stomach. I took twelve bottles of your medicines, six bottles of Dr. Pierce's Golden Medical Discovery and the same amount of his "Favorite Prescription." was using them for about six months, and can say that they did their work well. I have ever since felt like another person, and do not think I can say enough in their praise. I have no more weakness, and all evidence or erysipelas has disappeared.

Respectfully yours, MRS. SARAH E. WHITE, Kennon, Belmont Co., O.

FALLING OF WOMB.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Having suffered for years with what my doctor called "Falling of the Womb" I was advised to try Dr. Pierce's Favorite Prescription. The effect has been simply marvelous; a single bottle relieved me of all pain and enabled me to sleep at night, which I had not been able to do for a long time. For three months I have not had any return of the complaint above named. I feel as well as I ever did. I shall heartily recommend "Favorite Prescription" to all afflicted as I was. Yours truly,

MRS. SAMUEL GIVENS. Leesburg, Harrison Co., Ky.

DYSPEPSIA, UTERINE DISEASE.

MRS. J.A.MARTIN, of _Cleburne, Texas_, had not had good health since the birth of her child, eight years before; had a headache with burning and throbbing sensations; and a hurting in her stomach; there was a dead aching and gnawing or drawing of the stomach as she described it; sharp pain in the stomach extending to her right breast and shoulder. Weighed in health 135 pounds, but was reduced to 95 pounds; was weak; could scarcely walk at all, was sick at stomach a great deal; when her monthly sickness came on had much pain and the sickness of the stomach remained until menstruation stopped. She writes:

WORLD'S DISPENSARY MEDICAL ASSOCIATION Buffalo, N.Y.:

_Gentlemen_--"I have taken about six bottles of your 'Golden Medical Discovery' and 'Favorite Prescription,' and am glad to say that I feel better and stouter than I have felt in a long time. I can work all day now and not be tired at night. My head don't trouble me now. When I commenced the use of the medicine I weighed 89 pounds, and to-day I weigh 98 pounds. I feel better than I have for months."

COUGH AND NIGHT SWEATS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--In regard to your medicines I will say that they are always in the house. I shall never forget those nights when I was down with pneumonia. Had it not been for Dr. Pierce's Golden Medical Discovery I would not be a well man to-day. One bottle stopped the cough and night sweats.

My wife was troubled with leucorrhea so bad that we did not know what to do until Dr. Pierce's Favorite Prescription was brought into the house and gave her rest.

Yours truly, H.M. DETELS, Travor, Tulare Co., Cal.

"CHANGE OF LIFE."

WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--It was four years ago that I applied to you for treatment. My family physician did me no good. When I began your treatment I was nearly bed-fast; my life was a misery to me. I have taken eight bottles of your medicine and it has cured me. If I could tell the whole world of your medicine I would do it. If any woman undergoing the "change of life" will take Dr. Pierce's Golden Medical Discovery and his "Favorite Prescription," according to directions, they will cure her. When I began taking them I could scarcely do anything and now I can do all my housework and pick two hundred pounds of cotton a day.

Yours truly, MRS. M.E.E. PRICHARD, Thornton, Limestone Co., Texas.

COMPLICATION OF DISEASES.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--For twenty years, I suffered with womb disease and most of the time I was in constant pain which rendered life a great burden. I cannot express what I suffered. I had eight doctors and all the medicine I had from them failed--the one after the other.

I was nervous, cold hands, feet, palpitation, headache, backache, constipation, leucorrhoea and no appetite, with bearing down pains. I got so weak I could not walk around. I had to keep my bed, thinking I would never get any better.

One day my husband got one of your little books and read it to me. He said there was nothing doing me any good. I said I would try Dr. Pierce's Favorite Prescription. I did try it. After the first few weeks my appetite was better; I was able to sit up in bed. I wrote to the World's Dispensary Medical Association, at Buffalo, N.Y., and described my case; they sent me a book on woman's diseases. I read carefully and followed the directions as near as I could, and took the medicine for two years, With the blessing of God and your medicines I am entirely cured. That was three years ago:

Yours most respectfully, MRS. ALEX. ROBERTSON, Half Rock, Mercer Co., Mo.

VAGINITIS--IRREGULAR MENSTRUATION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was married in April, 1893. Soon after I discovered that I was a sufferer from a very painful condition of the vagina and from irregular menstruation. In fact the latter was true from its first appearance. I consulted our family physician but he gave me no relief. At last I applied to Dr. Pierce for aid: he advised me to take his "Favorite Prescription," which I did faithfully. I bought seven bottles of it and one of the "Golden Medical Discovery." After I had taken two bottles of the "Favorite Prescription," my menses began to be more regular and I was also relieved of the other diseases. Before I began taking the medicine, I felt great lassitude and weakness at times, but I now feel quite strong.

I can confidently recommend Dr. Pierce's Favorite Prescription to any one suffering as I did.

Yours truly, MRS. MARIA L. PARKER, Aten, Cedar Co., Neb.

CONSUMPTION.

DR. R.V. PIERCE, Buffalo, N.Y.: New London, Union Co., Ark.

_Dear Sir_--Some five or six years ago I had a bad cough and got so low with it that I could not sit up long at a time. We called our family physician, and he said I had consumption. All our neighbors thought so too. I had pains through my chest and spit up blood. I commenced with your "Golden Medical Discovery" and had only taken it two or three days when I felt like a different person. I took four bottles of the medicine and it cured my cough. Have not been bothered since, until a short time ago I took cold and commenced to cough again; I got a bottle of the "Discovery" and it relieved me at once. I think it is the best medicine in the world. It saved my life. I don't think any one would die of consumption if they would take Dr. Pierce's Golden Medical Discovery. I recommend it to all my friends, and tell them what it did for me. Yours respectfully,

Mittie Gray

LEUCORRHEA, "FEMALE WEAKNESS."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I have used your "Favorite Prescription" and must acknowledge to you and the public also, the benefits I received from the use of a half dozen bottles of it. My condition was pitiful before I was persuaded to use it. I had leucorrhea, no appetite, cold feet, weakness, fainting spells, melancholy. I felt that I would soon leave my children motherless. I fell off in flesh to a pitiful looking object. My friends around said I must be consumptive. My family doctor gave me nearly all kinds of blood medicine for over a year--all kinds of tonics to build up flesh, but nothing seemed to benefit me.

Last September--one year ago, I began using Dr. Pierce's Favorite Prescription, being convinced that my disease was female weakness. I had only used it three days when I began to feel better and, after using three bottles accompanied by the "Discovery," I felt as though I was well, and continued its use until I had used half a dozen bottles for fear of a relapse.

Was a living picture of surprise to my friends. They had all expected my death. I have given birth two months ago to a baby and no return of my old disease. I hope that all females, dragging about with pain and weakness, dyspepsia, melancholy feelings, restlessness at night, and not feeling like getting up in the morning, may commence the use of Dr. Pierce's Favorite Prescription, and be well again. Yours respectfully,

MRS. ANNIE H. JONES, No. 316 Effingham Street, Portsmouth, Norfolk Co., Vt.

FEMALE WEAKNESS, ASTHMA, SEVERE COUGH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I had been ailing for a year or more, being troubled with "Female Weakness" and leucorrhoea, when I took a severe cold which settled on my lungs, and I had a very severe attack of asthma, which was so bad that for three weeks I could not lie down in bed at all. I had a terrible cough, in fact, every one thought I had consumption and nothing gave me relief until I took your medicines, using two bottles of "Favorite Prescription" and two of "Golden Medical Discovery." They cured me and I have had no return of the dreadful cough since, and that has been two years now and I have had good health ever since.

I am in possession of a copy of the Common Sense Medical Adviser, which I would not part with for anything.

Respectfully yours, MRS. S.A. MONROE, 315 S. Regester Street, Baltimore, Md.

LEUCORRHEA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I have been troubled with falling of the womb for years, and was hardly able to drag around. The doctors said I had ovarian tumors and leucorrhea; the treatment they gave me only produced temporary relief. I grew worse with leucorrhea all the time until I chanced to see your remedies.

I consulted you; you pronounced my trouble leucorrhea, and advised Dr. Pierce's Favorite Prescription. You sent me some prescriptions to have filled here, which I used with great success. I am entirely free from my old trouble--leucorrhea. I only used three bottles of "Favorite Prescription."

I could not thank you enough for the cure. When I commenced with your remedies I weighed one hundred and nine pounds; I now weigh one hundred and forty-six.

Respectfully, MRS. MATTIE L. CHAPEL, Dawson, Hopkins County, Ky.

"FEMALE WEAKNESS," THE RESULT OF GRIP.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.

_Gentlemen_--I was taken sick with the grip on the first day of January, 1892. I employed a doctor, until in May I was some better, but could not do any work. The Grip left me with a weakness, my head felt very badly and I would get so discouraged and despondent. It affected my back, hips, and legs, and made me miserable indeed. My stomach was very bad; it soured and burned after eating. My heart, also, gave me much distress by beating so fast and loud at times.

In May I commenced using Dr. Pierce's Favorite Prescription; took seven bottles of that, and then, by your advice, began taking Dr. Pierce's Golden Medical Discovery. I took five bottles of that, making twelve bottles in all.

My niece lives with me, and she, also, took the "Favorite Prescription," which did her a great deal of good.

Yours respectfully, MRS. E.J. SPEER, North Barton, Tioga Co., N.Y.

"FEMALE WEAKNESS" PERMANENTLY CURED.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--My trouble was "female weakness" and womb disease. I suffered greatly for twelve years. Four years ago my health became so poor I was confined to my bed most of the time from May until September. I was treated by our family physician but received no benefit; I then consulted Dr. R.V. Pierce, of Buffalo. Through his good advice I began using his "Favorite Prescription," having taken in all eight bottles of "Prescription" and two of his "Golden Medical Discovery." I am at present enjoying better health than I have for twelve years. As it is now three years since I quit using those medicines and I have no return of my old trouble. I consider myself permanently cured.

Yours truly, MRS. MOLLIE L. RAMSEY, Liberal, Barton County, Mo.

TORPID LIVER, SUPPRESSED MENSTRUATION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I had suffered so much for years from "Liver Complaint" that I did not care whether I got well or not, but my husband urged me to take your "Golden Medical Discovery." I had not had my courses for six months; after I had taken your medicine about two months, I was well.

When one of my daughters with a baby two weeks old was in so much pain that she could not rest day or night, I went to her as quickly as I could, and commenced giving her your "Favorite Prescription." The next morning the pains were all gone. She said, "oh, mother, I would have died if you had not come. I do feel so good." Your medicine makes people feel like they wanted to live. There is a woman at Verdi who had several children who died with consumption of the bowels and _chronic diarrhea_. She had another one who was going the same way. The doctor said it was bound to die. I went there and gave it five drops of Dr. Pierce's Extract of Smart-Weed, and increased the dose every time its bowels moved, until I got to a half teaspoonful. The next morning the child was almost well. That woman says I saved her baby's life.

I could write a week and not tell half the good your medicines have done through my hands. Two weeks ago, a young man at my house was taken with _cholera morbus_. He thought he was surely going to die, but as quickly as I could get some hot water, I put hot applications on his stomach and bowels, and gave him a few doses of your Extract of Smart-Weed. He got well immediately.

MRS. MARY ISABELL FITZGERALD, Reno, Washoe Co., Nev.

SUPPRESSED MENSTRUATION AND NERVOUS DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Dear Sirs_--My health is quite good, so I have been able to do all my own work, and I know Dr. Pierce's Favorite Prescription is what helped me.

We never think of doing without Dr. Pierce's Pleasant Pellets in the house. I give them to my children when they need anything of the kind, and they never fail to do good. Gratefully yours,

MRS. WARREN CLARK, Mount Pleasant, Isabella Co., Mich.

DISEASE OF WOMB.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I cannot say too much for Dr. Pierce's Favorite Prescription. I feel it my duty to say to all women who are suffering from any disease of the womb that it is the best medicine on earth for them to use; I cannot praise it too highly for the good it did me. If any one doubts this, give them my name and address.

Respectfully, MRS. CORA S. WILSON, Carlisle, Sullivan Co., Ind.

"HER FAVORITE".

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y. :

_Gentlemen_--Dr. Pierce's Favorite Prescription is my favorite medicine. I recommend it highly to my friends. Mrs. James Grant of Fort Fairfield, Maine, one year ago was a very sick woman. I told her what your medicine had done for me and others whom I know, and I think it raised her from the death-bed; her husband thinks it a miracle that she got better. My health at present is good.

Respectfully yours, MRS. GEORGE A. COLLINES, Maysville Centre, Aroostook Co., Maine.

WORDS OF PRAISE. UTERINE DISEASE.

DR. PIERCE, Buffalo, N.Y.:

_Dear Sir_--Years ago you sent a box of medicine to my sister, Mrs. Cynthia P. Freer in New Albion, N.Y., which did so much for her that after I was married I used them in my own family. Two different times I have used the "Discovery" when physicians told me they could only patch me up--I was so bad and getting steadily worse. I sat down and wrote to you; even after the letter was written I felt so worthless it seemed foolish to try, so kept my letter for some time thinking it better not to trouble you with it, but finally mailed it little thinking your advice and the "Discovery" could so speedily restore me to my usual health.

A near neighbor used it for a cough occasioned by a sudden cold, and less than one bottle stopped the cough. We use the "Pellets" for malaria and the numberless ills and epidemics that go the rounds, always with happy results; it saves us physicians' bills and much suffering. We consult your Common Sense Medical Adviser as our family physician. It saves much anxiety and fruitless journeyings after a physician, perhaps to find them gone or unwilling to breast the storm or heat, to say nothing of the delay and danger of being too late.

Both my sister and myself have used your "Favorite Prescription" and know it to be what it is represented by you to be. I can conscientiously recommend those of your remedies we have used. I am willing to answer letters of inquiry, if stamps are enclosed for reply.

Respectfully. MRS. ABBIE J. PIERCE, Box 22, Waterbury, Dixon Co., Nebraska.

"FEMALE WEAKNESS".

DR. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--I had been a great sufferer from "female weakness;" I tried three doctors; they did me no good; I thought I was an invalid forever. But I heard of Dr. Pierce's Golden Medical Discovery and his "Favorite Prescription," and then I wrote to him and he told me just how to take them. I commenced last Christmas and took eight bottles. I now feel entirely well. I could stand on my feet only a short time, and now I do all my work for my family of five. My little girl had a very bad cough for a long time. She took your "Golden Medical Discovery" and is now well and happy.

Yours respectfully, MRS. WILLIAM HOOVER, Bellville, Richland Co., Ohio.

STERILITY CURED

WORLD'S DISPENSARY MEDICAL. ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I will always recommend Dr. Pierce's Favorite Prescription, it cured me when all 'other' medicines failed. For ten years I suffered untold misery. I commenced taking your medicines and found relief before finishing one bottle. After using your medicine eleven months, I made my husband the present of a twelve pound boy. I think it is the best medicine in the world.

Yours truly, MRS. CAROLINE KING, New Boston, Scioto Co., O.

"WOMB TROUBLE."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--For three years I suffered from what my doctor called womb trouble. I cannot find language to describe the tortures I suffered.

Sixteen weeks ago I began to use your medicine and now feel better and stronger than I have felt for years, in fact my health is thoroughly restored and there are no signs of any return of my former trouble. I owe it all to your wonderful "Favorite Prescription" which I shall always praise wherever I go.

Yours truly, MRS. MAMIE DEMBY, 1503 Saratoga St., Baltimore, Md.

UTERINE DEBILITY CURED

AFTER SIXTEEN YEARS OF SUFFERING.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I must tell you that I have enjoyed better health since I began treatment with Dr. Pierce's Favorite Prescription, for Leucorrhea and Uterine Debility than I have for sixteen years. I am cured of my trouble and now weigh one hundred and sixty-six pounds, whereas my weight for many years stood at one hundred and twenty-five pounds. With pleasure, I remain,

Yours truly, HARRIET HARDS, Montpelier, Idaho.

FEMALE WEAKNESS, NERVOUSNESS AND DYSPEPSIA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I suffered everything from bearing-down sensations, headaches, cold feet and hands, leucorrhea, backache, and general weakness. Was exceedingly nervous and very gloomy and despondent; had poor appetite, constipation, distress in stomach after eating, and could not sleep well. Began using "Favorite Prescription" alternately with "Golden Medical Discovery" in April, and by July was cured.

Respectfully, MRS. S.F. ROSS, No. 200 Market Street, Amesbury, Mass.

THREATENED MISCARRIAGE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I cannot say enough in praise of Dr. Pierce's Favorite Prescription, as it has done me a world of good and undoubtedly saved my baby's life, as I came near losing him twice before the proper time.

Respectfully, MRS. C.P. MILLER, No. 1638 Frederick Ave., St. Joseph, Mo.

WAS A GREAT SUFFERER.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--When I began to take your medicine I could not do any work to speak of. I was in such misery that many times, as I lay down for the night, have I prayed that I might never see the rising of another sun. It was almost death to me to stand on my feet.

When I began using your medicines, I weighed 103 pounds. I have taken in all, ten bottles of your Dr. Pierce's Favorite Prescription, six of "Golden Medical Discovery," and some of your "Extract of Smart-Weed." To-day I am well, and weigh 148½ pounds, and am doing the work for my family of nine.

Respectfully, MRS. FRED KEMPSON, Cambria, Hillsdale Co., Mich.

TROUBLES INCIDENT TO "CHANGE OF LIFE."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I can testify to the efficacy of Dr. Pierce's medicines. I have been using his "Golden Medical Discovery," "Favorite Prescription," and "Pellets" for several years, for troubles incident to the "turn of life." I have found them to be of very great benefit to me, and cheerfully recommend them to all similarly afflicted.

Respectfully, Mrs. M.C. CARPENTER, Berlin, Sangamon Co., ID

DYSPEPSIA AND "FEMALE WEAKNESS."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Words fail to describe my sufferings before I took your "Golden Medical Discovery" and "Favorite Prescription." I could not walk across the room without great suffering, but now I am able to do my own work, thanks to your wonderful medicines, I am a well woman. I suffered all the time with a weight in the bottom of my stomach, and the most severe bearing-down pains, low down, across me, with every step I attempted to take. I also suffered intense pain in my back and right hip. At times I could not turn myself in bed. My complexion was yellow, my eyes blood-shot, and my whole system was a complete wreck. I suffered greatly from headaches, and the thought of food would sicken me. Now I can eat anything, and at any time. My friends are all surprised at the great change in me. Every one thought I would not live through the month of August. Two of my neighbors are using your medicines, and say they feel like new beings.

Truly yours, MRS. ANNIE HUTCHINSON, Cambridge, Dorchester Co, Md.

WOMB DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.

_Gentlemen_--I am now entirely cured by the use of your medicines. I think, and so do my relations, that if it had not been for your medicines that I could never have lived. I had many physicians before but got no relief until I began to take Dr. Pierce's Favorite Prescription and his "Golden Medical Discovery." I then commenced to get better right away. I kept getting better and am now entirely cured. They are the best remedies for women and all their ailments.

I suffered from severe pain in back and region of womb, frequent headache, was pale and sallow, with dark circles around eyes, was very nervous, cross, fretful, had spells of crying, and was out of sorts generally.

Respectfully, MRS. SUSAN CUMMINGS, Shawano, Shawano Co., Wis.

"FEMALE WEAKNESS." PERIODICAL PAINS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was sick for four years. For two years I could do no work. I had five different physicians, who pronounced my case a poor or impoverished condition of the blood, and uterine trouble. I suffered a great deal with pain in both sides, and much tenderness on pressing over the womb. I bloated at times in my bowels and limbs. Was troubled with leucorrhea. I could not sleep, and was troubled with palpitation of the heart. Suffered a great deal of pain in my head, temples, forehead and eyes. I had a troublesome cough, and raised a great deal, and at times experienced a good deal of pain in my chest and lungs. My voice at times was very weak. I suffered excruciating monthly, periodical pains. Since taking seven bottles of your "Favorite Prescription" some time ago, I have enjoyed better health than I have for more than four years previously; in fact, for several months past I have been able to work at sewing. I have gained in weight thirty-nine pounds since taking your medicines; the soreness and pain, of which I formerly complained so much, have disappeared. Yours truly.

Miss MARY TANNER, North Lawrence, St. Lawrence Co., N.Y.

FALLING OF WOMB.

WORLD'S DISPENSARY MEDICAL ASSOCIATION. Buffalo, N.Y.:

_Gentlemen_--I cannot tell you how my wife has improved since she began the use of your "Favorite Prescription," coupled with "Golden Medical Discovery." She has no more trouble with falling of the womb, and she never feels any pain unless she stands too long. She has no bearing-down pains since she began the use of your remedies. She does nearly all of her own housework now, but before she commenced taking your remedies, she could hardly walk across the room.

I do not know now to thank you for all the good your remedies have done her, for the best doctors had given her case up as incurable.

Yours truly, ALFRED LEWIS, Fairport Harbor, Lake Co., Ohio.

UTERINE DEBILITY.

PERMANENTLY CARED, AFTER TAKING FIVE BOTTLES OF "PRESCRIPTION."

_Dep't of Photography, U.S. Artillery School_, Fortress Monroe, Va.

WORLD'S DISPENSARY MEDICAL ASSOCIATION:

_Gentlemen_--My wife cannot speak too highly of your Dr. Pierce's Favorite Prescription, it having completely cured her of a serious womb trouble of long standing. She took five bottles altogether, and she has borne a large, healthy child since. There has been no return of the complaint.

She only wishes every poor, suffering woman should know of the inestimable value your "Favorite Prescription" would be to them, and thanks you, gentlemen, from the bottom of her heart, for the benefit she has received.

Yours very truly, EDWARD F.F. SARGENT.

"FEMALE WEAKNESS."

DR. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--I am enjoying good health, and I deem it my duty to send you my testimonial. I can conscientiously recommend your medicines to any suffering woman. I think they are indeed the best medicines for "female complaint" that has ever been invented. Had it not been for them I surely would have died.

I tried numbers of remedies from doctors but without getting any relief; I then took Dr. Pierce's Golden Medical Discovery and his "Favorite Prescription" and I feel confident that I am permanently cured.

I told my mother to try it; she has taken four bottles--two of the "Golden Medical Discovery" and two of the "Prescription." She says it is the best medicine she has ever tried for her case; she is in better health than she has been for fifteen years. Mrs. Shelton also used it, says it has done her more good than all the doctors' medicine ever did; she has "female complaint."

Yours respectfully, MRS. NORA DAVIS, Noble, Ozark County, Missouri.

UTERINE DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I had "Female Weakness" very bad--in bed most of the time, dragging down pains through my back and hips; no appetite; no energy. The family physician was treating me for liver complaint. I did not get any better under that treatment so I thought I would try Dr. Pierce's Favorite Prescription and "Golden Medical Discovery." I felt better before I used one bottle of each. I continued their use until I took six bottles of each. In three months' time I felt so well I did not think it necessary to take any more. In childbirth it does what Dr. Pierce recommends it to do. I would like to recommend Dr. Pierce's Extract of Smart-weed to those who have never tried it; it surely is the best thing for cholera morbus, or pain in the stomach I ever used; it WORKS like a charm. I try never to be without it.

Yours respectfully, MRS. IDA COVENTRY, Huntsville, Logan Co., O.

LEUCORRHEA, IRREGULAR MENSTRUATION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--After years of suffering I have been cured by your wonderful medicine, when I commenced your medicines I could neither eat nor sleep; my hands and feet were constantly cold. I had leucorrhea for twenty years and my monthly periods were never regular, occurring about once in three weeks. I used three bottles of Dr. Pierce's Prescription and two of his "Golden Medical Discovery," and am a well, hearty woman to-day--thanks to your kind advice and excellent medicine. Our family doctor said to-day, "I can't beat Dr. Pierce's Favorite Prescription; it is a wonderful medicine."

Yours respectfully, MRS. MARY KENISON, Catlin, Otero County, Colorado.

"CHANGE OF LIFE," ORGANIC HEART DISEASE, WOMB TROUBLE.

Dr. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--I feel that I would be doing an injustice to you and to suffering humanity if I did not write you a statement of my case.

I have been a constant sufferer all my life, and for the past five years have been under the care of many good physicians, who, I must say, have only given me relief for a short time. I cannot describe the constant pain and torment to which I was subjected every moment of my life, and I was so reduced in flesh and strength that I could scarcely walk across the floor and had little hope of ever being any better.

I was induced, by the advice of a friend, to take your "Favorite Prescription," as she had been cured after taking several bottles of it. My physicians said I was suffering from the effects of "change of life," organic heart disease and womb trouble.

I sent for your Common Sense Medical Adviser and then wrote to you. You advised me to take six bottles more of the "Favorite Prescription," which I did, and in a reasonable length of time after taking it, I felt very grateful for the happy relief I obtained. I do not suffer near so much with my heart as I did before taking the "Favorite Prescription." I had not been able to do any kind of work at all for two years, and I am now able to attend to my household duties without suffering any pain.

I have two daughters--17 and 19 years old, that have been in very bad health for twelve months or more. I gave them each several bottles of the "Favorite Prescription," and it entirely cured them.

I would send you my photo., as you request, but have none, and there is no place nearer than Natchez, Miss., thirty miles distant, where I could have one taken.

I now thank you most kindly for the happy relief and cure which myself and daughters received from taking your "Favorite Prescription."

With many thanks and wishing you success, I am.

Yours respectfully, Mrs N.E. Reily, Bougere, Concordia Parish, La.

ULCERATION OF THE WOMB.

_Gentlemen_--This is to let you knew what your medicine is doing here. I was In bad health; age was working upon me, and had ulceration of the womb; I could not get about; I took Dr. Pierce's Favorite Prescription and it cured me; I felt ten years younger. I have not had any return of my trouble. I am the mother of thirteen children and I am fifty-three years old, have never seen a better woman's friend than your medicine. I have recommended it to my friends here, and it has never failed in any case, so let me thank you for the good it did me.

Yours, MRS. M.A. MCALLISTER, Lim Rock, Jackson County, Ala.

REV. W.J. WALKER'S PRAYER.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I wish to inform you of the benefit my wife has received from the use of your medicines. I must say that your "Favorite Prescription" is the best female regulator on earth; my wife has been cured by the timely use of it. I have been using the "Golden Medical Discovery" and "Pleasant Pellets," and I am fully satisfied they are all you claim them to be; so I wish you abundant success, and hope that the Almighty God will continue His blessings toward you in your noble work.

Respectfully, REV. W.J. WALKER, Vancleave; Jackson Co., Miss.

TERRIBLE PAIN AND FAINTING SPELLS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--When I commenced taking your medicine I was very sickly. I had frequent spells of fainting, terrible pain in my head, and life was a burden to me. I was attended by one of the best physicians in our town, but with no good results. At last a neighbor advised me to try Dr. Pierce's Favorite Prescription, which I did, and after taking one bottle I felt greatly benefited. I would advise all ladies similarly afflicted to try "Favorite Prescription."

Yours truly, Mrs. SAMUEL A. JACOBS, Mechanicsburgh, Cumberland County, Pennsylvania

"WAS THE PICTURE OF DEATH."

PHYSICIANS FAILED.

DR. R.V. PIERCE: _Dear Sir_--My daughter has been sick all her life, and the older she grew, the worse she was until she was the picture of death: the physicians could not do her any good.

I heard of your "Favorite Prescription," for women, and I gave her three bottles, and now she is a perfectly healthy girl.

Have recommended it to a great many sufferers from "female complaints," and it has cured them.

I think it is the greatest medicine in the world, and I have never found anything to compare with it.

Yours truly, MRS. M.J. LOYD, Wesson, Copiah Co., Miss.

UTERINE DISEASE OF YEARS' STANDING.

SUFFERED FOR TWELVE YEARS.

_Oreide, (formerly Enterprise,) Taylor County, W. Va._

_Gentlemen_--A heart overflowing with gratitude prompts me to write you. Twelve long weary years I suffered greatly from Uterine derangement and at last was given up by my physician to die, besides spending almost all we had. After five months' treatment with your Doctor Pierce's Favorite Prescription, I now enjoy most excellent health. I would, to-day, have been in my grave, and my little children motherless, had it not been for you and your medicine. I will recommend your medicine as long as I live. If any one doubts this, give my name and address.

Yours sincerely, MRS. MALVINA WILSON.

ST. VITUS'S DANCE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--My boy had been in bad health for a long time. We called our home doctor, but he got no better. Finally he had the St. Vitus's Dance, and our doctor did not know what to do. So I wrote to you and did as you told me: I got two bottles of your "Favorite Prescription," and one bottle and a half did the work all right. At that time, eighteen months ago, his weight was 85 pounds, now it is 135 to 140; he is fourteen years old.

Yours truly, JEREMIAH PONSLER, Zenas, Jennings County, Ind.

"FALLING OF WOMB."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I take great pleasure in recommending Doctor Pierce's Favorite Prescription for "Falling of the Womb." I was troubled with bearing down pains and pains in my back whenever I would be on my feet any length of time. I was recommended to try Dr. Pierce's Favorite Prescription, which I did with happy results. I feel like a new person after taking three bottles of it.

Respectfully, MRS. ALLEN SHARRARD, Hartney, Selkirk Co., Man.

UTERINE DISEASE, "CHANGE OF LIFE."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am happy to say that my health remains good since my sickness four years ago. I took several bottles of "Pellets," one of "Golden Medical Discovery," and two of "Favorite Prescription" and gained right along after I had been taking them. I am at a loss to give my sickness a name, as my physician called it a "Complication of Diseases," resulting from change of life and over-work. I take great pleasure in recommending your remedies to suffering women. May you live many years to administer to the suffering and afflicted is the wish of your sincere friend.

Yours, etc., MRS. J.T. FLETCHER, Pony, Madison Co., Montana.

MAKES CHILDBIRTH EASY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I never can thank you enough for what your treatment has done for me; I am stronger now than I have been for six years. When I began your treatment I was not able to do anything. I could not stand on my feet long enough to wash my dishes without suffering almost death; now I do all my housework, washing, cooking, sewing and everything for my family of eight.

Your "Favorite Prescription" is the best medicine to take before confinement that can be found; or at least it proved so with me. I never suffered as little with any of my children as I did with my last, and she is the healthiest we have. I recommend your medicines to all of my neighbors, and especially "Favorite Prescription" to all women who are suffering. Have induced several to try it, and it has proved good for them.

Very respectfully, MRS. DORA A. GUTHRIE, Oakley, Overton Co., Tenn.

SHORTENS LABOR.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I began taking your "Favorite Prescription" the first month of pregnancy, and have continued taking it since confinement. I did not experience the nausea or any of the ailments due to pregnancy, after I began taking your "Prescription." I was only in labor a short time, and the physician said I got along unusually well.

We think it saved me a great deal of suffering. I was troubled a great deal with leucorrhea also, and it has done a world of good for me.

Yours truly, MRS. W.C.BAKER, South Bend, Pacific Co., Wash.

"FEMALE WEAKNESS."

DR. B.V.PIERCE, Buffalo, N.Y.:

_Dear Sir_--My wife was hardly able to walk about the house when she began using Dr. Pierce's Favorite Prescription, and by the time she had used one bottle of it and one bottle of his "Pellets," she could walk a half a mile with more ease than she could walk across the house before she began to take it; she says she thinks it is just what all weakly women ought to have.

Yours truly, GEORGE W. SHEPHERD, Sigman, Putnam Co., W. Va.

"FEMALE WEAKNESS."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I began taking "Favorite Prescription" about a year ago. For years I have suffered with falling and ulceration of the womb, but to-day, I am enjoying perfect health.

I took four bottles of the "Prescription" and two of the "Golden Medical Discovery." Every lady suffering from female weakness should try the "Prescription" and "Golden Medical Discovery."

Yours respectfully, Mrs. F.L. INMAN, Manton, Wexford Co., Mich.

"FEMALE WEAKNESS".

"COULD SCARCELY DRAG AROUND."

DR. R.V.PIERCE: _Dear Sir_--Several years ago I took your "Favorite Prescription." At that time, I was so miserable (and had been so for many years) that I could scarcely drag myself around. Concluded to try your medicine. I took half a dozen bottles and I have not had a return of my old trouble.

Hoping others will be benefited as I have been, I remain,

Sincerely, MRS. C.H. BAKER, Freytown, Lackawanna Co., Pa.

OBSTINATE CHRONIC DISEASE CURED.

MINISTERS ENDORSE IT.

DR. R.V. PIERCE: _Dear Sir_--For some six or seven years my wife had been an invalid. Becoming convinced that it was her only hope, we bought six bottles of Dr. Pierce's Favorite Prescription and "Golden Medical Discovery." To the surprise of the community and the joy of myself and family, in one week my wife commenced to improve, and long before she had taken the last bottle she was able to do her own work (she had not been able to do it before for seven years), and when she had taken the last of the medicine she was soundly cured.

Yours truly, REV. T.H. STIMPSON, Donnoha, Forsyth Co., N.C.

NERVOUS DYSPEPSIA; UTERINE AND SPINAL WEAKNESS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I had nervous dyspepsia for twenty years, followed by uterine and spinal weakness with irritation of the same. In the Spring of 1890 I became so exhausted that I was compelled to keep to my bed with symptoms of paralysis in the lower limbs, and many other distressing symptoms. I accidentally obtained one of Dr. Pierce's Medical Advisers from a friend, and finding my ailments so well described therein, I wrote to Dr. Pierce for his advice, which he sent by return mail. For my recovery he requested me to use his "Golden Medical Discovery," his "Favorite Prescription," and his "Pleasant Pellets." He also gave me some directions for every-day living. These means accomplished my complete cure. I am thankful that we can have such reliable medicines brought into our homes without great expense.

Yours truly, MRS. AMERICA NAY, Volga, Jefferson Co., Ind.

THICK NECK (GOITRE),

NERVOUS DEBILITY AND WEAKNESS CURED.

MISS ELLA A. HOUGHTON, of _Theresa, Jefferson Co., N.Y._, was cured of Thick Neck, Nervous Prostration, Weakness and a complication of ailments by Dr. Pierce's "Discovery" and "Favorite Prescription." She says: "My health is now as good as it was before I was sick. The swelling (goitre) has all gone from my neck. I don't have any bad feelings. My gratitude for the benefit I have received from your treatment has induced me to recommend you to all whom I know to be sick." "I have known of two or three middle aged ladies residing near here, who have been cured by your 'Favorite Prescription.'"

SUPPRESSED MENSTRUATION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--It is almost two years ago that my little girl was taken with a spasm which frightened me so that my menses became suppressed. I suffered severely with pressure on the brain so that I often thought I should go insane. I also had severe pain in the ovaries, and bearing down pain. I consulted a physician, who treated me for awhile till I began to feel worse, and consulted another physician whom I knew had treated several women for like ailments. He gave me medicine which did me no more good than that prescribed by the first physician.

Finally, after an examination, the doctor said that he should have to operate on me in order to have my health restored.

As my husband and I had heard and read so much about Dr. Pierce's medicines we decided to try them. We had Dr. Pierce's Common Sense Medical Adviser. I took three or four bottles of Dr. Pierce's Favorite Prescription and one bottle of "Golden Medical Discovery" and one vial of "Pellets." After using these I felt perfectly cured. As I am always troubled more or less with biliousness, I keep your little "Pellets" on hand and find relief by using them. One of them taken after meals acts splendidly for indigestion.

Respectfully, MRS. B.H. KAMFERBECK, Holland, Ottawa County, Michigan.

THICK NECK (GOITRE).

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:

_Gentlemen_--I am willing and pleased to have you publish anything I have written in regard to the cure of my little son of Goitre (that a surgeon of N. Adams said could never be cured).

I do hope that by so doing some little one may escape the misery my little one suffered for over a year until I began the use of the "Golden Medical Discovery." I followed your directions found in the little book around the bottles. Before the first bottle was gone, he could eat and sleep without that coughing and choking that, before the use of the "Discovery," was impossible.

The tumor began to lessen in size, and after the third bottle I would never have known he ever had a tumor there. He is now hearty and healthy. Sleeps as good as any child and is full of life. He does not take anything to prevent a return, and has not for over a year.

I have one of your Common Sense Medical Advisers, and found it worth five times what I gave for it; I have helped others to get it and the "Medical Discovery" and "Favorite Prescription" have brought relief to many through me. I use the "Prescription" off and on; it has given me strength; I think I should have been an invalid long ago without it.

Every one here knows the truth of this letter, and I would tell it to the world if I could.

Respectfully, MRS. ANNIE SUMNER, Heartwellville, Bennington Co., Vt.

DROPSY, SICK HEADACHE, DYSPEPSIA AND BLOODY PILES.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--In the winter of 1881, I became irregular in my monthly courses. Of course at first I paid but little attention to it, hoping it would amount to nothing and probably wear away. But I slowly but surely grew worse, and at last resolved to apply to the doctors for help. My water came often, and in small quantities, and with great pain, and with red brick-dust deposit. I was attacked with severe womb trouble, bloody piles and dropsy of the ovary. I was treated by five different doctors. I was compelled to wear an inside support for a year, but it still seemed impossible for me to get well and I began to feel exceedingly alarmed and very uneasy, not knowing what course to pursue, or what the consequences might be. I had heard of Dr. Pierce, and concluded to make one more trial, so I sat down and wrote a letter to him, stating matters as near as I could, and in due time I received a favorable reply; then I commenced with his medicine. I commenced somewhere in February 1891 with the "Golden Medical Discovery" and "Favorite Prescription," in alternate doses. A strange occurrence followed. My limbs felt like what we call "asleep," and I felt as if I were in a strange land and wondered what was going to take place. I kept on till I took nine bottles. The first relief I felt was from sick headache, which I had been troubled with for many years; I was also cured of a very bad cough which I had been troubled with for many years, and of dyspepsia of long standing. I was entirely cured of a very singular and severe itching on my back, between my shoulders, which our doctors called winter itch and which they pronounced incurable. I had suffered with this for twenty years; it would come in the winter and go away in the summer. I was also cured of the worst form of bloody piles and of womb disease. At present I feel like a new person.

When I first commenced with Dr. Pierce's medicines, I could not walk half a mile without a pain. The other day I walked to Mercersburgh post-office, a distance of twelve miles, and the next day walked back again, and felt no bad results from the journey. I am now 51 years old.

Mrs. Knavel further writes, that "To any person desiring to know more concerning my case and its wonderful cure, and who will enclose to me a return self-addressed and stamped envelope for reply, I will be pleased to write further information."

Yours respectfully, SARAH A. KNAVEL, Indian Springs, Washington Co. Md.

WOMB DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I have been a sufferer from womb trouble for eight years, having doctored with the most skillful physicians, but finding only temporary relief from medicines prescribed by them. I was advised by a friend to take the "Favorite Prescription," which I did, and found, in taking six bottles of the "Prescription" and two of the "Discovery," that it has effected a positive cure, for which words cannot express my gratitude for the relief from the great suffering that I so long endured.

Respectfully, MRS. W.O. GUNEKEL, No. 1461 South 7th St., Terre Haute, Ind.

GENERAL DEBILITY. "FEMALE WEAKNESS."

DR. R.V. PIERCE, Buffalo, N.Y.: Hardy, Cascade Co., Mont.

_Dear Sir_--I have enjoyed pretty good health for the past three years. Before I took your "Golden Medical Discovery" and your "Favorite Prescription" I was so weak that I could hardly do my housework. I took seven bottles in all of the two medicines; they did me a world of good; I do not think I should have been here to-day were it not for your medicines.

I would send you my photograph, but I have none, and live sixty miles from a photographer.

Gratefully yours, Mr. Thomas Prewett

TUMOR OF BREAST AND WOMB DISEASE.

Mrs. Jane Golden, of Durand, Pepin Co., Wis., writes Dr. R.V. Pierce, Chief Consulting Physician, at the Invalids' Hotel and Surgical Institute at Buffalo, N.Y., as follows: "It is my heart's desire to write to you of what your medicines have done for me. I was in a very bad state when I wrote to you, and you prescribed for me and I took your medicines according to directions and am a well woman again. I had uterine disease and tumor in the breast. The doctors said they could do nothing for me any more and must resort to the knife. I would not consent and so wrote to you, and followed your advice. I took two dozen bottles of your 'Favorite Prescription,' seven bottles of your 'Golden Medical Discovery' and my health is now better than it had been in twenty years; my neighbors said I could not live three months, and I know that your treatment and medicine cured."

ULCERATION OF WOMB. IRREGULAR MENSTRUATION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Please accept my heartfelt thanks for your medicines, which I have every reason to believe have cured me. I was afflicted for more than five years with falling of the womb and ulceration of the same, connected with very painful and irregular menstruation with chills during the same. Rush of blood to the head, sometimes falling down in insensibility and remaining so for several hours; and part of the time could not bear my weight on my limbs to stand up or walk at all for several days at a time. I was a burden to myself when I commenced taking Dr. Pierce's Favorite Prescription and "Golden Medical Discovery," and his "Pleasant Pellets" and "Smart-weed;" I used the glycerine and iodine as you prescribed for me also. I think I used one dozen bottles of "Prescription," half a dozen "Discovery" one dozen "Pills," one-half dozen "Smart-weed," at first and some more afterwards, only a few bottles, I don't remember how many.

I am now well, doing my own work, and do not suffer any more pain, and don't need any more medicine.

Respectfully, MRS. MARY J. SPICER, Boulder, Boulder Co., Colo.

SAVE DOCTORS' BILLS.

DR. R.V. PIERCE, Buffalo, N.Y.: Arcadia, Manistee Co., Mich.

_Dear Sir_--We received your kind letter, with the "Pellets," and are very much obliged for the same. We know they are just what you recommend them to be. We have used your medicines for about seven years and have depended almost entirely on them for five years. Before we began the use of your medicines, we used to have to employ a doctor every little while; now we do not have to. We have four children. We give them Dr. Pierce's Golden Medical Discovery when they take cold and I think it is far better than most cough medicines, for the "Discovery" helps the appetite and the cough medicines make one sick. I like your idea of keeping the blood pure and the "Discovery" is the medicine for that. I take a bottle twice a year, in the spring and fall, and I have recommended it to several other ladies who have tried it and they all think highly of it. I have bought thirteen bottles of the "Discovery" and three bottles of Dr. Pierce's Favorite Prescription and nine bottles of the "Pellets" in five years, so you see our doctor-bill has not been very large. Our oldest boy hurt himself, lifting, and I depended upon Dr. Pierce's Compound Extract of Smart-weed for external application, and it cured him. I bought two bottles of that.

Yours truly, Mrs. S. Keillor

"FEMALE WEAKNESS."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I took your Dr. Pierce's Favorite Prescription when I was run-down and through the warm weather. It worked like a charm on my system and I am a good deal heavier in flesh now. It is the best medicine in the world for "female troubles," for I took almost all kinds of Patent Medicines, and doctors' prescriptions without benefit. There is hardly a day passes but that I recommend it to some of my lady friends.

Yours truly, Mrs. CORA CUMMINGS, No. 74 E. Yates St., Ithaca, N.Y.

CHILDBIRTH MADE EASY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Your medicines have my greatest praise as they did me a great deal of good. I was sick for nearly three years. Sometimes I thought I would go crazy I was so weak, nervous, and down hearted, and sour in spirits, that I was afraid I would die every day, and such mean feelings I could not describe to any one. I remained in this stage for nearly three years, doctoring with every home doctor and trying every medicine that I thought would help me, and I could get no relief. I could not sleep at times and had palpitation of the heart so that I would have to get up, for my heart would beat so fast I thought every minute I would die. The misery I went through no one could describe.

A lady friend handed me Dr. Pierce's Common Sense Medical Adviser, and I wrote to you about myself, and you told me to take "Favorite Prescription" and "Golden Medical Discovery." I commenced in the spring and took three bottles of each of your medicines, and I felt so much better I thought that was enough, and ever since I have had my health. I grew stronger, and could run and skip about like a child, and was happy all day long. I felt so well I could hardly believe it was myself. I just used the two kinds of medicines--"Golden Medical Discovery" and "Favorite Prescription," and followed the "Common Sense Medical Adviser," took regular baths, and dieted for about a year, and the result was a bright baby boy which brightens our home. I took the "Favorite Prescription" before, and the result was a few hours' labor and got along splendidly; my baby weighed twenty-four pounds at seven months--a brighter, healthier baby than he is there never was.

Respectfully yours, MRS. MINA JOHNSON, Riverside, Ravalli Co., Mont.

PARTIAL PARALYSIS FROM UTERINE DISEASE.

Buffalo, Larue County, Ky.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am still having very good health. I value Dr. Pierce's Golden Medical Discovery and his "Favorite Prescription" very highly and often recommend them to others. I do not think I would ever have got well if it had not been for your medicines. I was in a sad condition. My bowels and half of my body (the left side), was nearly paralyzed, besides nearly my whole system was out of order. I suffered all the time; but after taking six bottles of "Golden Medical Discovery" and the same of "Favorite Prescription," and using two bottles of Sage's Catarrh Remedy as an injection, I felt like a new person. I have never seen anyone suffering in the same way as I did. If anyone with female trouble of any kind will use your medicines I am satisfied they will help them.

Yours truly, Mary A. Sallee

IRREGULARITY AND UTERINE DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I cannot say enough for your Dr. Pierce's Favorite Prescription. For years I suffered from irregularity and uterine debility, but now I feel as well as I ever did in my life. Thanks to you for your "Favorite Prescription," for it has performed a permanent cure of me. With gratitude, I remain,

Yours, L.M. HENDERSON, Springfield, South Dakota.

WOMB DISEASE.

DR. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--I think your "Favorite Prescription" was the preservation of my life. I was under the doctor's care for three months with womb disease and a gradual wasting all the time. I was so weak that I could not be raised in bed when I commenced taking the "Prescription," and by the time I had taken three bottles I was up and going wherever I pleased, and have had good health and been very strong ever since. That was four years ago. I have recommended it to a good many of my friends, and they have taken it and are highly pleased.

Yours truly, G.A. SPRIGGS, Long Savannah, James Co.. Tenn.

ULCERATION OF WOMB.

St. John, Whitman Co., Wash.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--For three months I was almost prostrated with ulceration of the womb. I began the use of Dr. Pierce's Favorite Prescription and his "Golden Medical Discovery," and other remedies that are prescribed in his treatise on womb diseases. After three months' use of same I was cured. I have implicit faith in their medicines and can recommend them to others who are similarly afflicted.

Yours truly, Mrs. Geo. Thornton.

LESSENS MISERY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Dear Sirs_--I think Dr. Pierce's Favorite Prescription the best medicine in the world for females; I consider myself entirely well. I can do as much work as any woman. I gave birth to a healthy girl; your medicine is the best in the world for pregnant ladies--_it lessens the misery of that critical period_. I cannot praise it too much. I have gained ten pounds since I began using your valuable remedy.

Yours respectfully, MRS. MARY LINDSEY, Williams Station, Escambia Co., Ala.

OVARIAN DISEASE.

Bridgeport, Putnam Co., Fla.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I received the Common Sense Medical Adviser and I am well pleased with it. I return many thanks to you for your kindness. My complaint was pain in my back, and in my side, that moved from the right side to the left; shortness of breath and pain in the lower part of the stomach, and my doctor said I had ovaritis and I took two bottles of the "Favorite Prescription" and one bottle of the "Golden Medical Discovery," and I am relieved of all pains in the back and sides, and of womb complaint. I shall always speak good words for you. I suffered with those pains for five years.

Yours truly, Mrs Nancy Brooks

LEUCORRHEA.

Brooklyn, Jackson Co., Mich.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am more than willing to say your most valuable medicine has cured me of a very disagreeable complaint, leucorrhea. I suffered for years with pain in my back, never a night was I free. At your request I commenced a course of Dr. Pierce's Favorite Prescription and "Golden Medical Discovery." I could not sleep on a mattress; it seemed as though it would kill me. Since taking the medicine I can sleep anywhere; I am perfectly well. I would not be placed in my former condition for any money. I bought six bottles, or $5.00 worth. I took but four, my husband took the "Golden Medical Discovery." At this time I had a servant girl who suffered badly from pain at the time of her monthly periods; she took the other bottle of "Favorite Prescription," which was a great help to her.

Gratefully yours, Mrs. J.H. Parker

SEVERE FLOWING (MENORRHAGIA.)

Lewistown, Mifflin Co., Penn's.

_Gentlemen_--Seven years ago this month, I was taken sick--was bed-fast six months, and during that time, many times, was not able to eat alone. I had the best doctor that could be got. I would have sinking spells. My nerves were prostrated and I had female weakness and ulceration of the womb, which caused such excessive flowing that they thought I would die; then I would take sinking spells. My stomach was too weak, the medicine could not do its part as it should have done. I had torpid liver and right side of lungs affected; catarrh of the throat and piles; palpitation of the heart, and kidneys were somewhat affected. My doctor got me up and able to walk through the house, but the flowing would still be so bad that I would have to take the bed; then would be able to be up again and learn to walk a little again till the time would come again.

My doctor treated me for the ulcers. A lady came to see me. She told me to try Dr. Pierce's Favorite Prescription. I got it but did not tell my doctor. He soon remarked the improvement and I then told him what I was using; he told me to use it, that it would be good for me. I used eleven bottles of the "Favorite Prescription," and two of the "Golden Medical Discovery." The flowing was not so bad. I got so I could sit up and be about at all times, and walk about in the house. I am still improving, and can do light house work. I am able to walk out to church every Sunday.

Yours truly, Mrs Abner Knepp

"FEMALE WEAKNESS."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--A few years ago my health failed. I was troubled with female disease in its worst form having been afflicted about fifteen years. I was also troubled with constipation, loss of appetite, dizziness and ringing in my head, nervous prostration, hysteria, loss of memory, palpitation of the heart together with "that tired feeling" all the time. I consulted several physicians--no one could clearly diagnose my case and their medicine failed to give relief. After much persuasion I commenced taking Dr. Pierce's Favorite Prescription--have taken five bottles and am a well woman doing all my housework; from a run down condition I have been restored to health. I feel it my duty to recommend your "Favorite Prescription" for ladies afflicted with female diseases as I have been.

Gratefully yours, MRS. BYRON DANARD, Milford, Prince Edward Co., Ont., Canada.

INDIGESTION, IMPOVERISHED BLOOD.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--After suffering for over a year with indigestion and low condition of the blood I was advised to try Dr. Pierce's Favorite Prescription. I had hardly finished the first bottle when I felt a great change, so I continued on until I had taken three bottles, and at the end of that time I was completely cured. My health was so much impaired that I feel I owe a great deal to your wonderful medicine. Thanking you for the advice which you so kindly gave me while taking your medicine, I am,

Most gratefully. Miss CASSIE SAMPSON, No. 347 McHaren Street, Ottawa, Ottawa County, Ontario.

"FEMALE WEAKNESS."

DR. R.V. PIERCE, Buffalo, N.Y.: Nixon, Hardin Co., Tenn.

_Dear Sir_--I am in very good health now. I think your "Favorite Prescription" is wonderful. I brought forth a fine son the first day of December--the fattest baby I ever saw, and that is why I think your medicine is such a fine one for poor sickly females. I know I never would have become pregnant, if I had not got in better health. I feel it my duty to do all that I can to praise you and your wonderful "Favorite Prescription." I can highly recommend it to all females who are suffering with leucorrhea, for I don't think any one suffered any worse than I did when I made my case known to you. May God bless you, and your great medicine--the "Favorite Prescription."

Yours truly, _Sallie L. Howard_

ULCERATION AND FALLING OF WOMB.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I had been suffering from ulceration and abscess in the womb, and falling of the womb, for several years or since the birth of my youngest child. I consulted all the physicians around here and they gave me up and said there was no help for me.

At last, almost discouraged, I found in a little book your medicines advertised. I did not have any faith in them--I had tried so much and failed to get relief. But I began taking Dr. Pierce's Golden Medical Discovery and his "Favorite Prescription," and took five bottles of each, and used two bottles of your Sage's Catarrh Remedy for vaginal injections. It is three years since and I have not had any return of the trouble. I feel very grateful, and in fact, owe you my life, for I do not think I should have been alive now if I had not taken your remedies.

Respectfully, Mrs. ABRAM LYON, Lorraine, Jefferson County, N.Y.

BARRENNESS, DYSPEPSIA, "LIVER COMPLAINT."

Basin, Cassia Co., Idaho.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I first had dyspepsia and "liver complaint" for five years, and I took six bottles of Dr. Pierce's Golden Medical Discovery and his "Pleasant Pellets," which Entirely cured me of that complaint. I also had painful menstruation, and took about eight bottles of Dr. Pierce's Favorite Prescription and two bottles of his Compound Extract of Smart-weed, which cured me. The symptoms of this disease were very severe, pain in the region of the womb, back and thighs, Chilliness and nausea; this disease was so severe that I was barren for two years of married life, and after taking the "Favorite Prescription," I became the mother of a boy.

Yours respectfully, Mrs Emma Mcintosh

GENERAL DEBILITY, MALARIA, SICK HEADACHE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am happy to say that your valuable medicine has been a great benefit to me. I was suffering from general debility, malaria and nervous sick headaches, and after my third child was born (a beautiful baby boy of ten pounds) I only recovered after a long illness; I barely gained strength enough in two years' time so that I was able to crawl about to accomplish the little housework that I had, by lying down to read many times each day; had sick headaches very often; and many pains and aches, all the time complaining of getting no better. I finally asked my husband to get a bottle of Dr. Pierce's Favorite Prescription, which he promptly did. After I had taken one bottle I could see a great change in my strength, and fewer sick headaches.

I continued taking the medicine until I had taken eight bottles--seven of the "Favorite Prescription" and one of the "Golden Medical Discovery." For some time past I have not used it but I am now able to do the housework for myself, husband and two children (aged nine and five years). I also take in dressmaking, and enjoy walking a mile at a time, and I think it is all due to the medicine, for I know I was only failing fast before I commenced to take it. I take great pleasure in recommending the "Favorite Prescription" to all women who suffer from debility and sick headache.

Respectfully yours, MRS. J.H. LANSING, Fort Edward, Washington Co., N.Y.

OVARIAN PAINS.

Ligonier, Westmoreland Co., Pa.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--The doctors never gave any name for my disease except that one doctor said it was severe pain in the ovaries. His medicine did me no good; but whatever ailed me I was in such misery I could not describe what I suffered. The first thing that gave me any relief was Dr. Pierce's Favorite Prescription. The first half bottle made me feel much better. I used two or three bottles and thought I was cured, but it came back in three or four months, and as soon as I began to take the medicine again I got better. I took two or three bottles again, and never felt anything of it since; and that is nearly four years ago, and I give all thanks to Dr. Pierce's Favorite Prescription. I use no other medicine at all for stomach trouble but Dr. Pierce's Golden Medical Discovery. I have been troubled some with rheumatism, when nothing else would do any good, "Golden Medical Discovery" cured me; I had not taken more than one-half bottle when I felt like another woman, and I would advise any who has any trouble with his stomach, or who has rheumatism, to try it as there is not its equal to be found.

Yours truly, Mrs S.A. Beatty

"GIVES A NEW LEASE OF LIFE."

Jamestown, Chautauqua Co., N.Y.

DR. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--Both your communications have been received. I have neglected to answer them. I am glad to say in this letter that my sister is very much improved in health, and says she feels as if she had a new lease of life. She feels so much better since she commenced taking your medicine. I think it was just the medicine she needed, and am more than thankful to you for the kindly interest you have taken, and hope that others will find the same benefit from your valuable books and medicines, that my sister has. I will close with gratitude to you.

Yours respectfully, Miss MOLLIE M. CROWLEY, (for sister) care Sherman House, Jamestown, N.Y.

MOTHERS' RELIEF.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Doctor Pierce's Medicines have been our family medicines for twenty years. They are all they have been represented to be, and untold benefits have been derived from them.

Have been treated by you with your Special Remedies, and cured of difficulties that our family doctor failed to cure; and when ailing, by the use of a few bottles of "Golden Medical Discovery," have been always benefited.

I recommend Dr. Pierce's Favorite Prescription to every one who is having a family--taken as directed, it works like a charm in confinement.

Respectfully, MRS. A.D. SIMMONS, Emporia, Lyon Co., Kas.

"FALLING OF WOMB."

Clover Hill, Coahoma Co., Miss.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I cannot tell you how I have improved since I have used Dr. R.V. Pierce's Favorite Prescription and his "Golden Medical Discovery." I had been suffering for four years and I began to get worse and worse until I commenced using these medicines, and then I began to get better, and now I feel like a new woman.

I suffered much from "falling of the womb," and headache, and pains in my back, and I thank you kindly for the good your medicines done me. I can do my housework now and not feel bad from it. I hope others will find the same benefit from your valuable books and medicines that I have.

Gratefully yours, Eliza Allen.

"WOMAN'S ILLS."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--A few years ago I took Dr. Pierce's Favorite Prescription, which has been a great benefit to me. I am in excellent health now. I hope that every woman, who is troubled with "women's ills," will try the "Prescription" and be benefited as I have been.

Yours truly, MRS. W..R. BATES, Dilworth, Trumbull Co., Ohio.

AN OLD LADY'S TRIBUTE. BETTER THAN CALOMEL.

Clinton, Hinds Co., Miss.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--It gives me much pleasure to say that I have been greatly benefited by Dr. Pierce's Pleasant Pellets. They act on the stomach and liver, and clear the complexion better than calomel, and you are relieved of that awful sickness and constipation which other medicines produce.

Dr. Pierce's Golden Medical Discovery is the greatest tonic in the world, to build up the broken-down constitution. I am an elderly lady, sixty-six years old. I feel that my days are of short duration and would not give a word of recommendation if I did not feel it my duty to suffering humanity.

Yours truly, Mrs. N.A. Watts.

A YOUNG LADY'S ADVICE TO INVALIDS.

"A SURE AND CERTAIN CURE."

DR. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--Please accept my thanks for the good your medicines have done me. I truly believe the "Favorite Prescription" saved my life; it is a sure and certain cure. I am having perfect health; I am stout and can do all my housework.

Every invalid lady should take Dr. Pierce's Favorite Prescription and "Golden Medical Discovery."

Yours respectfully, ROZZIE FUGATE, Madisonville, Hopkins Co., Ky.

BETTER THAN "SUPPORTERS."

Leesville Cross Roads, Crawford Co., Ohio.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Four years ago, I became afflicted with womb trouble--knew nothing but pain and suffering. Began doctoring right away with our home doctor. He not doing me any good, I went to another doctor who advised me to wear an inside supporter, _which really did me more harm than good_. Last spring was taken down sick and laid on my back for ten weeks; when I heard of Dr. Pierce's wonderful Favorite Prescription. The first bottle helped me. I have now taken four bottles and feel perfectly cured. I cannot find language to express my gratitude for being restored to perfect health from a condition worse than death.

Yours truly, Mrs F. Holmes.

SUPPRESSED MENSTRUATION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--When I was fourteen years old I took a bad cold and there resulted internal troubles. I was a great sufferer for four years. I had tried two physicians but neither gave me any relief. After taking Dr. Pierce's Favorite Prescription I can't say enough for it. It cured me so I have no more pains. I am now nineteen years of age.

Respectfully, Miss MAMIE BURK, Everett, Bedford Co., Pa.

HOW TRAVELING INVALIDS MAY BE IMPOSED UPON.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--It is now about five years since I spent eight days at the Invalids' Hotel and Surgical Institute, under treatment for a chronic disease of eighteen years' standing. I had given up to die. Going to your Dispensary was a last resort with me; I had undergone a surgical operation at the hands of my family physician from which I grew worse every day for eight months, so that I very despondently started for your institution; and when I had traveled eleven hundred miles I was made more despondent by inquiring of a man how far I had to travel to reach Buffalo, N.Y.: He answered, "Just one hundred miles." I then inquired of him if he had ever been in Buffalo, N.Y. He replied, "Many a time." I then asked him, what about Dr. Pierce's world-famed Surgical Institute? "Oh, it's a humbug. They have some drawings or pictures taken from some government buildings, that's where they get that fine building you see pictured in their books and pamphlets."

I don't suppose there ever was a sadder heart entered the door of the Invalids' Hotel than that heart of mine; but it was soon made glad to be glad ever since. During the first night in the Invalids' Hotel I met and talked with patients afflicted as I was. Many of them were cured and talking of going home next day, and sure enough, they went; but I never missed them in number for others kept coming.

I can honestly and truthfully say that the World's Dispensary Medical Association of Buffalo, N.Y., is anything else than a humbug. The reason why they are not humbugs is plain. They continue to perform wonderful cures and treat their patients with unsurpassed nursing, and a kinder lot of physicians, surgeons and nurses I don't believe can be found in the world.

I cheerfully advise all persons suffering from chronic diseases not to stop to count the distance from where they live to Buffalo, N.Y., but go straight to the Invalids' Hotel and Surgical Institute without delay, for it is by the will of God and their skill that I am living to-day.

Yours truly, L.M. McPhail, Autun, Anderson County, S.C.

NERVOUSNESS, "FEMALE WEAKNESS," NASAL CATARRH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--My health was utterly gone. Was suffering from nervousness, female troubles and nasal catarrh; life was almost a burden to me, but a glorious change came, due solely to Dr. Pierce's Favorite Prescription and Dr. Sage's Catarrh Remedy. I have suffered more than tongue can ever tell. I have been treated by good physicians but they only help me temporarily. I have taken a great many patent medicines with the same result. In 1890, I began taking Dr. Pierce's Favorite Prescription and Dr. Sage's Catarrh Remedy, which gave me immediate relief and a permanent cure.

Respectfully, MRS. BELLE SANDERSON, Sprout, Nicholas Co., Ky.

MADE HER "STRONG AND WELL."

DR. R.V. PIERCE, Buffalo, N.Y.:

West Liberty, Ohio.

_Dear Sir_--I can cheerfully recommend your valuable medicine, the "Favorite Prescription," to suffering females. Three years ago my health became so poor that I was scarcely able to help with the household duties. I was persuaded to try your medicine, and purchased six bottles. That, with the local treatment you advised, made me strong and well. My sister has used it in the family with like results.

Yours truly, L.E. Johnson

MADE LIFE A BURDEN.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--For years I suffered monthly from periodic pains which at times were so acute as to render life a burden. I began using Dr. Pierce's Favorite Prescription. I used seven bottles in as many months and derived so much benefit from it and the home-treatment recommended in his Treatise on Diseases of Women, that I wish every women throughout our land, suffering in the same way, may be induced to give your medicines and treatment a fair trial.

Gratefully yours, Miss G.F. CRAWFORD, Limestone, Me.

"FEMALE WEAKNESS," LEUCORRHEA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I will write you a few lines to-day and feel thankful that I can say I enjoy good health most all the time. When I first commenced using your medicine I was suffering from female weakness, leucorrhea, bearing-down pains and a soreness across me that at times I could hardly stand up straight when I would get up off of my chair to walk across the room. I got a bottle of your "Favorite Prescription" and by the time I had used half of it, the soreness began to get better. I used three bottles altogether, and since that, you might say I am enjoying the best of health most of the time. I have had two baby boys since--both healthy, although the baby is only three weeks old, and I am doing all of my own work since he was two and one-half weeks old.

I always speak highly and recommend your medicine because I know it deserves a good name; and I feel certain it will cure female diseases if they give it a fair trial.

Yours respectfully, MRS. RICHARD REED, Springfield, Kings Co., N.B.

FEMALE IRREGULARITIES.

Cuscowilla, Mecklenburg Co., Va.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I take pleasure in adding my testimonial to the great list, and hope that it will be of interest to suffering humanity. I tried three doctors and none of them seemed to do me any good. When at last I almost despaired of health any more, I saw in a paper one of your advertisements, and I sent for and got two bottles of Dr. Pierce's Golden Medical Discovery, and I improved so rapidly that I sent for and got three bottles of your "Favorite Prescription," and now I am as well as I have been since I was a child.

I had been a sufferer for three years when I commenced taking Dr. Pierce's medicines. When I commenced taking it, I was not able to walk across my room without help, or rise from my chair. I suffered from nervousness very much, and with the least excitement I would faint; and I think, in short, I suffered with female irregularities and that your medicine has brought me through. I don't think I can say enough for it. I have used five bottles of your medicine in all.

If any one wishes to know what I have to say, they can address me in person, enclosing stamps. With respect, I am,

Yours, Sarah E. Ineker

"JUST A MERE SKELETON."

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--If I had not taken your medicine I would not be here now. The doctors did me no good, I was just a mere skeleton, could not eat. I would have awful pain in my stomach--pain in my side, bowels and chest; soreness in my back and womb; was weak, nervous and could not sleep.

After I took your "Favorite Proscription" and "Golden Medical Discovery," I commenced to improve. In two weeks could walk about the house--could eat--did not have any more pain in my stomach--threw away my morphine powders. When I first commenced taking the medicine it made me feel worse. I was hoarse, could not speak aloud for three days; as I got better my pains and bad feelings left me and I could sleep good; my nerves got better. Before I took your medicine I kept my bed four months--got worse all the while. I am now quite fleshy and can work all day.

Respectfully, MRS. WILLIAM ROBERTS, Bridgeport, N.Y.

CONSTANT SUFFERER FOR MANY YEARS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--For many years my wife has been a constant sufferer from indigestion, sick headache, nervous prostration and all other complaints that the female sex is heir to, and, after trying many remedies and doctors with but little or no relief, I persuaded her to try Dr. Pierce's Favorite Prescription and "Golden Medical Discovery." She was so out of heart, she returned the answer that it would be like all the rest--of no good; but on my account, she said she would try it, so I got one bottle each; and before she had used half of a bottle she felt that it was benefiting her, and she has continued to improve ever since, and now thinks it the most wonderful remedy on earth for her sex, and recommends it to all suffering females. She has not been so well in ten years.

I write this without any solicitation and with a free, good will, so that you may let all who may suffer know what it has done for her.

Yours truly, M.W. SCOTT, U.S. Marshall's Office, Atlanta, Ga.

A MOTHERS' FRIEND.

Tanks, Cottle Co., Texas.

DR. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--I took your "Favorite Prescription" previous to confinement and never did so well in my life. It is only two weeks since my confinement and I am able to do my work. I feel stronger than I ever did in six weeks before.

Yours truly, Corda Culpepper

BED FAST.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:

_Gentlemen_--For about two years I was a constant sufferer from diseases peculiar to my sex. I had to be carried from my bed, had horrible dreams, sinking sensations, was very nervous and had little or no appetite. In short, my whole body was racked with pain. I had frequent attacks of hysteria, and was completely discouraged, for I found no medicine did me any good. At last I determined to give your "Favorite Prescription" a trial. I had taken but two bottles before I felt so much better! I took eleven bottles. To-day I am well. I have never felt the least trace of my old complaint in the last six years. We use the "Golden Medical Discovery" whenever we need a blood-purifier. By its use, eruptions of all kinds vanish and the skin is rendered clear and soft, almost as an infants.

Respectfully, MRS. HARRY TAPPAN, Reynolds, Neb.

AT DEATH'S DOOR.

Abita Springs, La.

DR. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--My wife suffered from laceration of the womb and inflammation--she was completely bed-ridden and lingered about one year at death's door. Local applications were given her and Dr. Pierce's Favorite Prescription; she gradually regained strength and continued to do so until she recovered. I am convinced that any case of womb disease can be certainly and permanently cured by the use of your remedies.

M. Green Agt. Southern Exp. Co.

HEART, LIVER, AND STOMACH DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--About nine years ago my health began to fail; had a continual pain and aching under my right shoulder and in or under my right breast; I could not eat anything but a little milk or bread, and even that made my stomach pain and hurt me so I could not rest; I kept getting weaker all the time and I could no longer sit up; I sent for our family physician; he said I had dyspepsia and inflammation of the liver, and gave me medicine two or three months, but I kept getting weaker all the time; it seemed to me that I was diseased all over; thought I had heart disease; had the doctor examine my heart several times. I became so discouraged that I gave up all hope of ever getting well, but consented to send to Dr. Pierce for medicine. I commenced taking it and in a short time I was able to sit up; continued to take his medicine three months and felt like a new person--didn't need any more medicine and have not yet. I can eat anything I wish; am sixty-three years old; can walk a mile without any trouble, and I can truly say that I believe it was Dr. Pierce's medicines that saved my life.

Respectfully yours, MRS. VIRGINIA LANDRUM, Merino, Logan Co.. Col.

UTERINE DISEASE.

Creston, Iowa.

DR. R.V. PIERCE, Buffalo, N.Y.:

_Sir_--My wife improved in health gradually from the time she commenced taking "Favorite Prescription" until now. She has been doing her own housework for the past four months. When she began taking it, she was scarcely able to be on her feet, she suffered so from uterine debility. I can heartily recommend it for such cases.

Yours truly, H.H. Snyder

THE PICTURE OF HEALTH.

DR. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--My daughter, Miss MEEKER, was sick and we called in one of the best doctors here. She got so weak that I had to help her out of bed and draw her in a chair. She then tried some of Dr. Pierce's Favorite Prescription. In less than a week she was out of bed and has been working about five weeks now, and looks the picture of health. As for myself I am much better of my female complaint. Before taking the "Favorite Prescription," I suffered most of the time from catarrhal inflammation.

Yours respectfully, MRS. NANCY MEEKER, Dunraven, Delaware Co., N.Y.

LIFTED THE BURDEN.

Nye, Putnam Co., W. Va.

DR. R.V. PIERCE, Buffalo, N.Y.:

_Dear Sir_--Mine is a case of eleven years' standing, which baffled the skill of the best medical aid procurable. I obtained no good effect, until I began the use of the "Favorite Prescription," which lifted the burden which was seeking my life. My gratitude I owe to the "Prescription." I hope that all suffering humanity (as in my case) may profit by the result of my experience.

Yours truly, Evoline Neil

* * * * *

SPERMATORRHEA

(SEMINAL WEAKNESS),

or emission of semen without copulation, is generally induced by the early habit of masturbation. It is one of the evidences that passion, instead of prudence, has held sway. Passion may aptly be termed the voice of the body, by which, if we listen, we are enchanted and led astray. Conscience is the voice of the soul, which remonstrates, and if we obey, we shall be guided aright. We cannot reconcile these conflicting voices, and if we indulge the passions when conscience forbids gratification, the remembrance of the wrong remains forever, and constant fear is an everlasting punishment.

WRECKED MANHOOD. Man possesses few powers which are more highly prized than those of virility, which is the very essence of manhood. "He is but the counterfeit of a man, who hath not the life of a man."

THE SEMEN is a milky fluid of the consistency of mucus. It is secreted by the testicles and is intermixed with the fluids secreted by the prostate and by Cowper's glands. Its fertilizing property depends on the presence of minute bodies, termed _spermatozoa_. These consist of little polliwig-shaped bodies (Fig. 3), having large heads and long filaments or tails. Under the microscope these little bodies are seen to describe movements not unlike those of polliwigs.

WHY EMISSIONS OF THE VITAL FLUID DEBILITATE. The seminal fluid consists of the most vital elements in the human body. It not only assists in maintaining the life of the individual, but communicates the essential, transforming principle which generates another mortal having an imperishable existence. Its waste is a wanton expenditure, which robs the blood of its richness and exhausts the body of its animating powers. No wonder that its loss enfeebles the constitution, and results in impotency, premature decline, St. Vitus's dance, paralysis, epilepsy, consumption, softening of the brain, and insanity. No wonder that conscience and fear become tormenting inquisitors, and that the symptoms are changed into imaginary specters of stealthily approaching disease.

"There is no future pang Can deal that justice on the self-condemned He deals on his own soul."

THE PRACTICE OF ONANISM squanders the vitality and bankrupts the constitution. Indigestion, innutrition, emaciation, shortness of breath, palpitation, nervous debility, are all symptoms of this exhaustion. Subsequently, the yellow skin reveals the bones, the sunken eyes are surrounded by a leaden circle, the vivacious imagination becomes dull, the active mind grows insipid--in short, the spring, or vital force, having lost its tension, every function wanes in consequence. Excessive lustful enjoyment produces feebleness, and finally terminates in disease and impotency.

SEMINAL WEAKNESS may be the result of marital excesses. A _proper_ sexual gratification contributes to the health and happiness of both parties. On the other hand, intemperate indulgence not only prevents fruitfulness, but ultimately, if persisted in, renders the husband entirely impotent, and undermines and destroys the constitution of the wife. Spermatorrhea may be induced by spinal irritation, intestinal worms, or piles. It may also result from inherited, as well as acquired, constitutional weakness.

NOCTURNAL OR NIGHT EMISSIONS. Involuntary emissions of semen most frequently occur during amorous dreams at night, and are therefore termed _nocturnal emissions_. Although they are at first occasioned by lascivious dreams, attended by erections and pleasurable sensations, yet, as the disease progresses, the erections become less perfect and the losses are only revealed by the depression of spirits experienced the following morning, and by the stiffened and stained spots on the linen. At first, these emissions may occur but once in two or three weeks, unless the patient be excited by company, stimulation, food, drinks, or other causes; but, at a later stage of the disease, they sometimes take place every night. In aggravated cases, the seminal sacs are so weakened that the warmth of the bed, friction of the clothing, reading obscene literature, viewing indecent pictures, indulging in lewd conversation, or even being in the presence of women, produces a waste of semen--many times unattended by erections. When there is great weakness, seminal discharges may be induced by lifting heavy weights, pressure upon the genital organs, horseback riding, straining at stool, or even upon urinating, as observed when muscular efforts are made to expel the last drops, which appear thick and viscid. If the urine be allowed to stand for a few hours, the seminal discharge will be precipitated, and will form a light-colored deposit at the bottom of the vessel. If the sediment be examined with a microscope, spermatozoa can readily be detected in it.

WASTING AWAY OF THE TESTICLES. Masturbation not only occasions loss of semen, but frequently the testicles and other generative organs waste and become reduced in size as a result of the abuse. Fig. 1 shows the testicle in a healthy condition, while Fig. 2 represents one much reduced, as a result of self-abuse.

The celebrated Dr. Drewery, of London, speaking of the reason why masturbation is so extremely injurious in its effects upon both body and mind, says:

"This is a question which I have often been asked by patients, and it is one which is rather difficult to explain to any one not acquainted with the phenomena of reflex nervous action.

"Perhaps the simplest mode of putting it is to say that the effects produced by the excitement of the parts are not the direct result of the stimulation, but that the excitement of the extremities of the nerves is conveyed through them to the spinal cord and brain, and that the emission which occurs, when sufficient stimulus has been applied, is the result of nervous force reacting upon the parts from the spinal cord back again. This action is termed reflex, and is similar to that of vomiting, which is only produced through the medium of the great nervous centres; so that if the nervous communication between the stomach and spinal cord and brain is cut off, nothing in the stomach could possibly cause vomiting, whereas if the communication remains intact, this action can be immediately produced by irritation of nerves far away from the stomach, viz., by tickling the fauces, as every drunkard is well aware who has ever put his finger down his throat for the purpose of emptying his stomach of the contents which are poisoning him, but which without the additional stimulus he is unable to expel. It will be seen, therefore, from this that the act of emission is only produced through the agency of the spinal cord, and not by any direct nervous action between the parts which are stimulated, and those which are concerned in the emission.

"The brain is also concerned to the fullest extent in the production of these phenomena, as are all the senses of the body; this is proved by the fact that emissions occur during sleep, without any excitement beyond the engorgement of the parts with blood, produced by the cerebellar congestion of the brain, usually found to follow lying upon the back during sleep. This, however, is unnatural and unhealthy, and is usually the result, as before pointed out, of masturbation. But these two important points must be remembered--that emission may be produced by friction merely as a purely spinal reflex action, and it may be caused by the action of the brain without any friction whatever. Both these results are unhealthy and injurious. A true natural and healthy act of sexual intercourse demands the excitement of brain, spinal cord, and every nerve in the body simultaneously, and resembles the lightning flash which restores the equilibrium of electric force disturbed during a thunderstorm.

"It is useless to endeavor to describe the marvelous actions of nervous force, but from what has been said it is not difficult to comprehend that if a convulsive action is produced in any part of the body by the sole excitement of the spinal cord, when it is necessary for its healthy and natural production that the brain and senses generally should be equally excited, the balance of nerve power is destroyed, which fact alone is proved by the effects upon the nervous system always following masturbation, which is the irritation of the spinal cord without the assistance of the brain."

VARIOUS COMPLICATIONS are likely to arise in the progress of this malady.

STRICTURE of THE URETHRA, or water passage, is a very common complication and, even when quite slight, generally interferes very seriously with the cure of the spermatorrhea when overlooked by the attending physician, as is very commonly done, especially when the constriction of the water passage is only slight. Very often it occurs in our practice that on examining a case of this disease that has been the rounds of the doctors, we find a stricture, which had been entirely overlooked by other practitioners, being so slight as not to occasion serious obstruction to the flow of urine but yet sufficient to interfere very much with the cure of the spermatorrhea. The size of the urethra, or water passage, should bear an exact and proportionate relation to that of the penis, and when from any cause the urethra is contracted below this normal size, it should receive attention, as otherwise the stricture is likely to increase and the passage becomes so constricted as to produce serious disease of the bladder, and not fail to perpetuate spermatorrhea, when this disease exists.

HYDROCELE (_Dropsy of the Scrotum_) consists of an undue secretion of the fluid which moistens the _tunica vaginalis_, and may arise from an irritation of the testicle, produced by masturbation. This subject is fully considered in the Medical Adviser.

VARICOCELE is a dilatation of the veins of the spermatic cord and scrotum, and is frequently a result of masturbation. It is readily distinguished under the form of a soft, doughy, compressible, knotty, and unequal enlargement of the veins, and a tumid condition of the adjacent parts. One writer, speaking of the enlargement of the spermatic vessels, describes them as "feeling like a coiled up bundle of worms."

DISEASE OF THE PROSTATE GLAND is frequently caused by solitary indulgence. Venereal excesses produce congestion and the gland is overnourished. It becomes greatly enlarged, a condition called _hypertrophy_. This affection gives rise to a heavy feeling or pressure in the region below the bladder, and often interferes seriously with urination, and gives great pain and uneasiness, and often results in grave and dangerous complications.

PROSTATORRHEA consists of an unnatural flowing or wasting of the prostatic secretion, which may be known by its mucous-like appearance, and, when placed within the field of the microscope, by the absence of _spermatozoa_ or fecundating germs. It is often mistaken for spermatorrhea, or for gleet, by inexperienced and careless physicians. For a full consideration of diseases of the prostate gland, see Part IX of our Dime Series of pamphlets, which will be sent on receipt of ten cents in postage stamps.

Again, the habit of self-pollution weakens all the structures of the genital organs, and induces seminal waste, which may lead to a morbid diminution in the size of the prostate gland. This condition, which is exactly the opposite of the one above described, is _atrophy_. Any disease which renders the circulation in the prostate gland languid and feeble interferes with the nutrition of that organ and impairs its function.

IMPOTENCY (_Loss of Sexual Power_). Masturbation prevents the excitability of the nervous system and sexual organs and causes debility, which is indicated by the premature discharge of semen during sexual intercourse. These premature emissions indicate not only partial impotency, but also that the nerve-centres have become morbidly sensitive by the practice of solitary vice, or marital excesses. At length the powers of the erectile tissues are diminished, and there is weakness which prevents the act of copulation, or the erection may be slow and not last long enough, on account of a faulty functional condition of the spinal cord.

A PECULIAR FORM OF IMPOTENCY is associated with certain abnormal nutritive changes which give rise to a lymphatic or fat condition of the system. Not that the temperament in all these cases is originally lymphatic, but the system degenerates in consequence of nutritive perversion. With the loss of sexual ardor, there is also apathy of mind, loss of manliness, and the victim becomes cold, dispassionate, and treacherous, devoid of any admiration or love for the opposite sex. He acquires rotundity of person, the face is fat, smooth, often beardless, and the voice is feminine.

The victims of this disease represent two distinct classes, viz.: (1) those who are fearfully tormented by the consciousness that they are losing their virile powers, and become irritable, jealous and often desperate; and (2) those who are completely indifferent to this deprivation.

(1.) Patients of the former class are readily restored to health by proper treatment, for they are willing to make an effort for the recovery of their manly powers. There is not complete loss of sexual desire, yet their disappointment is so great that they may entertain suicidal thoughts. They are moody, fickle, discontented, excitable, and remarkably impulsive. With proper treatment, they regain tone of body, vigor of mind, an increase of sexual desire, and become more attentive to business affairs, and less indifferent to the gentler sex. With the restoration of the general health and the sexual functions, remarkable constitutional changes occur. It is often the case that their intimate friends hardly recognize them by looks or acts.

(2.) It is equally true that those who are wholly indifferent to the loss of virile power, uninterested in the evidences of their manhood, are sometimes incurable. In fact, it is useless to treat the latter class, because they will neither co-operate with the physician, nor persist in the treatment necessary to effect a radical and constitutional change.

Masturbation perverts and finally destroys the secretory functions of the testicles. It sometimes causes chronic inflammation, which may result in obliteration of the minute seminal canals, or obstruction of the conveying ducts. The sperm is imperfectly elaborated and totally unfit for procreative purposes. Sometimes the spermatozoa are entirely absent, and, when present, are very few in number, incomplete in structure, diseased, and deficient in power as well as in organization. Fig. 3 represents the spermatozoa in a healthy condition, and Fig. 4, when they are sickly, deficient and inanimate. The husband may appear to be healthy, and _his_ inability to procreate may be erroneously considered a defect in his wife.

SYMPTOMS OF SPERMATORRHEA. The indications of abuse of the sexual organs are loss of nervous energy, dullness of the mental faculties, and delight in obscene stories. The expression of the face becomes coarse, and the movements slow; the eye is sunken, the face bloated and pale, and the disposition is fretful and irritable; the appetite is capricious, the throat irritated, and the patient makes frequent attempts to clear it, in order to speak distinctly. There are pains in the chest, wakefulness, and during the night lascivious thoughts and desires. The relish for play or labor is gone, and a growing distaste for business is apparent; there is a determination of blood to the head, headache, noises and roaring sounds in the ears, the eyes may be blood-shot and watery, weak or painful, the patient imagines bright spots or flashes passing before them, and there may be partial blindness. There is increasing stolidity of expression, the eye is without sparkle, and the face becomes blotched and animal-like in its expression. The victim is careless of his personal appearance, not unscrupulously neat, and not unfrequently a rank odor exhales from the body.

There are troublesome sensations, as of itching and crawling, in and about the scrotum. Subsequently, there is obstinate constipation, and all the symptoms of dyspepsia follow. Gradually the pallor deepens, the patient becomes emaciated. There is a shortness of breath, palpitation after even moderate exercise, trembling of the knees, and eruptions on the skin. There may also be cough, hoarseness, stitch in the side, loss of voice. The sleep is not refreshing, the patient has frequent nightmare, or the dreams are lascivious, and the involuntary emissions of semen become more frequent. The weakness increasing, the sufferer experiences a weakness in his legs and staggers like a drunken man, his hands tremble and he stammers.

The victim is unable to concentrate his thoughts, cannot remember what he reads, and is mentally indolent. He begins to be suspicious of his friends, has less confidence in others, and desires to be alone, is despondent and has suicidal thoughts. He has pain in the back, does not like to walk, and is inclined to lie down. The semen is prematurely discharged upon attempting coition, and if there be offspring, it is apt to be feeble or subject to scrofula, consumption, or convulsions. The genital organs, especially the penis and testicles, diminish in size, as the disease progresses, lose their energy, and the glands of the penis become cold and flaccid. There is frequent desire to urinate, chronic irritation in the neck of the bladder, and pain in the spermatic cord and testicle, and sometimes in the end of the penis. The microscope shows that semen involuntarily discharged may be devoid of spermatozoa, or if present, they are defective, their heads being without tails. The urine is loaded with mucus or bears up a filmy, membranous, transparent matter, or it may be covered with a thin fluid having an oily appearance, but in rare cases is clear. Again, it may hold substances in solution, which are deposited in crystals or incrust the urine, or it may precipitate a material having the appearance of brick-dust, and sometimes semen tinged with blood. The dyspeptic symptoms when present are followed by diarrhea. The limbs are cramped and rigid, the feet bloated, and the patient becomes melancholy and relinquishes all hope of recovery. As the disease progresses, the patient lacks firmness and is absent-minded.

When the erections are imperfect and the semen is prematurely discharged, or when a lengthy coition is required before the sperm can be ejected, it is evident that the patient is rapidly becoming impotent; the virile powers are vanishing and manhood is surrendering sway to a merciless foe. We frequently witness this condition in men, even at the age of thirty-five, when the summit of vigor and strength should only have been reached. How often are we solicited to restore these lost hopes and powers! To what tales of ignorance and recklessness, or submission and remorse, do we repeatedly listen from these unfortunate sufferers! In patients of this class, sexual intercourse prevents spontaneous emissions, but it does not remove the functional and organic derangements of the nerve-centres; hence, at a time when the victims of this disease should be in the prime of life, they are impotent, and epilepsy, apoplexy, paralysis, softening of the brain, or insanity, frequently results.

EPILEPSY (OR FITS). This dread disease is one of the most common and serious complications of the more advanced stages of spermatorrhea. The injury done to the nerve-centres by the practice of masturbation is manifested in epileptic convulsions, more or less frequent. If proper treatment be early adopted, and faithfully pursued, the case is not yet hopeless; though, in the majority of cases, the patient never recovers after the disease assumes this phase.

PARALYSIS. Paralysis, or Palsy, when occurring as a complication of spermatorrhea, may be preceded by an attack of apoplexy, in which the patient loses consciousness, and lays in a condition of profound stupor for a time, and on recovery from his unconscious state, finds himself unable to use one or more of his limbs, or the disability and loss of power, which may also be accompanied by more or less loss of sensation, may come on gradually, without any premonition or marked manifestation of its approach. In either case, its appearance is to be regarded as a matter of serious importance. Paralysis, when occurring as a consequence of masturbation or sexual excesses, is usually difficult of cure; yet, now and then, cases are cured at our Institutions even after this grave malady has appeared as a complication.

SOFTENING OF THE BRAIN. This malady, although less common as a result of masturbation than the complications mentioned in the preceding paragraphs, is of sufficiently frequent occurrence to entitle it to a passing notice here. This condition usually results ultimately in complete dementia, or loss of reason. It is an incurable disease.

INSANITY. This deplorable malady is not a very uncommon result of masturbation and its various resultant morbid conditions, as the records of the many institutions for the unfortunate class of sufferers from this disease bear abundant witness. Sometimes it manifests itself in the milder forms of hallucination, or monomania, but in the majority of cases, the patient sinks into a despondent hypochondria, which is many times followed, sooner or later, by a raving mania.

In cases of monomania resulting from masturbation, the mental derangement is often so slight as to escape detection by the patient's friends, the peculiar freaks of disposition being regarded rather as eccentricities of character than as symptoms of serious disease. Fits of despondency are usually common with such sufferers. The mental derangement is not always accompanied or preceded by spermatorrhea or frequent seminal emissions, the injury done to the nervous system by the practice of self-abuse, or sexual excesses, being first noticeable in various phantasms or imaginings on the part of the patient. These are, in different cases, so various, both in character and degree, as not to admit of any classification, each case presenting phases peculiar to itself. In many cases, the patient imagines that his best friends are conspiring to injure him, or that some great calamity is about to befall him. In most cases there is danger of the patient's committing suicide, if not closely watched. Especially is this true of those who suffer from fits of hypochondria.

Except in its milder forms, insanity resulting from masturbation and sexual excesses, is rarely curable.

DON'T BE ALARMED. A nocturnal seminal emission now and then, or at long intervals is not, in and of itself, evidence of the existence of spermatorrhea or other serious disease. A full blooded, strong, passionate man, in vigorous health, and who has never abused himself, may now and then, at long intervals, if his sexual passions be not gratified naturally, or if he permit his mind to run much upon lascivious subjects, experience an emission while asleep and dreaming. As to whether such occurrences are evidence of disease or not, in any given case, depends upon their frequency, and as to whether they are the result of a weakness of the organs and are followed by more or less depression and debility, or are merely the overflow of a robust system, or the outburst of restrained, pent-up, and ungratified passions. In the latter case, and when only occurring at long intervals, the emissions are not followed by any perceptible enervating or weakening effects.

QUACKERY RAMPANT. This country is flooded with cheap circulars and pamphlets, circulated openly and broadcast, wherein ignorant, pretentious, blatant quacks endeavor to frighten young men who may never have practiced self-abuse, or been guilty of excesses in any way, and yet who experience, now and then at long intervals, nocturnal seminal emissions. In such cases, it is the duty of the conscientious, honest, and sympathetic practitioner of the healing art to give assurance, and not to unnecessarily alarm those who experience nothing inconsistent with a state of fairly good health. To frighten such young men into believing themselves diseased, when in reality they experience nothing but what may occasionally occur in the experiences of any robust, healthy man, is the most detestable, downright quackery.

TREATING THE WRONG DISEASE. Not only are many men subjected to useless treatment by general practitioners who overlook the real disease, caused by pernicious youthful habits pursued in solitude, or later excesses in venery, but the female sex are also quite as often subjected to treatment for diseases which do not exist, the real trouble being nervous debility and other weaknesses that have resulted from the youthful pernicious practices common to both sexes, or later excesses in marital pleasures.

MORAL CONSIDERATIONS. Masturbation is a habit which tyrannizes over the mind, perverts the imagination, and forces upon the victim venereal desires, even while he is forming the strongest resolutions to reform. It constrains into its service the higher faculties, such as friendship, confidence, love, reason, and imagination, to make its ideal graceful and beautiful.

SENSUAL LUST. The fancy creates an attractive partner, possessed of girlish beauty, a perfect type of goodness, blended with sexuality, and whom the subject worships with all the ardor of passion. Around this _beau ideal_ all his affections are clustered; to her the purest of his blood is offered in sacrifice, and it is no wonder that female associates seem tame and unattractive when such imaginary and consummate divinity is courted. In the sensual delirium is conceived an elysium of carnal bliss, where half-nude nymphs display their charms and invite to sensual enjoyments. Thus we see how this habit makes the spiritual faculties subservient to morbid passion, and by what means elevating influences are prostituted to vulgar and base-born creations.

SYMPTOMS VARY IN DIFFERENT CASES. We can only partially delineate the terrible effects resulting from the abuse of the sexual organs. The symptoms are multitudinous, but, as we have before stated, no two persons are similarly influenced by this disease. The symptoms will vary according to the severity of the affection, the age of the patient, and his constitutional peculiarities. The presence of only a few of the symptoms which we have enumerated is evidence of abnormal weakness, which demands treatment.

Montaigne says: "We must see and get acquainted with our sins if we expect to correct them." Virtue presupposes trials just as much as victory implies warfare. The triumph of virtue is to defeat morbid or excessive passion, for virtue is only realized when it is a conquering force. Innocence is passive but virtue is an active quality, purified in the fiery furnace of temptation. As men have in all ages been influenced by passions, so temptation has ever found its victims. It is an obligation that one owes to himself to overcome every evil passion or weakness to which he is subject, and the discharge of this personal duty requires moral courage.

THE REWARD OF VIRTUE. Our Saviour invited all erring mortals to enter upon a higher life when He said, "Come unto Me, all ye that labor and are heavy laden, and I will give you rest." The invitation is accompanied with a promise. To all who are weary of excess and bowed down by passion, rest and restoration are promised, if they will but reform and employ proper means to that end.

THE SUFFERERS MUST REFORM. Just as there is no spiritual restoration without obeying the Saviour, so there can be no physical restoration unless we fulfill nature's imposed conditions. There can be no salvation unless sin be discarded, and so there can be no redemption from the bad effects of a practice, so long as it is continued. It is no easy task to master a despotic passion. Appetite is often stronger than the will. The treatment must begin with moral reformation. Every manly impulse, and all the higher qualities of the patient's nature, must be enlisted in the struggle for virtue and health.

If the passions are restrained, then the capital of health increases, for the saving of the vital secretions is equal to compound interest. This illustrates the truth of the Latin proverb: "_No gain is so certain as that which proceeds from the economical use of what you have"!_ The patient actually acquires confidence and manly courage by the retention of the seminal fluid, which directly increases his virile powers.

HYGIENIC ADVICE TO PATIENTS. Daily physical exercise and regular habits must be established. It is important that the mind, as well as the physical powers, be directed into active and wholesome channels. There must be restraint and discipline. It is useless to begin medical treatment while the patient continues to read exciting, amorous stories and obscene books, which are suggestive of lewd thoughts. Something practical ought to occupy the thoughts and engage the hands.

Regular and vigorous physical exercise is necessary to assist the circulation of the blood, and compel its determination into the minute and extreme parts of the vascular system. When the blood is thus directed, nutrition is more vigorous and the activity of all the functions is augmented.

Not only should there be regularity in eating, but sound discretion should be exercised in selecting a plain, wholesome diet, consisting of such articles of food as best favor a daily and free evacuation of the bowels. Avoid the use of those articles of food which produce excessive acidity of the stomach. Hearty or late suppers are not allowable. The patient should use no alcoholic beverages, and should abstain from such stimulants as tea, coffee, beer, wine, and tobacco. We cannot even recommend their _moderate_ use, for total abstinence is the better plan.

The patient should sleep in a well-ventilated room, on a hard bed, and have only sufficient covering for warmth and comfort. He should not lie upon the back, because in this position nightly emissions are more likely to occur. The patient should go to bed when he feels sleepy, and not resist the inclination until wakefulness is induced.

He should rise early in the morning and immediately take a cold hand bath. For this purpose a quart or two of water and a common hand towel only are required. After bathing, rub the surface of the body with the dry hand or a crash towel, and continue the friction until the skin is red and a reaction is established. Do not excuse yourself from following these hygienic suggestions. A refreshing bath changes the morbid sensibilities to a more healthful state by the reaction of the nervous system.

It is beneficial to apply a towel saturated with cold water to the genital organs fifteen minutes before leaving the bed. Douching, or showering the genital organs with cold water once or twice a day will also be beneficial. It should not be practiced, however, just before going to bed. It is well to bathe the head with cold water, and this can be done much better if the hair be kept closely cut.

Horseback riding, climbing, and all exercises which rub, chafe, or excite the genital organs, should be avoided. Even the clothing should be loose, so that walking will not produce friction or cause any excitement of these organs. The calls of nature should receive prompt attention, and the urine be voided at any time (especially during the night) when there is an inclination. If there be irritation of the bladder and lower bowels, the patient will receive decided benefit from the daily use of an injection of cold water into the bowels. From a half pint to a pint of cold water may be used at one time, and the injection should be retained for a few minutes before going to bed. The bowels will thus be relieved, the heat and irritation subdued, and the liability to seminal emissions lessened.

Patients afflicted with spermatorrhea should not allow their thoughts to dwell upon their ailments, for they are apt to become moody, self-deceived, and even insane upon this subject. To avoid this, harmless amusements should be indulged in, and good moral company cultivated. They become suspicious, skeptical, and believe that they are victims of imposture. When they lose self-reliance, their faith and trust in others begins to waver, especially if their health does not improve so rapidly as they had anticipated: As much depends upon the faithful observance of the hygienic rules as upon the constant and proper use of medicines. The rapidity of recovery depends upon the constitutional energies and the vigor of the vital resources. If the blood be greatly impoverished, or the nervous system much impaired, recovery will be necessarily slow. Time, patience, and perseverance, are just as essential to a recovery from the effects of these abuses as the best medical treatment that can be employed.

THE MEDICAL TREATMENT OF SPERMATORRHEA AND IMPOTENCY. Few diseases require so many modifications of treatment, to suit the peculiarities of individual cases as spermatorrhea, because it is attended with so many complications and morbid functional and structural changes. Every complication must be considered, and great judgment exercised in the selection of remedies. As this selection must depend upon the peculiarities of the case involved, it is impossible to impart to the non-professional readers sufficient medical knowledge to enable them to choose the appropriate remedies for these intricate disorders. Hence it would be useless to specify the various medicines which our specialists employ in treating them. It would only lead to many fruitless experiments, which might result in great harm to the afflicted. For remedies powerful enough to effect cures of spermatorrhea and impotency are capable, when improperly employed, of doing great harm. Especially should all ready-made, proprietary or put-up medicines, such as are sold in drug stores and chemists' shops, be avoided, for reasons already mentioned. Great harm, also, often results from the employment of "galvanic belts," "galvanic batteries and pads," and other catch-penny devices, with which the too confiding are not only duped and swindled, but terribly injured. They are all worse than useless, and often render the mildest case very difficult to cure by inducing serious complications. It is better to take no medical treatment, but rely solely on the hygienic advice we have given, rather than to resort to any of the so-called "_specifics"_ found in the drug shops, or to any such silly, good-for-nothing trash as the various "Pastilles," "Boluses," "Curative Rings," "Voltaic Belts," or other quackish medicines and contrivances.

IMPORTANCE OF HYGIENIC DISCIPLINE. The invalid should restrict his attention to hygiene, and learn that patient endurance and heroic perseverance are necessary, even when taking the most efficient remedies. His entire system having gradually become deranged, corrective medicines must necessarily be _chronic_ in their operations; in other words, they must act insensibly, slowly, and progressively. Some of the symptoms of sexual weakness will, under proper hygienic and medical treatment, generally begin to disappear within a month. If the nervous system be very much impaired, however, a longer time will elapse before the restorative effects of treatment will be observed. Neither the physician nor the patient should expect that a broken-down constitution can be immediately repaired. The day of miracles is past. The most rational method of treating the sick promises nothing supernatural, nothing which is not in accordance with science. Diseases of this character are always slow in their inception, or development and progress, and must be cured in like manner, step by step. Nature never hurries; atom by atom, little by little, she achieves her work.

OUR IMPROVED TREATMENT. Tears ago our specialists resolved to pay particular attention to the investigation and treatment of these diseases, which are not only alarmingly prevalent, but sadly neglected and mistreated by the general practitioner of medicine.

UNFAILING REMEDIES. Having successfully treated many thousands of cases, we can safely say of our remedies that they are very positive in their remedial effects. The great success which has attended the employment of these remedies has led us to rely upon them with implicit faith. By their persistent use, spermatorrhea and threatened impotency can be cured as readily as other chronic or lingering diseases. We particularly solicit those cases which have heretofore been regarded as incurable. The patient is subjected to no surgical operation, and he can safely and accurately follow the directions given, while the treatment does not interfere with any ordinary occupation in which he may be engaged. These delicate diseases should not be intrusted to physicians who advertise under fictitious names, or to those of ordinary qualifications. The general practitioner may be thoroughly read in these diseases, but he cannot acquire the skill of a specialist who annually treats thousands of cases, while the former seldom, if ever, has occasion to prescribe for them.

SIGNS OF IMPROVEMENT WHEN UNDER TREATMENT. Under our peculiar and improved system of treatment, gradual improvement in the patient's condition will be manifested. The eye becomes more brilliant and sparkling, the patient is less morose, his digestion improves, he is less listless and despondent, takes more interest in business and other affairs, his sleep is less disturbed and more refreshing, the strength improves, and, if the sexual organs had become wasted in size, weak in function, and flaccid and soft, they begin, by and by, to have more tone and firmness, and to develope and increase in size, as their nutrition is restored, by the checking of the exhausting drain which they have sustained. If nocturnal emissions occur occasionally, the discharge will, under the microscope, be found to be less watery, and to contain increased numbers of _spermatozoa_, with heads and filaments perfect. The patient now begins to gain in self-confidence, courage, and other manly attributes, and, instead of the bashful, retiring, nervous, languid hypochondriac, we see a man of ambition and energy, competent to battle with the adversities of life. Who can estimate the value of such a transformation from nervousness and despondency to vigorous manhood? Who would begrudge all their earthly goods and treasures when thus afflicted, to be so restored to health and enjoyment for of what avail are the greatest riches when health and manhood itself are lost?

OUR TERMS BUSINESS-LIKE AND FAIR. Occasionally persona solicit us to undertake the cure of these ailments, and, in case of failure, receive no compensation. They write: "If you will _warrant_ that your prescriptions will result in a _perfect restoration to health_, we will gladly pay the fees that you ask." The absurdity of such a request is apparent, and therefore we answer: "We cannot _warrant_ that you will live even for the next twenty-four hours. We do not bet, play for stakes, or wager our skill for money. Personal responsibility cannot be shifted or evaded, and life and health, with all their momentous considerations, are necessarily individual affairs. Therefore a proposal to make the conditions of health a subject of speculation is a challenge to gamble." The patient may not comply with the specified conditions, and the physician's success depends upon a faithful application of the prescribed treatment. For these reasons only a quack will be a party to any such transaction. Ours is not a trading, hazardously speculative profession. Besides, thousands of our patients reside long distances away and we cannot know of their responsibility or honesty, nor spend time inquiring after their financial standing.

EVIDENCES OF THE CURABILITY OF SPERMATORRHEA AND IMPOTENCY. Many individuals afflicted with spermatorrhea and impotency, particularly those who have been swindled by some of the many charlatans who are to be found in nearly every city, are incredulous, and doubt our ability to cure these maladies. Others are skeptical, because their physician, who may be a very skillful general practitioner, but who has had very little or no experience in treating these delicate maladies, has failed to relieve them, and, perhaps, has told them the disease is incurable.

We therefore beg the indulgence of our readers for here offering some indisputable evidence of the extraordinary success which we have achieved, by our peculiar methods of treating these affections, as pursued at the World's Dispensary and Invalids' Hotel and Surgical Institute.

This evidence is introduced for the encouragement of an unfortunate class of invalids, for many of whom existence has ceased to possess any charms. The grateful manifestations which we have received from this class of sufferers have afforded us one of the greatest pleasures of our lives, and have alone been a rich remuneration for the diligent study and arduous labors devoted to the investigation of these diseases and to the perfecting of our peculiar and successful methods of treating them.

SACREDLY CONFIDENTIAL. In introducing the following extracts from our extensive files of letters, the names of the writers will be omitted, as we regard all such correspondence, as well as facts communicated to us in personal consultations, as _sacredly confidential._

Lack of space and fear of wearying the reader, prevent us from introducing more than a few extracts; but these are only fair samples of _thousands_ that have been received. Those given, present cases in almost every stage of treatment, some soon after commencing, others further advanced, and still others which are cured. If we could devote the space, and had we time to select them, we could insert an almost unlimited number of those received from patients who have been perfectly cured; but we think the reader will be more interested in expressions coming from patients in all stages of treatment, as they are daily received. Therefore, without regard for literary excellence, we append a number chosen miscellaneously, and given _verbatim_. They express the sentiments of persons in all stages of life, and illustrate the views and feelings generally entertained by those whom we have been called upon to treat.

The following extracts are spontaneous acknowledgments, and are, therefore, more valuable and truthful than if obtained by solicitation, a practice contrary to our sense of propriety, and, hence, one in which we never indulge. Although ofttimes less expressive of satisfaction and gratitude than if the communication were presented in full, yet only sufficient space can be spared for a brief quotation from each letter.

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TESTIMONIALS

CASE 175,827. IMPOTENCY, CONSTIPATION, AND SEMINAL LOSS AT STOOL AND WITH THE URINE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--Since I have taken the remainder of a third month's treatment that you gave me I have been relieved of my trouble. The emissions have ceased and the losses at stool and in the water have left me. Eighteen months ago I was almost a complete wreck; now I take an Interest in business and am in excellent health.

Respectfully, S., Waveland, Ind.

CASE 177,068. SPERMATORRHEA. LOSS OF VITAL STRENGTH. CARED WITH SEVEN MONTHS' TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--You have undoubtedly wondered at my long silence. Since last I wrote you there has been a marked change in my life (of which I will speak further on), under your skillful treatment. I improved so rapidly, notwithstanding the many interruptions which misfortune on my part occasioned, that six months ago I considered myself cured. I have been married three months and a half to a worthy woman, who should have gained for herself a husband who never deviated from a virtuous path as much as I; but the attachment formed was so strong that no misfortune seemed powerful enough to sever it. The barrier which seemed insurmountable, and which I had erected myself by early indiscretions and excesses, has given way, thanks to your superior medical knowledge and skillful treatment. Again I can hold up my head and say, "I am a man. I never fail to call the attention of my friends to your Institution as the best in the world, for I have reason to know that it is truly so. I have recommended two friends of mine to you, who are under your treatment, and are getting well. One has tried all the local physicians, and many firms, but with no success. May God bless you, and may your Institution meet with all the success it so richly deserves, is the prayer and wish of one you have caved. J., Leadville, Colo.

CASE 178,666. EMISSIONS, AND LOSS OF WEIGHT AND STRENGTH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have had no emissions now for some time, and feel well in every way. I am gaining in strength and weight, and find I shall not need further medical treatment. The four months' medicines that you have sent me have effected a radical regeneration in my health, and I thank you for it. M., Hartford, Conn.

CASE 111,477. SPERMATORRHEA AND IRRITABLE BLADDER; CURED BY TWO MONTHS' TREATMENT.

This was a badly complicated case of spermatorrhea, the patient being also troubled with frequent urination, partial impotency, mucous discharges from the urethra, and a burning sensation in the testicle and groin.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I took the two months' treatment sent me by you as directed. After taking the first month's treatment the emissions ceased entirely, my appetite increased, and I slept much better. Eight months ago I finished the second month's treatment and have since been in perfect health. I am fully convinced that you do every thing that you promise. I am, gentlemen, yours respectfully,

R., Fort Totten, Dakota.

CASE 266,080. SPERMATORRHEA. THREATENED IMPOTENCY. A SEVERE CASE, CURED BY SIX MONTHS' TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have received the last medicine sent me, and have taken all with the best results. I have so improved in health that I think it unnecessary for me to take any more medicine. It is now several days since I took the last of the medicine, and have not had any return of the disease. The desire to masturbate seems to have left me, and I feel well, happy and strong. When I look back to the time before I commenced to take your medicine, the change that has taken place seems wonderful. I had lost all hope of being restored from the ruinous habit I had practiced for many years without knowing how fatal it was to health. I tried hard to stop the practice, but it had grown so strong on me that I would always practice it again, and was fast becoming impotent. Had emissions at night; was nervous, downhearted; and I lost flesh, and felt miserable in many ways too numerous to mention. But now I feel healthy and well. If I had been more careful, and had not stopped treatment so soon before, I might have been cured in four or five months. Nevertheless, I am well satisfied, and thankful that I am restored to health in six months; and I wish to express my sincere thanks to you and your Institution, for I owe my restoration to health and happiness to you. If in the future I need any medical skill, I shall always apply to your Institution, being certain of receiving the best attention. Yours thankfully, S., Pittsburgh, Pa.

CASE 62,365. VERY BAD CASE OF SPERMATORRHEA AND IMPOTENCY. CURED WITH SIX MONTHS' TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--It has now been nine months since I stopped your treatment, and as there has been no return of former symptoms, I judge there can be no doubt as to my cure being permanent. I must confess that, having been duped and swindled by so many previous to visiting you, I had not much confidence when I went to Buffalo to see you. But your specialists, and your Manager, seemed to talk so straightforwardly and without making any of those extravagant promises that I have become so used to, that I became convinced of your skill before I had been long in your wonderful Institution. I think almost any invalid who will visit your Hotel, and see for themselves the wonderful appliances that you have accumulated for the cure of disease, must soon become convinced that if there can be any hope of relief it can be secured there, if anywhere. There I saw those who told me they had been brought there on beds or couches for hundreds of miles, and that they had not been able to walk for two to four years, and yet with two or three months' treatment were able to go about everywhere, and were about ready to return home. Such experiences as these established my confidence, and to-day I bless the day I first visited the Invalids' Hotel. True, it took six months to cure me, but I presume you seldom have cases to equal in severity the condition I was in when I applied to you. I was so bad, as you will remember, though I do not suppose you rely upon any thing but your records in referring to cases, having so many under treatment at all times, at all events, if you will turn to the record of my case, which is "File No. 62,365," you will see that I had discharges of semen every time my bowels moved and without erections. In fact, I was completely impotent. I am now as strong and vigorous as any man. You told me it would probably take a year to cure me, but as you accomplished it in five months, though I continued to take medicine a month longer to insure against a relapse, I think myself very fortunate. Should any of your staff have occasion to come this way, I should be only to glad to do any thing I can to entertain them.

Gratefully yours, C., St. Louis, Mo.

CASE 183,998. GENERAL DEBILITY. EMISSIONS AND LOSS OF ENERGY. URINARY IRRITATION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--The reason for my not continuing treatment further than the fourth month, is the fact that my health is so much improved that I do not need it. I feel like a new being. All of my bad symptoms are gone, and I feel that I am cured. For eight months my health has continued to improve all the time. I owe you and your staff a debt of gratitude that I can never pay.

Yours with thanks, H., Johnson's Bayou, La.

CASE 152,504. SPERMATORRHEA.

Mr. S., of Bagwell, Texas, writes as follows: "language fails to express my gratitude for what your treatment has done for me. I have gained forty-two pounds since coming under your care. My cure is perfect."

CASE 174,628. SPERMATORRHEA. EXTREMELY BAD CASE. LOSS OF VOICE; THREATENED WITH CONSUMPTION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am thankful to say that as a result of eight months' treatment you have given me, the symptoms of my disease have been entirely removed. My voice has got strong and clear, and my breathing is easy and natural. My weight is increased, and in every way I am feeling well. I cannot refrain from penning a few lines.

H., Port Hope, Ont.

CASE 113,274. SPERMATORRHEA.

Mr. K., of Kalamazoo, Mich., writes: "I feel that you have proven to be the best friend I have on earth. It is about three weeks now since I finished the last month's medicines, and I feel as strong as I ever did in my life. When I commenced taking your medicines I only weighed 155 pounds, but now I weigh 170 pounds. I feel strong and rugged; my step is firm and bold; and I feel altogether a new man, for which I return you my sincere thanks."

CASE 173,399. EMISSIONS. LOSS OF WEIGHT AND APPETITE; DYSPEPSIA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--I write to let you know that my health is improved, and to thank you for the same. The emissions occur only at intervals of several months, and I do not have any more polluting dreams. I am better in every way. My appetite is improved, and my digestion is perfect. Have gained in weight, and sleep well. I have not required all of the last supply of medicine, the sixth month, and I think I will pull through all right. Please accept my thanks for the benefit effected.

D., Valparaiso, Ind.

CASE 45,757. SPERMATORRHEA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--Received yours dated Oct. 27th, and am happy to say that I have so far recovered as to believe further treatment unnecessary. I feel like a new man; am able to do a full day's work without pain or laziness. I am very thankful for the benefits I have received through your skill, and should I think it necessary at any time for me to renew the treatment, I will be glad to call on you.

Yours with great respect. A., Zanesville, O.

CASE 175,315. SPERMATORRHEA; DIZZINESS AND BILIOUSNESS; DYSPEPSIA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am in good health, and can say that I am cured. The emissions have stopped, and I have no unnatural discharges, nor dizziness in the head. My health is good in general, and I work hard every day. Physically, I have a good appetite and digestion, which is a great change from what it was when you first treated me. Although I continued the treatment for eight months, owing to the complications and severity of my case, yet I am thankful for the great relief.

D., Newport, Ark.

CASE 39,625. SEMINAL AND NERVOUS DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--My case was one of long standing, and had brought me to think and meditate more of dying a consumptive's death, than living. The ill success I had met in trying to recover my lost manhood, had put me in such a constantly low-spirited condition, that nothing was interesting or pleasurable. I am highly pleased to report the improvement in my condition. My voice, weak and hoarse when I commenced treatment, is now strong and masculine. Hope and self-confidence have returned, and my countenance is firm and resolute. The dull, heavy, pressing pain under my left shoulder, is entirely gone, long ago. The pain and weakness in hips, back, and side, are never felt. I am in every way fully restored to perfect health and manhood.

Yours sincerely, O. Sheboygan, Mich.

CASE 67,546. SPERMATORRHEA. CURED IN FOUR MONTHS.

[EXTRACT FROM LETTER.]

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--It is with great pleasure that I write you. I have taken but one month's treatment from you, and if I should just give you a full history of my case before and since I have taken your medicine, you would not believe the improvement could be true. I feel better every way. I am without language to express my thanks to you for the great work you have done for me.

Your ever true friend, B., Blountville, Sullivan Co., Tenn.

CASE 22,511. IMPOTENCY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--Accept my thanks for the great benefit received from your treatment. I never thought I could be so fully restored.

G., Peru, Ind.

CASE 450,422. SPERMATORRHEA, SEMINAL DEBILITY, MUSCULAR RHEUMATISM. CURED WITH SIX MONTHS' TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am thankful to say that, as the result of the six months' treatment you have given me, that I am cured of my trouble. Since the beginning of the treatment the losses became less and less frequent, and now I am entirely relieved, and desire to return my sincerest thanks to you for the good you have done and the kind attention that you gave me.

Sincerely yours, G., Milverton, Ont.

CASE 48,927. NERVOUS DEBILITY AND IMPOTENCY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--My head is clear and I feel like myself again, and now only wish that the money I spent for useless medicines and experimenting doctors, had at once found its way to you. By recommending you to others suffering as I did, I hope to assist in your honorable work. For my restoration to health and manhood, I am deeply grateful.

Truly yours, B., Philadelphia, Pa.

CASE 154,136. SEMINAL WEAKNESS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I see no further use in continuing your medicines, as I now feel perfectly well and the emissions have stopped entirely. I used to feel dizzy, exhausted, and irritable on arising in the morning, but now I feel nothing of the kind.

Respectfully, K., Johnstown, Pa.

CASE 175,391. SPERMATORRHEA, WITH SYMPTOMS OF BRIGHT'S DISEASE AND TORPID LIVER.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--When I applied to you for treatment, although a man of apparently perfect health, yet I was subject to an exhausting drain, and felt myself gradually declining in vigor of intellect and constitution. The five months' treatment that you have sent me has effected a very remarkable change in my health. My kidneys (which had troubled me so that I feared Bright's disease) and torpid liver have become natural, and I feel like a new man. The only precaution I now take is not to sleep on my back; and I feel that I am cured. I send you the names of some other patients, and close by saying that I thank you sincerely for the cure, and the great benefit in my health that has resulted from your treatment.

M., Manhattan, Kans.

CASE 110,837, STRICTURE AND SPERMATORRHEA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--My seminal trouble was cured long since, and I had forgotten it. Your medicines relieved me of that in a short time, and I am satisfied that it will cure the worst cases in a few weeks. I am also satisfied that you and your faculty accomplish more in the healing art than any other in the country, and I cannot say too much in recommendation of your institution. I have tried your institution, and have found your words true in every sense, and take pleasure in authorizing you to use my name in any way to suit yourself. My appetite is good, and I have no pain or trouble whatever. The neuralgia in the lungs, the tough phlegm, weakness, etc., have all disappeared.

A.

CASE 111,571. SPERMATORRHEA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Under the influence of your last course of medicine my health has improved so greatly that I feel any further treatment to be unnecessary. My health is better now than at any other period for years. The night emissions have ceased entirely, I not having had one now for many months. I feel better in every way.

Respectfully, P. Pittsburgh, Pa.

CASE 57,757. LOST SEXUAL POWER REGAINED.

[EXTRACT FROM LETTER.]

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--While taking your medicine I labored physically. I am cheerful, hopeful, joyous, glad, and grateful for my restoration to sound and vigorous health. My friends daily express surprise at the great change in my personal appearance, and declare that I appear younger than I did fifteen years ago. I always reply that I obtained my new lease of life from the World's Dispensary Medical Association, Buffalo, N.Y.

With sincere gratitude and great respect, I subscribe myself W., Canyon City, Grant Co., Oregon.

CASE 3,508. SEMINAL AND NERVOUS DEBILITY OF THIRTY YEARS' STANDING. CURED IN TWO MOUTHS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _My kind Benefactors_--Inclosed find the case of my daughter-in-law, whom I desire you to treat, believing that you can cure her. I feel assured that if you fail in the cure of her case, now so chronic, that no human skill will be of benefit.

Some four or five years ago you treated me for general debility and premature decay, with severe attacks of vertigo. The first month's medicines, which were sent by express, effected a relief of my case. Owing to the long standing of my trouble (twenty-five or thirty years), I concluded to continue the treatment another month. My order was promptly filled by mail. By these two months' treatment I was perfectly cured, my whole system renovated and invigorated. I have been repeatedly asked what I had been doing to cause such an improvement in my personal appearance, and activity, for an old man. With profound gratitude, adding love,

I am your obedient servant, W., Rusk, Texas.

CASE 250,336. SPERMATORRHEA; LOSS OF STRENGTH AND WEAKNESS OF MEMORY. CURED WITH SEVEN MONTHS' TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have not taken any medicine since last December, at which time I had closed the seventh months' treatment. I am happy to say that, as a result, my mind is clear and easy. I am steadily gaining in strength, and feel better than I have for many years, and owe it all to your treatment and advice. I hope you will live long and prosper, and continue to dispense a balm for suffering humanity. I will close by giving your faculty my greatest devotion and sincere thanks, and hope success will crown your business.

W., Pickens, Miss.

CASE 82,127. SPERMATORRHEA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Your last month's treatment has entirely cured me. I have been married three weeks and am happy, thanks to your unexampled skill.

B., Blackberry, Kane Co., Ill.

CASE 88,736. SPERMATORRHEA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Sure enough I am well, and I desire to thank you for your medical skill. My strength is very greatly increased, my digestion and appetite are perfect. I sleep well and awake refreshed, and, in fact, feel better every way. My eyesight, which was weak, is wonderfully improved, and my physical condition is now perfect in every way. All the emissions have ceased.

Respectfully, B., Fayette, Howard Co., Mo.

CASE 144,241. SEMINAL DEBILITY. CURED WITH FOUR MONTHS' TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am happy to say that your treatment, which I have taken four months, has effected a radical cure of my trouble, and you are at liberty to use my name and address as a reference. Your treatment has effected a cure in my case.

Very truly yours, M., Trout Creek, N.Y.

CASE 71,250. SPERMATORRHEA OF THIRTEEN YEARS' STANDING.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I can honestly say, as the result of your treatment, that I feel better now than at any time previous for years. My disease is under complete control, and I have no fear of any further trouble in that direction. In a word, I feel that I am cured and well; and you may rest assured that I shall take great pains to avoid in the future the cause that brought me to my former condition. I am, indeed, thankful to you, as your treatment has made it possible for me to lead a better life, and effectually to resist those passions which so long dominated over me.

I remain, very respectfully yours, H, Council Bluffs, Iowa

CASE 142,842. SPERMATORRHEA CURED.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--it is with great thankfulness to you that I pen these few lines. I am to-day a strong and healthy man, which I never would have been but for your kind and skillful attention. My health was completely broken down by the effects of self-abuse, and I doctored with other physicians for two years, but with no success. However, after a few months of your treatment I find my health fully restored. I am now in a condition to enjoy the world and take comfort wherever I am; in a word, I am "a man among men." I most cordially invite all persons requiring skillful medical treatment to apply to the World's Dispensary.

M., Fredericville, Mich.

CASE 174,937. SPERMATOZOA. THREATENED WITH IMPOTENCY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I finished your three months' course of treatment some weeks ago, and am glad to say that I am a well man. A thousand thanks to you.

K., Warm Springs, Mont. Ter.

CASE 52,272. SEMINAL DEBILITY. LOSS OF MANHOOD. GENERAL WEAKNESS FROM EXCESSES.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--I took your medicines according to directions, and I feel that I am fully restored to health and the enjoyment of my manly powers. My health is better than it has been for years, and is improving all the time. The headache and dizziness have entirely left me. You have my honest recommendations to all sufferers.

Thankfully yours, M., Hudson, N.Y.

CASE 44,573. IMPOTENCY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--As a result of your three months' treatment, I am feeling better than I have for twenty years,--more of a man in every way.

S., Prairie Star, Neb.

CASE 56,811. NERVOUS DEBILITY. AFFECTION OF SEVERAL YEARS' STANDING, PERMANENTLY CURED BY ONE MONTH'S TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--Five years have elapsed since my case was cured by you with one month's treatment. Since that time I have not had the first symptom of the disease. I know I am cured.

Yours with thanks, C., Kalamazoo, Mich.

CASE 175,579. EMISSIONS, YELLOW COMPLEXION, BLACK HEADS AND ERUPTIONS ON THE FACE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION:, _Gentlemen_--I am happy to say that I have not used all of the last month's medicine. The five months' treatment that I have had from you has effected my entire cure. I have had no losses for many weeks, and my complexion is restored to its natural clearness and purity. The black heads and pimples have all disappeared.

K., Neillsville, Wis.

CASE 21,437. IMPOTENCY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--I have, as a result of your treatment, been more of a man than before in six years. I have felt, worked, and eaten better than ever before. My strength is in every way fully restored.

C., Jordanville, N.Y.

CASE 38,005. IMPOTENCY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--When I first wrote you I had given up all hope of ever getting well. I had not worked for two years. I had not been under your treatment three months before I went to work, and have been at it ever since. I gain every day.

C., Hinsdale, N.H.

CASE 53,578. SPERMATORRHEA. GREAT LOSS OF STRENGTH AND FLESH, APPETITE REGULAR, SOMETIMES RAVENOUS AND THEN VERY POOR. INTELLECT AND MEMORY MUCH ENFEEBLED, THE RESULT OF LOSSES THROUGH THE URINE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--The condition of my health is highly satisfactory, thank Heaven and you as the instrument. It has often been a cause of astonishment to me, to think now admirably your medicines controlled my cage; it seems wonderful even now. I say, with all my heart, God bless your noble work, for the cure of my disease and perfect restoration of my health and strength.

A., Shongo, Allegany Co., N.Y.

CASE 52,920. SPERMATORRHEA, RESULTING IN DYSPEPSIA AND HEART DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am gratified to be able to report my cure. My case was a severe one, the insidious drain upon my system producing general debility, attacks of severe palpitation of the heart, and obstinate dyspepsia. Since using your medicines, I have been cured of these troubles. I have no palpitation, digestion good, not easily worried, able to work hard without undue fatigue, strength greatly increased. My weight is now 163. I am thankful to God and to you for the evidence of my final cure.

Yours devotedly, R.

CASE 51,002. SPERMATORRHEA. RHEUMATIC PAINS, GENERAL LOSS OF MEMORY, STRENGTH, MANLINESS, AND INTELLECTUAL POWER.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--When I sent to you for medicines, I little expected the remarkable benefit that has resulted. The rheumatic pains that have so long troubled me, ceased within a week. I am now able to attend to my business with my former ability and energy. You have my gratitude for the cure effected in my case.

Very respectfully, P., Bloomington, Ill.

CASE 146,406. SPERMATORRHEA, WITH DYSPEPSIA, CATARRH, AND BACKACHE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am happy to say that as a result of five months' treatment, the weakness of my urinary and generative organs has been entirely relieved. My catarrh is so much better. The difficulty in the head is now gone, and I have no discomfort. The weakness in the back, and pain in the kidneys, has all left me, and I rest well at night. There are now no unnatural discharges, and I am happy to say that your medicines have effected such a change in my condition that now I continue to improve all the time.

D., Medusa, N.Y.

CASE 52,121. SPERMATORRHEA. SYMPTOMS: DIURNAL AND NOCTURNAL EMISSIONS, LOSS OF SEXUAL POWER AND WASTING OF THE ORGANS, GENERAL DEPRESSION AND EMACIATION. MOST SEVERE FORM OF THE DISEASE. CURE WITH THREE MONTHS' TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--I have waited several months and find my cure perfect and permanent. Thanks to you my health and manhood have been perfectly restored, and I am as fat as a bullock.

S., Millbrook, Ont.

CASE 4,100. SPERMATORRHEA. ENTIRELY BROKEN DOWN.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--Over eight years ago I visited you at your office this present month, very melancholy and thinking perhaps that in six months I would be lying in my cold and silent grave, and now I am strong and healthy. I never was so healthy in my life. Am married, and we have two of the nicest children you ever saw. I am the happiest man in town, and hope to ever be so. My sickness was contracted through ignorance and self-abuse. I am glad to say that I have had a permanent cure, and thank God. I feel grateful to you and thank you kindly.

Yours very truly, L., Barnes' Corners, N.Y.

CASE 52,004. EMISSIONS. LOSS OF WEIGHT, STRENGTH, AND MENTAL POWER.

WORLD'S DISPENSARY MEDICAL, ASSOCIATION: _Dear Sirs_--I received the month's treatment sent for, and took it. It worked like a charm. I have no more emissions, and my weight, energy and strength, are fully restored.

R., Fort Collins, Colo.

CASE 53,859. SPERMATORRHEA. FIVE YEARS' STANDING. SYMPTOMS: FREQUENT NOCTURNAL EMISSIONS, LOSS OF MEMORY, NERVOUS, NO ENERGY OR STRENGTH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--Pardon me for not sending you a report of my condition before this. Have been waiting to see if there would be any relapse. I am assured that my cure is complete and perfect. None of the symptoms of the disease remain. Your medicines I can recommend as the most powerful and direct to accomplish good I have ever taken. I feel it my duty now to give you my heart-felt acknowledgment for the good done me.

Respectfully, H. Goshen N.Y.

CASE 38,973. SPERMATORRHEA. EXTREMELY BAD CASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--You have cured me sound and well of the terrible effects of early indiscretion. My case was worse than any I have ever read, and I never expected to get well. With eight months treatment taken at my home, I have been fully restored. You have my sincere and hearty thanks. C., Halifax, N.S.

CASE 70,648. SPERMATORRHEA AND THREATENED IMPOTENCY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _My Dear Benefactors_--Please accept my sincere thanks. Words at my command are inadequate to express my feelings when I realize the great beneficial features of your most excellent remedy. I have spoken to several of my most intimate friends who are similarly affected, and after I took the first dose I was completely relieved, and the flesh I gained was in such abundance that I was scarcely identified by them. I gave part of your _par excellence_ medicine to a bosom companion of mine, named ----. He became convalescent, but desires another bottle. Write to him at once. Your name will be held in the highest esteem by these invalids, and by

Yours respectfully, H., Cincinnati, Ohio.

CASE 143,838. SPERMATORRHEA, WITH PARALYSIS AND DYSPEPSIA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Sirs_--Your treatment worked like a charm with me. Before I sent to you I consulted my family doctor, and asked him what he thought of my case. To give you his own words, he said. "J., I think you will be an entire cripple." I then thought I would write to you. I had not taken more than three months' medicine when I was out in the harvest field. I sleep all night, have a good appetite, my back has got well, and I can lay all night. My limbs are stronger, and my nerves are again all right. Upon the whole I am a new man, and my mental powers are much relieved. In eighteen months from the time I placed my case under your treatment, I was better than I had been in ten years, and feel like myself.

Yours truly, J., Peru Mills, Pa.

CASE 93,264. SEMINAL WEAKNESS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Allow me most sincerely to thank you for the great benefit I have derived from your two months' treatment. When I first wrote to you I felt as if my life on earth was short, indeed; but, thank God, through His help and yours, I have been saved from filling an early grave as the results of self-abuse. Before I began treatment I was pale and sickly; I had palpitation of the heart so bad that I often expected to drop dead in the street; I had loss of voice; always felt tired; I had involuntary emissions of semen in the night, which always made me feel weak through the next day; whilst quite often my mind was filled with suicidal thoughts. Such was the price I was compelled to pay for violating the laws of God and nature. Now every thing is changed. I thank you a thousand times, Doctor, for the great good you nave done me. May God bless you. I shall always be pleased to recommend your treatment to everybody, and I will cheerfully answer any communication that I may receive in relation to this. W., Lynn, Mass.

CASE 140,948. SPERMATORRHEA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Dear Sirs_--I believe myself to be free of the trouble for which you have been treating me. It seems too good to be true, yet I feel satisfied that I am more of a man than ever before in my life. I have not the time nor ability to thank you in the high-flown language peculiar to testimonial writers, but suffice it to say that I am.

Most gratefully yours, S.

CASE 44,464. NERVOUS PROSTRATION.

This gentleman, engaged as the head of a large academy, suffered severely from mental depression, weakened memory, nervous exhaustion, and lack of intellectual power, the result of the delicate drain upon the nervous system and his severe labors. We append his letter after four months' treatment:

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--My friends all notice and speak of my decided improvement. My health and faculties are again as they were years ago. Yours, H., Philadelphia, Penn'a.

CASE 33,928. SPERMATORRHEA, RESULTING IN CONSUMPTION.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--I would have been beyond the reach of aid now but for your treatment. I am now enjoying perfect health. Yours gratefully. H., Gillie's Hill Ont.

CASE 42,921. SPERMATORRHEA, RESULTING IN DYSPEPSIA AND DECIDED LOSS OF STRENGTH.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am deeply indebted to you. The disagreeable head symptoms, dyspepsia and weakness are all gone. I can now eat and digest as hearty a meal as any one, and feel well, healthful and energetic. Never have any losses. I was very sick when I commenced treatment, but was speedily relieved.

Yours truly, S., Charles River Village, Mass.

CASE 44,866. SPERMATORRHEA, WITH MARKED LOSS OF MEMORY, HEALTH, AND TONE OF SYSTEM.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I took treatment of you last summer. The improvement was marked, and I have continued to grow healthier and stronger, notwithstanding I have been busy all the time and nave studied very hard. Do not get fatigued as before. I read six orations of CICERO in seven weeks and passed with honor a very close examination. My limbs are solid and strong, whereas before I was weak, and my flesh cold, soft, and clammy. I am in college working hard. Truly, P.

CASE 147,411. APPROACHING IMPOTENCY. RENEWED HEALTH AFTER FIVE MONTHS' TREATMENT.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I can gratefully say I am feeling like a new man since taking your prescription for seminal weakness. While I was in the West two months, my wife received two months' treatment from you, and on my return home, to my greatest satisfaction, her cheeks were as red as roses and her health greatly improved, for which accept our profound thanks. May your honored President live long and do good unto the sons and daughters of afflicted humanity, is our prayer. W., Aral, Va.

CASE 44,198. NERVOUS PROSTRATION, CAUSED BY SELF-ABUSE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--Your kindness to me I can never forget. I cannot express half my feelings of gratefulness to you. I had despaired of ever getting well. Thanks to your skill I am now a new being. Yours very truly, B., Steuben County, N.Y.

CASE 53,816. NERVOUS DEBILITY, CAUSED BY SELF-ABUSE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--My health has improved so that I no longer need treatment. You have my heart-felt thanks for the good you have done me, and may you have as good success in treating the hundreds of others as you have had in mine. I remain yours very truly, K., Hartford, Conn.

CASE 53,913. NERVOUS DEBILITY AND IMPOTENCY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I shall ever remember you with gratitude. My relief is perfect and permanent. I feel _so_ much better. I remain yours truly, J., Jacksonville, Ill.

CASE 254,484. SPERMATORRHEA; GENERAL DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am happy to say that your medicines and treatment are always ahead of what they are represented, and I hope you will accept my deep and sincere thanks for the good you have done me. My weakness and debility have entirely disappeared, and I can say that the expense of the six months' treatment I received from you, has been repaid a hundredfold, by the benefits it has effected in my condition. F., Starkey, N.Y.

CASE 54,803. NERVOUS DEBILITY AND IMPOTENCY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have taken the last of the medicine which you sent me, and feel satisfied it has entirely cured me. I return my thanks to you for the good you have done me. F., East Liverpool, Ohio.

CASE 69,116. SEMINAL WEAKNESS, WITH CANCEROUS TESTICLE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--It has now been over two years since you treated me and found it necessary to remove one testicle on account of cancerous disease, that must soon have destroyed life had the operation not been performed. T feel myself a strong, healthy man, having had no symptoms of the seminal weakness for months past. Yours, P., Pittsburgh. Penn's.

CASE 51,417. IMPOTENCY.

I am getting along so well with the medicine that I am a standing wonder to my friends, and I shall not cease, while life lasts, to praise the skill that has brought about such miraculous results.

Yours truly, K., Chillicothe, Ohio.

CASE 67,004. IMPOTENCY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am only too happy to say that I have fully recovered my powers in every particular since placing myself under your treatment. I would not take $5,000 for the good you have done me. I am only sorry that I did not go to you before wasting time and money on the quacks connected with that "Museum of Anatomy" in New York.

T., Philadelphia, Penn'a.

CASE 67,208. SPERMATORRHEA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--When placing myself under your treatment, I was told that my case being an exceedingly bad one, it would probably require six months in which to effect a perfect cure. After taking your remedies four months I found myself in perfect health, and have remained so ever since. I cannot express the gratitude I feel for you, and can never half repay the debt of gratitude I owe you. I have given your pamphlet,-"Abuse of the Male Generative Organs and the Diseases to which it Gives Rise," to quite a number of young men whom I had reason to suspect it might benefit.

Gratefully yours, T., Norfolk, Virginia.

CASE 67,070. SPERMATORRHEA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have now returned home a now man, after four months' treatment from you. I need no more medicines now. I would urge all suffering to go to you for help. Thanking you for your services,

I remain yours truly, R., Bunch, Iowa.

CASE 431,637. IMPOTENCY, WITH NERVOUS DEBILITY AND LIVER DISEASE.

This gentleman applied for the relief of the following symptoms: Exhausting and frequent seminal emissions, losses in the urine, want of manly strength, nervous prostration, indigestion, torpid condition of the liver, headache, nausea, and constipation. After a course of five months' treatment he writes:

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am very grateful to you for the good you have done me, and I feel like a man now. It is sometime since I left off medicine. I have continued to improve, and I feel better than I have for years before treatment. I am happy at the restoration of my health and vigor. I shall recommend you to all sufferers. Hoping you will continue to be successful.

I remain, Yours truly, P., Canaan, Conn.

CASE 111,489. SEMINAL EMISSIONS, LOSS OF MEMORY AND GENERAL DECLINE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Inclosed please find money for my last supply of medicines. You seem to understand my condition thoroughly. My color, appetite, and strength have improved wonderfully, and my sleep is sound, undisturbed and refreshing. Under the influence of your medicines I have completely recovered my mental and physical powers, and I feel that I am able to discontinue further treatment. The emissions have become less and less frequent until now they do not trouble me at all.

I remain, yours truly, H., Eagle Springs, Coryell Co., Tex.

CASE 51,203. SPERMATORRHEA. PERFECT CURE. HIS LETTER BEFORE TREATMENT, AND AFTER.

(First letter.)

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--It was my pleasant privilege to read concerning your skill in the treatment of all kinds of diseases, and concerning your reputation, which is most justly merited. Encouraged by these facts to place explicit confidence in you. I beg leave to state my own case as clearly as I may be able. It is as sad as it is fatal if no thorough cure can be effected. I have from my twelfth year onward been practicing, though not excessively, the evil, _self-abuse._ Although I have been led to abandon the pernicious habit for several years, my age being twenty-four, the horrible effects have not disappeared. The serious result is that I am suffering from spermatorrhea. An involuntary discharge of the seminal fluid occurs invariably once, not infrequently twice, every week during sleep. The genital organs have become diminished in size. I will proceed to state the symptoms which I have been able to observe. They are--disposition to solitude, inaptitude for study, indolence, forgetfulness, melancholy, weakness in the back (especially perceptible after standing), a lack of confidence in my own ability, want of energy, sometimes pain in the chest, elbow, arm, knees, and loins. Uneasy nights, disturbed and highly disagreeable dreams becoming more and more irritating as the time for the discharge of the seminal fluid draws nearer, also a desire to lie longer in bed in the morning.

Now, dear Doctors, permit me to ask your kind advice as to what means are to be taken. I have tried numerous remedies for more than a year, but to no effect. My suffering grows severer. Please reply as speedily as you may be able. If you be so kind as to honor me with an answer, please state the amount of money needed for your services, which shall be forwarded at once. Please find inclosed one dollar, remuneration for your kind services.

Very respectfully, M., Wheeling, Cook Co., Ill.

(At the close of treatment.)

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have finished the eight months' treatment; had I been able to follow the directions more closely, three months' treatment would have effected a permanent cure of my case. Now I am well, body strengthened, mind invigorated, memory revived, energy to work restored, cheerfulness and bright hopes, once altogether lost, are now fully regained. Indeed, I feel like a new being. And now, dear Doctors, in closing our important correspondence, permit me to render my heart-felt thanks for your kindness to me, and for the benefit received from your invaluable treatment. Adieu; may God grant you a long life, that you may benefit many an afflicted one.

Very truly yours, M., Wheeling, Cook Co., Ill

CASE 464,255. MASTURBATION. LOSS OF FLESH AND MENTAL POWER.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--After three months of your treatment, I find myself cured of one of the worst habits that it has ever been the lot of man to fall into. My whole system is invigorated; I have no more weak back nor legs; no more emissions; my strength is greatly increased, and my weight is more than it has ever been before. The dull, heavy feeling in my head is entirely past, and I can truly say that I feel like a new man. Hoping you will do as much good in the future as you have in the past, is the wish of, Yours truly, B., Holyoke, Mass.

CASE 91,656. SPERMATORRHEA. OBSTINATE CASE OF EIGHT YEARS' STANDING.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I have taken seven months' treatment from you, and to-day I am a well man. My friends are surprised at the great change which has taken place in me. The emissions have ceased entirely, and I am strong and well. I am a thousand times obliged to you for the good your treatment has done for me.

Respectfully yours, U., Topeka, Kansas.

CASE 461,306. ONANISM. MELANCHOLIA; CONTEMPLATED SUICIDE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--Having waited several weeks after finishing the last medicine, to see if there would be any relapse, I now send you a report of treatment. I believe I am thoroughly cured, not only of poor health, but of all desire to abuse myself. I have regained health, spirits, and confidence. Am married, something I have long desired, but never before dared to attempt. Please accept my sincere thanks, gentlemen. Your medicine has saved me from a suicide's grave.

H., Denver, Col.

CASE 110,838. SEMINAL WEAKNESS AND FISTULA IN ANO.

A case of anal fistula that had been unsuccessfully treated by Prof. ----, of Nashville, who had operated with the knife. He had also been unsuccessfully treated by several home physicians who stated that his symptoms of spermatorrhea were all that could be described, and more too. The sensations of crawling and itching in the rectum were very severe, and as a result of weakness there was a serious palpitation of the heart, and general debility. The generative organs were unduly excitable and weak. He complained of weakness in the rectum and loins, with irregularity of the bowels, trembling and weakness of the entire system. There was profuse discharge from the fistula and also from the urethra. We undertook his case without making any promises of a radical cure, as it seemed that the disease had progressed so that it would be impossible to effect more than satisfactory improvement in his general condition, and a palliation of the symptoms of disease. At the end of seven months' treatment he writes as follows:

WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--The result of the treatment you have sent me is a permanent cure of the fistula beyond a doubt, and in a magical manner. My heart is very much improved, so that it does not trouble me in the least. My health is perfect in every way. It is unnecessary for me to order any more medicines, but should I think at any time that a little is required to keep me in good health, I will order at once. I think that I am entirely through with the fistula and sympathetic weakness, and I can truly say that your remedies delivered me from the jaws of death. With sincere thanks to you, I am, yours for ever. D.

CASE 140,056. SPERMATORRHEA.

The following long-standing and aggravated case of seminal debility began to yield at once under the specific influence of our medicines. Frequent nocturnal emissions were present, and the semen also passed off, unobserved and unsuspected, in the urine; of course a ceaseless vital drain of this character began quickly and profoundly to impress the constitution, so that when the patient under consideration applied to us for relief, the most unmistakable symptoms of commencing organic disease of the heart and lungs had plainly declared themselves to be present. Like many hundreds, of similar cases which we cure annually, the disease yielded promptly and perfectly to the well-directed efforts of our specialist in this important branch of practice; indeed, so easy, swift and perfect was the cure that the patient failed to realize the necessity of continuing the treatment a few weeks in order to insure himself against the possibility of a relapse, and discontinued his correspondence with us, whereas it is in precisely such cases that we recommend the treatment to be not too abruptly discontinued.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Your kind favor, thoughtfully inquiring after my health, came duly to hand. In answer, permit me to say that it was not my intention to take further treatment as I considered my cure to be perfect, all local and general symptoms having wholly subsided before I had finished the month's course, and thus far manifesting no disposition to return. However, in the light of your wisdom and experience, I have reconsidered the matter and now believe with you that another month's course of treatment is advisable, in order effectually to guard against the possibility of a relapse. I accordingly inclose you the price of the additional month's course. The second morning after commencing the use of your medicines I awoke refreshed in body and mind, and this experience has been repeated every morning since. The emissions were arrested at once, and I have not had a single unnatural discharge since, except once when I experienced a slight nocturnal emission, which, however, was followed by no depressing after-effects, but altogether the reverse. I feel so much stronger and better in all respects that It is a positive pleasure for me to do a hard day's work now.

Respectfully, B., Crystal Lake, Wis.

CASE 86,291.

This gentleman had suffered during eleven years from seminal weakness as the result of indiscretions in youth; nocturnal emissions were present, and there was also a seminal loss with the urine, and at stool; the patient's memory was greatly impaired and his mind otherwise affected from the vital drain; he was dyspeptic, his bowels were costive, and threatening symptoms of consumption had already begun to manifest themselves when he came under our care. Two months of our special treatment, at the patient's home, effected a perfect and permanent cure, and completely arrested all abnormal seminal losses. The following grateful letter is from the gentleman in question:

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Permit me to say that, six months after having discontinued your treatment, my cure remains perfect. This great permanent and enduring benefit was secured to me through only two months of your skillful treatment and careful management of my case. Your medicines had a wonderful control over my disease, driving away its terrible symptoms as if by magic; they imparted to me a new power, filled my body and mind with unusual vigor, and transformed me from one racked with pain and living death or worse, to a full measure of health and happiness. I feel that if I had not been opportunely and successfully treated by you, that my life would have been permanently blighted, and that the happy and contented mind that now inspires these lines would ere this have been dethroned of reason. I feel that you have been my savior. I have not had a single nocturnal emission since leaving your treatment, six months ago. Thanking you, gentlemen, from the depths of a grateful heart, I remain.

Your obedient servant, G., Cayuta, Schuyler Co., N.Y.

* * * * *

Did the interest of our readers demand it, we could add to the preceding list an almost endless number of extracts from letters written by grateful patients, expressing their heart-felt thanks for having been cured of spermatorrhea and impotency by our treatment. But we have we trust given sufficient to illustrate our great success in dealing with these maladies.

A CAUTION TO THE AFFLICTED. We are daily consulted by persons suffering from spermatorrhea and impotency who have been victimized by ignorant charlatans. Some seek to dupe and swindle the unwary by claiming to have themselves been cured of spermatorrhea or impotency by some prescription, which they offer to send free to any sufferer. When the prescription is obtained it is found to consist of a few articles well-known to every druggist, coupled with certain arbitrary and fictitious terms, unknown to everybody and not to be found in any medical work extant. Following the prescription is a modest suggestion that if it cannot be filled by the home druggist, the benevolently-disposed party furnishing the prescription will be pleased to send the medicine, already prepared, for from three to five dollars. Of course, the whole scheme from beginning to end being a swindle, when the "medicine" is obtained and taken it proves entirely useless. Skill and genuine merit do not go begging. Men who spend hundreds of dollars for the publication of advertisements offering to give away valuable information can always be safely set down as swindlers.

In the public prints will be found advertised various ready prepared, "put-up," or proprietary, so-called "remedies," "Specifics," "Boluses," "Pastiles," "Rectal Pearls," "Urethral Crayons," "Voltaic Belts," "Galvanic Belts," "Batteries," and "Pads," all recommended as infallible remedies for spermatorrhea and impotency.

A vast experience in the treatment of these affections has satisfied us that each case must be studied and treated according to the symptoms manifested, and that medicines that are adapted to one stage of the disease are entirely unsuited to other stages of the same case. No "Pad" or "Battery and Pad," "Galvanic" or "Voltaic Belts," "Battery," "Bolus," or "Soluble Crayon," ever did or can help a case of this disease, except it be in the imagination. Although the proprietors of the most popular proprietary medicines in the market, medicines carefully adapted to the cure of the diseases for which they are recommended, yet, should we attempt to get up a general remedy to cure spermatorrhea and kindred maladies, we are certain it would be an utter failure, and this is entirely true of all such preparations now and heretofore offered for sale, and, from the very nature of the diseases they are recommended to cure, ever must be. Each case must have medicines carefully prepared to meet the conditions present, and when these conditions, from the effects of treatment or other causes, change, the treatment must be varied accordingly.

POSITIVE INJURY instead of benefit often results from the employment of some of the nostrums advertised for the cure of spermatorrhea, impotency and kindred affections. Especially have we found that the use of "Soluble Urethral Crayons," "Boluses," "Pastiles", and kindred contrivances, which are so extensively advertised, are exceedingly injurious, and often render otherwise moderate and simple cases, complicated and incurable.

Although of pretended French origin, they are evidently the invention of an ignoramus, who knows nothing of the delicate anatomy of the generative organs or of the proper treatment of the diseases incident thereto, for none other would have thought of such a preposterous plan of treatment. No man should insert such absurdly devised and mischief breeding contrivances into his urethra (urinary canal), for thereby he is almost sure to do himself a permanent injury. So far from having been invented by an eminent French surgeon, as claimed, such treatment is entirely unknown in France, and ever has been, as the writer well knows from personal observation and enquiry while sojourning in that country and visiting its most noted hospitals and medical institutions.

All the various "Troches," "Boluses," "Wafers," "Suppositories," "Pearls," "Rectal Pearls," "Rectal Capsules," and other contrivances which are recommended for the cure of Spermatorrhea and kindred weaknesses, and which are designed to be employed by inserting them into the lower bowel (rectum), and there permitting them to dissolve, are only so many irrational and filthy devices for duping the ignorant and innocent sufferers from these maladies.

AN ALLURING SWINDLE. A still more enticing, and hence more dangerous, device for swindling unfortunate sufferers, is the widely advertised "Vacuum Treatment" or "appliance" so loudly and plausibly recommended for "Developing weak and wasted organs." A simple, little, brass air pump, connected with a glass tube, or cylinder, fitted with a valve at one end, which costs not to exceed one dollar and a half, is the worthless device palmed off on the confiding ones _at from fifteen to thirty dollars_. This is done under the _false pretense_ that its daily use to pump blood into the weak or wasted organs, will cause their development and growth.

Thousands have invested their hard earned cash in this worse than worthless, injurious, contrivance. In fact the head of the concern putting out this alluring device is said to have amassed a fortune out of the nefarious business.

So far from benefiting any one, out of several hundreds of cases that have come under our personal observation, in which this apparatus has been faithfully used for a long period of time, we have never met with a single case that had derived the slightest benefit therefrom. On the contrary, we have been called upon to examine many who had been _seriously injured_ by its use.

The sudden congestion or filling and over-distention of the delicate blood-vessels of the organ operated upon, caused by placing it in a vacuum, is liable to rupture these minute vessels, causing the infiltration of blood into the tissues and giving rise to inflammation, and in some cases, to _suppuration, mortification, sloughing_ and _death_.

In other cases, the blood-vessels of the organ and adjacent parts are so weakened by the _strain_ put upon them as to induce varicocele and other diseased conditions. In spermatorrhea, it is the worst possible thing that can be applied, for by forcing an undue amount of blood into the part the sensitiveness of the organ is increased, irritation is set up in the deep urethra, and the emissions are increased in frequency. In this, and other ways, hundreds of men but slightly out of health have been permanently injured.

But this is only a small part of the story connected with the reprehensible business of palming off "The Vacuum Developing and Strengthening Appliance." The precious rascals, not content with making from a thousand to fifteen hundred per cent. profit on the miserable device furnished, while advertising fifteen dollars ($15.00) as the price of the "appliance" and "accompanying preparations," for "_ordinary cases_," make a general practice, when they have secured the fifteen dollars ($15.00), of sending it by express _with a bill to be collected on delivery_ FOR FIFTEEN DOLLARS ($15.00) MORE. With this bill they send an explanation, that "on re-examining the case" they "found it necessary, or thought it advisable, to send their stronger and more expensive preparations and appliances _for the worst cases_ AND SO HAVE CHARGED FIFTEEN DOLLARS ($15.00) MORE TO COVER THE EXTRA EXPENSE."

It is astonishing that there are those who can be induced to part with their money for such claptrap devices, and still more so that having been duped and swindled out of their hard earned money through false pretenses and promises of benefit held out to them, they should submit quietly to such extortion and not have the swindlers arrested and prosecuted for obtaining money under false pretenses as they richly deserve. For what crime can be more deserving of punishment than the holding out of false hopes and pretenses to the unfortunate? Employing the United States mails for swindling is a pretty dangerous business, and sooner or later these rascals will, we predict, find it out to their sorrow. They are pretty sure to get hold of some men, ere long, who will invoke the aid of the United States District Attorney to bring them to justice.

YOUNG MAN, if you have, through ignorance, fallen into practices that have arrested your physical growth and development in any of your organs or parts, shun all such unscientific and worse than worthless contrivances as you would shun a pestilence. No matter how plausible the web of arguments woven to entrap you, be assured, they are the utterance of knaves who care not what false hopes they encourage so they secure your money.

Consult only those whose well known skill, experience and integrity will insure honest dealings and the most scientific treatment known to the "healing art," and who supply the latter at reasonable cost.

Be assured also, that when, through proper treatment, your weakness and functional derangements are overcome, the parts that have suffered therefrom, will regain all the strength and development possible to impart to them through the aid of the physician's skill. Nature often accomplishes wonders in this direction, when aided by the skillful practitioner.

* * * * *

VARICOCELE;

_OR, ENLARGED VEINS OF THE SCROTUM SOMETIMES CALLED FALSE RUPTURE_

Probably no affection of the generative organs has been given more attention by surgeons than this. Its great frequency, being present in about one-third of all cases of spermatorrhea, and its disposition to result in impotency and wasting away of the testicles, bring it constantly before the profession.

CAUSES.--Varicocele commonly results from long continued fatiguing exercise, in the upright position, heavy lifting, jumping, straining, severe constipation, injuries from horseback riding, bicycle riding, especially the latter, or any obstruction or obstacle to the free return of blood through the spermatic veins. Self abuse and excessive sexual indulgence are also prolific causes of varicocele.

When the spermatic veins are over-distended to such an extent that their tonicity is impaired, they gradually lose their capacity for transmitting the blood, and a slowly increasing enlargement and tortuously of veins results. This goes on, becoming steadily more marked, until the pressure of the engorged vessels upon the spermatic cord impedes the full circulation of blood in the testicle and causes a wasting and softening of this gland. A loss of sexual power and increasing weakness of the generative organs generally follow this gradual destruction of the testicle, and sometimes total and incurable impotency results.

This affection is also designated by the terms _circocele_ and _spermatocele_. It consists of an enlargement or varicose condition of the veins of the scrotum or spermatic cord, and affects the left side more frequently than the right. This is due to the fact that the spermatic veins of that side are longer, more dependent and tortuous, and, consequently, support a greater column of blood than the other side. The enlarged veins feel like a bundle of earth-worms. The knotty and tortuous vessels sometimes form quite a large tumor, which is, now ever, but rarely sensitive to the touch, yet sometimes causes a feeling of weight in the scrotum and loins, and sometimes produces a sensation of numbness in the thighs.

When varicocele of an aggravated or largely developed type is present, associated with any weakness of the generative organs, as spermatorrhea or impotency, it must be cured before the organs can regain a healthy condition, as by the constant pressure of the abnormal quantity of blood and enlarged veins upon the spermatic cord, arteries, and testicles, the irritability, weakness, and wasting, are increased. The use of suspensory bandages, with strongly astringent lotions, will, in mild cases, produce relief and many times cure. Except in the worst cases, it is well to try these means before resort is had to operative surgical treatment, unless the patient is anxious to be cured in a more speedy manner. The treatment by suspensory bandage and lotions is necessarily somewhat slow in producing remedial results; yet, many quite well marked cases have, in our experience, been cured by such means perseveringly applied. Although many who have been unable to come to us for an operation, have been cured by suspensory bandages and our improved lotions applied to the affected parts, in all cases in which the veins are very much enlarged, we recommend the sufferers to come here and undergo our surgical treatment, which is painless in its execution and radical in its results.

It has been recognized by physicians and surgeons for over a century, that in bad cases of varicocele a cure can only be certainly and permanently effected by operation. Many have been the methods of operation advanced by the prominent surgeons of every age, but all have met with such an alarming mortality, that they have been one by one abandoned, except as a last resort in extremely bad cases. A late author gives the percentage of deaths from the various old operations, now in general use throughout this country and Europe, as varying from seven to fifteen per cent. of all cases. In contrast to this, we point with pride to our records, by which we are shown to have operated upon over a thousand cases by our original method, obtaining in each and every instance a perfect cure, without a single alarming symptom or a death ensuing. This we think is sufficient evidence of the perfect safety of the operation and its superiority over every other method. So every sufferer with the disease, we would recommend it as a positive means of securing a permanent cure. Various worse than useless devices are advertised by quacks, who, as a class, are afraid to undertake surgical treatment for the cure of varicocele. One has what he calls a "varix clamp," or "clasp," to be worn upon the enlarged veins. Many "compressors" and other equally useless devices are advertised and sold for the same purpose. These are not only perfectly worthless, but positively dangerous in their application. The pressure they make upon the spermatic cord, nerves, and artery, is very apt to result in impotency and a rapid wasting away of the testicles. Patients should avoid all the catch-penny devices recommended for varicocele, as none of them are worth a moment's consideration.

Even a moderate degree of morbid enlargement of the spermatic veins will sometimes cause such engorgement and obstruction to the free circulation of the blood in the testicle, as to cause gradual wasting or shriveling of that organ. In some cases the morbid condition will give rise to seminal weakness, or spermatorrhea. Many of these cases that can only be cured by surgery, are trifled with by quacks, who attribute the spermatorrhea, or loss of semen, to everything else than its true cause--varicocele.

To illustrate, Mr. B., of Colorado, applied at the Invalids' Hotel and Surgical Institute, a few years ago, and said he had for five years been troubled with nightly emissions of semen and his testicles were gradually wasting away. He had been under the treatment of men making great pretensions as specialists, to whom he had paid several hundred dollars in the vain hope of getting cured of spermatorrhea. They treated him with medicines only, and did him no good whatever. On examination, we found a very varicose or enlarged condition of the left spermatic veins, and gave it as our opinion that the seminal loss was wholly due to this abnormal condition and could only be cured by an operation that would remove the varicocele. The operation was promptly performed. In two days he was able to leave his bed, and in a week started home to Colorado. Some months thereafter we received a letter from him wherein he said: "The enlarged veins continued to absorb and grow less and less, until, in a few weeks' time, all unnatural enlargement had disappeared. With a steady improvement in the condition of the veins, I experienced corresponding improvement in my general health, and the seminal losses grew less and less, and finally, long ago, disappeared entirely. I feel that my manhood, with all the powers that should belong thereto, are mine to enjoy. In other words, my restoration to health is complete. Had I saved the large amount of money that I fooled away on those quacks, and given it all to you, I feel that you would then have been only fairly paid for the great good you have done me."

The foregoing is but a fair sample of letters that we are almost constantly receiving from those who have pursued useless treatment for spermatorrhea, dependent upon varicocele, and have been speedily cured by our never-failing operation for this malady. Among the great variety of operations in surgery for various diseased conditions, performed by our surgeons, none have been attended with more uniform satisfaction, and perfect success, than has our operation for varicocele.

A PAINLESS OPERATION.

By the injection of a few drops of a medicated solution under the skin, at the point where the incision is to be made, we are now able to produce such complete local anæsthesia as to render the operation _entirely painless_ without the administration of either chloroform or ether. This is an important consideration, as many are averse to taking chloroform or ether, and now that we are possessed of an agent that produces, locally, _complete insensibility to pain_, we are very glad to be able to dispense with their use in all such minor operations. Many examinations heretofore very painful, as of the bladder for stone, and of the deep urethra for strictures, are now rendered _entirely painless_ by the use of this wonderful agent.

A great variety of surgical operations are now performed by our surgeon specialists, without any suffering on the part of our patients, by the local use of an anæsthetic solution injected into the parts to be operated upon. Formerly we were obliged either to administer chloroform or ether, or subject our patients to a great deal of suffering. Our specialists were among the first surgeons in this country to employ local anæsthesia successfully. We regard it as a great boon to our patients, and never withhold it in any case where it can be employed to prevent suffering, its use being attended with no danger and followed by no bad or disagreeable results.

OUR PAINLESS OPERATION.

Having operated with unvarying success, during the past twenty-five years, upon several thousand cases of varicocele, at the Invalids' Hotel and Surgical Institute, we now invite special attention to the results of our peculiar operation, which is neither severe nor dangerous, and from which the patient makes a much more rapid, and in every respect more satisfactory, recovery than from other operations in use by surgeons generally. In our practice we have never failed to secure the happiest results from our operation. The saving of time is also of importance to the laboring man as well as to the millionaire. Instead of being confined to his bed for ten to twenty days, and to his room for a month or more, as is the case following other operations, the patient is not confined to bed at all, and can generally return home in a week or ten days at the longest. The only precaution necessary is that he should, for a reasonable time after the operation, wear a well-fitting suspensory bandage. This can, in a little time, be entirely dispensed with. When we contrast these results with those obtained from ligation, graduated pressure by "clamps," suture pins, or the slicing off of a part of the scrotum, and suturing, or stitching, the wide gaping wound so caused, as is practiced to-day by other surgeons, the marked superiority of the results obtained, through our superior method of operating on this affection, must be apparent.

A very large part of those cured by our treatment have previously spent far more money for worthless "electric suspensories," "equable scrotal compressors," "scrotal clamps," various "rings," and other "jim cracks," than was paid us _for a radical and permanent cure_. Some of these instruments are so formidable as to suggest the racks and thumbscrews of the middle ages. Such useless appliances often weaken the scrotal muscles by the unnatural compression which they produce and make the discomfort far worse when they are discontinued than before their use.

For such cases as cannot come to us at once for an immediate and _perfect cure_, we have a common sense method of treatment, comparatively inexpensive, that gives relief and comfort in all cases, and in mild cases often effects a complete cure. This treatment leaves the scrotum and its contents in an improved, strengthened and more healthful state.

* * * * *

TESTIMONIALS.

If the following letters had been written by your nearest, most respected and trustworthy neighbors, they could not be entitled to more confidence than they now are, coming, as they do, from intelligent citizens, each one of whom, in his own neighborhood, enjoys the full confidence of all his acquaintances. These letters are taken at random from among hundreds of similar ones, received from former patients of ours, residing in all parts of the United States and Canada, and if it would add anything to the endorsement in the way of giving greater confidence in our ability to treat successfully the malady under consideration, we could multiply the letters which we here introduce many times over. To publish more, however, would seem to be tedious repetition, for there necessarily must be a sameness in all such letters testifying to our skill, and we must, therefore, be content to rest our case with the limited number of endorsements which we have room for only in this volume.

VARICOCELE.

A PERFECTLY PAINLESS OPERATION. PATIENT SMOKES A CIGAR AND TALKS WITH THE SURGEONS WHILE OPERATION IS BEING PERFORMED.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I suffered with varicocele at the age of nine years, caused by a fall, and doctored for same about fifteen years, and obtained no relief. Renowned surgeons of Pittsburgh, New York, and other cities pronounced my case incurable.

I heard of the Invalids' Hotel, No. 663 Main Street, Buffalo, N.Y., and entered it as a last resource. On the third day after entering the Institution I was treated, and during the operation (which was a painless one), I smoked a cigar and talked with the operating surgeons, feeling _no pain whatever_. I remained in the Hotel one week, and during that time I never once was unable to walk to the elevator and have my meals in the dining room. The tables were laden with the best the country can produce. It is truly "The Invalids' Hotel" (or rather _home_), as the clerks and nurses are very kind, attentive and social.

Will add, that I am permanently cured, and advise any person thus afflicted not to hesitate entering the Invalids' Hotel for treatment.

Respectfully, A.J. SETH, Lucinda, Clarion Co., Penna.

VARICOCELE.

Fair View, Sanpete Co., Utah.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I feel it my duty to thank you for the benefit I received at your Institution during the month of December, 1892.

I was afflicted with varicocele on the left side, which caused me a great deal of trouble and almost made me feel at times that I did not want to live any longer if I could not be restored to soundness again. Hearing of your skill in the treatment of varicocele I determined to give you a trial, which I accordingly did, and with gratifying results for now I am as sound and well as a gold dollar.

The operation which was performed on me at your Institution for the permanent cure of varicocele was, to my great surprise, entirely painless and performed in a much briefer time than I expected. I only remained at your noble Institution ten days after the operation, at the end of which time I returned to my home at Chatham Hill, Smyth Co., Va. When I got home I experienced very little soreness from the operation and I felt that I could enjoy life fully. About six months after, I got married and came to Utah where I now reside, and I am very much pleased to say that I am now as sound and well as ever, and very happy in my married state.

When I went to your Institution I was surprised to see such a great number of young men from almost every State in the Union, who had come there to be operated upon for varicocele; and they all told me that the operation was painless to them, as it also was to me, and they said they were fast improving and were glad they had come there for treatment. I never experienced such great and unprecedented kindness as I did during the ten days I was at the "Invalids' Hotel." I had an excellent room--well furnished, plenty to eat, and was treated with the kindness of a mother by the nurses and attending physician.

I advise all who are afflicted with varicocele to go to your Institution at once for an operation, which I assure them they will never regret. Trusting that those who require an operation of any kind, or who are afflicted in any way, may go to your Institution and be restored to health, and again thanking you for my restoration to health and YOUR great kindness and good treatment of me while I was with you, I remain,

Yours very truly, William F. Petts

P.S.--My sister's life was saved by your "Favorite Prescription," W.F.P.

VARICOCELE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--It is with great pleasure I recommend those suffering from varicocele to your skillful hands. I suffered with varicocele for seven years, caused by standing behind the counter at business from seven in the morning until ten and twelve o'clock at night.

In 1888 a friend gave me a copy of your Common Sense Medical Adviser. After perusing its pages I was convinced of the genuineness of its doctrine. I immediately started for Buffalo--a distance of 1,900 miles. During my stay of ten days at your Institution I was treated with the utmost kindness by the nurses and surgeons, all of whom are expert specialists.

The equipment of the Institution is something immense. I often think of the appetite those healthy exercises in the treatment room gave me when dinner time came.

After being in the Institution three days I underwent an operation for varicocele--an injection of medicine locally making the operation _absolutely free from pain_. The operation was performed in about thirty minutes, immediately after which I could walk to my room, and, after resting an hour, descended to the dining room and took my dinner as usual.

While at the Institution I met numerous persons suffering from varicocele, and it was quite pleasing to contrast their happy looks as they wished you "goodbye" with the haggard appearance they had upon entering.

After leaving the Institution I traveled about 1,400 miles by rail and 500 miles by water without the least inconvenience, which I consider a fair test of the operation.

Five years have passed since that time, and I now feel as sound as it is possible to feel.

In conclusion, let me say to those suffering from varicocele that it is impossible for them to do better than follow my example.

Respectfully yours, ARTHUR EBSARY, (Care of Hon. Jas. Baird.) Water Street, St. John's, Newfoundland.

VARICOCELE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am a carpenter and some years ago, I fell from a scaffold which in time almost killed me. I wasn't hurt very much at the time, but a dull aching pain seemed to take me in the left side of the scrotum, and after I could stand it no longer, I went to my doctor. He said that I had a rupture of the blood veins of the left testicle, and it was incurable. I gave up in despair; but at last, a friend handed me some of your advertising papers, and I saw the Common Sense Medical Adviser advertised and sent for the book and studied its contents carefully, and came to the conclusion that I was suffering from varicocele. I found on consulting you that my suspicions were right. I at once wrote you for particulars, and in less than a week I was at the Invalids' Hotel for treatment. At that time no one knows how I suffered; but I hadn't long to suffer. In ten days after _an entirely painless operation_ I was a well man and returned home.

I cannot say too much in regard to the treatment and care from both Surgeons and Nurses. Nothing was left undone to promote comfort and good care. It is the only place on earth that I would feel safe to trust my life for a severe operation. There were, I think, over 100 patients at the Invalids' Hotel and Surgical Institute, at the time I was there, and as I had a good chance to be with them, I found that they were all doing remarkably well.

At the date of my operation which was the 7th of March, 1893, I weighed just 165 pounds; to-day I weigh 189. I have gained in health, strength and vigor every day, I believe.

I would just say, in conclusion, that I can give my word as an honest man to any sufferer that I believe he can be cured of almost any chronic malady at the Invalids' Hotel and Surgical Institute.

Respectfully yours, F.H. JENKINS, (Box 13), Ascot Corner, Sherbrooke Co., P.Q., Canada.

VARICOCELE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Having been operated upon at the Invalids' Hotel and Surgical Institute. Buffalo, N.Y., for the radical cure of a varicocele of the left side from which I had suffered for four years, I take pleasure in certifying to the speedy and certain relief afforded me, and the painless nature of the operation, as performed by the surgeons of the World's Dispensary Medical Association. Fourteen days from the time of the operation I returned home cured, and went to work. I desire to express my thanks to the Medical Staff for their skill and attention. I met several patients while at the Sanitarium, and they all reported as getting along favorably and well. Respectfully,

R.C. MARTIN, Gambril, Scott Co., Iowa.

VARICOCELE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I can heartily say that the operation was a great success. I had rupture of the veins, or Varicocele, ten years. I never thought that I could be cured so easily. The operation was entirely painless, and I was only nine days away from home. I am now as well as ever and I recommend the Invalids' Hotel and Surgical Institute to any one who is suffering from any chronic disease. Yours,

CHARLES DOVE, 33 John St., Wilkes Barre, Pa.

VARICOCELE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I was successfully treated for varicocele at the Invalids' Hotel. The operation was made painless by local application, previously applied, which made the parts insensible, and I returned home the ninth day. While there I met with patients from all parts of the country, and all spoke in the highest terms of the treatment received from the surgeons and nurses and all connected with the Institution.

Yours respectfully, J.F. SINGREY, Maryville, Nodaway Co., Mo.

VARICOCELE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I feel very thankful to the Association for the benefit received--due to an operation performed for the cure of a varicocele of many years' standing. All traces of the disease have disappeared. I was surprised to know that so little pain was connected with the operation.

Will say to those who think of visiting the Invalids' Hotel, that they will be treated well, and their visit will be made as pleasant as possible during their stay.

Yours respectfully, HENRY P. SMITH, Warren, Huntington Co., Ind.

VARICOCELE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Having been operated upon at the Invalids' Hotel and Surgical Institute, Buffalo, N.Y., for varicocele of ten years' standing, I take pleasure in certifying to a speedy and perfect cure. The operation was made painless by local applications previously applied, which made the parts insensible to such a degree that the operation was performed without any suffering on my part. Time of stay, after operation, was ten days. I cannot speak too highly of the care and attention I received from the surgeons and nurses while there; everything that was provided was of the best--the best of food, clean apartments and pleasant rooms.

I would recommend your Institution to any one suffering from any kind of chronic or surgical disease; and if they will only go to your Institution, they will meet with patients cured and others on the way to recovery from the same difficulty they have themselves--no matter what it is, if curable at all. I wish you success,

Yours truly, GEORGE R. SOUTHERN, Morris, Otsego Co., N.Y.

VARICOCELE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.

_Gentlemen_--It is with pleasure that I certify to the success of the operation performed upon me for varicocele at your Institution some months ago. This operation was performed by one of your specialists in a skillful and painless manner.

I found the Invalids' Hotel just what it is represented to be, and all patients who were there were well satisfied with the treatment.

I was not confined to bed at all after the operation, and was able to leave at the end of ten days in an excellent condition.

I am unable to express the great relief which your treatment has given me and I cannot say too much in praise of your Institution.

I take great pleasure in recommending you whenever I get a chance, and cannot thank you enough for what you have done for me. With kindest regards,

I am sincerely yours, B.T. STONE, Fellowsville, Preston Co., W. Va.

LARGE VARICOCELE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--It gives me much pleasure to state that during my stay at your Sanitarium I was treated with the utmost kindness, and found everything there just as represented in your pamphlet, if not indeed better. Your Institution is the best of the kind that I have ever seen and if it is possible for a person to be cured your specialists will accomplish it. A visit there convinced me that you do not make promises which you do not fulfill. After being there and having a surgical operation successfully performed, I heartily recommend all invalids to give your place a trial. Much to my surprise the operation which was performed was perfectly painless, no anæsthetic was given, and I was not confined to my bed for an hour. I was able to leave your Institution at the end of ten days completely cured. I can heartily commend your efforts in the cause of suffering humanity, and shall be pleased to offer my personal testimony at any time. With best wishes to the World's Dispensary Medical Association, I am,

Sincerely yours, C.W. KELLY, Riverside, Riverside Co., Cal.

VARICOCELE. THE RESULT OF INJURY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Nine years ago I was struck with a springing pole, causing the spermatic cord to swell badly. I applied for medical aid and was told that no harm would result. But I grew worse, and spent over one hundred dollars with quacks and received no help.

Four years ago while reading a chapter in Dr. Pierce's Common Sense Medical Adviser, I noticed that no hesitation was made in stating that a permanent and radical cure of varicocele could be made at the Invalids' Hotel and Surgical Institute. I went to the Hotel and the result was I returned home in eleven days permanently cured. I cannot speak in too high praise of the surgeon, and his delicacy and kindness in performing a painless operation; or of the nurses, who almost hourly visit the invalids and minister to their comfort. The Institution is fully equipped and nothing is left undone that can relieve suffering. I conversed with a great many patients while at the Invalids' Hotel and language could not express their delight at their treatment there.

I earnestly urge all invalids to save time and suffering by being treated at the Invalids' Hotel and Surgical Institute where the latest and most improved methods are used, and operations are made painless and where everything is delightful and comfortable. I owe my life to the tenderness and skill of the surgeon and nurses at the Invalids' Hotel and Surgical Institute.

Very truly yours, CLARENCE F.L. DEHAVEN, Haynes, Hocking Co., Ohio.

VARICOCELE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I can say that while in your Institution I received the best of care and attention both by doctors and nurses; that your operation was almost entirely without pain; that my virility has increased since then as well as the tone of my general health; that your Institution is as commodious and cheerful as one could wish. Your patients with whom I became acquainted while there nearly all seemed to be well pleased with the ease and comfort of their surroundings as well as the manner in which they were treated for varicocele.

Respectfully, FLAVIUS BROOKS, Sinnamahoning, Cameron Co., Pa.

BAD VARICOCELE OF MANY YEARS' STANDING.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I take pleasure in recommending your Invalids' Hotel and Surgical Institute as first-class in every respect. Some four years ago I was there and had an operation performed on me for a very bad varicocele with which I had been troubled some 15 or 20 years. The operation was made painless by the use of local applications. After staying at your place about twenty days (longer than is generally necessary) I was able to make my long trip home. The operation was a very successful one, considering the long time my trouble had been neglected, as I have suffered little or no inconvenience since. I saw a very large number of patients at the Invalids' Hotel from all parts of the United States and Canada, and all of them seemed to have a very high opinion of the treatment they were receiving from your Specialists, and I know personally, of several remarkably successful operations performed by your skillful surgeons while I was there.

Respectfully, D.E. MOOREFIEID, Nathalie, Halifax Co., Va.

VARICOCELE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Having been operated upon at the Invalids' Hotel and Surgical Institute for the cure of Varicocele, which was caused from heavy lifting, I take pleasure in informing you that it is entirely cured; it was a varicocele of a number of years' standing and a bad case. It has been three years since I was operated upon and I have not experienced any trouble from it since; in fact, I feel that I am now entirely cured. _The operation is painless_ and gives entire satisfaction in every respect.

I advise all who are suffering from this or any other chronic disease to take treatment at the Invalids' Hotel and Surgical Institute and they will be well rewarded by so doing.

Yours respectfully, DAVID H. MILLER, Markle, Huntington Co., Ind.

VARICOCELE OR FALSE RUPTURE--DUE TO STRAINING AND OVERWORK.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo. N.Y.:

_Gentlemen_--I can bear testimony to the removal of the difficulty for which you treated me, for I had been to experts in Philadelphia and they did not know how to perform the operation, and said I could not be cured. I was treated by experts in Albany and other cities, but all for no use. I went to the Invalids' Hotel and Surgical Institute and was operated upon and find I am cured. The treatment in every other respect was good; everything was done to make patients happy and pleasant; the best of care and attention was paid to all.

Yours truly, W. McGOWAN, Orbisonia, Huntingdon Co., Pa.

VARICOCELE OR FALSE RUPTURE--TWELVE YEARS' STANDING--CURED IN TEN DAYS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Having been operated upon at the Invalids' Hotel and Surgical Institute, Buffalo, N.Y., for the radical cure of a Varicocele of the left side, from which I had suffered for twelve years, I take pleasure in certifying to the speedy and certain relief afforded, and the painless nature of the operation as performed by the surgeon of the World's Dispensary Medical Association. Ten days from the time of the operation, I returned home radically and permanently cured. I desire to express my thanks to the medical staff for their skill and attention.

Gratefully yours, N.H. SHARITZ, Box 22. Rural Retreat, Wythae Co., Va.

VARICOCELE AND RESULTANT WEAKNESSES.

WASTING OF STRENGTH AND MANLY VIGOR--NOW STRONG AND WELL.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I am unable to find words to express my feelings of gratefulness and gratitude that I owe to your Institution, for the able and gentlemanly treatment that I was favored with during my stay with you, by officials and attendants in their respective capacities, in every department. Nothing was left undone that could possibly be of benefit to me or add to my comfort, and to your Institution, your treatment, which in my own experience I have found to be marvelously wonderful, I feel to-day as if I owe my health, my strength, my life; for I firmly believe if it had not been for your timely and painless treatment, instead of writing to you at this time, being in the enjoyment of health and strength, I would be filling a place in an insane asylum or an invalid's grave. And it may not be more than just to your wonderful treatment to say that the Varicocele and resultant weaknesses was of about fifteen years' standing, during which time I had spent time and money with both physicians and quacks, without any result for the better, and when my life blood was daily wasting away, and the powers of manly strength and vigor were completely gone, by an act of Providence I went to your Institution as a last resort, for life or death. I was painlessly operated upon by you for my complaint, from which time I have steadily improved in health, strength, weight and vigor, until I have gone from 135 pounds, my weight when operated upon, to 174, at which I tip the balance as I write to you to-day. If the afflicted everywhere could only realize that so many lives may be spared by your wonderful treatment, none would stay away.

You are at liberty to give my testimony to the world in whatever way it may be of most benefit to you. I also enclose a photograph of myself that has been taken since the effects of your treatment have been shown. With feelings of much gratefulness, I am,

Very truly yours, ROBERT B. WILLS, No. 23 Elizabeth St., Hagerstown, Md.

RUPTURE OF SPERMATIC VEINS.

VARICOCELE (FALSE RUPTURE)--PREVIOUS OPERATOR LEFT PART OF SURGEON'S NEEDLE IN FLESH; SUCCESSFULLY EXTRACTED AT INVALIDS' HOTEL.

"WHAT I THINK OF THE INVALIDS' HOTEL AND SURGICAL INSTITUTE:"

The Invalids' Hotel and Surgical Institute is an Institution first-class in every respect, presided over by a capable, honest and pleasant lot of medical experts who certainly know their business. I cannot speak of it too highly.

I was treated there in the summer of 1887, for Rupture of the Spermatic Veins, previous to which I had been operated on two different times, with no relief, by a doctor here in this place cracked up to be one of the best in Northern Illinois, and an officer of the Chicago Eye and Ear Infirmary. The operation at the Invalids' Hotel was perfectly painless, did not have to take any anæsthetic, neither was I confined to my bed at all, and the result a perfect success; while in the two previous operations I had here at home, I was confined to my bed a week each time and another week scarcely able to move about, be sides getting worse each time with pain enough to drive one crazy. But the half has not been told. About two and a half years after I had been cured of my difficulty at Buffalo, I commenced having terrible pains in my leg and abdomen, for which I could not account, and after standing it until it seemed as though I would be glad to die, I again consulted the Invalids' Hotel; after a thorough investigation they operated on me where my pain seemed the most apparent, and dug out a piece of a surgeon's needle something over half an inch in length, that had been broken off in the first operation I had by the doctor here at home, and so admitted by him when confronted with it. I have spent lots of money and nearly six years of the worst pain man ever stood getting relief, while had I known of this place on the start, an operation with no pain whatever and scarcely more discomfort than a sore mouth after having a tooth removed, would have ended it all.

In conclusion, I will say to any poor sufferer, don't do as I did and put your trust in the would-be greatest doctor you have at home, but go to this place at Buffalo, where you will have proof of their ability, and where you will surely meet patients about to leave, cured; others on their way to recovery for the same difficulty you may have yourself, no matter what it is, if curable at all; a place where you will have the kindest of attention, the best of medical and surgical skill, and where you can see sufferers going away every day with hearts full of gratitude and happy.

Respectfully, CHAS. P. MORSE, 311 North Avon St., Rockford, Ills.

VARICOCELE-FALSE RUPTURE CAUSED BY INJURY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--In the year 1866, sometime in July, I jumped from a load of lumber to the ground, and at once felt a sharp severe pain along the spermatic cord of left side of scrotum, preventing my walking to the house without help. The veins near the cord filled to such extent that they seemed solid, and could not be reduced for some time. I went to a good doctor and by him was advised to "pay no attention to it, it will not amount to much." From that time I suffered continually, and will not try to describe what I endured until I was relieved by a surgical operation performed on me by the surgeon-specialist of the Invalids' Hotel and Surgical Institute, of Buffalo, N.Y. After working-hard for several years my suffering increased and I was advised to consult Prof. L., of Chicago Hahnemann College (of Homeopathic School) and by him was informed an operation of tieing the veins (choking them off) could be performed but 90 per cent (if I remember rightly) of the operations proved fatal. I decided not to try it. By accident I learned of your great skill, and though my case was of twenty-one years' time, and my health and strength gone, I considered the method plausible and reasonably safe. I had the operation performed, and now after six years have passed, I can say with satisfaction, there is little to be noticed or remind me of the past years of misery. The parts are of healthy-color. Urine has assumed a natural appearance, both sides of scrotum seem in size alike. No bandage is worn and for two years has been discarded. My weight increased and for two years prior to the taking of my photo, I did the work of handling a third-class post office, doing a money order business of $50,000, not losing a day in that time, and at the present time in this hot climate, I have been doing outdoor work, some of it hard, and with mercury at 100 degrees. I have worked and found no need of a bandage; and no unnatural relaxation of the scrotum or veins is noticed.

If anyone wishes to write me, they are at liberty to do so. If my experience can be of benefit to any, I will answer all enquiries, and in a general way will now say no one should delay attending to such difficulty, for if the blood is in a reasonably healthy condition your surgeon will operate in such a way that the result will be all right in time. I send photo taken in 1891.

Respectfully, GEORGE W. McCOLLOM, Monrovia, Los Angeles Co., Cal.

VARICOCELE.

Sanborn, Barnes Co., N. Dak., Aug. 9th, 1895.

PROPRIETOR INVALIDS' HOTEL AND SURGICAL INSTITUTE, Buffalo, N.Y.:

_Dear Sir_--Having been afflicted with varicocele and loss of manhood and having heard so much of the cure for these troubles at the Invalids' Hotel. Buffalo. N.Y., I went there and was operated upon. The operation itself is nothing to bear. It is painless and the result is a radical cure. For this you have my sincere thanks. I take pleasure in recommending your Institution to all sufferers and know that it is in every respect just as claimed to be. I would say to all who suffer from this trouble: go to the Invalids' Hotel and Surgical Institute, at Buffalo, N.Y., and you will get relief. You will receive kind attention from all.

Very truly yours, George Bignall.

VARICOCELE AND GENERAL DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I can bear testimony to the removal of varicocele, for which you treated me. I had been in the habit of getting out with the boys and trying to see which could kick the highest with one foot on the ground, and it caused me to have varicocele. I went to my home doctor and he treated me with no success. It was getting worse all the time and I got out of shape all over. My health got bad and I thought my case hopeless. I had tried two doctors and received no benefit.

I had one of your little Memorandum Books in my pocket, and one day, looking through it I saw you treated such cases, and wrote you and received word in a few days that you would treat me, so I sent off for one month's treatment; and in five months I had gained my weight back, and that was eight years ago and I feel sound and well and my health has been good ever since.

You are at liberty to use my testimony in whatever way if may be of most benefit to you.

I also enclose a photograph of myself that was taken soon after your treatment.

With feelings of much gratefulness, I am,

Very truly yours, J.L. RIDINGS, Clarence, Shelby County, Missouri.

VARICOCELE AND NERVOUS DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I commenced treatment, I think, in July or August, of 1888, and continued four months. My case was nervous debility of fifteen years' standing.

I tried home doctors but found they were only aggravating my case. I also tried the Remedy Company, then of St. Louis, who claimed to perform wonderful cures with their "Pastiles," but they proved utterly worthless. Having come in possession of Dr. Pierce's little book and circulars, a perusal of the same convinced me that my health would not be trifled with at his Institution.

I was a poor man and could not afford much experimenting. I ordered one month's treatment, and at the end of this first month, I found, to my surprise, that I was feeling different. The second month, still more surprised at my returning health. Third month thought I was cured, and engaged myself to a young lady, and wrote you to that effect, and you advised me with your congratulations to marry, and to order another month's treatment; and at the end of the fourth month I was a _man_, something I did not know what it would be like to be before.

I have now been married five years, and have two healthy children--a boy and a girl. I would never have dared to marry had it not been for your medicines. I must add that during this treatment I was troubled with varicocele on left side. I wrote you this at third month of treatment, and you sent without extra charge, a Suspensory and Lotion, and two months' treatment cured me sound and well of this distressing malady; I have not felt the least symptoms of its return.

I want the world to know what a competent and honorable firm the World's Dispensary Medical Association is. I would love to shake you by the hand. May God let you continue to be a help to mankind is my prayer.

Yours truly, D.A. WALTON, Marion, Grant County, Ind.

BAD VARICOCELE OF LONG STANDING.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I feel many obligations to your noble skill, as physicians. I was treated with much kindness by physicians and nurses. I was surprised to find such a speedy cure of such a bad case of varicocele of long standing; the operation was entirely painless and I felt a great change in myself, as a result of it. Am so glad to tell any sufferer of that terrible disease to apply to you at once and be cured, for I am sure I could not have lived long as the pressure and burden was so great _I could scarcely be on my feet at all_; any work in an upright position was impossible.

Now it has been five years since I was operated upon and I feel well of that disease--varicocele attended with impotency or weakness of the generative organs, caused by varicocele.

Thanks to the good physician who relieved me--hope he may live long and be able to relieve all that submit themselves to him for treatment, as I