Chapter 30

breathing, and an occasional ringing cough, the child should be kept in bed, comfortably covered, but not overloaded with clothes, and the tincture or fluid extract of veratrum viride administered as follows: Take fluid extract of veratrum, five drops; sweet spirits of nitre, one teaspoonful; pure water, twenty teaspoonfuls; mix, sweeten with white sugar, and give a teaspoonful of the mixture every half-hour to two hours, according to the age of the child and the severity of the case. If there be great prostration, with cold extremities, the carbonate of ammonia should be administered, in doses of from one to two grains, every second hour, in gum arabic mucilage. Quinine is a valuable remedy, and is tolerated in large doses. The patient's body should be frequently sponged with warm water in which a sufficient quantity of saleratus or ordinary baking-soda has been dissolved to render it quite strongly alkaline. If the bowels be constipated they should be moved by an injection of starch-water. Beef tea and other concentrated, supporting diet should be administrated. In those cases in which there is a tendency to croup, the Golden Medical Discovery, together with iron and the bitter tonics, should be given to build up the system and counteract such tendency. The treatment which we have advised has been put to the severest tests in the most severe forms of the disease, and has resulted most successfully. If, however, in any case it does not give prompt relief, our advice is to lose no time in summoning a physician who is known to be skilled in the treatment of diseases of children.

SPASMODIC CROUP. In this affection no false membrane is formed. It seems to have a nervous origin. Most frequently the child is awakened in the night by a sense of suffocation. He may cry out that he is choking. The countenance is livid, the breathing is hurried and each respiration is attended by a crowing sound. The child has fits of coughing or crying, and makes vehement struggles to recover his breath. This complaint, unlike croup, is unattended by fever, it being of a purely spasmodic character with no inflammation.

Apply hot fomentations to the throat, and give frequent small doses of tincture or fluid extract or syrup of lobelia, to produce slight nausea; or, better still, an acetic syrup of blood-root, made by adding one teaspoonful of the crushed or powdered root to one gill of vinegar and four teaspoonfuls of white sugar. Heat this mixture to the boiling point, strain, and administer from one-fourth to one teaspoonful every half-hour or hour. Slight nausea should be kept up, but it is unnecessary to produce vomiting. This is usually all the treatment that is required.

WHOOPING-COUGH. (PERTUSSIS.)

This is primarily a disease of the nervous system, involving the respiratory organs through the medium of the pneumogastric nerve. It is considered a disease of childhood, though we have met with it in _old age_. It is eminently a contagious affection, and occurs generally but once during life.

SYMPTOMS. It is at first manifested by a catarrhal cough, gradually developed. After a while it becomes paroxysmal, generally worse at night. The cough is severe, and long-continued; when a prolonged inspiration occurs, it is accompanied by a peculiar shrill sound, the characteristic _whoop_, which, when once heard, is never forgotten. The cough is attended by a copious secretion of glairy mucus, which is brought up at the latter part of the paroxysm. During, or at the end of the paroxysm, vomiting frequently occurs, and sometimes nosebleed. The cough is so severe at times, that the patient turns purple, gasps for breath, and presents all the symptoms of suffocation. Bronchitis sometimes is a troublesome complication. Immediately preceding a paroxysm of coughing a sense of impending danger appears to seize the child, and it runs to its mother, or grasps some support, as if for protection. Until the paroxysmal character and peculiar _whoop_ is developed, the disease is diagnosed with difficulty.

TREATMENT. We have found the Golden Medical Discovery to modify the disease and cut it short. The philosophy of its action can be readily understood by its effect on the pneumogastric nerve, as explained under consumption and bronchitis. Jaborandi, described under the head of diaphoretics, often speedily arrests this disease. The employment of an infusion of red clover blossoms, in small doses, is of undoubted value in modifying the irritation of the air-passages, and may be used to good advantage with, or in alternation with the Golden Medical Discovery. Exposure to cold and wet should be avoided.

NOSEBLEED.

Hemorrhage from the nose is commonly the result either of a catarrhal or an inflammatory condition of the nasal mucous membrane. Individuals are susceptible to it who are oppressed by fever or constitutional diseases that reduce the strength. There is also a condition of the nervous system in which there is congestion of the nerve centres which favors manifestations of this somewhat troublesome difficulty.

CAUSES. In some instances an examination of the nose will reveal the presence of a small point of congested vessels, usually about the size of a split pea. Upon this portion of the mucous membrane small scabs form, and at any time when they may be dislodged, by accident or otherwise, a hemorrhage will ensue.

The constitutional conditions that produce the tendency to hemorrhage are most important. In individuals of a debilitated condition, it results from the lack of a proper amount of fibrin in the blood. Where the blood becomes thin, or loses a large share of its red corpuscles, the individual is pale, and hemorrhages are frequent from the mucous surfaces of any portion of the body, the nasal mucous surface being especially liable to such attacks.

TREATMENT. This is local and constitutional. Where there is constitutional imperfection, it should be remedied. Usually in young women there is some difficulty with the ovarian or uterine circulation, and the attack of hemorrhage from the nose is reflex in its character, appearing just before or at the time of the menstrual flow, accompanied with troublesome headache. The correction of this form is by the use of the "Favorite Prescription" and "Golden Medical Discovery," using of each a teaspoonful three times a day, taking the "Prescription" before meals and the "Discovery" after meals. If the bowels are constipated, the "Pellets" should be employed, in order to overcome any congestion of the liver which favors the manifestation of nosebleed. In children there is usually a debilitated state of the system, which is best remedied by the use of a half teaspoonful dose of the "Discovery," taken three times a day, after meals, with sweetened water. This treatment should be continued for a month or six weeks. By this means the blood-making organs rapidly improve in their activity and functions, the blood becomes rich in corpuscles and fibrin, thus strengthening the walls of the blood-vessels and tending to prevent a hemorrhage following undue excitement or injury. With men the use of laxatives is of great importance. One or more of the "Pellets," taken on retiring at night, are most beneficial. Where the blood is not up to the standard of purity, even though the individual be fleshy, the "Discovery" should be used, a teaspoonful or two, three times a day, after meals, in conjunction with plenty of outdoor exercise and the best of food. Where the hemorrhages occur in those having too much blood, the diet must be corrected by the use of vegetables and fruit, diminishing the amount of meat and pastries to a minimum. The amount of fibrin should also be increased by the use of the "Golden Medical Discovery."

LOCAL TREATMENT. Of those applied directly to the membrane, Dr. Sage's Catarrh Remedy, used according to the directions which wrap the bottle, is excellent in bringing about a normal condition of the mucous surfaces. Following this, a small amount of Subnitrate of Bismuth may be snuffed into each nostril. Usually the amount required to cover a three-cent silver piece is sufficient. The powder dries the surface and favors the speedy formation of a coagulum, or clotted covering, which effectually checks any further hemorrhage. The application of a firm compress to the upper lip will also diminish the flow of blood through the arteries that run to the anterior portion of the mucous surface. Good effects often follow the use of a small piece of ice applied to the nape of the neck. This, with a reclining posture, will cause contraction of the blood-vessels. If the Subnitrate of Bismuth is not to be readily obtained, the use of any other powder such as starch, finely divided and baked so as to be free from a tendency to form starch paste when applied to a mucous surface, is equally good. Well-browned flour is also serviceable. The use of the contents of a puff-ball, which contains many millions of fine spores, has been employed from time immemorial. The use of such drying powders tends to favor the speedy formation of clots. Where the small points of engorged vessels are to be readily reached, use a solution of the Tincture of Chloride of Iron, one part in four of water, applying with a small pledget of soft cotton wrapped about, or fastened to, the end of a pencil or stick. In this way the solution may be applied in very small amount to the spot where the hemorrhage appears, and will give immunity from future attacks. Any of the styptics (see pages 320-325) can be called into service. Those who have the advantage of the city drug store may use a solution of basic ferric sulphate (Monsell's solution), or the spray of a three or four percent. solution of cocaine. The latter is one of the most pleasant and effective remedies in these emergencies. Before its administration the nasal cavity should be cleansed by snuffing up the nostrils salt and warm water. When washed, immediately apply the spray. If the constitutional condition which led to the hemorrhage continues, the general remedies--of which the "Golden Medical Discovery" is the most efficacious--should be administered. This agent increases the number of red blood corpuscles, and enriches the blood in fibrin, so that the relief obtained is absolutely permanent.

INFLAMMATION OF THE STOMACH. (GASTRITIS.)

Gastritis is generally defined as an inflammation of the mucous membrane of the stomach. However, the cellular, muscular, and serous tissues are all liable to be more or less affected. Gastritis may be either _acute_ or _chronic_. Either form is a distinct modification of disease, manifesting peculiar symptoms and requiring special remedies.

_Acute Gastritis_ generally occurs as a result or complication of other diseases. It is an occasional feature In scarlatina, serious cases of bilious fever, and in cutaneous affections of every description. The mucous membrane of the stomach is placed in intimate communication with all the vital organs, by means of the nerves of the solar-plexus, hence the sympathy between the stomach and skin, and the morbid condition of the stomach occasioned by disease of other organs.

THE EARLY SYMPTOMS of acute gastritis are a burning sensation in the stomach, accompanied by nausea and frequent vomiting. The respiratory movements are rapid and shallow, the pulse is hard and short, and as the disease progresses, becomes small, frequent, and thready. The tongue usually retains its natural appearance, but it is sometimes dry and tinged with a vivid scarlet at the tip and edges. Intense thirst and hiccough are occasional symptoms. The facial expression is haggard, and indicative of the most intense suffering. The stomach will not retain the mildest liquids. In the early stages of the disease, the ejections consist of chyme and mucus, streaked with blood. As it progresses, the vomiting becomes a sort of regurgitation, the contents of the stomach being ejected without any apparent nausea or effort. The ejections then consist of a dark-colored granular matter, resembling what is known in yellow fever as _black-vomit_.

CAUSES. Formerly it was supposed that this was a very common disorder, and the term _acute gastritis_ was applied to every development of symptomatic fever. But late clinical and pathological investigations clearly indicate that acute gastritis is of rare occurrence. It may be caused by the excessive and habitual use of alcoholic drinks, especially if taken without food, by copious draughts of cold water, or by intense emotions. But its _general_ cause is the ingestion of irritating and corrosive poisons.

Where the former causes are known not to exist, the presence of poison should always be suspected. As the cause sometimes becomes a matter of legal investigation, it is very important that the practitioner should be able to determine the _real_ origin. If caused by poison, the disease is very suddenly developed, the patient complaining of a very intense burning sensation in the throat and the lining membrane of the mouth, which will generally show the action of the poison. A diarrhea is also more apt to accompany the disease. If inorganic or vegetable poisons are known or suspected irritants, the appropriate antidotes should be promptly administered. For a list of the principal poisons and their antidotes, with practical suggestions for treatment, the reader is referred to the article in this volume, on Accidents and Emergencies.

TREATMENT. The inflammation should be allayed, and a tea made of peach-tree leaves is very serviceable. Small pieces of ice, swallowed, will generally allay the thirst and vomiting, and a mucilage of slippery-elm is very soothing to the inflamed mucous membrane. This is an important disease, and its management should be entrusted to a skillful physician.

CHRONIC INFLAMMATION OF THE STOMACH.

_Chronic Gastritis_ is sometimes mistaken for dyspepsia or gastralgia. It is very necessary to discriminate between these diseases, as the appropriate remedies of the latter will often only aggravate and augment the former.

A chronic inflammation of the stomach is a very common affection and has many phases, but the term chronic gastritis is applied only to that species of inflammation occasioned and accompanied by irritation. It is seldom a result of the _acute_ form.

THE SYMPTOMS of chronic gastritis are various and sometimes vague. Among those which are prominent we may mention an irregular appetite. At times it is voracious and the patient will consume every available article of diet, while at others he will experience nausea and disgust at the sight of food. Even when very hungry, one mouthful of food will sometimes produce satiety and cause vomiting. The appearance of the tongue is variable, sometimes natural, at others thickly coated. The desire for drink is capricious, varying from intense thirst to indifference. Another prominent symptom is a sense of heaviness and heat in the epigastric region, after partaking of food. Often a small quantity, as a teaspoonful of milk, will produce a sensation of weight, as a heavy ball lying at the pit of the stomach. This symptom is frequently accompanied by a frontal headache, and a small and wiry pulse. Dull or shooting pains are experienced in the stomach and between the shoulders, and the patient becomes weary, melancholy, and emaciated.

CAUSES. The general cause of chronic gastritis is excess in eating or drinking, and the use of alcoholic liquors. We have known it to be produced by drinking _hard_ cider. Great mental excitement predisposes the system to this affection. Occasionally it is a result of febrile diseases, as scarlatina, typhoid fever, etc. In some families there is a constitutional tendency to its development.

TREATMENT. All medicines which tend to irritate the stomach, should be studiously avoided. The bowels should be kept regular, and the skin clean by frequent bathing. Stimulants of all kinds must be avoided. As a principle article of diet, we would recommend milk and farinaceous articles. If these precautions be observed, nature will sometimes effect a cure. Lime water and the subnitrate of bismuth, in twenty-grain doses three or four times a day, are useful to allay irritation. Other suggestions applicable to its domestic management, maybe found under the hygienic and medicinal treatment of dyspepsia, to which we refer the reader.

NEURALGIA OF THE STOMACH. (GASTRALGIA.)

Gastralgia is a neuralgic affection of the stomach, unaccompanied by inflammation. It is sometimes mistaken for chronic gastritis, although there is a marked difference in the symptoms.

A PROMINENT SYMPTOM OF GASTRALGIA is a _paroxysmal_ pain radiating from the epigastric region, to all parts of the thoracic cavity. The pain is sometimes lessened by walking, lying on left side, or by gentle pressure, and usually abates after eating, but is renewed in a few hours. The patient occasionally experiences a sense of heaviness at the pit of the stomach, nausea, and frequent salty eructations. The tongue is white, the appetite variable, and there is no desire for liquids. The sleep is usually refreshing, and when not suffering from acute pain, the patient is apparently well.

The _distinguishing_ symptom of this disease is a feeling of intense despondency, and, sometimes, a morbid fear of death.

An effectual method of distinguishing between gastralgia and chronic gastritis is by the administration of an alcoholic stimulant. If gastritis be the affection the pain will be augmented; whereas, if it be gastralgia, it will be relieved.

CAUSE. The cause of gastralgia is a local or sympathetic irritation of the nerves distributed to the stomach.

TREATMENT. The pain of gastralgia is sometimes allayed by using half a teaspoonful of subcarbonate of bismuth, and repeating the dose, if the attack is not relieved. The following is a very effectual remedy: take twenty grains of quinine, combined with one drachm of prussiate of iron, and divide it into ten powders, and administer a powder every three hours until the pain is completely arrested. Temporary relief may be given by administering one-quarter of a grain of morphine, or ten to twenty drops of chloroform in a teaspoonful of glycerine, slightly diluted, taken in one dose. One of the most effective remedies for preventing a return of the attacks is that invigorating tonic and alterative, the "Golden Medical Discovery." The patient should be careful in diet, and not eat too much food, which should not only be of a nutritious kind, but easy of digestion. Cleanliness, suitable clothing, bodily warmth, exercise, and rest must not be neglected. Sometimes it is lingering and requires long persistence in hygienic and medicinal treatment. Everything tending to promote the tone of the digestive organs, and improve the functions of the system generally may be considered advantageous in this neuralgic affection.

PERITONITIS.

The _peritoneum_, or serous membrane which lines the abdominal cavity and invests the intestines, is liable to become inflamed. When this occurs, the affection is termed peritonitis, and may be divided into the _acute_ and _chronic_ forms.

ACUTE PERITONITIS. This form may be circumscribed; that is, confined to one spot, or it may extend over the entire surface of the peritoneum, when it is known as _general_.

SYMPTOMS. There is headache, quick pulse, tongue coated white, countenance pallid, features pinched, respiration difficult, nausea and vomiting, severe pain in the abdomen, which is extremely sensitive to pressure and becomes very much distended. There is also pain in the limbs, the bowels are constipated, and, in exceptional cases, diarrhea is a prominent symptom. The urine is deficient in quantity, and there is sleeplessness, chilliness, and great general prostration. Vomiting and coughing or sneezing increase the pain. An erect position occasions intense suffering. The patient is compelled to assume a recumbent posture and is inclined to lie on the back, for in that position the sufferer experiences the least pressure of the vital organs against the peritoneum. There is also an inclination to draw up the lower limbs and retain them in a flexed position.

CAUSES. Prominent among these are injuries which have been inflicted upon the intestines, compression of the colon, or rectum, perforation of the stomach or bowels, either by violence or some pre-existing disease, thus allowing the discharge of blood, urine, bile, or fecal matter into the abdominal cavity; also abortion, over-exertion, and exposure to wet or cold. As acute peritonitis is always a grave disease, involving more or less danger to life, it is the wisest course to employ a physician and trust the case to his management. The same remark is equally applicable to the chronic form of the disease.

CHRONIC PERITONITIS. Like the acute, it may be either _circumscribed_ or _general_. This form is sometimes, though rarely, a sequel of the acute. When it appears independently of the acute, it is generally associated with some cutaneous affection pertaining to the abdominal cavity, and the inflammation is induced by the tumor. If chronic peritonitis be connected with the _tubercular_ diathesis, tubercles may be discovered upon the surface of the stomach and alimentary canal, and may also be found in the lungs and brain.

When the affection is not tubercular there will appear in the abdominal cavity an effusion of serous fluid of greater or less quantity, mingled with blood and pus. When such an effusion takes place, the abdomen gradually increases in size, or becomes smaller than is natural. There is pain, attended by soreness upon pressure, and the patient becomes emaciated.

Inflammation of the peritoneum is frequently an accompaniment of _puerperal fever_, which is a disease peculiar to childbirth, and which may arise from cold, or be communicated from one parturient patient to another by midwives.

TREATMENT. In the remedial management of acute peritonitis, it is obviously necessary to use some agent which will at once influence and change the congested state and inflammatory condition. One of the best agents employed to make a decided impression upon the vascular system, subdue inflammation, and modify its action, is the fluid extract of veratrum viride, administered in full doses, and repeated until the system shows its effects in a decided manner. Warm fomentations applied to the abdomen are sometimes very serviceable, and are objectionable only because of their liability to dampen the bed-clothes. When the abdomen will bear a thick, warm poultice, apply it, and then cover the entire surface with oiled silk. The tincture of opium, in doses sufficient to relieve pain and quiet the peristaltic action of the intestines, is generally necessary.

EPIDEMIC CHOLERA.

This is an epidemic disease, supposed to be due to an impalpable specific poison, but as to the exact nature of this poisonous matter nothing definite is known.

This plague first made its appearance on our continent in 1834. Owing to its great fatality, it is a disease much to be dreaded.

SYMPTOMS. These are well defined. It is characterized in its earlier stages by pain in the stomach and bowels, especially in the umbilical region, nausea, vomiting, diarrhea; later, the purging is excessive, and the matter dejected resembles rice-water, and contains white, solid, curd-like matter. The patient loses strength, and sinks rapidly. The secretory organs fail to perform their functions normally, the skin is sometimes moist, but oftener cold and dry; but little if any bile is found in the excretions, and the urine voided is very scanty. There is general nervous derangement, as indicated by the spasmodic contraction or cramping of the muscles. This first attacks the extremities, but soon affects the entire body, and gives rise to excruciating pains. The head is affected by singing, roaring, disagreeable noises in the ears, the pulse is feeble, but quick, the nails are of a bluish color, the tongue is coated white, the eyes are sunken, and the patient has a corpse-like appearance; the temperature of the body rapidly falls, the surface becomes deathly cold, and, unless the disease is promptly arrested in its course, speedy dissolution follows. The disease is rarely prolonged beyond twenty-four hours, and sometimes terminates within three or four hours after its first attack.

TREATMENT. The kind of medicine required depends upon the severity of the attack and stage of the disease. In all cholera epidemics, there are premonitory symptoms, such, as an uneasy sensation at the pit of the stomach, and a rumbling of the bowels. This is apt to be followed by a painless diarrhea, which occasions no alarm, and the patient pays but little attention to it. Herein is the great and dangerous mistake. The patient is already in the stage of _invasion_, which must be promptly arrested, or he will suddenly be precipitated into the stage of _collapse_. The patient should lie down, and have placed about him bottles filled with hot water, thereby exciting warmth upon the surface of the body. At the same time, administer two teaspoonfuls of the Extract of Smart-weed. If the symptoms are urgent, repeat the dose every fifteen minutes. Brandy, thickened with sugar, may also be given. In either the stage of _invasion_ or _collapse_, the leading indication is to establish _reaction_ by promoting perspiration. Bathe the feet in water as hot as can be borne, give the Extract of Swart-weed freely, and thus endeavor to excite profuse diaphoresis. No time should be lost, for delays are dangerous. When the reaction is established, the patient should remain quiet, and not attempt to exert himself.

After reaction has taken place, the sweating should be maintained for twelve hours, and the patient should drink slippery-elm tea and toast-water, and partake sparingly of soft toasted bread and chicken broth. The food should be fluid and nutritious, but taken in small quantities. Do not disturb the bowels with laxatives until the third day after the patient begins to improve, and then they may be moved by an injection of warm water. Great care should be taken that the patient does not indulge too soon or too freely in the use of food. When a skillful physician can be had, no time should be lost in securing his services, but since in epidemics of this nature, medical men are generally overworked, and not always easily and promptly to be had, we have been quite explicit in giving full directions for treatment.

CHOLERA MORBUS, also known as _sporadic cholera_ and _simple cholera_, usually occurs during the summer months. The attack may be sudden, although it is usually preceded by a sensation of uneasiness and colicky pains in the stomach.

SYMPTOMS. Nausea, vomiting and purging are the most prominent symptoms. The discharge from the bowels is at first of a thin, yellow appearance, but finally it becomes almost colorless. Sometimes, after the contents proper of the bowels have been evacuated, the dejections have a bilious appearance. Severe cramps and pain accompany the vomiting. The vomiting and purging usually occur in paroxysms, but finally become less frequent, a reaction takes place, the extremities grow warm, and the patient gradually recovers. It may be accompanied by intense thirst and a quick pulse, yet the surface may be cool.

CAUSES. Cholera morbus is most prevalent in warm climates, and especially in malarial districts. It is generally the result of eating indigestible articles of food, such as unripe fruit or uncooked vegetables. Stimulating drinks, or those articles which furnish the elements for fermentation, also favor the production of this disease.

TREATMENT. If the attack be superinduced by eating unripe or stale fruit, it may be proper to give an emetic or a cathartic, but ordinarily first give a full dose of the Extract of Smart-weed, and, if the vomited matter is very sour, give the patient a weak, alkaline drink, which may be made by dropping a few live, hard-wood coals into a tumbler of water. This will not only assist in neutralizing the acidity of the stomach, but will help to allay the thirst and accompanying fever. If the patient throw up the first dose of the Extract of Smart-weed, a second should be given. Do not allow the patient to drink cold water, and give only tablespoonful doses of the alkaline solution every thirty minutes. If the thirst is great, occasionally give a tablespoonful of a tea made from scorched Indian meal, which not only allays the desire to drink, but also the irritation of the stomach. If to be obtained, give a tea of the leaves or bark of the peach tree. The patient should be well covered in bed and kept warm. Laudanum by the stomach, or by enema, may he necessary in severe cases to relieve the pain and check the purging. Hot fomentations applied to the bowels are very valuable. A mustard plaster applied over the abdomen will assist materially in relieving the nausea and vomiting. It should not be left on sufficiently long to blister. When the affection is promptly treated as we have suggested, the patient generally quickly recovers. If, however, it does not yield to these measures, the family physician should be called in.

ACCIDENTS AND EMERGENCIES.

Accidents and emergencies which require immediate attention frequently occur. Professional aid cannot always be quickly obtained and hence fatal results often follow. It is, therefore, important that all persons should not only know how to proceed under such circumstances, but that they should be able to exercise that deliberation and self-control so necessary in emergencies of all kinds. Most persons are more or less affected by the sight of blood or severe wounds, and it requires an effort to maintain self-possession. One should act resolutely; otherwise he will find himself overcome and unable to render any assistance.

WOUNDS.

Wounds may be classified as _incised, punctured, contused, lacerated_, or _poisoned_.

_Incised_ wounds are those which are made with a sharp, cutting instrument, and are characterized by their extent of surface.

_Punctured_ wounds are made with a pointed instrument, and distinguished for their depth rather than breadth.

_Contused_ wounds are those produced by bruises.

_Lacerated_ wounds are those in which the flesh is torn and mangled.

_Poisoned_ wounds are made with a poisoned instrument, or by some poisonous reptile or insect or rabid animal.

In all cases of wounds, the immediate danger is in the _shock_ produced upon the nervous system, and in the liability to _hemorrhage_.

SHOCK. If severe, the shock is attended with symptoms of extreme prostration, such as a feeble pulse, shivering, partial unconsciousness, fainting, hiccough, vomiting, and involuntary discharges of the urine and feces.

TREATMENT OF SHOCK. The clothing should be loosened immediately after the accident, so that the blood may have free circulation, and the patient should be kept in a recumbent position. He should have plenty of fresh air. Camphor or ammonia may be inhaled. If he can swallow, stimulants may be given, as whiskey or brandy, but with care that they do not run into the trachea, or windpipe. If he be unable to swallow, they may be administered as injections, but should gradually be discontinued as reaction takes place. A warm pillow placed at the back and the use of electricity may be beneficial.

HEMORRHAGE, or bleeding, may generally be controlled by a _compress, tourniquet, flexion of the joint_, or _styptics._ A _compress_ consists of several folds of cloth laid upon a wound, the edges of which have been brought together, and made secure by a moderately tight bandage.

_A tourniquet_ may be extemporized by rolling a handkerchief into a cord and tying it around the limb, over a compress, between the wound and the heart. A stick should then be thrust between the handkerchief and skin and twisted around several times, until the pressure is sufficiently great to arrest the circulation of the blood in the wounded part. A representation of this operation may be seen in Fig. 1.

_Flexion of the joint_, as represented in Figs. 2, 3, and 4, is adapted to many cases of hemorrhage. As water cannot flow through a rubber tube bent at a sharp angle, so the acute flexion of a limb prevents the free flow of blood through the arterial tubes.

In some cases, _styptics_ may be directly applied to the wounded tissues. Cold acts as a powerful styptic, and may generally be made available for arresting hemorrhage.

POISONED WOUNDS. The treatment of these should chiefly consist in the prevention of the spread of the poison. This may be done by tightly applying bandages above the wound and scarifying or sucking the parts. Nitrate of silver may then be used and the ligatures removed. Alcohol, in any form, is an antidote to snake poison. For the stings of insects, apply aqua ammonia, fresh earth, raw onion, plantain, or spirits of turpentine.

FRACTURES AND DISLOCATIONS.

The treatment of injuries received from the fracture of bones and the dislocation of joints should never be attempted by the inexperienced, nor should the management be left to incompetent physicians but _skillful_ surgical aid should at once be summoned.

SPRAINS.

A sprain consists of a sudden and forcible stretching of the ligaments and tendons connected with a joint, without there being any dislocation. It is attended with severe pain and is followed by rapid swelling.

The treatment should consist of measures to prevent inflammation, promote absorption, and restore a healthy action. The affected part should be kept at rest in an elevated position, and hot or cold water applied frequently. If there is much inflammation, fomentations of hops may be used. The Compound Extract of Smart-weed is an excellent application.

When the acute symptoms have disappeared, absorption should be favored by systematic rubbing and the application of stimulating liniments, or by the use of a well-adjusted bandage. Passive motion may be resorted to gradually and the subject may use the joint moderately. Should any stiffness remain, warm salt water douches should be employed and the Extract of Smart-weed applied once a day.

BRUISES.

Bruises or contusions are caused by falls, wrenches, or blows from blunt instruments, without breaking the skin. The soft tissues are lacerated and blood is poured out into them, constituting _ecchymosis_. The discoloration passes through various shades from a bluish-black to a violet, a green, and finally, a yellow.

If the bruise is severe, the affected part should be kept at rest and frequently bathed with the Compound Extract of Smart-weed or the tincture of arnica. If inflammatory symptoms supervene, fomentations and poultices should be applied.

FOREIGN BODIES IN THE NOSE.

Foreign bodies, such as beads, peas, coffee-grains, and small gravel-stones are occasionally introduced into the nostrils of children, becoming fastened there, and causing great anxiety and alarm. If allowed to remain, they generally cause inflammation and suffering.

Such bodies may generally be washed out by gently injecting a stream of tepid salt water with a syringe or Dr. Pierce's Nasal Douche. In no case should force be used. If these means fail, a competent surgeon should be consulted.

FOREIGN BODIES IN THE THROAT AND AIR-PASSAGES.

Foreign bodies are generally arrested so high up that they may be seen by simply depressing the tongue, and removed with the finger or a pair of forceps. The head should be thrown back in such a position as to cause the chin to project as little as possible beyond the prominence known as Adam's apple, in order that the finger or forceps may be readily introduced and the body released and ejected. When the foreign bodies are so small as to pass out of sight in the larynx, windpipe, or esophagus, it is generally difficult to extract them, and the services of a surgeon are required. Fortunately, however, there is not much immediate danger from suffocation in such cases.

DROWNING.

Recovery from drowning sometimes occurs when life is apparently extinct. The treatment, however, should be immediate and energetic, and should be given in the open air, unless the weather be too cold.

TREATMENT. The patient should be gently placed upon the face with his wrists under his forehead. The tongue will then fall forward and the water run out of his mouth and throat, while the windpipe, or air-passage, will be free. To restore respiration, he should be instantly turned upon his right side, his nostrils excited with snuff or ammonia, and cold water dashed upon his face and chest. If this operation prove unsuccessful, replace the patient upon his face, care being taken to raise and support his chest, turn the body gently on the side and quickly again upon the face. Alternate these movements about every four seconds, and occasionally change sides. When the body is turned on the face, gentle but efficient pressure should be made along the back, between the shoulder blades, to assist in forcing the air out of the lungs, but this pressure ought to be removed before the patient is turned back on his side. Persistently repeat this operation, and success will often be the reward. As soon as respiration is established, warmth may be promoted by the application of warm flannels to the body and bottles of hot water to the stomach, armpits, thighs, and feet. During the entire process of restoration, the body should be thoroughly rubbed _upwards_. Turning the body upon the back or handling it roughly should be avoided. The person should not be held up by his feet, or be rubbed with salt or spirits. Rolling the body on a cask is improper, and injections of the smoke infusion of tobacco are injurious. Avoid the constant application of the warm bath, and do not allow a crowd to surround the body.

FAINTING.

When a person faints, _he should be allowed to remain or be placed in a recumbent posture_, and his clothing immediately loosened. The extremities should be rubbed, the patient permitted to have plenty of fresh air, and, if at hand, ammonia or camphor should be applied to the nostrils.

BURNS AND SCALDS.

The danger arising from burns and scalds depends not only upon the extent of surface involved, but also upon the depth of the injury. Burns are most dangerous when occurring upon the head, chest, or abdomen.

TREATMENT. Soothing applications, and those which will exclude the air, should be made. Grated potato, poultices of slippery-elm, sweet oil, cotton saturated in a mixture composed of two or three grains of carbolic acid and two ounces of glycerine, and linseed oil and white lead, are all beneficial for the treatment of burns. If internal treatment be necessary, it should be given under the direction of a competent physician.

SUN-STROKE.

In cases of sun-stroke, the patient should be at once removed into the shade. If the face is _flushed_, apply cold water to the head and neck, and mustard to the feet. The body should be bathed in tepid water and the head slightly elevated. If the countenance is pale, the symptoms denote exhaustion, and the patient should be kept in a recumbent position, the extremities rubbed, camphor and ammonia inhaled, mustard applied to the spine, and stimulants, such as brandy or whiskey, should be administered.

POISONS AND THEIR ANTIDOTES. ----------------------+-------------------------------------------------- POISONS. | ANTIDOTES. ----------------------+-------------------------------------------------- ACIDS. | | Acetic Acid. | Alkalies--carbonate of soda and potash--also Citric Acid. | lime and magnesia are antidotes to these Muriatic Acid. | poisons. As soon as the acid is neutralized, Tartaric Acid. | mucilaginous teas, such as flax-seed, gum | arabic, or slippery-elm, may be given. | Sulphuric Acid | Soap, in solution, or magnesia will counteract (Oil of Vitriol). | its influence. Water should _not_ be given | as it causes great heat when mixed with this | acid. | Nitric Acid | Lime-water, carbonates of lime and magnesia (Aqua Fortis). | in solution, are the only antidotes. Give Oxalic Acid. | mucilaginous drinks. | Carbolic Acid. | There is no special antidote. Oil, glycerine, | milk, flour and water, white of eggs, | magnesia, and flax-seed tea may be used. | Prussic Acid. | Ammonia, by inhalation or in solution, may Laurel Water. | be used. Apply a cold _douche_ to the head. Oil of Bitter Almonds.| | These agents are | speedily fatal. | | ----------------------+-------------------------------------------------- | ALKALIES. | | Liquor of Ammonia. | Vegetable acids, such as vinegar, lemon-juice, Water of Ammonia. | citric and tartaric acids, neutralize this Muriate of Ammonia. | poison. | Liquor of Potassa. | All the fixed oils, such as linseed, castor Nitrate of Potassa | and sweet oil, also almonds and melted lard (Saltpetre). | destroy the caustic effects of these poisons Carbonate of Potassa | Mucilaginous drinks may be given. (Pearlash). | Salts of Tartar. |

--------------------+----------------------------------------------------- POISONS. | ANTIDOTES, --------------------+----------------------------------------------------- | IODINE. | Starch, wheat flour mixed with water, In its | whites of eggs, milk, and mucilaginous different forms. | drinks are excellent antidotes. | --------------------+----------------------------------------------------- | VOLATILE OILS AND | AGENTS. | | The same antidotes as in case of poisoning Creosote | with iodine may be used in this, or the (Oil of Smoke). | stomach may be evacuated with an emetic or a Oil of Tar. | stomach-pump. Oil of Turpentine. | | --------------------+----------------------------------------------------- | A powerful emetic of white vitriol or mustard | should be given at once, cold should be ALCOHOL. | applied to the head, and the extremities | vigorously rubbed. | --------------------+----------------------------------------------------- ANTIMONY AND ITS | COMPOUNDS. | If vomiting has not occurred, induce it by | tickling the throat and giving large draughts Tartar Emetic | of warm water, after which administer Butter of Antimony | astringents, such as infusions of galls, oak bark, Oxide of Antimony. | Peruvian bark, or strong green tea. | --------------------+----------------------------------------------------- | ARSENIC AND ITS | COMPOUNDS. | | White Arsenic. | Oils, or fats lard, melted butter, or milk Yellow Sulphuret of | should be given, then induce vomiting with Arsenic | sulphate of zinc, sulphate of copper or Red Sulphuret of | mustard; fine powdered iron rust or magnesia Arsenic | may be given every five or ten minutes. King's Yellow. | Mucilaginous drinks should be given as soon Fly Powder. | as the stomach is evacuated. Arsenical Paste. | Arsenical Soap. | Scheele's Green. | Paris Green. | | --------------------+----------------------------------------------------- COPPER AND ITS | COMPOUNDS. | Avoid the USE of vinegar. Give albuminous | substances, such as milk, whites of eggs, wheat Blue Vitriol | flour in water, or magnesia; yellow prussiate Verdigris. | of potash in solution may also be given freely. |

--------------------------+------------------------------------- POISONS | ANTIDOTES. --------------------------+------------------------------------- LEAD AND ITS COMPOUNDS. | In lead, or painters' colic purgatives | and anodynes may be given, together Acetate of Lead | with large doses of iodide of (Sugar of Lead) | potassium. White Lead. | Red Lead. | Litharge. | --------------------------+-------------------------------- MERCURY AND ITS | COMPOUNDS. | Albumen in some form should be | given; if the poison is not Corrosive Sublimate. | absorbed, follow with a mustard White Precipitate. | or lobelia emetic. Red Precipitate. | Calomel. | --------------------------+----------------------------------- ACRONARCOTICS. | | The general treatment indicated for Ergot | this class of poisons, is to Black Hellebore. | evacuate the stomach with a Veratrum Viride | stomach-pump or an emetic composed (American Hellebore). | of fifteen or twenty grains of Aconite. | sulphate of zinc or copper, or large Foxglove. | doses of mustard, repeated every Gelseminum. | quarter of an hour until the full | effect is produced. | Belladonna. | Morphine, sassafras, iodine, and Stramonium. | stimulants. | Nux Vomica. | Large doses of camphor, chloroform, Strychnia. | and tobacco, may all be beneficial. | Poison Oak. | Muriate of ammonia, in solution, may Poison Vine. | be applied externally, and from ten | to fifteen grains given internally; | soda is also useful. --------------------------+----------------------------------- NARCOTICS | | White Henbane. | Sassafras may be used as an antidote Opium. | for henbane. Belladonna is an | antidote of opium; cold water should | also be applied to the head | of the patient, and the extremities | should be well rubbed. --------------------------+----------------------------------- ANIMAL POISONS. | Excite vomiting by drinking sweet | oil. Sugar and water, milk, or Spanish Fly. | linseed tea in large quantities, and Potato Fly. | emollient injections are valuable. |

POSTERIOR SPINAL CURVATURE.

(HUMPBACK.)

Posterior curvature of the spine, sometimes known as Pott's Disease, occurs most frequently in children, and is generally developed before the seventh year. Children of a scrofulous diathesis are especially liable to this affection. It is generally due to disease of the inter-vertebral cartilages and bodies of the vertebræ. It comes on in a slow, insidious manner, hence, it often makes serious inroads upon the spine and system before its character is even suspected.

Generally the first point of invasion is the cartilaginous substances between the bodies of the vertebræ, beginning with inflammation, and finally resulting in ulceration and a breaking-down of the cartilages. It next invades the vertebræ themselves, and producing caries, or death and decay of the bony substance, which softens and wastes away, as shown in Fig. 1. The vertebræ become softened and broken down, and weight of the body pressing them together produces the deformity known as "humpback." (See Fig. 2 and Fig. 3.)

SYMPTOMS. Among the various symptoms present in the earlier stages of the disease, and during its progress, we deem it necessary to mention only a few of the more prominent ones. While the patient is yet able to go around, the disease manifests itself by occasional pain in the bowels, stomach, and chest. Often there is a hacking cough, nervousness, lassitude, and a generally enfeebled condition of the whole system. The patient is easily fatigued; there is apparent loss of vitality, impaired appetite, a feeling of tightness across the stomach and chest, gradually declining health, and loss of flesh and strength, torpidity of the liver, deficient secretions, constipation, and morbid excretions from the kidneys. The victim, in passing chairs, tables, and other objects, instinctively places his hands upon them, and, as the disease progresses, when standing, leans upon some support whenever possible. In walking, he moves very carefully and cautiously, with elbows thrown back and chest forward, to assist the body in keeping its equilibrium. The body being kept in an upright position, the patient bends the knees rather than the back in stooping, as illustrated in Fig. 5, and the body is frequently supported by the hands being placed upon the thighs or knees. Sudden movements or shocks cause more or less pain.

The development of the disease then becomes rapid; suffering increases, and pain about the joints and lower extremities and muscles of the posterior part of the pelvis is experienced; numbness and coldness of the extremities are felt; locomotion becomes more difficult, and a slight projection is observed upon the back. Even in this somewhat advanced stage of the disease, when the symptoms are so apparent, many cases are shamefully neglected because an ignorant adviser says it is nothing serious and that the patient will outgrow it. The pain and tenderness not always being in the back, the inexperienced are very often misled as to the true character of the trouble. This distortion or deformity of the back now becomes painfully prominent; the diseased vertebræ quickly soften and waste away; the pressure upon the spinal cord increases, and paralysis of the limbs supervenes; the power of locomotion is lost, and, at last, the danger is realized and the struggle for life begins.

Thus, through ignorance, neglect, and improper treatment, the poor, helpless victim is doomed to a life of hideous deformity and suffering. We would, therefore, urge upon parents whose children are afflicted with this terrible disease, the great importance of placing them under the care of surgeons who have for many years made the treatment of such cases a specialty, and who have every facility and all necessary surgical appliances for insuring success in every case undertaken.

TREATMENT. The great essentials for the successful treatment of disease and deformities of the spine are first, a thorough knowledge of the structure and parts involved by the disease; secondly, the adjustment of mechanical appliances perfectly adapted to the requirements and necessities of each individual case, and the proper use of our system of "vitalization," applied to the spinal muscles to strengthen the weaker and relieve the undue contraction of the stronger. For many years our specialists have experimented, and have given the various appliances in common use in these cases most thorough and practical tests, and have found them very defective, being generally constructed upon wrong principles. The physician who sends to a mechanic for an appliance, such as are now made in the shops of most instrument makers, and uses the same, is doing himself an injustice, and barbarously torturing his patient by forcing him to wear an apparatus which is heavy, clumsy, and inevitably injurious, instead of being beneficial in its results. In the treatment of diseases and deformities of the spine, there should be no compromising; the appliance that fails to give complete support should not be worn. In our treatment of these maladies we employ only appliances which are constructed under the personal supervision of our specialists, upon principles dictated by common sense and the actual necessities of the case. We do not confine the body in an iron jacket. Our apparatus is light, yet durable, and is worn by the most delicate children without pain or inconvenience. It gives proper support to all parts, and is so nicely adjusted as to produce pressure only upon those points which should receive support, leaving the muscles of the spine freedom of action, thereby assisting in their development. In many hundreds of cases treated by our specialists, the disease has been entirely cured and the deformity removed. After seeing the patients and adjusting the appliances, they can generally be treated at their homes.

LATERAL CURVATURE OF THE SPINE.

(CROOKED BACK.)

This deformity appears more frequently in anæmic persons, in whom the flexibility and elasticity of the muscles are weakened, than in those of a plethoric habit. It is generally contracted during youth, between the ages of twelve and eighteen. Persons of sedentary and indolent habits are especially liable to this deformity, hence, girls are most frequently its victims. It is never seen among the natives of tropical countries who habitually live in the open air, and seldom among the barbarous races of northern latitudes. A distinguishing feature of the American Indian is his erect carriage. The _primary_ curvature is generally toward the right side, as represented in Figs. 6 and 7. Figs. 8 and 9 show the disease in a more advanced stage. The ribs are thus forced into an unnatural position, and the vital organs contained in the cavity of the chest are compressed or displaced, thus distorting the form of the whole upper portion of the body.

SYMPTOMS. The first indication of lateral curvature of the spine is a marked projection of the right scapula, or shoulder-blade. It is sometimes first observed by the dressmaker, or, accidentally, while bathing. The right shoulder is slightly elevated, while the left hip is depressed and projects upward. If not corrected while in its earlier stages, it progresses very rapidly, and a second curvature is developed. The symptoms vary in different cases, and in the early stages are somewhat obscure and undefined, but generally the patient feels a sense of uneasiness, languor, stupor, and nervousness, loss of energy and ambition, general debility, poor appetite, gradually declining health, loss of strength and flesh, and, as the disease progresses, a slight elevation of one of the shoulder-blades is noticed, as well as the deviation of the spine to one side. The curve, or distortion, of the spine increases more rapidly as the body becomes heavier, the spine often assuming the shape of the letter S, and, from compression by torsion of the vertebræ and distortion of the ribs, the vital organs are encroached upon, causing serious functional derangement of the heart, lungs, liver, and stomach, producing, as its inevitable consequence a list of maladies fearful to contemplate.

CAUSES. In rare instances, the lateral curvature of the spine is due to defects of certain bones of the pelvis or limbs. Cases are recorded in which this deformity was caused by diseases of the abdominal organs, but, as we have intimated, it is generally due to a lack of tonicity of the muscles, or, as a late writer has expressed it, "Want of correspondence in the antagonism of those muscles which control the motions of the spinal column." Habitual sitting or standing in a leaning posture, or standing upon one foot, thus constantly using one set of the muscles of the back, while the other becomes enfeebled by the lack of exercise, is a common cause of this deformity. The habit which so many school-girls contract of drawing up one foot under the body while sitting, often produces a lateral curvature of the spine.

TREATMENT. No disease or deformity of the spine is so easily cured and perfectly corrected, if the proper plan of treatment is pursued. To correct this deformity, many ingenious forms of apparatus have been devised and invented by our specialists, which should be carefully adjusted to each individual case. In addition to this, our method of treatment by "vitalization," and by mechanical movements and manipulations, is almost indispensable in these cases. It never fails to give relief, and, if properly pursued, invariably results in a permanent cure.

DEFORMED FEET, HANDS AND LIMBS.

There are thousands whose feet, hands, and limbs are almost entirely useless, besides having an unsightly appearance. Their condition has been helpless so long, their treatment so varied, and their hopes of relief or cure have been so often disappointed, that few can believe the truth of our statement, when we positively assert that we can correct and cure nearly all cases of talipes, club, or crooked feet and deformed hands, and make them as perfect in appearance, and as useful in action, as feet and hands which have never been deformed. While this may seem miraculous, or even impossible, to those who are unacquainted with the wonderful improvements and rapid progress made in this department of surgical science, it is attested and verified by living witnesses whose feet and hands were once deformed and useless, but which have been made perfect by our new and improved method of treatment. We do not make these statements in a spirit of vain boastfulness, but having devoted many years to improving and perfecting surgical appliances and apparatus, and having had practical experience in the successful treatment of thousands of cases, we do say that our manner of treatment is original and employed only by us. We entirely ignore the ineffectual methods usually employed in such cases. Our treatment causes no pain, and little inconvenience, yet the curative results are speedy and certain, and a hundredfold more satisfactory than those obtained by any other course.

We have most thoroughly tested all the best forms of treatment heretofore devised and employed in this class of diseases, and have adopted the best features of all the various methods heretofore pursued. We have combined these with our own improvements and, as the result, we have perfected a thorough and efficient system of treatment, based upon scientific principles.

* * * * *

MECHANICAL AIDS

IN THE TREATMENTS OF

CHRONIC DISEASES.

We have, in different parts of this work, referred to a large variety of ingeniously devised machinery and apparatus employed at the Invalids' Hotel and Surgical Institute, in the treatment of chronic diseases. Although we can, on paper, give but a meagre idea of the variety and adaptability of these valuable mechanical appliances, yet we will endeavor to illustrate and explain a few of our machines for the application of transmitted motion.

Fig. 1 represents a machine, called the Manipulator, which transmits motion through suitable attachments, which are adjustable by means of the ratchet _G_, so as to reach all parts of the body. It is equally available for applying motion to the head, feet, or any intermediate part of the body.

_B, B_ are rubbing attachments, with two opposing elastic, adherent surfaces, between which an arm or a leg may be included. These have alternate reciprocating action from the rock-shaft _H_, and are made to approach each other, and press the included part at the will of the patient. This is sometimes called the double-rubber, and is made detachable if desired.

_A_ is the lever, by which the two parts of the double-rubber are made to compress the arm or leg.

_D_ is a single attachment for rubbing. It may be connected at either side of the machine, so as to present the rubbing surface in four different directions, as may be most convenient. It will act perpendicularly, horizontally, or diagonally, and from below or from above the part receiving the action, according to requirements. The shank of the rubber may have any special form to suit special cases.

_C_ is the _foot holder._ It communicates to the leg the semi-rotary or oscillating motion of the rock-shaft. It may be attached to either end of the rock-shaft.

_E_ is the _hand holder,_ which, grasped by the hand, communicates motion to the arm, shoulder, and chest; or the hand may be inserted passively, when the effect of motion is more confined to the hand and fore-arm.

In the position shown in Fig. 2, by means of the single rubber attachment, the manipulator acts upon the upper portion of the trunk, neck, head, and arms; by means of the hand-holder, upon the arms; by means of the double-rubber, upon the arms, shoulders, and scalp.

When the acting part or head is lowered to its extreme limit, the machine occupies the least space. In this position, by means of the foot-holder it communicates oscillation to the legs; by means of the single-rubber, it acts upon the feet, ankles, and lower leg; by means of the double-rubber, it acts upon the legs, including the feet, the patient either sitting or lying.

In all of these applications of motion, energy travels from inanimate to animate matter; non-vital contributes to vital energy: and the various processes through which vital power is developed are promoted and carried forward in a degree till the point which constitutes health is attained.

The name, _Manipulator_, is very naturally applied to the instrument, the action of which resembles so much that of the living operator. It is, however, impossible for the unaided hand to impart the degree of rapidity necessary to secure the effects easily attained by this machine; and, practically, restoration is often secured in cases in which it is quite unattainable by any other remedial agent.

Motion, transmitted by the manipulator, exerts a curative effect in _all_ chronic affections, and is not limited, as is sometimes supposed, to paralytic affections and deformities. In these latter affections it is a great assistance in effecting a cure; while, in chronic affections, whatever the local symptoms, it supplies the additional energy which is indispensable for recovery in all diseases of long standing.

_Mode of Operation_.--Fig. 4 represents the manipulator in operation. The machine is propelled by steam power at the Invalids' Hotel and Surgical Institute, but may be worked by hand, as here represented. One arm is inserted between the double-rubbing pads, which are raised to about the height of the shoulders, the patient being seated at the side of the machine; the other hand is placed on the lever, and as much pressure is applied as is perfectly agreeable, care being taken to diminish the pressure at any part which is unusually sensitive. All portions of the arm from the shoulder down are successively included in the rubbers, while a suitable degree of reciprocating or rubbing action is obtained by giving motion to the wheel.

To apply the same operation to the other arm, the patient may either turn in his seat or change his position to the opposite side of the machine.

If any portion of the extremity is affected with inflammation or swelling, it is necessary to apply the action described to the whole of the unaffected portion first; after this the affected part may be beneficially operated on, provided that the sensations are strictly heeded, and that it is so managed that only a comfortable feeling is produced.

In Fig. 5, the patient is so seated beside the machine that he can insert one thigh between the pads of the rubber, and also control the lever with the hand. It is sometimes more convenient to suspend a movable weight from the lever. While the machine is running, he can withdraw the leg gradually, as each portion receives its proper amount of action, till the whole, including the foot, becomes glowing with the effect. The boot or shoe affords no impediment to the effect, and should remain on.

Sometimes, especially in the beginning, or when the feet are habitually cold, it is better to apply the action only from the knees down.

The rubbing-pad (d) may be attached to either side of the machine, according to convenience or effect sought. The action derived from the right end of the rock-shaft is much less severe than that from the left, on account of the shape of the rubber appendage, and at the beginning should be used in preference. In Fig. 6, the patient sits on an ordinary stool, or, if feeble, in a chair, and presents any portion of the chest or abdomen to the action of the rubber. The instrument is raised or lowered to suit convenience, while the patient gently presses portions of the trunk successively upon the rubbing-pad. The degree of the effect is thus always under the absolute control of the one receiving the action. This operation, like the preceding, produces great heat, reddens the skin, relieves pain, and greatly stimulates the functions, not only of the skin, but of the organs contained in the cavities of the chest and the abdomen.

The same operation may be applied also to the legs while the patient is standing.

In Fig. 7, the back is presented to the action of the rubbing-pad. The action will, if desired, be made to reach from the neck to the hips, and even to the thighs. All sensitive portions of the back should at first be omitted, in order that they may be benefited by the counter-irritation or drawing away of the blood. This is easily produced by those familiar with the use of the machine. The rubbing of the back should be deferred till the close of each application, in order that the spinal centers may be relieved of hyperaemia, or excess of blood.

The machine, as represented by Fig. 8, is brought to the desired elevation, about as high as the shoulders, and the hand-holder is attached. One arm is extended horizontally, and the hand grasps the hand-holder, while rapid motion is given by turning the wheel. An alternate twisting motion is communicated to the arm, which causes corresponding pressure and relaxation of all the soft tissues of the limb, combined with slight rubbing or attrition. The action is increased by contracting the muscles, and also by grasping at greater distance from the center. Both hands may grasp at the same time, or the two sides may receive the motion in turn. The effect is similar to that of the rubbing before described, but it is less limited; by grasping firmly, it may extend to the whole chest.

The foot-holder is attached, as shown in Fig. 9, and brought by the means before described to a position to receive one foot at a comfortable elevation, the leg being extended, while the patient is seated in an ordinary chair in an easy position. The action is precisely like that above described as applied to the arm, and extends to the thigh and pelvis. If the knee is slightly flexed, the action is almost entirely confined to the lower leg. Each leg may be operated on in turn.

_Mode of Applying Mechanical Movements to Very Feeble Invalids_.--Experience demonstrates that no degree of feebleness excludes the beneficial use of these operations. Invalids too weak to stand, or able to help themselves in the least degree are often treated with perfect success. A judicious use of the Manipulator _always_ increases nutrition and strength without any fatigue or exhaustion, however feeble the patient may be. It is only necessary to provide for these cases additional conveniences, so that the applications can be made in the recumbent position, and also that proper intervals of rest be allowed between successive operations. For this purpose couches are provided, each containing a certain portion of the Manipulator. These are operated by means of a short connecting-rod, joining the rock-shafts of the two pieces of mechanism, as shown in Fig. 10. The Vibrator has two small discs, or heads acting through an opening in the couch on which the invalid rests. These impinge with a rapid, direct stroke upon the portion of the body exposed to the action. The top of the couch is adjustable, and is quickly placed at the elevation which secures the proper force of the instrument, as shown in Fig 11. By simply turning and moving the body, the patient brings any part in contact with the vibrating discs. The cut represents the Vibrator, in which the force impinges at right angles with the surface of the body, sending waves of motion through its substance.

The rubbing which is shown in Figs. 4 and 5 may be applied to all parts of the body in a recumbent position. A couch is required of similar construction to the vibrating couch, but with a rubbing-pad instead of vibrating heads acting through the opening and operated by appropriate connections, as shown in Fig. 12. The top is adjustable, and the degree of effect desired is capable of easy regulation. The patient turns different portions of the body to the action of the rubber as required.

KNEADING. Kneading is a process applied chiefly to the abdomen. The purpose of this operation is to increase nutrition, the muscular power and action of the abdominal walls, and the function of the organs which they contain. Three modes of applying this operation by the mechanical apparatus are in use, effected by the Direct, the Rotary, and the Revolving Kneader.

THE DIRECT KNEADER. This resembles in form and action the vibrating instrument shown in Fig. 11. The impinging heads, however, are made broader, the motion greater in extent, and the rate of motion less than one-tenth of that employed for the purpose of vibrating. This slowness of motion seems to increase the action of the muscles.

THE ROTARY KNEADER. The action of the kneading heads in this form of apparatus, as shown in Fig. 13, is _inward_ and _upward_ alternately, and it is eminently well calculated to stimulate the action of the abdominal organs.

THE REVOLVING KNEADER. In the form of kneading apparatus, shown in Fig. 14, two thick rollers, which move freely on axes at the extremities of arms, projecting on either side of a shaft turned by a crank or belt, are made to act alternately upon each side of the abdomen.

In the methods of kneading above described, the degree of force acting on the body is governed by an arrangement for elevating or depressing the upholstered top of the couch upon which the patient rests, and through which the action is transmitted to the body.

If this form of apparatus is driven at a rate ten times more rapidly than is desired for kneading, the effect is vibratory, and it is, in fact, used for that purpose.

THE CURE OF SWELLINGS AND TUMORS.

The application of motion through the Manipulator promotes absorption, and thus all kinds of _swellings_ and non-malignant _tumors_ are made to diminish under its use. In these cases the vessels of the affected part are distended with stagnant blood, and a portion of the fluid passes through their walls, distending the surrounding tissues, which become more or less hardened. By the transmission of active motion to the affected parts, the contents of the vessels are urged forward; the outside fluids are thus permitted to return to the general circulation and become subject to the energetic vital action of the general system, local deficiencies of oxidation being increased to the normal degree, causing destruction of morbid matter and giving place for new and wholesome nutritive materials for vital use. In short, normal functional activity is established, both locally and generally. Scrofulous, dropsical, rheumatic, and other local accumulations disappear, and even tumors are dispersed, by the use of the Manipulator, in cases in which the knife would otherwise be required.

COUNTER-IRRITATION AND REVULSION.

Artificial means have always been employed to produce an energetic flow of blood in different parts of the body, thereby relieving morbid distention of the vessels, and consequent irritation and pain in neighboring parts. Cupping, hot applications, mustard, capsicum, blisters, and other irritants, are resorted to, but their effects, while generally very good in acute cases, are too transient to be of material aid in chronic affections. By the use of the Manipulator, we can produce the most thorough revulsive effects, operating upon large surfaces, and causing large masses of muscle to receive an increased amount of blood, thus drawing it away from parts oppressed by too great a supply, constituting engorgement. No injury is done to the parts acted upon; on the contrary, they are strengthened by the application, which can be repeated as often as necessary till relief is permanent. Thus, the head, heart, digestive organs, liver, chest, or whatever part is oppressed by excess of blood, may be speedily and permanently relieved. By means of this ability to relieve any part of the system from engorgement, and consequent inflammation and its results, are we enabled to permanently cure a large variety of chronic inflammatory, ulcerative, and nervous affections.

Local inflammations by this method of treatment may be speedily cured.

CURE OF NEURALGIA.

By the transmission of motion through the Manipulator and other ingeniously devised apparatus and machinery, we increase the functional power and activity of the muscles, and thereby diminish morbid sensibility of the nerves, which is present in neuralgia. Prolonged and excessive nervous action is attended with too great a rush of blood to the nerve-centers, which can only be relieved by increasing the flow in the muscles. Congestion, or hyperaemia, in the spinal cord or brain, or both, is a condition ever present in neuralgia. The application of motion through the manipulator causes the blood to flow to the muscles, thus relieving nervous congestion and consequent neuralgia.

CURE OF PARALYSIS.

In no single disease has the transmission of motion through the Manipulator proved more thoroughly efficacious than in _paralysis_. The most prominent requirements in these cases seem to be the following:

Excess of blood in the brain and spinal cord needs to be removed and diverted to parts in which it will be useful instead of obstructive.

The contractile power of the capillaries should be improved.

The quality of nutritive fluids should be improved by the promotion of oxidation through increased circulation.

These and many more wants of disordered nerves, are readily supplied by transmitted motion.

The Manipulator combines, in a single ingenious mechanical contrivance, the several movements best adapted for the promotion of healthy functional activity.

CURE OF DEFORMITIES.

"Deformities arising from _paralysis and contractions of muscles and tendons_, producing stiffened joints and distorted limbs, are of common occurrence. A rational explanation of the wonderful curative results which follow the employment of transmitted motion in these cases may not be without interest to the reader. The muscles are composed of _bundles_ of little fibers which glide upon one another in every movement. Another set of fibers called _connective tissue_, holds the fibers together in bundles or separate muscles, and interlaces and crosses them in every direction. Now, if these fibers remain long in a fixed position, or are involved in inflammation, there is danger of adhesions forming between them, producing permanent immobility; gliding movements are interfered with, and the muscle ceases to perform its function. Inflammation gives rise to effusion, or the formation of a kind of cement which binds together the muscular fibers and prevents motion.

Rubbing, kneading, and actively manipulating the affected parts with that intensity of administration secured by the manipulator, rends asunder and breaks up these minute adhesions, re-establishing gliding motions, causes absorption of effused materials, and restores the affected part to a normal condition.

The deformed limb is straightened by the filling out of the muscle-cells, and increasing the length and also the nutrition of the affected muscles. No pulling or _forced extension_ is required. Deformity ceases when the conditions upon which it depends are removed by rational appliances, which are always agreeable. No brace, splints, or other confining appliances are necessary, except in rare cases in which the bones are very badly distorted.

In withered and deformed limbs, resulting from infantile paralysis, the manipulator furnishes the most agreeable, direct, and certain remedy. It restores nutrition, sensation, and power, and dispenses almost wholly with mechanical supports. Club-feet, wry neck, spinal curvature, hip-joint disease, white swellings, and stiffened joints, are all readily amendable to the curative effects of motion administered by the manipulator and other machinery.

Contracted and shortened muscles are gradually lengthened by vigorous, long-continued, and frequently repeated rubbing with the manipulator across their longitudinal fibers; bound-down and confined tendons are liberated and normal movements established.

DISEASES OF WOMEN.

Uterine and ovarian congestion, chronic inflammation, discharges, morbid enlargement, prolapsus, anteversion and retroversion, anteflexion and retroflexion, and other derangements of the womb and its appendages, are radically cured by the vibratory, rubbing, kneading, and other movements, administered through the manipulator and other mechanical appliances employed at the Invalids' Hotel and Surgical Institute.

To those who are tired of taking medicine, this mode of treatment commends itself as being both agreeable and efficient. There is no case too weak, nervous, or helpless for the use of this curative agent. It is entirely devoid of objectionable features, being _always applied outside the clothing_.

CAUSE OF FEMALE WEAKNESS. The true relations of cause and effect are very liable to be misunderstood, when considering the various diseases incident to the organs contained in the female pelvis. Treatment intended to be remedial is therefore very often misdirected and fails to afford relief, positive injury frequently resulting instead. When the nature of these diseases is properly understood, their cure can be effected with comparative ease.

These diseases are always attended with weakness, which is often very great, of the muscles that hold the diseased organs in position. The muscles forming the walls of the abdomen, and the diaphragm, or midriff, all of which are concerned in the act of respiration, become feeble and only partially perform their functions. In health, they act constantly, even during sleep, producing a rhythmical movement, which is communicated to the contents of the abdominal and pelvic cavities. This motion promotes a healthy circulation in the parts. In almost all affections of the pelvic organs, this normal condition is greatly diminished.

Diminution of the motions of respiration is attended with an increase of the amount of the blood in the pelvic organs, constituting an engorgement of the parts, called congestion, or inflammation. This gives rise to enlargement of the womb, ulcerations, tumors, and a multitude of kindred secondary effects, usually considered as the primary disease and treated as such. The contents of the cavity of the trunk, weighing several pounds, are allowed to gravitate down and rest upon the contents of the pelvis, forcing the congested uterus and ovaries down out of their natural positions, and often bending or tipping the womb in various directions. A long list of symptoms follows as the natural consequence of these abnormal conditions.

RATIONAL TREATMENT. Ovarian congestion and inflammation, inflammation of the uterus, ulceration of this organ, deranged menstruation, leucorrhea with the attendant pain, nervousness, and other derangements depending upon loss of supporting power in the abdominal muscles, all result from loss of the _natural_ motions of respiration, and consequent deranged circulation. These several conditions can be cured by removing their cause. When the power of the parts involved in the weakness is restored, all these morbid conditions disappear. Judicious cultivation of power in the weakened supports is attended with certain curative results. This is best accomplished by mechanical motion, by which the normal circulation is restored, inflammations and congestions are subdued, displacements corrected, ulcers healed, and functional activity is re-established.

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.

Deformities are easily cured without the cutting of tendons, or use of mechanical supports.

It hardens the flesh by increasing muscular development and improves digestion and nutrition.

* * * * *

WORLD'S DISPENSARY MEDICAL ASSOCIATION

INCORPORATED UNDER STATUTE ENACTED BY THE LEGISLATURE OF NEW YORK.

Dr. R.V. PIERCE, having acquired a world-wide reputation in the treatment of Chronic Diseases, resulting in a professional business far exceeding his individual ability to conduct, some years ago induced several medical gentlemen of high professional standing to associate themselves with him, as the Faculty of the World's Dispensary and Surgical Institute, the Consulting Department of which has since been merged into the Invalids' Hotel. The organization is duly incorporated under a statute enacted by the Legislature of the State of New York, and under the name and style of the "WORLD'S DISPENSARY MEDICAL ASSOCIATION," of which Dr. PIERCE is President, and in the affairs of which he will, as heretofore, take an active and constant part.

* * * * *

EUROPEAN BRANCH, NO. 3 NEW OXFORD STREET, LONDON, ENG.

* * * * *

IMPORTANT ANNOUNCEMENT.

Dr. R.V.PIERCE, having in the Fall of 1880 resigned his seat in Congress, has since been able to devote his whole time and attention to the interests of the Association, and those consulting our Medical and Surgical Faculty have the full benefits of his council and professional services. That he should prefer to give up a high and honorable position in the councils of the nation, to serve the sick, is conclusive evidence of his devotion to their interests and of love for his profession.

* * * * *

INVALIDS' HOTEL

A MODEL SANITARIUM AND SURGICAL INSTITUTE.

NOT A HOSPITAL, BUT A PLEASANT REMEDIAL HOME,

ORGANIZED WITH

A FULL STAFF OF EIGHTEEN PHYSICIANS AND SURGEONS

AND EXCLUSIVELY DEVOTED TO THE

TREATMENT OF ALL CHRONIC DISEASES.

This imposing Establishment was designed and erected to accommodate the large number of invalids who visit Buffalo from every State and Territory, as well as from many foreign lands, that they may avail themselves of the professional services of the Staff of Skilled Specialists in Medicine and Surgery that compose the Faculty of this widely-celebrated institution.

DESTROYED BY FIRE.

On the sixteenth of February 1881, the original Invalids' Hotel was totally destroyed by fire. Although occupied at the time by a large number of invalids, yet, through the extraordinary exertions of the Faculty and employees, all were safely removed from the building without injury to any one. The Board of Trustees took prompt steps to rebuild, for the accommodation of the many sufferers who apply, to avail themselves of the skill, facilities and advantages of treatment which such a perfectly equipped establishment affords. Profiting by the experience afforded by several years' occupancy of the original Invalids' Hotel building, which at the date of its erection was the largest and most complete establishment of its kind in the world, we believe we have, in the building of the elegant structure illustrated herein, made great improvements over the original Invalids' Hotel, for the accommodation of our patients. Although our new building has only been occupied about two years, yet almost immediately our business required the erection of a very large addition thereto, to accommodate our growing practice. This large _Annex_, which is about the size of the original building, has ever since been kept well filled with patients, hailing from every State and Territory of the United States, Canada and occasionally from a foreign country,

THE INVALIDS' HOTEL AND SURGICAL INSTITUTE IS PLEASANTLY SITUATED AT NO. 663 MAIN STREET,

in the city of Buffalo, just above and outside the business and bustle of this Queen City of the Lakes. It is easily reached from the railroad depots by the Exchange and Main Street car lines (see map on last page of this book). It is a substantially built brick building, trimmed with sandstone, well lighted and provided with a patent hydraulic elevator, so that its upper stories are quite as desirable as any, being more quiet than those lower down. It is well provided with fire escapes, and, in fact, nothing has been neglected that can add to the comfort and home-like make-up of this popular national resort for the invalid and afflicted. Great pains and expense have been assumed in providing perfect ventilation for every room and part of the building.

The surroundings of the Hotel are very pleasant, it being located in the finest built part of the city, among the most elegant residences.

STAFF OF PHYSICIANS AND SURGEONS.

Only men who are, by thorough education and experience, especially fitted to fill their respective positions, have been chosen to serve as physicians and surgeons in this institution. After having spent a very large sum of money in erecting and furnishing this national resort for invalids with every requirement and facility for the successful treatment of all classes of chronic diseases, it is the determination of the Board of Directors that the Faculty of Physicians and Surgeons shall be superior in culture, experience and skill.

We have not the space to speak, individually, of the eighteen professional gentlemen composing the Faculty, but will say that among them are those whose long connection with the World's Dispensary and Surgical Institute has given them great experience and rendered them _experts_ in their specialties. Several of them had previously distinguished themselves in both private and hospital practice, had held important chairs as lecturers and teachers in Medical Colleges, and had filled responsible positions in military and civil hospitals; also in some of the most noted Asylums, Dispensaries, and Sanitary Institutions in the land.

With such a staff of Physicians and Surgeons, efficient and trained nurses, and with all the most approved sanitary, medical and surgical appliances which study, experience, invention and the most liberal expenditure of money, can produce and bring together in one institution, the Invalids' Hotel and Surgical Institute affords the afflicted unusual opportunities for relief.

THE GRAND ENTRANCE.

The entrance to the Invalids' Hotel and Surgical Institute is covered by a lofty porch of beautiful design, the roof of which is supported upon heavy iron columns. Above the massive double doors, through which the visitor enters, are large, heavy panels of beautifully wrought stained glass, on which the words "Invalids' Hotel and Surgical Institute" stand out conspicuously.

FIRST FLOOR.

The first floor of the building is reached through a beautifully finished vestibule, by a short flight of broad, easy stairs, and once inside the visitor is struck by the beauty of design as well as by the home-like appearance of the surroundings. The wood-work is mainly of hard woods, oak and cherry predominating. In a large part of the house the floors are of oak, with a cherry border, neatly finished in oil and shellac, and covered with rich rugs and elegant carpets of the very best quality.

On the first floor is the gentlemen's reception-room, which is thronged with patients from early in the morning until late in the afternoon. It is entirely distinct from the large reception-room and parlors for lady patients, and the utmost privacy is secured throughout the whole arrangement of the Institution. On this floor are the suites of offices, parlors, and private consultation-rooms, some fifteen in all; also a well furnished reading-room and circulating library, for the use of the inmates of the Institution. On all sides are beautifully frescoed walls adorned with numerous choice engravings and other pictures. All the rooms throughout the house are furnished in the best of style, and in a manner to afford the utmost comfort and cheerfulness of surroundings for the sick and afflicted who seek this remedial resort. The Turkish and other baths are elegantly fitted up on the first floor, opposite the reading-room.

THE UPPER FLOORS.

Above the first, or main floor, the building is divided into separate rooms and suites of rooms for the accommodation of patients. All are well lighted, have high ceilings, and are cheerful and well ventilated apartments. On the second floor is the large medical library and medical council-room, for the exclusive use of the Faculty, also the museum-room, which contains a large and valuable collection of anatomical and morbid specimens, many of them being obtained from cases treated in this Institution. On this floor are also suites of rooms, occupied by the Bureau of Medical Correspondence, wherein from ten to twelve physicians, each supplied with the improved graphophone, are constantly employed in attending to the vast correspondence received from invalids residing in all parts of the United States and Canada. Every important case receives the careful consideration of a council composed of from three to five of these expert specialists, before being finally passed upon and prescribed for.

ON THE THIRD FLOOR

are the large treatment-rooms, supplied with all the apparatus and appliances for the successful management of every chronic malady incident to humanity. Electrical apparatus of the latest and most approved kinds, some of it driven and operated by steam-power, dry cupping and equalizing-treatment apparatus, "vitalization" apparatus, numerous and most ingenious rubbing and manipulating apparatus and machinery, driven by steam-power, are among the almost innumerable curative agencies that are here brought into use as aids in the cure of human ailments. Our

ELECTRICAL OUTFIT

is the finest to be found in any sanitarium in the United States and, we believe, in the world. There are two forty-cell galvanic batteries with switch boards for controlling the voltage, or force, from the whole power to one-fortieth of this amount, at the will of the physician. Safe-guards in the shape of milli-ampere meters continually indicate to the operator the force of the current. There is a dynamo for charging the storage batteries, which may be used in a patient's room when this method is found more convenient or more comfortable for the invalid. There are two static or Franklin machines. These are used when the milder current is desired, and for spraying, sparking, etc. One of the instruments is of high voltage and furnishes us with the X rays for examining the interior parts of the body. The largest treatment room also contains a powerful ozone generator, operated by a dynamo. This supplies the room with allotropic oxygen and is invaluable in treating diseases of the lungs and air passages. This supplies the patient with vitalized air, equal to the most salubrious atmosphere in any part of the globe.

Beyond this and separated by a court, across which is an iron bridge, are the large dispensing-rooms, stocked with drugs and medical compounds of almost endless variety, and representing every branch of the _materia medica_. Here all medicines prescribed are most carefully and specially prepared for each individual case. Those to be sent away by mail or express, to patients being treated at a distance, are placed in trays, with full directions for use, and sent to another large room, where they are carefully packed, and shipped thence to their destination.

FOURTH FLOOR.

On the fourth floor are located the surgical operating-rooms and surgical ward. There are also a large number of nice, large, well furnished separate rooms on this floor, used principally for the accommodation of surgical cases. Strong, broad, iron staircases connect all the upper floors with the ground, so that in case of fire, patients need have no fear of being unable to get out safely. In fact, the building has been constructed so as to render the rapid spread of fire through it impossible, all the floors being laid on cement.

A STEAM PASSENGER ELEVATOR

is provided, so that the upper floors are quite as desirable as those lower down. The dining-rooms for gentlemen, as well as those for ladies, are located in the basement, which is reached either by stairways or by the elevator. The kitchen, store-rooms, chill-rooms, pantries, and all culinary arrangements are also in the basement.

FIRE-PROOF VAULTS.

Six large fire-proof vaults are provided in this building in which to preserve, secure from observation, as well as from fire, all records of cases examined and treated by the Faculty.

Throughout all this vast building the visitor is struck with the wonderful order and system with which every detail is carried out.

THE BATH DEPARTMENT.

The Invalids' Hotel and Surgical Institute, as hereinbefore indicated, is provided with Turkish, and other approved baths, with a treatment-room, fitted up with vacuum and movement-treatment apparatus of the most modern and approved style. These and much more ingeniously devised apparatus and appliances are brought into use in a great variety of chronic affections with marvelously successful results. A perfect system of physical training, especially adapted to the wants of the invalid and weak, and most skillfully conducted and applied, is not the least important among the many advantages that the chronic sufferers here find.

THE SURGICAL DEPARTMENT.

In the Surgical Department, every instrument and appliance approved by the modern operator is provided, and many and ingenious are the instruments and devices that the Faculty of this institution have invented and perfected to meet the wants of their numerous cases.

OUR REMEDIES.

In the prescribing of remedies for disease, the Staff resort to the whole broad field of _materia medica_, allowing themselves to be hampered by no school, _ism_,_pathy_, or sect. The medicines employed are all prepared by skilled chemists and pharmacists, and the greatest care is exercised to have them manufactured from the freshest and purest ingredients. Our Faculty probably employ a greater number and variety of extracts from native roots, barks and herbs in their practice than are used in any other invalids' resort in the land. All of the vegetable extracts employed in our practice are prepared in our own Laboratory.

REGULATION OF DIET.

The table is supplied with an abundance of wholesome and nutritious food, especially adapted and prepared to suit the invalid, it being varied to suit each particular case. The Faculty recognize the importance of proper food as one of the greatest factors in the treatment of chronic diseases. While properly regulating and restricting the food of the invalid when necessary, they also recognize the fact that many are benefited by a liberal diet of the most substantial food, as steaks, eggs, oysters, milk, and other very nutritious articles of diet, which are always provided in abundance for those for whom they are suited.

From previous experience somewhere, some people get the impression that they are to be half starved at such an institution as this. If this is the case anywhere it is not so here, as any one who has ever resided at our sanitarium will attest.

TRAINED ATTENDANTS.

A sufficient number of trained and experienced nurses are employed, that those requiring attendance may have the very best of care.

GOOD ORDER.

The institution is conducted in an orderly manner, that the utmost quiet may be secured. The Faculty insist, upon the part of the invalid, while under treatment, on the observance of habits of regularity in eating, sleeping, bathing and exercise. Only by such observance of hygienic laws can they succeed in their course of remedial training, and make the treatment curative.

AMUSEMENTS.

While insisting upon strict observance of rules established for the good of the patient, they do not make their requirements so rigid as to interfere with the comfort and enjoyment of their patients, but, on the contrary, endeavor, in every manner possible, to provide innocent and entertaining amusements for all, recognizing the great importance of pleasant occupation of the mind, as an essential part of the treatment. Hence the introduction of music, amusing games, light reading, and kindred agencies for pleasant entertainment, is not neglected.

UNPARALLELED SUCCESS.

The founder of this institution commenced, many years ago, with little capital, to build up a business in the treatment of chronic diseases and devoted himself diligently to that end. His reputation for skill in his chosen field of practice gradually extended until, to-day, his fame and that of the World's Dispensary and Invalids' Hotel and Surgical Institute, are simply world-wide. As the business increased those eminent for skill have been induced to join the Faculty, until eighteen professional gentlemen, each devoting his attention to a special branch of practice, constitute the Medical and Surgical Staff.

One reason why we excel in the treatment of _chronic diseases_ is the fact that we are supplied with all the modern improvements in the way of instruments, appliances and remedial agents used in the healing art, the expense of which deters the local physician in general practice from procuring, for the treatment of the limited number of cases that come within the circuit of his practice. The treatment of such cases requires special attention and special study to be successful.

A COMMON SENSE VIEW.

It is a well-known fact, that appeals to the judgment of every thinking person, that a physician who devotes his whole time to the study and investigation of a certain class of diseases, must become better qualified to treat them than he who attempts to treat every ill to which flesh is heir, without giving special attention to any particular class of diseases. Men, in all ages of the world, who have _made their marks_, or who have become famous, have devoted their lives to some special branch of science, art or literature.

LIBERALITY.

We wage no war against any physician, no matter what school of medicine he may represent; but, on the other hand, we invite the co-operation of all regular physicians. We are always ready and willing to impart to them any information or render any assistance that will be of mutual benefit to them and their patients.

OUR PHYSICIANS AND SURGEONS

do not travel to solicit practice, having all the business that they can attend to at our institution, nor do we employ any agents to travel and peddle or otherwise sell our medicines. If any one engaged in such business, represents himself as in any way connected with our institutions, he is a swindler and should be apprehended and prosecuted as such. And any one who will give us such information as will lead to the arrest and conviction of any person so misrepresenting will be liberally rewarded.

While not permitting any member of our professional staff to travel and solicit practice, yet we are always willing to accommodate and send a specialist to visit important or critical cases in consultation, or otherwise, or to perform important surgical operations as explained on page 971 of this book.

Let none deceive you by representing that they have heretofore been connected with our institution and have thereby learned our original and improved methods of treatment. We have a large and competent Staff of Specialists and while we have sometimes found it necessary to make changes, yet we always manage to retain the most expert and skillful, as we cannot afford to part with the services of those who excel.

By adopting similar names to those which have long designated our world-famed institutions, some have endeavored to deceive and mislead invalids who were seeking relief. Others have named so-called "Electric" Trusses, "Liver Pads," and other contrivances after our President, thereby expecting to reap benefits from Dr. Pierce's well-known professional standing. Neither the Doctor nor this Association have any interest in any such articles.

NO BRANCHES.--Remember we have no branches except the one at No. 3 New Oxford Street, London, England.

Those desiring to consult us by letter, should address all communications plainly to

World's Dispensary Medical Association, _No. 663 MAIN STREET,_ BUFFALO, N.Y.

* * * * *

WORLD'S DISPENSARY.

The immense building erected and occupied by the World's Dispensary Medical Association as a Laboratory, wherein are manufactured our Dr. Pierce's Standard Family Medicines, as well as all the various Tinctures, Fluid Extracts and other pharmaceutical preparations used by the Staff of Physicians and Surgeons of the Invalids' Hotel and Surgical Institute in their practice, is not inappropriately called the _World's Dispensary_, for within its walls is prepared a series of remedies of such exceeding merit that they have acquired world-wide fame, and are sold in vast quantities in nearly every civilized country.

The structure, located at 660 to 670 Washington Street, immediately in the rear of the Invalids' Hotel and Surgical Institute, is of brick, with sandstone trimmings, six stories high, and 100 feet square. Its most striking architectural features exteriorly are massiveness, combined with grace and beauty of outline, and great strength.

THE BASEMENT.

The basement or first story opens on a level with the Washington Street sidewalk, and is occupied by a plant of two large boilers, which supply the steam to run a huge American engine, of 100 horse-power, built by the American Engine Co., Bound Brook, N.J. It drives all the machinery of the establishment, including drug mills, pill machines, packing machinery, a large number of printing presses, folding machines, stitching, trimming, and many other machines, located on the different floors, and used in the manufacture of medicines, books, pamphlets, circulars, posters, and other printed matter. On this floor is located steam bottle-washing machinery, and also the shipping department. Here may be seen huge piles of medicine, boxed, marked, and ready for shipment to all parts of the civilized world. A large steam freight elevator leads from this to the floors above.

MACHINERY.

In addition to the power engine just mentioned is a 25 horse-power upright engine for running the dynamo for electric lighting, with a capacity of three hundred (300) lights. This engine and dynamo were also manufactured for us by the American Engine Company of Bound Brook, N.J. There is a small dynamo with a capacity of one hundred (100) lights used during the day to light safes, vaults, dark closets and hallways. All the offices and rooms of patients are supplied with electric light, as well as illuminating gas. An automatic Worthington pump is also located in the basement. This supplies the elevator and sprinkling system. The sprinklers come into play only in case of fire, when they are self-acting. This pump at its best is capable of forcing nearly two hundred gallons of water a minute. There is no place in which pure water is more desirable than in the manufacture of medicines. Our New York filter could, if such a large quantity were ever required, furnish the Dispensary with one hundred (100) barrels of pure water a day. Just beyond the south wall and buried several feet under ground is a boiler-shaped tank capable of storing ten thousand (10,000) gallons of medicine.

MAIN FLOOR.

The main or second floor of the Dispensary is entered from Main Street, through a hall leading from the Invalids' Hotel and Surgical Institute. On this floor are located business offices, counting-room, the advertising department and mailing rooms. Large, fire-proof vaults are provided for the safe keeping of books, papers, and valuables, whilst the counting-room and offices are elegantly finished in hard woods, and present a beautiful and grand appearance.

THIRD FLOOR.

On this floor are the Association's extensive printing and binding works. Fourteen large presses, driven by power, with numerous folding machines, trimming, cutting, and stitching machinery, are constantly running in this department. Here is printed and bound Dr. Pierce's popular work of over a thousand pages, denominated "The People's Common Sense Medical Adviser," over 1,200,000 copies of which have been sold. Millions of pocket memorandum books, pamphlets, circulars and cards are also issued from this department and scattered broadcast to every quarter of the globe.

FOURTH FLOOR.

Large mills for crushing, grinding and pulverizing roots, barks, herbs, and other drugs occupy a considerable part of this floor. Extensive drying-rooms, in which articles to be ground in the drug mills are properly dried, are also located upon this floor, as are also thousands of reams of paper ready for printing the different books, pamphlets, labels, etc. In large rooms set aside for that purpose, are stored vast quantities of labels and wrappers, for use in putting up medicines.

FIFTH FLOOR.

On this floor is located ingeniously devised filling and bottling machinery, also rooms for labeling, wrapping, and packing medicines; others are occupied for the storage of crude drugs, glass, corks, and supplies for use in the general business.

SIXTH FLOOR.

This entire floor is occupied with mixing, percolating, distilling, filtering, and other processes employed in the manufacturing of medicines. Every process is conducted under the watchful care of an experienced chemist and pharmacist, and in the most perfect and orderly manner; the apparatus employed being of the most approved character. Here are manufactured all the various medicinal preparations and compounds prescribed by the Faculty, in the treatment of special cases.

GENERAL CONSIDERATIONS.

In all departments of this vast business establishment, the visitor is struck with the perfect system which everywhere prevails, and the wonderful accuracy with which every process and transaction is carried on and consummated; hence the uniformity of purity and strength for which the medicines here manufactured have so long been celebrated. To this, also, is due much of the marvelous success attained in the department established for the special treatment of chronic and obstinate cases of disease. In this department the Faculty are not at all limited or hampered in prescribing, and do not confine themselves in the least to the proprietary or standard medicines manufactured for general sale through druggists, but employ a series of curative agents unsurpassed in variety and range of application. They aim to carefully adapt their prescriptions to each individual case.

* * * * *

THE

INVALIDS' HOTEL AND SURGICAL INSTITUTE

_SOME OF THE CAUSES THAT LED TO ITS ERECTION, AND THE ADVANTAGES WHICH IT AFFORDS._

The destinies of institutions, like those of men, are often determined by pre-existing causes. The destinies of some men are like those of way-side plants, springing up without other apparent cause than the caprice of nature, developing without any apparent aim, yielding no perfected fruit, and finally, dying, leaving scarcely a trace of their existence. Thus it is with institutions which have their origin only in man's caprice. To be enduring, they must be founded upon the needs and necessities of humanity. Many of the great men of the world owe their greatness more to surrounding circumstances than to the genius within them. The highest genius can be dwarfed or deformed by the force of adverse circumstances; hence the poetic truth of Gray in those exquisite lines:

"Some mute inglorious Milton here may lie, Some Cromwell guiltless of his country's blood."

Opportunity is the guiding star of genius. Without it, genius would drift hither and thither upon the restless, ever-changing waves of circumstance, never casting anchor in a secure haven. Upon opportunity, too, depends the success of institutions. By opportunity we mean a real and acknowledged public want. Whoever undertakes to supply this want finds himself upon the crest-wave of prosperity. It was to supply such a want that this institution was erected.

A REMEDIAL HOME.

Of the seventy millions of people living in the United States to-day, it is estimated that nearly twelve millions are sufferers from chronic disease. Think for a moment! Twelve millions of people slowly but surely dying by the insidious and fatal development of chronic diseases! This is an appalling fact. And yet this is the very class of diseases with which the general practitioner is least familiar.

As a general practitioner of the healing art, fresh from _curriculum_, the founder of this institution early realized that the grand unpardonable sin of the medical profession was the neglect to more thoroughly study and investigate this class of diseases.

The profession is diligently cauterizing and poulticing the sores which now and then appear on the surface, but the internal chronic disease, of which these are merely the external signs, is too often overlooked or neglected.

Some years ago we devised and put into practical operation a method of

TREATING PATIENTS AT THEIR HOMES,

without requiring them to undergo personal examinations. We reasoned that the physician has abundant opportunity to accurately determine the nature of most chronic diseases without ever seeing the patient. In substantiating that proposition, we cited the perfect _accuracy_ with which scientists are enabled to deduce the most minute particulars in their several departments, which appears almost miraculous, if we view the subject in the light of the early ages. Take, for example, the electro-magnetic telegraph, the greatest invention of the age. Is it not a marvelous degree of accuracy which enables an operator to _exactly_ locate a fracture in a sub-marine cable nearly three thousand miles long? Our venerable "clerk of the weather" has become so thoroughly familiar with the most wayward elements of nature that he can accurately predict their movements. He can sit in Washington and foretell what the weather will be in Florida or New York, as well as if hundreds of miles did not intervene between him and the places named. And so in all departments of modern science, what is required is the knowledge of certain _signs_. From these, scientists deduce accurate conclusions regardless of distance. A few fossils sent to the expert geologist enables him to accurately determine the rock-formation from which they were taken. He can describe it to you as perfectly as if a cleft of it were lying on his table. So also the chemist can determine the constitution of the sun as accurately as if that luminary were not ninety-five million miles from his laboratory. The sun sends certain _signs_ over the "infinitude of space," which the chemist classifies by passing them through the spectroscope. Only the presence of certain substances could produce these solar signs.

So, also, in medical science,

DISEASE HAS CERTAIN UNMISTAKABLE SIGNS,

or symptoms, and, by reason of this fact, we have been enabled to originate and perfect a system of determining with the greatest accuracy the nature of chronic diseases without seeing and personally examining our patients. In recognizing diseases without a personal examination of the patient, we claim to possess no miraculous powers. We obtain our knowledge of the patient's disease by the practical application of well-established principles of modern science to the practice of medicine. And it is to the accuracy with which this system has endowed us that we owe our almost world-wide reputation for the skillful treatment of all lingering, or chronic, affections. This system of practice, with the marvelous success which has been attained through it, demonstrates the fact that diseases display certain phenomena, which, being subjected to scientific analysis, furnish abundant and unmistakable data to guide the judgment of the skillful practitioner aright in determining the nature of diseased conditions.

So successful has been this method of treating patients at a distance that there is scarcely a city or a village in the United States that is not represented by one or more cases upon the "Records of Practice" at the Invalids' Hotel and Surgical Institute. In all chronic diseases that are curable by medical treatment, it is only in very rare cases that we cannot do as well for the patient while he or she remains at home, as if here in person to be examined. But we annually treat hundreds of cases requiring surgical operations and careful after-treatment, and in these cases our Invalids' Hotel, or home, is indispensable. Here the patient has the services not only of the most skillful surgeons, but also, what is quite as necessary in the after treatment, of thoroughly trained and skilled nurses.

What should be the essential characteristics of an Invalids' Home?

CLIMATE.

Obviously, the most important of these characteristics is _climate_. Climatology, from being a mere speculative theory, has arisen to the deserved rank of a science. The influence of the climate of a country on the national character has long been observed and acknowledged. The languid but passionate temperaments of the South are like its volcanoes, now quiet and silent, anon bursting forth with terrible activity, flooding entire cities with molten fire; or, like its skies, now sunny, cloudless, an hour hence convulsed with lightnings and deluging the earth with passionate rain; or like its winds, to-day soft, balmy, with healing on their wings, to-night the wind fiend, the destroying simoom, rushing through the land, withering and scorching every flower and blade of herbage on its way. On the other hand, the calm, phlegmatic temperament of the North accords well with her silent mountains, her serener skies, and her less vehement, but chilling winds. The South, too, is the native home of the most violent acute diseases, such as yellow fever and cholera. But, aside from this general climatic influence, there is the yet more restricted one of locality. It has often been observed that certain classes of diseases are most prevalent in certain localities, the prevalence in every instance being due to peculiarities of climate.

EXTREME HEALTHFULNESS OF BUFFALO.

In the published records of the examination for military service in the army, during our late civil war, this fact was clearly and definitely stated, and maps were prepared and presented showing the comparative prevalence of certain diseases in the several States and districts represented. The maps are prepared by a graduation of color, the lighter shades indicating the localities where the special disease under consideration is least prevalent; and it is a very significant and important fact that in all chronic diseases not due to occupation or accident, Buffalo and its immediate vicinity is marked by the lighter shades. Thus, in epilepsy, paralysis, scrofula, rheumatism, and consumption, our city is little more than tinted with the several colors used to denote these diseases.

There is a popular, but unfounded, belief that Buffalo is a hot-bed for pulmonary diseases. This idea could have originated only in an ignorant disregard of facts; for medical statistics prove that in her freedom from this class of diseases she is unrivaled by any city in America, not excepting those on the seaboard.

EVIDENCE OF HEALTH STATISTICS.

Compare, if you please, the statistics of Buffalo with those of the great Eastern cities in this respect. In Boston and New York the death-rate from consumption shows a ratio of about 1 to 5 of the whole number of deaths. In Baltimore and Philadelphia the ratio is 1 to 6, while in Buffalo the death rate from consumption is only 1 to 10--very remarkable difference in favor of our city. Only last summer a gentleman residing in the eastern part of our State collected and compared the health statistics for 1876 of all the prominent cities in the United States. The result showed that

BUFFALO OUTRANKS ALL IN HEALTHFULNESS.

A great deal of precious breath has been expended in blustering about "Buffalo zephyrs," as our delightful lake breezes are sometimes ironically termed. It seems to be a popular belief among our sister cities that old Boreas has chosen Buffalo for his headquarters. When we hear a person dilating upon "Buffalo's terrific winds," we are reminded of one of our lady acquaintances who recently returned from a European tour. She was asked how she enjoyed her sea voyage, and she replied, "Oh, it was delightful, really charming! There is something so grand about the sea!" We were not a little surprised at this enthusiastic outburst, as we had been told by a member of her party that the lady had industriously vomited her way to Hamburg and back again. But the lady's enthusiasm was easily explained. It is fashionable to characterize sea voyages as delightful, charming, etc. Now, we suspect this popular notion about our "trying winds" is traceable to the same source. It has become customary to call Buffalo a "windy place," and so, when the traveler feels a slight lake breeze, he imagines it to be a terrific gale. Whatever may have originated this notion, certain it is that it is utterly, undeniably false; and, in making this denial, we are not alone dependent upon observation, but upon the

FACTS OF SCIENCE.

The issue of July 18, 1874, of the Buffalo _Commercial Advertiser_, contained a series of tables, furnished by the Signal Service Bureau, showing the velocity of the wind at eleven prominent cities for the year 1873. An examination of the table shows that the total velocity for the year was the _lowest in Buffalo_ of any of the lake ports; while Philadelphia and New York showed far higher aggregates of velocity than our city. On this subject, in the issue of August 21st of the same year, the editor pleasantly remarks: "Only the interior and southern seaboard cities, and not many of them, show a lower total velocity of wind than is marked against this city; and as for those places, heaven help their unfortunate inhabitants in the sultry nights of the summer season, when they are gasping in vain for a breath of that pure, cool lake air, which brings refreshing slumbers to the people of blessed, breezy Buffalo."

EQUABILITY OF CLIMATE.

Then, in regard to _equability of climate_, the great desideratum for invalids in any locality, here again sentiment and science are greatly at variance. An examination of the official records of the Signal Service Bureau, and the statistics of the Smithsonian Institute, showed that out of a list of forty cities on the continent Buffalo ranked highest for equability of climate. Thus we quote from an editorial in the _Advertiser_ of the same issue: "While the aggregate of change for Buffalo stood at 67 for the year, that of Philadelphia reached 204, Washington was 224, Cincinnati 205, St. Louis 171. Winchester, in one of the healthiest parts of Virginia, reached as high as 201. Aiken, in South Carolina, a famous resort for invalids, touched 220. St. Augustine, one of the lowest in the list, showed a much less equable climate than that of Buffalo, being 94 to our 67." The transition from summer to winter, and _vice versa_, is exceedingly gradual, and, consequently, Buffalonians are seldom afflicted with those epidemic diseases which generally appear in other localities during the spring and summer months. Thus the thermometric readings of the Signal Service Bureau for 1873, show that the average temperature for July and August was 74°. For September it was about 64°, which was again reduced by about 10° for October. The monthly average for November was 73°, and for December 25°, which was also the average for January. Then the readings for February showed an average of 26°, for March 32°, and 43° for April. A more equable and gradual transition from midsummer heat to midwinter cold cannot be shown by any locality on this continent. Seldom does the mercury rise above ninety during our warmest summers, or fall below zero in our most severe winters. In J. Disturnal's work, entitled "The Influence of Climate in North and South America," published by Van Nostrand, in 1867, the climate of Buffalo is thus characterized: "From certain natural causes, no doubt produced by the waters of Lake Erie, the winters are less severe, the summers less hot, the temperature night and day more equable, and the transition from heat to cold less rapid, in Buffalo than in any other locality within the temperate zone of the United States, as will be seen by the following table." The table referred to shows that, "during the summer months, the temperature of Buffalo is from 10° to 20° cooler than that of any other point east, south, or west of the ports on Lake Erie; while the refreshing and invigorating lake breeze is felt night and day." The author further adds that "during the winter months the thermometer rarely indicates zero, and the mean temperature for January, 1858, was 20° above."

A careful investigation into the comparative climatology of the several great social and commercial centers, proved _Buffalo to be superior to all others in the climatic requirements for the invalid_. Besides, it has the important advantage of being a central point of traffic and travel between the West and the East.

ADVANTAGES OF LOCATION.

The second important consideration in projecting this home for invalids was _location_. It has generally been customary to locate institutions of this character in rural districts, removed from the advantages of city life, on the plea of escaping the confusion and excitement so detrimental to recovery. The result is well known. Invalids have regarded them more as pleasure resorts than health resorts, spending the summer months there, but fleeing to their homes at the fall of the first snow-flake. The good that was done in the summer is undone by carelessness and exposure in the winter. A location that would combine both city advantages and rural pleasures, seemed to us, upon reflection, to be the desirable one. Fortunately, Buffalo afforded the happy mean. Our extensive parks, our unsurpassed facilities for yachting, fishing, and all aquatic sports, our many sylvan lake and river retreats, our world-famed Niagara,--certainly a more desirable selection of rural scenes and pleasures cannot be found in another locality in America.

A GENUINE HOME.

In erecting the Invalids' Hotel and Surgical Institute, our paramount design was to make it a genuine home--_not a hospital_--a home where the child of fortune would miss none of the comforts of her palatial home, while the poor man would find not only health but his pleasures multiplied a thousand fold.

OUR TERMS MODERATE.

The wholesale merchant's prices are far less than those of the retail dealer. He can afford it, his sales are so much larger. It is on precisely the same principle that we are able to make the rates at the Invalids' Hotel and Surgical Institute comparatively low. If we had only a limited number of patients, we should be obliged to make the charges commensurate with our expenses; but our practice having become very extensive, and the income being correspondingly large, we are enabled to make the rates at the Invalids' Hotel and Surgical Institute so moderate that all who desire can avail themselves of its medical, surgical, and hygienic advantages.

FACILITIES FOR TREATMENT.

Of the many advantages afforded by the Invalids' Hotel and Surgical Institute, in treating disease, we can make only brief mention of a few of the more prominent.

DIVISION OF LABOR.

In the examination and treatment of patients, our practice is divided into specialties. Each member of the Faculty, although educated to practice in _all_ departments of medicine and surgery, is here assigned to a special department only, to which he devotes his entire time, study and attention.

ADVANTAGES OF SPECIALTIES.

The division-of-labor system proves as effectual in the exercise of the professions as in manufactures. In the legal profession this has long been a recognized fact. One lawyer devotes his attention specially to criminal law, and distinguishes himself in that department. Another develops a special faculty for unraveling knotty questions in matters of real estate, and, if a title is to be proved, or a deed annulled, he is the preferred counselor. In a certain manner, too, this has long been practiced by the medical profession. Thus some physicians (and we may add physicians who call themselves "regular," and are specially caustic in their denunciation of "advertising doctors") are accustomed to distribute cards among their patrons, certifying that they give special attention to diseases of women and children. In this institution each physician and surgeon is assigned a special department of medicine or surgery. By constant study and attention to his department, each has become a skillful specialist, readily detecting every phase and complication of the diseases referred to him. Not only is superior skill thus attained, but also _rapidity_ and _accuracy_ in diagnosis.

Thoroughness and efficiency in any branch of learning can be secured only by devoting to it special study and attention. When the faculty of a university is to be chosen, how are its members selected? For instance, how is the chair of astronomy filled? Do they choose the man who is celebrated for his general scholastic attainments, or do they not rather confer it upon one who is known to have devoted special attention and study to the science of astronomy, and is, therefore, especially qualified to explain its theories and principles? Thus all the several chairs are filled by gentlemen whose general scholarship not only is known to be of the highest standard, but who devote special attention to the departments assigned them, thus becoming proficient specialists therein. The same system of specialties is observed in the departments of a medical college. The professor who would assume to lecture in all the departments with equal ease and proficiency would be severely ridiculed by his colleagues; and yet it is just as absurd to suppose that the general practitioner can keep himself informed of the many new methods of treatment that are being constantly devised and adopted in the several departments of medicine and surgery.

PROGRESS IN MEDICINE.

In no other science is more rapid and real progress being made at the present time than in that of medicine. Even the specialist must be studious and earnest in his work to keep himself well and accurately informed of the progress made in his department. Thus it so often happens that the general practitioner pursues old methods of treatment which science has long since replaced with others, acknowledged to be superior. The specialist, on the contrary, by confining his studies and researches to one class of diseases only, is enabled to inform himself thoroughly and accurately on all the improvements made in the methods and means of practice in his special department.

The difference between the practice of specialists and that of general practitioners is aptly illustrated by the difference between the old-fashioned district school, in which the school-master taught all the branches, from a-b-abs to the solution of unknown quantities and the charmed mysteries of philosophy, and the modern seminary, with its efficient corps of teachers, each devoting his or her whole attention to the study and teaching of one special department of learning.

We attribute the success which has attended the practice at the Invalids' Hotel and Surgical Institute, in a great measure, to a wise adoption of this system of specialties.

ADVANTAGES OFFERED TO INVALIDS.

Obviously, the most important of these advantages is _facility of treatment_. Of the thousands whom we have cured of chronic diseases, we have probably not seen one in five hundred, having accomplished the desired result through remedies sent either by mail or express, and advice given by letter. Yet in some obstinate forms of disease, we can here bring to bear remedial means not to be found or applied elsewhere.

That thousands of cases of chronic disease, pronounced incurable, have, by our rational and scientific treatment, been restored to perfect health, is conclusively proved by the records of practice at the Invalids' Hotel and Surgical Institute. Here, in obstinate cases, are brought to bear all the most scientific remedial appliances and methods of treatment.

A system of mechanical movements, passive exercises, manipulations, kneadings and rubbings, administered by a large variety of ingeniously-contrived machinery, driven by stream-power, has been found especially efficacious and valuable, as an aid to medical and surgical treatment, in the cure of obstinate cases of nervous and sick headache, constipation, paralysis, or palsy, stiffened joints, crooked and withered limbs, spinal curvature, tumors, diseases of women, especially displacements of the uterus, or womb, such as prolapsus, retroversion and anteversion, chronic inflammation, enlargement and ulceration of the uterus, and kindred affections; also in nervous debility, sleeplessness, and other chronic diseases. Mechanical power, or force, is by these machines transmitted to the system, in which it is transformed into vital energy and physical power or strength. This mechanical, passive exercise, or movement-cure treatment, differs widely from, and should not be confounded with, "Swedish movements," to which it is far superior in efficacy. Coupled with our improved and wonderful system of "Vitalization" treatment, it affords the most perfect system of physical training and development ever devised. For the restoration of power to wasted, undeveloped, or weakened organs or parts, for their enlargement, this combined movement and "Vitalization" treatment is unequaled. It can be applied to strengthen or enlarge any organ or part. We also employ both Dynamic and Static electricity, "Franklinism" and Electrolysis, and chemical, Turkish and other baths, in all cases in which they are indicated. Inhalations, administered by means of the most approved apparatus, are employed with advantage in many obstinate lung, bronchial, and throat affections. We have no hobby or one-idea system of treatment, no good remedial means being overlooked or neglected.

A FAIR AND BUSINESS-LIKE OFFER TO THE AFFLICTED.

Reader, are you accustomed to think and act for yourself? Do you consult your own reason and best interests? If so, then do not heed the counsel of skeptical and prejudiced friends, or jealous physicians, but listen to what we have to say.

You perhaps know nothing of us, or our systems of treatment, or of the business methods we employ. You may _imagine_, but you _know nothing_, perhaps, of our facilities and advantages for performing cures in cases beyond the reach or aid of the general practitioner. Knowing nothing, then, of all these advantages, you still know as much as the would-be friend or physician who never loses an opportunity to traduce and misrepresent us, and prejudice the afflicted against us.

Now to the point--are you listening? Then permit us to state that we have the largest, the best, and the finest buildings of any like Association, company, or firm in this country. We employ _more_ and _better_ Medical and Surgical Specialists in our Invalids' Hotel and Surgical Institute than any similar Association, company, or individual, and actually have more capital invested. We have a thoroughly qualified and eminent Specialist for every disease that we treat. We treat more cases, _and absolutely cure more patients_ than any similar institution in America. In addition to those we treat medically, we perform all the most difficult surgical operations known to the most eminent Surgeons, and so frequently do many of these operations occur with us that some of our Specialists have become the most expert and skillful Surgeons on this continent.

We wish to add further that we are responsible to _you_ for what we represent; we therefore ask you to come and visit our institutions; and, if you find on investigation that we have misstated or misrepresented _in any particular_ our institutions, our advantages, or our success in curing Chronic Diseases, _we will gladly and promptly refund to you all the expenses of your trip_. We court honest, sincere investigation, and are glad and anxious to show interested people what we can do and are daily doing for suffering humanity. Can a proposition be plainer? Can an offer be more fair and business-like? If, therefore, you are afflicted, and are seeking relief, come where genuine ability is a ruling feature, where _success_ is our watchword and the alleviation of human suffering our mission.

Whether arriving in our city by day or night, _come directly to the Invalids' Hotel and Surgical Institute, 663 Main Street_, where you will be hospitably received and well cared for.

Address all correspondence to

WORLD'S DISPENSARY MEDICAL ASSOCIATION, _663 Main Street, BUFFALO, N.Y._

* * * * *

SUCCESSFUL TREATMENT OF CHRONIC OR LINGERING DISEASES.

For many years the founder of the Invalids' Hotel and Surgical Institute and World's Dispensary has devoted himself very closely to the investigation and treatment of chronic diseases. Some few specifics have, during this time, been developed for certain forms of chronic ailments, and given to the public, but they have not been lauded as "cure-alls," or panaceas, but only recommended as remedies for certain well-defined and easily recognized forms of disease. These medicines are sold through druggists very largely, and have earned great celebrity for their many cures. So far from claiming that these proprietary medicines will cure all diseases, their manufacturers advise the afflicted that, in many complicated and delicate chronic affections, they are not sufficient to meet the wants of the case. These must have special consideration and treatment by a competent physician and surgeon, the medicines and other remedial means required being selected and prepared with reference to each particular case.

In order to be able to offer those afflicted with chronic ailments the most skillful medical and surgical services, Dr. Pierce, many years ago, associated with himself several eminent physicians and surgeons, as the Faculty of the old and renowned World's Dispensary, the consulting Department of which is now merged with the Invalids' Hotel and Surgical Institute.

DIVISION OF LABOR.

In the organization of the medical and surgical staff of the Invalids' Hotel and Surgical Institute, several years ago, we assigned to one physician the examination and treatment of diseases of the nervous system; to another, surgical operations and the treatment of surgical diseases; a third had charge of catarrhal and pulmonary diseases and affections of the heart; a fourth attended to diseases peculiar to women; a fifth, to diseases of the eye and ear; a sixth, to diseases of the digestive organs; a seventh, to special surgical cases; to another we entrusted diseases of the urogenital organs; and to others, various other specialties. Now that our practice has become so very extensive as to require for its conduct a greatly increased number of physicians and surgeons. Thus four physicians and surgeons devote their undivided attention to the examination and treatment of diseases of the urinary and generative organs of men. Three physicians give their sole attention to diseases peculiar to women and three to those of the nasal organs, throat and chest, embracing all chronic diseases of the respiratory organs. Thus we have a full council of three and four physicians in these several specialties. In several other divisions we have two specialists. No case is slighted either in the examination or in the treatment. All doubtful, obscure or difficult cases are submitted to a council composed of several physicians and surgeons. Skilled pharmaceutists are employed to compound the medicines prescribed. For the purpose of enabling us to conduct our extensive correspondence (for we have an extensive practice en every part of the United States and Canada, as well as in Great Britain from our London branch), graphophones are employed, to which replies are dictated, recording the words of the speaker. Afterwards the letters are written out in full, generally on a type-writing machine, which prints them in a plain, legible style. These machines are operated as rapidly as a person can think of the letters which compose a word, each operator thus accomplishing the work of several copyists. This system, by which we are enabled to correspond with our patients as rapidly as we can talk, has been rendered necessary by the growth of our business, which has attained immense proportions, giving rise to so large a correspondence that a dozen physicians cannot possibly conduct it all and give each patient's case careful attention, without the employment of graphophones and all other facilities which modern invention has given us. By the adoption of these various means, we are enabled to fully meet the demands of the afflicted, and give every case the most careful attention.

As many persons, particularly young ladies and gentlemen, having catarrh or almost any other chronic disease, especially if of the urogenital organs, are very sensitive and fearful that somebody will know that they are afflicted and employing medical treatment, precautions are taken that none who consult us may incur the least risk of exposure. Although none but the most honorable and trustworthy gentlemen are employed as assistants, yet as a _guarantee_ of perfect security to our patients, that every communication, whether made in person or by letter, will be treated as _sacredly confidential_, each professional associate, clerk, or assistant, is required to take a solemn oath of secrecy. Great care is also taken to send all letters and medicines carefully sealed in plain envelopes and packages, so that no one can even _suspect_ the contents or by whom they are sent.

ADVANTAGES OF SPECIALTIES.

By thorough organization and a perfect system of subdividing the practice of medicine and surgery in this institution, every invalid consulting us is treated by a specialist--one who devotes his undivided attention to the particular class of diseases to which his or her case belongs. The advantage of this arrangement must be obvious. Medical science offers a vast field for investigation, and no physician can, within the limit of a single life-time, achieve the highest degree of success in the treatment of _every_ malady incident to humanity. A distinguished professor in the medical department of one of our universities, in an address to the graduating class, recently said: "Some professional men seem to be ashamed unless they have the character of universal knowledge. He who falls into the error of studying everything will be certain to know nothing well. Every man must have a good foundation. He must, in the first place, be a good general practitioner. But the field has become too large to be cultivated in its entirety by any individual; hence the advantage of cultivating special studies in large towns, which admit of the subdivision of professional pursuits. It is no longer possible to know everything; something must be wisely left unknown. Indeed, a physician, if he would know anything well must be content to be profoundly ignorant of many things. He must select something for special study, and pursue it with devotion and diligence. This course will lead to success, while the attempt to do everything eventuates unavoidably in failure. Let there be single hands for special duties." Our institution is the only one in this country in which these common-sense-ideas are _thoroughly_ carried out. The diversified tastes and talents of physicians cause each to excel in treating some one class of diseases, to which he devotes more attention and study than to others. One medical student manifests great interest in the anatomy, physiology, pathology, and treatment of diseases of the eye. He becomes thoroughly familiar with all the minutest details relative to that organ and its diseases, and so thoroughly qualifies himself in this branch of knowledge that he is able to cure an inflammation or other affection of the eye in a very short time. Another student is more interested in some other class of diseases, for the study of which he has a liking, and neglects to inform himself in the ophthalmic branch of medical and surgical science. If after engaging in the practice of his chosen profession, he is consulted by persons suffering from diseases of the eye, he tortures them with unnecessary and oftimes injurious applications, clumsily and carelessly made, and, as the result of such unskillful treatment, the inestimable blessing of sight may be sacrificed.

The great majority of physicians allow acute maladies, diseases of children, and the practice of midwifery, to engross most of their time and attention. They manifest an absorbing interest in everything that relates to these subjects, and devote little or no time to acquiring an intimate knowledge of the great variety of chronic maladies which afflict mankind. They acquire skill and reputation in their favorite line of practice, but are annoyed if consulted by one suffering from some obscure chronic affection, usually turn the invalid off with a very superficial examination, and, perhaps, only prescribe some placebo,[6] apparently indifferent as to the result, but really desiring thus to conceal their lack of familiarity with such diseases. The specialist, the treatment of chronic diseases being his vocation, is equally annoyed if consulted by those suffering from acute diseases, but does not pursue the inconsistent course of assuming to treat them. He refers them to those of his medical brethren whose daily dealings with such cases make them, in his way of thinking, more competent than himself to render valuable service to such sufferers. He recognizes the fact that no man is likely to succeed in any line of study or business for which he possesses no talent or relish, nor does he believe in being a "jack-at-all-trades and master of none."

ADVERTISING.

Having thoroughly qualified himself for the practice of some particular branch of the healing art, the specialist sees no impropriety in acquainting the public with his ability to relieve certain forms of suffering. He believes that medical men should possess equal rights with other business men, and that any code of medical ethics which would deprive him of any of the sacred rights guaranteed to all by the liberal laws of the country, is professional _tyranny_, and merits only his contemptuous disregard. Nor does he display any false modesty in the _manner_ of making known his skill. He maintains that he has an undoubted right to place his claim to patronage before the public by every fair and honorable means. He recognizes the display of goods in the merchant's show-windows as no less an advertisement and in no better taste than the publication of a card in the newspaper. So, likewise, he regards the various devices by which the extremely _ethical_ physician seeks to place himself conspicuously before the public, as but so many ways of advertising, and as not more modest than the publication of cures actually performed, or than his announcement through the public press of his professional resources for treating certain maladies.

The physician who expresses a "holy horror" of the "_advertising doctor_," liberally bestowing upon him the epithet of "quack," announces _himself_ a graduate, talks learnedly and gives notice to the public in _some_ way that he is ready to serve them. He endeavors to impress upon the mind of the patient and family his skill, frequently exaggerates as to the extent of his practice, rides furiously about when he has no professional calls, keeps up business appearances by driving several horses, or joins influential societies. He may make a great display in style, manner, dress, pretensions, writing for the newspapers, exhibiting literary pedantry, referring to the superior facilities afforded by some particular school or society to which he belongs; or by editing and publishing a medical journal, ostensibly for the advancement of medical science, but practically to display titles or professorships, to publish reports which flatteringly allude to cases he has treated, the number of capital surgical operations he has performed, or the distinguished families he is treating. All these are but _modes of advertising_ professional wares; in short, are artful, though not refined, tricks, resorted to for private announcement. We say to all such adventurers in modern advertising diplomacy, that these indirect, clandestine methods are not half so candid and honorable as a direct public statement of the intentions and proposals of a medical practitioner, who thereby incurs an individual responsibility before the law and his fellow-men.

No good reason has ever been assigned why any well educated physician, trained in the school of experience until he becomes proficient in medical skill, may not publish facts and evidence to disclose it, especially when these are abundant and conclusive. The following extracts from an able article by the Rev. THOMAS K. BEECHER embodies a sound view of the subject of medical advertising. He says:

* * "I am glad that the doctor cured him; I am glad that the doctor put it in the paper that he could cure him. And if any doctor is certain that he can cure such diseases and don't put it in the paper, I am sorry. What a pity it would have been had this doctor come to town with his wealth of science and experience and gone away leaving him uncured! What a pity it would have been if he had been so prejudiced against advertising as to read the responsible certificate of the doctor and give him the go-by as a quack! What are newspapers for, if not to circulate information? What more valuable information can a newspaper give than to tell a sick man where he can be cured? If a man has devoted his life and labor to the study of a special class of diseases, the necessity of his saying so becomes all the more pressing. His _duty_ to advertise becomes imperative.

"When I was in England, I found on all the dead walls of London, placards, declaring that Dean Stanley, Chaplain to the Prince of Wales, would preach at such a place; that his grace the Archbishop (I think) of Canterbury would preach at another time and place; again, that an Oxford professor would preach. In short, religious notices were sprinkled in among the theater bills, and the highest church dignitaries were advertised side by side with actors, singers, and clowns. Of course, I was shocked by it, but in a moment I bethought me--if it be all right and dignified to hire a sexton to ring a bell when the minister is going to preach, it is all the same to silence the bell and hire a bill-sticker to tell the same news, the essential thing being to tell the truth every time. The remedy for the lying advertisements is for honest men to tell the truth. 'When iniquity cometh in like a flood, then the spirit of the Lord lifts up the standard.' A really able man, whatever be his gifts, makes a great mistake if he fail to use those gifts through want of advertising."

If a physician possesses knowledge that enables him to remedy diseases heretofore regarded as incurable, what virtue or modesty is there to "hide his light under a bushel"? In this free country the people think and act for themselves, and hence all have a deep concern in the subject of health. The strong popular prejudice against the doctors who advertise is due to the fact, that by this method so many ignorant charlatans are enabled to palm off their worthless services upon the uneducated and credulous; but the practice of such imposition should not cause a presumption against the public announcement of real skill, for the baser metal bears conclusive evidence that the pure also exists.

Every step in scientific investigation, every proposition which relates to the interest and happiness of man, every statement and appeal involving a valuable consideration, must be submitted to the scrutiny and judgment of individual reason; for every person has the right to form his own conclusions, and justify them by experience. Those claims which are only supported by empty assertion are very doubtful. Misty theories vanish before the sun of truth. He who renders professional services cannot be successful, unless he be sustained by real merit.

TREATING PATIENTS WHO RESIDE AT A DISTANCE.

We can treat many chronic diseases as successfully without as with a personal consultation, as our vast experience enables us to correctly determine the malady from which the patient is suffering, from a history of the symptoms, and answers to questions furnished. We have not seen one person in five hundred of those whom we have cured.

Some may suppose that a physician cannot obtain, through correspondence, a sufficiently accurate idea of the condition of a patient to enable him to treat the case successfully; but a large experience in this practice has proved the contrary to be true, for some of the most remarkable cures have been effected through the medium of correspondence. In most long-continued cases, the patient has thought over his symptoms hundreds of times. The location of every pain, whether acute or mild, constant or occasional, and the circumstances under which it occurs, have been carefully noted. He has observed whether he had a rush of blood to the head, was feverish or chilly, whether troubled with cold hands and feet, whether full of blood, or pale and bloodless; and he states these matters with accuracy and common sense when writing to us, for he has a very good, if not a professional, knowledge of the relative importance of these symptoms. So in regard to digestion, he states what kinds of food agree with him, or whether he is troubled with excessive acidity or a flatulent condition of the stomach. He also informs us whether his tongue is coated and bilious, or clean and healthy, and gives many other particulars too various to enumerate, by which we are enabled to gain a perfect understanding of the case. If his description be not sufficiently complete to enable us to obtain a definite understanding of the case, he is requested to answer a list of important questions which are sent him. The people are far more intelligent in these matters than physicians are generally willing to admit. A patient is often 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, he states the exact symptoms, and carefully reads over the letter to see if it is a complete and accurate description of his sufferings. In this way he conveys a much better idea of the case than if present in person, and subjected to the most thorough questioning and cross-examination. The timid lady and nervous young man write just as they feel; and one important reason why we have had such superior success in treating intricate and delicate diseases, is because we have obtained such true and natural 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 infallibly detect spurious money by a glance at the engraving or a touch of the paper, so the experienced physician, by his great familiarity with disease, becomes equally skilled in detecting the nature and extent of a chronic malady from a written description of its symptoms.

URINARY SIGNS.

A careful microscopical examination and chemical analysis of the urine is a valuable aid in determining the nature of many chronic diseases, particularly those of the nervous system, blood, liver, kidneys, bladder, prostate gland and generative organs. This important fact is not overlooked at the Invalids' Hotel and Surgical Institute, where an experienced chemist is employed to make such examinations and report the result to the attending physicians. Medical authors, professors, and practitioners of all schools, admit and even insist upon the importance of such examinations in diagnosticating diseases. Many practitioners neglect to take advantage of this invaluable aid, while others fear that if they attach much importance to such examinations they will be ranked with "uroscopian" or "water" doctors, a class of enthusiasts who claim to be able to correctly diagnosticate every disease by an examination of the urine. Persons consulting us and wishing to avail themselves of the advantages afforded by these examinations can send small vials of their urine by express. The vials should be carefully packed in saw-dust or paper and enclosed in a light wooden box. All charges for transportation must be prepaid, and a complete history of the case including the age and sex of the patient, must accompany each package, or it will receive no attention. This saves valuable time by directing the examination into the channels indicated, thus avoiding a lengthy series of experiments. As we are daily receiving numerous vials of urine, every sample should, to prevent confusion, be labeled with the patient's name.

There is a natural, definite proportion of the component elements of every solid and fluid of the human body. These proportions have been reduced to definite standards, a deviation from which affords evidence of disease. Thus, there being a fixed standard in a normal proportion of the elements of the blood, any deviation from it, as in anæmia, leucocythæmia, etc., indicates disease. So also the standard proportion of the urinary elements being known, any considerable change, either in quantity or quality of its parts, bears unmistakable evidence of disease. The invention of the microscope has provided increased facilities for detecting diseases by examination of the urine. By the aid of this wonderful instrument, we are enabled to discover with absolute certainty the various urinary deposits characteristic of different maladies; thus in Fig. 1, A represents in a general way the sediment of abnormal urine as seen under the microscope. In division B is represented oxalate of urea upon precipitation by oxalic acid. Nitrate of urea is represented in division C. A deficiency of urea in the urine, with albumen and casts present, is a most important guide in the diagnosis of Bright's disease. The average quantity of urea present during health is 21.57 parts in 1,000. The microscopic examination of the urine, notwithstanding the distaste, and even contempt, which many physicians manifest for such investigations, is pursued at the Invalids' Hotel and Surgical Institute, with inestimable benefit to our patients. It has revealed the existence of many serious affections, which, with all our other modes of investigation, we might have been unable to detect. It has also thrown light upon many obscure chronic diseases.

We have already spoken of the marked changes effected in the urine by a derangement of the digestive functions. It is a matter of surprise that physicians generally pay so little attention to the urine when dyspepsia is suspected, since all admit that an examination of that excretion furnishes unmistakable evidence of the nature and complications of the disease. In this way we are many times enabled to determine whether the indigestion is caused by congestion or functional disease of the liver or kidneys or by nervous debility. And when such cases are treated in accordance with the indications furnished, increased success attends our practice. In Fig. 2 highly magnified urinary deposits, which indicate impairment of the digestive functions, are represented. The crystals are composed of oxalate of lime and appear in the different forms shown in the five sections, of octahedral, decahedral, round and dumb bell shapes. The latter are formed in the kidneys, and are sometimes discovered adhering to casts.

INVALUABLE AIDS IN DETERMINING DISEASES OF THE KIDNEYS AND BLADDER.

The various forms of gravel, Bright's disease of the kidneys, hæmaturia, inflammation of the kidneys and bladder, diabetes, and other functional and organic diseases of the urinary organs effect characteristic changes in the urine, thus enabling us to distinguish them with certainty and exactness. Some of the various microscopical appearances of the urinary deposits in diseases of the kidneys and bladder, are represented in Fig. 3. In division A is represented pus and mucus, with decomposition, indicating suppuration somewhere along the urinary tract. In B pus globules are alone represented. In the division marked C are shown blood corpuscles as they are arranged in blood drawn from a vein or artery. D represents the same separated, as they always are when present in the urine. In E highly magnified oil globules are represented. If present in the urine, they indicate disease of the kidneys. In F are represented epithelial cells, the presence of which in large numbers is indicative of diseases of the mucous lining of the urinary organs.

Fig. 4 represents the microscopic appearance of phosphates in the urine. These are present in great quantity in cases of nervous debility and kindred affections. By attaching the _camera lucida_ to the microscope we can throw an image of these urinary deposits upon paper. By the art of the engraver this may be faithfully traced, and thus we are enabled to produce an accurate representation of them. Some of the beautiful crystalline deposits shown in Fig. 4 represent less than a millionth part of a grain, yet their forms are delineated with geometrical precision. Earthy phosphates are often mistaken for pus and also seminal fluid. Phosphates are always found in decomposed urine, otherwise they indicate brain affections, acute cystitis, etc. Experience has taught us that the voiding of urine loaded with phosphates is a forerunner of cystitis, or enlargement of the prostate gland, or both. In fact, persons so affected are "prone to serious consequences from mild attacks of almost any and every acute disease."

Fig. 5 represents the microscopic appearance of mixed urinary deposits. In division A is represented fermentation spores as they appear in diabetic urine. Pasteur asserts that the germs of this fungus get into the urine after it has been passed. Urates appear in division B. These indicate waste of flesh, as in fevers, consumption, prolonged physical efforts, etc. Division C pictures urates of ammonia. These appear in alkaline decomposition of the urine; it is isomeric with uric acid in acid urine. In division D is represented urate of soda, which is present in the tissues of persons suffering from gout. The crystals shown in division E consist of the same salt.

In Fig. 6, division A, is represented purulent matter as it appears in the urine. The formation of pus in different parts of the genitourinary system is accompanied by the appearance of pus corpuscles in the urine. When fat globules, represented in division B, are found in the urine, they indicate fatty degeneration. In division C are representations of the cells found in the urine of persons suffering from cystitis or other inflammatory diseases.

Fig. 7, divisions A and B, represent different forms of cystine. Fortunately this substance is rarely found in the urine. When present however it indicates liability to, or the actual presence of, a calculus or stone in the bladder. In division C is a representation of the deposits seen in the urine of those who are greatly debilitated. In division D are seen epithelial cells mixed with mucus.

In Fig. 8, division A, are represented the caudated cells from the deep structure of the bladder. The cells represented in division B are amyloid concretions, found where there is an enlarged prostate gland.

Fig. 9 represents the appearance of spermatozoa as seen in the urine. When present, they afford indisputable evidence of the escape of semen in the renal excretions.

We might add many other illustrations of urinary deposits and state their several indications, but a sufficient number has been introduced to show the importance and practical value of microscopic examinations of the urine in revealing obscure diseases.

Although the microscope is of inestimable value in examining the renal excretion, it does not entirely supersede other valuable instruments and chemical re-agents in determining constitutional changes. By the urinometer we determine the specific gravity of the urine; by the use of litmus its acid or alkaline reaction, is ascertained; while various chemicals, when added to it, produce certain specific changes, according to the morbid alterations which it has undergone by reason of disease. By the application of heat, or the addition of a few drops of nitric acid, the albumen, which is invariably present in Bright's disease of the kidneys, is coagulated. By the employment of other re-agents we may determine the presence of sugar--a characteristic of diabetic urine. And thus we might mention almost innumerable chemical tests by which the several changed conditions of the urine, _characteristic_ of different diseases, may be ascertained with _absolute certainty_.

THE MOST EMINENT MEDICAL AUTHORITIES ENDORSE IT.

Dr. Eberle, a distinguished allopathic author, thus writes: "Whatever may be the disease, the urine seldom fails in furnishing us with a clue to the principles upon which it is to be treated."

Dr. Braithwaite also says: "We can arrive at a more accurate knowledge respecting the nature of diseases from examining the urine than from any other symptom."

Golding Bird, whose writings are regarded as sound and practical by the most learned of the medical profession, says: "The examination of the urine in disease is now regarded as one of the most important aids in diagnosis, and which it would be injurious alike to the welfare of the patient and the credit of the practitioner to avoid."

The eminent Dr. F. Simon writes as follows: "From the physical and chemical state of the urine, the attentive and observing physician may obtain a great quantity of information for ascertaining and establishing a diagnosis. More than all other signs, the correct examination of the sediment is of importance to the physician. * * * For the medical man it is the compass which guides him in the unlimited chaos of disease and its treatment; for the patient it is the thermometer of his condition, the premonitory indication of the decrease or aggravation of his malady; and for the healthy man it is the regulator of his diet and his life. Every one is aware of the variations of the barometer, and we know that the fluctuations of the column of mercury are closely associated with the variable conditions of the atmosphere; so, to the practical observer, variations of the urine, as well as the elements composing it, point out with certainty the changes in health, and the condition of the organs."

While we recognize the importance of examining the urine as an aid in distinguishing diseases, and have made this old German method of diagnosis a special study, yet we do not claim that _all_ diseases can be unmistakably distinguished by such examinations _alone_. We take a conservative position and have no confidence in that class of ignorant fanatics whose pet hobby is "uroscopy."

From every person who solicits our professional services, we require explicit answers to numerous important questions, that we may know the age, sex, vocation, etc., as well as the prominent symptoms manifested.

CONSULTATIONS BY LETTER.

Formerly, we published in this book a very extensive list of questions to be answered by those consulting us, but a large experience has convinced us that beyond requiring answers to a few leading questions, which we still retain, it is better to let the patient describe the malady in his or her own way and language. After receiving and considering such a history, if we do not fully understand the patient's malady, we will ask such further questions as may be necessary. The patient should, however, in addition to writing name, post-office, county, and state, _plainly_, state the name of the town containing the nearest express office. Next give age, sex, whether married or single, complexion, height, present and former weight, if known, and occupation. State also if you have been a hard worker, and whether it is necessary for you to labor hard now, how long you have been out of health, and from what particular symptoms you suffer most. Follow this with a history of your case in your own language. If you find in this volume an accurate description of your disease, state the page and paragraph where it occurs.

FREE CONSULTATION.

We now make no charge for consultation by letter, but, instead of the one dollar formerly charged by us as a consultation fee, as we are desirous of making our facilities for treatment known to invalids far and near, we request that all persons writing to us for advice send us the names of all those within the circle of their acquaintance who are in any way in need of medical or surgical treatment for chronic diseases. If convenient, send the list on a separate piece of paper.

CHARGES MUST BE PREPAID.

Should you send a vial of urine for analysis, about a cupful will do, and _all express charges on it must be prepaid_. All liquids are excluded from the mails, when discovered, and yet we have received hundreds of samples through the mails safely when put in homoeopathic or other _very small_ vials, well corked and carefully packed in a light tin can or _wooden_ box, or in a light pine stick bored out hollow, the vial being carefully packed in sufficient saw-dust or blotting paper to absorb all liquid should the vial get broken. Letter postage, that is, two cents for each one ounce or fraction thereof, must be paid upon these sealed packages. Send the first urine that is passed after rising in the morning.

RELIABLE MEDICINES.

Next in importance to a correct understanding of the patient's disease, is the possession of reliable remedies for its treatment. Many of the medicines employed by physicians engaged in general practice are prepared from old drugs that have lost all their medicinal virtues, and hence are utterly useless and ineffectual. Many vegetable extracts are inert, because the plants from which they are produced were not gathered at the proper time. To give the reader an idea of the great care which we exercise in the selection and preparation of our medicines, he is requested to read under the head of "The Preparation of Medicines," in "The People's Common Sense Medical Adviser."

OUR TERMS FOR TREATMENT

require the payment of monthly fees, in advance, which entitles the patient to medicines specially prepared for and adapted to his or her particular case, and to all necessary attention and advice. Our fees for treatment are moderate, varying according to the nature and requirements of each particular case, and will be made known at the time of consultation.

WHY OUR FEES ARE REQUIRED IN ADVANCE.

We receive applications from strangers residing in all parts of America, and even in foreign countries, and it is not reasonable to suppose that credit could be dispensed so indiscriminately. It would not be a correct business transaction for a merchant to send a barrel of sugar or a roll of cloth to a stranger living hundreds of miles away, to be paid for when used. Our knowledge and medicines constitute our capital in business, and an order upon that capital should be accompanied with an equivalent. Some applicants refer us to their neighbors for a testimonial of their integrity. We cannot spare the time or employ assistants to make such inquiries for the sake of trusting any one. Should credit be thus indiscriminately given, there would necessarily be losses, and, to compensate for these, and the extra expense incurred by the employment of assistants, our fees would have to be much larger, thereby imposing the burden upon those who _do_ pay. Instead of following this method of procedure, we place professional services within the reach of all, so that a greater number may be benefited. Many invalids say that they have paid large sums of money to medical men for treatment without obtaining relief. Unfortunately our land is cursed with quacks and unprincipled practitioners, who seek no one's good but their own, and it is a defect in our law that it permits such swindlers to go unpunished. Not so reprehensible is the family physician who fails, because his limited and varied practice does not permit him to become proficient in treating chronic diseases.

The following beautiful sentiment of Hood truthfully expresses the sacredness of the physician's trust:

"Above all price of wealth The body's jewel. Not for minds or hands profane To tamper with in practice vain. Like to a woman's virtue is man's health; A heavenly gift within a holy shrine! To be approached and touched with serious fear, By hands made pure and hearts of faith severe, E'en as the priesthood of the One Divine."

We are in regular practice, responsible for what we say and do, and cordially invite those who desire further evidence of our success in curing chronic diseases to come to the Invalids' Hotel and Surgical Institute and satisfy themselves of the truthfulness of our statements.

We are warranted in saying that our responsibility and disposition for fair dealing are known to many of the principal mercantile houses, as well as to all prominent American editors. We also refer to our present and former patients, one or more of whom may be found in almost every hamlet of America. To all who are under our treatment we devote our highest energies and skill, fully realizing that an untold blessing is conferred upon every person whom we cure, and that such cures insure the permanency of our business. On the contrary, we realize how unfortunate it is for us to fail in restoring to health any person whom we have encouraged to hope for relief. We are careful, therefore, not to assume the treatment of incurable cases, except when desired to do so for the purpose of mitigating suffering or prolonging life; for we never wish to encourage false hopes of recovery.

TERMS FOR BOARD AND TREATMENT AT THE INVALIDS' HOTEL AND SURGICAL INSTITUTE

are moderate, varying with the nature of the case and the apartments occupied. At times so great is the number applying to avail themselves of the skill of our Faculty, and the advantages which our institution affords, that we are unable to receive all applicants. To be sure of securing good apartments, it is well to engage them sometime ahead, and make an advance payment of fifty dollars or more upon them, which will be refunded in case acute sickness or any similar cause should prevent the patient from occupying them at the time specified. Complete terms for treatment and board can be arranged only when personal application for entrance to the institution is made, and the nature and extent of the disease and the necessary treatment fully determined by personal examination of the case. If satisfactory terms and arrangements cannot at that time be agreed upon, or if the case be deemed incurable, any advance payments that have been made to secure good apartments will be promptly refunded.

SPECIAL ADVICE.

Those coming here to consult us personally, should bring the money to pay for our services and for board and care while remaining here, in the form of drafts on New York City, Boston or Chicago, and _not_ in the form of checks on a local or home bank. Such drafts can be purchased in the home bank by paying a small amount for the exchange. If more convenient, post office orders payable at Buffalo post office will do.

VISITING PATIENTS WHO RESIDE AT A DISTANCE.

We are frequently asked to visit patients residing hundreds of miles away, that we may personally examine their cases, or perform difficult surgical operations. We can seldom comply with such requests as the time of our professional Staff is generally very fully occupied.

TO PHYSICIANS

wishing to consult us in intricate cases of chronic diseases under their treatment, we desire to say that we shall, as in the past, take pleasure in responding to their solicitations. We have all the necessary instruments and appliances required in executing the most difficult surgical operations, and, as we have had much experience in this department, we are always ready and able to assist physicians who do not practice operative surgery. In this age of railways and telegraphs medical and surgical aid can be summoned from a distance and promptly obtained.

OUR MEDICINES

as put up for sale through druggists, are not recommended as "cure-alls," or panaceas, but only as superior remedies for certain common and easily-recognized diseases. They are our favorite prescriptions, improved and perfected by long study and a vast experience in the treatment of chronic diseases, and have gained world-wide celebrity and sale. We are well aware that there are many chronic diseases that can only be successfully treated and cured by careful adaptation of remedies to each individual case. This is especially true of the ever-varying and delicate diseases of the kidneys and bladder. It is not less so with reference to nervous debility, involuntary vital losses, with which so many young and middle-aged men are afflicted; and we may also include in this list epilepsy or fits, paralysis or palsy, obstinate gleety discharges, and many other chronic and delicate ailments of which our staff of physicians and surgeons cure annually many thousands of cases, but _for which we do not recommend_ any of our put-up, ready-made, or proprietary medicines.

NO RELATIONSHIP WITH HUMBUGS.

Had our put-up or proprietary medicines, as sold by druggists the world over, been adapted to all classes and forms of chronic diseases, there would have been no necessity for our organizing a competent staff of physicians and surgeons to act as experts in the treatment of difficult, obscure, and complicated cases of chronic diseases. That we keep constantly employed, in our Buffalo and London institutions, eighteen medical gentlemen, with such helpers as chemists, clerks, etc., is indisputable proof that the medicines we offer for sale through druggists should not be classed with the humbug nostrums recommended to cure everything. They are the outgrowth of our vast and extended practice in the treatment of chronic diseases; are well-tried, world-famed, and _honest medicines_. They are not unduly puffed and lauded, but simply recommended for such diseases as are easily recognized and which they are _known to cure._

NOT CONFINED IN PRESCRIBING

Our physicians, in the treatment of cases consulting us, prescribe just such medicines as are adapted to each particular case. _They are not confined in the least_ to our list of a few put-up or proprietary medicines (valuable as they are when applicable to the case) but resort to the whole broad range of the _materia medica_, employed by the most advanced physicians of the age. They are not hampered by any school, _ism_ or "_pathy_."

OUR MEDICINES PREPARED WITH THE GREATEST CARE.

The medicines employed are all prepared in our own Laboratory by skilled chemists and pharmacists, and the greatest care is exercised to have them manufactured from the freshest and purest ingredients. Our Faculty probably employ a greater number and variety of native roots, barks, and herbs, in their practice then are used in any other invalids' resort in the land. Using vast quantities of these indigenous medicines, we can afford and do not neglect to have them gathered with great care, at the proper seasons of the year, so that their medicinal properties may be most reliable. Too little attention is generally paid to this matter, and many failures result from the prescribing of worthless medicines by physicians who have to depend for their supplies upon manufacturers who are careless or indifferent in obtaining the crude plants and roots from which to manufacture their medicines for the market. While depending largely upon solid and fluid extracts of native plants, roots, barks, and herbs, in prescribing for disease, yet we do not use them to the exclusion of other valuable curative drugs and chemicals. We aim to be unprejudiced and independent in our selection of remedies, adopting at all times a rational system of therapeutics. This liberal course of action has, in a vast experience, proved most successful.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 MAIN STREET, BUFFALO, N.Y.

* * * * *

PRESIDENT GARFIELD'S

ENDORSEMENT OF THE

INVALIDS' HOTEL AND SURGICAL INSTITUTE

_AND ITS FOUNDER._

The following letter from an eminent lawyer of Tennessee, is noteworthy, inasmuch as it shows the estimation in which Dr. Pierce and the institutions which he has founded were held by the lamented Garfield, who was one of the Doctor's intimate friends and colleagues while he was serving as a member of Congress:

OFFICE OF H.F. COLEMAN, ATTORNEY AT LAW, SNEEDVILLE, TENN., Aug. 11, 1884

_World's Dispensary Medical Association, 663 Main St., Buffalo, N.Y._

GENTLEMEN:--Your letter of the 31st ult. just received and contents noted. I am perfectly satisfied with the explanation, and ask pardon for the sharp letter written you some days since. The mails are very irregular, as you know, and we are too apt to be impatient and attribute our mishaps to the wrong cause. Your honesty, integrity and ability are not doubted in the least by me.

I have, perhaps, a higher endorsement of you than any other patient under your care, and for your gratification I will give it to you.

Some time since I was in conversation with Congressman Pettibone, of this State, when the following conversation took place: "You say," said the Major, "that you have visited Dr. Pierce's medical establishment in Buffalo, New York?" "Yes, sir, I did." "You found everything as represented?" "Yes, sir, as was represented, and which I assure you was quite encouraging to a man who had traveled as far as I had to visit an institution of that kind." "That man, Dr. Pierce," said the Major, "is one of the best men of the times. While at Washington, during my first term," he continued, "one day I was in President Garfield's room and a fine-looking, broad-foreheaded gentleman came in, and President Garfield arose and took him by the hand and said, 'Good morning, Doctor, I am so glad to see you,' and then turned and introduced him to me as Dr. Pierce, of Buffalo, New York. Knowing the Doctor by reputation, and having seen his pictures, I at once recognized him. He, in a short time, left the room, and Garfield said to me, 'Major, that is one of the best men in the world, and he is at the head of one of the best medical institutions in the world.'"

With this high endorsement, I have unbounded confidence in your integrity and ability.

Very truly yours, H.F. COLEMAN.

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NOTICES OF THE PRESS.

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OUR PROFESSIONAL STAFF.

The Buffalo _Evening News_ says: "Each and every member of the medical and surgical staff of the Invalids' Hotel and Surgical Institute is a graduate in medicine and surgery from one or more legally chartered medical colleges, and several of the members have had many years of experience as army surgeons, and in hospital and general as well as in special practice. One is a licentiate of the Royal College of Physicians, Edinburgh; licentiate of the Faculty of Physicians and Surgeons, Glasgow; licentiate of midwifery, Glasgow; member of the Royal College of Surgeons, London, England; extraordinary member of the Royal Medical Society, Edinburgh, etc. Another is a graduate of the University of Pennsylvania, at Philadelphia; another of the New York Medical College; another of the Buffalo Medical College, and of the College of Physicians and Surgeons, New York; another of Cincinnati Medical College, and of the University of New York; another from Buffalo Medical College, and diplomas from all these institutions, as well as from many others equally noted, can be seen at the offices of this institution, if any one feels any interest in them."

* * * * *

_FROM THE "ROMAN CITIZEN," (ROME, N.Y.)._

THE INVALIDS' HOTEL AND SURGICAL INSTITUTE.

One of the most extensive institutions in this country for the treatment of chronic ailments is the Invalids' Hotel and Surgical Institute at Buffalo, under the control of the World's Dispensary Medical Association, of which Dr. R.V. PIERCE is President. The hotel itself is a wonderful affair, combining all the comforts and conveniences of a luxurious home with the most complete facilities for the successful treatment of all chronic diseases incident to humanity. Dr. PIERCE has a world-wide fame as a skillful practitioner, and his corps of assistants comprises many physicians and surgeons of great ability and large experience in the treatment of chronic and surgical diseases. Those who have been treated by the Association are loud in their praises, and we understand that the number of its patients increases with each succeeding year. The country is full of people who have been "doctoring" year after year without successful results, and the probabilities are that in a majority of such cases a few months spent at the Invalids' Hotel and Surgical Institute in the care of its medical experts, would result in material and permanent benefit.

* * * * *

_FROM THE WASHINGTON (D.C.) CHRONICLE._

ONE OF THE ATTRACTIONS AT BUFFALO.

In the enterprising city of Buffalo some eminent and capable professional people have established an "Invalids' Hotel and Surgical Institute," under the comprehensive direction and control of the "World's Dispensary Medical Association" at 663 Main Street, in that beautiful city. This Institute is organized with a full staff of eighteen physicians and surgeons, and the hotel is exclusively devoted to treatment of chronic diseases. This corps of doctors make a specialty of chronic maladies, and the Institute is reputed to have abundant skill, facilities and apparatus for the successful treatment of every form of chronic ailment, whether requiring for its cure medical or surgical means.

The building occupied is a massive one of five stories.

* * * * *

_FROM THE MISSOURI REPUBLICAN_ (_ST. LOUIS_).

A REMARKABLE PROFESSIONAL SUCCESS.

Among the notable professional men of this country who have achieved extraordinary success is Dr. R.V. PIERCE, of Buffalo, N.Y. The prominence which he has attained has been reached through strictly legitimate means, and so far, therefore, he deserves the enviable reputation which he enjoys. This large measure of success is the result of a thorough and careful preparation for his calling, and extensive reading during a long and unusually large practice, which has enabled him to gain high commendation, even from his professional brethren. Devoting his attention to certain specialties of the science he has so carefully investigated, he has been rewarded in a remarkable degree. In these specialties he has become a recognized leader. Not a few of the remedies prescribed by him have, it is said, been adopted and prescribed by physicians in their private practice. His pamphlets and larger works have been received as useful contributions to medical knowledge. He has recently added another, and perhaps more important work, because of more general application, to the list of his published writings. This book, entitled "The People's Common Sense Medical Adviser," is designed to enter into general circulation. For his labors in this direction, Dr. PIERCE has received acknowledgments and honors from many sources, and especially scientific degrees from two of the first medical institutions in the land. His works have been translated into the German, Spanish, French, and other foreign languages.

* * * * *

_FROM THE TOLEDO BLADE_.

Dr. PIERCE has now been before the general public long enough to enable the formation of a careful estimate of the efficiency of his treatment and his medicines, and the verdict, we are glad to know, has been universally favorable to both.

* * * * *

_FROM THE ST. LOUIS GLOBE_.

THE SUCCESSFUL PHYSICIAN.

Dr. PIERCE is a type of a class of men who obtain success by careful and well-directed effort, not attempting too much, nor creating false ideas as to ability. The only reliable physician, in these days of complicated disorders and high-pressure living, is the "Specialist," the man who understands his own branch of the business. Such, in his line, is Dr. Pierce. He has written a "Common Sense Medical Adviser," which is well worth reading. With strict business honor, high professional skill, reasonable fees, and a large corps of competent assistants Dr. Pierce has made his name as familiar as "household words."

* * * * *

From _the Rocky Mountain Herald_.

Dr. R.V. PIERCE, the greatest American specialist, and proprietor of the World's Dispensary, Buffalo, N.Y., has sent us his new book entitled "The People's Common Sense Medical Adviser," which is a handsome, large volume, elegantly got up, with hundreds of wood-cuts and colored plates, and a complete cyclopedia of medical teachings for old and young of both sexes. _It has every thing in it,_ according to the latest scientific discoveries, and withal is wonderfully _commomensical_ in its style and teachings.

* * * * *

_From the Lafayette Daily Courier._

Dr. R.V. PIERCE, of Buffalo, distinguished in surgery, and the general practice of the profession he honors, has made a valuable contribution to the medical literature of the day, in a comprehensive work entitled "The People's Common Sense Medical Adviser." While scientific throughout, it is singularly free from technical and stilted terms. It comes right down to the common-sense of every-day life, and, to quote from the author himself, seeks to "inculcate the facts of science rather than the theories of philosophy." This entertaining and really instructive work seems to be in harmony with the enlarged sphere of thought, as touching the open polar sea of evolution. He considers man in every phase of his existence, from the rayless atom to the grand upbuilding of the noblest work of God. Dr. PIERCE is a noble specimen of American manhood. He has sprung from the people, and with many sympathies in common with the masses, has sought to render them a substantial service in this the great work of his life.

* * * * *

_From the New York Independent._

LAURELS FOR TRUE WORTH.

"A wise physician, skill'd our wounds to heal, Is more than armies to the public weal."

To be honored in his own land is the crowning blessing of the man who has been "the architect of his own fortune"--the man who has made for himself, with his own hands and brain, a princely fortune and an enduring fame. From COMLEY'S History of New York State, containing biographical sketches of the men who "have given wealth, stamina, and character" to the Empire State, we clip the following brief sketch of the distinguished physician, Dr. R.V. PIERCE, of Buffalo: "Every nation owes its peculiar character, its prosperity--in brief, every thing that distinguishes it as an individual nation,--to the few men belonging to it who have the courage to step beyond the boundaries prescribed by partisanship, professional tradition, or social customs. In professional no less than in political life there occasionally arise men who burst the fetters of conventionalism, indignantly rejecting the arbitrary limits imposed upon their activity, and step boldly forward into new fields of enterprise. We call these men _self-made._ The nation claims them as her proudest ornaments--the men upon whom she can rely, in peace for her glory, in war for her succor. Of this class of men the medical profession has furnished a distinguished example in the successful and justly-celebrated physician, Dr. R.V. PIERCE, of Buffalo, N.Y., and any history treating of the industries of the Empire State would be incomplete without a sketch of his useful and earnest work. * * * Specially educated for the profession which he so eminently adorns, he early supplemented his studies by extensive and original research in its several departments. He brought to his chosen work acute perceptive and reflective powers, and that indomitable energy that neither shrinks at obstacles nor yields to circumstances. In physique, Dr. PIERCE is an ideal type of American manhood. Of medium stature, robust, his appearance is characterized by a healthful, vigorous vitality, while the full, lofty brow and handsomely cut features are indicative of that comprehensive mental power and remarkable business sagacity which have combined to place him among the distinguished men of the age. * * * As an earnest worker for the welfare of his fellow-men, Dr. PIERCE has won their warmest sympathy and esteem. While seeking to be their servant only, he has become a prince among them. Yet the immense fortune lavished upon him by a generous people he hoards not, but invests in the erection and establishment of institutions directly contributive to the public good, the people thus realizing, in their liberal patronage, a new meaning of the beautiful Oriental custom of casting bread upon the waters. Noted in both public and private life for his unswerving integrity and all those sterling virtues that ennoble manhood, Dr. PIERCE ranks high among those few men whose names the Empire State is justly proud to inscribe upon her roll of honor." Dr. PIERCE has lately erected a palatial Invalids' Hotel for the reception of his patients, at a cost of over half a million dollars.

* * * * *

A MAN OF THE TIME.

Speaking of Dr. R.V. PIERCE, the _Buffalo_ (N.Y.) _Commercial_ says: "He came here an unknown man, almost friendless, with no capital except his own manhood, which, however, included plenty of brains and pluck, indomitable perseverance, and inborn uprightness, capital enough for any man in this progressive country, if only he has good health and habits as well. He had all these great natural advantages, and one thing more, an excellent education. He had studied medicine and been regularly licensed to practice as a physician. But he was still a student, fond of investigation and experiment. He discovered, or invented, important remedial agencies or compounds. Not choosing to wait wearily for the sick and suffering to find out (without any body to tell them) that he could do them good, he advertised his medicines and invited the whole profession of every school, to examine and pronounce judgment on his formulas. He advertised liberally, profusely, but with extraordinary shrewdness, and with a method which is in itself a lesson to all who seek business by that perfectly legitimate means. His success has been something marvelous--so great, indeed, that it must be due to intrinsic merit in the articles he sells, more even than to his unparalleled skill in the use of printer's ink. The present writer once asked a distinguished dispensing druggist to explain the secret of the almost universal demand for Dr. PIERCE'S medicines. He said they were in fact genuine medicines--such compounds as every good physician would prescribe for the diseases which they were advertised to cure. Of course, they cost less than any druggist would charge for the same article, supplied on a physician's prescription, and, besides, there was the doctor's fee saved. Moreover, buying the drugs in such enormous quantities, having perfect apparatus for purifying and compounding the mixture, he could not only get better articles in the first place, but present the medicine in better form and cheaper than the same mixture could possibly be obtained from any other source.

* * * * *

_Extracts from Biographical Sketches of New York Senators._

At the age of eighteen, he (Dr. PIERCE) entered a medical school, and proved a devoted student, graduating at twenty-three with the highest honors. A simple knowledge of the routine of practice as then in vogue, was not enough. He sought new means of healing, and explored "schools" of practice that were prohibited by his sect. He denounced errors in the prevailing "schools" and accepted truths belonging to those prohibited. Every one knows how such daring and destructive innovations are regarded by the medical profession generally. Dr. PIERCE was no exception to the rule. But he paid no attention to detraction, pursuing his own way with that energy which proves now to be a most excellent ally of his medical instincts.

The World's Dispensary is to-day the greatest institution of its kind in the world. More than two hundred persons are employed, eighteen being skillful physicians and surgeons, each devoting himself to a special branch of the profession, all acting together when required, as a council. The printing department of the Dispensary is larger than the similar department of any paper outside of the _New York Herald._

* * * * *

_From The New York Times._

WELL-MERITED SUCCESS.

The author of "The People's Medical Adviser" is well-known to the American public as a physician of fine attainments, and his Family Medicines are favorite remedies in thousands of our households. As a counselor and friend, Dr. PIERCE is a cultured, courteous gentleman. He has devoted all his energies to the alleviation of human suffering. With this end in view and his whole heart in his labors, he has achieved marked and merited success. There can be no real success without true merit. That his success is _real_, is evidenced by the fact that his reputation, as a man and physician, does not deteriorate; and the fact that there is a steadily increasing demand for his medicines, proves that they are not nostrums, but reliable remedies for disease. The various departments of the World's Dispensary in which his Family Medicines are compounded and his special prescriptions prepared, are provided with all modern facilities.

* * * * *

_The New York Tribune says:_

"The American mind is active. It has given us books of fiction for the sentimentalist, learned books for the scholar and professional student, but _few books for the people_. A book _for the people_ must relate to a subject of universal interest. Such a subject is the physical man, and such a book 'The People's Common Sense Medical Adviser,' a copy of which has been recently laid on our table. The high professional attainments of its author,--Dr. R.V. PIERCE, of Buffalo, N.Y.,--and the advantages derived by him from an extensive practice, should alone insure for his work a cordial reception." Price $1.50, post-paid. Address, WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.

* * * * *

_From The Boston Daily Globe._

A CURE FOR MANY EVILS.

What can be accomplished by judicious enterprise, when backed up by ability and professional skill, is shown by the magnificent buildings of the World's Dispensary and the Invalids' Hotel and Surgical Institute, at Buffalo. While models of architectural beauty and completeness, their real worth and usefulness consist rather in the humanitarian objects they are made to serve. They stand superior to all institutions of their kind, not only in material proportions but as well in the medical knowledge and practical experience of those connected with them. In each department are those and those only who by natural bent and training are specially adapted to combating their particular class of "the ills which flesh is heir to."

VOCABULARY

OF THE

COMMON SENSE MEDICAL ADVISER,

_GIVING EACH TECHNICAL WORD EMPLOYED, REFERRING TO ITS IMAGES/ADVISE WHEN POSSIBLE, AND IN CASE THE WORD WILL NOT PERMIT OF A SHORT DEFINITION, REFERRING TO THE PAGE WHERE A FULL DESCRIPTION OF ITS MEANING MAY BE FOUND._

A

ABDOMEN. The part of the body between the diaphragm and pelvis, containing the stomach, intestines, etc. The belly.

ABDOMINAL. Belonging to the Abdomen.

ABORTION. Expulsion of the foetus before the seventh month of pregnancy.

ABSORPTION. The function of taking up substances from within or without the body.

ACETABULUM. The bone socket which receives the head of the thigh bone.

ACNE. Pimples upon the face, more common at the age of puberty.

ADIPOSE TISSUE. A thin membrane composed of cells which contain fat.

ADVENTITIOUS. Acquired.

ALBUMEN IN URINE in chemical composition resembles the white of an egg, and is detected by the application of heat, nitric acid, etc.

ALBUMINOID. Of the nature of albumen.

ALBUMINURIA. A condition or disease in which the urine contains albumen. (See above.)

ALIMENTARY CANAL. The canal extending from the mouth to the anus, through which the food passes.

ALLOPATHY. Allopathic school. Defined on page 293.

ALTERATIVE. A medicine which gradually changes the constitution, restoring healthy functions.

ALVEOLAR PROCESS. The bony structure which contains the sockets of the teeth.

AMAUROSIS. Loss or decay of sight from disease of the optic nerve.

AMENORRHEA. Suppression of the menses.

AMNION. A membrane enveloping the foetus and the liquid.

AMPUTATION. The operation of cutting off a limb.

AMYLOID DEGENERATION. Alteration in the texture of organs, which resembles wax or lard.

AMYLOIDS. Foods composed of carbon and hydrogen; as sugar, starch, etc.

ANÆMIA. Privation of blood. Lack of red corpuscles in the blood.

ANASARCA. Dropsy attended with bloating all over the body.

ANATOMY. The science of the structure of the body.

ANESTHETIC. An agent that prevents feeling in surgical operations, and in some diseases of a painful nature.

ANGINA (PECTORIS). Violent pain about the heart, attended with anxiety and difficult breathing.

ANIMALCULA, ANIMALCULE. An animal so small as to be invisible, or nearly so, to the naked eye.

ANODYNES. Medicines which relieve pain.

ANTEVERSION. The womb falling forward upon the bladder. Illus. p. 716.

ANTHELMINTICS. Medicines which destroy or expel worms from the stomach and intestines.

ANTIDOTE. A remedy to counteract the effect of poison.

ANTIFEBRILE. A remedy which abates fever.

ANTIPERIODIC. A remedy which prevents the regular appearance of similar symptoms in the course of a disease.

ANTISEPTIC. Medicines which prevent putrefaction.

ANTISPASMODICS. Medicines which relieve spasm.

ANUS. The circular opening at the end of the bowel, through which the excrement leaves the body.

AORTA. The great artery of the body arising from the heart. Illus. page 58.

APERIENT. A medicine which moves the bowels gently.

APHTHÆ. Sore mouth, beginning in pimples and ending in white ulcers.

APHTHOUS. Complicated with aphthæ.

APNOEA. Short, hurried breathing.

APOPLEXY. The effects of a sudden rush of blood to an organ; as the brain, lungs, etc. Brain pressure, from rupture of a blood-vessel.

AQUEOUS HUMOR. The clear fluid contained in the front chambers of the eye.

ARACHNOID. A thin, spider-web like membrane covering the brain.

AREOLAR TISSUE. The network of delicate fibres spread over the body, binding the various organs and parts together.

ARTERY. A vessel carrying blood from the heart to the various parts of the body; usually red in color.

ARTICULAR. Relating to the joints.

ARTICULATED. Jointed.

ARTICULATIONS. The union of one bone with another. A Joint.

ASCITES. Accumulation of fluid in the abdominal cavity.

ASPHYXIA. A condition of apparent death owing to the supply of air being cut off; as in drowning, inhalation of gases, sun-stroke, etc.

ASPIRATOR. An instrument for the evacuation of fluids from the cavities of the body, as water in abdominal dropsy, the contents of tumors, etc.

ASSIMILATION. Appropriating and transforming into its own substance, matters foreign to the body.

ASTRINGENTS. Medicines which contract the flesh.

ATONIC, ATONY. Wanting tone.

ATROPHIED. Wasted; lessened in bulk.

ATROPHY. Wasting away; diminution in size.

AUDITORY NERVES. The nerves connecting the brain with the ears and employed in exercising the sense of hearing.

AUSCULTATION. Diagnosing diseases by listening, either with or without instruments.

B

BALANITIS. Gonorrhea of the mucous surface of the head of the penis.

BENIGN. Harmless; a term applied to tumors.

BEVERAGE. A liquor for drinking.

BILE. A yellow bitter fluid secreted by the liver. Defined on page 80.

BILIOUS. Disordered in respect to bile. Relating to bile.

BILIOUS TEMPERAMENT, VOLITIVE TEMPERAMENT. See page 173.

BIOLOGY. The science of life.

BISTOURY. A small cutting knife.

BLADDER (URINARY). The organ, situated behind the pubic bone, which holds the urine until its expulsion. Illus. pages 206 and 207.

BLEBS. Eminences of the skin containing a watery fluid.

BLOODY-FLUX. A disease characterized by frequent, scanty, and _bloody_ stools.

BOIL. An inflamed tumor which comes to a head and discharges matter and a core. See page 443.

BOLUS. A large pill.

BOUGIE. A long, flexible instrument used for dilating contracted canals and passages.

BREACH. Some form of hernia of the abdomen. See page 862.

BROAD LIGAMENTS OF THE UTERUS. Folds of the peritoneum which support the womb and contain the Fallopian tubes and ovaries. Illus. p. 206.

BRONCHEA. Tubes formed by the division of the windpipe. Illus. page 64.

BRONCHOCELE. Thick neck, goitre.

BUBO. An inflammatory tumor in the groin.

BULLA. A bleb or large pimple containing transparent fluid.

C

CACHEXIA. A depraved condition of the system; as from poor food, syphilis, etc.

CALCAREOUS. Containing lime.

CALCIFICATION. The process of forming of, or converting into, chalk.

CALCULUS, CALCULI. Stones or similar concretions formed by the deposit of solid matter; of lime, soda, uric acid, urates, oxalates, etc.

CALISTHENICS. Healthful exercise of the body and limbs, for purposes of strength and agility.

CANCELLATED STRUCTURE. Cells communicating with each other forming a structure resembling "lattice-work."

CANKER. Ulcers in the mouth.

CAPILLARIES. Very small blood-vessels. Defined on page 60.

CARBONIC ACID. A heavy, poisonous gas. Choke damp.

CARDIAC. Pertaining to the heart. Near or towards the heart.

CARMINATIVES. Medicines which allay pain in the stomach and intestines by expelling the gas.

CAROTIDS. The great arteries at the sides of the neck.

CARTILAGE. A solid part of the body found in the joints, ends of the ribs, etc. It is softer than bone but harder than ligament.

CARTILAGINOUS TISSUE. Parts of the body of the nature of cartilage.

CARUNCULÆ. Fleshy growths.

CASEIN. The part of milk which contains nitrogen. Cheese curd.

CATALYTICS. Medicines which destroy morbid agencies in the blood. Alteratives.

CATAMENIA. Monthly flow of the female.

CATARACT. Opacity of the lens of the eye, or its covering, or both.

CATHARTICS. Medicines which cause evacuation of the bowels.

CATHETER. A hollow tube introduced into the bladder through the urethra for the purpose of drawing off the urine.

CAUSTICS. Substances which destroy animal tissue.

CAUTERIZATION. Burning or searing by a hot iron, or caustic medicines.

CAUTERIZE. To burn or sear by a hot iron, or by medicines which destroy.

CELL. A little vessel having a membranous wall and containing fluid. The whole body may be considered as formed of different kinds of cells.

CELLULAR STRUCTURE. See CANCELLATED STRUCTURE.

CEREBELLUM. Little brain. Base brain. Illus. page 100.

CEREBRUM. The upper or large brain. Illus. page 100.

CERVIX. Neck; neck of the womb. Illus. page 206.

CHALYBEATE. Mineral waters which contain iron.

CHANCRE. A virulent, syphilitic ulcer. Figs. 27 and 28, Plate V., Pamphlet X.

CHANCROID. Resembling infectious chancre. Soft chancre.

CHLOROSIS. Green sickness. A disease of young women attended with a greenish hue of the skin, debility, etc.

CHOLAGOGUES. Cathartics which stimulate the liver.

CHORDÆ TENDINEÆ. Cord-like substances about the valves of the heart. See page 57.

CORDEE.

CHOROID. The dark colored lining membrane of the eye.

CHYLE. Food digested and ready for absorption. See pages 45 and 49.

CHYLOUS PRODUCTS. See CHYLE.

CHYME. Food after being subjected to the action of the gastric fluids.

CICATRIX. The scar or place where parts which have been cut or divided, are united.

CILIA. Small hairs.

CIRCUMCISION. An operation for removing superfluous foreskin.

CIRCUMVALLATE. Arranged in oblique lines, as the prominences on the back of the tongue.

CLAP. Gonorrhea. A venereal disease of the urethra.

CLAVICLE. See COLLAR-BONE.

CLINICAL MEDICINE. Investigation of disease at the bedside.

COAGULATE. To thicken or harden, as heat hardens the white of an egg.

COITION. Sexual intercourse. The act of generation.

COLLAR-BONE (CLAVICLE). A bone at the front and top of chest, attached by one end to the breast-bone and by the other to the shoulder-blade.

COLON. Part of the large intestines. Illus. page 40.

COMA. A condition of profound sleep from which it is difficult to arouse the patient.

COMEDONES. Pimples on the face. See page 412, and Fig. 8. Plate II.

COMPRESS. A soft cloth folded to several thicknesses, so that with a bandage pressure can be applied, or by wetting in hot water, a part can be subjected to the influences of heat and moisture.

CONCEPTION. Impregnation of the ovum; the beginning of a new being.

CONGENITAL. Applied to a disease born with one; from birth.

CONGESTION. An abnormal amount of blood in a part or organ.

CONJUNCTIVA. The membrane which covers the external surface of the eyeball.

CONJUNCTIVITIS. Inflammation of the eye.

CONTAGION. The transmission of disease from one to another by contact, as hydrophobia, syphilis; or otherwise, as measles, scarlet fever, etc.

CONTAGIOUS. Capable of being transmitted from one person to another.

CONTINENCE. Abstinence from sexual intercourse or excitement.

CONVALESCENCE. The recovery of health after sickness.

CONVOLUTED. Curved or rolled together.

COPULATION. Sexual intercourse.

CORIUM. A layer of the akin.

CORNEA. A transparent covering of the front of the eye.

CORPUSCLES OF THE BLOOD. Defined and illustrated on page 53.

COUNTER-IRRITANTS. Defined on page 331.

COWPER'S GLANDS OF THE MALE. Glands situated in front of the prostate gland. Illus. page 207.

COXALGIA. Hip-joint disease. See page 451.

CRANIUM. The skull. The bones of the head.

CRAYONS. Sticks or cylinders made of Cocoa butter and medicated.

CROSS-EYE. One or both eyes drawn towards the nose. Squint.

CRUSTACEOUS. Belonging to the class of animals covered by a crust-like shell.

CUTANEOUS. Belonging to, or affecting, the skin.

CUTICLE. The outer layer of the skin, consisting of small bony scales.

CYSTITIS. Inflammation of the bladder. In chronic form, Catarrh of the bladder.

D

DEBRIS. Broken-down tissue. Waste material.

DECOCTION. Defined on page 303.

DEFECATION. Voiding excrement from the body.

DEGENERATION, FATTY. The deposit of particles of fat instead of the proper muscular tissue.

DEGLUTITION. Swallowing. Conveying food to the stomach.

DEJECTION OF MIND. Despondency. Low spirits.

DEJECTIONS. The matter voided from the bowels.

DELETERIOUS. Destructive. Poisonous.

DENTITION. Cutting of the teeth in infancy.

DEODORIZER. A substance that destroys a bad smell.

DEPLETION. To empty the blood-vessels by lancing a vein or by medicines.

DEPRAVATION. Corruption.

DEPURATING. Cleansing.

DERMATOLOGIST. One who makes diseases of the skin a specialty.

DESICCATE. To dry up.

DESQUAMATION. Scaling off of the skin, after fevers.

DESQUAMATIVE NEPHRITIS, Bright's Disease, in which epithelial cells escape with the urine.

DIABETES. Defined on page 835.

DIAGNOSIS. The determination of a disease by its symptoms or characteristics.

DIAGNOSTIC. The symptoms by which a disease is distinguished from others.

DIAPHORETIC. Medicines which increase perspiration.

DIAPHRAGM. Defined on page 32.

DIATHESIS. Peculiarity of constitution. Predisposition to certain diseases.

DIGESTION. The function by which food passing along the alimentary canal is prepared for nutrition.

DILATATION. Increasing in size by Instruments or other agencies.

DILUENTS. Fluids which thin the blood or hold medicines in solution.

DIRECTOR. An instrument having a groove which directs the knife and protects underlying parts from injury.

DISINFECTANTS. Substances which arrest putrefaction.

DISLOCATION. The act of or state of, being forced from its proper situation.

DISTILLED. Separated by heat from other substances and collected by condensation.

DIURETICS. Medicines which increase the flow of urine.

DOUCHE. Dashes of water. An instrument for washing the nasal membrane.

DRASTICS. Medicines which move the bowels harshly or frequently.

DROPSY. The accumulation of fluid In the cavities or cellular tissue of the body.

DUODENUM. The first portion of the intestines. Illus. page 44.

DURA MATER. A thick, fibrous membrane lining the skull.

DYSCRASIA. A bad condition of body.

DYSENTERY. A disease characterized by frequent, scanty and _bloody_ stools.

DYSMENORRHEA. Difficult or painful menstruation.

DYSPNOEA. Difficult breathing.

E

EAR, INTERNAL. Defined on page 110. Illus. page 109.

EARTHY PHOSPHATES. The white deposit in urine, composed of phosphoric acid and a base.

ECCHYMOSIS. Black or yellow spots produced by effused blood. Black eye Is an example.

ECLECTIC SCHOOL. See page 294.

ECRASEUR. An instrument which amputates by a loop of wire.

ECZEMATOUS. Of the nature of Eczema. See page 430.

EDEMA (OEDEMA). Puffiness of the skin from the accumulation of fluid. General dropsy.

EFFLUVIA. Unpleasant odors or exhalations.

EFFUSION. The pouring out of blood or other fluid.

ELECTROLYSIS. Decomposing or modifying by the application of electricity.

ELIMINATED. Discharged, expelled.

EMACIATION. Leanness in flesh.

EMBRYO. The young of an animal at the beginning of its development in the womb.

EMETICS. Medicines which empty the stomach upwards.

EMMENAGOGUES. Medicines which favor or cause menstruation.

EMPIRICISM. Practicing medicine upon results of experience, generally by a person without a medical education.

ENCEPHALIC TEMPERAMENT. Defined on page 177.

ENDOCARDITIS. Inflammation of the lining membrane of the heart.

ENDOCARDIUM. The lining membrane of the heart

ENDOMETRLTLS. Disease of the lining membrane of the womb.

ENTERIC. Intestinal.

ENTERITIS. Inflammation of the mucous lining of the small intestines.

EPIDEMICS. Diseases which attack a number of persons at the name time: as yellow fever, small-pox, etc.

EPIGLOTTIS. A cap over the windpipe, allowing the admission of air, but preventing the introduction of foreign bodies.

EPITHELIAL CELLS. Cells belonging to the epithelium.

EPITHELIUM. The thin covering upon the lips, nipple, mucous and serous membranes and lining the ducts, blood-vessels and other canals.

ESOPHAGUS (OESOPHAGUS). The food-pipe. Illus. page 44.

EUSTACHLAN TUBE. The tube leading from the throat to the inner ear. Illus, page 109.

EVACUAUT. Cathartic.

EVOLUTION. Defined on page 14.

EXCORIATES. Removes the skin in part.

EXCORIATION. A wound which removes some of the skin.

EXCREMENTITIOUS. Pertaining to the matter evacuated from the body.

EXCRESCENCES. Surface tumors; as warts, piles, polypi, etc.

EXCRETION. The process by which waste materials are removed from the blood, performed particularly by the lungs, skin and kidneys.

EXCRETORY DUCTS. Minute vessels which transmit fluid from glands.

EXHALATIONS. That which is thrown off by the body, as vapor, gases, etc.

EXPECTORANTS. Medicines which promote discharges from the lungs.

EXPIRATION. Expelling the breath.

EXTRANEOUS MATTER. Any substance which finds a place in the body and does not belong there. Foreign substances.

EXTRA-UTERINE. Outside of the womb, but in its vicinity.

EXTRAVASATED. Escaped into surrounding tissues.

EXTREMITIES. Legs or arms.

EXUDATION. Substances discharged through the pores.

EXUDE. To sweat; to pass through a membrane.

F

FALLOPIAN TUBE. The canal through which the ovum passes from the ovary to the womb.

FARADIZATION. The application of electricity by inductive currents.

FASCIA. The white fibrous expansion of a muscle which binds parts together.

FATTY DEGENERATION. The deposit of particles of fat instead of proper muscular tissue.

FEBRIFUGE. A medicine which abates or cures fevers.

FEBRILE. Relating to fever.

FECUNDATION. The ovum uniting with the male germ. Impregnation.

FEMORAL HERNIA. Thigh hernia. Illus. page 863.

FERMENTED. Changed by a process of decomposition.

FERRUGINOUS. Containing iron.

FETID. Having an offensive smell. Stinking.

FETOR. Offensive smell. Stench.

FIBROUS. Composed of fibres.

FIBROUS TISSUE. The texture which unites every part of the body.

FILAMENTS. Fibre; the basis of texture.

FIMBRIATED. Finger-like.

FIRST INTENTION, HEALING BY. Healing without suppuration or the formation of pus.

FISSURE. A crack.

FISTULA: FISTULÆ. Small canals or tubes which carry pus or other liquids through the flesh.

FISTULA, URINARY. The abnormal communication between the urinary passages and the external surface.

FISTULOUS OPENINGS. The outer end of canals or tubes which carry pus to the surface.

FLATULENCY. Wind gathered in the stomach or bowels.

FLEXION OF THE WOMB. A partial misplacement in which the womb is bent upon itself.

FLEXURES. Bending. Motion of a joint.

FLOCCULENT. Combining or adhering in flocks or flakes.

FLUID EXTRACTS. The active principles of medicines in fluid form.

FOETUS. The unborn child.

FOLLICLES (OF HAIR). Small depressions in the skin.

FOLLICULAR. Relating to or affecting follicles.

FOMENTATIONS. Local application of cloths wrung out of hot water.

FORCEPS. An instrument having a motion and use like the thumb and fore-finger. Pincers. Obstetrical forceps embrace the head of the foetus.

FORESKIN. That part of the skin of the penis which is prolonged over the head of the organ.

FORMICATION. A sensation like a number of ants creeping on a part.

FRACTURE. Broken bone. _In compound fracture_ the end of the bone projects through the skin.

FUNCTION. The peculiar action of an organ, or part of the body.

FUNCTIONAL. Pertaining to the specific action of an organ or part.

FUNDUS. The bottom or base of an organ. The fundus of the womb is its upper part, when in its natural position.

FUNGIFORM. Mushroom-shaped.

G

GALVANISM. Electricity.

GALVANO-CAUTERY. Burning or scarring by galvanic electricity.

GANGLION. A nerve center which forms and distributes nerve-power.

GANGRENE. Death of a part.

GASTRIC. Pertaining to the stomach.

GASTRIC JUICE. The digestive fluid supplied by the mucous membrane of the stomach.

GELATINOUS. Jelly-like.

GENERATION. The functions which are active in reproduction.

GENITALS. The sexual organs.

GESTATION. Carrying the embryo in the uterus.

GLANS. Head of the penis.

GONORRHEA. A discharge of mucous from inflammation of the urethra or vagina, caused by impure connection. Clap.

GRANULAR CASTS. Moulds of epithelium found by the microscope in chronic Bright's Disease.

GRANULAR LIDS. Roughness on the inner surface of the eyelids.

GRANULATIONS HEAL BY. See GRANULATIONS.

GRANULATIONS. Flesh-like shoots, which appear in a wound and form its scar.

GRANULES. Small grains.

GRAVEL. Substances precipitated in the urine resembling sand.

GROIN. The oblique depression between the belly and thigh.

GRUBS. Pimples on the face. See page 442.

GYNECOLOGIST. One who makes the Diseases of Women a specialty.

H

HAIR BULBS. The expansion or root of the hair.

HALLUCINATIONS. Perception or sensation of objects which do not exist; as in Tremens.

HECTIC. Constitutional; as hectic fever, in which all parts of the body become emaciated.

HEMIPLEGIA. Paralysis affecting only one side of the body.

HEMORRHOIDAL VEINS. The veins about the rectum which enlarge and form piles.

HEPATIC. Relating or belonging to the liver.

HEREDITARY. A disease transmitted from parent to child.

HERNIA. Defined on page 862.

HOLLOW OF THE SACRUM. The concave portion of the lower part of the spinal column within the pelvis.

HOMEOPATHY. Defined on page 294.

HYALINE CASTS. Glassy appearing substances found by the microscope in urine in chronic Bright's Disease.

HYDRAGOGUES. Cathartics which produce copious watery discharges.

HYDROCELE. Accumulation of fluid in the scrotum.

HYDROCEPHALUS. Accumulation of fluid in the membranes about the brain.

HYDROTHORAX. Accumulation of fluid in the chest cavities.

HYGIENE. The principles or rules for the promotion or preservation of health.

HYMEN. Described on page 687. HYPERSEMIA. Full of blood. Congestion.

HYPERTROPHY. Enlargement, thickening.

HYPOCHONDRIAC. A person, usually dyspeptic, who is unreasonably gloomy, particularly about his health.

HYPODERMIC SYRINGE. An instrument having a very fine tube and needle-like point, by which medicines are lodged immediately under the skin.

HYSTEROTOME. An instrument described and illustrated on page 696.

I

IDIOPATHIC. Primary: not depending on another disease.

ILLICIT. Not permitted; unlawful.

ILLUSIONS. See HALLUCINATIONS.

IMPACTED. Wedged. Applied to feces which have remained in the rectum a long time.

IMPERFORATE. Without a natural opening.

IMPOTENCY. Loss of sexual power.

IMPREGNATION. Imparting the vital principle of the sperm-cell to the germ-cell, by which a new being is created.

INCIPIENT. Commencement; first stage.

INDEPENDENT PHYSICIAN. Defined on page 295.

INDIGENOUS. Native. Grows in a country.

INDOLENT. Painless; a term applied to tumors.

INDURATION. Hardening of a part or organ.

INFECTION. A prevailing disease. A disease spread only by contact, as itch, syphilis, etc.

INFILTRATION. The passage of fluid into the cellular tissue; as in General Dropsy.

INFLAMMATION. Defined on page 398.

INFUSION. Defined on page 303.

INGUINAL CANAL. A canal situated in the groin, through which the spermatic cord passes. The common seat of Hernia. Illus. page 862.

INOCULATE. To communicate a disease by inserting matter in the flesh; as by vaccination.

INORGANIC. Mineral. Bodies without organs.

INSALIVATION. Mixed with the saliva of the mouth, as food.

INSEMINATION. The emission of sperm in coition.

INSPIRATION. Drawing in the breath.

INTEGUMENT. The skin.

INTENTION, HEALING BY FIRST. Healing without the formation of pus.

INTERCOSTAL. Between the ribs.

INTERMITTENT. Having paroxysms or intervals.

INTERNAL EAR. Described on page 110; Illus. page 109.

INTUSSUSCEPTION. One part of the intestines forced into another part.

INVAGINATION. See INTUSSUSCEPTION

IRIDECTOMY. A surgical operation for the removal of the Iris.

IRIS. A curtain which gives the eye its color.

ISOLATION. Separation from others.

K.

KADESH-BARNEA. The holy place in the desert of wandering; the headquarters of the Israelites for 37 years.

L

LABORATORY. The work-room of a chemist or pharmacist.

LACERATION. A wound made by tearing.

LACHRYMAL. Belonging to the tears.

LACHRYMAL GLANDS. Minute organs about the eyes which secrete tears.

LACTATION. The act of giving suck.

LACTEALS. The vessels of the breast which convey milk.

LAMELLA. Layer.

LAMINAE. Thin bones, or the thin parts of a bone.

LANCINATING. Acute, shooting pains fancifully compared to the pierce of a lance.

LARYNX. That portion of the air-passage indicated in the male by "Adam's Apple."

LASCIVIOUS. Lustful; producing unchaste emotions.

LATERAL OPERATION. Cutting through the perinæum into the bladder.

LAXATIVES. Medicines which move the bowels gently.

LESION. Derangement. Tearing or other division of parts, previously continuous.

LEUCORRHEA. Described on page 702.

LIBERAL PHYSICIAN. Defined on page 295.

LIGAMENT. A white inelastic tendon binding bones together.

LIGATION. See LIGATURE.

LIGATURE. A cord or catgut tied around a blood-vessel to arrest hemorrhage.

LINE. One-twelfth part of an inch.

LITHIC DEPOSITS. Sediment or stone formed in the urine by uric acid.

LOBES. Bound projecting parts of an organ; as lobes of the lungs, of the liver, etc.

LOIN. The side of the body between the hip-bone and ribs.

LOTION. A wash.

LUMBAGO. Rheumatism in the small of the back and loins.

LUMBAR VERTEBRÆ. That part of the backbone in the vicinity of the loins.

LYMPH. A transparent fluid, resembling blood, found in lymphatic vessels. It contains corpuscles and coagulates.

LYMPHATICS. Defined on page 49.

LYMPHATIC TEMPERAMENT. Described on page 157.

M

MALARIA. See MIASM.

MALFORMATION. Irregularity in structure.

MALIGNANT. Applied to diseases which threaten life.

MAMMÆ. See MAMMARY GLANDS.

MAMMALIA. Animals that suckle their young.

MAMMARY GLANDS. The breasts or organs which secrete milk.

MANIPULATIONS. Examination and treatment by the hand.

MASSAGE. Kneading, rubbing and stroking the surface to improve circulation and nutrition and to remove effete material.

MASTICATION. Chewing.

MASTURBATION. Excitement of the sexual organs by the hand.

MEATUS. Canal or passage. External opening of a canal.

MEDIAN SECTION. An operation for stone in the bladder in which the perineum and part of the urethra are cut; the prostatic portion of the urethra is dilated to introduce forceps and withdraw the stone.

MEDULLA OBLONGATA. Described on page 90; illus. page 96.

MELANCHOLIA. A mild form of insanity attended with great gloom and mental depression.

MEMBRANOUS. Of the nature or construction of membrane.

MENINGES. Membranes covering the brain.

MENORRHAGIA. Immoderate monthly flow.

MENSES. Monthly flow of the female. See page 686.

MENSTRUATION. The bloody evacuation from the womb.

MENSTRUUM. A solvent; as water, alcohol, etc.

MESENTERIC GLANDS. Glands about the peritoneum which secrete lymph.

MESENTERY. Described on page 49.

MIASM, MIASMA. A poisonous, gaseous exhalation from decaying vegetation, or from the earth.

MIDWIVES. Females who attend women at childbirth.

MISCARRIAGE. Defined on page 682.

MOLECULE. A minute portion of any body.

MONADS. The smallest of all visible animalcules.

MONOMANIA. Insanity on one subject.

MUCO-PURULENT. Composed of mucus and pus.

MUCOUS MEMBRANE. The thin, web-like lining to the canals and cavities which secretes a fluid by which it is constantly lubricated.

MUCUS. A mucilaginous fluid found on the surface of certain membranes which keeps them soft and pliable. See MUCOUS MEMBRANE.

MUSCLE. The structures of the body which execute movements.

MUSCULAR TISSUE. The flesh forming the muscles of the body.

MYALGIA. Muscular rheumatism.

N

NARCOTICS. Medicines which stupefy.

NECROSIS. Mortification or death of bone.

NERVINES. Defined on page 345.

NERVOUS TISSUE. That part of the body composed of nerve-fibres.

NEURALGIA. Described on page 635.

NICOTIN. A poisonous principle of tobacco.

NITROGEN. One of the gases in the atmosphere.

NODES. Hard lumps, principally found upon the bones in syphilis.

NOXIOUS. Injurious.

NYMPHOMANIA. Extreme desire for sexual intercourse in the female.

O

OBSTETRICAL. Relating or appertaining to childbirth.

OCCLUSION. Approximation or closure.

OEDEMA. See EDEMA.

OLFACTORY NERVE. The nerve employed in the sense of smell. Illus. page 111.

ONANISM. See MASTURBATION

OPACITY. Opaque condition of parts of the eye, causing blindness.

OPALESCENT. Reflecting a milky light.

OPAQUE. See OPACITY.

OPHTHALMIA. Inflammation of the eye.

OPHTHALMIC. Belonging to the eye.

OPHTHALMOSCOPE. An instrument for examining the inside of the eye, for diagnostic purposes.

OPTIC NERVE. The nerve connecting the brain and eye, and employed in the sense of sight.

ORGANIC. Pertaining to the structure of an organ.

ORIFICE. Opening or mouth.

OSSEOUS TISSUE. Bony structure.

OSSIFICATION, OSSIFYING. Made into bone by the deposit of phosphate of lime.

OS UTERI. Mouth of womb. Illus. page 206.

OVA. Plural of ovum.

OVARIES. Two ovoid bodies situated either side of the womb. Illus. page 206.

OVARY. The female organ in which the ovum, or germ-cell, is formed. Illus, page 206.

OVULATION. The formation of the germ-cell in the ovary and its release from that organ.

OVUM. Defined and illustrated on pages 12 and 13.

OXYGEN. The vital gas of the atmospheric air.

OZÆNA. Described on page 474.

P

PALLIATIVE. A remedy or treatment which relieves, but does not cure.

PAPILLA, PAPILLAE. Small, nipple-shaped prominences found on the tongue, the skin, etc.

PARAPLEGIA. Paralysis affecting the upper or lower extremities of the body

PARASITES. Animals which live in the bodies of other animals; as the tape-worm itch insect, etc.

PARENCHYMA. The texture of an organ; as the liver, kidneys, etc.

PAROTID GLANDS. These are situated under the ear, just at the angle of the lower jaw, and secrete saliva.

PAROXYSMS. The periodical attack, fit or aggravation in the course of a disease.

PARTURIENT. Bringing forth or having recently brought forth.

PARTURITION. Labor; the delivery of the foetus.

PASTILES. Small medicated lozenges.

PATHOGNOMONIC. A _characteristic_ symptom of a disease.

PATHOLOGY. That part of the Science of Medicine the object of which is the knowledge of disease.

PEDICLE. The stalk or narrow part of a tumor by which it is attached and supported.

PELVIC. Belonging to and relating to the pelvis.

PELVIS. The lower part of the abdomen or trunk, composed of bone, containing the genital and urinary organs; supports the backbone and is supported by the legs.

PENIS. The male organ of generation. Illus. page 207.

PEPSIN. The digestive solvent secreted by the stomach.

PEPTIC. Pertaining to the stomach.

PERCUSSION. Striking the surface and by the sound produced judging of the condition of the internal organs.

PERICARDITIS. Described on page 548.

PERICARDIUM. The membranous sac enclosing the heart.

PERINEAL SECTION. An operation by division of the perineum.

PERINEUM. The space bounded by the end of the spine, sexual organs and the bony prominences on which one sits.

PERIOSTIUM. The membranous covering to all bones.

PERISTALTIC MOTION. A worm-like movement of the bowels by which the food is moved forward.

PERITONEUM. The membrane (serous) which lines the abdominal cavities and surrounds the intestines.

PERITONITIS. Inflammation of serous membrane lining abdominal and pelvic cavities.

PESSARIES, PESSARY. An instrument for holding the womb in its place.

PESTILENCE. A malignant, spreading disease. A plague.

PHAGADENIC. That which corrodes or eats away rapidly.

PHARMACEUTICAL. Anything belonging to pharmacy.

PHARYNX. The cavity back of the mouth and palate through which the air passes when breathing and the food when swallowing.

PHIMOSIS. Elongated prepuce

PHLEGMONOUS. Affecting the cellular membrane. The common boil is an example.

PHOSPHATE. A substance containing phosphorus.

PHOSPHATES, EARTHY. The white deposit in urine composed of phosphoric acid and a base.

PHTHISIC. Consumption. By some the word is used for Asthma, or difficulty in breathing.

PHTHISIS. Consumption. See p. 497.

PHYSIOLOGICAL ANATOMY. The branch of medicine that defines the organs of the body and their particular actions.

PHYSIOLOGY. The science which treats of the phenomena and functions of animal life.

PIA MATER. The internal vascular membrane covering the brain.

PIMPLES ON THE FACE. Defined on page 443.

PLACENTA. Afterbirth.

PLAGUE. A malignant epidemic; begins in Asia Minor.

PLETHORA, PLETHORIC. Full of blood; maybe general or confined to a part.

PLEURA. Defined on page 64.

PLEURODYNIA. Spasmodic or rheumatic pain in the chest muscles.

PLEURO-PNEUMONIA. Inflammation of both the pleura and lungs.

POLLUTION (SELF). Excitement of the sexual organs by the hand or other unnatural method.

POLYP. An aquatic animal, as the coral builders.

POLYPI. More than one polypus.

POLYPOID. Like a polypus in shape or construction.

POLYPUS. Tumors which grow from mucous membranes, commonly found in the nasal and vaginal cavities.

PORTAL VESSELS. The cluster of veins which join and enter the liver.

POTT'S DISEASE. Described on page 898; illus. pages 898 and 899.

POULTICE. A mixture of bread or meal, etc., and hot water, spread on a cloth and applied to the surface.

POX. Syphilis.

PRECOCITY. Prematurely developed.

PREHENSION. Carrying food to the mouth.

PREPUCE. Foreskin.

PROBANG. Soft swab.

PROBE. An instrument for examining wounds and cavities. A piece of wire with a blunt point is a probe.

PROCREATION. Production or generation of offspring.

PROGNOSIS. Opinion of the future course of a disease.

PROLAPSUS. A falling down of an organ through an orifice, as the womb, bowel, etc.

PROPHYLACTIC. Preventive.

PROPRIETARY MEDICINES. Described on page 298.

PROSTATE GLAND. Described on page 778 and illus. on page 207.

PROTEIDS. goods composed Of carbon, hydrogen, oxygen and nitrogen: as the white of an egg.

PROTOZOÖN. First life; life in the lowest scale; as sponges.

PROUD-FLESH. Abnormal growths which arise in wounds or ulcers.

PRURITIC. Itching.

PRURITUS VULVAE. A nervous disease attended with excessive itching of the external genital parts of the female.

PSOAS OR LUMBAR ABSCESS. An abscess discharging at the groin.

PSYCHICAL. The relation of the soul to animal experiences and being.

PSYCHOLOGICAL. The spiritual potencies of the soul.

PTYALIN. The ferment of the saliva which converts starch into sugar.

PUBERTY. The age at which the subject is capable of procreation.

PUBIC. Relating to the pubes, a part above the genital organs, covered with hair at puberty.

PUERPERAL FEVER. Child-bed fever.

PULMONARY. Relating to the lungs.

PUPIL. The circular opening in the colored curtain within the eye.

PURGATIVES. Medicines which cause evacuation of the bowels.

PURULENT. Discharging pus; as an ulcer.

PUS. A yellowish, inodorous, creamy secretion from inflamed parts; contained in abscesses or discharging from ulcers.

PUSTULAR. Belonging to or affected by pustules.

PUSTULE. An elevation on the skin, containing pus or "matter," and having an inflamed base.

PUTRESCENCE. Decomposition, rottenness.

PUTRESCENT. Decomposing offensively.

PUTRIDITY. Corruption.

PYRÆMIA. Blood-poisoning from the absorption of decomposing pus or "matter."

PYLORIC ORIFICE. The lower opening of the stomach; illus. page 39.

PYRIFORM. Shaped like a pear.

Q

QUICKENING. The time when the motion of the foetus within the womb is first perceptible; between the fourth and fifth months of pregnancy.

R

RADICAL CURE. A cure in which the disease is entirely removed, root and branch.

RALES. Noises produced by air passing through mucus in the lungs.

RECTAL. Pertaining to the rectum.

RECTUM. The lower portion of the intestines terminating in the anus.

RECUMBENT. Reclining.

REFLEX ACTION. See pages 93 and 99.

REGURGITATION. The act by which blood is forced backwards in an unnatural manner.

REMISSION. A temporary diminution of the symptoms of fever.

REPRODUCTION. Producing living bodies similar to the parents.

RESOLUTION. The disappearance of inflammation without suppuration.

RESPIRATION. The function by which the blue blood is converted into red blood in the lungs.

RESPIRATOR. Described on page 230.

RETINA. Defined on page 107.

RETROCEDENT. Moving from one part of the body to another; as gout.

RETROCESSION. Change of an eruption from the surface to the inner parts.

RETROVERSION. A change in the position of the womb in which the top falls back against the rectum.

REVULSION, REVULSIVE. Calling the blood away from the diseased part.

RICKETS. A disease in children characterized by crookedness of the spine and long bones resulting from scrofula or poor and insufficient food.

RICKETY. Affected with rickets.

RINGS (HERNIAL). Circular openings with muscular edges through which a vessel or part passes.

RUBEFACIENTS. Medicines which produce redness of the skin.

RUPTURE. Bursting. Hernia.

S

SACCHARINE. Like or containing sugar.

SALIVA. The secretion of the glands of the mouth.

SALPAE. Little sack-like shaped, soft, fleshy bodies, found in the open ocean, and sometimes phosphorescent.

SANATIVE. Curative. Tending to restore lost health.

SANGUINE TEMPERAMENT. Described on page 163.

SANITARIUM. An institution for the treatment of the sick. A healthy retreat.

SCALES. The epidermis or outer part of the skin consists of minute scales. See Fig. 50, page 71.

SCALP. The skin covering the head.

SCAPULA. Shoulder blade.

SCIATIC NERVE. The great nerve of the thigh.

SCIRRHUS. Stony hardness, characteristic of cancer.

SCLEROTIC COAT. The hard, pearly white covering of the eye.

SCORBUTIC. Producing scurvy, a disease caused by improper or insufficient food.

SCORBUTUS. Scurvy.

SCROFULOUS. Suffering from a condition of the system characterized by enlargement of the glands, eruptions, etc., with great susceptibility to contagion.

SCROTUM. The bag of skin which covers the testicles.

SCURVY. A disease due to impaired nutrition.

SEA TANGLE. A water-plant, which in its dried state is introduced into a canal and dilates the canal as it expands by the absorption of moisture.

SEBACEOUS GLANDS. The oil-tubes of the skin. Illus. page 71.

SECRETION. The process by which substances are separated from the blood.

SEDATIVES. Medicines which allay irritation or irritability of the nervous system.

SEDENTARY. Requiring much sitting.

SELF-POLLUTION. See SELF-ABUSE.

SEMEN. The secretion of the testicles which is thrown out during sexual intercourse and contains the principle of generation.

SEMI-FLUID. Half fluid.

SEMILUNAR VALVES. Valves in the heart. See 9 and 17, Fig. 41, page 58.

SEMINAL VESICLES. Reservoirs for the sperm. See Seminal Sac, on page 207.

SEPTIC. That which corrodes or produces putrefaction.

SEPTICÆMIA. Blood-poisoning; usually by absorption.

SEQUEL. That which follows; the condition or malady which follows a disease.

SEROUS. Watery. Pertaining to the serous membrane.

SEROUS TISSUE. The membranes lining the closed cavities of the body, which secrete a watery, lubricating fluid.

SHOCK. Sudden depression of vitality occasioned by injury.

SITZ BATH. See page 367.

SLOUGHING. The process of separating a mortified part from a healthy part, through the agency of pus.

SMELL, NERVES OF. Illus. page 111.

SOLAR PLEXUS. Described on page 104.

SOLVENTS. Those chemicals which break up or dissolve substances.

SORDES. Foul accumulation on the teeth, noticed in fevers.

SOUND. An instrument for exploring cavities or canals for diagnosis or treatment.

SPECIALTY. That to which special attention is given.

SPECIFIC GRAVITY. Comparative weight; as between urine and water.

SPECULUM. An instrument for examining cavities. Illus. pages 717 and 718.

SPERM. See SEMEN.

SPERMATIC CORD. The mass of arteries, veins, nerves, absorbents and their coverings, which passes along the groin and over the pubic bone, to the testicle.

SPERMATORRHEA. Described on page 772.

SPERMATOZOA. More than one Spermatozoön.

SPERMATOZOON. Defined on page 12; Illus. page 13.

SPHINCTERS. Bound muscles which close natural openings.

SPHYGMOGRAPH. An instrument for examining the heart. Illus. page 548.

SPICULA. A small pointed piece of bone.

SPINAL COLUMN. The twenty-four bones, which, situated one above the other, form the backbone.

SPINAL CORD. Described on page 90.

SPIROMETER. A gauge of chest capacity. Illus. page 392.

SPONGE TENT. Compressed, dried sponge previously treated with Gum Arabic, used for dilating the uterine canal.

SPORADIC, SPORADICALLY. A term for diseases which appear frequently, independent of epidemic or contagious influences.

SPRAIN. A straining or rupture of the fibrous parts of a joint.

STAPHYLOMA. Protrusion of the eye, sometimes with loss of sight.

STERILITY. Barrenness. Inability to bear children.

STERNUM. The breast-bone.

STETHOSCOPE. An instrument for examining the heart and lungs.

STIMULANTS. Medicines which increase the vital activity of the body.

STOOL. Evacuations of the bowels. Dung.

STRABISMUS. Cross-eyes.

STRANGULATED. Caught or fastened in the hernial canal.

STRIATED. Grooved or striped.

STRICTURE. A contracted condition of a canal or passage; of the food-pipe, rectum, urethra, etc.

STRUCTURAL. Belonging to the arrangements of tissues or organs.

STRUMOUS. Scrofulous.

STUPOR. Great diminution of sensibility.

STYE. A little boil on the eyelid.

STYPTIC. An external astringent wash.

SUB-ACUTE. A moderate form of acute.

SUDORIFEROUS GLANDS. Minute organs in the skin, which secrete the perspiration. Illus. page 70.

SUPPORTERS (UTERINE). Instruments intended to hold the womb in its natural position.

SUPPRESSION. Stoppage or obstruction of discharges; as urine, menses, etc.

SUPPURATION. A gathering. Formation of pus, as in an abscess or ulcer.

SUTURE PINS. Pins or needles, which are passed through the edges of wounds to bring them together. Thread is then wound around the pin to hold the edges in place.

SUTURES. The ragged edges of bones by which they are joined to each other. Stitches of thread to bring the edges of a wound together for their union.

SYMPATHETIC NERVE. Defined on page 101.

SYMPTOM. A change in the body or in its functions which indicates disease.

SYMPTOMATIC. Pertaining to symptoms.

SYNOVIAL MEMBRANE. The lining of a joint, which from its oily secretion allows the bones to move freely upon each other.

SYNOVITIS. Described on page 452.

T

TAPPING. Removing collected fluid by introducing a hollow tube through the flesh.

TEMPERAMENT. Peculiarities of the constitution manifested by traits which we denominate character.

TENESMUS. Straining at stool.

TENT. A compressed, dried cylinder of sponge, previously treated with Gum Arabic, which enlarges the canal in which it is placed by expansion from the absorption of moisture.

TESTICLES. Described on page 773; Illus. page 207.

THERMOMETER. An instrument for determining temperature.

THORACIC DUCT. A canal which carries the chyle from its repository in the abdomen to the large vein in the chest, near the heart.

THORAX. Chest.

TINCTURES. Medicines held in solution by alcohol.

TONIC. Defined on page 350.

TOPICAL. Local.

TOPOGRAPHY. Description in detail of a place; in hygiene, to determine its adaptability to residence.

TORMINA. Griping of the bowels.

TORTICOLLIS. Stiffness or contraction of the muscles of the neck. Wryneck.

TOURNIQUET. An instrument to stop bleeding. Illus. Fig. 252, page 890.

TRACHEA. Windpipe. See page 63.

TRANSLUCENT. Transmitting light, but not permitting objects to be seen distinctly.

TRANSUDATION. Passage of liquid through the tissues of the body.

TRAUMATIC. Relating to a wound or injury.

TREPHINING. Removing a piece of bone by a cylindrical saw.

TRITURATE. To pulverize.

TROCAR. An instrument for removing fluids from cavities. It consists of a perforator within a cylinder.

TRUNCATED. Shaped like a pyramid with its top cut off.

TRUSS. A mechanical appliance for preventing protrusion or strangulation. Hernial support.

TUBERCLE. See pages 431 and 498.

TURN OF LIFE. The change of life when menstruation ceases.

TYMPANUM. Ear-drum. Illus. p. 109.

U

UMBILICAL. Of the navel; as umbilical hernia. Illus. page 883.

UMBILICAL CORD. A cord-like substance which conveys the blood to the foetus from the placenta or afterbirth.

UMBILICUS. The Navel.

UNSTRIATED. Not grooved or striped.

URÆMIC. Pertaining to blood-poisoning from the presence of urea in the circulation.

URATES. The pinkish deposit found in urine.

UREA. A constituent of the urine.

URETERS. The canals leading from the kidneys to the bladder. Illus. pages 85 and 207.

URETHRA. The canal leading from the bladder outwards, by which the urine is voided. Illus. page 207.

URETHROTOMY. The operation for opening the urethra for the removal of stricture.

URIC ACID. A constituent of the urine.

URINARY FISTULA. Abnormal communication between the urinary passages and the surface.

URINO-GENITAL ORGANS. Pertaining to the urinary and sexual organs.

UTERINE. Belonging or relating to the womb.

UTERINE CAVITY OR CANAL. From the month of the womb to a constriction called the internal orifice, is a cylindrical space called the canal. Above this to the fundus or base is a triangular and flat space called the cavity.

V

VAGINA. A canal, five or six inches long, situated between the vulva and womb.

VAGINAL. Pertaining to the vagina.

VAGINISMUS. Irritable vagina.

VALVES OF THE HEART. See page 58.

VARICOCELE. Described on page 803.

VARICOSE. Veins that are twisted or dilated.

VASCULAR. Belonging or relating to vessels.

VASCULAR SYSTEM. The heart and blood-vessels.

VEINS. The vessels which return the blue blood to the heart.

VENEREAL. Syphilitic.

VENTRICLES. Chambers in the heart. See 5 and 14, Fig. 41, page 58.

VERMIFUGE. A medicine which destroys or expels worms.

VERSION. Displacement of the womb forwards or backwards.

VERTEBRÆ. The twenty-four bones which joined together form the backbone.

VERTEBRATES. Animals having the jointed skeleton within; distinguishes between these and insects, worms, oysters, jelly fish, etc.

VERTIGO. Dizziness Or swimming of the head.

VESICLES. Small bladders or sacs. Pimples.

VESICULAR. Belonging to or containing cells.

VILLI. Minute thread-like projections.

VIRILE POWER. Masculine vigor. Sexual vigor.

VIRUS. Poison. The agent which transmits infectious disease.

VISCERA. (Plural of Viscus.) More than one internal organ.

VISCOUS. Sticky. Tenacious.

VISCUS. Any internal organ.

VITREOUS HUMOR. The fluid in the eye behind the lens. Illus. page 107.

VOLITIVE TEMPERAMENT. See page 171.

VULVA. The external organs of generation in the female, or the opening between these projecting parts.

W

WALLS. The sides of an enclosure, as the walls of the vagina, which to soma extent support the womb.

WHITES. Described on page 702.

* * * * *

HOW TO AVOID SWINDLERS

WHO SOMETIMES INFEST THE CARS AND DEPOTS IN AND NEAR THIS CITY.

* * * * *

WE WARN ALL THOSE WHO CONTEMPLATE VISITING US, that we have the most _positive proofs_ that a gang of confidence men have at different times made it their business to watch for sick and infirm people on the way to our institutions, and divert them into the hands of "sharpers," confidence men and swindlers. These men have watched for the coming of invalids on the cars, in and around the depots, in the offices of the hotels located near the depots, and if inquiry was made for our institutions, or if the object of the visit to the city was made known or suspected from the invalid appearance of the traveler, they at once commenced weaving their skillfully-wrought web to catch a victim.

WE, THEREFORE,

ADVISE ALL THOSE DESIRING TO VISIT US,

FIRST.--TO ASK FOR NO INFORMATION FROM POLICEMEN, OR THOSE APPEARING TO BE POLICEMEN, IN OR ABOUT OUR DEPOTS. CONFIDENCE MEN OFTEN ASSUME A STYLE OF DRESS SIMILAR TO THAT WORN BY POLICEMEN.

SECOND.--LET THE OBJECT OF YOUR VISIT TO THE CITY BE KNOWN TO NO ONE WHOM YOU MEET ON THE CARS, OR IN THE DEPOTS OR NEAR THEM.

THIRD.--IF YOU HAVE A CHECK FOR BAGGAGE, WHEN THE BAGGAGE-MAN COMES THROUGH THE CARS, AS ONE DOES ON EVERY TRAIN BEFORE IT REACHES THE CITY, ASKING IF YOU WILL HAVE YOUR BAGGAGE DELIVERED ANYWHERE IN THE CITY, OR, IF YOU WILL HAVE A CARRIAGE; IF YOU HAVE A TRUNK, GIVE HIM THE CHECK FOR IT, PAY HIM 25 CENTS ONLY AND HE WILL HAVE IT DELIVERED AT THE INVALIDS' HOTEL AND SURGICAL INSTITUTE. 663 MAIN STREET. (Do not forget the number). You had better, also, procure a ticket from this baggage-man, or agent, for a _coupe_ or carriage to our place, for which you will have to pay only fifty cents. (Outside prices are higher.) This saves all trouble and anxiety, as the agent will look carefully after both yourself and baggage, and you are sure of reaching our place promptly and safely. If you have only hand-baggage, such as bundles, traveling-bags, or similar luggage, you can take it with you in the carriage without extra cost.

Mr. C.W. Miller, whose agents solicit on all the in-coming trains for the delivery of passengers and baggage, has an office in every passenger depot in this city, to which you can apply if, by any chance, you miss his agent on the train.

THE INVALIDS' HOTEL AND SURGICAL INSTITUTE IS OPEN DAY AND NIGHT, AND YOU WILL BE CORDIALLY RECEIVED AND WELL TAKEN CARE OF.

THE TABLE IS PROVIDED WITH THE BEST OF FOOD.

NO HOTEL IN THE CITY HAS BETTER ROOMS OR BEDS THAN THE INVALIDS' HOTEL.

THIS INSTITUTION IS NOT A HOSPITAL, BUT A COMMODIOUS AND COMFORTABLE INVALIDS' HOME.

If all we say of our institutions, and our advantages and facilities for the successful treatment of disease is not found, on your arrival and investigation, to be just as we have represented them, WE WILL PAY ALL THE EXPENSES OF YOUR TRIP AND YOU CAN RETURN HOME AT ONCE.

"A WORD TO THE WISE,"

in the nature of advice, to those about to visit us, in conclusion, may not be out of place.

KEEP YOUR BUSINESS TO YOURSELF WHILE ON THE ROAD HERE, ALSO WHEN ABOUT THE DEPOTS, AND ASK NO QUESTIONS OF ANYBODY.

MAKE NO TRAVELING ACQUAINTANCES. THEY ARE DANGEROUS.

Observe the foregoing directions, and any child of twelve years, possessed of ordinary intelligence, can reach our conspicuous place, 663 MAIN STREET, Buffalo, N.Y., without fail.

WORLD'S DISPENSARY MEDICAL ASSOCIATION.

* * * * *

* * * * *

INDEX.

A

Abortion, 682 Abscess, Lumbar, 446 Abscess, Psoas, 448 Absence of the Ovaries, 688 Absence of the Womb, 689 Absolutely Painless Operation, 491 Absorption, 48 Acacia Catechu, 325 Accidents, 889 Acetabulum, 25 Acetate of Potato, 338 Acid, Aromatic Sulphuric, 310 Acid Bath, 367 Acid, Carbolic, 318 Acid, Gallic, 325 Acid, Hydrochloric, 310 Acid, Muriatic, 310 Acid, Tannic, 325 Acid, Uric, 86 Acids, 309, 895 Acidum Gallicum, 325 Acidum Tannicum, 325 Acne, 442 Aconite, 346 Acute Articular Rheumatism, 425 Acute Bright's Disease, 830 Acute Bronchitis, 509 Acute Catarrh, 473 Acute Gastritis, 883 Acute Inflammation of the Bladder, 824 Acute Inflammation of the Bowels, 655 Acute Inflammation of the Kidneys, 823 Acute Inflammation of the Liver, 569 Acute Inflammation of the Stomach, 565 Acute Laryngitis, 496 Acute Nephritis, 829 Acute Peritonitis, 886 Adhesion, 400 Adipose Tissue, 20 Affections, Alphous, 441 Affections, Boil-like, 443 Affections, Bullous, 438 Affections, Eczematous, 430 Affections, Erythematous, 436 Affections, Furuncular, 443 Affections, Nervous, of the Skin, 440 Affections of the Hair-follicles, 441 Affections of the Male Generative Organs, 773 Affections of the Urinary Organs, 825 Affections of the Urinary Organs, Sympathetic, 826 Afferent Nerves, 87,93 Afterbirth, 216 Age of Nervousness, the, 619 Ague, 405 Air-cells, 63 Air-passages, Foreign Bodies in the, 893 Air, Pure, 822, 223, 378 Albumen, 53, 238 Albuminuria, 422 Alcohol, 849, 627, 896 Alcohol Habit, 627 Alcoholic Liquors, 255 Alder, 304 Alkalies, 809, 895 Alkaline Bath, 367 Allopathic School of Medicine, 293 Alnuin, 305 Alnus Eubra, 304 Aloes, 328 Alphos, 441 Alphous Affections, 441 Alteratives, 303 Alteratives, Compounding of, 303 Alternate Generation, 16 Althea Officinalis, 336 Amenorrhea, 687 American Colombo, 353 American Hellebore, 347 American Poplar, 350 Ammonia, 349 Amnion, 216 Amperemeter, 630 Amygdalus Persica, 346 Amyloid Degeneration of the Kidneys, 830 Amyloids, 238 Anæmia, 419 Anaesthesia, Local, 806 Anaesthetics, 806 Anal Fistula, 583 Anasarca, 422 Anatomy, 11 Anatomy, Physiological, 11, 19, 30, 37, 48, 56, 63, 68, 75, 84, 87 Anatomy, Physiological, of the Testes, 774 Anatomy, Physiological, of the Urinary Organs, 823 Angina Pectoris, 552 Ammalcular Lite, Universality of, 16 Animal Extracts as Remedies, 631 Animal Faculties, 130 Animal Food, Value of, 241 Animals, Cold-blooded, 55 Anise-seed, 325 Anodynes, 310 Anteflexions of the Uterus, 714 Anterior view of Deformed Nasal Cavity, 492 Anterior view of Nasal Cavity, 490 Anthelmintics, 319 Anthrax, 475 Antidotes for Poisons, 895 Antiperiodics, 316 Antiseptics, 317 Antispasmodics, 318 Anus, Fistula of the, 583 Aorta, 58 Aperients, 326 Aphasia, 639 Apnoea, 421 Appendix Vermiformis, 41 Apthæ, 553 Aqueous Humor, 107 Arachnoid Fluid, 90 Arachnoid Membrane, 90 Arbutus, Trailing, 336 Arctium Lappa, 307 Areolar Tissue, 19 Aristolochia Serpentaria, 333 Aromatic Sulphuric Acid, 310 Arteries, 58 Artery, Pulmonary, 58 Art of Swimming, 274 Ascaris Lumbricoides, 561 Ascaris Vermioularis, 561 Ascites, 423 Asclepias Tuberosa, 332 Asclepin, 333 Aseptic Precautions in Operations, 492 Ashes, 335 Ash, Prickly, 349 Aspen Poplar, 315 Asphyxia, 421 Aspidium Filix Mas., 315 Assafetida Ferula, 318 Assimilation, 233 Asthma, 511 Asthma, Hay, 514 Astringents, 320 Ataxia, Locomotor, 640 Atomizer, 481 Atomizer, Steam, 482 Atropa Belladonna, 312 Atrophy of the Heart, 551 Atrophy of the Testicles, 773 Atropia, 312 Atropin, 312 Auricle, 57 Auscultation, 391 Axis, Cerebro-spinal, 89 Axis-cylinder, 87

B

Back, Crooked, 901 Baked Mutton, 248 Balmony, 315 Baptisia Tinctoria, 318 Baptisin, 318 Barber's Itch, 442 Bark, Cramp, 320 Bark, Slippery-elm, 335 Barosma Crenata, 338 Barosmin, 338 Barrenness, 707 Base Ball, 273 Basilar Faculties, 132 Battery for home use, 631, 632 Bath, Acid, 367 Bath, Alkaline, 367 Bath, Cold, 356 Bath, Cool, 357 Bath, Douche, 365 Bath, Foot, 366 Bath, Head, 367 Bath, Hot, 358 Bath, Iodine, 368 Bath, Russian, 358 Bath, Scott's Acid, 367 Bath, Shower, 365 Bath Sitz, 367 Bath, Spirit Vapor, 382 Bath, Sponge, 365 Bath, Sulphur, 368 Bath, Temperate, 357 Bath, Tepid, 357 Bath, Turkish, 358 Bath, Warm, 357 Bathing, 353 Bathing, Sea, 364 Baths, Medicated, 367 Bed, 279, 377 Bedding, 380 Beef Soup, 247 Beef Tea, 381 Belladonna, 312 Beverages, 248 Bicarbonate of Potash, 309 Bile, 80 Biliary Calculi, 560 Biliary Salts, 81 Bilious Colic, 557 Bilious Disorder, 569 Bilious Fever, 408 Biliverdin, 81 Biology, 11 Blackberry-root, 321 Black Cohosh, 305, 341 Black Pepper, 348 Black-root, 327 Black Snake-root, 305, 341 Black Vomit, 883 Bladder, 823 Bladder, Chronic Inflammation of the, 836 Bladder, Stone in the, 838 Blood, 53 Blood Corpuscles, 53 Blood, Physical Properties of the, 53 Blood-root, 306 Blood, Vital Properties of the, 53 Bloody-flux, 888 Blue Flag, 307 Blushing, 62 Boiled Fish, 247 Boiled Meat, 247 Boil-like Affections, 443 Boils, 443 Bones, 19 Bones of the Head, 22 Bones of the Lower Extremities, 27 Bones of the Upper Extremities, 25 Boneset, 316, 341 Boxing, 273 Boxwood, 351 Brain, 95 Brain Fatigue, 621 Branny Tetter, 431 Breach, 864 Bread, 248 Bright's Disease, Acute, 830 Broiled Steak, 247 Bronchia, 63 Bronchial Cells, 63 Bronchitis, 476 Bronchitis, Chronic, 509 Bruises, 892 Buchu, 338 Bugle-weed, 383 Bullous Affections, 438 Burdock, 307 Burns, 894 Bursæ Mucosæ, 29 Butterfly-weed, 333 Butternut, 328 Butter-weed, 324

C

Chachexia, 431 Caecum, 41 Caliculi, 837 Camp Fever, 408 Camphor, 312 Canada Fleabane, 324 Canals, Haversian, 21 Canals, Semi-circular, 110 Canker, 553 Cannabis Indica, 334 Capacity, Cranial, 139 Capillaries, 60 Capsicum Annuum, 348 Capsule, Synovial, 29 Carbolic Acid, 318 Carbonate of Iron, 354 Carbuncle, 444 Carminatives, 325 Carpus, 26 Cartilage, 29 Cartilaginous Tissue, 20 Cascara Sagrada, 328 Casein, 82, 338 Castor Oil, 328 Catarrh, Acute, 473 Catarrh, Chronic Nasal, 474 Catarrh, Hay, 514 Catechu, 325 Cathartics, 326 Catnip, 334 Caustics, 331 Cayenne Pepper, 348 Cellars, Damp, 228 Cells, Bronchial, 66 Centres of Ossification, 20, 27 Centre, Specific, 14 Cephælis Ipecacuanha, 339 Cerebellum, 95, 97 Cerebral Nerves, 89 Cerebral Physiology, 114 Cerebro-spinal Axis, 89 Cerebro-spinal System, 89 Cerebrum, 95, 98 Cerevisiæ Fermentum, 317 Ceruminous Glands, 77 Cervical Rheumatism, 427 Cessation of the Menses, 700 Chalybeate Waters, 250 Chamomile, 350 Chamomile, Wild, 834 Chelone Glabra, 315 Chelonin, 315 Chicken-pox, 412 Chimaphila Umbellate, 338 Chimaphilin, 338 Chloride of Iron, Tincture of, 355 Chloride of Sodium, 815 Cholagogues, 326 Cholera, Epidemic, 887 Cholera Infantum, 555 Cholera Morbus, 888 Cholesterin, 81 Chordæ Tendineæ, 57 Chorea, 650 Chorion, 216 Choroid, 107 Chronic Articular Rheumatism, 426 Chronic Bright's Disease, 830 Chronic Bronchitis, 509 Chronic Cystitis, 836 Chronic Diarrhea, 568 Chronic Gastritis, 884 Chronic Gout, 430 Chronic Hepatitis, 569 Chronic Inflammation of the Bladder, 836 Chronic Inflammation of the Bowels, 549 Chronic Inflammation of the Liver, 569 Chronic Inflammation of the Stomach, 884 Chronic Laryngitis, 496 Chronic Nasal Catarrh, 474 Chronic Peritonitis, 886 Chronic Ulcers, 454 Chyle, 45, 49 Chyme, 45 Cimicifuga Racemosa, 305, 341 Circulatory Organs, 56 Citrate of Iron, 354 Classes of Food, 238 Clavicle, 26 Cleanliness of Body, 281, 380 Clergymen's Sore Throat, 496 Climate, 243 Closure of the Tear-duct, 477 Clot, 54 Clothing, 264, 380 Coagulation, 55 Coccyx, 23, 25 Cochlea, 110 Cochlearia Armoracia, 331 Coffee, 258 Cohosh, Black, 305, 341 Cold-blooded Animals, 55 Colic, 557 Colic, Bilious, 557 Colic, Flatulent, 558 Colic, Lead, 558 Colic, Painters', 558 Coliea Pietonum, 558 Collinsonia Canadensis, 337 Colombo, American, 358 Colon, 41 Colts-tail, 324 Columnæ Carneæ, 57 Column, Spinal, 24 Comedones, 442 Compound Extract of Smart-weed, 312, 326, 335, 342, 349 Compounding of Alteratives, 308 Conception, Double, 215 Conception, Prevention of, 212 Congestive Fever, 406 Conium Maculatum, 311 Conjugal Love, 186 Connective Tissue, 19 Constipation, 573 Consumption, 476, 497 Consumption, Curability of, 503 Consumption, Tubercular, 497 Continued Fevers, 407 Contractility, 34 Contused Wounds, 889 Convolutions, 98 Cookery, 246 Copper, Sulphate of, 339 Coptis Trifolia, 354 Cord, Spinal, 90 Cord, Umbilical, 217 Core, 399 Cornea, 106 Cornus Florida, 351 Corpora Olivaria, 95, 96 Corpora Pyramidalia, 95 Corpora Quadrigemina, 95, 97 Corpora Restiformia, 95, 96 Corpus Callosum, 98 Corpuscles, Blood, 53 Corpuscles, Ganglionic, 87, 88 Costiveness, 573 Cotton-wool Respirator, 230

Cough, 502, 506 Countenance, 394 Counter-irritants, 331 Cow-pox, 411 Coxalgia, 450 Cramp Bark, 450 Cranberry, High, 320 Cranesbill, 322 Cranial Capacity, 139 Cranial Nerves, 100 Cranium, 22 Creasote, 317 Creation, Special, 14 Creeping Palsy, 640 Cricket, 273 Criminal Abortion, 682 Crocus Sativus, 333 Crooked Back, 901 Croup, Membranous, 878 Croup, Spasmodic, 878 Crow-foot, 332 Crura Cerebelli, 97 Crusted Tetter, 433 Crystalline Lens, 107 Cueurbita Chrullus, 338 Cucurbita Pepo, 338 Culture, Mental, 276 Culver's-root, 327 Cupri Sulphas, 339 Curability of Consumption, 503 Cure, Radical, for Hernia, 892 Curvature of the Spine, Lateral, 901 Curvature, Posterior Spinal, 898 Cuticle, 68, 70 Cutis Vera, 68 Cypripedin, 320, 345 Cypripedium Pubescens, 320, 345 Cystitis, Chronic, 836

D

Damp Cellars, 228 Dancing, 276 Dandruff, 431 Danger in the use of Instruments, 846 Datura Stramonium, 344 Deadly Nightshade, 312 Deafness, 476 Debility, Sexual, Symptoms of, 777 Decidua, 216 Decoctions, 303 Deformed Feet, 903 Deformed Hands, 903 Deformed Limbs, 903 Deformity of the Nasal Septum, 490 Degeneration of the Heart, Fatty, 551 Degeneration of the Kidneys, 832 Deglutition, 233 Desquamative Nephritis, 833 Development of the Individual, 192 Diabetes, 835 Diagnosis, 390 Diagnostic Symptoms, 390 Diaphoretics, 332 Diaphragm, 32 Diarrhea, 502, 555 Diarrhea, Chronic, 568 Diathesis, 391 Diathesis, Scrofulous, 445 Diathesis, Strumous, 445 Diet, 380 Digestibility of Food, 248 Digestion, 37 Digestive Organs, 37 Digitalis Purpurea, 387 Dilatation of the Heart, 551 Diluents, 335 Dioecious Reproduction, 202 Dioscorea Villosa, 320 Dioscorein, 320 Diptheria, 414 Discovery, Golden Medical, 308, 316, 355 Disease, Bright's, 830 Disease, Dust and, 229 Disease, Hip-joint, 450 Disease, Remedies for, 298 Disease of the Throat, 476 Diseases and their Remedial Treatment, 386 Diseases of the Heart, 547 Diseases of the Kidneys, 829 Disease of the Larynx, 476 Diseases of the Liver, 559, 569 Diseases of the Skin, 430 Diseases of the Stomach, 430 Diseases of the Urinary Organs, 823 Diseases of Women, 684 Disinfectants, 317 Dislocations, 892 Displacements of the Womb, 713 Distilled Liquors, 264 Diuretics, 336 Dock, Yellow, 304 Dog-button, 350 Dogwood, 351 Domestic Management of Fevers, 403 Door of Life, the, 681 Dose, 300 Double Conception, 215 Douche Bath, 365 Douche, Dr. Pierce's Nasal, 486 Dover's Powder, 311 Drastics, 326 Dropsies, 422 Dropsy of the Scrotum, 821 Drowning, 893 Ducts, Lactiferous, 82 Duodenum, 40 Dura Mater, 90 Duration of Pregnancy, 219 Dust and Disease, 229 Dwellings, Ventilation of, 226 Dynamometer, 391 Dysentery, 588 Dysmenorrhea, 692 Dyspepsia, 565 Dyspnoea, 502

E

Ear, Catarrh of the, 477 Eating, 233 Eclectic School of Medicine, 294 Eczema, 430 Eczema, Infantile, 430 Eczematous Affections, 430 Efferent Nerves, 87, 98 Effusion, 400 Electricity in Nervous Affections, 629 Elixir of Vitriol, 310 Elongation of the Uvula, 419, 495 Emergencies, 889 Emetics, 339 Emetic-weed, 340 Emissions, Involuntary Seminal, 773 Emissions, Nocturnal 773 Emmenagogues 341 Emotive Faculties 126 Encephalic Temperament 177 Endocarditis 549 Endocardium 57 Endolymph 110 Enlarged Spermatic Veins 803 Enlarged Tonsils 417, 494 Enlargement of the Prostate Gland 840 Enteric Fever 407 Envelope 9 Epidemic Cholera 887 Epidermis 68, 70 Epigea Repens 336 Epiglottis 67 Epilepsy 647 Epsom Salts 328 Erect Carriage 272 Ergot 341 Erigeron Canadense 324 Eruption, Heat 430 Eruptive Fevers 408 Erysipelas 413 Erythema 436 Erythemaious Affections 436 Esophagus 39 Ethmoid Bone 22 Eupatorin 316, 341 Eupatorin (Purpu) 338 Eupatorium Perfoliatum 316, 341 Eupatorium Purpureum 338 Eustachian Tube 110 Evolution 14 Examination, Microscopical 398, 825 Examination of the Urine 397, 625, 825 Excretion 84 Exercise 382 Exercise, Horseback 276 Exercise, Physical 270 Exercises of the Gymnasium 275 Expanding Uterine Speculum 718 Expectorants 342 Expectoration 502 External Auditory Meatus 77, 109 Extract of Smart-weed 312, 326, 335, 342, 349 Exudation 422 Eye 397

F

Face, Bones of the 23 Factories, Ventilation of 226 Faculties, Animal 130 Faculties, Basilar 132 Faculties, Emotive 126 Faculties, Volitive 129 Fainting 894 Falling of the Uterus 713 Fallopian Tubes 209 False Measles 413 False Membrane 878 False Passages 846 Fascia 30 Fasciculus 30 Fats 238 Fatty Degeneration of the Heart 551 Fatty Degeneration of the Kidneys 832 Favorite Prescription, Pierce's 342, 346, 355 Favus 441 Fecundation 211 Feebleness, Region of 134 Feeding Infants 235 Feet, Deformed 903 Female Generative Organs 206 Female Regulator 341 Female Urinary Organs 206 Femoral Hernia 863 Femur 27 Fencing 273 Fennel-seed 325 Fergusson Speculum 717 Fermented Liquors 263 Fern, Male 315 Ferri Carbonas 354 Ferri Citras 354 Ferri Ferrocyanidum 316 Ferri Pyrophosphas 354 Ferri Redactum 354 Ferrocyanide of Iron 316 Ferrum 354 Fever 401 Fever and Ague 405 Fever, Bilious 406 Fever, Camp 408 Fever, Congestive 406 Fever, Enteric 407 Fever, Gastric 405 Fever, Hay 514 Fever, Hectic 502 Fever, Hospital 408 Fever, Intermittent 405 Fever, Jail 408 Fever, Pernicious 406 Fever, Remittent 406 Fever, Scarlet 408 Fever, Ship 408 Fever, Typhoid 407 Fever, Typhus 408 Fever-sore 446, 454, 456 Fevers, Continued 407 Fevers, Domestic Management of 403 Fevers, Eruptive 408 Fevers, Malignant 407 Fevers, Putrid 407 Fibrillæ 30, 32 Fibrin 53, 238 Fibroid Polypus 487 Fibroid Tumors 722 Fibula 27 Fish 247 Fissure of Sylvius 98 Fistula in Ano 583 Fits 647 Flag, Blue 307 Flatulent Colic 558 Flax-seed 335 Fleabane, Canada 324 Flesh 30 Flexions of the Uterus or Womb 709, 714 Fluid Arachnoid 90 Focus 108 Foetus 216 Follicles of Lieberkuhn 79 Follicular Laryngitis 496 Follicular Ulcer 718 Fomentations 386 Food 233 Food, Classes of 238 Food, Digestibility of 243 Food, Preparation of 236 Food, Value of Animal 241 Food, Variety of, Necessary 236, 239 Foot-bath 366 Foreign Bodies in the Nose 893 Foreign Bodies In the Throat and Air-passages 893 Fountain Syringe 705 Foxglove 867 Fractures 892 Franklin Electric Machine 629 Frasera Carolinensis 353 Fraserin 353 Fretfulness 623 Frontal Bone 22 Function 11 Furuncular Affections 443 Furunculus 443

G

Gall-bladder 80 Gallic Acid 325 Gall-stones 560 Galvano-Faradic Battery 628 Galvanometer 630 Gamboge 327 Ganglia 89, 103, 115 Ganglionic Corpuscles 87, 89 Gangrene 400 Garget 304 Gastralgia 885 Gastric Fever 405 Gastric Juice 45, 79 Gastritis, Acute 883 Gastritis, Chronic 884 Gaultheria Procumbens 325 Gelatinoid Polypus 487 Gelsemin 320, 348 Gelseminum Sempervirens 319, 348 General Paralysis 639 General Treatment of Paralysis 641 Generation 11, 12 Generation, Alternate 16 Generation, The Process of 15 Generative Organs, Hygiene of the 282 Generative Organs, Male, Affections of the 772 Gentian 350 Geranin 323 Geranium Maculatum 322 Geranium, Spotted 322 Germ-cell 12, 15 Ginger 325, 335 Gland, Prostate 827 Gland, Prostate, Enlargement of the 840 Gland, Sublingual 38 Gland, Submaxillary 39 Glands, Ceruminous 77 Glands, Meibomian 78 Glands of Brunner 79 Glands, Parotid 38 Glands, Salivary 38 Glands, Sebaceous 70, 77 Glands, Sudoriferous 69 Glycocholate of Soda 81 Goitre 470 Golden Medical Discovery 308, 316, 355 Golden Saffron 333 Golden-seal 352 Gold-thread 354 Gouty Headache 635 Granular Ulcer 717 Gravel 837 Gravel-plant 336 Gravel-root 336, 338 Gravel-weed 338 Gray Matter 91 Great Sympathetic System 101 Grip, The 471 Gum Arabia 335 Gutta Rosacea 433 Gymnasium, Exercises of the 275

H

Habit, Alcohol 627 Habit, Opium 627 Habit, Tobacco 627 Hæmatoxylon Campeachianum 321 Hæmoptysis 502, 507 Hair-follicles, Affections of the 441 Hairs 72 Hamamelin 322 Hamamelis Virginica 321 Hands, Deformed 903 Hardhack 323 Haversian Canals 21 Hay Asthma 514 Hay Catarrh 514 Hay Fever 514 Headache 634 Headache, Malarial 635 Headache, Nervous 635 Headache, Neuralgic 635 Headache, Periodical 635 Headache, Rheumatic 635 Head Bath 358 Head, Scald 441 Head, The Bones of the 22 Health, Light and 231 Hearing 109 Heart 56 Heart, Atrophy of the 551 Heart, Dilatation of the 551 Heart, Diseases of the 547 Heart, Fatty Degeneration of the 651 Heart, Hypertrophy of the 550 Heart, Neuralgia of the 552 Heart, Organic Disease of the 547 Heat Eruption 430 Heat, Prickly 432 Hectic Fever 502 Hedeoma Pulegioides 341 Hellebore, American 347 Hellebore, Swamp 347 Hellebore, White 347 Hemiplegia 639 Hemlock, Poison 311 Hemorrhage 578, 890 Hemorrhoids 578 Hemp, Indian 344 Henbane 311, 343 Hepatitis, Chronic 569 Hermaphrodite 199 Hermaphroditic Reproduction 199 Hernia 862 Hernia, Radical Cure for 866 Herpes 438 High Cranberry 320 Hitus 84 Hip joint Disease 450 History of Marriage 188 Hives 437 Homes, Site for 227 Homoeopathy 294 Hops 312, 345 Horseback Exercise 276 Horse-balm 337 Horse-radish 331 Hospital Fever 408 Hot Bath 358 How to use Vaginal Injections 705 How to use Water 252 Human Temperaments 148 Humerus, 26 Humid Tetter, 430 Humor, Aqueous, 107 Humor, Vitreous, 107 Humpback, 898 Humulin, 312, 345 Humulus Lupulus, 312, 345 Hydragogues, 326 Hydrargyri Sulphas Flava, 339 Hydrarthrus, 452 Hydrastia, Muriate of, 352 Hydrastin, 352 Hydrastis Canadensis, 352 Hydrocele, 423, 821 Hydrocephalus, 433 Hydrochloric Acid, 310 Hydrothorax, 423 Hygiene ,222 Hygiene of the Reproductive Organs, 282 Hygiene, Practical Summary of, 288 Hygienic Treatment of the Sick, 375 Hymen, Imperforate, 687 Hyoscyamin, 311, 344 Hyoscyamus Niger, 311, 343 Hypertrophy of the Heart, 550 Hysterical Headache, 635

I

Icterus, 559 Ileum, 40, 41 Imperforate Hymen, 687 Impetigo, 433 Impotency, 776 Impoverished Blood, 626 Impurities, Mineral, 249 Incised Wounds, 889 Incus, 110 Independent Physician, 295 Indian Hemp, 344 Indian Physic, 327 Indian Poke, 347 Indian Tobacco, 340 Indigestion, 565 Indigo, Wild, 318 Individual, Development of the, 192 Indolent Ulcer, 455 Indulgence, Solitary, 772 Induration, 400 Infantile Eczema, 430 Infants, Feeding of, 235 Inferior Maxillary Bone, 22 Inferior Turbinated Bones, 22 Inflammation, 398 Inflammation of the Bladder, Chronic, 836 Inflammation of the Bones, 458 Inflammation of the Liver, 569, 570 Inflammation of the Stomach, Acute, 882 Inflammation of the Stomach, Chronic, 884 Inflammation of the Vagina, 702 Inflammation, Phlegmonous, 399 Inflammation, Termination of, 400 Inflammation, Treatment of, 401 Influenza, 471 Infusions, 303 Inguinal Hernia, 863 Insalivation, 233 Insertion, 31 Insomnia, 623 Instruments, Danger in the use of, 846 Intermediate Muscles, 32 Intermittent Fever, 405 Interpretation of Symptoms, 893 Intestinal Juice, 79 Intestinal Worms, 561 Intestines, 49 Introductory Words, 9 Involuntary Muscles, 32 Involuntary Seminal Emissions, 773 Iodine, 307, 896 Iodine Bath, 368 Ipecac, 339 Ipomoea Jalapa, 326 Iris, 107 Iris Versicolor, 307 Iron, 354 Iron by Hydrogen, 354 Iron, Carbonate of, 354 Iron, Citrate of, 354 Iron, Ferrocyanide of, 316 Iron, Pyrophosphate of, 354 Iron, Tincture of Muriate of, 355 Irritable Ulcer, 455 Itch, 434 Itch, Barber's, 442 Itching of the Vulva, 702

J

Jaborandi, 334 Jail Fever, 408 Jalap, 326 Jalapin, 327 Jaundice, 559 Jejunum, 40, 41 Jessamine, Yellow, 319, 348 Juglandin, 328 Juglans Cinerea, 328 Juice, Gastric, 45, 79 Juice, Intestinal, 79 Juice, Lemon, 335 Juice, Orange, 335 Juice, Pancreatic, 89 Juice, Tamarind, 335

K

Kidneys, 823 Kidneys, Diseases of the, 829 Knee-joint, Tuberculosis of the, 453 Knot-root, 337

L

Labyrinth, 110 Lacerated Wounds, 890 Lachrymal Bones, 22 Lacteals, 48 Lactiferous Ducts, 82 Lady's-slipper, Yellow, 320, 345 Laryngitis, Chronic, 496 Laryngitis, Follicular, 496 Larynx, 63 Larynx, Disease of the, 476 Latent Life, 11 Lateral Curvature of the Spine, 901 Late Suppers, 235 Laudanum, 310 Laxatives, 326 Lead Colic, 558 Lemons, 335 Lens Crystalline, 107 Leptandra Virginica, 327 Leptandrin, 327 Lesions, Valvular, 549 Leucocythæmia, 491

Leucorrhea 702 Liberal Physician 295 Lichen 431 Lids, Granular 649 Life, Latent 11 Life Line 169 Life, Origin of 17 Life-root 341 Life, Transmission of 181 Life, Turn of 700 Ligaments 29 Light and Health 231, 378 Limbs, Deformed 903 Liniments 342 Liquor Amnii 216 Liquor Sanguinis 53 Liquors, Alcoholic 255 Liquors, Distilled 264 Liquors, Fermented 263 Liquors, Malted 262 Liriodendron Tulipfera 350 Literature, Obscene 285 Liver 42 Liver, Chronic Inflammation of the 569 Liver Complaint 569 Liver, Diseases of the 569 Lobelia Inflata 340 Lobes 64, 80 Lobules 64, 80 Locomotor Ataxia 640 Logwood 321 Loss of Sexual Power 776 Love 184 Love, Conjugal 186 Lower Extremities, the Bones of the 27 Lumbago 427 Lungs 63 Lycopin 324 Lycopus Virginicus 323 Lymph 51 Lymphatics 49 Lymphatic System 49 Lymphatic Temperament 157

M

Machines, Electrical 629 Macrotin 306 Macrotys 305 Mad-dog Weed 345 Magnesia Sulphas 328 Malar Bones 22 Malaria 227 Malarial Headache 635 Male Fern 315 Male Generative Organs 207 Male Generative Organs, Affections of the 772 Male Generative Organs, Physiology of the 772 Malformation of the Vagina 687 Malformation of the Womb 687 Malignant Fevers 407 Malleus 110 Malted Liquors 262 Management, Domestic, of Fevers 403 Mandrake 304 Manipulator 373 Marriage 184 Marriage, History of 188 Marsh-mallow 336 Maruta Cotula 334 Massage 362 Mastication 233 Masturbation 286, 772 Matter, Gray 91 Matter, Sebaceous 77 Maxillary Bones 22 May-apple 304 May-weed 334 Meadow Sweet 323 Meals, Regularity of 234 Measles 412 Measles, False 413 Meatus External Auditory 77, 109 Mechanical Movements in the Treatment of Paralysis 641 Mechanical Movements, Value of 371 Mediastinum 65 Medical Diagnosis 390 Medicated Bath 367 Medicine, Allopathic School of 293 Medicine, Eclectic School of 294 Medicine, Homoeopathic School of 294 Medicine, Preparation of 301 Medicine, Progress of 292 Medicine, Properties of 300 Medicine, Rational 292 Medicines, Proprietary 298 Medulla Oblongata 95 Medulla Spinalis 25 Meibomian Glands 78 Melancholy 621 Membrane, Arachnoid 90 Membrane, False 878 Membrane, Mucous 37 Membrane, Pituitary 111 Membrane, Synovial 29 Membranous Croup 878 Menorrhagia 697 Menses 210 Menses, Cessation of the 700 Menses, Retention of the 687, 688, 689, 690 Menses, Suppression of the 687, 688, 689, 690 Menstruation 210, 686 Menstruation, Painful 692 Menstruation, Profuse 697 Mental Culture 276 Mentha Piperita 326 Mentha Viridis 326 Mercury 307 Mercury, Yellow Subsulphate of 339 Metacarpus 26 Metatarsus 27 Miasm 405 Microscopical Examination 398 Miliaria 439 Milk 381 Mind, Nature of 146 Mineral Foods 238 Mineral Impurities 249 Mitral Valve 57 Miscarriage 682 Modified Small-pox 411 Monogamy 188 Morphine 311 Motherwort 342 Motion as a Remedial Agent 369 Motion, Peristalic 49 Motor Nerves 87, 93 Mouth 37 Mouth, Nursing Sore 554 Mouth, Sore 553 Movements, Mechanical, in the Treatment of Paralysis 661 Mucosin 78 Mucous Membrane 37 Mucus 78 Mumps, 471 Muriate of Hydrastia, 352 Muriate of Iron, Tincture of, 355 Muriatic Acid, 310 Muscles, 30 Muscles, Intermediate, 32 Muscles, Involuntary, 32 Muscles, Voluntary, 31 Muscular Tissue, 20 Mustard, 331, 339 Mutton Soup, 247 Myalgia, 427

N

Nails, 73 Narcotics, 343, 897 Nasal Bones, 22 Nasal Catarrh, Chronic , 474 Nasal Cavity, anterior view of, 490 Nasal Cavity, view of deformed, 492 Nasal Douche, Dr. Pierce's, 485 Nasal Polypus, 487 Nasal Tumors, 489 Nasal Septum, deformed, 490 Nature of Asthma, 512 Nature of Disease, 390, 512 Nature of Mind, 146 Nature's Mode of Sustaining Health 371 Neck, Thick, 470 Necrosis, 456 Nepeta Cataria, 334 Nerve-fibers, 87 Nerve, Pneumogastric, 101 Nerves, Afferent, 87, 93 Nerves, Cerebral, 89 Nerves, Cranial, 100 Nerves, Efferent, 87, 93 Nerves, Motor, 87, 93 Nerves, Olfactory, 100, 111 Nerves, Sensory, 87, 93 Nerves, Spinal, 89 Nerves, Sympathetic, 101 Nervines, 345 Nervous Affections of the Skin, 440 Nervous Debility , 619 Nervous Exhaustion, 619 Nervous Headache, 635 Nervous System, 87, 617 Nervous System, overworked, 622 Nervous Tissue, 20 Nettle-rash, 437 Neuralgia, 635 Neuralgia of the Heart, 552 Neuralgia of the Stomach, 885 Neuralgic Headache, 635 Neurasthenia, 620, 622 Neurilemma, 89 Nightshade, Deadly, 312 Nitre, Sweet Spirits of, 338 Nocturnal Emissions, 773 Nosebleed, 881 Nose, Foreign Bodies in the , 893 Nucleolus, 19 Nucleus, 19,64 Nurse, 375, 376 Nursing Sore Mouth, 554 Nux Vomica, 350

O

Obscene Literature, 285 Occipital Bone, 22 OEdema, 422 Old School of Medicine, 293 Old Sores, 454 Oleum Ricini, 328 Olfactory Nerves, 100, 111 Onanism, 286, 772 Opium, 310 Opium Habit, 627 Opium, Use of, 384 Oranges, 335 Organic Disease of the Heart, 547 Organic Extracts as remedies, 631 Organic Impurities in Water, 251 Organs, Circulatory, 56 Organs, Digestive, 37 Organs, Generative, 206, 207 Organs of Respiration, 63 Organs, Urinary, 206, 207 Orifice, Pyloric, 82 Origin, 31 Origin of Life, 17 Os Hyoides, 23 Osmosis, 46 Os Orbiculare, 110 Ossa Innominata, 23, 25 Osscous Tissue, 20 Ossification, 20 Ossification, Centers of, 20, 27 Ovarian Tumors, 722 Ovaries, 209 Ovaries, Absence of the, 688 Ovaries, Disease of the, 710 Ovulation, 209 Ovum, 12, 209 Ozæna, 474, 475

P

Pack, Wet Sheet, 368 Pain, 395 Painful Menstruation, 692 Painters' Colic, 558 Palate Bones, 22 Pallor, 62 Palsy, 638 Palsy, Creeping, 640 Palsy, Shaking, 641 Pancreas, 44 Pancreatic Juice, 80 Pancreatin, 80 Papaver Somniferum, 310 Papillae, 69, 112 Paralysis, 638 Paralysis Agitans, 641 Paralysis, General, 639 Paralysis, General Treatment of, 641 Paralysis, Progressive, 640 Paraplegia, 639 Paregoric, 310 Parietal Bones, 22 Parotid Glands, 38 Parotitis, 471 Parsley, Poison, 311 Passages, False, 846 Passions, Influence of Physical Labor on, 283 Patella, 27 Patient, Clothing and Bedding of, 380 Peach Tree, 346 Peduncles of the Cerebellum, 97 Pelvis, 25 Pelvis, Bones of the, 85 Pemphigus, 139 Pennyroyal, 341 Pepper, Black 348 Peppermint 326 Pepsin 79 Percussion 391 Pericarditis 548 Pericardium 56 Perichondrium 29 Perilymph 110 Periodical Headache 635 Periosteum 27 Peristaltic Motion 45 Peritoneum 84 Peritonitis 886 Permanganate of Potash 318 Pernicious Fever 406 Perpetual Reproduction 11 Perpetuation of the Species 194 Perspiration 75 Pertussis 880 Pettenkoffer's Test 81 Phalanges 27 Pharyngitis and Post-nasal Catarrh 493 Pharynx 39 Phthisic 511 Phthisis Pulmonalis 497 Physical Exercise 270 Physical Properties of the Blood 53 Physician, Independent 295 Physiological Anatomy 11, 19, 30, 37, 48, 56, 63, 68, 75, 84, 87 Physiological Anatomy of the Urinary Organs 823 Physiology 11 Physiology, Cerebral 114 Physiology of the Male Generative Organs 772 Phytolacca Decandra 304 Phytolaccin 304 Pia Mater 90 Pierce's Comp Extract of Smart-weed 312, 326, 335, 342, 349 Pierce's Favorite Prescription 342, 346, 355 Pierce's Golden Medical Discovery 308, 316, 355 Pierce's Nasal Douche 485 Pierce's Purgative Pellets 308, 328 Pigeon-berry 304 Piles 578 Pile Tumors, Radical Cure of 581 Pine-apples 335 Pink-root 314 Pin-worm 561 Pipsissewa 338 Pituitary Membrane 111 Pityriasis 431 Placenta 216 Pleura 64 Pleurisy-root 332 Pleurodynia 427 Pleximeter 391 Pneumogastric Nerve 101 Podophyllin 304 Podophyllum Peltatum 304 Poison Hemlock 311 Poison Parsley 311 Poisoned Wounds 890 Poisons and their Antidotes 895 Poke 304 Poke, Indian 347 Pollution, Voluntary 772 Polygamy 188 Polypi 723 Polypoid Tumors 723 Polypus, Nasal 487 Polyuria 835 Pond's Sphygmograph 548 Pons Varolii 97 Poplar 315, 350 Populin 315 Pork Steaks 247 Portal System, Veins of the 60 Position in Sleep 280 Position of Patient 393 Posterior Pyramids 95, 96 Posterior Spinal Curvature 898 Post-nasal Catarrh 493 Post-nasal Syringe 493 Potash, Acetate of 338 Potash, Bicarbonate of 309 Potash, Nitrate of 338 Potash, Permanganate of 318 Pott's Disease 898 Powder, Dover's 311 Practical Summary of Hygiene 288 Preface 5, 7 Pregnancy 212 Pregnancy, Derangements Incident to 721 Pregnancy, Duration of 219 Pregnancy, Signs of 219 Prehension 233 Premature Labor 682 Preparation of Food 236 Preparation of Medicines 301 Prescription, Pierce's Favorite 342,346,355 Prevention of Conception 212 Prickly-ash 349 Prickly Heat 437 Pride-weed 324 Prince's Pine 338 Principle, Vital 15 Processes, Articular 24 Processes, Spinous 24 Processes, Transverse 24 Process of Generation 15 Profuse Menstruation 697 Prognosis 390 Progress of Medicine 292 Progressive Paralysis 640 Prolapsus of the Uterus 713 Properties of Medicine 300 Proprietary Medicines 298 Prostate Gland 827 Prostate Gland, Enlargement of the 840 Proteids 238 Prurigo 440 Pruritus Vulvae 702 Prussian Blue 316 Psoriasis 431 Ptyalin 78 Puberty 210 Puccoon, Red 306 Pulmonary Artery 58 Pulmonary Tuberculosis 497 Pulmonary Veins 60 Pulsatilla Nigricans 346 Pulse 61, 395 Pumpkin Seeds 338 Puncta Lachrymalia 77 Punctured Wounds 889 Pupil 107 Pure Air 222, 223, 378 Purgatives 326 Purification of Water 252 Putrid Fevers 407 Pyloric Orifice 83 Pyrophosphate of Iron 354

Q

Quackery Exposed, 780 Queen of the Meadow, 338 Quickening, 217 Quinine, 315 Quinsy, 416

R

Rachitis, 453 Radical Cure for Hernia, 866 Radical Cure for Pile Tumors, 581 Radius, 26 Rash, 436 Rash, Papular, 431 Rash, Rose, 413 Rational Medicine, 292 Receptaculum Chyli, 46 Rectum, 42 Red Puccoon, 306 Reflex Action of the Spinal Cord, 93 Region of Feebleness, 134 Regularity of Meals, 234 Regular School of Medicine, 293 Remedial Agent, Motion as a, 369 Remedial Treatment of Diseases, 386 Remedies for Disease, 298 Remittent Fever, 406 Renal Calculi, 837 Reproduction, 11, 196 Reproduction, Dioecious, 202 Reproduction, Hermaphroditic, 199 Reproductive Organs, Hygiene of the, 282 Resolution, 400 Respiration, Organs of, 63 Respiration, Pure Air for, 223 Respirator, Cotton-wool, 230 Rete Mucosum, 70 Retention of the Menses, 687, 688, 689, 691 Retina, 106, 107 Retroflexion of the Uterus, 709, 714 Rheumatic Headache, 635 Rheumatism, Acute Articular, 425 Rheumatism, Cervical, 427 Rheumatism, Chronic Articular, 426 Rheumatism, Muscular, 127 Rhubarb, 327 Ribs, 24 Rickets, 453 Right to Terminate Pregnancy, 218 Rooms, Sleeping, 278 Rose Rash, 413 Rosy Drop, 433 Rubbing, 372 Rubeola, 412 Running Scall, 430 Running-sores, 454 Rupia, 439 Rupture, 862 Russian Bath, 358

S

Sacrum, 23, 25 Sage, 313, 333 Saleratus, 309 Salicin, 315, 351 Saliva, 38, 78 Salivary Glands, 38 Salt, 315 Saltpetre, 333 Salt-rheum, 430 Salts, 53 Salts, Biliary, 81 Salvia Officinalis, 313, 333 Sanguinaria Canadensis, 308 Sanguine Temperament, 163 Santonin, 313 Sarcolemma, 32 Saturnine Colic, 558 Scabies, 434 Scalds, 894 Scall, 433 Scall, Running, 430 Scaly Skin Diseases, 441 Scapula, 26 Scarlatina, 408 Scarlet Fever, 408 School-rooms, Ventilation of, 225 Sclerotic, 106 Scott's Acid Bath, 367 Scrofula, 445 Scrotum, Dropsy of the, 821 Scull-cap, 345 Sea Bathing, 364 Seat, 390 Seat-worm, 561 Sebaceous Glands, 70, 77 Sebaceous Matter, 77 Secretion, 75 Sedatives, 346 Self-abuse, 286, 622 Self-pollution, 772 Semen, 772 Semi-circular Canals, 110 Semilunar Valves, 58 Seminal Emissions, Involuntary, 773 Sense of Hearing, 109 Sense of Sight, 106 Sense of Smell, 111 Sense of Taste, 112 Sense of Touch, 113 Senses, Special, 106 Sensory Nerves, 87, 93 Septum, Deformed Nasal, 490 Serum, 54, 55, 238 Sexual Abuse, Story of, 394 Sexual Debility, Symptoms of, 776 Sexual Influences, 383 Sexual Power, Loss of, 776 Shaking Palsy, 641 Shingles, 438 Shock, 890 Shower Bath, 365 Sick, Hygienic Treatment of the, 375 Sick-room, 377 Sick, Visiting the, 383 Sight, 106 Signs of Pregnancy, 219 Site for Homes, 227 Sitz Bath, 367 Skeleton, 22 Skin, 68 Skin, Diseases of the, 430 Skin Diseases, Scaly, 441 Skin, Nervous Affections of the, 440 Skoke, 304 Sleep, 278, 382 Small-pox, 410 Smart-weed, Compound Extract of, 312, 326, 335, 342, 349 Smell, 111 Snake-head, 315 Snake-root, Black, 306 Society, Welfare of, 193 Soda, Glycocholate of, 81 Soda, Sulphite of 309 Soda, Taurocholate of 81 Sodium, Chloride of 315 Soft Rubber Bulb Syringe 705 Solitary Indulgence 772 Sore Mouth 553 Sore Mouth, Nursing 554 Sore Throat, Clergymen's 496 Soups 246 Spasmodic Croup 878, 879 Spearmint 326 Special Creation 14 Special Senses 106 Species 14 Species, Perpetuation of the 194 Specific Center 14 Speculum 717 Spermatic Veins, Enlarged 803 Spermatocele 803 Spermatorrhea 620, 772, 844 Spermatozoön 12 Sperm-cell 15 Sphenoid Bone 22 Sphygmograph, Pond's 548 Spigelia Marilandica 314 Spinal Column 24 Spinal Cord 25, 90 Spinal Cord, Reflex Action of the 93 Spinal Curvature, Posterior 898 Spinal Nerves 89 Spirit Vapor-bath 362 Spirometer 391, 392 Spleen 44 Sponge Bath 365 Sprains 892 Squaw-root 305 Stapes 110 Static Electrical Machine 629 Sterility 707 Sternum 23 Stethoscope 391 Stimulants 348 Stomach 39, 52 Stomach, Inflammation of the 882, 884 Stomach, Neuralgia of the 885 Stomatitis 553 Stomatitis Materna 554 Stone in the Bladder 838 Stone-pock 442 Stone-root 337 Story of Sexual Abuse 394 Stramonium 344 Striae 31 Stricture of the Urethra 775, 843 Strumous Diathesis 445 Strumous Synovius 453 St. Vitus's Dance 650 Styptics 320, 890 Sublingual Gland 39 Submaxillary Gland 38 Sudatorium 359 Sudoriferous Glands 69 Sudorifics 332 Sulphate of Copper 339 Sulphate of Quinia 315, 339 Sulphate of Zinc 318 Sulphite of Soda 309 Sulphur Bath 368 Sulphuric Acid, Aromatic 310 Sulphur Vapor-bath 368 Summer Complaint 555 Sun-stroke 894 Superior Maxillary Bones 22 Suppers, Late 235 Suppression of the Menses 687, 688, 689, 691 Suppuration 400 Surgical Treatment of Epilepsy 649 Sutures 23 Swamp Alder 304 Swamp Dogwood 351 Sweet Elder 307 Sweet Spirits of Nitre 338 Swelling 400 Swelling, White 452 Swimming 274 Sycosis 442 Sylvius, Fissure of 98 Sympathetic Nerve 101 Symptoms 390, 392, 393 Symptoms, Interpretation of 393 Symptoms 01 Sexual Debility 776 Synovia 29 Synovial Capsule 29 Synovial Membrane 29 Synovitis 453 Synovitis, Rheumatic 453 Synovitis, Strumous 453 Synovitis, Syphilitic 453 Syphilitic Synovitis 453 Syringe, Post-nasal 493 Syringe, Soft Rubber Bulb 705 System, Cerebro-Spinal 89 Systemic Veins 60 System, Lymphatic 49 System, Nervous 87, 617 System, the Great Sympathetic 101 System, Vascular 56

T

Tænia 562 Tag Alder 304 Tall Speedwell 327 Tamarind 335 Tanacetum Vulgare 341 Tannin 325 Tansy 341 Tape-worms 562 Tarsus 27 Taste, Sense of 112 Taurocholate of Soda 81 Tea 253 Tear-duct, Closure of the 477 Tear-duct, Obstruction of the 477 Tears 77 Teeth 37 Temperaments, Classified 156 Temperaments, Human 149 Temperate Bath 357 Temporal Bones 22 Tentorium 97 Tepid Bath 357 Termination of Inflammation 400 Test, Pettenkoffer's 81 Tetter, Branny 431 Tetter, Crusted 433 Tetter, Humid 430 Thick Neck 470 Thoracic Duct 42 Thorn-apple 344 Thoroughwort 316 Thread-worm 561 Throat, Disease of the 476 Throat, Foreign Bodies in the 893 Throat, Ulceration of the 496 Thrush 553 Tibia, 27 Time for Sleep, 279 Tinctura Ferri Chloridi, 355 Tincture of the Chloride of Iron, 355 Tincture of the Muriate of Iron, 355 Tinctures, 302 Tissue, Adipose, 20 Tissue, Areolar, 19 Tissue, Cartilaginous, 20 Tissue, Connective, 19 Tissue, Muscular, 20 Tissue, Nervous, 20 Tissue, Osseous, 20 Tobacco Habit, 627 Tobacco, Indian, 340 Tobacco, Use of, 384 Tongue, 3, 394 Tonics, 350 Tonsilitis, 416 Tonsils, Enlarged, 417, 494 Torpid Liver, 569 Torticollis, 427 Touch, Sense of, 113 Tourniquet, 890 Trachea, 63 Trailing Arbutus, 336 Transmission of Life, 181 Transudation, 422 Treatment, 390 Treatment of Diseases, Remedial, 386 Treatment of Epilepsy, Surgical, 649 Treatment of Inflammation, 401 Treatment of Paralysis, 641 Treatment of the Sick, Hygienic, 375 Trichina Spiralis, 564 Tricocephalus Dispar, 562 Tricuspid Valve, 57 True Skin, 68 Trumpet-weed, 338 Trunk, 23 Tube, Eustachian, 110 Tube, Eustachian, Obstruction of the, 477 Tubercle, 445 Tubercular Consumption, 497 Tuberculosis of the Knee-joint, 453 Tuberculosis, Pulmonary, 497 Tumors, Fibroid, 722 Tumors, Ovarian, 722 Tumors, Polypoid, 723 Tumors, Uterine, 122 Turkish Bath, 358 Turn of Life, 700 Turpeth Mineral, 339 Tympanum, 110 Typhoid Fever, 407 Typhus Fever, 407

U

Ulceration of the Throat, 496 Ulceration of the Uterus, 717 Ulcer; Follicular, 718 Ulcer, Granular, 717 Ulcer, Indolent, 455 Ulcer, Irritable, 455 Ulcer, Varicose, 455 Ulcers, Chronic, 454 Ulna, 26 Umbilical Cord, 217 Umbilical Hernia, 863 Umbilicus, 217 Universality of Animalcular Life, 16 Upper Extremities, the Bones of the, 25 Uræmic Headache, 635 Urea, 86 Ureters, 84 Urethra, 86, 827 Urethra, Stricture of the, 843 Uric Acid, 86 Urinary Fistula, 721 Urinary Organs, Diseases of the, 823 Urinary Organs, Physiological Anatomy of the, 823 Urine, 86 Urine, Examination of the, 397, 825 Urinometer, 392 Urticaria, 437 Use of Tobacco and Opium, 384 Uterine Pregnancy, 215 Uterine Speculum 717, 718 Uterine Tumors, 722 Uterus, Falling of the, 713 Uterus, Prolapsus of the, 713 Uvula, Elongation of the, 495

V

Vaccinia, 411 Vagina, Inflammation of the, 702 Vagina, Irritable, 702 Vagina, Malformation of the, 687 Vaginal Injections, How to Use, 705 Vaginitis, 702 Valerian, 320 Valeriana Officinalis, 320 Value of Animal Food, 241 Value of Mechanical Movements, 371 Valve, Mitral, 57 Valve, Tricuspid, 57 Valves, Semilunar, 58 Valvulæ Conniventes, 40 Valvular Lesions, 549 Vapor-Bath, 358 Vapor-Bath, Spirit 362 Vapor-Bath, Sulphur 368 Varicella, 412 Varicocele, 803 Varicose Ulcer, 455 Variety of Food necessary, 239 Variola, 410 Varioloid, 411 Vascular System, 56 Veins, 59 Veins, Enlarged Spermatic, 803 Veins of the Portal System, 60 Veins, Pulmonary, 60 Veins, Systemic, 60 Vena Cava, 56,60 Ventilation of Dwellings, 226 Ventilation of Factories, 226 Ventilation of School Rooms, 225 Ventilation of Workshops, 226 Ventricle, 57 Veratrum Viride, 347 Vermifuge, 313 Versions of the Uterus or Womb, 709, 714 Vertebræ, 23 Vesical Calculi, 838 Vestibule, 110 Viburnin, 320 Viburnum Opulus, 320 Villus, 41,48 Virginia Snake-root, 333 Visiting the Sick, 383 Vital Principle, 15 Vital Properties of the Blood, 53 Vitreous Humor, 107 Vitriol, Elixir of, 310 Vitriol, White 818 Volitive Faculties 129 Volitive Temperament 171 Voluntary Muscles 31 Voluntary Pollution 772 Vomer 22 Vomit, Black 883 Vulvitis 702

W

Wafer-ash 351 Wakefulness 623 Warm Bath 357 Warmth 379 Water 248 Water-bugle 323 Water-hoarhound 323 Water, How to use 252 Water-melon Seeds 338 Water, Organic Impurities in 251 Water-pink 336 Water, Purification of 252 Waters, Chalybeate 250 Waters, Saline 250 Waters, Sulphurous 250 Welfare of Society 193 Wet Sheet Pack 368 White Hellebore 347 White Poplar 350 White Swelling 452 White Vitriol 318 White-root 332 Whitewood 350 Whites 702 Whooping-cough 880 Wild Chamomile 334 Wild Indigo 318 Wild Yam 320 Willow 351 Windpipe 63 Wintergreen 325 Witch-hazel 321 Woman and her Diseases 684 Womb, Absence of the 687 Womb, Displacements of the 713 Womb, Elongation of the Neck of the 709 Womb, Flexions of the 709, 714 Womb, Malformation of the 687 Womb, Versions of the 709, 714 Workshops, Ventilation of 226 Worms, Intestinal 561 Wounds 889

X

Xanthoxylin 349 Xanthoxylum Fraxineum 349

Y

Yam, Wild 320 Yeast 317, 335 Yellow Dock 304 Yellow Jessamine 319, 348 Yellow Lady's-slipper 320, 345 Yellow Subsulphate of Mercury 339

Z

Zinci Sulphas 318, 339 Zinc, Sulphate of 318, 339 Zingiber Officinalis 325, 335

* * * * *

INDEX TO APPENDIX

A

Advantages Offered to Invalids 951 Advantages of Location 948 Advantages of Specialties 950, 956 Advertising 958 Affidavit 905 Aids, In valuable, in Urinary Diseases 964 Amusements 932 Analysis of Urine 962, 967 Appendix 905

B

Bath Department 931 Beecher on Advertising 959 Board and Treatment, Terms for 970 Buffalo Outranks all in Healthfulness 946

C

Cause of Female Weakness 919 Caution 936 Charges Must be Prepaid 968 Chemical Laboratory 940 Chronic Diseases, Mechanical Aids in the Cure of 906 Chronic Diseases, Treatment of 954 Climate 944 Common Sense View, A 934 Consultation, Free 968 Consultations by Letter 968 Consultations with Physicians 971 Counter-Irritation 916 Cure of Deformities 917 Cure of Neuralgia 916 Cure of Paralysis 917 Cure of Swellings 915 Cure of Tumors 917

D

Deformities, Cure of 917 Disease Has Certain Unmistakable Signs 943 Diseases of Women 918 Division of Labor 949, 954

E

Eminent Medical Authorities 967 Endorsement, President Garfield's 973 Equability of Climate 945, 947 Evidence of Health Statistics 945 Extreme Healthfulness of Buffalo 944

F

Facilities of Treatment 949 Facts of Science 946 Fair and Business-like Offer 953 Fees, Why Required in Advance 969 Female Weakness, Cause of 919 Fire-Proof Vaults 930 Free Consultation 968

G

General Considerations 940 Genuine Home, A 948 Good Order 932

H

Home, A Genuine 948 Home, Remedial 942 How to Avoid Swindlers 990

I

Important Announcement 921 Invalids, Advantages Offered to 951 Invalids' Hotel and Surgical Institute 922, 924, 941 Invaluable Aids in Urinary Diseases 964

J

Joints, Stiffened 951

K

Kneader 914

L

Liberality 934 Location, Advantages of 948

M

Manipulator 908 Map of Buffalo 992 Mechanical Aids in the Cure of Chronic Diseases 906 Medical Authorities, Eminent 967 Medicine, Progress of 950 Medicines, Our 971 Moderate, Terms 949

N

Neuralgia, Cure of 916 Not Confined in Prescribing 972 Notices of the Press 974

O

Offer, Fair and Business-like 953 Our Medicines Prepared with the Greatest Care 972 Our Physicians and Surgeons 935 Our Remedies 931

P

Paralysis, Cure of 917 Patient's Room 945 Patients, Treating at a Distance 960, 971 Physicians and Surgeons, Staff of 925 Physicians, Consultation with 971 President Garfield's Endorsement 973 Press Notices 974 Printing Department 939 Progress in Medicine 950

R

Rational Treatment 919 Recapitulation 920 Regulation of Diet 931 Reliable Medicines 969 Remedial Home, 942 Revulsion 916

S

Signs, Urinary 962 Specialties, Advantages of 950, 956 Staff of Physicians and Surgeons 925 Statistics, Evidence of Health 945 Steam Passenger Elevator 930 Surgical Department 931 Swellings, Cure of 915 Swindlers, How to Avoid 935, 990

T

Terms for Board and Treatment 970 Terms for Treatment 969 Trained Attendants 932 Treating Patients at their Homes 942 Treatment, Facilities of 949 Treatment of Chronic Diseases 954 Tumors, Cure of 915 Turkish Bath 931

U

Unparalleled Success 933 Urinary Signs 962

V

Vibrator 911 Visiting Patients who Reside at a Distance 971 Vocabulary 979

W

World's Dispensary 937 World's Dispensary Medical Association 921

* * * * *

FOOTNOTES

Footnote 1: Darwin.

Footnote 2: The males of Cryptophialus and Alcippe, species of marine animals, are apparent exceptions to this rule. They are parasitic, possess neither mouth, stomach, thorax, nor abdomen, and are, necessarily, short-lived.

Footnote 3: Dalton--Human Physiology.

Footnote 4: In the use of the terms psychical and psychological, we have observed the distinction which metaphysicians have recently made. They employ the term psychical to indicate the relation of the human soul to sense, appetite, propensity, etc., and psychological, as indicating the ultimates of spiritual being. In this manner we use the word psychical as describing the relationship of the soul to animal experiences and being, and psychological as referring to the spiritual potencies of the soul. The distinction being introduced, we continue its use rather then coin new words.

Footnote 5: Certain disturbances of the bodily organs excite fear. The apprehension of danger, or simply mental excitement, does not explain what is called "water fright," "stage fright," terror excited by the raging of a storm, or the rocking of a boat. In such instances the heart may beat heavily, the respiration be irregular and attended by precordial oppression, giddiness, weakness, and physical inability to articulate a word or recall a thought. These bodily conditions are not subject to the control of the will, but arise when individuals are perfectly assured that no danger threatens. At other times, as in a fearful tempest upon the sea, although the danger be imminent, if the bodily functions are not disturbed, there is not the least manifestation of fear.

Footnote 6: A _placebo_ is a harmless and valueless prescription, which physicians sometimes make merely to gratify the patient, as a dose of "bread pills," etc.