THE PEOPLE'S

COMMON SENSE

MEDICAL ADVISER

IN PLAIN ENGLISH:

OR,

MEDICINE SIMPLIFIED.

BY

R.V. PIERCE, M.D.

ONE OF THE STAFF OF CONSULTING PHYSICIANS AND SURGEONS

AT THE INVALIDS' HOTEL AND SURGICAL INSTITUTE, AND

PRESIDENT OF THE WORLD'S DISPENSARY

MEDICAL ASSOCIATION.

FIFTY-FOURTH EDITION.

One Million, Six Hundred and Fifty Thousand.

TABLE OF CONTENTS

PREFACE TO THE PRESENT EDITION

The popular favor with which former editions of this work have been received has required the production of such a vast number of copies, that the original electrotype plates from which it has heretofore been printed, have been completely worn out.

The book has been re-produced in London, England, where six editions have already been necessary to supply the demand for it.

In order to continue its publication to meet the demand which is still active in this country, it has been necessary, inasmuch as the original electrotype plates have become worn and useless, to re-set the work throughout. This has afforded the Author an opportunity to carefully revise the book and re-write many portions, that it may embody the latest discoveries and improvements in medicine and surgery. In performing this labor he has been greatly assisted by contributions and valuable aid kindly supplied by his staff of associate specialists in medicine and surgery who constitute the Faculty of the Invalids' Hotel and Surgical Institute.

That part of the book treating of Diseases and Their Remedies will be found to be thoroughly reliable; the prescriptions recommended therein having all received the sanction and endorsement of medical gentlemen of rare professional attainments and mature experience.

THE AUTHOR.

BUFFALO, N.Y., January, 1895.

PREFACE TO THE FIRST EDITION.

Every family needs a COMMON SENSE MEDICAL ADVISER. The frequent inquiries from his numerous patients throughout the land, suggested to the Author the importance and popular demand for a reliable work of this kind. Consequently, he has been induced to prepare and publish an extensive dissertation on Physiology, Hygiene, Temperaments, Diseases and Domestic Remedies. It is for the interest and welfare of every person, not only to understand the means for the preservation of health, but also to know what remedies should be employed for the alleviation of the common ailments of life.

The frequency of accidents of all kinds, injuries sustained by machinery, contusions, drowning, poisoning, fainting, etc., and also of sudden attacks of painful diseases, such as headache, affections of the heart and nerves, inflammation of the eye, ear and other organs, renders it necessary that non-professionals should possess sufficient knowledge to enable them to employ the proper means for speedy relief. To impart this important information is the aim of the author.

Moreover, this volume treats of Human Temperaments, not only of their influence upon mental characteristics and bodily susceptibilities, but also of their vital and non-vital combinations, which transmit to the offspring either health, hardihood, and longevity, or feebleness, disease, and death. It clearly points out those temperaments which are compatible with each other and harmoniously blend, and also those which, when united in marriage, result in barrenness, or produce in the offspring imbecility, deformity, and idiocy. These matters are freely discussed from original investigations and clinical observations, thus rendering the work a true and scientific guide to marriage.

[pg 8]While instruction is imparted for the care of the body, those diseases (alas how prevalent!) are investigated which are sure to follow as a consequence of certain abuses, usually committed through ignorance. That these ills do exist is evident from the fact that the Author is consulted by multitudes of unfortunate young men and women, who are desirous of procuring relief from the weaknesses and derangements incurred by having unwittingly violated physiological laws.

Although some of these subjects may seem out of place in a work designed for every member of the family, yet they are presented in a style which cannot offend the most fastidious, and with a studied avoidance of all language that can possibly displease the chaste, or disturb the delicate susceptibilities of persons of either sex.

This book should not be excluded from the young, for it is eminently adapted to their wants, and imparts information without which millions will suffer untold misery. It is a false modesty which debars the youth of our land from obtaining such information.

As its title indicates, the Author aims to make this book a useful and practical Medical Adviser. He proposes to express himself in plain and simple language, and, so far as possible, to avoid the employment of technical words, so that all his readers may readily comprehend the work, and profit by its perusal. Written as it is amid the many cares attendant upon a practice embracing the treatment of thousands of cases annually, and therefore containing the fruits of a rich and varied experience, some excuse exists for any literary imperfections which the critical reader may observe.

THE AUTHOR.

BUFFALO, N.Y., July, 1875.

INTRODUCTORY WORDS.

Health and disease are physical conditions upon which pleasure and pain, success and failure, depend. Every individual gain increases public gain. Upon the health of its people is based the prosperity of a nation; by it every value is increased, every joy enhanced. Life is incomplete without the enjoyment of healthy organs and faculties, for these give rise to the delightful sensations of existence. Health is essential to the accomplishment of every purpose; while sickness thwarts the best intentions and loftiest aims. We are continually deciding upon those conditions which are either the source of joy and happiness or which occasion pain and disease. Prudence requires that we should meet the foes and obviate the dangers which threaten us, by turning all our philosophy, science, and art, into practical common sense.

The profession of medicine is no sinecure; its labors are constant, its toils unremitting, its cares unceasing. The physician is expected to meet the grim monster, "break the jaws of death, and pluck the spoil out of his teeth." His ear is ever attentive to entreaty, and within his faithful breast are concealed the disclosures of the suffering. Success may elate him, as conquest flushes the victor. Honors are lavished upon the brave soldiers who, in the struggle with the foe, have covered themselves with glory, and returned victorious from the field of battle; but how much more brilliant is the achievement of those who overwhelm disease, that common enemy of mankind, whose victims are numbered by millions! Is it meritorious in the physician to modestly veil his discoveries, regardless of their importance? If he have light, why hide it from the world? Truth should be made as universal and health-giving as sunlight. We say, give light to all who are in darkness, and a remedy to the afflicted everywhere.

We, as a people, are becoming idle, living in luxury and ease, and in the gratification of artificial wants. Some indulge in the [pg 10]use of food rendered unwholesome by bad cookery, and think more of gratifying a morbid appetite than of supplying the body with proper nourishment. Others devote unnecessary attention to the display of dress and a genteel figure, yielding themselves completely to the sway of fashion. Such intemperance in diet and dress manifests itself in the general appearance of the unfortunate transgressor, and exposes his folly to the world, with little less precision than certain vices signify their presence by a tobacco-tainted breath, beer-bloated body, rum-emblazoned nose, and kindred manifestations. They coddle themselves instead of practicing self-denial, and appear to think that the chief end of life is gratification, rather than useful endeavor.

I purpose to express myself candidly and earnestly on all topics relating to health, and appeal to the common sense of the reader for justification. Although it is my aim to simplify the work, and render it a practical common-sense guide to the farmer, mechanic, mariner, and day-laborer, yet I trust that it may not prove less acceptable to the scholar, in its discussion of the problems of Life. Not only does the method adopted in this volume of treating of the Functions of the Brain and Nervous System present many new suggestions, in its application to hygiene, the management of disease, generation and the development and improvement of man, but the conclusions correspond with the results of the latest investigations of the world's most distinguished savants. My object is to inculcate the facts of science rather than the theories of philosophy.

Unto us are committed important health trusts, which we hold, not merely in our own behalf, but for the benefit of others. If we discharge the obligations of our trusteeship, we shall enjoy present strength, usefulness, and length of days; but if we fail in their performance, then inefficiency, incapacity, and sickness, will follow, the sequel of which is pain and death. Let us, then, prove worthy of this generous commission, that we may enjoy the sweetest of all pleasures, the delicious fruitage of honest toil and faithful obedience.

PART I.

PHYSIOLOGY.

CHAPTER I.

BIOLOGY.

In this chapter we propose to consider Life in its primitive manifestations. Biology is the science of living bodies, or the science of life. Every organ of a living body has a function to perform, and Physiology treats of these functions.

Function means the peculiar action of some particular organ or part. There can be no vital action without change, and no change without organs. Every living thing has a structure, and Anatomy treats of the structures of organized bodies. Several chapters of this work are devoted to Physiological Anatomy, which treats of the human organism and its functions.

The beginning of life is called generation; its perpetuation, reproduction. By the former function, individual life is insured; by the latter, it is maintained. Since nutrition sustains life, it has been pertinently termed perpetual reproduction.

Latent Life is contained in a small globule, a mere atom of matter, in the sperm-cell. This element is something which, under certain conditions, develops into a living organism. The entire realm of nature teems with these interesting phenomena, thus manifesting that admirable adjustment of internal to external relations, which claims our profound attention. We [pg 12]are simply humble scholars, waiting on the threshold of nature's glorious sanctuary, to receive the interpretation of her divine mysteries.

Some have conjectured that chemical and physical forces account for all the phenomena of life, and that organization is not the result of vital forces. Physical science cannot inform us what the beginning was, or how vitality is the result of chemical forces; nor can it tell us what transmutations will occur at the end of organized existence. This mysterious life-principle eludes the grasp of the profoundest scientists, and its presence in the world will ever continue to be an astonishing and indubitable testimony of Divine Power.

The physical act of generation is accomplished by the union of two cells; and as this conjugation is known to be so generally indispensable to the organization of life, we may fairly infer that it is a universal necessity. Investigations with the microscope have destroyed the hypothesis of "spontaneous generation." These show us that even the minutest living forms are derived from a parent organization.

Generation. So long as the vital principle remains in the sperm-cell, it lies dormant. That part of the cell which contains this principle is called the spermatozoön, which consists of a flattened body, having a long appendage tapering to the finest point. If it be remembered that a line is the one-twelfth part of an inch in length, some idea may be formed of the extreme minuteness of the body of a human spermatozoön, when we state that it is from 1/800 to 1/600 part of a line, and the filiform tail 1/50 of a line, in length. This life-atom, which can be discerned only with a powerful magnifying glass, is perfectly transparent, and moves about by executing a vibratile motion with its long appendage. Within this speck of matter are hidden the multifarious forces which, under certain favorable conditions, result in organization. Magnify this infinitesimal atom a thousand times, and no congeries of formative powers is perceived wherewith to work out the wonders of its existence. Yet it contains the principle, which is the contribution on the part of the male toward the generation of a new being.

The ovum or germ-cell, is the special contribution on the [pg 13]part of the female for the production of another being. The human ovum, though larger than the spermatozoön, is also extremely small, measuring not more than from 1/20 to 1/10 of a line, or from 1/240 to 1/120 of an inch, in diameter.

Fig. 1. A. Human Spermatozoön magnified about 3,800 diameters. B. Vertical and lateral views of spermatozoa of man. C, D, E, F. Development of spermatozoa within the vesicles of evolution. G. Cell of the sponge resembling a spermatozoön. H. Vesicles of evolution from the seminal fluid of the dog in the parent cell I. Single vesicles of different sizes. J. Human spermatozoön forming in its cell. K. Rupture of the cell and escape of the spermatozoön.

The sperm and the germ-cells contain the primary elements of all organic structures, and both possess the special qualities and conditions by which they may evolve organic beings. Every cell is composed of minute grains, within which vital action takes [pg 14]place. The interior of a cell consists of growing matter; the exterior, of matter which has assumed its form and is less active.

When the vital principle is communicated to it, the cell undergoes a rapid transformation. While this alteration takes place within the cell, deteriorating changes occur in the cell-wall. Although vital operations build up these structures, yet the animal and nervous functions are continually disintegrating, or wasting, them.

Throughout the animal kingdom, germ-cells present the same external aspect when carefully examined with the microscope. No difference can be observed between the cells of the flowers of the oak and those of the apple, but the cells of the one always produce oak trees, while those of the other always produce apple trees. The same is true of the germs of animals, there being not the slightest apparent difference. We are unable to perceive how one cell should give origin to a dog, while another exactly like it becomes a man. For aught we know, the ultimate atoms of these cells are identical in physical character; at least we have no means of detecting any difference.

Species. The term species is generally used merely as a convenient name to designate certain assemblages of individuals having various striking points of resemblance. Scientific writers, as a rule, no longer hold that what are usually called species are constantly unvarying and unchangeable quantities. Recent researches point to the conclusion that all species vary more or less, and, in some instances, that the variation is so great that the limits of general specific distinctness are sometimes exceeded.

Our space will not permit us to do more than merely indicate the two great fundamental ideas upon which the leading theories of the time respecting the origin of species are based. These are usually termed the doctrine of Special Creation and the doctrine of Evolution. According to the doctrine of Special Creation, it is thought that species are practically immutable productions, each species having a specific centre where it was originally created, and from which it spread over a certain area until its further progress was obstructed by unfavorable conditions. The advocates of the doctrine of Evolution hold, on the contrary, that species are not permanent and immutable, but that they are subject to modification, and that "the existing forms of life are [pg 15]descendants by true generation of pre-existing forms."^[1] Most naturalists are now inclined to admit the general truth of the theory of evolution, but they differ widely respecting the mode in which it occurred.

THE PROCESS OF GENERATION.

The vital principle, represented in the sperm-cell by a spermatozoön, must be imparted to a germ-cell in order to effect impregnation. After touching each other, separate them immediately, and observe the result. If, with the aid of a powerful lens, we directly examine the spermatozoön, it will be perceived that, for a short time, it preserves its dimensions and retains all its material aspects. But it does not long withstand the siege of decay, and, having fulfilled its destiny, loses its organic characteristics, and begins to shrink.

If we examine the fertilized germ, we discover unusual activity, the result of impregnation. Organic processes succeed one another with wonderful regularity, as if wrought out by inexplicable intelligence. Here begin the functions which constitute human physiology.

Generation requires that a spermatozoön be brought into actual contact with a germ that fecundation may follow. If a spermatic cell, or spermatozoön, together with several unimpregnated ova, no matter how near to one another, if not actually touching, be placed on the concave surface of a watch-crystal, and covered with another crystal, keeping them warm, and even though the vapor of the ova envelops it, no impregnation will occur. Place the spermatozoön in contact with an ovum, and impregnation is instantly and perfectly accomplished. Should this vitalizing power be termed nerve-force, electricity, heat, or motion? It is known that these forces may be metamorphosed; for instance, nervous force may be converted into electricity, electricity into heat, and heat into motion, thus illustrating their affiliation and capability of transformation. But nothing is explained respecting the real nature of the vital principle, if we assert its identity with any of these forces; for who can reveal the true nature of any of these, or even of matter?

ALTERNATE GENERATION.

In several insect families, the species is not wholly represented in the adult individuals of both sexes, or in their development, but, to complete this series, supplementary individuals, as it were, of one or of several preceding generations, are required. The son may not resemble the father, but the grandfather, and in some instances, the likeness re-appears only in latter generations. Agassiz states: "Alternate generation was first observed among the Salpæ. These are marine mollusks, without shells, belonging to the family Tunicata. They are distinguished by the curious peculiarity of being united together in considerable numbers so as to form long chains, which float in the sea, the mouth(m) however being free in each.

Fig. 2.

Fig. 3.

"Fig. 2. The individuals thus joined in floating colonies produce eggs; but in each animal there is generally but one egg formed, which is developed in the body of the parent, and from which is hatched a little mollusk.

"Fig. 3, which remains solitary, and differs in many respects from the parent. This little animal, on the other hand, does not produce eggs, but propagates, by a kind of budding, which gives rise to chains already seen in the body of their parent(a), and these again bring forth solitary individuals, etc."

It therefore follows that generation in some animals require? two different bodies with intermediate ones, by means of which and their different modes of reproduction, a return to the original stock is effected.

Universality of Animalcular Life.—Living organisms are universally diffused over every part of the globe. The gentle zephyr wafts from flower to flower invisible, fructifying atoms, which quicken beauty and fragrance, giving the promise of a golden fruitage, to gladden and nourish a dependent world. Nature's own sweet cunning invests all living things [pg 17]constraining into her service chemical affinities, arranging the elements and disposing them for her own benefit, in such numberless ways that we involuntarily exclaim,

"The course of Nature is the art of God."

The microscope reveals the fact that matter measuring only 1/120000 of an inch diameter may be endowed with vitality, and that countless numbers of animalcules often inhabit a single drop of stagnant water. These monads do not vary in form, whether in motion or at rest. The life of one, even, is an inexplicable mystery to the philosopher. Ehrenberg writes: "Not only in the polar regions is there an uninterrupted development of active microscopic life, where larger animals cannot exist, but we find that those minute beings collected in the Antarctic expedition of Captain James Ross exhibit a remarkable abundance of unknown, and often most beautiful forms."

Even the interior of animal bodies is inhabited by animalcules. They have been found in the blood of the frog and the salmon, and in the optic fluid of fishes. Organic beings are found in the interior of the earth, into which the industry of the miner has made extensive excavations, sunk deep shafts, and thus revealed their forms; likewise, the smallest fossil organisms form subterranean strata many fathoms deep. Not only do lakes and inland seas abound with life, but also, from unknown depths, in volcanic districts, arise thermal springs which contain living insects. Were we endowed with a microscopic eye, we might see myriads of ethereal voyagers wafted by on every breeze, as we now behold drifting clouds of aqueous vapor. While the continents of earth furnishes evidences of the universality of organic beings, recent observations prove that "animal life predominates amid the eternal night of the depths of the liquid ocean."

THE ORIGIN OF LIFE.

The ancients, rude in many of their ideas, referred the origin of life to divine determination. The thought was crudely expressed, but well represented, in the following verse:

"Then God smites his hands together,
And strikes out a soul as a spark,
Into the organized glory of things.
From the deeps of the dark."

[pg 18]According to a Greek myth, Prometheus formed a human image from the dust of the ground, and then, by fire stolen from heaven, animated it with a living soul. Spontaneous generation once held its sway, and now the idea of natural evolution is popular. Some believe that the inpenetrable mystery of life is evolved from the endowments of nature, and build their imperfect theory on observations of her concrete forms and their manifestations, to which all our investigations are restricted. But every function indicates purpose, every organism evinces intelligent design, and all proclaim a Divine Power. Something cannot come out of nothing. With reason and philosophy, chance is an impossibility. We, therefore, accept the display of wisdom in nature as indicative of the designs of God. Thus "has He written His claims for our profoundest admiration and homage all over every object that He has made." If you ask: Is there any advantage in considering the phenomena of nature as the result of DIVINE VOLITION? we answer, that this belief corresponds with the universally acknowledged ideas of accountability; for, with a wise, and efficient Cause, we infer there is an intelligent creation, and the desire to communicate, guide and bless, is responded to by man, who loves, obeys, and enjoys. Nothing is gained by attributing to nature vicegerent forces. Is it not preferable to say that she responds to intelligent, loving Omnipotence? Our finiteness is illustrated by our initiation into organized being. Emerging from a rayless atom, too diminutive for the sight, we gradually develop and advance to the maturity of those conscious powers, the exercise of which furnishes indubitable evidence of our immortality. We are pervaded with invisible influences, which, like the needle of the compass trembling on its pivot, point us to immortality as our ultimate goal, where in the sunny clime of Love, even in a spiritual realm of joy and happiness, we may eternally reign with Him who is all in all.

CHAPTER II.

PHYSIOLOGICAL ANATOMY.

THE BONES.

All living bodies are made up of tissues. There is no part, no organ, however soft and yielding, or hard and resisting, which has not this peculiarity of structure. The bones of animals, as well as their flesh and fat, are composed of tissues, and all alike made up of cells. When viewed under a microscope, each cell is seen to consist of three distinct parts, a nucleolus, or dark spot, in the center of the cell, around which lies a mass of granules, called the nucleus; and this, in turn, is surrounded with a delicate, transparent membrane, termed the envelope. Each of the granules composing the nucleus assimilates nourishment, thereby growing into an independent cell, which possesses a triple organization similar to that of its parent, and in like manner reproduces other cells.

Fig. 4. Nucleated cell. From Goeber. 1. Periphery of the cell, or cell-wall. 2. Nucleus. 3. Nucleolus in the center.

A variety of tissues enters into the composition of an animal structure, yet their differences are not always distinctly marked, since the characteristics of some are not unlike those of others. We shall notice, however, only the more important of the tissues.

The Areolar, or Connective Tissue, is a complete network of delicate fibers, spread over the body, and serves to bind the various organs and parts together. The fibrous and serous tissues are modifications of the areolar.

[pg 20]The Nervous Tissue is of two kinds: The gray, which is pulpy and granulated, and the white fibrous tissue. The Adipose Tissue is an extremely thin membrane, composed of closed cells which contain fat. It is found principally just beneath the skin, giving it a smooth, plump appearance.

Fig. 5. Arrangement of fibers in the Areolar Tissue. Magnified 135 diameters.

The Cartilaginous Tissue consists of nucleated cells, and, with the exception of bone, is the hardest part of the animal frame. The Osseous Tissue, or bone, is more compact and solid than the cartilaginous, for it contains a greater quantity of lime. The Muscular Tissue is composed of bundles of fibers, which are enclosed in a cellular membrane.

Fig. 6. Human Adipose Tissue.

Various opinions have been entertained in regard to the formation, or growth, of bone. Some anatomists have supposed that all bone is formed in cartilage. But this is not true, for there is an intra-membranous, as well as an intra-cartilaginous, formation of bone, as may be seen in the development of the cranial bones, where the gradual calcification takes place upon the inner layers of the fibrous coverings. Intra-cartilaginous deposit is found in the vicinity of the blood-vessels, within the cartilaginous canals; also, there are certain points first observed in the shafts of long bones, called centers of ossification. These points are no sooner formed than the cartilage corpuscles arrange themselves in concentric zones, and, lying in contact with one another, become very compact. As ossification proceeds, the cup-shaped cavities are converted into closed interstices of bone, with extremely thin lamellæ, or layers. These, however, soon increase [pg 21]in density, and no blood-vessels can be observed within them.

Fig. 7. Vertical section of cartilage near the surface of ossification. 1. Ordinary appearance of the temporary cartilage. 1'. Portion of the same more highly magnified. 2. The cells beginning to form into concentric zones. 2'. Portion more magnified. 3. The ossification is extending in the inter-cellular spaces, and the rows of cells are seen resting in the cavities so formed, the nuclei being more separated than above. 3'. Portion of the same more highly magnified.

Fig. 8. Thigh-bone, sawn open lengthwise.

Fig. 9. Lower end of the thigh-bone sawn across, showing its central cavity.

The bony plates form the boundaries of the Haversian, or nutritive canals of the bones. In the second stage of ossification, the cartilage corpuscles are converted into bone. Becoming flattened against the osseous lamellæ already formed, they crowd upon one another so as to entirely obliterate the lines that distinguish them; and, simultaneously with these changes, a calcareous deposit takes place upon their interior. Bones grow by additions to their ends and surfaces. In the child, their extremities are [pg 22]separated from the body of the bone by layer of cartilage, and the cancellated, or cellular structure, which remains for a time in the interior, represents the early condition of the ossifying substances.

The bones contain more earthy matter in their composition than any other part of the human body, being firm, hard, and of a lime color. They compose the skeleton or frame work, and, when united by natural ligaments, form what is known as the natural skeleton; when they are wired together, they are called an artificial skeleton. The number of bones in the human body is variously estimated; for those regarded as single by some anatomists are considered by others to consist of several distinct pieces. There are two hundred distinct bones in the human skeleton besides the teeth. These may be divided into those of the Head, Trunk, Upper Extremities, and Lower Extremities.

Fig. 10. The bones of the skull separated. 1. Frontal, only half is seen. 2. Parietal. 3. Occipital, only half is seen. 4. Temporal. 5. Nasal. 6. Malar. 7. Superior maxillary (upper jaw). 8. Lachrymal. 9. Inferior maxillary (lower jaw). Between 4 and 6 a part of the sphenoid or wedge-shaped bone, is seen. Another bone assisting to form the skull, but not here seen, is called the ethmoid (sieve-like, from being full of holes), and is situated between the sockets of the eyes, forming the roof of the nose.

The Bones of the Head are classed as follows: eight belonging to the Cranium, and fourteen to the Face. The bones of the Cranium are the occipital, two parietal, two temporal, frontal, sphenoid, and ethmoid. Those composing the face are, the two nasal, two superior maxillary, two lachrymal, two malar two palate, two inferior turbinated, vomer, and inferior maxillary. The cranial bones are composed of two dense plates, between which there is, in most places a cancellated or cellular tissue. The external [pg 23]plate is fibrous, the internal, compact and vitreous. The skull is nearly oval in form, convex externally, the bone being much thicker at the base than elsewhere, and it is, in every respect admirably adapted to resist any injury to which it may be exposed, thus affording ample protection to the brain substance which it envelops. The internal surface of the cranium presents eminences and depressions for lodging the convolutions of the brain, and numerous furrows for the ramifications of the blood-vessels. The bones of the cranium are united to one another by ragged edges called sutures, which are quite distinct in the child but which in old age are nearly effaced. Some authorities suppose that by this arrangement the cranium is less liable to be fractured by blows; others think that the sutures allow the growth of these bones, which takes place by a gradual osseous enlargement at the margins. The bones of the Face are joined at the lower part and in front of the cranium, and serve for the attachment of powerful muscles which assist in the process of mastication. Although the soft parts of the face cover the bony structure, yet they do not conceal its principal features, or materially change its proportions. The form of the head and face presents some remarkable dissimilarities in different races.

Fig. 11. 1. The first bone of the sternum (breast-bone). 2. The second bone of the sternum. 3. The cartilage of the sternum. 4. The first dorsal vertebra (a bone of the spinal column). 5. The last dorsal vertebra. 6. The first rib. 7. Its head. 8. Its neck. 9. Its tubercle. 10. The seventh or last true rib. 11. The cartilage of the third rib. 12. The floating ribs.

Fig. 12. A vertebra of the neck. 1. The body of the vertebra. 2. The spinal canal. 4. The spinous process cleft at its extremity. 5. The transverse process. 7. The interior articular process. 8. The superior articular process.

The Trunk has fifty-four bones, which are as follows: The Os Hyoides, the Sternum, twenty-four Ribs, twenty-four vertebræ or bones of the Spinal Column, the Sacrum, the Coccyx, and two Ossa Innominata. The Os Hyoides, situated at the base of the tongue, is the most isolated bone of the skeleton, and serves for the attachment of [pg 24]muscles. The Sternum, or breast-bone, in a child is composed of six pieces, in the adult of three, which in old age are consolidated into one bone. The Ribs are thin, curved bones, being convex externally. There are twelve on each side, and all are attached to the spinal column. The seven upper ribs, which are united in front of the sternum, are termed true ribs; the next three, which are not attached to the sternum, but to one another are called false ribs; and the last two, which are joined only to the vertebræ, are designated as floating ribs. The first rib is the shortest, and they increase in length as far as the eighth, after which this order is reversed.

Fig. 13. 1. The cartilaginous substance which connects the bodies of the vertebræ. 2. The body of the vertebra. 3. The spinous process. 4,4. The transverse processes. 5,5. The articular processes. 6,6. A portion of the bony bridge which assists in forming the spinal canal (7).

Fig. 14. Backbone, spinal column, or vertebral column. All animals possessing such a row of bones are called vertebrates. Above b are the cervical (neck) vertebræ; b to c, dorsal (back) or chest vertebræ; c to d, lumbar (loins) vertebræ; d to e, sacrum; e to f, coccyx.

The Spinal Column or backbone, when viewed from the front presents a perpendicular appearance, but a side view shows four distinct curves. The bones composing it are called vertebræ. The body part of a vertebra is light and spongy in texture, having seven projections called processes, four of which are the articular processes, which furnish surfaces to join the different vertebræ of the spinal column. Two are called transverse, and the remaining one is termed the spinous. The transverse [pg 25]and spinous processes serve for the attachment of the muscles belonging to the back. All these processes are more compact than the body of the vertebra, and, when naturally connected, are so arranged as to form a tube which contains the medulla spinalis, or spinal cord. Between the vertebræ is a highly-elastic, cartilaginous and cushion-like substance, which freely admits of motion, and allows the spine to bend as occasion requires. The natural curvatures of the spinal column diminish the shock produced by falling, running or leaping, which would otherwise be more directly transmitted to the brain. The ribs at the sides, the sternum in front, and the twelve dorsal bones of the spinal column behind, bound the thoracic cavity, which contains the lungs, heart, and large blood-vessels.

Fig. 15. A representation of the pelvic bones. e. The lumbo-sacral joint. 2. The sacrum. 3. Coccyx. 1, 1. The innominata. 4,4. Acetabula.

The Pelvis is an open bony structure, consisting of the Os Innominata, one on either side, and the Sacrum and Coccyx behind. The Sacrum, during childhood, consists of five bones, which in later years unite to form one bone. It is light and spongy in texture, and the upper surface articulates with the lowest vertebra, while it is united at its inferior margin to the coccyx. The Coccyx is the terminal bone of the spinal column. In infancy it is cartilaginous and composed of several pieces, but in the adult these unite and form one bone. The Innominata, or nameless bones, during youth, consist of three separate pieces on each side; but as age advances they coalesce and form one bone. A deep socket, called the acetabulum, is found near their junction, which serves for the reception of the head of the thigh-bone.

Fig. 16. 1. Portions of the backbone. 2. Cranial bones. 4. Breast-bone. 5. Ribs. 7. Collar-bone. 8. Arm-bone (humerus). 9. Shoulder-joint. 10, 11. Bones of the fore-arm (ulna and radius). 12. Elbow-joint. 13. Wrist-joint. 14. Bones of the hand. 15, 16. Pelvic bones. 17. Hip-joint. 18. Femur. 19, 20. Bones of the knee-joint. 21, 22. Fibula and tibia. 23. Ankle bone. 24. Bones of the foot.

The Bones of the Upper Extremities are sixty-four in number, and are classified as follows: The Scapula, [pg 26]Clavicle, Humerus, Ulna, Radius, Carpus, Metacarpus, and Phalanges. The Scapula, or shoulder-blade, is an irregular, thin, triangular bone, situated at the posterior part of the shoulder, and attached to the upper and back part of the chest. The Clavicle, or collar-bone, is located at the upper part of the chest, between the sternum and scapula, and connects with both. Its form resembles that of the italic letter f, and it prevents the arms from sliding forward. The Humerus, the first bone of the arm, is long, cylindrical, and situated between the scapula and fore-arm. The Ulna is nearly parallel with the radius, and situated on the inner side of the fore-arm. It is the longer and larger of the two bones, and in its articulation with the humerus, forms a perfect hinge-joint. The Radius, so called from its resemblance to a spoke, is on the outer side of the fore-arm, and articulates with the bones of the wrist, forming a joint. The ulna and radius also articulate with each other at their extremities. The Carpus, or wrist, consists of eight bones, arranged in two rows. The Metacarpus, or palm of the hand, is composed of five bones [pg 27]situated between the carpus and fingers. The Phalanges, fourteen in number, are the bones of the fingers and thumb, the fingers each having three and the thumb two.

The Bones of the Lower Extremities, sixty in number, are classed as follows: The Femur, Patella, Tibia, Fibula, Tarsus, Metatarsus, and Phalanges. The Femur, or thigh-bone, is the longest bone in the body. It has a large round head, which is received into the acetabulum, thus affording a good illustration of a ball and socket joint. The Patella, or knee-pan, is the most complicated articulation of the body. It is of a round form, connects with the tibia by means of a strong ligament, and serves to protect the front of the joint, and to increase the leverage of the muscles attached to it, by causing them to act at a greater angle. The Tibia, or shin bone, is enlarged at each extremity and articulates with the femur above and the astragalus, the upper bone of the tarsus, below. The Fibula, the small bone of the leg, is situated on the outer side of the tibia, and is firmly bound to it at each extremity. The Tarsus, or instep, is composed of seven bones, and corresponds to the carpus of the upper extremities. The Metatarsus, the middle of the foot, bears a dose resemblance to the metacarpus, and consists of five bones situated between the tarsus and the phalanges. The tarsal and the metatarsal bones are so united as to give an arched appearance to the foot, thus imparting elasticity. The Phalanges, the toes, consist of fourteen bones, arranged in a manner similar to that of the fingers.

We are not less interested in tracing the formation of bone through its several stages, than in considering other parts of the human system. The formation of the Haversian canals for the passage of blood-vessels to nourish the bones, the earlier construction of bony tissue by a metamorphosis of cartilaginous substance, and also the commencement of ossification at distinct points, called centers of ossification, are all important subjects, requiring the student's careful attention. The bones are protected by an external membranous envelope, which, from its situation is called the periosteum. The bones are divided into four classes, long, short, flat and irregular, being thus adapted to subserve a variety of purposes.

The Long Bones are found in the limbs, where they act as [pg 28]levers to sustain the body and aid in locomotion. Eachlong bone is composed of a cylinder, known as the shaft, and two extremities. The shaft is hollow, its wails being thickest in the middle and growing thinner toward the extremities. The extremities are usually considerably enlarged, for convenience of connection with other bones, and to afford a broad surface for the attachment of muscles. The clavical, humerus, radius, ulna, femur, tibia, fibula, the bones of the metacarpus, metatarsus and the phalanges, are classed as long bones.

Where the principal object to be attained is strength, and the motion of the skeleton is limited, the individual bones are short and compressed, as the bones of the carpus and tarsus. The structure of these bones is spongy, except at the surface, where there is a thin crust of compact matter.

Fig. 17. Anatomy of a joint, 1, 1. Bones of a joint. 2, 2. Cartilage. 3, 3, 3, 3. Synovial membrane.

Fig. 18. Anatomy of knee joint. 1. Lower end of thigh-bone. 3. Knee-pan. 2, 4 Ligaments of the knee-pan. 5. Upper end of the tibia, or shin-bone. 6, 12. Cartilages.

When protection is required for the organs of the body, or a broad flat surface for the attachment of the muscles, the bones are expanded into plates, as in the cranium and shoulder-blades.

The irregular or mixed bones are those which, from their peculiar shape, cannot be classed among any of the foregoing divisions. Their structure is similar to the others, consisting of cancellar tissue, surrounded by a crust of compact matter.

The vertebræ, sacrum, coccyx, temporal, sphenoid, ethmoid, malar, two maxillary, palate, inferior turbinated, and hyoid are known as irregular bones.

The formation of the joints requires not only bones, but also [pg 29]cartilages, ligaments, and the synovial membrane, to complete the articulation. Cartilage is a smooth, elastic substance, softer than bone, and invested with a thin membrane, called perichondrium. When cartilage is placed upon convex surfaces, the reverse is true. The Ligaments are white, inelastic, tendinous substances, softer than cartilage, but harder than membrane. Their function is to bind together the bones. The Synovial Membrane covers the cartilages, and is then reflected upon the ligaments, thus forming a thin, closed sac, called the synovial capsule.

All the synovial membranes secrete a lubricating fluid, termed synovia, which enables the surfaces of the bones and ligaments to move freely upon one another. When this fluid is secreted in excessive quantities, it produces a disease known as "dropsy of the joints." There are numerous smaller sacs besides the synovial, called bursæ mucosæ, which in structure are analogous to them, and secrete a similar fluid. Some joints permit motion in every direction, as the shoulders, some in two directions only, as the elbows, while others do not admit of any movement. The bones, ligaments, cartilages, and synovial membrane, are supplied with nerves, arteries, and veins.

When an animal is provided with an internal bony structure, it indicates a high rank in the scale of organization. An elaborate texture of bone is found in no class below the vertebrates. Even in the lower order of this sub-kingdom, which is the highest of animals, bone does not exist, as is the case in some tribes of fishes, such as sharks, etc., and in all classes below that of the cartilaginous fishes, the inflexible substance which sustains the soft parts is either shell or some modification of bone, and is usually found on the outside of the body. True bone, on the contrary, is found in the interior, and, therefore, in higher animals, the skeleton is always internal, while the soft parts are placed external to the bony frame. While many animals of the lowest species, being composed of soft gelatinous matter, are buoyant in water, the highest type of animals requires not only a bony skeleton, but also a flexible, muscular system, for locomotion in the water or upon the land. Each species of the animal kingdom is thus organically adapted to its condition and sphere of life.

CHAPTER III.

PHYSIOLOGICAL ANATOMY.

THE MUSCLES.

Fig. 19. Muscular fillers highly magnified.

The Muscles are those organs of the body by which motion is produced, and are commonly known as flesh. A muscle is composed of fascieuli, or bundles of fibers, parallel to one another. They are soft, varying in size, of a reddish color, and inclosed in a cellular, membranous sheath. Each fasciculus contains a number of small fibers, which, when subjected to a microscopic examination, are found to consist of fibrillæ, or little fibers; each of these fibrillæ in turn being invested with a delicate sheath. The fibers terminate in a glistening, white tendon, or hard cord, which is attached to the bone. So firmly are they united, that the bone will break before the tendon can be released. When the tendon is spread out, so as to resemble a membrane, it is called fascia. Being of various extent and thickness, it is distributed over the body, as a covering and protection for the more delicate parts, and aids also in motion, by firmly uniting the muscular fibers. The spaces between the muscles are frequently filled with fat, which gives roundness and beauty to the limbs. The muscles are of various forms; some are longitudinal, each extremity terminating in a tendon, which gives them a fusiform or spindle-shaped appearance; others are either fan-shaped, flat, or cylindrical.

Fig. 20. 1. A spindle-shaped muscle, with tendinous terminations. 2. Fan-shaped muscle. 3. Penniform muscle. 4. Bipenniform muscle.

Fig. 21. Striped muscular fibre showing cleavage in opposite directions. 1. Longitudinal cleavage. 2. Transverse cleavage. 3. Transverse section of disc. 4. Disc nearly detached. 5. Detached disc, showing the sarcous elements. 6. Fibrillæ. 7, 8. Separated fibrillæ highly magnified.

Every muscle has an origin and an insertion. The term origin is applied to the more fixed or central attachment of a muscle, and the term insertion to the movable point to which the force of the muscle is directed; but the origin is not absolutely fixed, except in a small number of muscles, as those of the face, which are attached at one extremity to the bone, and at the other to the movable integument, or skin. In most instances, the muscles may act from either extremity. The muscles are divided into the Voluntary, or muscles of animal life, and the Involuntary, or muscles of organic life. There are, however, some muscles which cannot properly be classified with either, termed Intermediate. The Voluntary Muscles are chiefly controlled by the will, relaxing and contracting at its pleasure, as in the motion of the eyes, mouth, and limbs. The fibers are of a dark red color, and possess great strength. These fibers are parallel, seldom interlacing, but presenting a striped or striated appearance; and a microscopic examination of them shows that even the most minute consist of parallel filaments marked by longitudinal and transverse striæ, or minute channels. The fibers are nearly the same length as the muscles to which they belong. Each muscular fiber is capable of [pg 32]contraction; it may act singly, though usually it acts in unison with others. By a close inspection, it has been found that fibers may be drawn apart longitudinally, in which case they are termed fibrillæ, or they may be separated transversely, forming a series of discs. The Sarcolemma, or investing sheath of the muscles, appears to be formed even before there are any visible traces of the muscle itself. It is a transparent and delicate membrane, but very elastic. The Involuntary Muscles are influenced by the sympathetic nervous system, and their action pertains to the nutritive functions of the body. They differ from the voluntary muscles in not being striated, having no tendons, and in the net-work arrangements of their fibers. The Intermediate Muscles are composed of striated and unstriated fibers; they are, therefore, both voluntary and involuntary in their functions. The muscles employed in respiration are of this class, for we can breathe rapidly or slowly, and, for a short time, even suspend their action; but soon, however, the organic muscles assert their instinctive control, and respiration is resumed.

Fig. 22. Unstriated muscular fiber; at b, in its natural state; at a, showing the nuclei after the action of acetic acid.

Fig. 23. A view of the under side of the diaphragm.

The Diaphragm, or midriff, is the muscular division between the thorax and the abdomen. It has been compared to an inverted basin, the concavity of which is [pg 33][pg 34]directed toward the abdomen. The muscles receive their nourishment from the numerous blood-vessels which penetrate their tissues. The voluntary muscles are abundantly supplied with nerves, while the involuntary are not so numerously furnished. The color of the muscles is chiefly due to the blood which they contain. They vary in size according to their respective functions. For example, the functions of the heart require large and powerful muscles, and those of the eye, small and delicate ones. There are between four hundred and sixty and five hundred muscles in the human body.

Fig. 24. A representation of the superficial layer of muscles on the anterior portion of the body.

Fig. 25. A representation of the superficial layer of muscles on the posterior portion of the body.

Very rarely is motion produced by the action of a single muscle, but by the harmonious action of several. There is infinite variety in the arrangement of the muscles, each being adapted to its purpose, in strength, tenacity, or elasticity. While some involuntarily respond to the wants of organic life, others obey, with mechanical precision, the edicts of the will. The peculiar characteristic of the muscles is their contractility; for example, when the tip of the finger is placed in the ear, an incessant vibration, due to the contraction of the muscles of the ear, can be heard. When the muscles contract, they become shorter; but what is lost in length is gained in breadth and thickness, so that their actual volume remains the same. Muscles alternately contract and relax, and thus act upon the bones. The economy of muscular power thus displayed is truly remarkable. In easy and graceful walking, the forward motion of the limbs is not altogether due to the exercise of muscular power, but partly to the force of gravity, and only a slight assistance of the muscles is required to elevate the leg sufficiently to allow it to oscillate.

Motion is a characteristic of living bodies. This is true, not only in animals, but also in plants. The oyster, although not possessing the power of locomotion, opens and closes its shell at pleasure. The coral insect appears at the door of its cell, and retreats at will. All the varied motions of animals are due to a peculiar property of the muscles, termed contractility. Although plants are influenced by external agents, as light, heat, electricity, etc., yet it is supposed that they may move in response to inward impulses. The sensitive stamens of the barberry, when touched at their base on the inner side, resent the intrusion, by making a sudden jerk forward. Venus's [pg 35][pg 36]fly-trap, a plant found in North Carolina, is remarkable for the sensitiveness of its leaves; which close suddenly and capture insects which chance to alight upon them. The muscles of the articulates are situated within the solid framework, unlike the vertebrates, whose muscles are external to the bony skeleton. All animals have the power of motion, from the lowest radiate to the highest vertebrate, from the most repulsive polyp to that type of organized life made in the very image of God.

The muscles, then, subserve an endless variety of purposes. By their aid the farmer employs his implements of husbandry, the mechanic deftly wields his tools, the artist plies his brush, while the fervid orator gives utterance to thoughts glowing with heavenly emotions. It is by their agency that the sublimest spiritual conceptions can be brought to the sphere of the senses, and the noblest, loftiest aims of to-day can be made glorious realizations of the future.

CHAPTER IV.

PHYSIOLOGICAL ANATOMY.

THE DIGESTIVE ORGANS.

Digestion signifies the act of separating or distributing, hence its application to the process by which food is made available for nutritive purposes. The organs of digestion are the Mouth, Teeth, Tongue, Salivary Glands, Pharynx, Esophagus, the Stomach and the Intestines, with their glands, the Liver, Pancreas, Lacteals, and the Thoracic Duct.

Fig. 26. A view of the lower jaw. 1. The body. 2, 2. Rami, or branches. 3, 3. Processes of the lower jaw. m. Molar teeth. b. Bicuspids, c. Cuspids. i. Incisors.

The Mouth is an irregular cavity, situated between the upper and the lower jaw, and contains the organs of mastication. It is bounded by the lips in front, by the cheeks at the sides, by the roof of the mouth and teeth of the upper jaw above, and behind and beneath by the teeth of the lower jaw, soft parts, and palate. The soft palate is a sort of pendulum attached only at one of its extremities, while the other involuntarily opens and closes the passage from the mouth to the pharynx. The interior of the mouth, as well as other portions of the alimentary canal, is lined with a delicate tissue, called mucous membrane.

The Teeth are firmly inserted in the alveoli or sockets, of the upper and the lower jaw. The first set, twenty in number, are temporary, and appear during infancy. They are replaced [pg 38]by permanent teeth, of which there are sixteen in each jaw; four incisors, or front teeth, four cuspids, or eye teeth, four bicuspids, or grinders, and four molars, or large grinders. Each tooth is divided into the crown, body, and root. The crown is the grinding surface; the body, the part projecting from the jaw, is the seat of sensation and nutrition; the root is that portion of the tooth which is inserted in the alveolus. The teeth are composed of dentine, or ivory, and enamel. The ivory forms the greater portion of the body and root, while the enamel covers the exposed surface. The small white cords communicating with the teeth are the nerves.

The Tongue is a flat oval organ, the base of which is attached to the os hyoides, while the apex, the most sensitive part of the body, is free. Its surface is covered with a membrane, which, at the sides and lower part, is continuous with the lining of the mouth. On the lower surface of the tongue, this membrane is thin and smooth, but on the upper side it is covered with numerous papillæ, which, in structure, are similar to the sensitive papillæ of the skin.

Fig. 27. The salivary glands. The largest one, near the ear, is the parotid gland. The next below it is the submaxillary gland. The one under the tongue is the sublingual gland.

The Salivary Glands are six in number, three on each side of the mouth. Their function is to secrete a fluid called saliva, which aids in mastication. The largest of these glands, the Parotid, is situated in front and below the ear; its structure, like that of all the salivary glands, is cellular. The Submaxillary gland is circular in form, and situated midway between the [pg 39]angle of the lower jaw and the middle of the chin. The Sublingual is a long flattened gland, and, as its name indicates, is located below the tongue, which when elevated, discloses the saliva issuing from its porous openings.

The Pharynx is nearly four inches in length, formed of muscular and membranous cells, and situated between the base of the cranium and the esophagus, in front of the spinal column. It is narrow at the upper part, distended in the middle, contracting again at its junction with the esophagus. The pharynx communicates with the nose, mouth, larynx, and esophagus.

The Esophagus, a cylindrical organ, is a continuation of the pharynx, and extends through the diaphragm to the stomach. It has three coats: first, the muscular, consisting of an exterior layer of fibers running longitudinally, and an interior layer of transverse fibers; second, the cellular, which is interposed between the muscular and the mucous coat; third, the mucous membrane, or internal coat, which is continuous with the mucous lining of the pharynx.

Fig. 28. A representation of the interior of the stomach. 1. The esophagus. 2. Cardiac orifice opening into the stomach. 6. The middle or muscular coat. 7. The interior or mucous coat. 10. The beginning of the duodenum. 11. The pyloric orifice.

The Stomach is a musculo-membranous, conoidal sac, communicating with the esophagus by means of the cardiac orifice (see Fig. 28). It is situated obliquely with reference to the body, its base lying at the left side, while the apex is directed toward the right side. The stomach is between the liver and spleen, subjacent to the diaphragm, and communicates with the intestinal canal by the pyloric orifice. It has three coats. The peritoneal, or external coat is composed of compact, cellular tissue, woven into a thin, serous membrane, and assists in keeping the stomach in place. The middle coat is formed of three layers of muscular fibers: in the first, the fibres run [pg 40]longitudinally; in the second, in a circular direction; and in the third, they are placed obliquely to the others. The interior, or mucous coat, lines this organ. The stomach has a soft, spongy appearance, and, when not distended, lies in folds. During life, it is ordinarily of a pinkish color. It is provided with numerous small glands, which secrete the gastric fluid necessary for the digestion of food. The lining membrane, when divested of mucus, has a wrinkled appearance. The arteries, veins, and lymphatics, of the stomach are numerous.

Fig. 29. Small and large intestines. 1, 1, 2, 2. Small intestine. 3. Its termination in the large intestine. 4. Appendix vermiformis. 5. Cæcum. 6. Ascending colon. 7. Transverse colon. 8. Descending colon. 9. Sigmoid flexure of colon. 10. Rectum.

The Intestines are those convoluted portions of the alimentary canal into which the food is received after being partially digested, and in which the separation and absorption of the nutritive materials and the removal of the residue take place. The coats of the intestines are analogous to those of the stomach, and are, in fact, only extensions of them. For convenience of description, the intestines may be divided into the small and the large. The small intestine is from twenty to twenty-five feet in length, and consists of the Duodenum, Jejunum, and Ileum. The Duodenum, so called because its length is equal to the breadth of twelve fingers, is the first division of the small intestine. If the mucous membrane of the duodenum be examined, it will be found thrown into numerous folds, which are called valvulæ conniventes, the chief function of which appears to be to retard the course of the alimentary matter, and afford a larger surface for the accommodation of the absorbent vessels. Numerous villi, minute thread-like projections, will be [pg 41]found scattered over the surface of these folds, set side by side, like the pile of velvet. Each villus contains a net-work of blood-vessels, and a lacteal tube, into which the ducts from the liver and pancreas open, and pour their secretions to assist in the conversion of the chyme into chyle. The Jejunum, so named because it is usually found empty after death, is a continuation of the duodenum, and is that portion of the alimentary canal in which the absorption of nutritive matter is chiefly effected. The Ileum, which signifies something rolled up, is the longest division of the small intestine. Although somewhat thinner in texture than the jejunum, yet the difference is scarcely perceptible. The large intestine is about five feet in length, and is divided into the Cæcum, Colon, and Rectum. The Cæcum is about three inches in length. Between the large and the small intestine is a valve, which prevents the return of excrementitious matter that has passed into the large intestine. There is attached to the cæcum an appendage about the size of a goose-quill, and three inches in length, termed the appendix vermiformis. The Colon is that part of the large intestine which extends from the cæcum to the rectum, and which is divided into three parts, distinguished as the ascending, the transverse, and the descending.

Fig. 30. Villi of the small intestine greatly magnified.

Fig. 31. A section of the Ileum, turned inside out, so as to show the appearance and arrangement of the villi on an extended surface.

[pg 42]The Rectum is the terminus of the large intestine. The intestines are abundantly supplied with blood-vessels. The arteries of the small intestine are from fifteen to twenty in number. The large intestine is furnished with three arteries, called the colic arteries. The ileo-colic artery sends branches to the lower part of the ileum, the head of the colon, and the appendix vermiformis. The right colic artery forms arches, from which branches are distributed to the ascending colon. The colica media separates into two branches, one of which is sent to the right portion of the transverse colon, the other to the left. In its course, the superior hemorrhoidal artery divides into two branches, which enter the intestine from behind, and embrace it on all sides, almost to the anus.

The Thoracic Duct is the principal trunk of the absorbent system, and the canal through which much of the chyle and lymph is conveyed to the blood. It begins by a convergence and union of the lymphatics on the lumbar vertebræ, in front of the spinal column, then passes upward through the diaphragm to the lower part of the neck, thence curves forward and downward, opening into the subclavian vein near its junction with the left jugular vein, which leads to the heart.

Fig. 32. c, c. Right and left subclavian veins. b. Inferior vena cava. a. Intestines. d. Entrance of the thoracic duct into the left subclavian vein. 4. Mesenteric glands, through which the lacteals pass to the thoracic duct.

Fig. 33. The inferior surface of the liver. 1. Right lobe. 2. Left lobe. 3. Gall-bladder.

The Liver, which is the largest gland in the body, weighs [pg 43]about four pounds in the adult, and is located chiefly on the right side, immediately below the diaphragm. It is a single organ, of a dark red color, its upper surface being convex, while the lower is concave. It has two large lobes, the right being nearly four times as large as the left. The liver has two coats, the serous, which is a complete investment, with the exception of the diaphragmatic border, and the depression for the gall-bladder, and which helps to suspend and retain the organ in position; and the fibrous, which is the inner coat of the liver, and forms sheaths for the blood-vessels and excretory ducts. The liver is abundantly supplied with arteries, veins, nerves, and lymphatics. Unlike the other glands of the human body, it receives two kinds of blood; the arterial for its nourishment, and the venous, from which it secretes the bile. In the lower surface of the liver is lodged the gall-bladder, a membranous sac, or reservoir, for the bile. This fluid is not absolutely necessary to the digestion of food, since this process is effected by other secretions, nor does bile exert any special action upon, starchy or oleaginous substances, when mixed with them at a temperature of 100° F. Experiments also show that in some animals there is a constant flow of bile, even when no food has been taken, and there is consequently no digestion to be performed. Since the bile is formed from the venous blood, and taken from the waste and disintegration of animal tissue, it would appear that it is chiefly an excrementitious fluid. It does not seem to have accomplished its function when discharged from the liver and poured into the intestine, for there it undergoes various alterations previous to re-absorption, produced by its contact with the intestinal juices. Thus the bile, after being [pg 44]transformed in the intestines, re-enters the blood under a new form, and is carried to some other part of the system to perform its mission.

The Spleen is oval, smooth, convex on its external, and irregularly concave on its internal, surface. It is situated on the left side, in contact with the diaphragm and stomach. It is of a dark red color, slightly tinged with blue at its edges. Some physiologists affirm that no organ receives a greater quantity of blood, according to its size, than the spleen. The structure of the spleen and that of the mesenteric glands are similar, although the former is provided with a scanty supply of lymphatic vessels, and the chyle does not pass through it, as through the mesenteric glands. The Pancreas lies behind the stomach, and extends transversely across the spinal column to the right of the spleen. It is of a pale, pinkish color, and its secretion is analogous to that of the salivary glands; hence it has been called the Abdominal Salivary Gland.

Fig. 34. Digestive organs. 3. The tongue. 7. Parotid gland. 8. Sublingual gland. 5. Esophagus. 9. Stomach. 10. Liver. 11. Gall-bladder, 14. Pancreas. 13, 13. The duodenum. The small and large intestines are represented below the stomach.

Digestion is effected in those cavities which we have described [pg 45]as parts of the alimentary canal. The food is first received into the mouth, where it is masticated by the teeth, and, after being mixed with mucus and saliva, is reduced to a mere pulp; it is then collected by the tongue, which, aided by the voluntary muscles of the throat, carries the food backward into the pharynx, and, by the action of the involuntary muscles of the pharynx and esophagus, is conveyed to the stomach. Here the food is subjected to a peculiar, churning movement, by the alternate relaxation and contraction of the fibers which compose the muscular wall of the stomach. As soon as the food comes in contact with the stomach, its pinkish color changes to a bright red; and from the numerous tubes upon its inner surface is discharged a colorless fluid, called the gastric juice, which mingles with the food and dissolves it. When the food is reduced to a liquid condition, it accumulates in the pyloric portion of the stomach. Some distinguished physiologists believe that the food is kept in a gentle, unceasing, but peculiar motion, called peristaltic, since the stomach contracts in successive circles. In the stomach the food is arranged in a methodical manner. The undigested portion is detained in the upper, or cardiac extremity, near the entrance of the esophagus, by contraction of the circular fibers of the muscular coat. Here it is gradually dissolved, and then carried into the pyloric portion of the stomach. From this, then, it appears, that the dissolved and undissolved portions of food occupy different parts of the stomach. After the food has been dissolved by the gastric fluid, it is converted into a homogeneous, semi-fluid mass, called chyme. This substance passes from the stomach through the pyloric orifice into the duodenum, in which, by mixing with the bile and pancreatic fluid, its chemical properties are again modified, and it is then termed chyle, which has been found to be composed of three distinct parts, a reddish-brown sediment at the bottom, a whey-colored fluid in the middle, and a creamy film at the top. Chyle is different from chyme in two respects: First, the alkali of the digestive fluids, poured into the duodenum, or upper part of the small intestine, neutralizes the acid of the chyme; secondly, both the bile and the pancreatic fluid seem to exert an influence over the fatty substances contained in the chyme, which assists the subdivision of these [pg 46]fats into minute particles. While the chyle is propelled along the small intestine by the peristaltic action, the matter which it contains in solution is absorbed in the usual manner into the vessels of the villi by the process called osmosis. The fatty matters being subdivided into very minute particles, but not dissolved, and consequently incapable of being thus absorbed by osmosis, pass bodily through the epithelial lining of the intestine into the commencement of the lacteal tubes in the villi. The digested substances, as they are thrust along the small intestines, gradually lose their albuminoid, fatty, and soluble starchy and saccharine matters, and pass through the ileo-cæcal valve into the cæcum and large intestine. An acid reaction takes place here, and they acquire the usual fæcal smell and color, which increases as they approach the rectum. Some physiologists have supposed that a second digestion takes place in the upper portion of the large intestine. The lacteals, filled with chyle, pass into the mesenteric glands with which they freely unite, and afterward enter the receptaculum chyli, which is the commencement of the thoracic duct, a tube of the size of a goose-quill, which lies in front of the backbone. The lymphatics, the function of which is to secrete and elaborate lymph, also terminate in the receptaculum chyli, or receptacle for the chyle. From this reservoir the chyle and lymph flow into the thoracic duct, through which they are conveyed to the left subclavian vein, there to be mingled with venous blood. The blood, chyle, and lymph, are then transmitted directly to the lungs.

The process of nutrition aids in the development and growth of the body; hence it has been aptly designated a "perpetual reproduction." It is the process by which every part of the body assimilates portions of the blood distributed to it. In return, the tissues yield a portion of the material which was once a component part of their organization. The body is constantly undergoing waste as well as repair. One of the most interesting facts in regard to the process of nutrition in animals and plants is, that all tissues originate in cells. In the higher types of animals, the blood is the source from which the cells derive their constituents. Although the alimentary canal is more or less complicated in different [pg 47]classes of animals, yet there is no species, however low in the scale of organization, which does not possess it in some form.^[2] The little polyp has only one digestive cavity, which is a pouch in the interior of the body. In some animals circulation is not distinct from digestion, in others respiration and digestion are performed by the same organs; but as we rise in the scale of animal life, digestion and circulation are accomplished in separate cavities, and the functions of nutrition become more complex and distinct.

CHAPTER V.

PHYSIOLOGICAL ANATOMY.

ABSORPTION.

Fig. 35. Villi of the small intestine greatly magnified.

Absorption is the vital function by which nutritive materials are selected and imbibed for the sustenance of the body. Absorption, like all other functional processes, employs agents to effect its purposes, and the villi of the small intestine, with their numberless projecting organs, are specially employed to imbibe fluid substances; this they do with a celerity commensurate to the importance and extent of their duties. They are little vascular prominences of the mucous membrane, arising from the interior surface of the small intestine. Each villus has two sets of vessels. (1.) The blood-vessels, which, by their frequent blending, form a complete net-work beneath the external epithelium; they unite at the base of the villus, forming a minute vein, which is one of the sources of the portal vein. (2.) In the center of the villus is another vessel, with thinner and more transparent walls, which is the commencement of a lacteal.

The Lacteals originate in the walls of the alimentary canal, [pg 49]are very numerous in the small intestine, and, passing between the laminæ of the mesentery, they terminate in the receptaculum chyli, or reservoir for the chyle. The mesentery consists of a double layer of cellular and adipose tissue. It incloses the blood-vessels, lacteals, and nerves of the small intestine, together with its accessory glands. It is joined to the posterior abdominal wall by a narrow root; anteriorly, it is attached to the whole length of the small intestine. The lacteals are known as the absorbents of the intestinal walls, and after digestion is accomplished, are found to contain a white, milky fluid, called chyle. The chyle does not represent the entire product of digestion, but only the fatty substances suspended in a serous fluid.

Formerly, it was supposed that the lacteals were the only agents employed in absorption, but more recent investigations have shown that the blood-vessels participate equally in the process, and are frequently the more active and important of the two. Experiments upon living animals have proved that absorption of poisonous substances occurs, even when all communication by way of the lacteals and lymphatics is obstructed, the passage by the blood-vessels alone remaining. The absorbent power which the blood-vessels of the alimentary canal possess, is not limited to alimentary substances, but through them, soluble matters of almost every description are received into the circulation.

The Lymphatics are not less important organs in the process of absorption. Nearly every part of the body is permeated by a second series of capillaries, closely interlaced with the blood-vessels, collectively termed the Lymphatic System. Their origin is not known, but they appear to form a plexus in the tissues, from which their converging trunks arise. They are composed of minute tubes of delicate membrane, and from their net-work arrangement they successively unite and finally terminate in two main trunks, called the great lymphatic veins. The lymphatics, instead of commencing on the intestinal walls, as do the lacteals, are distributed through most of the vascular tissues as well as the skin. The lymphatic circulation is not unlike that of the blood; its circulatory apparatus is, however, more delicate, and its functions are not so well understood.

Fig. 36. A general view of the Lymphatic System.

[pg 51]The lymph which circulates through the lymphatic vessels is an alkaline fluid composed of a plasma and corpuscles. It may be considered as blood deprived of its red corpuscles and, diluted with water. Nothing very definite is known respecting the functions of this fluid. A large proportion of its constituents is derived from the blood, and the exact connection of these substances to nutrition is not properly understood. Some excrementitious matters are supposed to be taken from the tissues by the lymph and discharged into the blood, to be ultimately removed from the system. The lymph accordingly exerts an important function by removing a portion of the decayed tissues from the body.

Fig. 37. 1. A representation of a lymphatic vessel highly magnified. 2. Lymphatic valves. 3. A lymphatic gland and its vessels.

In all animals which possess a lacteal system there is also a lymphatic system, the one being the complement of the other. The fact that lymph and chyle are both conveyed into the general current of circulation, leads to the inference that the lymph, as well as the chyle, aids in the process of nutrition. The body is continually undergoing change, and vital action implies waste of tissues, as well as their growth. Those organs which are the instruments of motion, as the muscles, cannot be employed without wear and waste of their component parts. Renovated tissues must replace those which are worn out, and it is a part of the function of the absorbents to convey nutritive material into the general circulation. Researches in microscopical anatomy have shown that the skin contains multitudes of lymphatic vessels and that it is a powerful absorbent.

Absorption is one of the earliest and most essential functions of animal and vegetables tissues. The simpler plants consist of only a few cells, all of which are employed in absorption; but [pg 52]in the flowering plants this function is performed by the roots. It is accomplished on the same general principles in animals, yet it presents more modifications and a greater number of organs than in vegetables. While animals receive their food into a sac, or bag called the stomach, and are provided with absorbent vessels such as nowhere exist in vegetables, plants plunge their absorbent organs into the earth, whence they derive nourishing substances. In the lower order of animals, as in sponges, this function is performed by contiguous cells, in a manner almost as elementary as in plants. In none of the invertebrate animals is there any special absorbent system. Internal absorption is classified by some authors as follows: interstitial, recrementitial, and excrementitial; by others as accidental, venous, and cutaneous. The general cutaneous and mucous surfaces exhale, as well as absorb; thus the skin, by means of its sudoriferous glands, exhales moisture, and is at the same time as before stated, a powerful absorbent. The mucous surface of the lungs is continually throwing off carbonic acid and absorbing oxygen; and through their surface poisons are sometimes taken into the blood. The continual wear and waste to which living tissues are subject, makes necessary the provision of such a system of vessels for conveying away the worn-out materials and supplying the body with new.

CHAPTER VI.

PHYSICAL AND VITAL PROPERTIES OF THE BLOOD.

Fig. 38. Red corpuscles of human blood, represented at a, as they are seen when rather beyond the focus of the microscope; and at b as they appear when, within the focus. Magnified 400 diameters.

Fig. 39. Development of human lymph and chyle-corpuscles into red corpuscles of blood. A. A lymph, or white blood-corpuscle. B. The same in process of conversion into a red corpuscle. C. A lymph-corpuscle with the cell-wall raised up around it by the action of water. D. A lymph-corpuscle, from which the granules have almost disappeared. E. A lymph-corpuscle, acquiring color; a single granule, like a nucleus, remains. F. A red corpuscle fully developed.

Blood is the animal fluid by which the tissues of the body are nourished. This pre-eminently vital fluid permeates every organ, distributes nutritive material to every texture, is essentially modified by respiration, and, finally, is the source of every secretion and excretion. Blood has four constituents: Fibrin, Albumen, Salts (which elements, in solution, form the liquor sanguinis), and the Corpuscles. Microscopical examination shows that the corpuscles are of two kinds, known as the red and the white, the former being by far the more abundant. They are circular in form and have a smooth exterior, and are on an average 1/3200 part of an inch in diameter, and are about one-fourth of that in thickness. Hence more than ten millions of them may lie on a space an inch square. If spread out in thin layers and subjected to transmitted light, they present a slightly yellowish color, but when crowded together and viewed by refracted light, exhibit a deep red color. These blood-corpuscles have been termed discs, and are not, as some have supposed, solid material, but are very nearly fluid. The red corpuscles although [pg 54]subjected to continual movement, have a tendency to approach one another, and when their flattened surfaces come in contact, so firmly do they adhere that they change their shape rather than submit to a separation. If separated, however, they return to their usual form. The colorless corpuscles are larger than the red and differ from them in being extremely irregular in their shape, and in their tendency to adhere to a smooth surface, while the red corpuscles float about and tumble over one another. They are chiefly remarkable for their continual variation in form. The shape of the red corpuscles is only altered by external influences, but the white are constantly undergoing alterations, the result of changes taking place within their own substance. When diluted with water and placed under the microscope they are found to consist of a spheroidal sac, containing a clear or granular fluid and a spheroidal vesicle, which is termed the nucleus. They have been regarded by some physiologists as identical with those of the lymph and chyle. Dr. Carpenter believes that the function of these cells is to convert albumen into fibrin, by the simple process of cell-growth. It is generally believed that the red corpuscles are derived in some way from the colorless. It is supposed that the red corpuscle is merely the nucleus of a colorless corpuscle enlarged, flattened, colored and liberated by the bursting of the wall of its cell. When blood is taken from an artery and allowed to remain at rest, it separates into two parts: a solid mass, called the clot, largely composed of fibrin; and a fluid known as the serum, in which [pg 55]the clot is suspended. This process is termed coagulation. The serum, mostly composed of albumen, is a transparent, straw-colored fluid, having the odor and taste of blood. The whole quantity of blood in the body is estimated on an average to be about one-ninth of its entire weight. The distinctions between the arterial and the venous blood are marked, since in the arterial system the blood is uniformly bright red, and in the venous of a very dark red color The blood-corpuscles contain both oxygen and carbonic acid in solution. When carbonic acid predominates, the blood is dark red; when oxygen, scarlet. In the lungs, the corpuscles give up carbonic acid, and absorb a fresh supply of oxygen, while in the general circulation the oxygen disappears in the process of tissue transformation, and is replaced, in the venous blood, by carbonic acid. The nutritive portions of food are converted into a homogeneous fluid, which pervades every part of the body, is the basis of every tissue, and which is termed the blood. This varies in color and composition in different animals. In the polyp the nutritive fluid is known as chyme, in many mollusks, as well as articulates, it is called chyle, but in vertebrates, it is more highly organized and is called blood. In all the higher animal types it is of a red color, although redness is not one of its essential qualities. Some tribes of animals possess true blood, which is not red; thus the blood of the insect is colorless and transparent; that of the reptile yellowish; in the fish the principle part is without color, but the blood of the bird is deep red. The blood of the mammalia is of a bright scarlet hue. The temperature of the blood varies in different species, as well as in animals of the same species under different physiological conditions; for this reason, some animals are called cold-blooded. Disease also modifies the temperature of the blood; thus in fevers it is generally increased, but in cholera greatly diminished. The blood has been aptly termed the "vital fluid," since there is a constant flow from the heart to the tissues and organs of the body, and a continual return after it has circulated through these parts. Its presence in every part of the body is one of the essential conditions of animal life, and is effected by a special set of organs, called the circulatory organs.

CHAPTER VII.

PHYSIOLOGICAL ANATOMY.

CIRCULATORY ORGANS.

Having considered the formation of chyle, traced it through the digestive process, seen its transmission into the vena cava, and, finally, its conversion into blood, we shall now describe how it is distributed to every part of the system. This is accomplished through organs which, from the round of duties they perform, are called circulatory. These are the Heart, Arteries, Veins, and Capillaries, which constitute the vascular system.

Within the thorax or chest of the human body, and enclosed within a membranous sac, called the pericardium, is the great force-pump of the system, the heart. This organ, to which all the arteries and veins of the body may be either directly or indirectly traced, is roughly estimated to be equal in size to the closed fist of the individual to whom it belongs.

It has a broad end turned upwards, and a little to the right side, termed its base; and a pointed end called its apex, turned downwards, forwards, and to the left side, and lying beneath a point about an inch to the right of, and below, the left nipple, or just below the fifth rib. Attached to the rest of the body only by the great blood-vessels which issue from and enter it at its base, the heart is the most mobile organ in the economy, being free to move in different directions.

The heart is divided into two great cavities by a fixed partition, which extends from the base to the apex of the organ, and which prevents any direct communication between them. Each of these great cavities is further subdivided transversely [pg 57]by a movable partition, the cavity above each transverse partition being called the auricle, and the cavity below, the ventricle, right or left, as the case may be.

Fig. 40. General view of the heart and lungs, t. Trachea, or windpipe, a. Aorta, p. Pulmonary artery, 1,2. Branches of the pulmonary artery, one going to the right, the other to the left lung. h. The heart.

The walls of the auricles are much thinner than those of the ventricles, and the wall of the right ventricle is much thinner than that of the left, from the fact that the ventricles have more work to perform than the auricles, and the left ventricle more than the right.

In structure, the heart is composed almost entirely of muscular fibers, which are arranged in a very complex and wonderful manner. The outer surface of the heart is covered with the pericardium, which closely adheres to the muscular substance. Inside, the cavities are lined with a thin membrane, called the endocardium. At the junction between the auricles and ventricles, the apertures of communication between their cavities are strengthened by fibrous rings. Attached to these fibrous rings are the movable partitions or valves, between the auricles and the ventricles, the one on the right side of the heart being called the tricuspid valve, and the one on the left side the mitral valve. A number of fine, but strong, tendinous chords, called chordæ tendineæ, connect the edges and apices of these valves with column-like elevations of the fleshy substance of the walls of the ventricles, called columnæ carneæ.

Fig. 41. 1. The descending vena cava. 2. The ascending vena cava. 3. The right auricle. 4. The opening between the right auricle and the right ventricle. 5. The right ventricle. 6. The tricuspid valves. 7. The pulmonary artery. 8, 8. The branches of the pulmonary artery which pass to the right and the left lung. 9. The semilunar valves of the pulmonary artery. 10. The septum between the two ventricles of the heart. 11, 11. The pulmonary veins. 12. The left auricle. 13. The opening between the left auricle and ventricle. 14. The left ventricle. 15. The mitral valves. 16, 16. The aorta. 17. The semilunar valves of the aorta.

The valves are so arranged that they present no obstacle to the free flow of blood from the auricles into the ventricles, but if any is forced the other way, it gets between the valve and the wall of the heart, and drives the valve backwards and upwards, thus forming a transverse partition between the auricle and ventricle, through which no fluid can pass.

At the base of the heart are given off two large arteries, one on the right side, which conveys the blood to the lungs, called the pulmonary artery, and one on the left side, which conveys the blood to the system in general, called the aorta. At the junction of each of these great vessels with its corresponding ventricle, is another valvular apparatus, consisting of three pouch-like valves, called the semilunar valves, from their resemblance, in shape, to a half-moon. Being placed on a level and meeting in the middle line, they entirely prevent the passage of any fluid which may be forced along the artery towards the heart, but, flapping back, they offer no obstruction to the free flow of blood from the ventricles into the arteries.

Fig. 42. A representation of the venous and arterial circulation of the blood.

The Arteries, being always found empty after death, were supposed by the ancients, who were ignorant of the circulation of the blood, to be tubes containing air; hence their name, which is derived from a Greek word and signifies an air-tube. Arteries are the cylindrical tubes which carry blood to every part of the system. All the arteries, except the coronary [pg 59]which supply the substance of the heart, arise from the two main trunks, the pulmonary artery and the aorta. They are of a yellowish-white color, and their inner surface is smooth. The arteries have three coats. (1.) The external coat, which is destitute of fat, and composed chiefly of cellular tissue, is very firm and elastic, and can readily be dissected from the middle coat. (2.) The middle, or fibrous coat, is thicker than the external, and composed of yellowish fibers, its chief property is contractility. (3.) The internal coat consists of a colorless, thin, transparent membrane, yet so strong that it can, it is thought, better resist a powerful pressure than either of the others. Arteries are very elastic as well as extensible, and their chief extensibility is in length. If an artery of a dead body be divided, although empty, its cylindrical form will be preserved.

The Veins are the vessels through which the venous blood returns to the auricles of the heart. They are more numerous than the arteries, and originate from numerous capillary tubes, while the arteries are given off from main trunks. In some parts of the body, the veins correspond in number to the arteries; while in [pg 60]others, there are two veins to every artery. The veins commence by minute roots in the capillaries, which are everywhere distributed through the body, and gradually increase in size, until they unite and become large trunks, conveying the dark blood to the heart. The veins, like the arteries, have three coats. The external, or cellular coat, resembles that of the arteries; the middle is fibrous, but thinner than the corresponding one of the arteries; and the internal coat is serous, and analogous to that of those vessels. The veins belong to the three following classes: (1.) The systemic veins, which bring the blood from different parts of the body and discharge it into the vena cava, by means of which it is conveyed to the heart; (2), the pulmonary veins, which bring the arterial, or bright red blood from the lungs and carry it to the left auricle; (3), the veins of the portal system, which originate in the capillaries of the abdominal organs, then converge into trunks and enter the liver, to branch off again into divisions and subdivisions of the minutest character.

The Capillaries form an extremely fine net-work, and are distributed to every part of the body. They vary in diameter from 1/3500 to 1/2000 of an inch. They are so universally prevalent throughout the skin, that the puncture of a needle would wound a large number of them. These vessels receive the blood and bring it into intimate contact with the tissues, which take from it the principal part of its oxygen and other elements, and give up to it carbonic acid and the other waste products resulting from the transformation of the tissues, which are transmitted through the veins to the heart, and thence by the arteries to the lungs and various excretory organs.

The blood from the system in general, except the lungs, is poured into the right auricle by two large veins, called the superior and the inferior vena cava,' and that returning from the lungs is poured into the left auricle by the pulmonary veins.

During life the heart contracts rhythmically, the contractions commencing at the base, in each auricle, and extending towards the apex.

Now it follows, from the anatomical arrangement of this [pg 61]organ, that when the auricles contract, the blood contained in them is forced through the auriculo-ventricular openings into the ventricles; the contractions then extending to the ventricles, in a wave-like manner, the great proportion of the blood, being prevented from re-entering the auricles by the tricuspid and mitral valves, is forced onward into the pulmonary artery from the right ventricle, and into the aorta from the left ventricle.

When the contents of the ventricles are suddenly forced into these great blood-vessels, a shock is given to the entire mass of fluid which they contain, and this shock is speedily propagated along their branches, being known at the wrist as the pulse.

On inspection, between the fifth and sixth ribs on the left side of the chest, a movement is perceptible, and, if the hand be applied, the impulse may be felt. This is known as the throbbing, or beating of the heart.

If the ear is placed over the region of the heart, certain sounds are heard, which recur with great regularity. First is heard a comparatively long, dull sound, then a short, sharp sound, then a pause, and then the long, dull sound again. The first sound is caused mainly by the tricuspid and mitral valves, and the second is the result of sudden closure of the semilunar valves.

No language can adequately describe the beauty of the circulatory system. The constant vital flow through the larger vessels, and the incessant activity of those so minute that they are almost imperceptible, fully illustrate the perfectness of the mechanism of the human body, and the wisdom and goodness of Him who is its author.

Experiments have shown that the small arteries may be directly influenced through the nervous system, which regulates their caliber by controlling the state of contraction of their muscular walls. The effect of this influence of the nervous system enables it to control the circulation over certain areas; and, notwithstanding the force of the heart and the state of the blood-vessels in general, to materially modify the circulation in different spots. Blushing, which is simply a local modification of the circulation, is effected in this way. Some emotion takes possession of the mind, and the action of the nerves, which ordinarily keep up a moderate contraction of [pg 62]the muscular coats of the arteries, is lost, and the vessels relax and become distended with arterial blood, which is a warm and bright red fluid; thereupon a burning sensation is felt, and the skin grows red, the degree of the blush depending upon the intensity of the emotion.

The pallor produced by fright and by extreme anxiety, is purely the result of a local modification of the circulation, brought about by an over-stimulation of the nerves which supply the small arteries, causing them to contract, and to thus cut off more or less completely the supply of blood.

CHAPTER VIII.

PHYSIOLOGICAL ANATOMY.

THE ORGANS OF RESPIRATION.

The Organs of Respiration are the Trachea, or windpipe, the Bronchia, formed by the subdivision of the trachea, and the Lungs, with their air-cells. The Trachea is a vertical tube situated between the lungs below, and a short quadrangular cavity above, called the larynx, which is part of the windpipe, and used for the purpose of modulating the voice in speaking or singing. In the adult, the trachea, in its unextended state, is from four and one-half to five inches in length, about one inch in diameter, and, like the larynx, is more fully developed in the male than in the female. It is a fibro-cartilaginous structure, and is composed of flattened rings, or segments of circles. It permits the free passage of air to and from the lungs.

The Bronchia are two tubes, or branches, one proceeding from the windpipe to each lung. Upon entering the lungs, they divide and subdivide until, finally, they terminate in small cells, called the bronchial or air-cells, which are of a membranous character.

Fig. 43. An ideal representation of the respiratory organs. 3. The larynx. 4. The trachea. 5, 6. The bronchia. 9, 9, 9, 9. Air-cells. 1, 1, 1, 2, 2, 2. Outlines of the lungs.

The Lungs are irregular conical organs rounded at the apex, situated within the chest, and filling the greater part of it, since the heart is the only other organ which occupies much space in the thoracic cavity. The lungs are convex externally, and conform to the cavity of the chest, while the internal surface is concave for the accommodation of the heart. The size of the lungs depends upon the capacity of the chest. Their [pg 64]color varies, being of a pinkish hue in childhood but of a gray, mottled appearance in the adult. They are termed the right and left lung. Each lung resembles a cone with its base resting upon the diaphragm, and its apex behind the collar-bone. The right lung is larger though shorter, than the left, not extending so low, and has three lobes, formed by deep fissures, or longitudinal divisions, while the left has but two lobes. Each lobe is also made up of numerous lobules, or small lobes, connected by cellular tissue, and these contain great numbers of cells. The lungs are abundantly supplied with blood-vessels, lymphatics, and nerves. The density of a lung depends upon the amount of air which it contains. Thus, experiment has shown that in a foetus which has never breathed, the lungs are compact and will sink in water; but as soon as they become inflated with air, they spread over a larger surface, and are therefore more buoyant. Each lung is invested, as far as its root, with a membrane, called the pleura, which is then continuously extended to the cavity of the chest, thus performing the double office of lining it, and constituting a partition between the lungs. The part [pg 65]of the membrane which forms this partition is termed the mediastinum. Inflammation of this membrane is called pleurisy. The lungs are held in position by the root, which is formed by the pulmonary arteries, veins, nerves, and the bronchial tubes. Respiration is the function by which the venous blood, conveyed to the lungs by the pulmonary artery, is converted into arterial blood. This is effected by the elimination of carbonic acid, which is expired or exhaled from the lungs, and by the absorption of oxygen from the air which is taken into the lungs, by the act of inspiration or inhalation. The act of expiration is performed chiefly by the elevation of the diaphragm and the descent of the ribs, and inspiration is principally effected by the descent of the diaphragm and the elevation of the ribs.

Fig. 44. A representation of the heart and lungs. 4. The heart. 5. The pulmonary artery. 8. Aorta. 9, 11. Upper lobes of the lungs. 10, 13. Lower lobes. 12. Middle lobe of the right lung. 2. Superior vena cava. 3. Inferior vena cava.

When the muscles of some portions of the air-passages are relaxed, a peculiar vibration follows, known as snoring. Coughing and sneezing are sudden and spasmodic expiratory efforts, and generally involuntary. Sighing is a prolonged deep inspiration, followed by a rapid, and generally audible expiration. It is remarkable that laughing and sobbing, although indicating opposite states of the mind, are produced in very nearly the same manner. In hiccough, the contraction is more sudden and spasmodic than in laughing or sobbing. The quantity of oxygen consumed during sleep is estimated to be considerably less than that consumed during wakefulness.

Fig. 45. View of the pulmonary circulation.

It is difficult to estimate the amount of air taken into the [pg 66]lungs at each inspiration, as the quantity varies according to the condition, size, and expansibility of the chest, but in ordinary breathing it is supposed to be from twenty to thirty cubic inches. The consumption of oxygen is greater when the temperature is low, and during digestion. All the respiratory movements, so far as they are independent of the will of the individual, are controlled by that part of the brain called the medulla oblongata. The respiratory, or breathing process, is not instituted for the benefit of man alone, for we find it both in the lower order of animals and in plant life. Nature is very economical in the arrangement of her plans, since the carbonic acid, which is useless to man, is indispensable to the existence of plants, and the oxygen, rejected by them, is appropriated to his use. In the lower order of animals, the respiratory act is similar to that of the higher types, though not so complex; for there are no organs of respiration, as the lungs and gills are called. Thus, the higher the animal type, the more complex its organism. The effect of air upon the color of the blood is very noticeable. If a quantity be drawn from the body, thus being brought into contact with the air, its color gradually changes to a brighter hue. There is a marked difference between the properties of the venous and the arterial blood.

[pg 67]The venous blood is carried, as we have previously described, to the right side of the heart and to the lungs, where it is converted into arterial blood. It is now of uniform quality, ready to be distributed throughout the body, and capable of sustaining life and nourishing the tissues. Man breathes by means of lungs; but who can understand their wonderful mechanism, so perfect in all its parts? Though every organ is subservient to another, yet each has its own office to perform. The minute air-cells are for the aeration of the blood; the larger bronchial tubes ramify the lungs, and suffuse them with air; the trachea serves as a passage for the air to and from the lungs, while at its upper extremity is the larynx, which has been fitly called the organ of the human voice. At its extremity we find a sort of shield, called the epiglottis, the office of which is supposed to be to prevent the intrusion of foreign bodies.

CHAPTER IX.

PHYSIOLOGICAL ANATOMY

THE SKIN.

Through digestion and respiration, the blood is continually supplied with material for its renewal; and, while the nutritive constituents of the food are retained to promote the growth of the body, those which are useless or injurious are in various ways expelled. There are, perhaps, few parts of the body more actively concerned in this removal than the skin.

Fig. 46: An ideal view of the papillæ. 1, 1. Cutis vera. 2, 2. Papillary layer. 3, 3. Arteries of the papillæ. 4, 4. Nerves of the papillæ. 5, 5. Veins of the papillæ.

The skin is a membranous envelope covering the entire body. It consists of two layers, termed the Cutis Vera, or true skin, and the Epidermis, or cuticle. The Cutis Vera is composed of fibers similar to those of the cellular tissue. It consists of white and yellow fibers, which are more densely woven near the surface than deeper in the structure; the white give strength, the yellow [pg 69]strength and elasticity combined. The true skin may be divided into two layers, differing in their characteristics, and termed respectively the superficial or papillary layer, and the deep or fibrous layer. Upon the external surface, are little conical prominences, known as papillæ. The papillæ are irregularly distributed over the body, in some parts being smaller and more numerous than in others, as on the finger-ends, where their summits are so intimately connected as to form a tolerably smooth surface. It is owing to their perfect development, that the finger-tips are adapted to receive the most delicate impressions of touch. Although every part of the skin is sensitive, yet the papillæ are extremely so, for they are the principal means through which the impressions of objects are communicated. Each papilla not only contains a minute vein and artery, but it also incloses a loop of sensitive nerves. When the body is exposed to cold, these papillæ can be more distinctly seen in the form of prominences, commonly known as "goose-pimples."

Fig. 47. A section of the skin, showing its arteries and veins. A, A. Arterial branches. B, B. Capillaries in which the branches terminate. C. The venous trunk into which the blood from the capillaries flows.

The internal, or fibrous layer of the skin, contains numerous depressions, each of which furnishes a receptacle for fat. While the skin is supplied with a complete net-work of arteries, veins, and nerves, which make it sensitive to the slightest touch, it also contains numerous lymphatic vessels, so minute that they are invisible to the naked eye.

Among the agents adapted for expelling the excretions from the system, few surpass the Sudoriferous Glands. These are minute organs which wind in and out over the whole extent of the true skin, and secrete the perspiration. Though much [pg 70]of it passes off as insensible transpiration, yet it often accumulates in drops of sweat, during long-continued exercise or exposure to a high temperature. The office of the perspiration is two-fold. It removes noxious matter from the system, and diminishes animal heat, and thereby equalizes the temperature of the body. It also renders the skin soft and pliable, thus better adapting it to the movements of the muscles. The Sebaceous Glands, which are placed in the true skin, are less abundant where the sudoriferous glands are most numerous, and vice versa. Here, as elsewhere, nature acts with systematic and intelligent design. The perspiratory glands are distributed where they are most needed,—in the eyelids, serving as lubricators; in the ear passages, to produce the cerumen, or wax, which prevents the intrusion of small insects; and in the scalp, to supply the hair with its natural pomatum.

Fig. 48. A perspiratory gland, highly magnified. 1, 1. The gland. 2, 2. Excretory ducts uniting to form a tube which tortuously perforates the cuticle at 3, and opens obliquely on its surface at 4.

Fig. 49. A representation of oil-tubes from the scalp and nose.

Fig. 50. Anatomy of the skin. 5, 5. Cutis vera (true skin). 4, 4. Nervous tissue. 3, 3. Sensitive layer in which are seen the nerves. 2, 2. The layer containing pigment cells. 1, 1. Epidermis (cuticle).

The Epidermis, or Cuticle, so called because it is placed upon the skin, is the outer layer of the skin. Since it is entirely destitute of nerves and blood-vessels, it is not sensitive. Like the cutis vera, it has two surfaces composed of layers. The internal, or Rete Mucosum, which is made up chiefly of pigment cells, is adapted to the irregularities of the cutis vera, and sends prolongations into all its glandular follicles. The external surface, or epidermis proper, is elastic, destitute of coloring matter, and consists of mere [pg 71]horny scales. As soon as dry, they are removed in the form of scurf, and replaced by new ones from the cutis vera. These scales may be removed by a wet-sheet pack, or by friction. The cuticle is constantly undergoing renewal. This layer serves to cover and protect the nervous tissue of the true skin beneath. We may here observe that the cuticle contains the pigment for coloring the skin. In dark races, as the negro, the cuticle is very thick and filled with black pigment. The radiation of animal heat is dependent upon the thickness and color of this cuticle. Thus, in the dark races, the pigment cells are most numerous, and in proportion as the skin is dark or fair do we find these cells in greater or lesser abundance. The skin of the Albino is of pearly whiteness, devoid even of the pink or brown tint which that of the European always possesses. This peculiarity must be attributed to the absence of pigment cells [pg 72]which, when present, always present a more or less dark color. The theory that climate alone is capable of producing all these diversities is simply absurd. The Esquimaux, who live in Greenland and the arctic regions of America, are remarkable for the darkness of their complexion. Humboldt remarks that the American tribes of the tropical regions have no darker skin than the mountaineers of the temperate zone. Climate may modify the complexion, but it cannot make it.

Fig. 51. Structure of the human hair. A. External surface of the shaft, showing the transverse striæ and jagged boundary, caused by the imbrications of the scaly cortex. B. Longitudinal section of the shaft, showing the fibrous character of the medullary substance, and the arrangement of the pigmentary matter. C. Transverse sections, showing the distinction between the cortical and medullary substances, and the central collection of pigmentary matter, sometimes found in the latter. Magnified 310 diameters.

Hairs are horny appendages of the skin, and, with the exception of the hands, the soles of the feet, the backs of the fingers and toes, between the last joint and the nail, and the upper eyelids, are distributed more or less abundantly over every part of the surface of the body. Over the greater part of the surface the hairs are very minute, and in some places are not actually apparent above the level of the skin; but the hair of the head, when permitted to reach its full growth, attains a length of from twenty inches to a yard, and, in rare instances, even six feet. A hair may be divided into a middle portion, or shaft, and two extremities; a peripheral extremity, called the point; and a central extremity, inclosed within [pg 73]the hair sac, or follicle, termed the root. The root is somewhat greater in diameter than the shaft, and cylindrical in form, while its lower part expands into an oval mass, called the bulb. The shaft of the hair is not often perfectly cylindrical, but is more or less flattened, which circumstance gives rise to waving and curling hair; and, when the flattening is spiral in direction, the curling will be very great. A hair is composed of three different layers of cell-tissues: a loose, cellulated substance, which occupies its center, and constitutes the medulla, or pith; the fibrous tissue, which incloses the medulla, and forms the chief bulk of the hair; and a thin layer, which envelops this fibrous structure, and forms the smooth surface of the hair. The medulla is absent in the downy hairs, but in the coarser class it is always present, especially in white hair. The color of hair is due partly to the granules and partly to an inter-granular substance, which occupies the interstices of the granules and the fibers. The quantity of hair varies according to the proximity and condition of the follicles. The average number of hairs of the head may be stated at 1,000 in a superficial square inch; and, as the surface of the scalp has an area of about one hundred and twenty superficial square inches, the average number of hairs on the entire head is 120,000. The hair possesses great durability, as is evinced by its endurance of chemical processes, and by its discovery, in the tombs of mummies more than two thousand years old. The hair is remarkable for its elasticity and strength. Hair is found to differ materially from horn in its chemical composition. According to Vauquelin, its constituents are animal matter, a greenish-black oil, a white, concrete oil, phosphate of lime, a trace of carbonate of lime, oxide of manganese, iron, sulphur, and silex. Red hair contains a reddish oil, a large proportion of sulphur, and a small quantity of iron. White hair contains a white oil, and phosphate of magnesia. It has been supposed that hair grows after death, but this theory was probably due to the lengthening of the hair by the absorption of moisture from the body or atmosphere.

The nails constitute another class of appendages of the skin. They consist of thin plates of horny tissue, having a [pg 74]root, a body, and a free extremity. The root, as well as the lateral portion, is implanted in the skin, and has a thin margin which is received into a groove of the true skin. The under surface is furrowed, while the upper is comparatively smooth. The nails grow in the same manner as the cuticle.

CHAPTER X.

PHYSIOLOGICAL ANATOMY.

SECRETION.

The term Secretion, in its broadest sense, is applied to that process by which substances are separated from the blood, either for the reparation of the tissues or for excretion. In the animal kingdom this process is less complicated than in vegetables. In the former it is really a separation of nutritive material from the blood. The process, when effected for the removal of effete matter, is, in a measure, chemical, and accordingly the change is greater.

Three elementary constituents are observed in secretory organs: the cells, a basement membrane, and the blood-vessels. Obviously, the most essential part is the cell.

The physical condition necessary for the healthy action of the secretory organs is a copious supply of blood, in which the nutritive materials are abundant. The nervous system also influences the process of secretion to a great extent. Intense emotion will produce tears, and the sight of some favorite fruit will generally increase the flow of saliva.

The process of secretion depends upon the anatomical and chemical constitution of the cell-tissues. The principal secretions are (1), Perspiration; (2), Tears; (3), Sebaceous matter; (4), Mucus; (5), Saliva; (6), Gastric juice; (7), Intestinal juice; (8), Pancreatic juice; (9), Bile; (10), Milk.

Perspiration is a watery fluid secreted in minute glands, which are situated in every part of the skin, but are more numerous on the anterior surfaces of the body. Long thread-like tubes, only 1/100th of an inch in diameter, lined with [pg 76]epithelium, penetrate the skin, and terminate in rounded coils, enveloped by a net-work of capillaries, which supply the secretory glands with blood. It is estimated by Krause that the entire number of perspiratory glands is two million three hundred and eighty-one thousand two hundred and forty-eight, and the length of each glandular coil being 1/16 of an inch, we may estimate the length of tubing to be not less than two miles and a third. This secretion has a specific gravity of 1003.5, and, according to Dr. Dalton, is composed of

Traces of organic matter, mingled with a free volatile acid, are also found in the perspiration. It is the acid which imparts to this secretion its peculiar odor, and acid reaction. The process of its secretion is continuous, but, like all bodily functions, it is subject to influences which augment or retard its activity. If, as is usually the case when the body is in a state of repose, evaporation prevents its appearance in the liquid form, it is called invisible or insensible perspiration. When there is unusual muscular activity, it collects upon the skin, and is known as sensible perspiration. This secretion performs an important office in the animal economy, by maintaining the internal temperature at about 100° Fahr. Even in the Arctic regions, where the explorer has to adapt himself to a temperature of 40° to 80° below zero, the generation of heat in the body prevents the internal temperature from falling below this standard. On the contrary, if the circulation is quickened by muscular exertion, the warmer blood flowing from the internal organs into the capillaries, raises the temperature of the skin, secretion is augmented, the moisture exudes from the pores, and perceptible evaporation begins. A large portion of the animal heat is thrown off in this process, and the temperature of the skin is reduced. A very warm, dry atmosphere can be borne with impunity but if moisture is [pg 77]introduced, evaporation ceases, and the life of the animal is endangered. Persons have been known to remain in a temperature of about 300° Fahr. for some minutes without unpleasant effects. Three conditions may be assigned as effective causes in retarding or augmenting this cutaneous secretion, variations in the temperature of the atmosphere, muscular activity, and influences which affect the nerves. The emotions exert a remarkable influence upon the action of the perspiratory glands. Intense fear causes great drops of perspiration to accumulate on the skin, while the salivary glands remain inactive.

Tears. The lachrymal glands are small lobular organs, situated at the outer and upper orbit of the eye, and have from six to eight ducts, which open upon the conjunctiva, between the eyelid and its inner fold. This secretion is an alkaline, watery fluid. According to Dr. Dalton, its composition is as follows:

The function of this secretion is to preserve the brilliancy of the eye. The tears are spread over this organ by the reflex movement of the eyelid, called winking, and then collected in the puncta lachrymalia and discharged into the nasal passage. This process is constant during life. The effect of its repression is seen in the dim appearance of the eye after death. Grief or excessive laughter usually excite these glands until there is an overflow.

Sebaceous Matter. Three varieties of this secretion are found in the body. A product of the sebaceous glands of the skin is found in those parts of the body which are covered with hairs; also, on the face and the external surface of the organs of generation. The sebaceous glands consist of a group of flask-shaped cavities, opening into a common excretory duct. Their secretion serves to lubricate the hair and soften the skin. The ceruminous glands of the external auditory meatus, or [pg 78]outer opening of the ear, are long tubes terminating in a glandular coil, within which is secreted the glutinous matter of the ear. This secretion serves the double purpose of moistening the outer surface of the membrana tympani, or ear-drum, and, by its strong odor, of preventing the intrusion of insects. The Meibomian glands are arranged in the form of clusters along the excretory duct, which opens just behind the roots of the eyelashes. The oily nature of this secretion prevents the tears, when not stimulated by emotion, from overflowing the lachrymal canal.

Mucus. The mucous membranes are provided with minute glands which secrete a viscid, gelatinous matter, called mucus. The peculiar animal matter which it contains is termed mucosin. These glands are most numerous in the Pharynx, Esophagus, Trachea, Bronchia, Vagina and Urethra. They consist of a group of secreting sacs, terminating at one extremity in a closed tube, while the other opens into a common duct. The mucus varies in composition in different parts of the body; but in all, it contains a small portion of insoluble animal matter. Its functions are threefold. It lubricates the membranes, prevents their injury, and facilitates the passage of food through the alimentary canal.

Saliva. This term is given to the first of the digestive fluids, which is secreted in the glands of the mouth. It is a viscid, alkaline liquid, with a specific gravity of about 1005. If allowed to stand, a whitish precipitate is formed. Examinations with the microscope show it to be composed of minute, granular cells and oil globules, mingled with numerous scales of epithelium. According to Bidder and Schmidt, the composition of saliva is as follows:

Two kinds of organic matter are present in the saliva; one, termed ptyalin, imparts to the saliva its viscidity, and it [pg 79]obtained from the secretions of the parotid, submaxillary and sublingual glands; another, which is not glutinous, is distinguished by the property of coagulating when subjected to heat. The saliva is composed of four elementary secretions, derived respectively, from the mucous follicles of the mouth, and the parotid, the submaxillary, and the sublingual glands. The process of its secretion is constant, but is greatly augmented by the contact of food with the lining membrane. The saliva serves to moisten the triturated food, facilitate its passage, and has the property of converting starch into sugar; but the latter quality is counteracted by the action of the gastric juice of the stomach.

Gastric Juice. The minute tubes, or follicles, situated in the mucous membrane of the stomach, secrete a colorless, acid liquid, termed the gastric juice. This fluid appears to consist of little more than water, containing a few saline matters in solution, and a small quantity of free hydrochloric acid, which gives it an acid reaction. In addition to these, however, it contains a small quantity of a peculiar organic substance, termed pepsin, which in chemical composition, is very similar to ptyalin, although it is very different in its effects. When food is introduced into the stomach, the peristaltic contractions of that organ roll it about, and mingle it with the gastric juice, which disintegrates the connective tissue, and converts the albuminous portions into the substance called chyme, which is about the consistency of pea-soup, and which is readily absorbed through the animal membranes into the blood of the delicate and numerous vessels of the stomach, whence it is conveyed to the portal vein and to the liver. The secretion of the gastric juice is influenced by nervous conditions. Excess of joy or grief effectually retard or even arrest its flow.

Intestinal Juice. In the small intestine, a secretion is found which is termed the intestinal juice. It is the product of two classes of glands situated in the mucous membrane, and termed respectively, the follicles of Lieberkuhn and the glands of Brunner. The former consist of numerous small tubes, lined with epithelium, which secrete by far the greater portion of this fluid. The latter are clusters of round follicles [pg 80]opening into a common excretory duct. These sacs are composed of delicate, membranous tissue, having numerous nuclei on their walls. The difficulty of obtaining this juice for experiment is obvious, and therefore its chemical composition and physical properties are not known. The intestinal juice resembles the secretion of the mucous follicles of the mouth, being colorless, vitreous in appearance, and having an alkaline reaction.

Pancreatic Juice. This is a colorless fluid, secreted in a lobular gland which is situated behind the stomach, and runs transversely from the spleen across the vertebral column to the duodenum. The most important constituent of the pancreatic juice is an organic substance, termed pancreatin.

The Bile. The blood which is collected by the veins of the stomach, pancreas, spleen, and intestines, is discharged into a large trunk called the portal vein, which enters the liver. This organ also receives arterial blood from a vessel called the hepatic artery, which is given off from the aorta below the diaphragm. If the branches of the portal vein and hepatic artery be traced into the substance of the liver, they will be found to accompany one another, and to subdivide, becoming smaller and smaller. Finally, the portal vein and hepatic artery will be found to terminate in capillaries which permeate the smallest perceptible subdivisions of the liver substance, which are polygonal masses of not more than one-tenth of an inch in diameter, called the lobules. Every lobule rests upon one of the ramifications of a great vessel termed the hepatic vein, which empties into the inferior vena cava. There is also a vessel termed the hepatic duct leading from the liver, the minute subdivisions of which penetrate every portion of the substance of that organ. Connected with the hepatic duct, is the duct of a large oval sac, called the gall-bladder.

Each lobule of the liver is composed of minute cellular bodies known as the hepatic cells. It is supposed that in these cells the blood is deprived of certain materials which are converted into bile. This secretion is a glutinous fluid, varying in color from a dark golden brown to a bright yellow, has a specific gravity ranging from 1018 to 1036, and a [pg 81]slightly alkaline reaction. When agitated, it has a frothy appearance. Physiologists have experienced much difficulty in studying the character of this secretion from the instability of its constituents when subjected to chemical examination.

Fig. 52. Section of the Liver, showing the ramifications of the portal vein. 1. Twig of portal vein. 2, 2', 2", 2"'. Interlobular vein. 3, 3', 3", Lobules.

Biliverdin is an organic substance peculiar to the bile, which imparts to that secretion its color. When this constituent is re-absorbed by the blood and circulates through the tissues, the skin assumes a bright yellow hue, causing what is known as the jaundice. Cholesterin is an inflammable crystallizable substance soluble in alcohol or ether. It is found in the spleen and all the nervous tissues. It is highly probable that it exists in the blood, in some state or combination, and assumes a crystalline form only when acted upon by other substances or elements. Two other constituents, more important than either of the above, are collectively termed biliary salts. These elements were discovered in 1848, by Strecker, who termed them glycocholate and taurocholate of soda. Both are crystalline, resinous substances, and, although resembling each other in many respects, the chemist may distinguish them by their reaction, for both yield a precipitate if treated with subacetate of lead, but only the glycocholate will give a precipitate with acetate of lead. In testing for biliary substances, the most satisfactory method is the one proposed by Pettenkoffer. A solution of cane-sugar, one part of sugar to four parts of water, is mixed with the suspected substance. Dilute sulphuric acid is then added until a white precipitate falls, which is re-dissolved in an excess of the acid. On the addition of more sulphuric acid, it becomes opalescent, and passes through the successive hues of scarlet, lake, and a rich purple. Careful experiments have proved [pg 82]that it is a constant secretion; but its flow is mere abundant during digestion. During the passage through the intestines it disappears. It is not eliminated, and Pettenkoffer's test has failed to detect its existence in the portal vein. These facts lead physiologists to the conclusion, that it undergoes some transformation in the intestines and is re-absorbed.

After digestion has been going on in the stomach for some time, the semi-digested food, in the form of chyme, begins to pass through the pyloric orifice of the stomach into the duodenum, or upper portion of the small intestine. Here it encounters the intestinal juice, pancreatic juice, and the bile, the secretion of all of which is stimulated by the presence of food in the alimentary tract. These fluids, mingling with the chyme, give it an alkaline reaction, and convert it into chyle. The transformation of starch into sugar, which is almost, if not entirely, suspended while the food remains in the stomach, owing to the acidity of the chyme, is resumed in the duodenum, the acid of the chyme, being neutralized by the alkaline secretions there encountered.

Late researches have demonstrated that the pancreatic juice exerts a powerful effect on albuminous matters, not unlike that of the gastric juice.

Thus, it seems that while in the mouth only starchy, and while in the stomach only albuminous substances are digested, in the small intestine all kinds of food materials, starchy, albuminoid, fatty and mineral, are either completely dissolved, or minutely subdivided, and so prepared that they may be readily absorbed through the animal membranes into the vessels.

Milk. The milk is a white, opaque fluid, secreted in the lacteal glands of the female, in the mammalia. These glands consist of numerous follicles, grouped around an excretory duct, which unites with similar ducts coming from other lobules. By successive unions, they form large branches, termed the lactiferous ducts, which open by ten to fourteen minute orifices on the extremity of the nipple. The most important constituent of milk is casein; it also contains oily and saccharine substances. This secretion, more than any other, as influenced by nervous conditions. A mother's bosom will [pg 83]fill with milk at the thought of her infant child. Milk is sometimes poisoned by a fit of ill-temper, and the infant made sick and occasionally thrown into convulsions, which in some instances prove fatal. Sir Astley Cooper mentions two cases in which terror instantaneously and permanently arrested this secretion. It is also affected by the food and drink. Malt liquors and other mild alcoholic beverages temporarily increase the amount of the secretion, and may, in rare instances, have a beneficial effect upon the mother. They sometimes affect the child, however, and their use is not to be recommended unless the mother is extremely debilitated, and there is a deficiency of milk.

CHAPTER XI.

PHYSIOLOGICAL ANATOMY.

EXCRETION.

The products resulting from the waste of the tissues are constantly being poured into the blood, and, as we have seen, the blood being everywhere full of corpuscles, which, like all living things, die and decay, the products of their decomposition accumulate in every part of the circulatory system. Hence, if the blood is to be kept pure, the waste materials incessantly poured into this fluid, or generated in it, must be as continually removed, or excreted. The principal sets of organs concerned in effecting the separation of excrementitious substances from the blood are the lungs, the skin, and the kidneys.

The elimination of carbonic acid through the lungs has already been described on page 66, and the excretory function of the skin on page 70.

Fig. 53. View of the kidneys, ureters, and bladder.

The kidneys are two bean-shaped organs, placed at the back of the abdominal cavity, in the region of the loins, one on each side of the spine. The convex side of each kidney is directed outwards, and the concave side is turned inwards towards the spine. From the middle of the concave side, which is termed the hilus, a long tube of small caliber, called the ureter, proceeds to the bladder. The latter organ is an oval bag, situated in the pelvic cavity. It is composed principally of elastic muscular fibers, and is lined internally with mucous membrane, and coated externally with a layer of the peritoneum, the serous membrane which lines the abdominal [pg 85]and pelvic cavities. The ureters enter the bladder through its posterior and lower wall, at some little distance from each other. The openings through which the ureters enter the bladder are oblique, hence it is much easier for the secretion [pg 86]of the kidneys to pass from the ureters into the bladder than for it to get the other way. Leading from the bladder to the exterior of the body is a tube, called the urethra, through which the urine is voided.

The excretion of the kidneys, termed the urine, is an amber-colored or straw-colored fluid, naturally having a slightly acid reaction, and a specific gravity ranging from 1,015 to 1,025. Its principal constituents are urea and uric acid, together with various other animal matters of less importance, and saline substances, held in solution in a proportionately large amount of water. The composition of the urine and the quantity excreted vary considerably, being influenced by the moisture and temperature of the atmosphere, by the character of the food consumed, and by the empty or replete condition of the alimentary tract. On an average a healthy man secretes about fifty ounces of urine in the twenty-four hours. This quantity usually holds in solution about one ounce of urea, and ten or twelve grains of uric acid. In the amount of other animal matters, and saline substances, there is great variation, the quantity of these ranging from a quarter of an ounce to an ounce. The principal saline substances are common salt, the sulphates and phosphates of potassium, sodium, calcium, and magnesium. In addition to the animal and the saline matters, the urine also contains a small quantity of carbonic acid, oxygen and nitrogen.

CHAPTER XII.

PHYSIOLOGICAL ANATOMY.

THE NERVOUS SYSTEM.

Hitherto, we have only considered the anatomy and functions of the organs employed in Digestion, Absorption, Circulation, Respiration, Secretion and Excretion. We have found the vital process of nutrition to be, in all its essential features, a result of physical and chemical forces; in each instance we have presupposed the existence and activity of the nerves. There is not an inch of bodily tissue into which their delicate filaments do not penetrate, and form a multitude of conductors, over which are sent the impulses of motion and sensation.

Fig. 54. The Nervous System.

Two elements, nerve-fibers and ganglionic corpuscles, enter into the composition of nervous tissue. Ordinary nerve-fibers in the living subject, or when fresh, are cylindrical-shaped filaments of a clear, but somewhat oily appearance. But soon after death the matter contained in the fiber coagulates, and then the fiber is seen to consist of an extremely delicate, structureless, outer membrane, which forms a tube through the center of which runs the axis-cylinder. Interposed between the axis-cylinder and this tube, there is a fluid, containing a considerable quantity of fatty matter, from which is deposited a highly refracting substance which lines the tube. There are two sets of nerve-fibers, those which transmit sensory impulses, called afferent or sensory nerves, and those which transmit motor impulses, called efferent or motor nerves. The fibers when collected in bundles are termed nerve trunks. All the larger nerve-fibers lie side by side in the nerve-trunks, and are bound together by delicate [pg 88][pg 89]connective tissue, enclosed in a sheath of the same material, termed the neurilemma. The nerve-fibers in the trunks of the nerves remain perfectly distinct and disconnected from one another, and seldom, or never, divide throughout their entire length. However, where the nerves enter the nerve-centers, and near their outer terminations, the nerve-fibres often divide into branches, or at least gradually diminish in size, until, finally, the axis-cylinder, and the sheath with its fluid contents, are no longer distinguishable. The investing membrane is continuous from the origin to the termination of the nerve-trunk.

Fig. 55. Division of a nerve, showing a portion of a nervous trunk (a) and separation of its filaments (b, c, d, e.)

In the brain and spinal cord the nerve-fibers often terminate in minute masses of a gray or ash-colored granular substance, termed ganglia, or ganglionic corpuscles.

The ganglia are cellular corpuscles of irregular form, and possess fibrous appendages, which serve to connect them with one another. These ganglia form the cortical covering of the brain, and are also found in the interior of the spinal cord. According to Kölliker, the larger of these nerve-cells measure only 1/200 of an inch in diameter. The brain is chiefly composed of nervous ganglia.

Nerves are classified with reference to their origin, as cerebral—those originating in the brain, and spinal—those originating in the spinal cord.

There are two sets of nerves and nerve-centers, which are intimately connected, but which can be more conveniently studied apart. These are the cerebro-spinal system, consisting of the cerebro-spinal axis, and the cerebral and spinal nerves; and the sympathetic system, consisting of the chain of sympathetic ganglia, the nerves which they give off, and the nervous trunks which connect them with one another and with the cerebro-spinal nerves.

THE CEREBRO-SPINAL SYSTEM.

The Cerebro-Spinal Axis consists of the brain and spinal cord. It lies in the cavities of the cranium and [pg 90]the spinal column. These cavities are lined with a very tough fibrous membrane, termed the dura mater, which serves as the periosteum of the bones which enter into the formation of these parts. The surface of the brain and spinal cord is closely invested with an extremely vascular, areolar tissue, called the pia mater. The numerous blood-vessels which supply these organs traverse the pia mater for some distance, and, where they pass into the substance of the brain or spinal cord, the fibrous tissue of this membrane accompanies them to a greater or less depth. The inner surface of the dura mater and the outer surface of the pia mater are covered with an extremely thin, serous membrane, which is termed the arachnoid membrane. Thus, one layer of the arachnoid envelopes the brain and spinal cord, and the other lines the dura mater. As the layers become continuous with each other at different points, the arachnoid, like the pericardium, forms a shut sac, and, like other serous membranes, it secretes a fluid, known as the arachnoid fluid. The space between the internal and the external layers of the arachnoid membrane of the brain is much smaller than that enclosed by the corresponding layers of the arachnoid membrane of the spinal column.

Fig. 56. Cross-section of spinal cord.

The Spinal Cord is a column of soft, grayish-white substance, extending from the top of the spinal canal, where it is continuous with the brain, to about an inch below the small of the back, where it tapers off into a filament. From this nerve are distributed fibers and filaments to the muscles and integument of at least nine-tenths of the body.

The spinal cord is divided in front through the middle nearly as far as its center, by a deep fissure, called the anterior fissure, and behind, in a similar manner, by the posterior fissure. Each of these fissures is lined with the pia mater, which also supports the blood-vessels which supply [pg 91]the spinal cord with blood. Consequently, the substance of the two halves of the cord is only connected by a narrow isthmus, or bridge, perforated by a minute tube, which is termed the central canal of the spinal cord.

Each half of the spinal cord is divided lengthwise into three nearly equal parts, which are termed the anterior, lateral, and posterior columns, by the lines which join together two parallel series of bundles of nervous filaments, which compose the roots of the spinal nerves. The roots of those nerves, which are found along that line nearest the posterior surface of the cord, are termed the posterior roots; those which spring from the other line are known as the anterior roots.

Several of these anterior and posterior roots, situated at about the same height on opposite sides of the spinal cord, converge and combine into what are called the anterior and posterior bundles; then two bundles, anterior and posterior, unite and form the trunk of a spinal nerve.

The nerve trunks make their way out of the spinal canal through apertures between the vertebra, called the inter-vertebral foramina and then divide into numerous branches, their ramifications extending principally to the muscles and the skin. There are thirty-one pairs of spinal nerves, eight of which are termed cervical, twelve dorsal, five lumbar, and six sacral, with reference to that part of the cord from which they originate.

When the cord is divided into transverse sections, it is found that each half is composed of two kinds of matter, a white substance on the outside, and a grayish substance in the interior. The gray matter, as it is termed, lies in the form of an irregular crescent, with one end considerably larger than the other, and having the concave side turned outwards. The ends of the crescent are termed the horns, or cornua, the one pointing forward being called the anterior cornu, the other one the posterior cornu. The convex sides of these cornua approach each other and are united by the bridge, which contains the central canal.

There is a marked difference in the structure of the gray and the white matter. The white matter is composed entirely of nerve fibers, held together by a framework of connective [pg 92]tissue. The gray matter contains a great number of ganglionic corpuscles, or nerve-cells, in addition to the nerve-fibers.

When the nerve-trunks are irritated in any manner, whether by pinching, burning, or the application of electricity, all the muscles which are supplied with branches from this nerve-trunk immediately contract, and pain is experienced, the severity of which depends upon the degree of the irritation; and the pain is attributed to that portion of the body to which the filaments of the nerve-trunk are distributed. Thus, persons who have lost limbs often complain in cold weather of an uneasiness or pain, which they locate in the fingers or toes of the limb which has been amputated, and which is caused by the cold producing an irritation of the nerve-trunk, the filaments, or fibers of which, supplied the fingers or toes of the lost member.

On the other hand, if the anterior bundle of nerve-fibers given off from the spinal cord is irritated in precisely the same way, only half of these effects is produced. All the muscles which are supplied with fibers from that trunk contract, but no pain is experienced. Conversely, if the posterior bundle of nerve-fibers is irritated, none of the muscles to which the filaments of the nerve are distributed contract, but pain is felt throughout the entire region to which these filaments are extended. It is evident, from these facts, that the fibers composing the posterior bundles of nerve-roots only transmit sensory impulses, and the filaments composing the anterior nerve-roots only transmit motor impulses; accordingly, they are termed respectively the sensory and the motor nerve-roots. This is illustrated by the fact that when the posterior root of a spinal nerve is divided, all sensation in the parts to which the filaments of that nerve are distributed is lost, but the power of voluntary movement of the muscles remains. On the other hand, if the anterior roots are severed, the power of voluntary motion of the muscles is lost, but sensation remains.

It appears from these experiments, that, when a nerve is irritated, a change in the arrangement of its molecules takes place, which is transmitted along the nerve-fibers. But, if the nerve-trunks are divided, or compressed tightly at any point [pg 93]between the portion irritated, and the muscle or nerve-centre, the effect ceases immediately, in a manner similar to that in which a message is stopped by the cutting of a telegraph wire. When the nerves distributed to a limb are subjected to a pressure sufficient to destroy the molecular continuity of their filaments, it "goes to sleep," as we term it. The power of transmitting sensory and motor impulses is lost, and only returns gradually, as the molecular continuity is restored.

From what has been said, it is plain that a sensory nerve is one which conveys a sensory impulse from the peripheral or outer part of a nerve to the spinal cord or brain, and which is, therefore, termed afferent; and that a motor nerve is one which transmits an impulse from the nerve centre, or is efferent. So difference in structure, or in chemical or physical composition, can be discerned between the afferent and the efferent nerves. A certain period of time is required for the transmission of all impulses. The speed with which an impulse travels has been found to be comparatively slow, being even less than that of sound, which is 1,120 feet per second.

The experiments heretofore related have been confined solely to the nerves. We may now proceed to the consideration of what takes place when the spinal cord is operated upon in a similar way. If the cord be divided with a knife or other instrument, all parts of the body supplied with nerves given off below the division will become paralyzed and insensible, while all parts of the body supplied with nerves from the spinal cord above the division will retain their sensibility and power of motion. If, however, only the posterior half of the spinal cord is divided, or destroyed, there is loss of sensation alone; and, if the anterior portion is cut in two, and the continuity of the posterior part is left undisturbed, there is loss of voluntary motion of the lower limbs, but sensation remains.

Reflex Action of the Spinal Cord. In relation to the brain, the spinal cord is a great mixed motor and sensory nerve, but, in addition to this, it is also a distinct nervous centre, in which originate and terminate all those involuntary impulses which exert so potent an influence in the preservation and economy of the body. That peculiar power of the cord by which it is enabled to convert sensory into motor impulse [pg 94]is that which distinguishes it, as a central organ, from a nerve, and is called reflex action.

The gray matter, and not the white, is the part of the cord which possesses this power. This reflex action is a special function of the spinal cord, and serves as a monitor to, and regulator of the organs of nutrition and circulation, by placing them, ordinarily, beyond the control of conscious volition.

Fig. 57.

If the foot of a decapitated frog is irritated, there is an instant contraction of the corresponding limb; if the irritation is intense the other limb also contracts. These motions indicate the existence, in some part of the spinal cord, of a distinct nerve-centre, capable of converting and reflecting impulses. It has been found by experiment, that the same movements will take place if the irritation be applied to any portion of the body to which the spinal nerves are distributed, thus giving undoubted evidence that the spinal cord in its entirety is capable of causing these reflections. Fig. 57 represents the course of the nervous impulses. The sensory impulse passes upward along the posterior root, a, until it reaches the imbedded gray matter, b, of the cord, by which it is reflected, as a motor impulse, downward along the anterior root, c, to the muscles whence the sensation was received. This is the reflex action of the spinal cord. There is no consciousness or sensation connected with this action, and the removal of the brain and the sympathetic system does not diminish its activity. Even after death it continues for some time, longer in cold-blooded than in warm-blooded animals, on account of the difference in temperature, thus showing this property of the spinal cord. By disease, or the use of certain poisons, this activity may be greatly augmented, as is frequently observed in the human subject. A sudden contact with a different atmosphere may induce these movements. The contraction of the muscles, or cramp, often experienced by all persons, in stepping into a cold bath, or emerging from the cozy sitting-room into a chilly December temperature, are familiar illustrations of [pg 95]reflex movements. It has been demonstrated that the irritability of the nerves may be impaired or destroyed, while that of the muscles to which they are distributed remains unchanged; and that the motor and sensory classes of filaments may be paralyzed independently of each other.

The reflex actions of the spinal cord have been admirably summed up by Dr. Dalton, as exerting a general, protective influence over the body, presiding over the involuntary action of the limbs and trunk, regulating the action of the sphincters, rectum, and bladder, and, at the same time, exercising an indirect influence upon the nutritive changes in all parts of the body to which the spinal filaments are distributed.

The Brain. The brain is a complex organ, which is divided into the medulla oblongata, the cerebellum, and the cerebrum.

The medulla oblongata is situated just above the spinal cord, and is continuous with it below, and the brain above. It has distinct functions which are employed in the preservation and continuance of life. It has been termed the "vital knot," owing to the fact that the brain may be removed and the cord injured and still the heart and lungs will continue to perform their functions, until the medulla oblongata is destroyed.

The arrangement of the white and gray matter of the medulla oblongata is similar to that of the spinal cord; that is to say, the white matter is external and the gray internal; whereas in the cerebellum and cerebrum this order is reversed. The fibres of the spinal cord, before entering this portion of the brain, decussate, those from the right side crossing to the left, and those from the left crossing to the right side. By some authors this crossing of the sensory and motor filaments has been supposed to take place near the medulla oblongata. Dr. Brown-Sequard shows, however, that it takes place at every part of the spinal cord. The medulla oblongata is traversed by a longitudinal fissure, continuous with that of the spinal cord. Each of the lateral columns thus formed are subdivided into sections, termed respectively the Corpora Pyramidalia, the Corpora Olivaria, the Corpora Restiformia and the Posterior Pyramids.

[pg 96]The Corpora Pyramidalia (see 1, 1, Fig. 58) are two small medullary eminences or cords, situated at the posterior surface of the medulla oblongata; approaching the Pons Varolii these become larger and rounded.

The Corpora Olivaria (3, 3, Fig. 58) are two elliptical prominences, placed exterior to the corpora pyramidalia. By some physiologists these bodies are considered as the nuclei, or vital points, of the medulla oblongata. Being closely connected with the nerves of special sensation, Dr. Solly supposed that they presided over the movements of the larynx.

Fig. 58.

Fig. 59.

The Corpora Restiformia (5, 5, Fig. 59) are lateral and posterior rounded projections of whitish medulla, which pass upward to the cerebellum and form the crura cerebelli, so called because they resemble a leg. The filaments of the pneumogastric nerve originate in the ganglia of these parts.

The Posterior Pyramids are much smaller than the other columns of the medulla oblongata. They are situated (4, 4, Fig. 59) upon the margin of the posterior fissures in contact with each other.

The functions of the medulla oblongata, which begin with the earliest manifestations of life, are of an instinctive [pg 97]character. If the cerebellum and cerebrum of a dove be removed, the bird will make no effort to procure food, but if a crumb of bread be placed in its bill, it is swallowed naturally and without any special effort. So also in respiration the lungs continue to act after the intercostal muscles are paralyzed; if the diaphragm loses its power, suffocation is the result, but there is still a convulsive movement of the lungs for sometime, indicating the continued action of the medulla oblongata.

The Cerebellum, or little brain, is situated in the posterior chamber of the skull, beneath the tentorium, a tent-like process of the dura mater which separates it from the cerebrum. It is convex, with a transverse diameter of between three and one-half and four inches, and is little more than two inches in thickness. It is divided on its upper and lower surfaces into two lateral hemispheres, by the superior and inferior vermiform processes, and behind by deep notches. The cerebellum is composed of gray and white matter, the former being darker than that of the cerebrum. From the beautiful arrangement of tissue, this organ has been termed the arbor vitæ.

The peduncles of the cerebellum, the means by which it communicates with the other portions of the brain, are divided into three pairs, designated as the superior, middle and inferior. The first pass upward and forward until they are blended with the tubercles of the corpora quadrigemina. The second are the crura cerebelli, which unite in two large fasciculi, or pyramids, and are finally lost in the pons varolii. The inferior peduncles are the corpora restiformia, previously described, and consist of both sensory and motor filaments. Some physiologists suppose that the cerebellum is the source of that harmony or associative power which co-ordinates all voluntary movements, and effects that delicate adjustment of cause to effect, displayed in muscular action. This fact may be proved by removing the cerebellum of a bird and observing the results, which are an uncertainty in all its movements, and difficulty in standing, walking, or flying, the bird being unable to direct its course. In the animal kingdom we find an apparent correspondence between the size of the cerebellum and the variety and extent of the movements of the animal. Instances [pg 98]are cited, however, in which no such proportion exists, and so the matter is open to controversy. The general function of the cerebellum, therefore, cannot be explained, but the latest experiments in physiological and anatomical science seem to favor the theory that it is in some way connected with the harmony of the movements. This co-ordination, by which the adjustment of voluntary motion is supposed to be effected, is not in reality a faculty having its seat in the brain substance, but is the harmonious action of many forces through the cerebellum.

The Cerebrum occupies five times the space of all the other portions of the brain together. It is of an ovoid form, and becomes larger as it approaches the posterior region of the skull. A longitudinal fissure covered by the dura mater separates the cerebrum into two hemispheres, which are connected at the base of the fissure, by a broad medullary band, termed the corpus callosum. Each hemisphere is subdivided into three lobes. The anterior gives form to the forehead, the middle rests in the cavity at the base of the skull, and the posterior lobe is supported by the tentorium, by which it is separated from the cerebellum beneath. One of the most prominent characteristics of the cerebrum is its many and varied convolutions These do not correspond in all brains, nor even on the opposite sides of the same brain, yet there are certain features of similarity in all; accordingly, anatomists enumerate four orders of convolutions. The first order begins at the substantia perforata and passes upward and around the corpus callosum toward the posterior margin of that body, thence descends to the base of the brain, and terminates near its origin. The second order originates from the first, and subdivides into two convolutions, one of which composes the exterior margin and superior part of the corresponding hemisphere, while the other forms the circumference of the fissure of Sylvius. The third order, from six to eight in number, is found in the interior portion of the brain, and inosculates between the first and second orders. The fourth is found on the outer surface of the hemisphere, in the space between the sub-orders of the second clasp. A peculiar fact relating to these convolutions is observed by all anatomists: mental [pg 99]development is always accompanied by an increasing dissimilarity between their proportional size.

The cerebral hemispheres may be injured or lacerated without any pain to the patient. The effect seems to be one of stupefaction without sensation or volition. A well-developed brain is a very good indication of intelligence and mental activity. That the cerebrum is the seat of the reasoning powers, and all the higher intellectual functions, is proved by three facts. (1.) If this portion of the brain is removed, it is followed by the loss of intelligence. (2.) If the human cerebrum is injured, there is an impairment of the intellectual powers. (3.) In the animal kingdom, as a rule, intelligence corresponds to the size of the cerebrum. This general law of development is modified by differences in the cerebral texture. Men possessing comparatively small brains may have a vast range of thought and acute reasoning powers. Anatomists have found these peculiarities to depend upon the quantity of gray matter which enters into the composition of the brain.

In the cerebro-spinal system there are three different kinds of reflex actions. (1.) Those of the spinal cord and medulla oblongata are performed without any consciousness or sensation on the part of the subject. (2.) The second class embraces those of the tuber annulare, where the perception gives rise to motion without the interference of the intellectual faculties. These are denominated purely instinctive reflex actions, and include all those operations of animals which seem to display intelligent forethought; thus, the beaver builds his habitation over the water, but not a single apartment is different from the beaver homestead of a thousand years ago; there is no improvement, no retrogression. Trains of thought have been termed a third class of reflex actions. It is evident that the power of reasoning is, in a degree, possessed by some of the lower-animals: for instance, a tribe of monkeys on a foraging expedition will station guards at different parts of the field, to warn the plunderers of the approach of danger. A cry from the sentinel, and general confusion is followed by retreat. Reason only attains its highest development in man, in whom it passes the bounds of ordinary existence, and, with the magic wand of love, reaches outward into the [pg 100]vast unknown, lifting him above corporeal being, into an atmosphere of spiritual and divine Truth.

Fig. 60. Section of the brain and an ideal view of the pneumogastric nerve on one side, with its branches, a. Vertical section of the cerebrum. b. Section of the cerebellum, c. Corpus callosum. d. Lower section of medulla oblongata. Above d, origin of the pneumogastric nerve. 1. Pharyngeal branch. 2. Superior laryngeal. 5. Branches to the lungs. 4. Branches to the liver. 6. Branches to the stomach.

The Cranial Nerves. From the brain, nerves are given off in pairs, which succeed one another from in front backwards to the number of twelve. The first pair, the olfactory nerves, are the nerves of the sense of smell. The second pair are the optic, or the nerves of the sense of sight. The third pair are called the motores oculi, the movers of the eye, from the fact that they are distributed to all the muscles of the eye with the exception of two. The fourth pair and the sixth pair each supply one of the muscles of the eye, on each side, the fourth extending to the superior oblique muscle, and the sixth to the external rectus muscle. The nerves of the fifth pair are very large; they are each composed of two bundles of filaments, one motor and the other sensory, and have, besides, an additional resemblance to a spinal nerve by having a ganglion on each of their sensory roots, and, from the fact that they have three chief divisions, are often called the trigeminal, or trifacial, nerves. They are nerves of special sense, of sensation, and of motion. They are the sensitive nerves which supply the cranium and face, the motor nerves of the muscles of mastication, the buccinator and the masseter, and their third branches, often called the gustatory, are distributed to the front portion of the tongue, and are two of the [pg 101]nerves of the special sense of taste. The seventh pair, called also the facial nerves, are the motor nerves of the muscles of the face, and are also distributed to a few other muscles; the eighth pair, termed the auditory nerves, are the nerves of the special sense of hearing. As the seventh and eighth pairs of nerves emerge from the cavity of the skull together, they are frequently classed by anatomists as one, divided into the facial, or portio dura, as it is sometimes called, and the auditory, or portio mollis. The ninth pair, called the glosso-pharyngeal, are mixed nerves, supplying motor filaments to the pharyngeal muscles and filaments of the special sense of taste to the back portion of the tongue. The tenth pair, called the pneumogastric, or par vagum, are very important nerves, and are distributed to the larynx, the lungs, the heart, the stomach, and the liver, as shown in Fig. 60. This pair and the next are the only cerebral nerves which are distributed to parts of the body distant from the head. The eleventh pair, also called spinal accessory, arise from the sides of the spinal marrow, between the anterior and posterior roots of the dorsal nerves, and run up to the medulla oblongata, and leave the cranium by the same aperture as the pneumogastric and glosso-pharyngeal nerves. They supply certain muscles of the neck, and are purely motor. As the glosso-pharyngeal, pneumogastric, and spinal accessory nerves leave the cranium together, they are by some anatomists counted as the eighth pair. The twelfth pair, known as the hypoglossal, are distributed to the tongue, and are the motor nerves of that organ.

THE GREAT SYMPATHETIC.

A double chain of nervous ganglia extends from the superior to the inferior parts of the body, at the sides and in front of the spinal column, and is termed, collectively, the system of the great sympathetic. These ganglia are intimately connected by nervous filaments, and communicate with the cerebro-spinal system by means of the motor and sensory filaments which penetrate the sympathetic. The nerves of this system are distributed to those organs over which conscious volition has no direct control.

Fig. 61. Course and distribution of the great Sympathetic Nerve

[pg 103]Four of the sympathetic centers, situated in the front and lower portions of the head, are designated as the ophthalmic, spheno-palatine, submaxillary and otic ganglia. The first of these, as its name indicates, is distributed to the eye, penetrates the sclerotic membrane (the white, opaque portion of the eyeball, with its transparent covering), and influences the contraction and dilation of the iris. The second division is situated in the angle formed by the sphenoid and maxillary bone, or just below the ear. It sends motor and sensory filaments to the palate, and velum palati. Its filaments penetrate the carotid plexus, are joined by others from the motor roots of the facial nerve and the sensory fibres of the superior maxillary. The third division is located on the submaxillary gland. Its filaments are distributed to the sides of the tongue, the sublingual, and submaxillary glands. The otic ganglion is placed below the base of the skull, and also connects with the carotid plexus. Its filaments of distribution supply the internal muscles of the malleus, the largest bones of the tympanum, the membranous linings of the tympanum and the eustachian tube. Three ganglia, usually designated as the superior, middle, and inferior, connect with the cervical and spinal nerves. Their interlacing filaments are distributed to the muscular walls of the larynx, pharynx, trachea, and esophagus, and also penetrate the thyroid gland. The use of this gland is not accurately known. It is composed of a soft, brown tissue, and consists of lobules contained in lobes of larger size. It forms a spongy covering for the greater portion of the larynx, and the first section of the trachea. That it is an important organ, is evident from the fact that it receives four large arteries, and filaments from two pairs of nerves.

The sympathetic ganglia of the chest correspond in number with the terminations of the ribs, over which they are situated. Each ganglion receives two filaments from the intercostal nerve, situated above it, thus forming a double connection. The thoracic ganglia supply with motor fibres that portion of the aorta which is above the diaphragm, the esophagus, and the lungs.

In the abdomen the sympathetic centers are situated upon the coeliac artery, and are termed, collectively, the semilunar [pg 104]coeliac ganglion. Numerous inosculating branches radiate from this center and are called, from the method of their distribution, the solar plexus. From this, also, originate other plexi which are distributed to the stomach, liver, kidneys, intestines, spleen, pancreas, supra-renal glands, and to the organs of generation. Four other pairs of abdominal ganglia connected with, the lumbar branches are united by filaments to form the semilunar ganglion.

The sympathetic ganglia of the pelvis consist of five pairs, which are situated upon the surface of the sacrum. At the extremity of the spinal column this system terminates in a single knot, designated as the ganglion impar.

Owing to the position of the sympathetic ganglia, deeply imbedded in the tissues of the chest and abdomen, it is exceedingly difficult to subject them to any satisfactory experiments. A few isolated facts form the basis of all our knowledge concerning their functions. They give off both motor and sensory filaments. The contraction of the iris is one of the most familiar examples of the action of the sympathetic system.

In the reflex actions of the nerves of special sense, the sensation is transmitted through the cerebro-spinal system, and the motor impulse is sent to the deep-seated muscles by the sympathetic system. Physiologists enumerate three kinds of reflex actions, which are either purely sympathetic, or partially influenced by the cerebro-spinal system. Dr. Dalton describes them as follows:

First.—"Reflex actions taking place from the internal organs, through the sympathetic and cerebro-spinal systems, to the voluntary muscles and sensitive surfaces.—The convulsions of young children are often owing to the irritation of undigested food in the intestinal canal. Attacks of indigestion are also known to produce temporary amaurosis [blindness], double vision, strabismus, and even hemiplegia. Nausea, and a diminished or capricious appetite, are often prominent symptoms of early pregnancy, induced by the peculiar condition of the uterine mucous membrane."

Second.—"Reflex actions taking place from the sensitive surfaces, through the cerebro-spinal and sympathetic systems [pg 105]to the involuntary muscles and secreting organs.—Imprudent exposure of the integument to cold and wet, will often bring on a diarrhea. Mental and moral impressions, conveyed through the special senses, will affect the motions of the heart, and disturb the processes of digestion and secretion. Terror, or an absorbing interest of any kind, will produce a dilatation of the pupil, and communicate in this way a peculiarly wild and unusual expression to the eye. Disagreeable sights or odors, or even unpleasant occurrences, are capable of hastening or arresting the menstrual discharge, or of inducing premature delivery."

Third.—"Reflex actions taking place through the sympathetic system from one part of the body to another.—The contact of food with the mucous membrane of the small intestine excites a peristaltic movement in the muscular coat. The mutual action of the digestive, urinary, and internal generative organs upon each other takes place entirely through the medium of the sympathetic ganglia and their nerves. The variation of the capillary circulation in different abdominal viscera, corresponding with the state of activity or repose of their associated organs, are to be referred to a similar nervous influence. These phenomena are not accompanied by any consciousness on the part of the individual, nor by any apparent intervention of the cerebro-spinal system."

CHAPTER XIII.

THE SPECIAL SENSES.

SIGHT.

The eye is the organ through which we perceive, by the agency of light, all the varied dimensions relations, positions, and visible qualities of external objects.

The number, position, and perfection of the eyes, vary remarkably in different orders, in many instances corresponding to the mode of life, habitation, and food of the animal. A skillful anatomist may ascertain by the peculiar formation of the eye, without reference to the general physical structure, in what element the animal lives. Sight is one of the most perfect of the senses, and reveals to man the beauties of creation. The æsthetic sentiment is acknowledged to be the most refining element of civilized life. Painting, sculpture, architecture, and all the scenes of nature, from a tiny way-side flower to a Niagara, are subjects in which the poet's eye sees rare beauties to mirror forth in the rhythm of immortal verse.

In the vertebrates, the organs of vision are supplied with filaments from the second pair of cranial nerves. In mammalia, the eyes are limited to two in number, which in man are placed in circular cavities of the skull, beneath the anterior lobes of the cerebrum. Three membranes form the lining of this inner sphere of the eye, called respectively the Sclerotic, Choroid, and Retina.

The Sclerotic, or outer covering, is the white, firm membrane, which forms the larger visible portion of the eyeball. It is covered in front by a colorless, transparent segment, termed the cornea, which gives the eye its lustrous appearance. Within the sclerotic, and lining it throughout, is a thin, dark membrane [pg 107]termed the Choroid. Behind the cornea it forms a curtain, called the iris, which gives to the eye its color. The muscles of the iris contract or relax according to the amount of light received, thus enlarging or diminishing the size of the circular opening called the pupil. The Retina is formed by the optic nerve, which penetrates the sclerotic and choroid and spreads out into a delicate, grayish, semi-transparent membrane. The retina is one of the most essential organs of vision, and consists of two layers. A spheroidal, transparent body, termed the crystalline lens, is situated directly behind the pupil. It varies in density, increasing from without inward, and forms a perfect refractor of the light received. The space in front of the crystalline lens is separated by the iris into two compartments called respectively the anterior and posterior chambers. The fluid contained within them, termed the aqueous humor, is secreted by the cornea, iris, and ciliary processes. The space behind the crystalline lens is occupied by a fluid, called the vitreous humor. This humor is denser than the other fluids and has the consistency of jelly, being perfectly transparent. "The function of the crystalline lens is to produce distinct perception of form and outline."^[3] The transparent humors of the eye also contribute to the same effect, but only act as auxiliaries to the lens.

Fig. 62.

The figure on the next page represents the course of the rays of light proceeding from an object a b, refracted by the lens, and forming the inverted image x y on the screen. All rays of light proceeding from b are concentrated at y, and those proceeding from a converge at x. Rays of light emanating from the center of the object a b pursue a parallel course, [pg 108]and form the center of the image. Rays of light passing through a double convex lens converge at a point called the focus. In the organ of vision, if perfect, the focus is on the retina, which serves as a screen to receive the image or impression. We have a distinct perception of the outline of a distant hill, and also of a book lying before us. The rays of light we receive from these objects cannot have the same focus. How, then, can we account for the evident accommodation of the eye to the varying distances? Various theories have been advanced to explain this adjustment; such as changes in the curvature of the cornea and lens; a movement of the lens, or a general change in the form of the eyeball, by which the axis may be lengthened or shortened.

Fig. 63.

Two facts comprise all the positive knowledge which we possess on this subject. Every person is conscious of a muscular effort in directing the eye to a near object, as a book, and of fatigue, if the attention is prolonged. If, now, the eyes be directed to a distant object, there will result a sense of rest, or passiveness. By various experiments it has been proved that the accommodation or adjustment of the eye for near objects requires a muscular effort, but for distant objects the muscles are in an essentially passive condition. An increase in the convexity of the crystalline lens is now admitted to be necessary for a distinct perception of near objects. We may give two simple illustrations, cited by Dr. Dalton in his recent edition of Human Physiology. If a candle be held near the front of an eye which is directed to a distant object, three reflected images of the flame will be seen in the eye, one on each of the anterior surfaces of the cornea and lens, and a third on the posterior surface of the latter. If the eye is directed to a near object, the reflection on the cornea remains unchanged, while that on the anterior surface of the lens gradually diminishes and approximates in size the reflection on the cornea, thus giving conclusive evidence that, in viewing a near object, the anterior surface of the crystalline lens become more convex, and at [pg 109]the same time approaches the cornea. Five or six inches is the minimum limit of the muscular adjustment of the eye. From that point to all the boundless regions of space, to every star and nebulæ which send their rays to our planet, human vision can reach. It is the sense by which we receive knowledge of the myriads of worlds and suns which circle with unfailing precision through infinite space.

HEARING.

Fig. 64. Internal and external ear. 1. External ear. 2. Internal auditory meatus. 3. Tympanum. 4. Labyrinth. 5. Eustachian tube.

Hearing depends upon the sonorous vibrations of the atmosphere. The waves of sound strike the sensitive portions of the ear, and their impressions upon the auditory nerves are termed the sensations of hearing. The ear is divided into three parts, called respectively the External, Middle, and Internal ear.

The external organs of hearing are two in number, and placed on opposite sides of the head. In most of the higher order of vertebrates, they are so situated as to give expression and proportion to the facial organs, and, at the same time, to suit the requirements of actual life.

The External ear is connected with the interior part by a prolongation of its orifice, termed the external auditory meatus. In man, this gristly portion of the auditory apparatus is about one inch in length, lined by a continuation of the integument of the ear, and has numerous hairs on its surface, to prevent the intrusion of foreign substances. Between the external meatus and the cavity of the middle ear is the membrana [pg 110]tympani, which is stretched across the opening like the head of a drum. The tympanum, or ear-drum, communicates with the pharynx by the eustachian tube, which is a narrow passage lined with delicate, ciliated epithelium. On the posterior portion it is connected with the mastoid cells. Three small bones are stretched across the cavity of the tympanum, and called, from their form, the malleus, incus and stapes, or the hammer, anvil, and stirrup. Agassiz mentions a fourth, which he terms the os orbiculare. Each wave of sound falling upon the membrana tympani, throws its molecules into vibrations which are communicated to the chain of bones, which, in turn, transmits them to the membrane of the foramen ovale. The three muscles which regulate the tension of these membranes are termed the tensor tympani, laxator tympani, and stapedium tympani.

The Labyrinth, or Internal ear, is a complicated cavity, consisting of three portions termed the vestibule, cochlea, and semi-circular canals. The vestibule is the central portion and communicates with the other divisions. The labyrinth is filled with a transparent fluid, termed perilymph, in which are suspended, in the vestibules and canals, small membranous sacs, containing a fluid substance, termed endolymph (sometimes called vitrine auditive from its resemblance to the vitreous humor of the eye). The filaments of the auditory nerve penetrate the membranous tissues of these sacs, and also of those suspended at the commencement of the semi-circular canals. These little sacs are supposed to be the seat of hearing, and to determine, in some mysterious way, the quality, intensity and pitch of sounds.

The determination of the direction of sound is a problem of acoustics. Some have contended that the arrangement of the semi-circular canals is in some way connected with this sensation. But this supposition, together with the theory of the transmission of sound through the various portions of the cranial bones, has been exploded.

From the foregoing description, it will be seen that the labyrinth and tympanum are the most essential parts of the organs of hearing. In delicacy and refinement this sense ranks next to sight. The emotions of beauty and [pg 111]sublimity, excited by the warbling of birds and the roll of thunder, are scarcely distinguishable from the intense emotions arising from sight. It is a remarkable fact, that the refinement or cultivation of these senses is always found associated. Those nations which furnish the best artists, or have the highest appreciation of painting and sculpture, produce the most skillful musicians, those who reduce music to a science.

SMELL.

Fig. 65. 1. Frontal sinus. 2. Nasal bone. 3. Olfactory ganglion and nerves. 4. Nasal branch of the fifth pair. 5. Spheno-palatine ganglion. 6. Soft palate. 7. Hard palate, a. Cerebrum, b. Anterior lobes, c. Corpus callosum. d. Septum lucidum. f. Fornix. g. Thalami optici. h. Corpora striata.

Next in order of delicacy, and more closely allied with the physical functions, is the sense of smell. Delicate perfumes, or the fragrance of a flower, impart an exhilarating sensation of delight, while numerous odors excite a feeling of disgust. The organ of smell is far less complicated in its structure than the eye or the ear. It consists of two cavities having cartilaginous walls, and lined with a thick mucous coat, termed the pituitary membrane, over which are reflected the olfactory nerves. Particles of matter, too minute to be visible even through the microscope, are detached from the odorous body and come in contact with the nerves of smell, which transmit the impressions or impulses thus received to the brain. Fig. 65 shows the distribution of the olfactory nerves in the nasal passages. The nose is supplied with two kinds of [pg 112]filaments which are termed respectively nerves of special and nerves of general sensation. Compared with the lower animals, especially with those belonging to the carnivorous species, the sense of smell in man is feeble. The sensation of smell is especially connected with the pleasures and necessities of animal life.

TASTE.

The sense of taste is directly connected with the preservation and nutrition of the body. A delicious flavor produces a desire to eat a savory substance. Some writers on hygiene have given this sense an instinctive character, by assuming that all articles having an agreeable taste are suitable for diet. The nerves of taste are distributed over the surface of the tongue and palate, and their minute extremities terminate in well developed papillæ. These papillæ are divided into three classes, termed, from their microscopic appearance, filiform, fungiform and circumvallate. The organ of taste is the mucous membrane which covers the back part of the tongue and the palate. The papillæ of the tongue are large and distinct, and covered with separate coats of epithelium. The filiform papillæ are generally long and pointed and are found over the entire surface of the tongue. The fungiform are longer, small at the base and broad at the end. The circumvallate are shaped like an inverted V and are found only near the root of the tongue; the largest of this class of papillæ have other very small papillæ upon their surfaces. It is now pretty satisfactorily established that the circumvallate, or fungiform papillæ are the only ones concerned in the special sense of taste.

The conditions necessary to taste are, that the substance be in solution either by artificial means, or by the action of the saliva; and that it be brought in contact with the sensitive filaments imbedded in the mucous membrane. The nerves of taste are both general and special in their functions. If the general sensibility of the nerves of taste is unduly excited, the function of sensibility is lost for some time. If a peppermint lozenge is taken into the mouth, it strongly excites the general sensibilities of taste, and the power of distinguishing between special flavors is lost for a few moments. A [pg 113]nauseous drug may then be swallowed without experiencing any disagreeable taste.

Paralysis of the facial nerve often produces a marked effect in the sensibility of the tongue. Where this influence lies has not been fully explained; probably it is indirect, being produced by some alteration in the vascularity of the parts or a diminution of the salivary secretions.

TOUCH.

By the sense of touch, we mean the general sensibility of the skin. Sensations of heat and cold are familiar illustrations of this faculty. By the sense of touch, we obtain a knowledge of certain qualities of a body, such as form consistency, roughness, or smoothness of surface, etc. The tip of the tongue possesses the most acute sensibility of any portion of the body, and next in order are the tips of the fingers. The hands are the principal organs of tactile sensation. The nerves of general sensibility are distributed to every part of the cutaneous tissue. The contact of a foreign body with the back, will produce a similar tactile sensation, as with the tips of the fingers. The sensation, however, will differ in degree because the back is supplied with a much smaller number of sensitive filaments; in quality it is the same.

CHAPTER XIV.

CEREBRAL PHYSIOLOGY.

By means of the nervous system, an intimate relation is maintained between mind and body, for nervous energy superintends the functions of both. The fibres of nervous matter are universally present in the organization, uniting the physical and spiritual elements of man's being. Even the minutest nerve-rootlets convey impressions to the dome of thought and influence the intellectual faculties. We recognize muscular force, the strength of the body, molecular force, molecules in motion, as heat, light, chemical force, electricity, and nervous force, a certain influence which reacts between the animal functions and the cerebrum, thus connecting the conditions of the body with those of the mind. We cannot speak of the effects of mind or body separately, but we must consider their action and reaction upon each other, for they are always associated. There are many difficulties in understanding this relationship, some of which may be obviated by a study of the development of nervous matter, and its functions in the lower orders of organization.

Within the plant-cells is found a vital, vegetable substance termed bioplasm, or protoplasm; which furnishes the same nutritive power as the tissues of the polyp and jelly fish. Many families of animals have pulpy bodies, and slight instinctive motion and sensibility, and in proportion as the nervous system is developed, both of these powers are unfolded. Plants have a low degree of sensibility, limited motion, respiratory and circulatory organs. Animals possess quicker perceptions and sensibilities, the power of voluntary motion, and, likewise [pg 115]a rudimental nervous system. Some articulates have no bony skeleton, their muscles being attached to the skin which constitutes a soft contracting envelope. One of the simplest forms of animal life in which a nervous system is found, is the five-rayed star-fish. In each ray there are filaments which connect with similar nerve-filaments from other rays, and form a circle around the digestive cavity. It probably has no conscious perception, and its movements do not necessarily indicate sensation or volition. In some worms a rudimentary nervous system is sparingly distributed to the cavities of the thorax and abdomen, and, as in the star-fish, the largest nerve-filament is found around the esophagus, presiding over nutrition.

Fig. 66.

A higher grade of organization requires a more complete arrangement of nervous substance. Stimulus applied to one organ is readily communicated to, and excites activity in another.

Fig. 67. A. Nervous system of a Crab, showing its ganglia. B. The nervous system of a Caterpillar.

The nervous system of some insects consists of two long, white cords, which run longitudinally through the abdomen, and are dilated at intervals into knots, consisting of collections of nerve-cells, called ganglia. They are really nerve-centers, which receive and transmit impulses, originate and impart nervous influence according to the nature of their organic surroundings. The ganglia situated over the esophagus of insects correspond to the medulla oblongata in man, in which originate the spinal [pg 116]accessory, glosso-pharyngeal, and pneumogastric nerves. The latter possess double endowments, and not only participate in the operations of deglutition, digestion, circulation, and respiration, but are also nerves of sensation and instinctive motion. The suspension of respiration produces suffocation. In insects, these ganglia are scarcely any larger than those distributed within the abdomen, with which they connect by means of minute, nervous filaments. Insects are nimble in their movements, and manifest instinct, corresponding to the perfection of their muscular and nervous systems. When we ascend to vertebrates, those animals having a backbone, the amount of the nervous substance is greater, the organic functions are more complex, and the actions begin to display intelligence.

Man possesses not only a complete sympathetic system, the rudiments of which are found in worms and insects, and a complete spinal system, less perfectly displayed in fishes, birds, and quadrupeds, but, superadded to all these is a magnificent cerebrum, and, as we have seen, all parts of the body are connected by the nervous system. The subtle play of sensory and motor impulses, of sentient and spiritual forces, indicates a perfection of nervous endowments nowhere paralleled, and barely approached by inferior animals. This meager reference to brainless animals, whoso knots of ganglia throughout their bodies act automatically as little brains, shows that instinct arises simultaneously with the development of the functions over which it presides. Here begins rudimentary, unreasoning intelligence. It originates within the body as an inward, vital impulse, is manifested in an undeviating manner, and therefore displays no intention or discretion. While Dr. Carpenter likens the human organism "to a keyed instrument, from which any music it is capable of producing can be called forth at the will of the performer," he compares "a bee or any other insect to a barrel organ, which plays with the greatest exactness a certain number of tunes that are set upon it, but can do nothing else." Instinct cannot learn from experience, or improve by practice; but it seems to be the prophetic germ of a higher intelligence. It is nearly as difficult to draw the dividing line between instinct and a low grade of intelligence, as it is to distinguish [pg 117]between the psychical and psychological^[4] functions of the brain.

The intimate relation of instinct to intelligence is admirably illustrated in the working honey-bee. With forethought it selects a habitation, constructs comb, collects honey, provides a cell for the ova, covers the chrysalis, for which it deposits special nourishment, and is disposed to defend its possessions. It is a social insect, lives in colonies, chastises trespassers, fights its enemies, and defends its home. It manifests a degree of intelligence, but its sagacity is instinctive. Reason, though not so acute as instinct, becomes, by education, discerning and keenly penetrative, and reveals the very secrets of profound thought. We recall the aptness of Prof. Agassiz's remark: "There is even a certain antagonism between instinct and intelligence, so that instinct loses its force and peculiar characteristics, whenever intelligence becomes developed." Animals having larger reasoning powers manifest less instinct, and some, as the leopard, exercise both in a limited degree. This double endowment with instinct and low reasoning intelligence, is indicated by his lying in ambush awaiting his prey, the hiding-place being selected near the haunt of other animals, where nature offers some allurement to gratify the appetite.

Simple reflex action is an instinctive expression, manifesting an intuitive perception, almost intelligent, as shown by the contraction of the stomach upon the food, simply because it impinges upon the inner coats, and thus excites them to action. A better illustration, because it displays sympathy, is when the skin, disabled by cold, cannot act, and its duties are largely performed by the kidneys. Though reflex action is easily traced in the lower organic processes, some writers have placed it on a level with rational deliberation. Undoubtedly, all animals having perception have also what perception implies—consciousness—and this indicates the possession, in some [pg 118]degree, of reason. Compound reflex action extends into the domain of thought. Simple reflex action, or instinct, answers to the animal faculties, such as acquisitiveness, secretiveness, selfishness, reproductiveness, etc., and accomplishes two important purposes; self-preservation and the reproduction of the specie. With many persons, these appear to be the chief ends of life!

The psychical functions connect, not only with animal propensities, but also with the highest psychological faculties. Instinct is the representative of animal conditions, just as the highest spiritual faculties are indicative of qualities and principles. The consistent mean of conduct is an equilibrium between these ultimate tendencies of our being. The psychological functions render the animal nature subservient to the rule of purity and holiness, and deeply influence it by the essential elements of spiritual existence. The psychical organs sustain an intermediate relation, receiving the impressions of the bodily propensities, and, likewise, of the highest emotions. Obviously, these extreme influences, the one growing out of animal conditions, the other, the result of spiritual relations, pass into the psychical medium and are refracted by it, or made equivalent to one force. The body requires the qualifying influences of mind. The tendencies of the animal faculties are selfish and limiting, those of the emotive, general, universal. The propensities, like gravity, expend their force upon matter; the emotions pour forth torrents of feeling, and produce rhapsodies of sentiment. The propensities naturally restrict their expression to a specific object of sense; the emotions respond to immaterial being. The tendencies of the former are acquisitive, selfish, gratifying; of the latter, bestowing, expanding, diffusing. The one class is restricted to the orbits of time and matter, the other flows on through the limitless cycles of infinity and immortality. The former is satiated in animal gratification, the latter in spiritual beatification. The one culminates in animal enjoyment, the other expands to its ultimate conceptions in the perfections of Divine Love.

In the present life, mind and body are intimately connected by nervous matter. In this dual constitution, the spiritual mental, and animal functions are made inseparable, and modify [pg 119]one another. The ultimate tendencies of each extreme exist, not absolutely for themselves, but for qualifying purposes, to establish a basis for the deeper economy of life. By the employment of reason, animal and spiritual experiences are mutually benefited, and the consciousness rendered accountable. The bodily and mental workings are in many senses one, and help to interpret each other.

Every fact of mind has many aspects. A brain force, which results in thought, is simultaneously a physiological force, if it influences the bodily functions. Likewise, spiritual conceptions take their rise in the same blood that feeds the grosser tissues. This vital fluid is momentarily imparting and receiving elements from all the bodily organs, and these, in turn, must influence the process of thought, and, in a degree, determine its quality. The delicate outline, yea, even the substance of an idea, may depend upon the condition of the animal organs. Thought is subject to the laws of biology, and, therefore, is a symbol of health. Morbid conditions of the system hang out their signs in words and utterances. Words which express fear are as true symptoms of functional difficulty as is excessive palpitation. The organ representing fear sustains a special relation to the functions of the heart both in health and disease. Bright hopes characterize pulmonary complaints as certainly as cough. Exquisite susceptibility of mind indicates equally extreme sensibility of body, and those persons capable of fully expressing the highest emotions are especially susceptible to bodily sensations. Tears are physical emblems of grief, and fellow-feeling calls forth sympathetic tears. Excessive anxiety of mind produces general excitability of body, which soon results in chronic disease. Pleasurable emotions stimulate the processes of nutrition, and are restorative. This concomitance of mental and bodily states is very remarkable. Joy and Love, as well as jealousy and anger, flash in the eye and mould the features to their expression. Grief excites the lachrymal, and rage the salivary glands. Shame reddens the ears, drops the eyelids, and flushes the face; but profligacy destroys these expressions. The blush which suffuses the forehead of the bashful maiden betrays her love, and maternal love, stirred by the appeals of an idolized infant, excites the mammary gland [pg 120]to the secretion of milk. The sigh of melancholia indicates hepatic torpor, thus showing a special relation between the liver and respiratory organs. These conditions of mind and body react upon one another. Even the thought of a luscious peach may cause the mouth to water. The thought of tasting a lemon fills the mouth with secretions, and a story with unsavory associations may completely turn the stomach.

The relationship of mental and physical functions may be illustrated by entirely removing the spleen of an animal, as that of a dog. An invariable result of its extirpation is an unusual increase of the appetite, for at times the animal will eat voraciously any kind of food. The dog will devour, with avidity, the warm entrails of recently killed animals, and thrive in consequence of such an appetite. Another symptom, which usually follows the removal of the spleen, is an unnatural ferocity of disposition. Without any apparent provocation, the animal will attack others of its own, or of a different species. In some instances, these outbursts of irritability and violence are only occasional, but the experiments show quite conclusively that the spleen moderates combativeness, restrains the appetite, and co-operates with the will and judgment in controlling them.

We shall briefly consider the practical question whether the elements of mind can be ideally arranged and presented, so as to more completely reveal their relations to, and disclose their effects upon the bodily functions. Modern philosophers conceive that mind consists of a triad of essentials; Intellect, Emotion, and Volition. Physiologists assign to the cerebrum its functions, and neurological, as well as phrenological writers, have located them as represented in Fig. 68. True, there is no structural division between the parts of the cerebrum to indicate this diversity of function, nor is there any perceptible limit between the sensory and motor filaments of the game nerve. As no one has any reason for denying that separate portions of the brain may manifest distinct functions of the mind, we shall assume it as a conceded proposition. The regions of the cerebrum, thus ideally represented, occupy but little more than half of the arc of a circle, whereas it is evident that the base of the nervous mass is not idle, and is equally entitled to our consideration. In the posterior chamber [pg 121]of the skull is the cerebellum, anterior to, and below which, is the medulla oblongata, connecting with the spinal cord and sympathetic system. These various parts are essential to the harmonious blending of mind and body. To this end, two conditions are necessary. (1.) All the nervous forces must be so related that action and reaction may be fully established. (2.) A complete nervous circuit is requisite for the reciprocal influence of mind and body.

Fig. 68.

Fig. 69.

Nature answers to mind in physical correspondences. The planetary system is fashioned after a circle. Life itself springs from a spherule of forces. The perfection of an idea, or the completeness of a conception may be expressed by a circle. The elements of Science, Astronomy, Geology, and Natural History, are pictorially represented in this manner. How appropriately and logically can a fragment of natural history, this epitome of all nature and science—the mind—be illustrated by a simple circle! Every element must act and react, and be equal and opposite. Thus may the existence of the opposing energies and functions of each faculty be equally represented. The contrast aids us in understanding their ultimate tendencies, and enables us to correctly value and define their nature. Faculties of kindred qualities may be grouped together, and their antagonisms represented in the opposite arc of the circle. Let us employ a circle to represent mind. The conception of the abstract [pg 122]quality of good, requires contrast with one of a converse nature, bad, (see Fig. 69). Opposite faculties may be portrayed in the same manner. The functions of the cerebrum and spinal system may be symbolically represented as those of the highest and lowest organs, thus giving rise to the positive and negative extremes of feeling. The writer conceives of no other way in which the widely contrasted facts of human experience can be so perfectly symbolized. Good (Fig. 69) may represent moral faculties, and bad, their opposites. Undoubtedly, nature is not so arbitrary in her arrangements as we are in shadowing forth our imperfect conceptions, yet is not this a decided improvement in determining cerebral faculties and their relations? We observe how scholars and philosophers confound the noblest and most exalted emotions with the animal propensities instead of distinguishing between them. "The emotions are a department of the feelings, formed by the intervention of intellectual processes. Several of them are so characteristic that they can be known only by individual experiences; as Wonder, Fear, Love, Anger." See Logic: Deductive and Inductive, by Alexander Bain, LL. D., page 508, (1874).

This is not an exceptional, but a common example of classifying Love, the highest and purest of the emotions, with Anger, an animal propensity. Is it not more practical and philosophical to group the emotional faculties together, and upon an opposite arc represent their antagonistic energies, the ultimate tendencies of which are criminal? Both groups are mutually modifying and restraining; the one relates instinctively to the bodily wants, the other to the requirements of mind, and each is essential to a consistent life. Accordingly, we deem it philosophical to consider words as symbols of mental faculties, and to classify together such spiritual unities as joy, hope, faith, and love, the tendencies of which are to quicken and transform the ultimates of carnal life into the rudiments of an immortal one, the beginning of heaven on earth. These restrain those opposites, which lead to crime and death. Love and Hate are as antagonistic as heat and cold, and the usefulness of both depends upon their proper temperament. Fig. 70 represents the antagonism of the Intellectual [pg 123]faculties to the Animal, the Emotional to the Criminal, the Volitive to the Enfeebling. It is not essential to discover in the nerve-substance the precise power from which an impulse originates. We may reasonably interpret the functions of the brain, and yet be unable to disclose the duties of any ganglionic corpuscle composing it. We may foretell what each season of the year will bring forth, when we cannot forecast the history of a blade of grass or a single grain of any kind. We may predict the amount of rain for a month, and be unable to prognosticate correctly, the character of any storm, or give the history of a special drop of water. Although we cannot follow the movements of individuals in a battle, yet we may predict the result of the combat; and thus, we judge of the functions of the brain without the ability to reveal the actions of one of the organic molecules of which it is composed. We aim to give a general, reasonable, and popular description of cerebral functions and their bearing upon health and disease.

Fig. 70.

REGIONAL DIVISIONS.

Fig. 71.

The anterior portion of the cerebrum is devoted to intellectual processes, which freely expend the vital energies. The Intellectual faculties are classified as represented in Fig. 71. The lower portion of the brain, bounded exteriorly by the superciliary ridge, corresponds to the Perceptive, the middle region to the Recollective, and the upper to the Reflective faculties. (See also Fig. 65, b.) If we divide the forehead by vertical lines, as shown in Fig. 71, the divisions thus formed represent respectively, the Active, Deliberative, and Contemplative departments of the intellect, all the processes of which are sustained by vital changes, the transformation of organized materials. No mental effort can be made without waste of [pg 124]nervous matter. The gardener's hoe wears by use, and so does every part of the animal organism. Otherwise, nutrition would be unnecessary for the adult. The production of thought wears away the cerebral substance. In ordinary use, the brain requires one-fifth of the blood to support its growth and repair. Great mental efforts are attended by a corresponding expenditure of vital treasures, which are abstracted from the total forces available for the necessities of the system. To repair the losses thus occasioned, materials are appropriated from the blood, which furnishes supplies in proportion to the demands made by the mental activities. The production of thought wears away the gray matter of the cerebrum as surely as the digging of a canal wears away the iron particles of the spade. The brain would soon wear out did not the nutritive functions constantly make good the waste. The intellect, whether engaged in observation, generalization, or profound study consumes the brain and blood, hence intellectual activity implies VITAL EXPENDITURE. Expenditure is an emphatic word because all functions are essential to the production of this nerve-energy, which returns to the system no equivalent. Physical exercise, although attended by structural waste, is advantageous to the circulation of the blood, nutrition, secretion, and, in fact, beneficial to all the organic processes. This is not true of vigorous and prolonged mental labor, which is not attended by any of these incidental advantages. If a child attends a school in which mental development supersedes physical culture, an inordinate ambition sways the youthful mind, and [pg 125]its baneful effects upon the health soon become manifest. Rigorous application of the intellectual faculties consumes the blood, exhausts the vital forces, weakens the organic functions, while pallor covers the face, and the eyes sparkle with a hectic radiance. The family physician pronounces the condition Anæmia (a deficiency of red corpuscles in the blood), and this change in the quality of the blood is owing to the undue appropriation by the brain. Conversely, if the blood be destroyed, or its vitality reduced, in the same proportion will the mental energies be weakened and all the functional powers of the physical system enfeebled. In brief, if the intellect be unduly exercised, the red corpuscles of the sanguine fluid will be gradually destroyed, and the serum allowed to predominate. The blood becomes weak and watery, the subject is nervous, dropsical, consumptive and derangement of the important functions follows almost invariably. Excessive intellectual activity often produces weak state of the system, and the person thus affected becomes languid, spiritless, and an easy prey to disease. This mental cause and its bodily results may be classified in the following order. Mental Cause: EXCESSIVE MENTAL EXERTION, which produces waste of the brain substance and blood.

This kind of waste is best summed up in the words, VITAL EXPENDITURE. Upon the forehead, as represented in Fig. 72, we will therefore inscribe INTELLECT, ACTIVITY, and VITAL EXPENDITURE. Intellectual employment is usually accompanied by sedentary habits, neglect of healthful exercise, and a deprivation of pure air, to all of which ill health may be attributed. Were the intellectual expenditure arrested, and the forces turned into recuperative channels, many a person would become beautiful with the ruddy glow of health. Without health there is no use for thought; cultivation of the mind is just as natural and essential as the culture of the body, and the trained development of both is needed for mutual improvement.

EMOTIVE FACULTIES.

Fig. 72.

What results follow the natural and the excessive exercise of the EMOTIVE FACULTIES? AS distinct organs of the body have diverse functions, so, in like manner, different parts of the brain perform the separate operations of the mind. It is easier to discriminate between the products of these dissimilar endowments than to determine the location of the faculties. The intellect deals with concrete subjects, and the emotions with abstractions; the intellect is exercised with material things, the emotions dwell upon attributes; the intellect considers the forces of matter, the emotions, the powers of [pg 127]the soul; the former deliberates upon the truths of science, the latter is concerned with duties, obligations, or moral responsibilities; the first is satisfied only with new truths, original ideas, and rational changes, the last rest securely on fundamental principles, moral certainties, and the absolute constancy of perfect love. The intellectual faculties are wakeful, questioning, mistrustful; the emotions are blind, hopeful, confiding; the one reasoning, exacting, demonstrating; the other, believing, inspiring, devout. The intellect sees, the emotions feel; and, though these functions may blend, the one can never supersede the other.

The quality of the emotional faculties is represented by Benevolence, Sympathy, Joy, Hope, Confidence, Gratitude, Love, and Devotion, all of which are the very antitheses of the attributes of animal feeling, described as Melancholy, Fear, Anger, Hate, Malevolence, and Despair. To the emotions we refer the highest qualities of character, while their opposites represent the animal or baser impulses. True, the emotions modify the propensities, as sympathy softens grief. They may subdue and refine the animal feelings, and thus veil them with a delicacy characteristic of their own purity; but the unrestrained influences of grief find vent in loud lamentations, and the bitter disappointments of the selfish faculties are passionate and violent.

The Emotive Faculties—the organs of spiritual perceptions—are impersonal, outflowing, bestowing. The function represented by Benevolence, is willing, giving. Devotion expresses dedication, consecration; Gratitude manifests a warm and friendly feeling toward a benefactor.

"The depth immense of endless gratitude."—MILTON.

Love flames toward its object, is out-pouring, blessing; indeed, all the emotions are gushing, effusive, impetuous, and profusely flowing; grand, torrent-like, overwhelming; employing ideal, immaterial, spiritual expressions, developing principles and perfections while aspiring to happiness and immortality. Though beginning with humanity, they embody the Divine. They expand to their ultimate conceptions in the sublime attributes: the perfections of the God of Love; associating [pg 128]with mortality a divine destiny commencing on earth, extending through time, pausing not at the portals of death, the gateway to eternity, but flowing onward into the realms of eternal day.

We may consider their counteracting influences, for, without doubt, by checking the selfish tendencies and restraining the animal propensities, they assist in controlling the sensual passions, and thus balance the mind and body. Such an equilibrium we call happiness. If the emotions be acute and vehement, they will absorb all other impressions and revel in their culminating and delightful experiences. They exhaust all the bodily energies, and a functional suspension, termed ecstasy, follows. It is a swooning, or fainting, a temporary loss of sensation and volition, accompanied by involuntary movements of the arms, smiting of the hands, sighing, and short ejaculatory expressions of rapture. This condition, occasioned by excessive emotion, as in praying, singing, exhortations, and sympathetic appeals, is contagious, often spreading with mysterious rapidity. Its culmination, ecstasy, is popularly termed "the power." When gradually induced, it is called trance, and each state is regarded by many as supernatural, caused by the immediate influence of the Holy Spirit. The explanation is this: when the emotive faculties are suddenly and powerfully excited, they quickly expend the organic forces, so that the individual swoons from sheer exhaustion. Undue expenditure of this class of brain functions not only consumes the bodily powers, but exhausts and prevents other mental operations. The sudden collapse of all voluntary functions resembles the fainting produced by blood-letting. We may sum up this rapid expenditure of energy in one expressive word, EXHAUSTION, which results in Ecstasy, or trance, and which, if carried a degree further, terminates in death. Beginning with the natural exercise of the emotions, we may state the order of sequences thus:

VOLITIVE FACULTIES.

What are the physiological and morbid results attending the ordinary and the immoderate exercise of the VOLITIVE FACULTIES?

The generic term will, comprehends those faculties, the action of which is termed volition. The faculties of the will are Determination, Firmness, Decision, Ambition, Authority, and Vigilance, all of which indicate strength and continuity of purpose. Bordering upon the emotions are Patience and Perseverance, while adjoining the animal faculties are Power, Coarseness, and Love of Display. The former exhibit moral, the latter animal heroism. A sense of power urges forward, whether it be higher or lower, just as the sense of greatness makes a man great by inspiring him with confidence to put forth exertion. Nature is truthful in her aspirations. We know that courage, assurance, and conscious power are necessary for the fulfillment of purpose, because intention precedes action. Will-power is an indication of HEALTH, and the constant exercise of these mental faculties exerts a steady, regular, and strengthening influence over the bodily functions. We translate mental energies into physiological industry. These faculties impart tone to the system, sustain the processes of nutrition, circulation, assimilation, secretion and excretion, and their distinguishing characteristics are vigor, tension, and elasticity. They temper each element of character, as well as every vital act. They infuse the organism with a resisting power which renders it proof against the influence of miasma and malaria, and overcomes that passivity and impressionability so favorable to disease. Firmness expresses a physiological cohesiveness which strongly binds together the fibers of the tissues, and renders the organization compact and powerful. He, who can skillfully employ these energies, is already master of half of the diseases incident to mankind, and wields an indispensable adjunct to medicine, in the practice of the healing art. It is the key to success, for it unlocks difficulties and opens wide the door which leads to favorable results.

Surplus energy sustains the circulation, increases capillary action, as if the excess of nerve-power were discharged from [pg 130]the distant extremity of each nerve and pervaded every tissue. The voluntary muscles indicate their participation in this energy, and, indeed, the whole organism is exalted by the influence of the mental faculties. They oppose the tendencies of Feebleness, Relaxation, and Derangement, and modify their proclivities to Disease. The will is the servant of the intellect, emotions, and propensities, and the executive agent of all the faculties. When the volitive faculties are in excess, they may overdo the other functions, prematurely break down the bodily organs, and, by overtaxing the system, subject it to pain and disorder.

VOLITIVE FACULTIES.

The natural effect of FIRMNESS is physiological stability. The exercise of the volitive faculties displays both mental and bodily ENERGY.

ANIMAL FACULTIES.

Fig. 73. is a representation of the cranial conformation of Alexander VI., exhibiting a full development of the conservative faculties. His character, according to history, brought reproach upon the papal chair.

Fig. 74. represents Zeno, a profound thinker and moral philosopher. The contrast in their cranial developments was no greater than that of their lives.

Under this generic term we will group those cerebral powers which are common to the inferior animals, and closely allied to bodily conditions and necessities. As denoting a group of animal faculties they relate not only to the organic functions and self-preservation, but combat the action of the intellect, [pg 131]oppose the evolution of new ideas, resist investigation, and discredit the value of truth. Adhesiveness, being blindly conservative, clings to old ideas and traditionary opinions. The animal faculties tend to stifle investigation, and put authority above truth and science. Having a fixity of nature, a stationary attachment, they treat all intellectual developments as absurd. When these faculties predominate, thought is obscured, intolerance of disposition is manifested, and mental progress is arrested. Thus they evince their conservative nature, and, since they relate to individual interests, they represent the elements of instinct. Such are the functions of Acquisitiveness, Secretiveness, Selfishness, and Combativeness, as well as the Generative powers. If these faculties predominate, all intellectual advancements are treated as experiments or theoretical novelties, and rejected as evanescent and worthless. If the promptings of these be followed, there will be no innovation, and the orthodoxy of the dark ages will remain the standard for all time. The animal faculties coincide with Lethargy, Sleep, and Nutrition, thus favoring organic restoration. The intellectual faculties are wakeful, active, irrepressible, while the animal powers tend to repose, sleep, and renovation, and thus suspend the activities of thought, sense, and motion. The intellect expends the energy of the sensorial centers, induces fatigue and suffering, whereas the animal faculties overcome the vigils of thought, and produce refreshing slumber. Dr. Young styles sleep "tired nature's sweet restorer." Swedenborg declared that, "in sleep the brain folded itself up, and the soul journeyed through the body, repairing the wastes of the previous day." When sleep is natural, the insane are in a fair way to recovery, the sick become convalescent, ulcers granulate, and lesions are made whole.

The animal faculties are skeptical, stubborn, and dogmatic, readily combining with those of the violent class, the ultimate tendencies of which are criminal. They are likewise conceited, assuming, and clannish. Any person distinguished by them, will cling to old associations, perpetuate the status of existing parties, be a stickler for creed, ceremonies, and stale opinions, and adhere to ancient orthodoxy in medicine and religion. The animal faculties, since they are staid and regular, are naturally [pg 132]antagonistic to genius, sensibility, and originality. Their mental tendencies have been fairly described and their physiological results may be represented as follows:

BASILAR FACULTIES.

The ultimate tendencies of the faculties, represented by the posterior base of the cerebrum, are violent and criminal. Being contiguous to the junction of the cerebrum and spinal system, they are subject to the influence of animal experiences. A large development of these faculties is indicated by an unusual breadth and depth of the back part of the base of the brain, and a full, thick neck, both of which denote good alimentary and digestive powers. Active nutrition, plethora of the circulation, vigorous secretion, a well developed muscular system, a large heart and lungs, are accessory conditions. We do not associate corpulence or surplus of vitality with a long, slender neck. The character of cerebral manifestations is represented by the baser faculties of mind, such as Combativeness, Destructiveness, Desperation, Turbulence, Hatred, and Revenge. If unrestrained, these culminate in violent and criminal acts; if regulated, they are employed in personal defense. When unduly excited, they lead to dissipation, obscenity, swearing, rowdyism, and licentiousness; when perverted, they are the source of recklessness, quarrels, frauds, falsehoods, robberies, and homicides. They are unlike instinct, inasmuch as they are not self-limiting. The intimate relation which they sustain to the stomach and nutritive functions is strikingly displayed in the habit of alcoholic intoxication. Spirituous drinks deprave the appetite, derange and destroy the stomach, poison the blood, and pervert all the functions of mind and body; and their injurious influence upon the nerves and basilar faculties is equally remarkable. They excite combativeness, selfishness, irritability, and exaggerate the influence of the animal organs. Intemperance results in disputes, fights, brawls, [pg 133]and murders—the legitimate consequences of which are misunderstandings, suits at law, criminal proceedings, imprisonment, and the gallows. It is, therefore, evident that the ultimate tendencies of these faculties are tyrannical, cruel, violent, and atrocious. They are opposed to the noble, moral faculties—Faith, Love, and Devotion—and, whenever temptation inordinately allures, the course of life is likely to be characterized by dishonorable, deceptive, and treacherous conduct.

The pangs of hunger cause soldiers to act more like ravenous beasts, than rational beings. It is animal instinct which impels the soldier to seek first for the gratification of his appetite. Some persons, instigated by carnivorous desires, yearn for raw meat, and will not be satisfied unless their food is flavored with the flesh of animals. Their bodies increase and thrive, even to repletion. Contrast these individuals with pale, lean, anæmic people, who crave innutritious articles of diet, and eat soft stones, slate, chalk, blue clay, and soft coal. Such perversions of the appetite are manifested only when there is either a diminution in the volume of blood, deficient alimentation, defective assimilation, or a general depravity of the nutritive functions. Morbid conditions generate vitiating tendencies and destroy the natural appetite.

While alcoholic stimulants affect the medulla oblongata principally, opium acts chiefly on the cerebrum, and excites reverie, dreamy ideality, optical delusions, and the creative powers of the imagination; some of these hallucinations are said to be grotesquely beautiful and enjoyable. The effects of this agent differ from those of alcoholic intoxication by not deadening the moral sensibilities, or arousing the animal propensities. Opium smokers are dreamy and abstracted, not quarrelsome or violent. Those who use ardent spirits lose their moral delicacy, their intellect becomes dull, the reason cloudy, and the judgment is overruled by appetite. It is conceded that the trophic center is principally in the medulla oblongata; the cerebellum and lower cerebral ganglia, however, favorably influence the nutritive functions, and, when these organs are large and active, a plethoric condition is the natural consequence. Redundancy of blood in the body indicates preponderance of the basilar organs. These faculties [pg 134]being vehement in character, an excess of animal characteristics produces those conditions which result in acute and inflammatory diseases. We may express these conditions of the system as follows:

The Animal Faculties correspond to the lower instinctive manifestations.

These naturally give rise to the following diseases: Inflammation, Rheumatism, Gout, Convulsions, etc., which, in these conditions, pursue a violent course.

REGION OF FEEBLENESS.

Although the middle lobe of the cerebrum, at the base of the brain, does not denote decided force of character, or energy of constitution, yet it has a certain sphere of normal action which is essential to the harmony of mind and body. If this region is largely developed, the constitution is languid, inefficient, sensitive, and abnormally disposed. But if it be deficient, the volitive energies preponderate, and there is a lack of those susceptibilities of constitution, which prevent excessive waste. The cerebral faculties are Fear, Anxiety, Sensibility, Servility, Relaxation, and Melancholy, and their excessive predominance indicates a weak, vacillating, irresolute character, and the existence of those bodily conditions which produce general excitability and chronic derangement. A full development of this portion of the brain indicates that the person is naturally dependent, inferior, and subservient to stronger characters. Such a one is fearful, fretful, complaining, irritable, dejected, morose, [pg 135]and, sooner or later, becomes a fit subject for chronic disease.^[5] The ultimate result of excessive fear, excitability, and irritability, is functional or organic derangement,—the morbid conditions represented by the word Disease. The medulla oblongata and portions of the middle lobe of the brain, the functions of which represent Excitability, Anxiety, Fear, and Irritability (symbols of physical profligacy), are located just between the ears (see Fig. 60). Inferior animals distinguished for breadth between the ears are not only cunning and treacherous, but very excitable and irritable. The head of the Fox is remarkable for its extreme width at the region of Fear. He is proverbially crafty and treacherous, always excitable, and so variable in temper that he can never be trusted. He is a very timid thief, exceedingly suspicious, irregular in habits, and frequently driven by hunger into mischievous depredations.

Fig. 75. Sly Reynard

The organ of alimentiveness, located directly in front of the ear, indicates the functional conditions of the stomach, which, when aroused by excessive hunger, exerts a debasing influence upon this and all of the adjacent organs, and is demoralizing to both body and mind. In obedience to the instinct of hunger, children will slyly plunder gardens and orchards, displaying profligate, if not reckless tendencies in the gratification of the appetite. In this regional division we include the medulla, the posterior and middle portions of which give rise to the pneumogastric nerve. This nerve receives branches from the spinal accessory, facial, hypoglossal, and the anterior trunks of the first and second cervical, and its filaments are distributed to the [pg 136]lungs, stomach, liver, spleen, pancreas, and gall bladder (see Fig. 60, with explanation) Its agency is necessary to maintain the circulation, and the respiration, since, as the medium of communication, it conveys from the brain large supplies of nervous force to sustain these vital functions. It likewise instantly reports the impressions of these physiological processes to the brain, and especially to those parts which, by analogy of functions. It likewise instantly reports the impressions of these physiological processes of the brain, and especially to those parts which, by analogy of functions, are intimately related to the stomach. Hence, we observe that the conditions of the stomach give rise to reflex impulses, which involuntarily excite the animal faculties to the gratification of the appetite. That the stomach has an intimate connection with the rest of the organism is evident from the fact that when it is inflamed the body is completely prostrated.

We have already alluded to the perverting tendencies of alcoholic stimulants. Their peculiar influence upon the cerebellum causes the subject to reel and stagger, as though a portion of that organ were removed; the group of energetic faculties is stupefied, and mental as well as corporeal lethargy is the result. The reaction, which inevitably follows, is almost unbearable, and relief is sought by repeating and increasing the poisonous draughts, the primary influence of which is stimulating, the ulterior, depressing. Alcoholic stimulants unduly excite the nervous centers, the heart, and the arteries, and, consequently, the blood is carried to the surface of the body, where it counteracts the influence of cold and exposure, the frequent attendants upon drunkenness. The use of alcoholic beverages perverts the appetite, interrupts habits of industry and destroys all force of character. Pecuniary, physical, and mental ruin, therefore, are sure to follow as the consequences of habitual, alcoholic intoxication.

That ordinary alimentation, which includes the process of digestion, the subsequent vital changes involved in the conversion of food into blood, and its final transformation into tissue, causes mental languor and dullness, as well as bodily exhaustion, is attested by universal experience. A torpid condition of the liver, one of the most inveterate of chronic derangements, is [pg 137]indicated by sullenness, melancholy, despondency, loss of interest in the affairs of life, sluggishness, etc., and the ultimate tendency of this morbid state is towards suicide. A broad and deep development of the middle lobe of the brain, shown by a fullness under the chin, and of the adjacent portion of the neck, denotes tendencies to somnambulism, delirium, and insanity. If such characteristics of the organization do not culminate in mental derangement, they exhibit childishness, helplessness, and great dependence. Age abates the vigor of the executive faculties, and old people manifest not only bodily infirmities, but the relaxing and enfeebling influences proceeding from the lower portions of the brain. They totter about in their second childhood, mentally and physically enervated. Those who become dissipated by the use of intoxicating beverages are not only weak, trifling, and foolish, but walk with an unsteadiness which betrays their condition. These illustrations show that this part of the brain is destitute of energy. Diseases of the digestive organs also indicate it. Cholera, whether induced by invisible animalcules in the air, or in water, takes the route of the alimentary canal, opens the vital gates, and myriads of victims are swept down to death. It proves remarkably fatal to those having this cerebral conformation. Perhaps enough has been said to indicate the relaxing and enfeebling tendencies of this region of the brain. They may be classified as follows:

This classification shows their tendencies to chronic disease, functional derangement, insanity, and suicide.

GENERAL CONSIDERATIONS.

Before the structure of the brain was understood, Buffon spoke of it as a "mucous substance of no great importance." Its functional significance was so slightly appreciated that some people hardly suspected they had any brains, until an accident revealed their existence. Latterly, however, it is generally understood that the perfection of an animal depends upon the number and the development of the organs controlled by the nervous system, the sovereign power of which is symbolized by a grand cerebrum, the throne of Reason. That animal which is so low in the scale of organization as to resemble a vegetable, belongs to an ascending series ending in man. The lowest species have no conscious perception, and their movements do not necessarily indicate sensation or volition. Instinct culminates in the Articulates, especially in Insects; while created intelligence reaches its acme in man, the highest representative of the Vertebrates.

"All things by regular degrees arise—
From mere existence unto life, from life
To intellectual power; and each degree
Has its peculiar necessary stamp,
Cognizable in forms distinct and lines."—LAVATER.

Fig. 76. Outline of Skulls. 1. European. 2. Negro. 3. Tiger. 4. Hedge Hog. 5. Sloth.

Man, in the faculties of mind, possesses more than a complement for instinct; some of the lower animals, however, seem to share his rational nature, and to a certain degree become responsible to him. Finally, the manifestations of mind bear a relation to the development of cerebral substance, and to the bodily organization which supplies the brain with blood. Fig. 76 shows the relative amount of brain matter in the lower animals, compared with [pg 139]that of man; the peculiarities of each agreeing with its cerebral conformation. It is easier to measure the capacity of skulls in different races than to procure and weigh their brains. The following table has been published.

Mr. Davis, of England, having a collection of about eighteen hundred cranial specimens obtained from different quarters of the globe, ascertained the relative volume of brain in different races, by filling the skulls with dry sand. He found that the European averaged 92 cubic inches, the Oceanic 89, the Asiatic 88, the African 86, the Australian 81. Dr. Morton, of Philadelphia, had a collection of over one thousand skulls, and his conclusions were that the Caucasian brain is the largest, the Mongolian next in size, the Malay and American Indian smaller, and the Ethiopian smallest of all. The average weight of brain, in 278 Europeans, was 49.50 oz., in 24 White American soldiers, 52.06 oz., indicating a greater average for the American brain.

The weight of the human brain varies from 40 to 70 oz.; that of idiots from 12 to 36 40 oz. The average of 273 [pg 140]male European brains was 49½ oz., while that of 191 females was 44 oz. If we compare the weight of the female brain with that of the body, the ratio is found to be as 1:36.46, while that of the male is as 1:36.50; showing that, relatively, the female brain is the larger. It appears that neither the absolute nor relative size of the cerebrum, but the amount of gray matter which it contains, is the criterion of mental power. Although a large cerebrum is generally indicative of more gray matter than a small one, yet it is ascertained that the grey substance depends upon the number, and depth of the convolutions of the brain, and the deeper its fissures, the more abundant is this tissue. It is this substance which is the source of thought, while the white portion only transmits impressions.

We do not wish to underrate any attempt heretofore made to classify the functions of mind and assign to them an appropriate nomenclature. It is not unusual for scientists to give advice to phrenologists and point out the fallacies of their system; but it is hardly worth while to indulge in destructive criticism, unless something better is offered, as the day has passed for ridiculing endeavors to understand and interpret the physiology of the brain. The all important question is, not whether phrenologists have properly located and rightly earned all the faculties of mind, but have their expositions been useful in the development of truth. While endeavoring to connect each mental power with a local habitation in the brain, the system of phrenology may be chargeable with some incongruous classification of the faculties, and yet it has furnished an analysis of the mind which has been of incalculable service to writers upon mental philosophy. Phrenology, in popularizing its views, has interested thousands in their own organizations and powers, who would otherwise have remained indifferent. It has called attention to mental and bodily unities, has served as a guide to explain the physical and psychical characteristics of individuals, and has been instrumental in applying physiological and hygienic principles to the habits of life, thus rendering a service for which the world is greatly indebted. Samuel George Morton, M.D., whose eminent abilities and scholarship are unquestionable, employs the following language:

[pg 141]"The importance of the brain as the seat of the faculties of the mind, is pre-eminent in the animal economy. Hence, the avidity with which its structure and functions have been studied in our time; for, although much remains to be explained, much has certainly been accomplished. We have reason to believe, not only that the brain is the center of the whole series of mental manifestations, but that its several parts are so many organs, each one of which performs its peculiar and distinctive office. But the number, locality, and functions of these several organs are far from being determined; nor should this uncertainty surprise us, when we reflect on the slow and devious process by which mankind has arrived at some of the simplest physiological truths, and the difficulties that environ all inquiries into the nature of the organic functions."

Fig. 77. Side view of the brain of a Cat. A. Crucial sulcus dividing anterior convolutions. B. Fissure of Sylvius. C. Olfactory bulb.

We may here allude to the recent experimental researches with reference to the functions of various portions of the brain, prosecuted by Dr. Ferrier, of England. He applied the electric current to different parts of the cortical substance of the cerebrum in lower animals which had been rendered insensible by chloroform, and by it could call forth muscular actions expressive of ideas and emotions. Thus, in a cat, the application of the electrodes at point 2, Fig. 77, caused elevation of the shoulder and adduction of the limb, exactly as when a cat strikes a ball with its paw; at point 4, corrugation of the left eye-brow, and the drawing inward and downward of the left ear; when applied at point 5, the animal exhibited signs of pain, screamed, and kicked with both hind legs, especially the left, at the same time turned its head around and looked behind in an astonished manner; at point 6, clutching movement of the [pg 142]left paw, with protrusion of the claws; at point 13, twitching backward of the left ear, and rotation of the head to the left and slightly upward, as if the animal were listening; at point 17, restlessness, opening of the mouth, and long-continued cries as if of rage or pain; at a point on the under side of the hemisphere, not shown in this figure, the animal started up, threw back its head, opened its eyes widely, lashed its tail, panted, screamed and spit as if in furious rage; and at point 20, sudden contraction of the muscles of the front of the chest and neck, and of the depressors (muscles) of the lower jaw, with panting movements. The movements of the paws were drawn inward by stimulating the region between points 1, 2, and 6; those of the eyelids and face were excited between 7 and 8; the side movements of the head and ear in the region between points 9 and 14; and the movements of the mouth, tongue and jaws, with certain associated movements of the neck, being localized in the convolutions bordering on the fissure of Sylvius (B), which marks the division between the anterior and middle lobes of the cerebrum. Dr. Ferrier made similar experiments on dogs, rabbits, and monkeys. The series of experiments made on the brain of the monkey is said to be the most remarkable and interesting, not only because of the variety of movements and distinctly expressive character of this animal, but on account of the close conformity which the simple arrangement of the convolutions of its brain bears to their more complex disposition in the human cerebrum. It is premature to say what import we shall attach to these experiments, but they have established the correctness of the doctrine, advanced on page 105, that thought, the product of cerebral functions, is a class of reflex actions. The cerebrum is not only the source of ideas but also of those co-ordinate movements which correspond to and accompany these ideas. Certain cerebral changes call forth mental states and muscular movements which are mutually responsive. They indicate that various functions are automatic, or dependent upon the will, and, as we have seen, experiments indicate that the electric current, when applied to the cerebrum, excites involuntary reflex action. We cannot say how far these experimental results justify the phrenological classification of the faculties of mind, by establishing a causative relation [pg 143]between the physical and psychical states. This short and unsatisfactory account furnishes one fact which seems to support the claim of such a relation: the apparent similarity between the motor center of the lips and tongue in lower animals, and that portion of the human cerebrum in which disease is so often found to be associated with Aphasia, or loss of voice. While these experiments are by no means conclusive in establishing a theory, yet they favor it.

It is wonderful that nervous matter can be so arranged as not only to connect the various organs of the body, but at the same time to be the agent of sensation, thought, and emotion. It is amazing, that a ray of light, after traversing a distance of 91,000,000 miles, can, by falling upon the retina, and acting as a stimulus, not only produce a contraction of the pupil, but excite thoughts which analyze that ray, instantly spanning the infinitude of trackless space! The same penetrative faculties, with equal facility, can quickly and surely discern the morbid symptoms of body and mind, become familiar with the indications of disease, and classify them scientifically among the phenomena of nature. The symptoms of disease which follow certain conditions as regularly as do the signs of development, and mind itself is no exception to this uniformity of nature. Thoughts result from conditions, and manifest them as evidently as the falling of rain illustrates the effect of gravity. The perceptive and highest emotive faculties of man depend upon this simple, but marvelously endowed nervous substance, which blends the higher spiritual with the lower physical functions. The functions of the body are performed by separate organs, distinguished by peculiar characteristics. To elucidate the distinctions between dissimilar, mental faculties, we have assigned their functions, with characteristic names, to different regions of the head. As they unquestionably influence the bodily organs, we are sustained by physical analogy, in our classification. Our knowledge of the structure and functions of the nervous system is yet elementary, and we are patiently waiting for scientists to develop its facts, and verify them by experimental investigations and such researches as time alone can bring to perfection. While real progress moves with slow and measured [pg 144]foot-steps, the inspirations of consciousness and the inferences of logic prepare the popular mind for cerebral analysis. No true system can contradict the facts of our inner experience; it can only furnish a more complete explanation of their relation to the bodily organs. It should be expected that such careful and pains-taking experiments, as are necessary to establish a science, will be preceded by intuitive judgments and accredited observations, which may be, for a time, the substitutes of those more abstruse in detail.

We have, in accordance with popular usage, treated the organs of thought as having anatomical relations. The views which we have presented in this chapter may seem speculative, but the facts suggesting the theory demand attention, and we have attempted to gather a few of the scattered fragments and arrange them in some order, rather than leave them to uncertainty and greater mystery. It is by method and classification that we are enabled to apply our knowledge to practical purposes. Possibly, to some, especially the non-professional, an allusion to the fact that cerebral physiology contributes to successful results in the practice of medicine, may seem to be an exaggerated pretension. None, however, who are conversant with the facts connected with the author's experience, will so regard this practical reference, for the statement might be greatly amplified without exceeding the bounds of truth. Physicians generally undervalue the nervous functions, and overlook the importance of the brain as an indicator of the conditions of the physical system, because they are not sufficiently familiar with its influence over the bodily functions. Pathological conditions are faithfully represented by the thoughts, and words, when used to describe symptoms, become the symbols of feelings which arise from disease. How few physicians there are who can interpret the thoughts, and glean, from the expressions and sentences of a letter, a correct idea of the morbid conditions which the writer wishes to portray! Each malady, as well as every temperament, has its characteristics, and both require careful and critical analysis before subjecting the patient to the influence of remedial agents.

In a treatise by Dr. J.R. Buchanan, entitled "Outlines of Lectures on the Neurological System of Anthropology," are [pg 145]presented original ideas pre-eminently useful to the physician. His researches, and those of later writers, together with our own investigations, have greatly increased our professional knowledge. It is by such studies and investigations that we have been prepared to interpret, with greater facility, the indications of disease, and diagnose accurately from symptoms, which have acquired a deeper significance by the light of cerebral physiology. We are enabled to adapt remedies to constitutions and their varying conditions, with a fidelity and scientific precision which has rendered our success in treatment widely known and generally acknowledged. We annually treat thousands of invalids whom we have never beheld, and relieve them of their ailments. This has been accomplished chiefly through correspondence. When patients have failed to delineate their symptoms currently, or have given an obscure account of their ailments, we have been materially assisted in ascertaining the character of the disease by photographs of the subjects. The cerebral conformation indicates the predisposition of the patient, and enables us to estimate the strength of his recuperative energies. Thus we have a valuable guide in the selection of remedies particularly suited to different constitutions. In the treatment of chronic diseases, the success attending our efforts has been widely appreciated, not only in this, but in other countries where civilization, refinement, luxurious habits, and effeminating customs, prevail. This fact is mentioned, not only as an illustration of the personal benefits actually derived from a thorough knowledge of the nervous system, but to show how generally and extensively these advantages have been shared by others.

A careful study of cerebral physiology leads us deeper into the mysteries of the human constitution, and to the philosophical contemplation of the relations of mind and body. Self-culture implies not only a knowledge of the powers of the mind, but also how to direct and use them for its own improvement, and he who has the key to self-knowledge, can unlock the mysteries of human nature and be eminently serviceable to the worlds For centuries the mind has been spreading out its treasury of revelations, to be turned to practical account, in ascertaining the constitution, and determining better methods of treating [pg 146]disease. Since comparative anatomists and physiologists have revealed the structure of animals and the functions of their organs, from the lowest protozoan to the highest vertebrate, the physician may avail himself of this knowledge, and thus gain a deeper insight into the structure and physiology of man. An intimate acquaintance with the physical, is a necessary preparation for the study of the psychical life, for it leads to the understanding of their mutual relations and reactions, both in health and disease.

Consciousness, or the knowledge of sensations and mental operations, has been variously defined. It is employed as a collective term to express all the psychical states, and is the power by which the soul knows its own existence. It is the immediate knowledge of any object whatever, and seems to comprise, in its broadest signification, both matter and mind, for all objects are inseparable from the cognizance of them. Hence, the significance of the terms, subjective-consciousness and objective-consciousness. People are better satisfied with their knowledge of matter than with their conceptions of the nature of mind.

THE NATURE OF MIND.

Since this subject is being discussed by our most distinguished scientists, we will conclude this chapter with an extract from a lecture delivered by Prof. Burt G. Wilder, at the American Institute:

"There now remains to be disposed of, in some way, the question as to the nature and reality of mind, which was rather evaded at the commencement of the lecture. The reason was, that I am forced to differ widely from the two great physiologists whom I have so often quoted this evening. Most people, following in part early instruction, in part revelation, in part spiritual manifestations, and in part trusting to their own consciousness, hold that the human mind is a spiritual substance which is associated with the body during the life of the latter in this world, and which remains in existence after the death of the body, and forms the spiritual clothing or embodiment of the immortal soul; and that the individual, therefore, lives after death as a spirit in the human form; that of this spiritual man, [pg 147]the soul is the essential being, of which may be predicted a good or evil nature, while the mind, which clothes it as a body, consists of the spiritual substances, affections, and thoughts, which were cherished and formed during the natural life.

Together with the above convictions respecting themselves, most people, when thinking independently of theological sublimations, feel willing to admit that animals have, in common with man, fewer or more natural affections and thoughts which make up their minds, but that the inner and immortal soul, which would retain them as part of an individual after death of the body, is not possessed by the beasts that perish. In short, the vast majority of mankind, when thinking quietly, and especially in seasons of bereavement, feel well assured of the real and substantial existence of the human mind, independently of its temporary association with the perishable body.

But in antagonism to this simple and comforting faith, stand theological incomprehensibilities on the one hand, and scientific skepticism on the other. The former would have us believe that the soul is a mere vapor, a cloud of something ethereal, of which can be expected nothing more useful than 'loafing around the Throne,' while the latter asks us to recognize the existence of nothing which the eyes cannot see and fingers touch; to cease imagining that there is a soul, and to regard the mind as merely the product of the brain; secreted thereby as the liver secretes bile. Let us hear what the two leading nervous physiologists, of this country, have to say upon this point:

'The brain is not, strictly speaking, the organ of the mind, for this statement would imply that the mind exists as a force, independent of the brain; but the mind is produced by the brain substance; and intellectual force, if we may term the intellect a force, can be produced only by the transmutation of a certain amount of matter; there can be no intelligence without brain substance.'—FLINT.

'The mind may be regarded as a force, the result of nervous action, and characterized by the ability to perceive sensations, to be conscious, to understand, to experience emotions, and to will in accordance therewith. Of these qualities, consciousness resides exclusively in the brain, but the others, as is clearly shown by observation and experiment, cannot be restricted to [pg 148]that organ, but are developed with more or less intensity, in other parts of the nervous system.'—HAMMOND.

Thus do the two extremes of theology and science meet upon a common ground of dreamy emptiness, and we who confess our comparative ignorance are comforted by the thought that some other things have been 'hid from the wise and prudent and revealed unto babes.' Yet, while feeling thus, it must be admitted that the existence of spirit and of a Creator do not yet seem capable of logical demonstration. The denial of their existence is not incompatible with a profound acquaintance with material forms and their operations; and, on the other hand, the belief in their existence and substantial nature, and in their powers as first causes, have never interfered with the recognition of the so-called material forces, and of the organisms through which they are manifested. At present, at least, these are purely matters of faith; but although the Spiritualist (using the term in its broadest sense as indicating a belief in spirits), may feel that his faith discloses a beauty and perfection in the union, otherwise imperceptible by him, there is no reason why this difference in faith should make him despise or quarrel with his materialist co-worker, for the latter may do as good service to science, may be as true a man, and live as holy a life, although from other motives.

The differences between religious sects are mainly of faith, not of works, and the wise of all denominations are gradually coming to the conviction that they will all do God more service by toleration and co-operation than by animosity and disunion. And so I hold that, until the spiritualist feels himself able to demonstrate to the unbeliever the existence of spirit and of God, as convincingly as a mathematical proposition, there should be no hard words or feelings upon these points. For the present they are immaterial in every sense of the word; and so long as he bows to the facts and the laws of Nature, and deals with his fellow men as he would be done by, so long will I work with him, side by side, knowing, even though I cannot tell him so, that whether or not he joins me in this world, we shall meet in the other world to come, where his eyes will be opened, and where his lips will at least acquit me of bigotry and intolerance."

CHAPTER XV.

THE HUMAN TEMPERAMENTS.

Organization implies vital energy, since there can be no organization without it. The sperm cell, as we have previously seen, exists before the initiation of the life of every individual organism. The early history of this fertilizing cell, which is composed of infinitesimal molecules which contain the embryo powers of life, is only partially written. It is a fact, authenticated by Faraday, that one drop of water contains, and may be made to evolve, as much electricity as, under a different mode of display, would suffice to produce a lightning-flash. Chemical force is of a higher order than physical, and vital force is of a still higher order. Within the microscopic compass of the sperm cell are a great number of forces acting simultaneously, which require the answering conditions of a germ cell, and are so blended as to occupy a minimum of space. The union of these subtle elements through the agency of their physical, chemical, and vital forces, constitutes the initiation of life. Elementary matter is transformed into chemical and organic compounds, by natural forces, upon the cessation of which, it is liberated by nature's great destroyer, and re-appears in the world of elements. Thus, man is formed out of the very dust by means of energies which reconstruct the crude, inert matter, and to dust he returns when those energies cease.

When we enter upon the consideration of the temperaments, we should bear in mind one peculiarity of life: that it combines, in a small space, many complex powers. In the process of reproduction, there is a complex combination of organic elements. Structures differ as greatly as their functions. So [pg 150]likewise do animals vary in their nature and organization, and individuals of the same species are, in some respects, dissimilar. Yet the characteristics which have distinguished the races of mankind, are fundamental and faithfully maintained. Time does not obliterate them. Within race-limits are found enduring peculiarities, and, although each individual is weaving out some definite pattern of organization, it follows the type of the race, as well as the more immediate, antecedent condition.

What then is a Temperament but a mixing together of these determining forces, a certain blending manifested in the constitution by signs, or traits, which we denominate character. The different races of mankind must have their several standards of temperament, for the peculiarities of one are not fully descriptive of, and applicable to the other.

The term temperament is defined by Dunglison, as being "a name given to the remarkable differences that exist between individuals, in consequence of the variety of relations and proportions between the constituent parts of the body.

For its simplicity and scope, we prefer the following definition, suggested by our friend, Orin Davis, M.D.: A TEMPERAMENT IS A COMBINATION OF ORGANIC ELEMENTS SO ARRANGED AS TO CHARACTERIZE THE CONSTITUTION.

This leads us to consider some of the elements, conditions and forces which give character to the organization. External circumstances supply necessary conditions to inward activity, for without air, food, or sunlight all living animals would perish. Everywhere, life is dependent upon conditions and circumstances; it is not self-generating. But the conditions of reproduction are very complex. External forces are transformed, and, in turn, become vital or formative powers. Development is a transmutation of physical and chemical forces into vital energy. Although unable to compute the ultimate factors of life, yet we may illustrate their reproductive possibilities and results by comparing them with those of a lower order.

Animal structures are mainly composed of four elements: oxygen, hydrogen, nitrogen and carbon. Other constituents, such as phosphorus, sulphur, potassium, sodium, calcium, magnesium, and iron, enter into their composition, but are [pg 151]found in much smaller quantities. From these elements is fabricated an organism which manifests peculiar properties and marvelous functions. If the proportion of these chemical elements be varied, the organic compound will be changed, or, the proportions remaining the same, if the grouping of the elements be altered, different compounds will be produced, showing that the properties of organized substances depend upon the molecular constitution of matter.

Rising in the scale of organization, we observe that every variation of the physical and chemical processes implies a corresponding modification of the vital. This is verified by the peculiarities of the several races of mankind. Individual differences are likewise modifications of these processes. Dynamical or vital differentiation depends upon these modifications for the display of vital energy, and is always associated with molecular changes. But it should be borne in mind that an effect may not resemble its cause in properties, and the qualities of a chemical compound may be quite different from those of its individual constituents. Organic matter, although more complex, may exhibit properties, both like and unlike its constituent elements. Within certain boundaries, the elements seek to satisfy their affinities. We discover that there are limits between the genera of animals, as well as the races of mankind. Not less really, though perhaps not as absolutely, are there individual precincts within the sphere of the human temperaments, which cannot be passed.

If we cannot satisfactorily explain, we can at least discover a reason for temperamental limitation. It is not designed to circumscribe healthful reproduction, but to serve as an effectual hindrance to abnormal deviations. We may state our belief in more positive terms: that the temperamental variations are essential to genesis and fertility, and indispensable to health and normal development.

Every individual is susceptible to impressions which dispose to action. Impressions which excite or increase this disposition, are called stimuli. Vital change implies the existence of stimuli and susceptibility to stimulation. The stimulus may not be furnished because the conditions on which it depends are wanting; again, susceptibility may exist at one time and not [pg 152]at another. Stimuli and susceptibility may be present in different degrees, but for the purpose of healthful reproduction they must not be impaired. No single class of foods, albuminous, starchy, saccharine, or mineral, is sufficient for the nutrition of the body, but the food must contain substances belonging to each of the different classes. If an animal be fed exclusively upon albumen, though this substance constitutes the largest part of the bodily mass, exhaustion will rapidly follow, since the food does not contain all the essential, nutritive elements. Again, when the solids of the body have been wasted, they lose their susceptibility to stimuli, and the food does no good. Thus patients become emaciated during acute attacks of disease, upon the cessation of which they are too feeble to recover, simply because they have lost the power to digest and assimilate their food.

In inanimate bodies, as in crystals, forces come to rest, but the very idea of life implies action and continual change. Hence diversity of constitutions and different temperaments are essential in order that marriage may result in the reproduction of vigorous beings.

VITAL AND NON-VITAL TEMPERAMENTS.

Fig. 78.

In the preceding chapter, we attempted to illustrate the unique blending of mind and body by means of the nervous system, and we now propose to exemplify the physical conditions of the organism by certain correspondences, observed in the development and conditions of that system. If nature answer to mind in physical correspondences, she will observe the same regularity in physical development. The simplest classification of the temperaments is represented in Fig. 78. Not only is mental activity dependent upon a vital activity in the brain, but the development of the cerebrum is dependent upon the supply of blood. The growth of the intellect requires the same conditions that aided in the [pg 153]development of Vulcan's right arm: waste and supply; disintegration and reparation of tissue. Our modern iron forges produce many an artisan whose great right arm proclaims him to be a son of power as well as of fire. Thus the fervid intellect, while forging out its thoughts, increases in size and strength. The difference between the development of the two is this; that the exercise of the blacksmith's right arm quickens the activities of all the bodily functions, whereas the employment of the intellect does not offer any healthy equivalent. Physical exercise is a hygienic demand, but intellectual employment exerts no salutary influence on the body, while it is constantly expending the nutritive energies of the blood. The emotions, likewise, make exhaustive draughts upon nutrition to supply the waste of brain substance, just as certainly as physical labor causes muscular change, and demands reparation. One expends cerebral, the other, muscular substance. The one is healthful in its general tendencies, the other, comparatively wasteful and destructive.

These nervous forces are transformed into spiritual products.

The base of the anterior lobes of the brain belong to the atonic region—the source of those languid, deranging influences which coincide with morbidity and disease. A disturbance of the corporeal organs, which especially influence this portion of the brain, naturally tends to the development of insanity or imbecility. Morel has traced, through four generations, the family history of a youth who was admitted to the asylum at Rouen while in a state of stupidity and semi-idiocy. The following summary of his investigations illustrates the natural course of degeneracy as it extends through successive generations: immorality, depravity, alcoholic excess, and moral degradation, in the great-grandfather, who was killed in a tavern brawl; hereditary drunkenness, maniacal attacks, ending in general paralysis, in the grandfather; [pg 154]sobriety, but hypochondriacal tendencies, delusions of persecutions, and homicidal tendencies in the father; defective intelligence in the son. His first attack of mania occurred at sixteen, and was followed by stupidity, and finally ended in complete idiocy. Furthermore, there was probably an extinction of the family, for the son's reproductive organs were as little developed as those of a child of twelve years of age. He had two sisters who were both defective physically and morally, and were classed as imbeciles. To complete the proof of heredity in this case, Morel adds that the mother had a child while the father was confined in the asylum, and that this child exhibited no signs of degeneracy. Statistics show that multitudes of human beings are born with a destiny against which they have neither the will nor the power to contend; they groan under the worst of all tyrannies, the tyranny of a bad organization, which is theirs by inheritance. We may represent the tendencies of the anterior portion of the brain by Fig. 79. The functional exercise of the anterior and superior portions of the cerebrum is disintegrating and devitalizing, while the anterior and inferior portions coincide with mental and physical derangement, unless counteracted by opposing forces. It is therefore evident that in any organization, upon which is entailed a perverted or excessive action of this portion of the cerebrum, the tendencies are NON-VITAL, i.e., unfavorable to fertility and physical health.

If the antagonizing regions are well developed, the tendencies are favorable to life.

Fig. 79

If this portion of the brain indicates a full development, we [pg 155]say of such a temperament that it is VITAL, because the functions of its nerve-centers are favorable to evolution. As degeneration observes conditions, so endurance and development conform to certain laws, and it is the duty of all truthful inquirers, who believe not only in the progress of human intelligence, but in physical improvement from generation to generation, to ascertain and comply with these essential conditions. When the anterior and middle lobes of the brain are fully developed at their inferior surfaces, it is regarded as an insane temperament, i.e. containing the germs of mental and bodily derangement.

[pg 156]How shall we distinguish the combination of organic elements, if not by the manner in which they characterize the constitution? Every human being is distinguished by natural peculiarities, both mental and physical. These are indicated not only by the color of the eyes, hair, and skin, and the mental expressions, but in the conformation and capabilities of the corporeal system. The color, form, size, and texture of a leaf indicate to the expert pomologist the nature of the fruit which the tree will bear, but how much more important is it to understand the harmonies of human development. If Prof. Agassiz could determine the form and size of a fish by seeing its scales, and Prof. Owen outline the skeleton of an unknown animal by viewing a portion of its fossil, why should not the physician understand the language of temperaments, since it opens to him the revelations of human development? The sculptor blends character with form, the artist endows the face with natural expression, the anatomist accurately traces the nerves and arteries, the physiognomist reads character, which the novelist delineates and the actor personates, because there are facts behind all these, the materials wherewith to construct a science. In organization there are permanent forces which operate uniformly, thus revealing the order of nature.

THE TEMPERAMENTS CLASSIFIED.

Fig. 80

We propose to speak of four constitutional variations entitled to separate consideration; the lymphatic, the sanguine, the volitive, and the encephalic. The brain controls all the voluntary, and modifies the involuntary functions of the body. A particular cerebral development modifies the functions of all the bodily organs, and thus tempers the constitution. We shall, therefore, base our classification of temperaments upon the mental and physiological characteristics, which are portrayed by cerebral development. Such an arrangement is illustrated by Fig. 80.

THE LYMPHATIC TEMPERAMENT.

The lymphatic temperament predominates when the anterior base of the brain and the middle lobe are developed so as to exert a preponderating influence over the bodily functions. The character of this influence we have described in cerebral physiology. It is difficult to state precisely the normal influences and nerve-forces which arise from these faculties, but it is evident that they are specially related to nutritive attraction, in opposition to volitive repulsion. It is only their excessive influence which produces worthless, miserable, morbid characters. A constitution marked by this development is indolent, relaxative, and an easy prey to epidemics. This treatment is also characterized by a low grade of vitality or resistance. When life is sustained by the volitive powers, it is distinguished by a softness of the bodily tissues, and the prevalence of lymph. The fact that all the organic functions are performed indolently, indicates lack of vital power. An excellent illustration of this temperament is found in Fig. 81, which represents a Chinese gentleman of distinction. In the lower order of animals, as in sponges, absorption is performed by contiguous cells, which are quite as effortless as in plants. Because of their organic indolence, sponges are often classed as vegetables. A body having an atonic or a lymphatic temperament is abundantly supplied with absorbent organs, which are very sluggish in their operations. In the lymphatic temperament, there seems to be less constructive energy, slower elaboration, and greater frugality. Lymph is a colorless or yellow fluid containing a large proportion of water. It is not so highly organized as the blood, but resembles it, when that fluid is deprived of its red corpuscles. In the sanguine temperament, circulation in the blood-vessels is the most active, in the lacteals next, and in the lymphatics the least so, but in the lymphatic temperament, this order is reversed.

Fig. 81.

Dr. W.B. Powell has observed that a lymphatic man has a large head, while a fat man has a small one, and also that fat and lymph, are convertible, one following the other, i.e., "a repletion consisting of fat may be removed, and one of lymph may replace it, and vice versa." He could not account [pg 158]for these alternations. The bear goes into his winter quarters sleek and fat, and comes forth in the spring just as plump with lymph, but he loses this fat appearance soon after obtaining food. This simply indicates that, during lymphatic activity, the digestive organs are comparatively quiescent. But when these are functionally employed again, lymphatic economy is not required. It is the duty of the lymphatics to slowly convert the fat by such transformation, that when it reaches the general circulation, it may there unite with other organic compounds, the process being aided by atmospheric nitrogen, introduced during the act of respiration. In this way it may become changed into those chemically indefinite, artificial products, called proteid compounds. This view is supported by the disappearance of fat as an organized product in the lymph of the lymphatic vessels, indicating that such transformation has occurred. In this way, by uniting with other organic compounds, [pg 159]it appears that lymph may serve as a weak basis for blood; that atmospheric nitrogen is also employed in forming these artificial compounds, is indicated by the fact that there is sometimes less detected in arterial than in venous blood.

Fig. 82. Judge Green, of the United States Court.

This temperament is indicated by lymphatic repletion, soft flesh, pale complexion, watery blood, slow and soft pulse, oval head, and broad skull, showing breadth at its base. Fig. 82 illustrates this temperament combined with sanguine elements. In all good illustrations of this temperament, there is a breadth of the anterior base of the skull extending forward to the cheek bones. There is likewise a corresponding fullness of the face under the chin, and in the neck, denoting a large development of the anterior base of the cerebrum. The cerebral conformation of the Hon. Judge Green indicates mental activity, and we have no reason to suppose that lymph was particularly abundant in his brain.

Fig. 83.

While this description of the lymphatic temperament is correct, when illustrated by the civilized races of men who are [pg 160]accustomed to luxury, ease, and an abundance of food, it does not apply with equal accuracy to the cerebral organization of the American Indian. His skull, though broad at its anterior base, and high and wide at the cheek bones, differs from the European in being broader and longer behind the ears. Fig. 83 is an excellent representation of a noted North American Indian. While a great breadth of the base of the brain indicates morbid susceptibilities, yet these, in the Indian, are opposed by a superior height of the posterior part of the skull. Consequently, he is restless, impulsive, excitable, passionate, a wanderer upon the earth. The basilar faculties, however, are large, and he is noted for instinctive intelligence. His habits alternate from laziness to heroic effort, from idleness and quiet to the fierce excitement of the chase, from vagabondism to war, sometimes indolent and at other times turbulent, but under all circumstances, irregular and unreliable. In this case, lacteal activity is greater than lymphatic, as his nomadic life indicates. Nevertheless, he manifests a morbid sensibility to epidemic diseases, especially those which engender nutritive disorders and corrupt the blood. Figs. 84 and 85 represent the brain of an American Indian, and that of a European, and show the remarkable difference in their anatomical configuration. Evidently it is a race-distinction. Observe the greater breadth of the brain of the Indian, which according to cerebral physiology indicates great alimentiveness, indolence, morbid sensibility, irritability, profligacy, but also note that it differs materially in the proportion of all its parts, from the European brain. Judging the character of the Indian from the aforesaid representation, we should say that he was cunning, excitable, treacherous, fitful, taciturn, or violently demonstrative. His constitution is very susceptible to diseases of the bowels and blood. His appetite is ungovernable, and his [pg 161]love of stimulants is strong. Syphilitic poison, small-pox, and strong drink will annihilate all these tribes sooner than gunpowder. Their physical traits of constitution are no less contradictory than their extremes of habit and character, for while there is evidence of lymphatic elements, yet it is contradicted by the color of the hair, eyes, and skin. This peculiar organization will not blend in healthful harmony with that of the European, and this demonstrates that the race-temperaments require separate and careful analytical consideration.

Fig. 84. American Indian.

Fig 85. European. (FROM MORTON'S CRANIA AMERICANA.) In the American Indian, the anterior lobe, lying between AA, and BB, is small, and in the European it is large, in proportion to the middle, lying between BB and CC. In the American Indian, the posterior lobe, lying between C and D Is much smaller than in the European. In the Indian, the cerebral convolutions on the anterior lobe and upper surface of the brain, are smaller than the European. If the anterior lobe manifests the intellectual faculties—the middle lobe the propensities common to man with the lower animals—and the posterior lobe, the conservative energies, the result seems to be, that the intellect of the American Indian is comparatively feeble—the European, strong; the animal propensities of the Indian will be great—in the European, more moderate; while reproduction, vital energy, and conservation of the species in the Indian is not as great as with the European. The relative proportions of the different parts of the brain differ very materially.

By physical culture and regulation of the habits, the excessive tendencies of this temperament may be restrained. Solid food should be substituted for a watery diet. If it be limited [pg 162]in quantity, this change will not only diminish the size, but increase the strength of the body. The body should be disciplined by daily percussion until the imperfectly constructed cells, which are too feeble to resist this treatment, are broken and replaced by those more hardy and enduring. Add to this treatment brisk, dry rubbing, calisthenic exercises, and daily walks, which should be gradually extended. Continue this treatment for three months, and its favorable effects upon the temperament will surprise the most skeptical; if continued for a year, a radical alteration will be effected, and the hardihood, health, and vigor of the constitution will be greatly increased.

This temperament may be improved physiologically, by being blended with the sanguine and volitive. The offspring will be stronger, the structures firmer, the organization more dense. Nutrition, assimilation, and all the constructive functions will be more energetic in weaving together the cellular fabric of the body. The sanguine temperament will add a stimulus to the organic activities, while the volitive will communicate manly, brave, and enduring qualities. When this temperament is united with the encephalic, if such a union does not result in barrenness, it adds expending and exhaustive tendencies to the enfeebling'ones already existing, and, consequently, the offspring lacks both physical power and intellectual activity.

The peculiarities of this temperament are observed in the diseases which characterize it. It is specially liable to derangements of digestion, nutrition, and blood-making. The blood is easily poisoned by morbid products formed within the body, as well as by those derived from the body of another. This is seen in pyæmia, produced by the introduction of decomposing pus, or "matter," into the blood. This condition is most likely to occur when the vital powers are low and the energies weak, for then the fibrin decreases, the red corpuscles diminish in number, the circulation becomes languid, the pulse grows fluttering and weak, and this increases until death ensues. An individual of this temperament is more easily destroyed than any other by the poison of syphilis, small-pox, and other contagious diseases. If the blood has received any hereditary taint, the lymphatic glands not only reproduce it but often increase the virulency of the original disease. This temperament indicates [pg 163]a necessity for the employment of stimulating, alterative, and antiseptic medicines. The torpid functions need arousing, the blood needs depuration, i.e., the elimination of corrupting matter, and the system requires alteratives to produce these salutary changes. The secretions need the correcting influence of cleansing remedies for the purification of the blood.

Persons of this temperament are more liable to absorption of morbid products within the body, which are in a state of decomposition, producing an infection of the blood, technically termed septicæmia. The fatal results which so suddenly follow child-bed fever are thus produced. This kind of poisoning sometimes takes place from the absorption of decomposed exudation in diphtheria, and, though rarely, from decomposing organic products collected in the lungs. Whenever the absorption of poison does take place, fatal consequences usually follow.

This passive temperament is more likely to sink under acute attacks of disease, especially alimentary disorders, such as diarrhea, dysentery, and cholera. It quickly succumbs to their prostrating effects, such as depression, congestion, and fatal collapse which rapidly succeed one another. Venesection and harsh purgatives are contra-indicated, and the physician who persists in their employment kills his patient. How grateful are warmth and stimulating medicines! The most powerful, diffusible, and nervous stimulants are required in cholera, when the system is devastated by the disease, as the plain is laid waste by the fierce tornado.

THE SANGUINE TEMPERAMENT.

Lymph is the characteristic of the lymphatic temperament, and its specific gravity, temperature, and standard of vitality are all lower than that of red blood. In the sanguine temperament all the vital functions are more active, the blood itself has a deeper hue, its corpuscles carry more oxygen, the complexion is quite florid, and the arterial currents impart to every faculty a more hopeful vigor. The blood-vessels are the most active absorbents, eagerly appropriating nutritive materials for the general circulation, while the respiration adds to it oxygen, that agent which makes vital manifestation possible. This temperament exhibits greater sensibility, the [pg 164]conceptions are quicker, the imagination more vivid, the appetite stronger, the passions more violent, and there is found every display of animal life and enjoyment.

A full development of the basilar faculties, indicated by an unusual breadth and depth of the base of the brain, accompanies this temperament. Its cerebral area includes the posterior and inferior portions of the cerebrum, the entire cerebellum, and that part of the medulla which connects with the spinal cord, all of which sustain intimate relations to vital conditions. Accordingly, such a development indicates good digestion, active nutrition, vigorous secretion, large heart and lungs, powerful muscles, and surplus vitality. The violent faculties, such as Combativeness, Destructiveness, and Hatred, are natural adjuncts, and their excess tends to sensuality and crime. They are not only secretive, appropriative, selfish, and self-defensive, but when redundant are aggressive and tend to destructiveness, the gratification of animal indulgence, intemperance, and debauchery. The correspondence between the cerebral conformation and the physical development is very obvious. Lower orders of animals possess these faculties, and their spontaneous exhibition is called instinct. They possess the acquisitive, destructive, and propagative propensities, which lead them to provide for their wants and secure to themselves a posterity. The exercise of their bodies causes a continual waste which demands incessant reparation, and they are governed measurably by these animal impulses.

All of these lower psychical faculties have a physiological significance. Acquisitiveness functionally expresses assimilation, accretion, animal growth, and tends to bodily repletion. Secretiveness expresses concealing, separating, withdrawing, and functionally signifies secretive action. Secretion is the separating and withdrawing from the blood some of its constituents, as mucus, bile, saliva, etc. This latter process indicates complex conditions of organization, so that the higher and more complex the tissue, the greater the number of secretory organs. Unrestrained selfishness, while it naturally conserves the individual interests, in its ultimate tendencies, is the very essence of human depravity. Without qualification, clearly, it is crime, for blind devotion to the individual must be in [pg 165]utter disregard for the good of others. The ultimate tendencies of these faculties are, therefore, criminal.

Exaggerate the faculty of acquisitiveness, and it becomes avariciousness. Develop secretiveness and selfishness, and they become cunning and profligacy, desperation and crime. Their functional development tends to produce physical disorder and violent disease. All of these faculties are vehement, contentious, thriving by opposition. Life itself has been called a forced state, because it wars with the elements it appropriates, and transmutes their powers into vitality.

Fig. 86.

We find men and women of this temperament, who are models of character and organization. George Washington is an excellent illustration. The impression that his presence made upon the Marquis de Chastellux, is given in the following words: "I wish only to express the impression General Washington has left on my mind; the idea of a perfect whole, brave without temerity, laborious without ambition, generous without prodigality, noble without pride, virtuous without severity." Gen. Scott, Lord Cornwallis, Dr. Wistar, Bishop Soule John Bright, Jenny Lind Goldsmidt, and Dr. Gall are good representatives of this temperament. Fig. 86 is an excellent illustration of it, finely blended and well balanced, in the person of Madame de Stael. This temperament requires fewer tonics and stimulants than the lymphatic. This constitution is best able to restore vital losses. It is a vital temperament, in other words, it combines favorably with all the others, and better adapts itself to their various conditions. Some regard it as the best adjusted one in all its organs and tissues, and as the most satisfactory and serviceable.

Fig. 87.

Excess of nutrition tends to plethora, to animal indulgence, and gross sensuality. Not only do the propensities rouse desire, but they excite the basilar faculties, and portray their wants in the outlines of the face, mould the features to their expression, and flash their significance from the eye. Who can mistake the picture of sensuality represented by Fig. 87? It is enough to shock the sensibility of a dumb animal, and to say that such a face has a beastly look, is an unkind reflection upon the brute creation. A large neck and corresponding development of the occipital half of the brain indicate nervous energy, yet nutrition is not absolutely dependent upon it, for the nutritive processes are active before a nervous system is formed. The lower faculties of the mind exert a remarkable influence over nutrition, secretion, and the molecular changes incident to life. Anger or fear may transmute the mother's nourishing milk into a virulent poison. The following incident, taken from Dr. Carpenter's Physiology, illustrates this statement: "A carpenter fell into a quarrel with a soldier billeted in his house, and was set-upon by the latter with his drawn sword. The wife of the carpenter at first trembled from fear and terror, and then suddenly threw herself between the combatants, wrested the sword from the soldier's hand, broke it in pieces, and threw it away. During the tumult, some neighbors came-in and separated the men. While in this state of strong excitement, the mother took up her child from the cradle, where it lay playing, and in the most perfect health, never having had a moment's illness; she gave it the breast, and in so doing sealed its fate. In a few minutes the infant left-off sucking, became restless, [pg 167]panted, and sank dead upon the mother's bosom. The physician who was instantly called-in, found the child lying in the cradle, as if asleep, and with its features undisturbed; but all resources were fruitless. It was irrecoverably gone. In this interesting case, the milk must have undergone a change, which gave it a powerful sedative action upon the susceptible nervous system of the infant."

Anxiety, irritation, hatred, all tend to the vitiation of the disposition and bodily functions, perverting the character and constitution at the same time. Depravity of thought and secretion go together. Degradation of mind and corruption of the body are concomitants. There is a very close affinity between mental and moral perversion and physical prostitution, of which fact too many are unconscious. Nervous influence preserves the fluidity of the blood and facilitates its circulation, for it appears that simple arrestment of this influence favors the coagulation of the blood in the vessels; clots being found in their trunks within a few minutes after the brain and spinal marrow are broken down. Habitual constipation is the source of many ills. Perversion of the functions of the stomach, and of the circulation of the blood, produce general disaster.

Diseases which characterize this temperament are acute, violent, or inflammatory, indicating repletion and active congestion; intense inflammation, burning fevers, severe rheumatism, a quick, full pulse, great bodily heat, and functional excitement are its morbid accompaniments. These diseases will bear thorough depletion of the alimentary canal, active, hydragogue cathartics being indicated. Sedatives and anodynes are also essential to modify the circulatory forces, and to relieve pain. Violent disturbance must be quelled, and among the remedial agents required for this duty we may include Veratrum, Ipecac, Digitalis, Opium, Conium, and Asclepias. While equalizing the circulatory fluids, restoring the secretions, and thoroughly evacuating the system, and thus endeavoring to remove disturbing causes, we find that the conditions of this temperament are exceedingly favorable for restoration to health. True, many chronic diseases are obstinate, yet a course of restorative medication persistently followed, promises a fortunate issue in this tractile temperament.

[pg 168]Hygienic management of the lymphatic and sanguine temperaments consists in the vigorous toning of the former, while restraint of the latter will greatly exempt it from the anxieties, contentions, and vexations which excite the mind, disturb the bodily functions, and end in chronic disease. People of the latter organization love mental and physical stimulants, are easily inflamed by passion, and their excitability degenerates into irritability, succeeded by serious functional derangements, which prematurely break down the individual with inveterate, deep-seated disorder. Serenity, hope, faith, as well as firmness, are natural hygienic elements. It is a duty we owe ourselves to promptly relinquish a business which corrodes with its cares, and depresses with its increasing troubles. Constant solicitude, and the apprehension of financial disaster, frustrate the bodily functions, disconcert the organic processes, and lead to mental aberration as well as physical degeneracy. Melancholy is chronic, while despair is acute mania, whose impulses drive the victim desperately toward self-destruction. The chronic derangement of these organs exerts with less force the same morbid tendency. Hence the necessity for exercising those hygienic and countervailing influences born of resolution, assurance, and confident trust, and the belief which strengthens all of the vital operations.

Doubtless, this temperament is the source of the reproductive powers. It is the corner-stone essential to the foundation of all other temperaments. It has been supposed by some that the cerebellum is the seat of sexual instinct. The fact appears that an ample development of the posterior base of the cerebrum and the cerebellum indicates nutritive activity, which is certainly a condition most favorable to the display of amativeness. In a double sense, then, this temperament is a vital one; both by nutritive repletion, and by reproduction. It is the blood-manufacturing, tissue-generating, and body-constructing temperament, causing growth to exceed waste, and promptly repairing the wear which follows continual labor.

While the sleazy structures of the lymphatic temperament are favorable to the functions of transudation, exhalation, and mutual diffusion of liquids, the sanguine, as its name indicates, is adapted to promote the circulation of the blood, to favor [pg 169]nutrition and reproduction. The former temperament does not move the world by its energies, or impress it vividly with its wisdom, and the latter is more enthusiastic, enjoyable, and quickening. Each temperament, however, possesses salient qualities and advantages.

THE LIFE LINE.

Dr. W.B. Powell, in his work on "The Human Temperaments," announces the discovery of a measurement which indicates the tenacity of life, and the vital possessions of the individual. He has observed that some persons of very feeble appearance possess remarkable powers of resistance to disease, and continue to live until the machinery of life literally wears out. Others, apparently stronger and more robust, die before the usual term of life is half completed. He also noticed that some families were remarkable for their longevity, while others reached only a certain age, less than the average term of life, and then died. He remarked also that some patients sank under attacks of disease, when, to all appearances, they should recover, and that others recovered, when, according to all reasonable calculations, they ought to die. He, therefore, not only believed that the duration of human life was more definitely fixed by the organization than is supposed, but he set himself to work to discover the line of life, and the measure of its duration. He made a distinction between vital vigor, and vital tenacity. Vital vigor he believed to be equivalent to the condition of vitality, which is indicated by the breadth of the brain found in the sanguine temperament; and vital tenacity to be measured by the depth of the base of the brain. Dr. Powell was an indefatigable student of nature, and followed his theory through years of observation, and measured hundreds of heads of living persons, in order to verify the correctness of the hypothesis. His method of measuring the head may be stated as follows: He drew a line from the occipital protuberance on the back of the head to the junction of the frontal and malar bones, extending it to a point above the center of the external orbit of the eye, near the termination of the brow. Then he measured the distance between this line and the orifice of the [pg 170]ear and thus obtained the measure indicating the vital tenacity or duration of, life. Fig. 88 is a representation of the skull of Loper, who was executed for murder in Mississippi. He might have attained a great age, had not his violent and selfish faculties led him into the commission of crime. In this illustration, B represents the occipital protuberance, and A the junction of the frontal and malar bones at the external angle of the eye. The distance between this line (A B) and the external orifice of the ear, is the measure of the life-force of Loper at the time of his: execution.

Fig. 88.

Fig. 89.

The tenacity of an individual's life, Dr. Powell determined by the following scale of measurements: three-fourths of an inch from the orifice of the ear to the life-line, is the average length in the adult, and indicates ordinary tenacity of life. As the distance decreases to five-eighths, one-half, or three-eighths of an inch, vital tenacity diminishes. If the distance is more than three-quarters of an inch, it denotes great vital endurance, excellent recuperative powers, and is indicative of longevity. If it measures less than half an inch, it shows that the constitution has a feeble, uncertain hold upon life, and an acute disease is very likely to sunder the vital relations. Dr. Powell contended that "life force and vital force are not equivalent terms, because much more vital force is expended upon our relations, than upon our organization in the preservation of life. Every muscular contraction, every thought, [pg 171]and every emotion requires an expenditure of vital force." He asserted that we inherit our life force or constitutional power, and that we can determine by this life-line, the amount which we so receive. And he believed that it could be increased by intellectual effort, just as we can increase vital force by physical exercise. Fig. 89 represents the skull of a man who died, at nearly the same age as Loper, of consumption, in the Charity Hospital, at New Orleans. The measurement of the skull in this case gives a space between the life-line and the orifice of the ear of one-sixteenth of an inch, showing that the consumptive had lived the full term of his life. Dr. Powell contended that the depth of a man's brain may be increased after maturity; muscular effort, mental activity, and a sense of responsibility being favorable to longevity, while idleness and dissipation are adverse to it. In justice to the Doctor, we have stated fully his theory and his method of determining the hardihood and endurance of the constitution, and we bespeak for it a candid examination. Without doubt it embodies a great deal of truth. Hereafter we shall endeavor to indicate by cerebral configuration, a better system of judging of the vital tenacity, hardihood, and constitutional energies, both inherited and acquired.

THE VOLITIVE TEMPERAMENT.

By reference to Figs. 72 and 80, the reader will be able to locate the region of the volitive faculties, previously described under the generic term will. This temperament is characterized by ambition, energy, industry, perseverance, decision, vigilance, self-control, arrogance, love of power, firmness, and hardihood. These faculties express concentration of purpose and their functional equivalents are power of elaboration, constructiveness, condensation, firmness of fiber, compactness of frame, and endurance of organization. The pulse is full, firm, and regular, the muscles are strong and well marked, the hair and skin dark, the temporal region is not broadly developed, the face is angular, its lines denoting both power of purpose and strength of constitution, with resolution and hardihood blended in the expression. The volitive temperament is distinguished by height of the posterior, superior occipital region, called the [pg 172]crown of the back head, and by corresponding breadth from side to side. The rule given by Dr. J.R. Buchanan applies not only to the convolutions, but to the general development of the brain; length gives power, or range of action, and breadth gives copiousness, or activity of manifestation. Thus a high, narrow back head indicates firmness and decision, but it is not as constant and copious in its manifestation as when it is associated with breadth. An individual having a narrow, high head, may determine readily enough upon a course of action, but he requires a longer period for its completion than one whose head is both high and broad. Such a cerebral conformation cannot accomplish its objects without enjoying regular rest, and maintaining the best of habits. Breadth of this region of the brain indicates ample resources of energy, both psychical and physical. It denotes greater vigor of constitution, one that continually generates volitive forces, and its persistency of purpose may be interpreted as functional tenacity. Inflexibility of will and purpose impart their tenacious qualities to every bodily function. The will to recover is often far more potent than medicine. We have often witnessed its power in restraining the ravages of disease. The energetic faculties, located at the upper and posterior part of the head, are the invigorating, or tonic elements of the constitution, imparting hardy, firm, steady, and efficient influences, checking excess of secretion, repressing dissipation, and tending to maintain self-possession, as well as healthy conditions of life. Fig. 90 is a portrait of U.S. Grant, which shows a well-balanced organization, with sufficient volitive elements to characterize the constitution.

Fig. 90.

The old term bilious temperament might possibly be retained [pg 173]in deference to long usage, did it not inculcate a radical error. Bilious is strictly a medical term, relating to bile, or to derangements produced by it, and it was used originally to distinguish a temperament supposed to be characterized by a predominance of the biliary secretion. In the volitive temperament, the firm, tenacious, toning, and restraining faculties repress, rather than encourage biliary secretion, and hence the necessity for administering large doses of cholagogues, remedies which stimulate the secretion of bile. When the system is surcharged with bile, from a congested condition of the liver, we use these agents in order to obtain necessary relief. In this temperament there is moderate hepatic development, lack of biliary activity, deficiency in the secretion of bile, and a sluggish portal circulation. Therefore, to apply the term bilious to this temperament is not only unreasonable, but it is calculated to mislead. The condition of the bowels is generally constipated, the skin dark and sometimes sallow. For these and other obvious reasons, we dismiss the word bilious, and substitute one which is more characteristic.

We will not dwell upon the volitive as psychical organs, except to show that, when their influence is transmitted to the body, they act as physiological organs, and thus demonstrate that all parts of the brain have their physiological, as well as mental functions. When Andrew Jackson uttered with great emphasis the memorable words, "BY THE ETERNAL," the effect was like a shock from a galvanic battery, thrilling the cells in his own body, and paralyzing with fear every one in Calhoun's organization. This is an illustration of the power or range of action of these faculties. Breadth or copiousness is illustrated in Gen. Grant's reply, "I PROPOSE TO FIGHT IT OUT ON THIS LINE, IF IT TAKES ALL SUMMER." Such a temperament has a profusion of constitutional power, great durability of the life-force, and, in our opinion, the combined height and breadth of this region correctly indicate the natural hardihood of the body and its retentiveness of life. No one need doubt its influence upon the sympathetic system, and, through that system, its power over absorption, circulation, assimilation, and secretion, as well as the voluntary processes. Mental hardihood seems wrought into concrete organization. It checks excess of glandular [pg 174]absorption, restrains the impulses of tumultuous passion, tones and regulates the action of the heart, and helps to weave the strands of organization into a more compact fabric. The toning energies of the volitive faculties are better than quinine to fortify the system against miasma or malaria, and they co-operate with all tonic remedies in sustaining organic action. Fig. 91 is a portrait of Prof. Tyndall, the eminent chemist, [pg 175]whose likeness indicates volitive innervation, showing great strength of character and of constitution; he is an earnest, thorough, and intense mental toiler; ambitious, but modest; brilliant, because persevering; diligent in scientific inquiry, and who follows the star of truth, whithersoever it may lead him. The expression of his countenance indicates his honest intentions, and displays strength of conscientious purpose; his physical constitution may be correctly interpreted in all of its general characteristics by the analysis of his energetic temperament, the great secret of his strength and success.

Fig. 91.

Fig. 92.

We desire to offer one more illustration of a marvelous blending of this temperament with large mental and emotional faculties. Fig. 92 is a representation of the martyred President Abraham Lincoln. During an eventful career, his temperament and constitution experienced marked changes, and while always distinguished for strength of purpose and corresponding physical endurance, he was governed by noble, moral faculties, manifesting the deepest sympathy for the down-trodden and oppressed, blending tenderness and stateliness without weakness, exhibiting a human kindness, and displaying a genuine compassion, which endeared him to all hearts. He was hopeful, patriotic, magnanimous even, while upholding the majesty of the law and administering the complicated affairs of government. The balances of his temperament operated with wonderful delicacy, through all the perturbating influences of the rebellion, showing by their persistence that he was never for a moment turned aside from the great end he had in view; the protection and perpetuation of republican liberty. His life exhibited a sublime, moral heroism, elements of character which hallow his name, and keep it in everlasting remembrance.

We have treated the brain, not as a mass of organs radiating from the medulla oblongata as their real center, but as two [pg 176]cerebral masses, each of which is developed around the great ventricle. We have freely applied an easy psychical and physiological nomenclature to the functions of its organs, knowing that there is no arbitrary division of them by specific number, for the cerebrum, in an anatomical sense, is a single organ. The doctrine of cerebral unity is true, and the doctrine of its plurality of function is true also. Whatever effect an organ produces when acting in entire predominance, is regarded as the function of that organ and is expressed by that name. Although our names and divisions are arbitrary and designed for convenience, yet they facilitate our consideration of the psychical, and their corresponding physiological functions. Every cerebral manifestation denotes a psychical organ, and in proportion as these acts are transmitted to the body it becomes a physiological organ. We have ventured to repeat this proposition for the sake of the non-professional reader, that he may be able to distinguish between' the two results of the manifestation of one organ. The transmission of the influence of the brain into the body enables the former to act physiologically, whereas, if its action were confined within the cranium, it would only be psychical. In the language of Prof. J.R. Buchanan, "every organ, therefore, has its mental and corporeal, its psychological and physiological functions—both usually manifested together—either capable of assuming the predominance." We have already seen to what degree the Will operates upon the organism, or how "the soul imparts special energy to single organs, so that they perform their functions with more than usual efficiency," and thus resist the solicitations of morbific agents. Doubtless our best thoughts are deeply tinged by the healthful or diseased conditions of such organs as the stomach, the lungs, the heart, or even the muscular or circulatory systems, and these impressions, when carried to the sensorium, are reflected by the thoughts, for reflex action is the third class of functions, assigned to the cerebrum. These reflex actions are either hygienic and remedial, or morbid and pernicious. Hence, it is philosophical not only to interpret the thoughts as physiological and pathological indications, but to consider the cerebrum as exerting real hygienic and remedial forces, capable of producing salutary reparative, and restorative effects. When a boiler carries more [pg 177]steam than can be advantageously employed, it is subjected to unnecessary and injurious strain, and is weakened thereby; so, when the body is overtasked by excessive pressure of the volitive faculties, it is prematurely enfeebled and broken down. There are many individuals who need to make use of some sort of safety valve to let off the surplus of their inordinate ambition; they need some kind of patent brake to slacken their speed of living; they should relieve the friction of their functional powers by a more frequent lubrication of the vital movements, and by stopping, for needed refreshment and rest, at some of the many way-stations of life.

THE ENCEPHALIC TEMPERAMENT.

The encephalic temperament is distinguished by prominence and breadth of the forehead, or by a full forehead associated with height and breadth at its coronal junction with the parietal bones, and extending toward the volitive region. (See Fig. 10, the space between 1 and 2 represents the coronal region, 1 indicating the frontal bone, and 2 the parietal). Prominence and great breadth of the forehead display analytical, i.e., scientific powers applicable to concretes, whereas a fair intellect, associated with a preponderating development of the coronal region, indicates analogical powers, i.e., faculties to perceive the relation and the agreement of principles. The former classifies and arranges facts, the latter invests them with moral and spiritual import. The one treats of matter, its physical properties, and chemical composition, the other of thoughts and intentions which involve right and wrong, relating to spiritual accountability. The intellect is employed upon an observable order of things, while the emotive faculties arrange the general laws of being into abstract science.

Fig. 93, a portrait of Prof. Tholuck, is a remarkable example of an encephalic organization. Figs. 72 and 79 fairly indicate the effects of undue mental activity, the intellect causing vital expenditure resulting in the devitalization of the blood. While the intellect displays keen penetration, subtle discrimination, and profound discernment, the emotions exhibit intense sensitiveness, acute susceptibility, and inspirational impressibility. [pg 178]The encephalic temperament is characterized by mental activity, great delicacy of organization, a high and broad forehead, expressive eyes, fine but not very abundant hair, great sensitiveness, refined feelings, vividness of conception, and intensity of emotion. If the brain is developed on the sides, there is manifested Ideality, Modesty, Hope, Sublimity, Imagination, and Spirituality. If the brain and forehead project, the Perceptive, Intuitive, and Reasoning faculties predominate. If it rises high, and nearly perpendicularly, Liberality, Sympathy, Truthfulness, and Sociability are manifested. When the emotive faculties are large, Faith, Hope, Love, Philanthropy, Religion, and Devotion characterize the individual. It is an artistic, creative, and aesthetic temperament, beautiful in conception and grand in expression, yet its sensitiveness is enfeebling, and its crowning excellence, when betrayed by the propensities, trails in defilement. Its purity is God-like, its debauchment, Perdition!

Fig. 93.

Fig. 94 is the likeness of Prof. George Bush. His forehead is amply developed in the region of Foresight, Liberality, Sympathy, Truthfulness, and Benevolence; his mouth expresses Amiability and Cheerfulness, and the whole face beams with [pg 179]Kindness and Generosity. This philanthropist, who is both a preacher and an author, has published several works upon theology, which distinguish him for great research and originality.

Fig. 94.

Fig. 95 represents the sanguine-encephalic temperament, the two elements being most happily blended. The portrait is that of Emmanuel Swedenborg, the great scholar and spiritual divine. The reader will observe how high and symmetrical is the forehead, and how well balanced appears the entire organization. He was remarkable for vivid imagination, great scientific acquirements, and all his writings characterize him as a subtle reasoner.

When the encephalic predominates, and the sanguine is deficient in its elements, we find conditions favorable to waste and expenditure, and adverse to a generous supply and reformation of the tissues. A child inheriting this cerebral development is already top-heavy, and supports, at an immense disadvantage, this disproportionate organization. The nutritive functions are overbalanced; consequently there is a [pg 180]predisposition to scrofulous diseases and disorders of the blood, various degenerating changes taking place in its composition; loss of red corpuscles, signified by shortness of breath; morbid changes, manifested by cutaneous eruptions; exhaustion from lack of nourishment, etc., until, finally, consumption finishes the subject.

Fig. 95.

Harmony is the support of all institutions, and applies with special cogency to the maintenance of health. When the mind dwells on one subject to the exclusion of all others, we call such a condition monomania. If we have an excessive development of mind, and deficient support of body, the result is corporeal derangement. It is unfortunate for any child to inherit unusually large brain endowments, unless he is possessed of a vigorous, robust constitution. Such training [pg 181]should be directed to that body as will encourage it to grow strong, hearty, and thrifty, and enable it to support the cerebral functions. The mental proclivities should be checked and the physical organization cultivated, to insure to such a child good health. Cut off all unnecessary brain-wastes, attend to muscular training and such invigorating games and exercises as encourage the circulation of the blood; keep the skin clean and its functions active, the body warm and well protected, the lungs supplied with pure air, the stomach furnished, with wholesome food, besides have the child take plenty of sleep to invigorate the system, and thus, by regular habits, maintain that equilibrium which tends to wholesome efficiency and healthful endurance.

TRANSMISSION OF LIFE.

As has been already stated in the chapter on Biology, reproduction of the species depends upon the union of a sperm-cell with a germ-cell, the male furnishing the former and the female the latter. It is a well-known fact that the marriage of persons having dissimilar temperaments is more likely to be fertile than the union of persons of the same temperaments; consanguineous marriages, or the union of persons nearly related by blood, diminish fertility and the vigor of the offspring. Upon this subject Francis Galton has given some very interesting historical illustrations in his well-known work, entitled "Hereditary Genius." The half-brother of Alexander the Great, Ptolemy I, King of Egypt, had twelve descendants, who successively became kings of that country, and who were also called Ptolemy. They were matched in and in, but in nearly every case these near marriages were unprolific and the inheritance generally passed through other wives. Ptolemy II married his niece, and afterwards his sister; Ptolemy IV married his sister. Ptolemy VI and VII were brothers, and they both consecutively married the same sister; Ptolemy VII also subsequently married his niece; Ptolemy VIII married two of his sisters in succession. Ptolemy XII and XIII were brothers, and both consecutively married their sister, Cleopatra. Mr. Galton and Sir Jas. Y. Simpson have shown that many peerages have become extinct through the evil results of inter-marriage. Heiresses are usually only children, the feeble product [pg 182]of a run-out stock, and statistics have shown that one-fifth of them bear no children, and fully one-third never bear more than one child. Sir J.Y. Simpson ascertained that out of 495 marriages in the British Peerage, 81 were unfruitful, or nearly one in every six; while out of 675 marriages among an agricultural and seafaring population, only 65 were sterile or barren, or a little less than one in ten.

While the marriages of persons closely related, or of similar temperaments are frequently unfruitful, we would not have the reader understand that sterility, or barrenness, is usually the result of such unions. It is most frequently due to some deformity or diseased condition of the generative organs of the female. In the latter part of this work may be found a minute description of the conditions which cause barrenness, together with the methods of treatment, which have proved most effectual in the extensive practice at the Invalids' Hotel and Surgical Institute.

The temperaments may be compared to a magnet, the like poles of which repel, and the unlike poles of which attract each other. Thus similarity of temperament results in barrenness while dissimilarity makes the vital magnetism all the more powerful. Marriageable persons moved by some unknown influence, have been drawn instinctively toward each other, have taken upon themselves the vows and obligations of wedlock, and have been fruitful and happy in this relation. Alliances founded upon position, money, or purely arbitrary considerations, mere contracts of convenience, are very apt to prove unhappy and unproductive.

Men may unconsciously obey strong instinctive impulses without being conscious of their existence, and by doing so, avoid those ills, which otherwise might destroy their connubial happiness. The philosophy of marriage receives no consideration, because the mind is pre-occupied with newly awakened thoughts and feelings. Lovers are charmed by certain harmonies, feel interior persuasions, respond to a new magnetic influence and are lost in an excess of rapture.

If the parties to a marriage are evenly balanced in organic elements, although both of them are vigorous, yet it is physiologically more suitable for them to form a nuptial alliance with [pg 183]an unlike combination. The cause of the wretchedness attending many marriages may be traced to a too great similarity of organization, ideas, taste, education, pursuits, and association, which similarity almost invariably terminates in domestic unhappiness. The husband and wife should be as different as the positive and negative poles of a magnet. When life is begotten under these circumstances we may expect a development bright with intelligence.

CHAPTER XVI

MARRIAGE.

LOVE.

"Love is the root of creation; God's essence; worlds without number
Lie in his bosom like children; he made them for this purpose only.
Only to love and to be loved again, he breathed forth his spirit
Into the slumbering dust, and upright standing, it laid its
Hand on its heart, and felt it was warm with a flame out of heaven."

        —LONGFELLOW.

Love, that tender, inexplicable feeling which is the germinal essence of the human spirit, is the rudimental element of the human soul. It is, therefore, a Divine gift, a blessing which the Creator did not withdraw from his erring children, when they were driven from a paradise of innocence and loveliness into a world of desolation and strife. He left it as an invisible cord by which to draw the human heart ever upward, to a brighter home—the heavenly Eden. Love is the very essence of Divine law, the source of inspiration, even the fountain of life itself. It is spontaneous, generous, infinite. To its presence we are indebted for all that is good, true, and beautiful in Art and Nature. It endows humanity with countless virtues, and throws a mystic veil over our many faults. It is this feeling, this immutable law, which controls the destiny of the race. From its influence empires have fallen, scepters have been lost. Literature owes to Love its choicest gems. [pg 185]The poet's lay is sweeter when Cupid tunes the lyre. The artist's brush is truer when guided by Love. Greece was the cradle of letters and art. Her daughters were queens of beauty, fitted to inspire the Love of her noblest sons.

Fig. 96.

The materialism of the nineteenth century has sought to degrade Love; to define it as purely physical. The result has been a corresponding degradation of art, and even literature has lost much of its lofty idealism. Nudity has become a synonym of vulgarity; Love, of lust. "Evil be to him who evil thinks." True Love never seeks to degrade its object; on the contrary, it magnifies every virtue, endows it with divinest attributes, and guards its chastity, or honor, at the sacrifice of its own life. It increases benevolence by opening the lover's heart to the wants of suffering humanity. Ideality is the canvas, and imagination the brush with which Love delineates the beauties of the adored. Love heightens spirituality, awakens hope, strengthens faith, and enhances devotion. It quickens the perceptions, intensifies the sensibilities, and redoubles the memory. It augments muscular activity, and imparts grace to every movement. The desire to love and to be loved is innate, and forms as much a part of our being as bone or reason. In fact, Love may be considered as the very foundation of our spiritual existence, as bone and reason are the essential bases of our physical and intellectual being. Every man or woman feels the influence of this emotion, sooner or later. It is the Kadesh-barnea of human existence; obedience to its intuitions insures the richest blessings of life, while neglect or perversion enkindles God's wrath, even as did the disobedience of the wandering Israelites.

The one great fact which pervades the universe is action. The very existence of Love demands its activity, and, hence, the highest happiness is attained by a normal and legitimate development of this element of our being. The heart demands [pg 186]an object upon which to lavish the largess of its affection. In the absence of all others, a star, a flower, or even a bird, will receive this homage. The bird warbles a gay answer to the well-known voice, the flower repays the careful cultivator by displaying its richest tints, the star twinkles a bright "good evening" to the lonely watcher, and yet withal there is an unsatisfied longing in the lover's heart, to which neither can respond; the desire to be loved! Hence, the perfect peace of reciprocated love. If its laws are violated, nature seeks revenge in the utter depression or prostration of the vital energies. Thus has the Divine Law-giver engraven His command on our very being. To love is, therefore, a duty, the fulfillment of which should engage our noblest powers.

This emotion manifests itself in several phases, prominent among which is filial affection, the natural harmonizer of society. Paternal love includes a new element—protection. Greater than either, and second only in fortitude to maternal affection, is

CONJUGAL LOVE.

"He is blest in Love alone
Who loves for years and loves but one."—HUNT.

With Swedenborg, we may assert, "that there is given love truly conjugal, which at this day is so rare, that it is not known what it is, and scarce that it is." The same author has defined this relation to be a union of Love and Wisdom. The fundamental law of conjugal love is fidelity to one love. God created but one Eve, and the essential elements of paternal and maternal love pre-suppose and necessitate, for their normal development, the Love of one only. Again, Love is the sun of woman's existence. Only under its influence does she unfold the noblest powers of her being. Woman's intuitions should therefore be taken as the true love-gauge. If she desire a plurality of loves, it must be a law of her nature; but is communism the desire of our wives and daughters? No! Every act which renders woman dear to us, denounces such an idea and reveals the exclusive sacredness of her Love. As condemning promiscuity in this relation, we may cite the lovers' pledges and oaths of fidelity, the self-perpetuity of Love itself, [pg 187]the common instincts of mankind, as embodied in public sentiment, and the inherent consciousness that first love should he kept inviolable forever. Again, Love is conservative. It clings tenaciously to all the memories connected with its first object. The scenes consecrated to "Love's young dream" are sacred to every heart. The woodland with its winding paths and arbors, the streamlet bordered with drooping violets and dreamy pimpernel, the clouds, and even "the very tones in which we spoke," are indelibly imprinted on the memory. There is also the "mine and thine" intuition of love. This sentiment is displayed in every thought and act of the lover. Every pleasure is insipid unless shared by the beloved; selfish and exacting to all others, yet always generous and forgiving to the adored. "Mine and thine, dearest," is the language of Conjugal Love.

The consummation desired by all who experience this affection, is the union of souls in a true marriage. Whatever of beauty or romance there may be in the lover's dream, is enhanced and spiritualized in the intimate communion of married life. The crown of wifehood and maternity is purer, more divine, than that of the maiden. Passion is lost; the emotions predominate.

The connubial relation is not an institution; it was born of the necessities and desires of our nature. "It is not good for man to be alone," was the Divine judgment, and so God created for him "an helpmate." Again, "Male and female created He them;" therefore, sex is as divine as the soul. It is often perverted, but so is reason, aye, so is devotion.

The consummation of marriage involves the mightiest issues of life. It may be the source of infinite happiness or the seal of a living death. "Love is blind" is an old saying, verified by thousands of ill-assorted unions. Many unhappy marriages are traceable to one or both of two sources, Physical Weaknesses and Masquerading. Many are the candidates for marriage who are rendered unfit therefor from weaknesses of their sexual systems, induced by the violation of well-established physical laws.

We cannot too strongly urge upon parents and guardians the imperative duty of teaching those youths who look to them for [pg 188]instruction, in all matters which pertain to their future well-being such lessons as are embraced in the chapter of this book entitled, "Hygiene of the Reproductive Organs." By attending to such lessons as will give the child a knowledge of the physiology and hygiene of his whole system, the errors into which so many of the young fall, and much of the misery which is so often the dregs of the hymeneal cup, will be avoided.

Masquerading is a modern accomplishment. Girls wear tight shoes, burdensome skirts, and corsets, all of which prove very injurious to their health. At the age of seventeen or eighteen, our young ladies are sorry specimens of womankind, and "palpitators," cosmetics, and all the modern paraphernalia of fashion are required to make them appear fresh and blooming. Man is equally to blame. A devotee to all the absurd devices of fashion, he practically asserts that "dress makes the man." But physical deformities are of far less importance than moral imperfections. Frankness is indispensable in love. Each should know the other's faults and virtues. Marriage will certainly disclose them; the idol falls and the deceived lover is transformed into a cold, unloving husband or wife. By far the greater number of unhappy marriages are attributable to this cause. In love especially, honesty is policy and truth will triumph.

HISTORY OF MARRIAGE.

Polygamy and Monogamy. We propose to give only a brief dissertation on the principles and arguments of these systems, with special reference to their representatives in the nineteenth century. Polygamy has existed in all ages. It is, and always has been, the result of moral degradation or wantonness. The Garden of Eden was no harem. Primeval nature knew no community of love. There was only the union of two "and the twain were made one flesh." Time passed; "the sons of God saw the daughters of men that they were fair; and they took them wives of all which they chose." The propensities of men were in the ascendant, and "God repented Him that He had created man." He directed Noah to take into the ark, two of every sort, male and female. But "the imagination of man's heart is evil from his youth," and tradition points to Polygamy as the generally recognized form of marriage among the ancients. [pg 189]The father of the Hebrew nation was unquestionably a polygamist, and the general history of patriarchal life shows that a plurality of wives and concubines were national customs. In the earlier part of Egyptian history, Menes is said to have founded a system of marriage, ostensibly monogamous, but in reality it was polygamous, because it allowed concubinage. As civilization advanced, the latter became unpopular, and "although lawful, was uncommon," while polygamy was expressly forbidden. Solomon, according to polygamous principles, with his thousand women, should have enjoyed a most felicitous condition. Strange that he exclaimed "A woman among all these have I not found." According to the distinguished Rabbi, Maimonides, polygamy was a Jewish custom as late as the thirteenth century. When Cecrops the Egyptian King, came to Athens (1550, B.C.) he introduced a new system, which proved to be another step toward the recognition of Monogamy. Under this code a man was permitted to have one wife and a concubine. Here dawned the era of Grecian civilization, the glory of which was reflected in the social and political principles of Western Europe. During the fourth and fifth centuries B.C., concubinage disappeared, but, under the new regime, the condition of the wife was degraded. She was regarded as simply an instrument of procreation and a mistress of the household, while a class of foreign women, who devoted themselves to learning and the fine arts, were the admired, and often the beloved companions of the husbands. These were the courtesans who played the same role in Athenian history, as did the chaste matron, in the annals of Rome. When Greece became subject to Rome and the national characteristics of these nations were blended, marriage became a loose form of monogamy. In Persia, during the reign of Cyrus, about 560 B.C., polygamy was sustained by custom, law, and religion. The Chinese marriage system was, and is, practically polygamous, for, from their earliest traditions, we learn that although a man could have but one wife, he was permitted to have as many concubines as he desired.

In the Christian era the first religious system which incorporated polygamy as a principle was Mohammedanism. This system, which is so admirably adapted to the voluptuous [pg 190]character of the Orientals, has penetrated Western Europe, Asia, and Africa. Hayward estimated the number of its adherents to be one hundred and forty millions. The heaven of the Mohammedan is replete with all the luxuries which appeal to the animal propensities. Ravishing Houris attend the faithful, who recline on downy couches, in pavilions of pearl. On the Western Continent a system of promiscuity was practiced by the Mexicans, Peruvians, Brazilians, and the barbarous tribes of North America.

The Mormon Church was founded by Joseph Smith, and professes to be in harmony with the Bible and a special revelation to its leading Saint. According to the Mormon code, "Love is a yearning for a higher state of existence, and the passions, properly understood, are feeders of the spiritual life;" and again, "nature is dual; to complete his organization a man must marry." The leading error of Mormonism is that it mistakes a legal permission for a Divine command. The Mormon logic may be premised as follows: the Mosaic law allowed polygamy; the Bible records it; therefore, the Bible teaches polygamy.

A Mormon Saint can have not less than three wives but as many more as he can conveniently support. The eight fundamental doctrines of the Mormon Church are stated as follows: 1. God is a person with the flesh and form of a man. 2. Man is a part of the substance of God and will himself become a god. 3. Man is not created by God but existed from all eternity. 4. Man is not born in sin, and is not accountable for offenses other than his own. 5. The earth is a colony of embodied spirits, one of many such settlements in space. 6. God is president of the immortals, having under Him four orders of beings: (1.) Gods—i.e., immortal beings, possessed of a perfect organization of soul and body, being the final state of men who have lived on earth in perfect obedience to the law. (2.) Angels, immortal beings who have lived on earth in imperfect obedience to the law. (3.) Men, immortal beings in whom a living soul is united with a human body. (4.) Spirits, immortal beings, still waiting to receive their tabernacle of flesh. 7. Man, being one of the race of gods, became eligible, by means of marriage, for a celestial throne, and his household of [pg 191]wives and children are his kingdom, not only on earth but in heaven. 8. The kingdom of God has been again founded on earth, and the time has now come for the saints to take possession of their own; but by virtue, not by violence; by industry, not by force. This sect has met with stern and bitter opposition. It was successively located in New York, Ohio, Missouri, and Illinois, from the last of which it was expelled by force of arms, and in 1848 established in Utah. Its adherents number, at the present time, more than two hundred thousand.

Another organization, differing from the Mormons, in many of its radical principles, is that of the "Communists," popularly termed "Free Lovers." It is located at Lennox, Madison Co., N.Y. Its members advocate a system of "complex marriage" which they claim is instituted with a conscientious regard for the welfare of posterity. They disclaim "promiscuity," and assert that the tie which binds them together is as permanent and as sacred as that of marriage. Community of property is commensurate with freedom of Love. They define love to be "social appreciation," and this element in their code of civilization, which they deem superior to all others, is secondary to "bodily support." The principles upon which their social status is founded may be briefly summarized as follows: "Man offers woman support and love (unconditional). Woman enjoying freedom, self-respect, health, personal and mental competency, gives herself to man in the boundless sincerity of an unselfish union. State—, Communism." In this, as in all forms of polygamous marriages, love is made synonymous with sexuality, and its purely spiritual element is lost. In every instance this spiritual element should constitute the basis of marriage, which, without it, is nothing more than legal prostitution. Without it, the selfish, degrading, animal propensities run rampant, while the emotions with all their boundless sweetness lie dormant. Woman is regarded as only a plaything to gratify the animal caprice.

That Monogamy is a law of nature is evident from the fact that it fulfills the three essential conditions which form the basis of true marriage: (1.) The development of the individual (2.) The welfare of society. (3.) The reproduction of the species.

THE DEVELOPMENT OF THE INDIVIDUAL.

PHYSICALLY. Reciprocated love produces a general exhilaration of the system. The elasticity of the muscles is increased, the circulation is quickened, and every bodily function is stimulated. The duties of life are performed with a zest and alacrity never before experienced. "It is not possible for human beings to attain their full stature of humanity, except by loving long and perfectly. Behold that venerable man! He is mature in judgment, perfect in every action and expression, and saintly in goodness. You almost worship as you behold. What rendered him thus perfect? What rounded off his natural asperities, and moulded up his virtues? Love mainly. It permeated every pore, so to speak, and seasoned every fiber of his being, as could nothing else. Mark that matronly woman. In the bosom of her family, she is more than a queen and goddess combined. All her looks and actions express the outflowing of some or all of the human virtues. To know her is to love her. She became thus perfect, not in a day or a year, but by a long series of appropriate efforts. Then by what? Chiefly in and by love, which is specifically adapted thus to develope this maturity." But all this occurs only when there is a normal exercise of the sexual propensities. Excessive indulgence in marital pleasures deadens all the higher faculties, love included, and results in an utter prostration of the bodily powers. The Creator has endowed man and woman with passions, the suppression of which leads to pain, their gratification to pleasure, their satiety to disgust. Excessive marital indulgence produces abnormal conditions of the generative organs and not unfrequently leads to incurable disease. Many cases of uterine disease are traceable to this cause.

MORALLY AND INTELLECTUALLY. In no country where the polygamous system prevails do we find a code of political and social ethics which recognizes the rights and claims of the individual. The condition of woman is that of the basest slave, a slave to the caprice and tyranny of her master. Communism raises her from the slough of slavery, but subjects her to the level of prostitution. An inevitable sequence of polygamy is a decline of literature and science. The natural tendency of [pg 193]each system is to sensualism., The blood is diverted from its normal channels and the result is a condition which may be appropriately termed mental starvation. Sensualism is in its very nature directly opposed to literary attainments or advancement. Happily there is a golden mean, an equalization of those elements which constitutes the acme of individual enjoyment.

THE WELFARE OF SOCIETY.

The general law of ethics, that "whatever is beneficial to the individual, contributed to the highest good of society and vice versa," applies with equal force to the hygienic conditions of marriage. Each family, like the ancient Roman household, is the prototype of the natural government under which it lives. Wherever the marriage relation is regarded as sacred, there you will find men of pure hearts and noble lives. Of all foreign nations the Germans are celebrated for their sacred regard of woman, and the duties of marriage, and all scholars from the age of Tacitus to the present day, have concurred in attributing the elevation of woman to the pure-minded Teutons. In America, the law recognizes only Monogamy; but domestic unhappiness is a prominent feature of our national life; therefore, argues the would-be free-lover, monogamy does not accord with the best interests of mankind. The fallacy lies in the first premise. Legally, our marriage system is monogamous but socially and practically it is not! Prostitution is the source of this domestic infelicity. The "mistress" sips the sweet nectar that is denied to the deceived wife. Legislators have battled with intemperance, but have done comparatively little to banish from our midst this necessary (?) evil. They recoil with disgust from this abyss of iniquity and disease. Within it is coiled a hydra-headed monster, which invades our hearthstones, contaminates our social atmosphere, and whose very breath is laden with poisonous vapors, the inexhaustible source of all evil.

The perverted appetites of mankind are mistaken for the natural desires and necessities of our being; and, accordingly, various arguments have been advanced to prove that monogamy is not conducive to social developement. It is curious that no one of these arguments refers to the health and well-being of [pg 194]the individual, thus overlooking, perhaps willfully, the great law of social economy. Even a few medical writers sometimes advocate the principles of this so-called liberalism. In a recently published work, there are enumerated only two demerits of polygamy and six of monogamy. These six demerits which the author is pleased to term a "bombshell," he introduces on account of his moral convictions no less than humanitarian considerations. The same author terms monogamy a "worm-eaten and rotten-rooted tree." The worm that is devastating the fairest tree of Eden and draining its richest juices is what our contemporary thinks, may be "plausibly termed, a necessary evil." It is claimed that monogamy begets narrow sympathies and leads to selfish idolatry. The fallacy of this argument lies in the misapprehension of the term selfishness. Self-preservation is literally selfishness, yet who will deny that it is a paramount duty of man. If perverted, it may be vicious, even criminal; but selfishness, in so far as it is generated by monogamy, is one of the chief elements of social economy; furthermore, it favors the observance of the laws of sexual hygiene. As we have said elsewhere, true love increases benevolence, and correspondingly expands and develops the sympathies. Selfish idolatry is preferable to social neglect. This argument will not bear a critical examination; for it is asserted that in a happy union, "love is so exclusive that there is hardly a liking for good neighbors, and scarcely any love at all for God." If the "good neighbors" were equally blessed, they would not suffer from this exclusiveness, and it is practically true that there is no higher incentive to love and obey our Maker than the blessing of a happy marriage.

THE PERPETUATION OF THE SPECIES.

The third essential object of marriage is the perpetuation of the species. The desire for offspring is innate in the heart of every true man or woman. It is thus a law of our nature, and, as such, must have its legitimate sphere. The essential features of reproduction proclaim monogamy to be the true method of procreation. Promiscuity would render the mother unable to designate the father of her children. Among lower animals, pairing is an instinctive law whenever the female is [pg 195]incapable of protecting and nourishing her offspring alone. During at least fifteen years, the child is dependent for food and clothing upon its parents, to say nothing of the requisite moral training and loving sympathy, which, in a great measure, mould its character. Fidelity to one promotes multiplication. It has been argued by the advocates of polygamy that such a system interferes with woman's natural right to maternity. Of the many marriages celebrated yearly, comparatively few are sterile. The statement that many single women are desirous of having children, would apply only to a very limited number, as it is seldom that they would be able to support children without the aid and assistance of a father. Promiscuity diminishes the number and vitiates, the quality of the human products. "Women of pleasure never give to the world sons of genius, or daughters of moral purity."

CHAPTER XVII.

REPRODUCTION.

Every individual derives existence from a parent, which word literally means one who brings forth. We restrict the meaning of the term reproduction, ordinarily, to that function by which living bodies produce other living bodies similar to themselves. Production means to bring forth; reproduction, the producing again, or renewing. To protract individual existence, nutrition is necessary, because all vital changes are attended by wear and waste. Nutrition is always engaged in the work of reparation. Every organism that starts out upon its career of development depends upon nourishing materials for its growth, and upon this renewing process for its development. Nutrition is all the while necessary to prolong the life of the individual, but at length its vigor wanes, its functions languish, and, finally, the light of earthly life goes out. Although the single organization decays and passes away, nevertheless the species is uninterruptedly continued; the tidal wave of life surges higher on the shores of time, for reproduction is as constant and stable as the attractive forces of the planetary system.

It is a fact, that many species of the lower order of animals which once existed are now extinct. It has been asserted and denied, that fossil remains of man have been found, indicating that races which once existed have disappeared from the face of the earth. The pyramids are unfolding a wonderful history, embracing a period of forty-five hundred years, which the world of science receives as literally authentic, and admits, also, that fifty-four hundred years are probably as correctly [pg 197]accounted for. The extinction of races is not at all improbable. At the present time, the aboriginal inhabitants of this continent seem to be surely undergoing gradual extinguishment! It, therefore, seems to be possible for a weaker race to deteriorate, and finally become extinct, unless the causes of their decadence can be discovered and remedied. All people are admonished to earnestly investigate the essential conditions necessary for their continuance, for the rise and fall of nations is in obedience to natural principles and operations. Viewed from this standpoint, it is possible that a careful study of the human temperaments and their relations to reproduction may be of greater moment than has hitherto been supposed, and a proper understanding of them may tend to avert that individual deterioration, which, if suffered to become general, would end in national disaster and the extinction of the race.

Until recently, even naturalists believed that descendants were strictly like their parents in form and structure. Now it is known that the progeny may differ in both form and structure from the parent, and that these may produce others still more unlike their ancestry. But all these peculiar and incidental deviations finally return to the original form, showing that these changes have definite limits, and that the alterations observe a specific variableness, which is finally completed by its assuming again the original form. (See page 16, Figs. 2 and 3).

Reproduction may be sexual or non-sexual. In some plants and animals it is non-sexual. The propagation of species is accomplished by buds. Thus the gardener grafts a new variety of fruit upon an old stock. The florist understands how to produce new varieties of flowers, and make them radiantly beautiful in their bright and glowing colors. The bud personates the species and produces after its kind. Some of the annelides, a division of articulate animals, characterized by an elongated body, formed of numerous rings or annular segments, multiply by spontaneous division. A new head is formed at intervals in certain segments of the body. (See Fig. 97).

Something similar to this process of budding, we find taking place in a low order of animal organization. Divide the fresh water polyp into several pieces, and each one will grow into [pg 198]an entire animal. Each piece represents a polyp, and so each parent polyp is really a compound animal, an organized community of beings. Just as the buds of a tree, when separated and engrafted upon another tree, grow again, each preserving its original identity, so do the several parts of this animal, when divided, become individual polyps, capable of similar reproduction.

Fig. 97. An annelid dividing spontaneously, a new head having been formed toward the hinder part of the body of the parent.

The revolving volvox likewise increases by growth until it becomes a society of animals, a multiple system of individuals. There are apertures from the parent, by which water gains a free access to the interior of the whole miniature series. This monad was once supposed to be a single animal, but the microscope shows it to be a group of animals connected by means of six processes, and each little growing volvox exhibits his red-eye speck and two long spines, or horns. These animals also multiply by dividing, and thus liberate another series, which, in their turn, reproduce other groups.

Generation requires the concurrence of stimuli and susceptibility, and, to perfect the process, two conditions are also necessary. The first is the sperm, which communicates the principle of action; the other is the germ, which receives the latent life and provides the conditions necessary to organic evolution. The vivifying function belongs to the male, that of nourishing and cherishing is possessed by the female; and these conditions are sexual distinctions. The former represents will and understanding; the latter, vitality and emotion. The father directs and controls, the mother fosters and encourages; [pg 199]the former counsels and admonishes, the latter persuades and caresses; and their union in holy matrimony represents one; that is, the blending of vitality and energy, of love and wisdom,—the elements indispensable to the initiation of life under the dual conditions of male and female,—one in the functions of reproduction.

Let us consider the modes of Sexual Reproduction, which are hermaphroditic and dioecious.

HERMAPHRODITIC REPRODUCTION.

We have said that two kinds of cells represent reproduction, namely, sperm and germ-cells. These may be furnished by different individuals, or both may be found in one. When both are found in the same individual, the parent is said to be a natural hermaphrodite. A perfect hermaphrodite possesses the attributes of both male and female—uniting both sexes in one individual. Natural hermaphroditic reproduction occurs only among inferior classes of animals, and naturalists inform us that there are a greater number of these than of the more perfect varieties. These are found low in the scale of animal organization, and one individual is able to propagate the species. In the oyster and ascidians no organs can be detected in the male, but in the female they are developed. Polyps, sponges, and cystic entozoa, may also be included among hermaphrodites.

It is only very low organisms indeed in which it is a matter of indifference whether the united sperm-cells and germ-cells are those of the same individual, or those of different individuals. In more elaborate structures and highly organized beings, the essential thing in fertilization is the union of these cells specially endowed by different bodies, the unlikeness of derivation in these united reproductive centers being the desideratum for perpetuating life and power.

In other classes, as entozoa, there appear to be special provisions whereby the sperm-cells and germ-cells may be united; i.e., the male organs are developed and so disposed as to fecundate the ova of the same individual. Sexual and non-sexual modes of reproduction are illustrated by that well-defined group of marine invertebrate animals, called cirripedia Fig. 98 represents one of this genus.

Fig. 98. Pollicipes Mitella.

Some of these are not only capable of self-impregnation, but likewise have what are called complemental males attache to some of the hermaphrodites. In the whole animal kingdom, it may be doubted if there exists another such class of rudimentary creatures as the parasitic males, who possess neither mouth, stomach, thorax, nor abdomen. After exerting a peculiar sexual influence, they soon die and drop off; so that in this class of animals may be found the sexual distinctions of male, female, and perfect hermaphrodites.

Fig. 99. Rotiferia; Brachionus Urceolaris; largely magnified.

There is a class of wheel-animalcules termed rotifera, of which the revolving volvox is one example. They have acquired this name on account of the apparent rotation of the disc-like organs which surround their mouths and are covered with cilia, or little hairs. They are minute creatures, and can best be viewed with a microscope, although the larger forms may be seen without such assistance. They are widely diffused on the surface of the earth, inhabit lakes as well as the ocean, and are found in cold, temperate, and tropical climates. The rotifera were once supposed to be hermaphrodites, but the existence of sexes in one species has been clearly established. The male, however, is much smaller, and far less developed than the female. In some of these species, germ-cells, or eggs, are found, which do not require fecundation for reproduction or development, so that they belong to the non-sexual class.

The third variety of hermaphrodites embraces those animals in which the male organs are so disposed as not to fecundate [pg 201]the ova of the same body, but require the co-operation of two individuals, notwithstanding the co-existence in each of the organs of both sexes. Each in turn impregnates the other. The common leech, earth-worm, and snail, propagate in this manner.

Unnatural hermaphrodism is characteristic of insects and crustaceans, in which the whole body indicates a neutral character, tending to exhibit the peculiarities of male or female, in proportion to the kind of sexual organs which predominates. Half of the body may be occupied by male, the other half by female organs, and each half reflects its peculiar sexual characteristics. Some butterflies are dimidiate hermaphrodites; i.e. one side of the body has the form and color of the male, the other the form and color of the female. The wings show by their color and appearance these sexual distinctions. The stag-beetle is also an example. We have accounts of dimidiate hermaphrodite lobster, male in one half and female in the other half of the body.

Among the numerous classes of higher animals, which have red blood, we have heard of no well-authenticated instance of hermaphrodism, or the complete union of all the reproductive organs in one individual. True, the term hermaphrodite is often applied to certain persons in whom there is some malformation, deficiency, or excess, of the genital organs. These congenital deformities consisting of combined increase or deficiency, supernumerary organs, or transposition of them, which usually render generation physically impossible, have been called bisexual hermaphrodism and classed as monstrosities. We have many published accounts of them, hence, further reference to them here is unnecessary. We would especially refer those readers who may desire to make themselves further acquainted with this interesting subject, to the standard physiological works of Flint, Foster, Carpenter, Bennett, Dalton, and others equally eminent in this particular branch of science.

Certain theories have been advanced concerning conditions which may influence the sex of the offspring. One is that the right ovary furnishes the germs for males, the left for females that the right testicle furnishes sperm capable of fecundating the germs of males, and the left testicle, the germs of the left [pg 202]ovary, for females. That fecundation sometimes takes place from right to left and thus produces these abnormal variations. We merely state the hypothesis, but do not regard it as accounting for the distinction of sex, or as causing monstrosities, though it is somewhat plausible as a theory, and is not easily disproved. In the lower order of animals, as sheep and swine, one of the testicles has been removed, and there resulted afterward both male and female progeny, so that the theory seems to lack facts for a foundation.

We sometimes witness in the child excessive development, as five fingers, a large cranium, which results in dropsical effusion, or deficient brain, as in idiots; sometimes a hand or arm is lacking, or possibly there is a dual connection, as in the case of the Siamese twins; or, two heads united on one body. It is difficult to give any satisfactory explanation of these abnormal developments. From age to age, the type is constant, and preserves a race-unity. The crossings of the races are only transient deviations, not capable of perpetuation, and quickly return again to the original stock. This force is persistent, for inasmuch as the individual represents the race, so does his offspring represent the parental characteristics, in tastes, proclivities, and morals, as well as in organic resemblances. This constancy is unaccountable, and more mysterious than the occasional malformation of germs in the early period of foetal life. If to every deviation from that original form and structure, which gives character to the productions of nature, we apply the term monster, we shall find but very few, and from this whole class there will be a very small number indeed of sexual malformations. If the sexes be deprived of the generative organs, they approach each other in disposition and appearance. All those who are partly male and partly female in their organization, unite, to a certain extent, the characteristics of both sexes. When the female loses her prolific powers, many of her sexual peculiarities and attractions wane.

DIOECIOUS REPRODUCTION.

Dioecious is a word derived from the Greek, and signifies two households; hence, dioecious reproduction is sexual generation by male and female individuals. Each is distinguished by sexual [pg 203]characteristics. The male sexual organs are complete in one individual, and all the female organs belong to a separate feminine organization. In some of the vertebrates, impregnation does not require sexual congress; in other words, fecundation may take place externally. The female fish of some species first deposits her ova, and afterwards the male swims to that locality and fertilizes them with sperm.

In higher orders of animals, fecundation occurs internally, the conjunction of the sperm and germ cells requiring the conjugation of the male and female sexual organs. The sperm-cells of the male furnish the quickening principle, which sets in play all the generative energies, while the germ-cell, susceptible to its vivifying presence, responds with all the conditions necessary to evolution. The special laboratory which furnishes spermatic material is the testes, while the stroma of the ovaries contributes the germ-cell. Several different modes of reproducing are observed when fecundation occurs within the body, which vary according to the peculiarities and organization of the female.

Modes of Dioecious Reproduction.—A very familiar illustration of one mode is found in the common domestic fowl, the egg of which vivified within the ovarium, is afterward expelled and hatched by the simple agency of warmth. This mode of reproduction is called oviparous generation.

The ovaries, as well as all their latent germs, are remarkably influenced by the first fecundation. It seems to indicate monogamy as the rule of higher sexual reproduction. The farmer understands that if he wishes to materially improve his cows, the first offspring must be begotten by a better, purer breed, and all that follow will be essentially benefited, even if not so well sired. Neither will the best blood exhibit its most desirable qualities in the calves whose mothers have previously carried inferior stock. So that there are sexual ante-natal influences which may deteriorate the quality of the progeny. The Jews understood this principle, in the raising up of sons and daughters unto a deceased brother. The fact that the sexual influence of a previous conception is not lost, is illustrated when, in a second marriage, the wife bears a son or daughter resembling bodily or mentally, or in both of these respects the former [pg 204]husband. This indicates a union for life by natural influences which never die out.

With some species of fish and reptiles, the egg is impregnated internally, and the process of laying commences immediately, but it proceeds so slowly through the excretory passages, that it is hatched and born alive. This is called ovo-viviparous generation.

As we rise in the scale of organization, animals are more completely developed, and greater economy is displayed in their preservation. The germ passes from the ovary into an organ prepared for its reception and growth, to which, after fecundation, it becomes attached, and where it remains until sufficiently developed to maintain respiratory life. This organ is called the womb, or uterus, and is peculiar to most mammalia. This mode of reproduction is termed viviparous generation.

The kangaroo and oppossum are provided with a pouch attached to the abdomen, which receives the young born at an early stage of development. They remain in contact with the mammæ, from which they obtain their nourishment, until their growth is sufficiently completed to maintain an independent existence. This is called marsupial generation. The variety of reproduction which is most interesting, is that of the human species, and is called viviparous generation. It includes the functions of copulation, fecundation, gestation, parturition, and lactation.

For the full and perfect development of mankind, both mental and physical chastity is necessary. The health demands abstinence from unlawful intercourse. Therefore children should not be allowed to read impure works of fiction, which tend to inflame the mind and excite the passions. Only in total abstinence from illicit pleasures is there moral safety and health, while integrity, peace, and happiness, are the conscious rewards of virtue. Impurity travels downward with intemperance, obscenity, and corrupting diseases, to degradation and death. A dissolute, licentious, free-and-easy life is filled with the dregs of human suffering, iniquity, and despair. The penalties which follow a violation of the law of chastity are found to be severe and swiftly retributive.

Fig. 100. Male

Fig. 101. Female

Fig. 102. Outline of the Female Urinary and Generative Organs.

The union of the sexes in holy matrimony is a law of nature finding sanction in both morals and legislation. Even some of the lower animals unite in this union for life, and instinctively observe the law of conjugal fidelity with a consistency which might put to blush other animals more highly endowed. It is important to discuss this subject and understand our social evils, as well as the unnatural desires of the sexes, which must be controlled or they lead to ruin. Sexual propensities are possessed by all, and they must be held in abeyance, until they are exercised for legitimate purposes. Hence parents ought to understand the value of mental and physical labor to elevate and strengthen the intellectual and moral faculties of their children, to develop the muscular system and direct the energies of the blood into healthful channels. Vigorous employment [pg 207]of mind and body engrosses the vital energies and diverts them from undue excitement of the sexual desires.

Fig. 103. Outline of the Male Reproductive Organs.

Sexual generation by pairing individuals is the most economical mode of propagating the species. The lower orders of animals possess wonderful multiplicative powers and their faculty for reproduction is offset by various destructive forces. The increased ability for self-maintenance implies diminished reproductive energy; hence the necessity for greater economy and safety in rearing the young. As certain larvæ and insects increase, the birds which feed upon them become more numerous. When this means of support becomes inadequate, these same birds diminish in number in proportion to the scarcity of their food. Many have remarked that very prolific seasons are followed by unusual mortality, just as periods of uncommon prosperity precede those of severe disaster.

The increased mental and moral cultivation of mankind imposes upon them the necessity for greater physical culture. [pg 208]"Wiser and weaker," is a trite saying, and means that the exercise of the higher nature discloses the equivalent necessity of culturing the body, in order to support the increasing expenditures of the former. Mental and moral discipline are essential for a proper understanding how to provide for the body, for physical training increases the capacity of the individual for self-preservation. Constant vigilance is the price of health as well as of liberty.

It is an interesting physiological fact that, while the growth and development of the individual are rapidly progressing, the reproductive powers remain almost inactive, and that the commencement of reproduction not only indicates an arrest of growth, but, in a great measure, contributes toward it. From infancy to puberty, the body and its individual organs, structurally as well as functionally, are in a state of gradual and progressive evolution. Men and women generally increase in stature until the twenty-fifth year, and it is safe to assume that perfection of function is not established until maturity of bodily development is completed. Solidity and strength are represented in the organization of the male, grace, and beauty in that of the female. His broad shoulders represent physical power and the right of dominion, while her bosom is the symbol of love and nutrition. The father encounters hardships, struggles against difficulties, and braves dangers to provide for his household; the mother tenderly supplies the infant's wants, finding relief and pleasure in imparting nourishment, and surrounds helpless infancy with an affection which is unwearied in its countless ministering attentions. Her maternal functions are indicated by greater breadth of the hips. Physical differences so influence their mental natures, that, "before experience has opened their eyes, the dreams of the young man and maiden differ." The development of either is in close sympathy with their organs of reproduction. Any defect of the latter impairs our fair ideal, and detracts from those qualities which impart excellence, and crown the character with perfections. Plainly has Nature marked out, in the organization, very different offices to be performed by the sexes, and has made these distinctions fundamental.

Likewise, Nature expresses the intention of reproduction [pg 209]by giving to plants and animals distinctive organs for this purpose. These are endowed with exquisite sensibility, so that their proper exercise produces enjoyment beneficial to both. Excessive sexual indulgence not only prostrates the nervous system, enfeebles the body, and drains the blood of its vivifying elements, but is inconsistent with intellectual activity, morality, and spiritual development. The most entrancing delights and consummate enjoyments are of the emotive order, ideal, abstract, and pure, so inspiring that they overpower the grosser sensual pleasures and diffuse their own sweet chastity and refining influence over all the processes of life.

Hence, the gratification of the sexual instincts should always be moderate. It should be regulated by the judgment and will, and kept within the bounds of health. No person has a moral right to carry this indulgence so far as to produce injurious consequences to either party, and he who cannot refrain from it is in no proper condition to propagate his species. In all culture there must be self-control, and the practice of self-denial at the command of love and justice is always a virtue. Self-government is the polity of our people, and we point with pride and laudable exultation to our political maxims, laws, and free institutions. The family is the prototype of society. If self-restraint be practiced in the marital relation, then the principle of self-control will carry health, strength, and morality into all parts of the commonwealth. The leading characteristics of any nation are but the reflection of the traits of its individual members, and thus the family truly typifies the practical morality and enduring character of a people.

OVULATION.

The Ovaries are those essential parts of the generative system of the human female in which the ova are matured. There are two ovaries, one on each side of the uterus, and connected with it by the Fallopian tubes; they are ovoidal bodies about an inch in diameter, and furnish the germs or ovules. These latter are very minute, seldom measuring 1/120 of an inch in diameter, and frequently are not more than half that size. The ovaries develop with the growth of the female, so that, finally, at the pubescent period, they ripen and liberate [pg 210]an ovum, or germ vesicle, which is carried into the uterine cavity through the Fallopian tubes. With the aid of the microscope, we find that these ova are composed of granular substance, in which is found a miniature yolk surrounded by a transparent membrane, called the zona pellucida. This yolk contains a germinal vesicle in which can be discovered a nucleus, called the germinal spot. The process of the growth of the ovaries is very gradual, and their function of ripening and discharging an ovum every month into the Fallopian tubes and uterus is not developed until between the twelfth and fifteenth years.

This period, which indicates, by the feelings and ideas, the desires and will, that the subjects are capable of procreation, is called puberty. The mind acquires new and more delicate perceptions, the person becomes plumper, the mammæ enlarge, and there is grace and perfection in every movement, a conscious completeness for those relations of life for which this function prepares them. The period of puberty is also indicated by

MENSTRUATION.

The catamenial discharge naturally follows the ripening and liberation of an ovum, and as the ovaries furnish one of these each month, this monthly flow is termed the menses (the plural of the Latin word mensis, which signifies a month). The menstrual flow continues from three to five days, and is merely the exudation of ordinary venous blood through the mucous lining of the cavity of the uterus. At this time, the nervous system of females is much more sensitive, and from the fact that there is greater aptitude to conception immediately before and after this period, it is supposed that the sexual feeling is then the strongest. When impregnation occurs immediately before the appearance of the menses, their duration is generally shortened, but not sufficiently to establish the suspicion that conception has taken place. The germ is the contribution of the female, which provides the conditions which only require the vivifying principle of the sperm for the development of another being. The period of aptitude for conception terminates at the time both ovulation and menstruation cease, [pg 211]which, unless brought about earlier by disease, usually occurs about the forty-fifth year of her age.

FECUNDATION.

Since in the beginning God created male and female, and said unto them, "Be fruitful, and multiply, and replenish the earth," it is evident that what was originated by creation must be continued by procreation. The process of generation the reader will find described on pages 12 and 13. Then commences a wonderful series of transforming operations, rudimentary changes preliminary to the formation of tissues, structures and functions, which finally qualify the organism for independent existence. The ovum, when expelled from the ovary, enters the fimbriated, or fringe-like extremity of the Fallopian tube, to commence at once its descent to the uterus. The process of passing through this minute tube varies in different animals. In birds and reptiles, the bulk of the expelled ova is so great as to completely fill up the tube, and it is assisted in its downward course, partly by its own weight and partly by the peristaltic action of the muscular coat of the canal. In the human subject, however, the ova are so minute that nature has supplied a special agent for their direct transmission; otherwise they might be retained, and not reach their destination. Accordingly, the fimbriated, trumpet-shaped extremity of the Fallopian tubes, which is nearest to the ovaries, and, consequently from the ovary first receives the ovum when expelled; is provided with a series of small hairs, termed cilia, forming the lining or basement membrane of the tubes, and, the movements of these cilia being towards the uterus, transmit, by their vibrating motion, the ovum from the ovary, through the Fallopian tubes, to the uterus.

The mature ovum, however, is not by itself capable of being converted into the embryo. It requires fecundation by the spermatic fluid of the male, and this may take place immediately on the expulsion of the ovum from the ovary, or during its passage through the Fallopian tube, or, according to Bischoff, Coste, and others, in the cavity of the uterus, or even upon the surface of the ovary. Should impregnation, however, fail, the ovum gradually loses its vitality, and is eventually [pg 212]expelled by the uterine secretions. It occasionally happens that the descent of the impregnated ovum is arrested, and the formation of the embryo commences in the ovary. This is termed ovarian pregnancy. Or again, the ovum may be arrested in its passage through the Fallopian tube, causing what is termed tubal pregnancy; or, after it has been expelled from the ovary, it may fail to be received by the fimbriated extremity, and escape into the cavity of the abdomen, forming what has been termed ventral pregnancy. If the microscopic germ lodges in some slight interstice of fiber, during its passage through the walls of the uterus, it may be detained long enough to fix itself there, and when this occurs, it is termed interstitial pregnancy. All these instances of extra-uterine pregnancy may necessitate the employment of surgical skill, in order that they may terminate with safety to the mother. Their occurrence, however, is very rare.

The intense nervous excitement produced by the act of coition is immediately followed by a corresponding degree of depression, and a too frequent repetition of it is necessarily injurious to health. The secretions of the seminal fluid being, like other secretions, chiefly under the influence of the nervous system, an expenditure of them requires a corresponding renewal. This renewal greatly taxes the corporeal powers, inducing lassitude, nervousness, and debility. It is a well known fact that the highest degree of mental and bodily vigor is inconsistent with more than a moderate indulgence in sexual intercourse.

To ensure strength, symmetry, and high intellectual culture in the human race, requires considerable care. Consideration should be exercised in the choice of a companion for life. Constitutional as well as hereditary ailments demand our closest attention. Age has also its judicious barriers. As before stated, when reproduction commences, growth, as a rule, ceases, therefore, it is inexpedient that matrimony should be consummated before the parties have arrived at mature stature.

PREVENTION OF CONCEPTION.

Much has been written upon the question whether married people have a right to decline the responsibilities of wedlock. [pg 213]The practice of inducing abortion is not only immoral but criminal, because it is destructive to both the health of the mother and the life of the embryo being. If both the parties to a marriage be feeble, or if they be not temperamentally adapted to each other, so that their children would be deformed, insane, or idiotic, then to beget offspring would be a flagrant wrong. If the mother is already delicate, possessing feeble constitutional powers, she is inadequate to the duties of maternity, and it is not right to lay such burdens upon her. Self-preservation is the first law of nature, which all ought to respect. The woman may be able to discharge the duties of a loving wife and companion, when she cannot fulfill those of child-bearing. If the husband love his wife as he ought, he will resign all the pleasure necessary to secure her exemption from the condition of maternity. It seems to us, that it is a great wickedness, unpardonable even, to be so reckless of consequences, and so devoid of all feeling, as to expose a frail, feeble, affectionate woman to those perils which almost insure her death. To enforce pregnancy under such circumstances is a crime. Every true man, therefore, should rather practice self-control and forbearance, than entail on his wife such certain misery, if not danger to life.

Undoubtedly, the trial is great, but if a sacrifice be required, let the husband forbear the gratification of passions which will assuredly be the means of developing in his delicate wife symptoms that may speedily hurry her into a premature grave. Before she has recovered from the effects of bearing, nursing, and rearing one child, ere she has regained proper tone and vigor of body and mind, she is unexpectedly overtaken, surprised by the manifestation of symptoms which again indicate pregnancy. Children thus begotten are not apt to be hardy and long-lived. From the love that parents feel for their posterity, from their wishes for their success, from their hopes that they may be useful from every consideration for their future well-being, let them exercise precaution and forbearance, until the wife becomes sufficiently healthy and enduring to bequeath her own vital stamina to the child she bears.

From what has been said on this subject, it behooves the prudent husband to weigh well the injurious, nay criminal [pg 214]results which may follow his lust. Let him not endanger the health, and it may be the life, of his loving and confiding wife through a lack of self-denial. Let him altogether refrain, rather than be the means of untold misery and, perhaps, the destruction of the person demanding his most cherished love and protection. On so important a subject, we feel we should commit an unpardonable wrong were we not to speak thus plainly and openly. An opportunity has been afforded us, which it would be reprehensible to neglect. We shall indeed feel we have been amply rewarded, if these suggestive remarks of ours tend in any way to remove or alleviate the sufferings of an uncomplaining and loving wife. Our sympathies, always susceptible to the conditions of sorrow and suffering, have been enlisted to give faithfully, explicitly, and plainly, warnings of danger and exhortations to prudence and nothing remains for us but to maintain the principles of morality, and leave to the disposal of a wise and overruling Providence the mystery of all seemingly untoward events. In every condition of life, evils arise, and most of those which are encountered are avoidable. Humanity should be held accountable for those evils which it might, but does not shun.

By a statute of the national government, prevention of pregnancy is considered a punishable offense; whereas every physician is instructed by our standard writers and lecturers on this subject, that not only prevention is necessary in many instances, but even abortion must sometimes be produced in order to save the mother's life. As we view the matter, the law of the national government asserts the ruling principle, and the exceptions to it must be well established by evidence, in order to fully justify such procedure. The family physician may, with the concurrence of other medical counselors, be justified, in rare cases, in advising means for the prevention of conception, but he should exercise this professional duty only when the responsibility is shared by other members of the profession, and the circumstances fully and clearly warrant such a practice.

After fecundation, the length of time before conception takes place is variously estimated. Should impregnation occur at the ovary or within the Fallopian tubes, usually about a week [pg 215]elapses before the fertilized germ enters the uterus, so that ordinarily the interval between the act of insemination and that of conception varies from eight to fourteen days.

DOUBLE CONCEPTION.

If two germs be evolved simultaneously, each may be impregnated by spermatozoa, and a twin pregnancy be the result. This is by no means a rare occurrence. It is very unusual, however, to have one birth followed by another after an interval of three or four months, and each babe present the evidences of full maturity. Perhaps such occurrences may be accounted for on the supposition that the same interval of time elapses between the impregnation of the two germs as there is difference observed in their birth; that after the act of insemination, sperm was carried to each ovary; that one had matured a germ ready for fecundation, then impregnation and conception immediately followed, and the decidua of the uterus hermetically sealed both Fallopian tubes, and thus securely retained the sperm within the other Fallopian canal. The stimulus of the sperm so pent up causes that ovary to mature a germ, although it may do so slowly, and after two or three months it is perfected, fertilized, and a second conception occurs within the uterus. If each embryo observe a regular period of growth and each be born at maturity, there must be an interval of two or three months between their births. But it is far more common for the parturition of the first, displaying signs of full maturity, to coincide with the birth of a second which is immature and which cannot sustain respiratory life. The birth of the latter is brought about prematurely, by the action of the uterus in expelling the matured child.

UTERINE PREGNANCY.

There are many who manifest a laudable desire to understand the physiology of conception, the changes which take place, and the order of their natural occurrence. When impregnation takes place at the ovaries or within the Fallopian tubes, there is exuded upon the inner surface of the womb a peculiar nutritious substance. It flows out of the minute porous openings surrounding the termination of the Fallopian tube within [pg 216]the uterine cavity, and, thus, is in readiness to receive the germ, and retain it there until it becomes attached. Undoubtedly, the germ imbibes materials from this matter for its nurture and growth. This membranous substance is termed the decidua, and disappears after conception is insured. Two membranes form around the embryo; the inner one is called the amnion, the outer one the chorion. Both serve for the protection of the embryo, and the inner one contains the liquor amnii, in which it floats during intra-uterine life. Immediately after conception, the small glands in the neck of the uterus usually throw out a sticky secretion, filling the canal, or uniting its sides, so that nothing can enter or leave the uterine cavity.

The fertilized ovum rapidly develops. After its conception it imbibes nourishment, and there is a disposition in fluids to pass into it, through its delicately-organized membranes. If this process is not involuntary, it is, at all events, at the convenience and use of the developing germ. After three months the embryo is termed the foetus. Its fluids are then so much more highly organized, that some of them are tinged with sanguine hues, and thenceforward acquire the characteristics of red blood. Out of red blood, blood-vessels are formed, and from the incipient development of the heart follow faint lines of arteries, and the engineers of nutrition survey a circulatory system, perfecting the vascular connections by supplementing the arteries with a complete net-work of veins and capillaries.

THE PLACENTA OR AFTERBIRTH.

Whenever conception occurs, a soft, spongy substance is formed between the uterus and the growing ovum, called the placenta. It is composed of membrane, cellular tissue, blood-vessels, and connecting filaments. The principal use of this organ seems to be to decarbonate the blood of the foetus, and to supply it with oxygen. It performs the same function for the foetus that the lungs do for the organism after birth. It allows the blood of the foetus to come into very close contact with that of the mother, from which it receives a supply of oxygen, and to which it gives up carbonic acid. This interchange of gases takes place in the placenta, or between it and the uterus, through the intervening membranes. This [pg 217]decarbonating function requires the agency of the maternal lungs, for the purpose of oxygenating the mother's blood.

The placenta is attached to the uterus by simple adhesion. True, in some instances, morbid adhesion takes place, or a growing together in consequence of inflammation, but the natural junction is one merely of contact, the membranes of the placenta spreading out upon the cavity of the uterus, so that, finally, the former may be entirely removed without a particle of disturbance or injury to the latter. Formerly, it was supposed that the placental vessels penetrated into the substance of the uterus. We know now there is no such continuation of the vessels of the one into the other. The decarbonation of the blood requires the placental and uterine membranes to be in contact with each other.

If the union were vascular, the mother's blood would circulate in the foetal body, and the impulses of the maternal heart might prove too strong for the delicate organism of the embryo. Besides, the separation of the placenta from the uterus might prove fatal to both parent and offspring. The placenta is only a temporary organ, and when its functions are no longer required, it is easily and safely removed.

THE UMBILICAL CORD.

The foetal blood is transmitted to and fro between the body of the child and the placenta, by a cord which contains two arteries and one vein. This is called the umbilical cord, because it enters the body at the middle of the abdominal region, or umbilicus. It is composed, also, of its own proper membranous sheath, or skin, and cellular tissues, besides the blood-vessels. Two months after pregnancy, this cord can be seen, when it commences to grow rapidly.

QUICKENING.

Not until the mother feels motion is she said to be quick with child. That is, the child must be old and strong enough to communicate a physical impulse, which the mother can distinctly perceive, before it is regarded as having received life. This is a fallacy, for the germ has to be endowed with life before organization can begin. The act of impregnation [pg 218]communicates the vital principle, and from that moment it starts upon its career of development. A long period elapses after this occurs before it can make the mother feel its motions. Before quickening, the attempt to destroy the foetus is not considered so grave a crime by our laws, but after this quickening takes place, it is deemed a felony.

THE RIGHT TO TERMINATE PREGNANCY.

The expediency and the moral right to prematurely terminate pregnancy must be admitted when weighty and sufficient reasons for it exist. Such a course should never be undertaken, however, without the advice and approval of the family physician, and, whenever it is possible, the counsel of another medical practitioner should be obtained. There may be so great a malformation of the pelvic bones as to preclude delivery at full term, or, as in some instances, the pregnant condition may endanger the life of the mother, because she is not able to retain nourishment upon the stomach. In such cases only, is interference warranted, and even then the advice of some well-informed physician should be first obtained, to make sure that the life of the mother is endangered before so extreme a measure is resorted to.

Those who are qualified for maternal duties should not undertake to defeat the intentions of nature, simply because they love ease and dislike responsibility. Such persons may be considered genteel ladies, but, practically, they are indifferent to the claims of society and posterity. How such selfishness contrasts with the glorious, heroic, Spartan spirit of the young woman who consulted us in reference to the acceptance of a tempting offer of marriage! She was below medium size and delicately organized. She hesitated in her answer, because she was uncertain as to her duty to herself, and to her proposed husband, and on account of the prospective contingencies of matrimony. After she was told that it was doubtful whether she could discharge the obligations of maternity with safety to herself, and yet that she might prove to her intended husband a true and valuable wife, she quickly answered, her black eyes radiant with the high purpose of her soul: "If I assent to this offer, I shall accept the condition and its consequences [pg 219]also, even if pregnancy be my lot and I know it will cost me my life!" She acceded to the proposal, and years found them one in happiness; then a daughter was born, but the bearing and nursing were too much for her delicate constitution, and she continued to sink until she found rest in the grave. Of all her beautiful and noble sayings, none reflect more moral grandeur of spirit than the one in which she expressed her purpose to prove true to posterity.

THE SIGNS OF PREGNANCY.

The symptoms which indicate pregnancy are cessation of the menses, enlargement of the mammæ, nausea, especially in the morning, distention of the abdomen, and movement of the foetus. A married woman has reason to suspect that she may have conceived, when, at the proper time, she fails to menstruate, especially when she knows that she is liable to become pregnant. A second menstrual failure strengthens this suspicion, although there are many other causes which might prevent the appearance of the menses, such as disease of the uterus, general debility, or taking cold, and all of these should be taken into account. In the absence of all apparent influences calculated to obstruct the menses, the presumption ordinarily is that pregnancy is the cause of their non-appearance. The evidence is still more conclusive when the mammæ and abdomen enlarge after experiencing morning sickness. Notwithstanding all these symptoms, the audible sound of the heart, or the movements of the foetus, are the only infallible signs of a pregnant condition.

THE DURATION OF PREGNANCY.

The ordinary duration of pregnancy is about forty weeks, or 280 days. It is difficult to foretell exactly when a pregnancy will be completed, for it cannot be known precisely when it began. Some gestations are more protracted than others, but the average duration is the time we have given. A very reasonable way to compute the term, is to reckon three months back from the day when the menses ceased and then add five days to that time, which will be the date of the expected time of confinement. It is customary, also, for women to [pg 220]count from the middle of the month after the last appearance of the menses, and then allow ten lunar months for the term. This computation generally proves correct, except in those instances in which conception takes place immediately before the fast appearance of the catamenia. A few women can forecast the time of labor from the occurrence of quickening, by allowing eighteen weeks for the time which has elapsed since conception, and twenty-two more for the time yet to elapse before the confinement. With those in whom quickening occurs regularly in a certain week of pregnancy, this calculation may prove nearly correct.

The English law fixes no precise limit for the legitimacy of the child. In France a child is regarded as lawfully begotten if born within three hundred days after the death or departure of the husband. There are a sufficient number of cases on record to show that gestation may be prolonged two, and even three, weeks beyond the ordinary, or average term. The variation of time may be thus accounted for: after insemination, a considerable interval elapses before fecundation takes place, and the passage of the fertilized germ from the ovary to the uterus is also liable to be retarded. There are many circumstances and conditions which might serve to diminish its ordinary rate of progress, and postpone the date of conception. This would materially lengthen the apparent time of gestation.

It is likewise difficult to determine the shortest period at which gestation may terminate, and the child be able to survive. A child may be born and continue to live for some months, after twenty-four or twenty-five weeks of gestation; it was so decided, at least, in an ecclesiastical trial.

We have not the space to describe minutely, or at length, the formation and growth of the foetal structures, and trace them separately from their origin to their completion at the birth of the child. The student of medicine must gain information by consulting large works and exhaustive treatises on this interesting subject.

What trifling contingencies defeat vitality! Conception may be prevented by acrid secretions, the result of disease of the reproductive organs. Leucorrheal matter may destroy the vitalizing power of the sperm-cells. There are many ways, even [pg 221]after impregnation, of compromising the existence of the frail embryo. Accidents, injuries, falls, blows, acute diseases, insufficient nutrition and development, in fact, a great variety of occurrences may destroy the life of the embryo, or foetus. After birth, numerous diseases menace the child. By what constant care must it ever be surrounded, and how often is it snatched from the very jaws of death!

What, then, is man but simply a germ, evolving higher powers, and destined for a purer and nobler existence! His latent life secretly emerges from mysterious obscurity, is incarnated, and borne upon the flowing stream of time to a spiritual destination—to realms of immortality! As he nears those ever-blooming shores, the eye of faith, illuminated by the inspired word, dimly discerns the perennial glories. Quickened by Faith, Hope, and Love, his spirit is transplanted into the garden of paradise, the Eden of happiness, redeemed, perfected, and made glorious in the divine image of Him who hath said, "I am the Way, the Truth, and the LIFE."

PART II.

HYGIENE.

CHAPTER I.

HYGIENE DEFINED.—PURE AIR.

The object of hygiene is the preservation of health. Hitherto, we have considered, at some length, the science of functions, or Physiology, and now, under the head of Hygiene, we will give an outline of the means of maintaining the functional integrity of the system. It is difficult to avoid including under this head Preventive Medicine, the special province of which is to abate, remove, or destroy the many causes of disease.

The Greeks bestowed divine honors upon Aesculapius, because he remedied the evils of mankind and healed the sick. The word hygiene is derived from Hygeia, the name of the Greek goddess of health. As male and female are made one in wedlock, so Medicine and Hygiene, restoration and preservation, are inseparably united.

Hygiene inculcates sanitary discipline, medicine, remedial discipline; hygiene prescribes healthful agencies, medical theory and practice, medicinal agencies; hygiene ministers with salubrious and salutary agents, medicine assuages with rectifying properties and qualities; hygiene upholds and sustains, medical practice corrects and heals; the one is preservative and conservative, the other curative and restorative. These discriminations are as radical as health and sickness, as distinct as physiology and pathology, and to confound them is as unnatural as to look for the beauties of health in the chamber of sickness.

[pg 223]The true physician brings to his aid Physiology, Hygiene, and Medicine, and combines the science of the former with the art of the latter, that restoration may be made permanent, and the health preserved by the aid of hygiene. But when any one makes Hygiene exclusively the physician, or deals wholly in hygienic regulations with little respect for physiology, or lavishly advertises with hygienic prefixes, we may at once consider it a display, not of genuine scientific knowledge, but only of the ignorance of a quack. Some of the modern twaddle about health is a conglomeration of the poorest kind of trash, expressing and inculcating more errors and whims than it does common sense. Many persons dilate upon these subjects with amazing flippancy, their mission seeming to be to traduce the profession rather than to act as help-mates and assistants. We do not believe that there is any real argument going on between the educated members of the medical profession but rather that the senseless clamor we occasionally hear comes only from the stampede of some routed, demoralized company of quacks.

In the following pages we shall introduce to the reader's attention several important hygienic subjects, although there are many more that ought to receive special notice. Such as we do mention, demand universal attention, because a disregard of the conditions which we shall enumerate, is fraught with great danger. Our lives are lengthened or shortened by the observance or neglect of the rules of common sense, and these do not require any great personal sacrifice, or the practice of absurd precautions.

PURE AIR FOR RESPIRATION.

Ordinary atmospheric air contains nearly 2,100 parts of oxygen and 7,900 of nitrogen, and about three parts of carbonic acid, in 10,000 parts; expired air contains about 470 parts of carbonic acid, and only between 1500 and 1600 parts of oxygen, while the quantity of nitrogen undergoes little or no alteration. Thus air which has been breathed has lost about five per cent. of oxygen and has gained nearly five per cent. of carbonic acid. In addition the expired air contains [pg 224]a greater or less quantity of highly decomposable animal matter, and, however dry the atmospheric air may be, the expired air is always saturated with watery vapor, and, no matter what the temperature of the external air may be, that of the exhaled air is always nearly as warm as the blood. An adult man on a average breathes about sixteen times in a minute and at every inspiration takes in about thirty cubic inches of air, and at every expiration exhales about the same amount. Hence, it follows that about 16-2/3 cubic feet of air are passed through the lungs of an adult man every hour, and deprived of oxygen and charged with carbonic acid to the amount of nearly five per cent. The more nearly the composition of the external air approaches that of the expired air, the slower will be the diffusion of carbonic acid outwards and of oxygen inwards, and the more charged with carbonic acid and deficient in oxygen will the blood in the lungs become. Asphyxia takes place whenever the proportion of carbonic acid in the external air reaches ten per cent., providing the oxygen is diminished in like proportion, and it does not matter whether this condition of the external air is produced by shutting out fresh air from a room or by increasing the number of persons who are consuming the same air; or by permitting the air to be deprived of oxygen by combustion by a fire. A deficiency of oxygen and an accumulation of carbonic acid in the atmosphere, produce injurious effects, however, long before the asphyxiating point is attained. Headache, drowsiness, and uneasiness occur when less than one per cent. of the oxygen of the atmosphere is replaced by other matters, and the constant breathing of such an atmosphere lowers vitality and predisposes to disease.

Therefore, every human being should be supplied, by proper ventilation, with a sufficient supply of fresh air. Every adult individual ought to have at least 800 cubic feet of air-space to himself, and this space ought to communicate freely with the external atmosphere by means of direct or indirect channels. Hence, a sleeping-room for one adult person should not be less than nine by ten feet in breadth and length and nine feet in height. What occurred in the Black Hole at Calcutta is an excellent illustration of the effect of vitiated air. One hundred and forty-six Englishmen were confined in a room eighteen [pg 225]feet square, with two small windows on one side to admit air. Ten hours after their imprisonment, only twenty-three were alive.

Ventilation of School Rooms. The depression and faintness from which many students suffer, after being confined in a poorly ventilated school room, is clearly traceable to vitiated air, while the evil is often ascribed to excessive mental exertion. The effect of ventilation upon the health of students is a subject of universal interest to parents and educators, and at present is receiving the marked attention of school authorities. Dr. F. Windsor, of Winchester, Mass., made a few pertinent remarks upon this subject in the annual report of the State Board of Health, of Massachusetts, 1874. One of the institutions, which was spoken of in the report of 1873, as a model, in the warming and ventilation of which much care had been bestowed, was visited in December, 1873. He reports as follows: "I visited several of the rooms, and found the air in all, offensive to the smell, the odor being such as one would imagine old boots, dirty clothes, and perspiration would make if boiled down together; again, in the new model school-house the hot air enters at two registers in the floor on one side, and makes (or is supposed to make) its exit by a ventilator at the floor, on the other side of the room." The master said "the air was supposed to have some degree of intelligence, and to know that the ventilator was its proper exit." Thorough ventilation has been neglected by many school officials on account of the increased expense it causes. In our climate, during seven months at least, pure atmospheric air must be paid for. The construction of vertical ducts, the extra amount of fuel, and the attendant expenditures are the objections which, in the opinion of many persons, outweigh the health and happiness of the future generation. It is necessary for the proper ventilation of our school rooms that an adequate supply of fresh air should be admitted, which should be warmed before being admitted to the room, and which should be discharged as contaminated, after its expiration. The proper ventilation of the school room consists in the warming and introduction of fresh air from without, and the discharge of the expired and unwholesome air from within. This may be accomplished by [pg 226]means of doors, windows, chimneys, and finally by ventilators placed, one near the level of the floor, and the other near the ceiling of the room. The ventilators ought to be arranged on the opposite sides of the room, in order to insure a current, and an abundant supply of air. When trustees and patrons realize that pure air is absolutely essential to health, and that their children are being slowly poisoned by the foul air of school rooms, then they will construct our halls of learning with a due regard for the laws of hygiene, and students will not droop under their tasks on account of the absence of Nature's most bountiful gift, pure air.

Ventilation of Factories and Workshops. This is a subject which demands the immediate attention of manufacturers and employers. The odors of oil, coal gas, and animal products, render the air foul and stagnant, and often give rise to violent diseases among the operatives. From two to four hundred persons are often confined in workshops six hundred feet long, with no means of ventilation except windows on one side only. The air is breathed and re-breathed, until the operatives complain of languor and headache, which they attribute to overwork. The real cause of the headache is the inhalation of foul air at every expansion of the lungs. If the proprietors would provide efficient means for ventilating their workshops, the cost of construction would be repaid with compound interest, in the better health of their operatives and the consequent increase of labor. Our manufacturers must learn and practice the great principle of political economy, namely, that the interests of the laborer and employer are mutual.

Ventilation of our dwellings. Not less important is the ventilation of our dwellings; each apartment should be provided with some channel for the escape of the noxious vapors constantly accumulating. Most of the tenements occupied by the poor of our cities are literally dens of poison. Their children inhale disease with their earliest breath. What wonder that our streets are filled with squalid, wan-visaged children! Charity, indeed, visits these miserable homes, bringing garments and food to their half-famished inmates; but she has been slow to learn that fresh air is just as essential to life as food or clothing. Care should be taken by the public [pg 227]authorities of every city, that its tenement houses do not degenerate into foul hovels, like those of the poor English laborer, so graphically portrayed by Dickens. But ill-ventilated rooms are not found exclusively in the abodes of the poor. True, in the homes of luxury, the effect of vitiated air is modified by food, etc. Men of wealth give far more attention to the architecture and adornment of their houses, to costly decorations and expensive furniture, than to proper ventilation. Farmers, too, are careless in the construction of their cottages. Their dwellings are often built, for convenience, in too close proximity to the barn. Because they do not construct a suitable sewer or drain, the filth and refuse food is thrown out of the back door, where it accumulates and undergoes putrefaction; the vitiated air penetrates the interior of the house, and, there being no means of ventilation, it remains to be breathed by the occupants. The result is, that for the sake of saving a few dollars, which ought to be expended in the construction of necessary flues and sewers, the farmer often sees the child he prizes far more than his broad acres gradually decline, or suddenly fall a victim to fevers or malignant disease. Parents, make your homes healthy, let in the pure, fresh air and bright sunlight, so that your conscience may never upbraid you with being neglectful of the health and lives of your little ones.

SITE FOR HOMES.

Malaria. When about to construct our residences, besides securing proper ventilation and adequate drainage, we ought to select the location for a home on dry soil. Low levels, damp surroundings, and marshy localities not only breed malaria and fevers, but are a prolific cause of colds, coughs, and consumption. Care should be taken not to locate a dwelling where the natural currents of air, or high winds, will be likely to bring the poison of decayed vegetable matter from low lands. Certain brooks, boggy land, ponds, foggy localities, too much shade, all these are favorable to the development of disease. Then the walls of a building should be so constructed as to admit air between the exterior and interior surfaces, otherwise the interior of the house will be damp and unwholesome. In the dead of winter in northern latitudes [pg 228]the house ought to be kept slightly tempered with warmth, both night and day, a condition very favorable to the introduction and change of atmospheric currents. The invigorating tendencies of a dry, pure atmosphere are remarkably beneficial, while air charged with moisture and decay is exceedingly baneful, introducing diseases under various forms.

Neither should the dwelling be shaded by dense foliage. The dampness of the leaves tends to attract malaria. Trees growing a little distance from the house, however, obstruct the transmission of unhealthy vapors arising beyond them. Malaria generally lurks near the surface of the earth, and seems to be more abundant in the night time. Persons sleeping in the upper story of a house may escape its morbid influence, while those occupying apartments on the lower floor, become affected.

DAMP CELLARS.

Damp cellars, under residences, are a fruitful cause of disease. Dr. Sanford B. Hunt, in an article in the Newark Daily Advertiser, speaking of the recent epidemic of diphtheria in New York City, says:

"Pestilences that come bodily, like cholera, are faced and beaten by sanitary measures. Those which come more subtly need for their defeat only a higher detective ability and a closer study of causes, many of which are known, but hidden under the cellars of our houses, and which at last are only preventable by public authority and at public expense in letting out the imprisoned dampness which saturates the earth on which our dwellings are built. Where wood rots, men decay. This is clearly shown in the sanitary map printed in the Times. In the great district surrounding Central Park, and which participates in its drainage system, there are no cases. On the whole line of Fifth Avenue there are none. The exempt districts are clearly defined by the character of the soil, drainage, and sewerage, and by the topography, which either has natural or artificial drainage, but most of which is so dry that only surface-water and house-filth—which does not exist in those palaces—can affect the health of the residents. But in the tenement houses and on the made lands where running streams have been filled in and natural springs choked up by earth [pg 229]fillings, diphtheria finds a nidus in which to develop itself. The sanitary map coincides precisely with the topographic map made by Gen. Viele. Where he locates buried springs and water-courses, there we find the plague spots of diphtheria and in the same places, on previous maps prepared by the Board of Health, we find other low types and stealthy diseases, such as typhoid and irruptive fevers, and there we shall find them again when the summer and autumnal pestilences have yielded place to those which belong to the indoor poisoned air in the winter. The experience of other cities, notably London and Dublin, once plague spots and now as healthy as any spot on earth, proves that most of the causations of disease are within the control of the competent sanitary engineer, even in localities crowded beyond American knowledge, and houses built upon soil saturated for centuries with the offal of successive and uncleanly generations. Wet earth, kept wet by the boiling up of imprisoned springs, is a focus of disease. Dry earth is one of the most perfect deodorizers, the best of oxydizers and absorbents, destroying the germs of disease with wonderful certainty. On those two facts rests the theory of public hygiene."

DUST AND DISEASE.

The air we breathe is heavily loaded with minute particles of floating dust, their presence being revealed only by intense local illumination. Professor Tyndall says: "solar light, in passing through a dark room, reveals its track by illuminating the dust floating in the air. 'The sun,' says Daniel Culverwell, 'discovers atoms, though they be invisible by candle-light, and makes them dance naked in his beams.'"

After giving the details and results of a series of experiments in which he attempted to extract the dust from the air of the Royal Institute by passing it through a tube containing fragments of glass wetted with concentrated sulphuric acid, and thence through a second tube containing fragments of marble wetted with a strong solution of caustic potash, which experiments were attended with perfect failure, the Professor continues, "I tried to intercept this floating matter in various ways; and on the day just mentioned, prior to sending the [pg 230]air through the drying apparatus, I carefully permitted it to pass over the tip of a spirit-lamp flame. The floating matter no longer appeared, having been burnt up by the flame. It was, therefore, of organic origin. I was by no means prepared for this result; for I had thought that the dust of our air was, in great part, inorganic and non-combustile." In a foot note he says, "according to an analysis kindly furnished me by Dr. Percy, the dust collected from the walls of the British Museum contains fully fifty per cent of inorganic matter. I have every confidence in the results of this distinguished chemist; they show that the floating dust of our rooms is, as it were, winnowed from the heavier matter." Again he says: "the air of our London rooms is loaded with this organic dust, nor is the country air free from its presence. However ordinary daylight may permit it to disguise itself, a sufficiently powerful beam causes dust suspended in air to appear almost as a semi-solid. Nobody could, in the first instance, without repugnance, place the mouth at the illuminated focus of the electric beam and inhale the thickly-massed dust revealed there. Nor is the repugnance abolished by the reflection that, although we do not see the floating particles, we are taking them into our lungs every hour and minute of our lives." "The notion was expressed by Kircher and favored by Linnaeus, that epidemic diseases are due to germs which float in the atmosphere, enter the body, and produce disturbance by the development within the body of parasitic life. While it was struggling against great odds, this theory found an expounder and a defender in the President of this institution. At a time when most of his medical brethren considered it a wild dream, Sir Henry Holland contended that some form of the germ-theory was probably true." Professor Tyndall proposes means by the application of which air loaded with noxious particles may be freed from them before entering the air passages. The following embodies his suggestions on this point:

COTTON-WOOL RESPIRATOR.

"I now empty my lungs as perfectly as possible, and placing a handful of cotton-wool against my mouth and nostrils, inhale through it. There is no difficulty in thus filling the lungs [pg 231]with air. On expiring this air through a glass tube, its freedom from floating matter is at once manifest. From the very beginning of the act of expiration the beam is pierced by a black aperture. The first puff from the lungs abolishes the illuminated dust, and puts a patch of darkness in its place; and the darkness continues throughout the entire course of the expiration. When the tube is placed below the beam and moved to and fro, the same smoke-like appearance as that obtained with a flame is observed. In short, the cotton-wool, when used in sufficient quantity, and with due care, completely intercepts the floating matter on its way to the lungs.

The application of these experiments is obvious. If a physician wishes to hold back from the lungs of his patient, or from his own, the germs or virus by which contagious disease is propagated, he will employ a cotton-wool respirator. If perfectly filtered, attendants may breathe the air unharmed. In all probability the protection of the lungs and mouth will be the protection of the entire system. For it is exceedingly probable that the germs which lodge in the air-passages, or find their way with the saliva into the stomach with its absorbent system, are those which sow in the body epidemic disease. If this be so, then disease can be warded off by carefully prepared filters of cotton-wool. I should be most willing to test their efficacy in my own person. But apart from all doubtful applications, it is perfectly certain that various noxious trades in England may be rendered harmless by the use of such filters. I have had conclusive evidence of this from people engaged in such trades. A form of respirator devised by Mr. Garrick, a hotel proprietor in Glasgow, in which inhalation and exhalation occur through two different valves, the one permitting the air to enter through the cotton-wool, and the other permitting the exit of the air direct into the atmosphere, is well adapted for this purpose. But other forms might readily be devised."

LIGHT AND HEALTH.

Our dwellings ought freely to admit the sunlight. Diseases which have baffled the skill of physicians have been known to yield when the patients were removed from dark rooms to light and cheerful apartments. Lavoisier placed light, as an [pg 232]agent of health, even before pure air. Plants which grow in the shade are slender and weak, and children brought up in dark rooms are pale, sallow, and rickety. It is a bad practice to avoid the sunlight through fear of spoiling the complexion, since the sun's rays are necessary to give to it the delicate tints of beauty and health. Air is necessary for the first inspiration and the last expiration of our lives, but the purity and healthfulness of the atmosphere depend upon the warming rays of the sun, while our bodies require light in order that their functions may be properly performed. We know that without solar light, there can be no proper vegetable growth, and it is equally necessary for the beauty and perfection of animal development. Our dwellings should therefore be well lighted and made as bright and cheerful as possible. Women who curtain the windows, soften the light, and tint the room with some mellow shade, may do so in order to hide their own faulty complexions. The skin of persons confined in dungeons or in deep mines becomes pale or sickly yellow, the blood grows watery, the skin blotches, and dropsy often intervenes. On the other hand, invalids carried out from darkened chambers into the bright sunlight are stimulated, the skin browns, nutrition becomes more active, the blood improves, and they become convalescent. Light is especially necessary for the healthy growth of children. There is nothing more beautiful and exhilarating than the glorious sunlight. Let its luminous, warming, and physiological forces come freely into our dwellings, enter into the chemistry of life, animate the spirits, and pervade our homes and our hearts with its joy-inspiring and health-imparting influences.

CHAPTER II.

FOOD. BEVERAGES. ALCOHOLIC LIQUORS. CLOTHING.

The human body is continually undergoing changes, which commence with the earliest dawn of existence and end only with death. The old and worn-out materials are constantly being removed to make room for the new. Growth and development, as well as the elimination of worn-out and useless matter, continually require new supplies, which are to be derived from our food. To fulfill these demands it is necessary that the nutriment should be of the proper quality, and of sufficient variety to furnish all the constituents of the healthy body. In order that food may be of utility, like other building materials, it must undergo preparation; the crude substance must be worked up into proper condition and shape for use, in other words, it must be digested. But this does not end the process of supply, each different substance must be taken by the different bands of workmen, after due preparation in the workshop, to its appropriate locality in the structure, and there fitted into its proper place; this is assimilation. In reality it becomes a portion of the body, and is advantageous in maintaining the symmetry and usefulness of the part to which it is assigned; this constitutes the ultimate object of food, nutrition.

Eating is the process of receiving the food into the mouth, i.e., prehension; mastication and insalivation—minutely dividing and mixing it with the saliva; deglutition—conveying it to the stomach. Plenty of time should be taken at meals to thoroughly masticate the food and mix it with the saliva, which, [pg 234]being one of the natural solvents, favors its farther solution by the juices of the stomach; the healthy action of the digestive powers is favored by tranquility of mind, agreeable associations, and pleasant conversation while eating. It is proverbial of the American people that they bolt their food whole, washing it down with various fluids, thus forcing the stomach to perform not only its own duties, but also those of the teeth and salivary glands. This manner of dispatching food, which should go through the natural process above described, is not without its baleful consequences, for the Americans are called a nation of dyspeptics.

Eating slowly, masticating the food thoroughly, and drinking but moderately during meals, will allow the juices of the stomach to fulfill their proper function, and healthy digestion and nutrition will result. If the food is swallowed nearly whole, not only will a longer time be required for its solution, but frequently it will ferment and begin to decay before nutritive transformation can be effected, even when the gastric juice is undiluted with the fluids which the hurried eater imbibes during his meal.

Regularity of Meals cannot be too strongly insisted upon. The stomach, as well as other parts of the body, must have intervals of rest or its energies are soon exhausted, its functions impaired, and dyspepsia is the result. Nothing of the character of food should ever be taken except at regular meal times. Some persons are munching cakes, apples, nuts, candies, etc., at all hours, and then wonder why they have weak stomachs. They take their meals regularly, and neither eat rapidly nor too much, and yet they are troubled with indigestion. The truth is they keep their stomachs almost constantly at work, and hence tired out, which is the occasion of the annoyance and distress they experience.

Eating too much. It should always be remembered that the nutrition of our bodies does not depend upon the amount eaten, but upon the amount that is digested. Eating too much is nearly as bad as swallowing the food whole. The stomach is unable to digest all of it, and it ferments and gives rise to unpleasant results. The unnatural distention of the stomach with food causes it to press upon the neighboring [pg 235]organs, interfering with the proper performance of their functions, and, if frequently repeated, gives rise to serious disease. People more frequently eat too much than too little, and to omit a meal when the stomach is slightly deranged is frequently the best medicine. It is an excellent plan to rise from the table before the desire for food is quite satisfied.

Late Suppers. It is generally conceded that late suppers are injurious, and should never be indulged in. Persons who dine late have little need of food after their dinner, unless they are kept up until a late hour. In such cases a moderate meal may be allowed, but it should be eaten two or three hours before retiring. Those who dine in the middle of the day should have supper, but sufficiently early so that a proper length of time may elapse before going to bed, in order that active digestion may not be required during sleep. On the other hand, it is not advisable to go wholly without this meal, but the food eaten should be light, easily digestible, and moderate in quantity. Persons who indulge in hearty suppers at late hours, usually experience a poor night's rest, and wake the next morning unrefreshed, with a headache and a deranged stomach. Occasionally more serious consequences follow; gastric disorders result, apoplexy is induced; or, perhaps, the individual never wakes.

Feeding Infants. For at least six or seven months after birth, the most appropriate food for an infant is its mother's milk, which, when the parent is healthy, is rich in all the elements necessary for its growth and support. Next to the mother's milk, that of a healthy nurse should be preferred; in the absence of both, milk from a cow that has recently calved is the most natural substitute, in the proportion of one part water to two parts milk, slightly sweetened. The milk used should be from but one cow. All sorts of paps, gruels, panadas, cordials, laxatives, etc., should be strictly prohibited, for their employment as food cannot be too severely censured. Vomiting, diarrhea, colic, green stools, griping, etc., are the inevitable results of their continued use. The child should be fed at regular intervals, of about two hours, and be limited to a proper amount each time, which, during the first month, is about two ounces. From 11 P.M. to 5 A.M. the child [pg 236]should be nursed but once. As the child grows older the intervals should be lengthened, and the amount taken at a time gradually increased. The plan of gorging the infant's stomach with food every time it cries, cannot be too emphatically condemned.

After the sixth or seventh month, in addition to milk, bits of bread may be allowed, the quantity being slowly increased, thus permitting the diet to change gradually from fluid to solid food, so that, when the teeth are sufficiently developed for mastication, the child has become accustomed to various kinds of nourishment. Over-feeding, and continually dosing the child with cordial, soothing syrups, etc., are the most fruitful sources of infant mortality, and should receive the condemnation of every mother in the land.

Preparation Of Food. The production of pure blood requires that all the food selected should be rich in nutritious elements, and well cooked. To announce a standard by which all persons shall be guided in the selection and preparation of their food is impossible. Especially is this the case in a country the inhabitants of which represent almost every nation on the face of the globe. Travelers are aware that there is as much diversity in the articles of food and methods of cookery, among the various nationalities, as in the erection of their dwellings, and in their mental characteristics. In America we have a conglomeration of all these peoples; and for a native American to lay down rules of cookery for his German, French, English, Welsh, and Irish neighbors, or vice versa, is useless, for they will seldom read them, and, therefore, cannot profit by them. There are, however, certain conditions recognized by the hygienic writers of every nation. The adequate nutrition of the organic tissues demands a plentiful supply of pure blood, or the digestive apparatus will become impaired, the mental processes deranged, and the entire bony and muscular systems will lose their strength and elasticity, and be incapacitated for labor.

Different Kinds of Food Required. The different periods and circumstances of life require their appropriate food, and the welfare of mankind demands that it should supply both the inorganic and organic substances employed in the development of every tissue. The inorganic elements employed in our [pg 237]construction, of which Phosphorus, Sulphur, Soda, Iron, Lime, and Potash are the most important, are not considered as aliments, but are found in the organic kingdom, variously arranged and combined with organic materials in sufficient quantities for ordinary purposes. When, however, from any cause, a lack of any of these occurs, so that their relative normal proportions are deranged, the system suffers, and restoration to a healthy condition can only be accomplished by supplying the deficiency; this may be done by selecting the article of food richest in the element which is wanting, or by introducing it as a medicine. It must be remembered that those substances which enter into the construction of the human fabric, are not promiscuously employed by nature, but that each and every one is destined to fulfill a definite indication.

Lime enters largely into the formation of bone, either as a phosphate or a carbonate, and is required in much greater quantities in early life, while the bone is undergoing development, than afterwards. In childhood the bones are composed largely of animal matter, being pliable and easily moulded. For this reason the limbs of young children bend under the weight of their bodies, and unless care is taken they become bow-legged and distorted. Whenever there is a continued deficiency of the earthy constituents, disease of the bones ensues. Therefore, during childhood, and particularly during the period of dentition, or teething, the food should be nutritious and at the same time contain a due proportion of lime, which is preferable in the form of a phosphate. When it cannot be furnished by the food, it should be supplied artificially. Delayed, prolonged, and tedious dentition generally arises from a deficiency of lime.

With the advance of age it accumulates, and the bone becomes hard, inelastic, and capable of supporting heavy weights. Farther on, as in old age, the animal matter of bone becomes diminished, and lime takes its place, so that the bones become brittle and are easily broken. Lime exists largely in hard water, and to a greater or less extent in milk, and in nearly all foods except those of an acid character.

Phosphorus exists in various combinations in different parts of the body, particularly in the brain and nervous system. Persons who perform a large amount of mental labor require [pg 238]more phosphorus than those engaged in other pursuits. It exists largely in the hulls of wheat, in fish, and in eggs. It should enter to a considerable extent into the diet of brain workers, and the bread consumed by them should be made of unbolted flour.

Sulphur, Iron, Soda, and Potash are all necessary in the various tissues of the body, and deficiency of any one of them, for any considerable length of time, results in disease. They are all supplied, variously arranged and combined, in both animal and vegetable food; in some articles they exist to a considerable extent, in others in much smaller quantities. Sulphur exists in eggs and in the flesh of animals, and often in water. Iron exists in the yolk of eggs, in flesh, and in several vegetables. Soda is supplied in nearly all food, and largely in common salt, which is a composition of sodium and hydrochloric acid, the latter entering into the gastric juice. Potash exists, in some form or other, in sufficient quantities for health, in both vegetable and animal food.

Classes of Food. All kinds of food substances may be divided into four classes. Proteids, Fats, Amyloids, and Minerals. Proteids are composed of the four elements, carbon, hydrogen, oxygen, and nitrogen, sometimes combined with sulphur and phosphorus. In this class are included the gluten of flour; the albumen, or white of eggs; and the serum of the blood; the fibrin of the blood; syntonin, the chief constituent of muscle and flesh, and casein, one of the chief constituents of cheese, and many other similar, but less frequent substances.

Fats are composed of carbon, hydrogen, and oxygen only, and contain more hydrogen than would be required to form water if united with the oxygen which they contain. All vegetable and animal oils and fatty matters are included in this class.

Amyloids consist of substances which are also composed of carbon, oxygen, and hydrogen only; but they contain just enough hydrogen to produce water when combined with their oxygen, or two parts of hydrogen to one of oxygen. This division includes sugar, starch, dextrine, and gum. The above three classes of food-stuffs are only obtained through the activity of living organisms, vegetable or animal, and have [pg 239]been, therefore, appropriately termed by Prof. Huxley, vital food-stuffs.

The mineral food-stuffs may, as we have seen, be procured from either the living or the non-living world. They include water and various earthy, metallic, and alkaline salts.

Variety of Food Necessary. No substance can serve permanently for food except it contains a certain quantity of proteid matter in the shape of albumen, fibrin, casein, etc., and, on the other hand, any substance containing proteid matter in a shape in which it can be readily assimilated, may serve as a permanent vital food-stuff. Every substance, which is to serve as a permanent food, must contain a sufficient quantity, ready-made, of this most important and complex constituent of the body. In addition, it must also contain a sufficient quantity of the mineral ingredients which enter into the composition of the body. Its power of supporting life and maintaining the weight and composition of the body remains unaltered, whether it contains fats or amyloids or not. The secretion of urea, and, consequently, the loss of nitrogen, goes on continually, and the body, therefore, must necessarily waste unless the supply of proteid matter is constantly renewed, since this is the only class of foods that contains nitrogen in any considerable quantity. There can be no absolute necessity for any other food-stuffs but those containing the proteid and mineral elements of the body. From what has been said, it will readily be seen that whether an animal be carnivorous or herbivorous, it begins to starve as soon as its vital food-stuffs consist only of amyloids, or fats, or both. It suffers from what has been termed nitrogen starvation, and if proteid matters are withheld entirely, it soon dies. In such a case, and still more in the case of an animal which is entirely deprived of vital food, the organism, as long as it continues to live, feeds upon itself, the waste products necessarily being formed at the expense of its own body.

Although proteid matter is the essential element of food, and under certain circumstances may be sufficient of itself to support the body, it is a very uneconomical food. The white of an egg, which may be taken as a type of the proteids, contains about fifteen per cent. of nitrogen, and fifty-three per cent. of carbon; therefore, a man feeding upon this, would [pg 240]take in about three and a half times as much carbon as nitrogen. It has been proved that a healthy, adult man, taking a fair amount of exercise and maintaining his weight and body temperature, eliminates about thirteen times as much carbon as nitrogen. However, if he is to get his necessary quantity, about 4000 grains of carbon, out of albumen, he must eat 7,547 grains of that substance; but this quantity of albumen contains nearly four times as much nitrogen as he requires. In other words, it takes about four pounds of lean meat, free from fat, to furnish 4,000 grains of carbon, the quantity required, whereas one pound yields the requisite quantity of nitrogen. Thus a man restricted exclusively to a proteid diet, must take an enormous quantity of it. This would involve a large amount of unnecessary physiological labor, to comminute, dissolve, and absorb the food, and to excrete the superfluous nitrogenous matter. Unproductive labor should be avoided as much in physiological as in political economy. The universal practice of subsisting on a mixed diet, in which proteids are mixed with fats or amyloids, is therefore justifiable.

Fats contain about 80 per cent. of carbon, and amyloids about 40 per cent. We have seen that there is sufficient nitrogen in a pound of meat free from fat, to supply a healthy adult man for twenty-four hours, but that it contains only one-fourth of the quantity of carbon required. About half a pound of fat, or one pound of sugar, will supply the quantity of carbon necessary. The fat, if properly subdivided, and the sugar, by reason of its solubility, pass with great ease into the circulation, the physiological labor, consequently, being reduced to a minimum.

Several common articles of diet contain in themselves all the necessary elements. Thus, butchers' meat ordinarily contains from 30 to 50 per cent. of fat; and bread contains the proteid, gluten, and the amyloids, starch and sugar, together with minute quantities of fat. However, on account of the proportion in which these proteid and other components of the body exist in these substances, neither of them, by itself is such a physiologically economical food, as it is when combined with the other in the proportion of three to eight, or three quarters of a pound of meat to two pounds of bread a day.

[pg 241]It is evident that a variety of food is necessary for health. Animals fed exclusively upon one class, or upon a single article of diet, droop and die; and in the human family we know that the constant use of one kind of diet causes disgust, even when not very long continued. Consequently, we infer that the welfare of man demands that his food be of sufficient variety to supply his body with all of its component parts. If this is not done the appetite is deranged, and often craves the very article which is necessary to supply the deficiency. After the component parts of the organism have assimilated the nutritious elements of particular kinds of food for a certain length of time, they lose the power of effecting the necessary changes for proper nutrition, and a supply of other material is imperatively demanded. When the diet has been long restricted to proteids, consisting largely of salt meats, fresh vegetables and fruits containing the organic acids, become indispensable; otherwise, the scorbutic condition, or scurvy, is almost sure to be developed. Fresh vegetables and fruits should be eaten in considerable quantities at the proper seasons.

Value Of Animal Food. The principal animal food used in this country consists of Pork, Mutton, Beef, and Fish. Beef and mutton are rich in muscle-producing material. Although pork is extensively produced in some portions of this country, and enters largely into the diet of some classes, yet its use, except in winter, is not to be encouraged. The same amount of beef would give far greater returns in muscular power.

In addition to the meats mentioned, Wild Game furnishes palatable, nutritious, and easily-digested food. Domestic Fowls, when young, are excellent, and with the exception of geese and ducks, are easily digested. Wild Birds are considered much healthier food than those which are domesticated. All of these contain more or less of the elements which enter into the composition of the four classes of foods.

Vegetable Foods. Wheat is rich in all the elements which compose the four classes, and, when the flour is unbolted, it is one of the best articles for supplying all the elements.

Barley stands next to wheat in nourishing qualities, but is not so palatable.

[pg 242]Oats are rich in all the elements necessary for nutrition. Oatmeal is a favorite article of diet among the Scotch, and, judging from their hardy constitutions, their choice is well founded. In consequence of the large proportion of phosphorus which they contain, they are capable of furnishing a large amount of nourishment for the brain.

Rye is nutritious, but it is not so rich in tissue-forming material.

Indian Corn is an article well known and extensively used throughout the United States, and is a truly valuable one, capable of being prepared in a great variety of ways for food. It contains more carbon than wheat, and less nitrogen and phosphorus, though enough of both to be extremely valuable.

Rice is rather meagre in nutriment; it contains but little phosphorous matter, with less carbon than other cereals, and is best and most generally employed as a diet in tropical countries.

Beans and Peas are rich in nutritious matter, and furnish the manual laborer with a cheap and wholesome diet.

The Potato is the most valuable of all fresh vegetables grown in temperate climates. Its flavor is very agreeable, and it contains very important nutritive and medicinal qualities, and is eaten almost daily by nearly every family in North America. Until very recently it, with the addition of a little butter-milk or skim-milk, constituted almost the sole diet of the Irish people. The average composition of the potato is stated by Dr. Smith to be as follows: Water 75 per cent., nitrogen 2.1, starch 18.8, sugar 3.2, fat 0.2, salts 0.7. The relative values of different potatoes may be ascertained very correctly by weighing them in the hand, for the heavier the tuber the more starch it contains.

Turnip and Cabbage are 92.5 per cent. water, and, consequently, poor in nutrition, though they are very palatable. The solid portions of cabbage, however, are rich in albumen.

It is evident that the quantity necessary to maintain the system in proper condition must be greatly modified by the habits of life, the condition of the organism, the age, the sex, and the climate. The daily loss of substance which must be [pg 243]replaced by material from without, as we have seen, is very great. In addition to the loss of carbon and nitrogen, about four and a half pounds of water are removed from the system in twenty-four hours, and it is necessary that about this quantity should be introduced into the system in some form or other, however much it may be adulterated. Professor Dalton states: "From experiments performed while living on an exclusive diet of bread, fresh meat, and butter, with coffee and water for drink, we have found that the entire quantity of food required during twenty-four hours by a man in full health and taking free exercise in the open air is as follows:

That is to say, rather less than two and a half pounds of solid food, and rather over three pounds of liquid food."

Climate exerts an important influence on the quantity and quality of food required by the system. In northern latitudes the inhabitants are exposed to extreme cold and require an abundant supply of food, and especially that which contains a large amount of fat. On this account fat meat is taken in large quantities and with a relish. The quantity of food consumed by the natives of the Arctic zone is almost incredible. The Russian Admiral, Saritcheff, relates that one of the Esquimaux in his presence devoured a mass of boiled rice and butter which weighed twenty-eight pounds, at a single meal, and Dr. Hayes states that usually the daily ration of an Esquimau is from twelve to fifteen pounds of meat, one-third of which is fat, and on one occasion he saw a man eat ten pounds of walrus flesh at a single meal. The intense cold creates a constant craving for fatty articles of food, and some members of his own party were in the habit of drinking the contents of the oil-kettle with great apparent relish.

Digestibility of Food. Unless an article of diet can be digested it is of no value, no matter how rich it may be in nutriment. The quantity of food taken, will influence to a considerable extent, the time consumed in its digestion. The [pg 244]stomachs of all are not alike in this respect, and the subject of time has been a difficult one to determine. The experiments of Dr. Beaumont with the Canadian, St. Martin, who accidentally discharged the contents of a loaded gun into his stomach, creating an external opening through which the process of digestion could be observed, have furnished us with the following table, which is correct enough to show relatively, if not absolutely, the time required for the digestion of various articles:

Milk is more easily digested than almost any other article of food. It is very nutritious, and, on account of the variety of the elements which it contains, it is extremely valuable an [pg 246]article of diet, especially when the digestive powers are weakened, as in fevers, or during convalescence from any acute disease. Eggs are also very nutritious and easily digested. Whipped eggs are digested and assimilated with great ease. Fish, as a rule, are more speedily digested than is the flesh of warm-blooded animals. Oysters, especially when taken raw, are very easily digested. We have known dyspeptics who were unable to digest any other kind of animal food, to subsist for a considerable period upon raw oysters. The flesh of mammalia seems to be more easily digested than that of birds. Beef, mutton, lamb, and venison are easily digested, while fat roast pork and veal are digested with difficulty. According to the foregoing table vegetables were digested in about the same time as ordinary animal food, but it should be remembered that a great part of the digestion of these is effected in the small intestine. Soups are, as a rule, very quickly digested. The time required for the digestion of bread is about the same as that required for the digestion of ordinary meats. Boiled cabbage is one of the most difficult substances to digest.

Cookery. "Cookery," says Mrs. Owen, "Is the art of turning every morsel to the best use; it is the exercise of skill, thought, and ingenuity to make every particle of food yield the utmost nourishment and pleasure, of which it is capable." We are indebted to this practical woman for many valuable suggestions in this art; and some of our recommendations are drawn from her experience.

Soups. The nutritious properties, tone, and sweetness of soup depend in the first place upon the freshness and quality of the meat; secondly on the manner in which it is boiled. Soups should be nicely and delicately seasoned, according to the taste of the consumer, by using parsley, sage, savory, thyme, sweet marjoram, sweet basil, or any of the vegetable condiments. These may be raised in the garden, or obtained at the drug stores, sifted and prepared for use. In extracting the juices of meats, in order that soups may be most nutritious, it is important that the meat be put into cold water, or that which is not so hot as to coagulate the albumen (which would prevent it from being extracted), and then, by slow heat and [pg 247]a simmering process, the most nutritious properties will be brought out.

Beef Soup may be made of any bone of the beef, by putting it into cold water, adding a little salt, and skimming it well just before it boils. If a vegetable flavor be desired, celery, carrots, onions, turnips, cabbage, or potatoes, may be added, in sufficient quantities to suit the taste.

Mutton Soup may be made from the fore-quarter, in the same manner as described above, thickened with pearl-barley or rice, and flavored to suit the taste.

Boiled Fish. Clean the fish nicely, then sprinkle flour on a cloth and wrap it around them; salt the water, and, when it boils, put in the fish; let them boil half an hour, then carefully remove them to a platter, adding egg sauce and parsley. To bake fish, prepare by cleaning, scaling, etc., and let them remain in salt water for a short time. Make a stuffing of the crumbs of light bread, and add to it a little salt, pepper, butter, and sweet herbs, and stir with a spoon. Then fill the fish with the stuffing and sew it up. Put on butter, salt, pepper, and flour, having enough water in the dish to keep it from burning, and baste often. A four pound fish will bake in fifty or sixty minutes.

Broiled Steak. Sirloin and porter-house steaks should be broiled quickly. Preserve them on ice for a day or two and their tenderness is much increased. Never broil them until the meal is ready to be served.

Boiled Meat. When meat is to be boiled for eating, put it into boiling water, by which its juices are coagulated and its richness preserved. The slower it boils, the more tender, plump, and white it will be. Meat should be removed as soon as done, or it will lose its flavor and become soggy.

Pork Steaks. The best steaks are cut off the shoulder—ham steaks being rather too dry. They should be well fried, in order to destroy the little living parasites, called Trichinæ which sometimes infest this kind of meat. They are introduced into the stomach by eating ham, pork, or sausages made from the flesh of hogs infested by them. Thorough cooking destroys them, and those who will persist in the use of swine's flesh can afford to have it "done brown."

[pg 248]Baked Mutton. To bake mutton well, a person should have a brisk, sharp fire, and keep the meat well basted. It requires two hours to bake a leg of mutton, weighing eight pounds.

Bread. The health and happiness of a family depend, to a certain extent, on good, well-baked bread. At all events, our enjoyment would be greater if it were only better prepared. We make the following extract from an article printed by the State Board of Health, concerning the food of the people of Massachusetts: "As an example of good bread we would mention that which is always to be had at the restaurant of Parker's Hotel, in Boston. It is not better than is found on the continent of Europe on all the great lines of travel, and in common use by millions of people in Germany and France; but with us, it is a rare example of what bread may be. It is made from a mixture of flour, such as is generally sold in our markets, water, salt, and yeast—nothing else. The yeast is made from malt, potatoes, and hops. The dough is kneaded from one and a half to two hours, and is then thoroughly baked." The truth seems to be that the kneading, which in this country takes the housewife's time and muscle, in Europe is done by the help of machinery. So here, in large villages and cities, people might furnish themselves with good bread, by means of co-operative associations, even at a less cost than at present.

BEVERAGES.

Water. The importance of water in the economy of nature is obvious to all. It is the most abundant substance of which we have knowledge. It composes four-fifths of the weight of vegetables, and three-fourths of that of animals. It is essential to the continuance of organic life. Water is universally present in all of the tissues and fluids of the body. It is not only abundant in the blood and secretions, but it is also an ingredient of the solids of the body. According to the most accurate computations, water is found to constitute from two-thirds to three-fourths of the entire weight of the human body. The following table, compiled by Robin and Verdeil, shows the proportion of water per thousand parts in different solids and fluids:

The Natural Drink of Man. Water constitutes the natural drink of man. No other liquid can supply its place. Its presence, however, in the body is not permanent. It is discharged from the body in different ways; by the urine, the feces, the breath, and the perspiration. In the first two, it is in a liquid form, in the others in a vaporous form. It is estimated that about forty-eight per cent. is discharged in the liquid, and fifty-two per cent. in the vaporous form; but the absolute as well as the relative amount discharged depends upon a variety of circumstances.

Water is never found perfectly pure, since it holds in solution more or less of almost every substance with, which it comes in contact. Rain falling in the country remote from habitations is the purest water that nature furnishes, for it is then only charged with the natural gases of the atmosphere. In cities it absorbs organic and gaseous impurities, as it falls through the air, and flowing over roofs of houses carries with it soot and dust. Water from melted snow is purer than rain-water, since it descends in a solid form, and is therefore incapable of absorbing gases. Rain-water is not adapted to drinking purposes, unless well filtered. All water, except that which has been distilled, contains air, and it is due to this fact, that aquatic animals can live in it; for example, put a fish in distilled water and it will soon die.

Mineral Impurities. Rain-water, which has filtered through the soil and strata of the earth, dissolves the soluble materials, and carries them down to lower levels, until they finally collect in the sea. Common well, spring, and mineral waters contain from 5 to 60 grains to the gallon; sea-water contains 2,000 grains while in some parts of the Dead Sea there are [pg 250]20,000 grams to the gallon. The principal mineral impurities of well and spring water are lime, magnesia, soda, and oxide of iron, combined with carbonic and sulphuric acids, forming carbonates, sulphates, and chloride of sodium, or common salt. The most general, however, are carbonate and sulphate of lime.

Mineral waters are usually obtained from springs which contain a considerable amount of saline matter. Those waters which abound in salts of iron are called chalybeate or ferruginous. Those containing salt are termed saline. Those in which contain sulphur are termed sulphurous. Water derives the quality of hardness from the salts of lime—chiefly the sulphates—which it contains. Hard water, being an imperfect solvent, is unsuitable for washing purposes. There are two varieties of hardness, one of which is temporary, being due to the presence of carbonic acid gas in the water which holds the salts in solution and may be removed by merely boiling the water and thus expelling the gas when the salts are deposited, while the other is permanent and can only be removed by the distillation of the water. It has been ascertained that twelve pounds of the best hard soap must be added to 10,000 gallons of water of one degree of hardness before a lather will remain and, consequently, 0.12 lb. to 100 gallons of water is a measure of one degree of hardness. Since hard water is not so useful in cooking and other domestic purposes, as soft water, causing a great waste of labor and material, it is often highly desirable to soften it, which is effected by the addition of lime in what is known as Clark's process. One ounce of quicklime should be added to 1000 gallons of water for each degree of hardness. It should be first slacked and stirred up in a few gallons and then thoroughly mixed with the entire quantity. Then it should be allowed to remain, and will become clear in about three hours, but should not be drunk for twelve hours.

The purity of drinking water is a matter of much importance. That which contains a minute quantity of lead will give rise to all the symptoms of lead poisoning, if the use of it be sufficiently prolonged. An account is given of the poisoning of the royal family of France, many of whom suffered from this cause when in exile at Claremont. The amount of [pg 251]lead was only one grain in the gallon. Care should therefore be taken to avoid drinking the water which has been contained in leaden pipes. It should always be allowed to run a few minutes before being used.

An excess of saline ingredients, which in small quantities are harmless, frequently produces marked disorders of the digestive organs. A small amount of putrescent matter habitually introduced into the system, as in the use of food, is productive of the most serious results, which can be traced to the direct action of the poison introduced. A case is recorded of a certain locality favorably situated with regard to the access of pure air, where an epidemic of fever broke out much to the astonishment of the inhabitants. Upon observation it was found that the attacks of fever were limited to those families who used water from a neighboring well. The disagreeable taste of the water which had been observed, was subsequently traced to the bursting of a sewer, which had discharged a part of its contents into the well. When the cause was removed, there was no recurrence of the evil effects.

Organic Impurities. "Water is liable to organic contamination from a multitude of causes, such as drainage from dwellings, dust, insects, the decaying of vegetable and animal matter. These impurities may be mechanically suspended or held in solution in the water. Although organic impurities, which are mechanically suspended in water, are poisonous, yet they are generally associated with animalculea, and these feed upon, and finally consume them. Good water never contains animalculæ. They are never found in freshly fallen rain-water, remote from dwellings, but abound, to a greater or less extent in cisterns, marshes, ponds, and rivers. These little workers serve a useful purpose since they consume the dead organic matter from the water, and, having fulfilled their mission, sink to the bottom and die. Water which contains organic matter is exceedingly dangerous to health, and its use should be carefully avoided.

In low lands where the current of streams is sluggish, and shallow pools abound, the water is apt to be more or less infected with decaying vegetable substances. Many people living in such localities, and wishing to obtain water with as little [pg 252]trouble as possible, dig a hole in the ground, a few feet in depth, and allow the stagnant surface water to accumulate. This water is used for drinking and cooking. The result is that ague prevails in such localities.

Care should be taken that wells, from which the water is used for household purposes, are located at a distance from barn-yards, privies, sinks, vaults, and stagnant pools.

Purification of Water. There are various methods of purifying water. It may be accomplished by distillation, which is the most perfect method; by filtration through sand, crushed charcoal, and other porous substances, which deprives it of suspended impurities and living organisms; by boiling, which destroys the vitality of all animal and vegetable matters, drives out the gases and precipitates carbonate of lime, which composes the crust frequently seen upon the inside of tea-kettles or boilers; by the use of chemical agents, which may be employed to destroy or precipitate the deleterious substances. Alum is often used to cleanse roily water, two or three grains in solution, being sufficient for a quart. It causes the impurities to settle to the bottom, so that the clear water can be poured or dipped out for use. One or two grains of the permanganate of potassium will render wholesome a gallon of water containing animal impurities.

How to Use Water. Very little if any water should be taken at meal time, since the salivary glands furnish an abundance of watery fluid to assist in mastication. When these glands are aided with water to "wash down" the food, their functions become feeble and impaired. The gastric juice is diluted and digestion is weakened. Large draughts of cold water ought never to be indulged in, since they cause derangement of the stomach. When the body is overheated, the use of much water is injurious. It should only be taken in small quantities. Thirst may be partially allayed, without injury, by holding cold water in the mouth for a short time and then spitting it out, taking care to swallow but very little. Travelers frequently experience inconvenience from change of water. If the means are at hand, let them purify their drinking water, if not, they should drink as little as possible. Persons who visit the banks of the Ohio, Missouri, or Mississippi rivers and [pg 253]similar localities, almost invariably suffer from some form of gastric or intestinal disease. Water standing in close rooms soon becomes unfit to drink and should not be used. A drink of cold water taken on going to bed, and another on rising are conducive to health, especially in the case of persons troubled with constipation. "Drink water" said the celebrated Dubois to the young persons who consulted him, "drink water, I tell you!" Du Moulin, the great medical authority of his time, wrote, just previous to his death, "I leave two great physicians behind me—diet and water."

Tea and Coffee. These substances are almost universally used as beverages, and when properly employed, serve a four-fold purpose: they quench thirst, excite an agreeable exhilaration, repress the waste of the system, and supply nourishment. In consequence of being generally used at meal times, their stimulant properties are employed to promote digestion, and consequently they are not so objectionable as they might otherwise be. The liquids introduced into the stomach at meal times should not be cold. Tea and coffee are drunk warm, while water, except in a few instances, is always drunk cold, the effects of which have already been shown. That their inordinate use may be injurious no body can deny, but this is equally true of other beverages, even pure, cold water. Scientific investigators inform us that the use of these agents as beverages, when judiciously employed, is not injurious. It has been urged that they are poisonous, but if they are, they are very slow in their operation.

When properly prepared, they are very agreeable beverages, and as man will drink more or less at meals, they are allowable; for if their use were excluded, some other beverage would be sought after, and quite likely one of an alcoholic character employed, so of two evils, if this be an evil, let us choose the least. Unlike alcoholic stimulants, they exhilarate without a depressing reaction after their influence has passed off. But one cup should be drunk at a meal, and it should be of moderate strength. The use of large quantities of drink at meals retards digestion by diluting the digestive fluids. The excessive use of large quantities of strong tea or coffee stimulates the brain and causes wakefulness, and produces irritability [pg 254]of the nervous system. When they are productive of such effects, their use is injurious, and should be considerably moderated or wholly discontinued. No criterion can be given by which the amount the system will tolerate can be regulated. What one person may take with impunity, may be deleterious to an other. Individuals differ greatly in this respect. There are some who cannot tolerate them at all, either because of some peculiarity of constitution, or on account of disease. And sometimes when tea is agreeable and beneficial, coffee disagrees with the individual and vice versa. Persons of nervous habits whether natural or acquired, are apt to find their wakefulness and irritability increased by the use of tea, particularly if strong, while coffee will have a tranquilizing effect. Persons of a lymphatic or bilious temperament often find that coffee disagrees with them, aggravating their troubles and causing biliousness, constipation, and headache, while tea proves agreeable and beneficial. Whenever they disagree with the system, the best rule is to abandon their use. We find many persons who do not use either, and yet enjoy health, a fact which proves that they are not by any means indispensable, and, no doubt, were it customary to go without them, their absence would be but slightly missed.

Tea and coffee are adulterated to a very great extent, and persons using them will be greatly imposed upon. This is an evil we cannot remedy. If people make use of them, their experience in selecting them must be their guide; however, it is believed that the Black and Japan varieties of tea are the least apt to be adulterated, and coffee, to insure purity, should be purchased in the berry, and ground by the purchaser.

In preparing tea an infusion should be made by adding boiling water to the leaves, and permitting them to steep for a few minutes only, for a concentrated decoction, made by boiling for a long time, liberates the astringent and bitter principles and drives off the agreeable aroma which resides in a volatile oil.

Coffee should be prepared by adding cold water to the ground berry, and raising it slowly to the boiling point. Long-continued boiling liberates the astringent and bitter principles upon which its stimulant effects to a great extent depend, and [pg 255]drives off with the steam the aromatic oil from which the agreeable taste is derived.

ALCOHOLIC LIQUORS.

These are divided into three classes: malted, fermented, and distilled. They all contain more or less alcohol, and their effects are, therefore, in some respects similar, and, in the words of Dr. B.W. Richardson, the great English authority on hygiene: "To say this man only drinks ale, that man only drinks wine, while a third drinks spirits, is merely to say, when the apology is unclothed, that all drink the same danger. * * Alcohol is a universal intoxicant, and in the higher orders of animals is capable of inducing the most systematic phenomena of disease. But it is reserved for man himself to exhibit these phenomena in their purest form, and to present, through them, in the morbid conditions belonging to his age, a distinct pathology. Bad as this is, it might be worse; for if the evils of alcohol were made to extend equally to animals lower than man, we should soon have, none that were tameable, none that were workable, and none that were eatable." Researches have shown that the proportion of half a drachm of alcohol to the pound weight of the body, is the quantity which usually produces intoxication, and that an increase of this amount to one drachm immediately endangers the life of the individual. The first symptom which attracts attention, when alcohol commences to take effect upon the body, is an increase in the number of the pulsations of the heart. Dr. Parkes and Count Wolowicz conducted a series of interesting experiments on young adult men. They counted the pulsations of the heart, at regular intervals, during periods when the subject drank only water; and then they counted the beats of the heart in the same individual during successive periods in which alcohol was drunk in increasing quantities.

The following details are taken from their report:

"The highest of the daily means of the pulse observed during the first or water period was 77.5; but on this day two observations were deficient. The next highest daily mean was 77 beats.

If instead of the mean of the eight days, or 73.57, we [pg 256]compare the mean of this one day, viz., 77 beats per minute, with the alcoholic days, so as to be sure not to over-estimate the action of the alcohol, we find:

On the ninth day, with one fluid ounce of alcohol,
    the heart beat 430 times more.
On the tenth day, with two fluid ounces, 1,872 times more.
On the eleventh day, with four fluid ounces, 12,960 times more.
On the twelfth day, with six fluid ounces, 30,672 times more.
On the thirteenth day, with eight fluid ounces, 23,904 times more.
On the fourteenth day, with eight fluid ounces, 25,488 times more.

But as there was ephemeral fever on the twelfth day, it is right to make a deduction, and to estimate the number of beats in that day as midway between the twelfth and twenty-third days, or 18,432. Adopting this, the mean daily excess of beats during the alcoholic days was 14,492, or an increase of rather more than thirteen per cent.

The first day of alcohol gave an excess of one per cent., and the last of twenty-three per cent.; and the mean of these two gives almost the same percentage of excess as the mean of the six days.

Admitting that each beat of the heart was as strong during the alcoholic as in the water period (and it was really more powerful), the heart on the last two days of alcohol was doing one-fifth more work.

Adopting the lowest estimate which has been given of the daily work done by the heart, viz., as equal to 122 tons lifted one foot, the heart, during the alcoholic period, did daily work in excess equal to lifting 15.8 tons one foot, and in the last two days did extra work to the amount of twenty-four tons lifted as far.

The period of rest for the heart was shortened, though, perhaps, not to such an extent as would be inferred from the number of beats; for each contraction was sooner over. The beat on the fifth and sixth days after alcohol was left off, and apparently at the time when the last traces of alcohol were eliminated, showed, in the sphygmographic tracing, signs of unusual feebleness; and, perhaps, in consequence of this, when the brandy quickened the heart again, the tracing showed a more rapid contraction of the ventricles, but less power than [pg 257]in the alcoholic period. The brandy acted, in fact, on a heart whose nutrition had not been perfectly restored."

The flush often seen on the cheeks of those who are under the influence of alcoholic liquors, and which is produced by a relaxed and distended condition of the superficial blood vessels, is erroneously supposed by many to merely extend to the parts exposed to view. On this subject, Dr. Richardson says: "If the lungs could be seen, they, too, would be found with their vessels injected; if the brain and spinal cord could be laid open to view, they would be discovered in the same condition; if the stomach, the liver, the spleen, the kidneys, or any other vascular organs or parts could be laid open to the eye, the vascular engorgement would be equally manifest. In the lower animals I have been able to witness this extreme vascular condition in the lungs, and once I had the unusual, though unhappy opportunity of observing the same phenomenon in the brain of a man who, in a paroxysm of alcoholic delirium, cast himself under the wheels of a railway carriage. The brain, instantaneously thrown out from the skull by the crash, was before me within three minutes after the accident. It exhaled the odor of spirit most distinctly, and its membranes and minute structures were vascular in the extreme. It looked as if it had been recently injected with vermilion injection. The white matter of the cerebrum, studded with red points, could scarcely be distinguished when it was incised, it was so preternaturally red; and the pia mater, or internal vascular membrane covering the brain, resembled a delicate web of coagulated red blood, so tensely were its fine vessels engorged. This condition extended through both the larger and the smaller brain, cerebrum, and cerebellum, but was not so marked in the medulla, or commencing portion of the spinal cord, as in the other portions.

In course of time, in persons accustomed to alcohol, the vascular changes, temporary only in the novitiate, become confirmed and permanent. The bloom on the nose which characterizes the genial toper is the established sign of alcoholic action on the vascular structure.

Recently, physiological research has served to explain the reason why, under alcohol the heart at first beats so quickly, [pg 258]why the pulse rises, and why the minute blood-vessels become so strongly injected.

At one time it was imagined that alcohol acts immediately upon the heart by stimulating it to increased motion; and from this idea,—false idea, I should say,—of the primary action of alcohol, many erroneous conclusions have been drawn. We have now learned that there exist many chemical bodies which act in the same manner as alcohol, and that their effect is not to stimulate the heart, but to weaken the contractile force of the extreme and minute vessels which the heart fills with blood at each of its strokes. These bodies produce, in fact, a paralysis of the organic nervous supply of the vessels which constitute the minute vascular structures. The minute vessels when paralysed offer inefficient resistance to the force of the heart, and the pulsating organ thus liberated, like the main-spring of a clock from which the resistance has been removed, quickens in action, dilating the feebly resistant vessels, and giving evidence really not of increased, but of wasted power."

The continued use of alcoholic liquors in any considerable quantity produces irritation and inflammation of the stomach, and structural disease of the liver. Dr. Hammond has shown that alcohol has a special affinity for nervous matter, and is, therefore, found in greater quantity in the brain and spinal cord than elsewhere in the body. The gray matter of the brain undergoes, to a certain extent, a fatty degeneration, and there is a shrinking of the whole cerebrum, with impairment of the intellectual faculties, muscular tremor, and a shambling gait.

Large doses of alcohol cause a diminution of the temperature of the body, which in fevers is more marked than in the normal state.

In addition to the organic diseases enumerated above, and delirium tremens, the following diseases are frequently the result of the excessive use of alcoholic liquors: epilepsy, paralysis, insanity, diabetes, gravel, and diseases of the heart and blood-vessels.

The physiological deductions of Dr. Richardson are so much in accord with our own that we quote them in full:

"In the first place we gather from the physiological reading of the action of alcohol that the agent is narcotic. I have [pg 259]compared it throughout to chloroform, and the comparison is good in all respects save one, viz.: that alcohol is less fatal than chloroform as an instant destroyer. It kills certainly in its own way, but its method of killing is slow, indirect, and by disease.

The well-proven fact that alcohol, when it is taken into the body, reduces the animal temperature, is full of the most important suggestions. The fact shows that alcohol does not in any sense act as a supplier of vital heat as is commonly supposed, and that it does not prevent the loss of heat as those imagine 'who take just a drop to keep out the cold,' It shows, on the contrary, that cold and alcohol, in their effects on the body, run closely together, an opinion confirmed by the experience of those who live or travel in cold regions of the earth. The experiences of the Arctic voyagers, of the leaders of the great Napoleonic campaigns in Russia, of the good monks of St. Bernard, all testify that death from cold is accelerated by its ally alcohol. Experiments with alcohol in extreme cold tell the like story, while the chilliness of the body which succeeds upon even a moderate excess of alcoholic indulgence leads directly to the same indication of truth.

The conclusive evidence now in our possession that alcohol taken into the animal body sets free the heart, so as to cause the excess of motion of which the record has been given above, is proof that the heart, under the frequent influence of alcohol, must undergo deleterious change of structure. It may, indeed, be admitted in proper fairness, that when the heart is passing through these rapid movements it is working under less pressure than when its movements are slow and natural; and this allowance must needs be made, or the inference would be that the organ ought to stop at once, in function, by the excess of strain put upon it. At the same time the excess of motion is injurious to the heart and to the body at large; it subjects the heart to irregularity of supply of blood, it subjects the body in all its parts to the same injurious influence; it weakens, and, as a necessary sequence, degrades both the heart and the body.

Speaking honestly, I cannot, by any argument yet presented to me, admit the alcohols by any sign that should distinguish them from other chemical substances of the paralysing narcotic class. When it is physiologically understood that what is called [pg 260]stimulation or excitement is, in absolute fact, a relaxation, a partial paralysis, of one of the most important mechanisms in the animal body, the minute, resisting, compensating circulation, we grasp quickly the error in respect to the action of stimulants in which we have been educated, and obtain a clear solution of the well-known experience that all excitement, all passion, leaves, after its departure, lowness of heart, depression of mind, sadness of spirit. We learn, then, in respect to alcohol, that the temporary excitement it produces is at the expense of the animal force, and that the ideas of its being necessary to resort to it, that it may lift up the forces of the animal body into true and firm and even activity, or that it may add something useful to the living tissues, are errors as solemn as they are widely disseminated. In the scientific education of the people no fact is more deserving of special comment than this fact, that excitement is wasted force, the running down of the animal mechanism before it has served out its time of motion.

It will be said that alcohol cheers the weary, and that to take a little wine for the stomach's sake is one of the lessons that comes from the deep recesses of human nature. I am not so obstinate as to deny this argument, There are times in the life of man when the heart is oppressed, when the resistance to its motion is excessive, and when blood flows languidly to the centres of life, nervous and muscular. In these moments alcohol cheers. It lets loose the heart from its oppression; it lets flow a brisker current of blood into the failing organs; it aids nutritive changes, and altogether is of temporary service to man. So far, alcohol may be good, and if its use could be limited to this one action, this one purpose, it would be amongst the most excellent of the gifts of science to mankind. Unhappily, the border line between this use and the abuse of it, the temptation to extend beyond the use, the habit to apply the use when it is not wanted as readily as when it is wanted, overbalance, in the multitude of men, the temporary value that attaches truly to alcohol as a physiological agent. Hence alcohol becomes a dangerous instrument even in the hands of the strong and wise, a murderous instrument in the hands of the foolish and weak. Used too frequently, used too excessively, this agent, which in moderation cheers the failing body, relaxes its vessels too [pg 261]extremely; spoils vital organs; makes the force of the circulation slow, imperfect, irregular; suggests the call for more stimulation; tempts to renewal of the evil, and ruins the mechanism of the healthy animal before its hour for ruin, by natural decay, should be at all near.

It is assumed by most persons that alcohol gives strength, and we hear feeble persons saying daily that they are being 'kept up by stimulants.' This means actually that they are being kept down; but the sensation they derive from the immediate action of the stimulant deceives them and leads them to attribute passing good to what, in the large majority of cases, is persistent evil. The evidence is all-perfect that alcohol gives no potential power to brain or muscle. During the first stage of action it may enable a wearied or a feeble organism to do brisk work for a short time; it may make the mind briefly brilliant; it may excite muscle to quick action, but it does nothing substantially, and fills up nothing it has destroyed, as it leads to destruction. A fire makes a brilliant sight, but leaves a desolation. It is the same with alcohol.

On the muscular force the very slightest excess of alcoholic influence is injurious. I find by measuring the power of muscle for contraction in the natural state and under alcohol, that so soon as there is a distinct indication of muscular disturbance, there is also indication of muscular failure, and if I wished by scientific experiment to spoil for work the most perfect specimen of a working animal, say a horse, without inflicting mechanical injury, I could choose no better agent for the purpose of the experiment than alcohol. But alas! the readiness with which strong, well-built men slip into general paralysis under the continued influence of this false support, attests how unnecessary it would be to subject a lower animal to the experiment. The experiment is a custom, and man is the subject.

The true place of alcohol is clear; it is an agreeable temporary shroud. The savage, with the mansions of his soul unfurnished, buries his restless energy under its shadow. The civilized man overburdened with mental labor, or with engrossing care, seeks the same shade; but it is shade, after all, in which, in exact proportion as he seeks it, the seeker retires from perfect natural [pg 262]life. To search for force in alcohol is, to my mind, equivalent to the act of seeking for the sun in subterranean gloom until all is night.

It may be urged that men take alcohol, nevertheless, take it freely, and yet live; that the adult Swede drinks his average cup of twenty-five gallons of alcohol per year and remains on the face of the earth. I admit force even in this argument, for I know under the persistent use of alcohol there is a limited provision for the continuance of life. In the confirmed alcoholic the alcohol is, in a certain sense, so disposed of that it fits, as it were, the body for a long season, nay, becomes part of it; and yet it is silently doing its fatal work. The organs of the body may be slowly brought into a state of adaptation to receive it and to dispose of it. But in that very preparation they are themselves made to undergo physical changes tending to the destruction of their function, to perversion of their structure, and to all those varied modifications of organic parts which the dissector of the human subject learns to recognize,—almost without concern, and certainly without anything more than commonplace curiosity,—as the devastations incident to alcoholic indulgence."

The statistics collected from the census of the United States for 1860, and given by Dr. De Marmon, in the New York Medical Journal for December, 1870, must carry conviction to all minds of the correctness of the foregoing deductions:

"For the last ten years the use of spirits has, 1. Imposed on the nation a direct expense of 600,000,000 dollars. 2. Has caused an indirect expense of 600,000,000 dollars. 3. Has destroyed 300,000 lives. 4. Has sent 100,000 children to the poorhouses. 5. Has committed at least 150,000 people into prisons and workhouses. 6. Has made at least 1,000 insane. 7. Has determined at least 2,000 suicides. 8. Has caused the loss by fire or violence, of at least 10,000,000 dollars' worth of property. 9. Has made 200,000 widows and 1,000 orphans."

If these were the statistics twenty-four years ago, with our greatly increased population, what must they be to-day? We will let the reader draw his own conclusions.

Malted Liquors. Under this head are included all those liquors into the composition of which malt enters, such as [pg 263]beer, ale, and porter. The proportion of alcohol in these liquors varies greatly. In beer, it is from two to five per cent.; in Edinburgh ale, it amounts to six per cent.; in porter, it is usually from four to six per cent. In addition to alcohol and water, the malted liquors contain from five to fourteen per cent. of the extract of malt, and from 0.16 to 0.60 per cent. of carbonic acid. They possess, according to Pereira, three properties: they quench thirst; they stimulate, cheer, and, if taken in sufficient quantity, intoxicate; and they nourish or strengthen. The first of these qualities is due to the water entering into their composition; the second, to the alcohol; the third is attributed the nutritive principles of the malt.

Objections to their use as Beverages. These articles are either pure or adulterated. In their pure state the objection to their use for this purpose lies in the fact that they contain alcohol. This, as we have seen, is a poisonous substance, which the human system in a state of health does not need. Its use, when the body is in a normal condition, is uncalled for, and can only be deleterious. Beverages containing this poison are more or less deleterious to healthy persons, according to the amount of it which they contain.

These liquors are frequently adulterated, and this increases their injurious effects. The ingenuity of man has been taxed to increase their intoxicating properties; to heighten the color and flavor, to create pungency and thirst; and to revive old beer. To increase the intoxicating power, tobacco or the seeds of the Cocculus indicus are added; to heighten the color and flavor, burnt sugar, liquorice, or treacle, quassia, or strychnine, coriander, and caraway seeds are employed; to increase the pungency, cayenne pepper or common salt is added; to revive old beer, or ale, it is shaken up with green vitriol or sulphate of iron, or with alum and common salt.

Fermented Liquors. These are cider and wine. Cider contains alcohol to the amount of from five to ten per cent., saccharine matter, lactic acid, and other substances. New cider may be drunk in large quantities without inducing intoxication, but old cider is quite as intoxicating as ale or porter.

The composition of wine is very complex, the peculiar qualities which characterize the different varieties cannot be [pg 264]ascertained by chemical analysis. Wine is a solution of alcohol in water, combined with various constituents of the grape. The amount of alcohol in wines ranges from six to forty per cent. As beverages, these are open to the same objections as those manufactured from malt. As a medicine, wine is a useful remedy. Concerning its use in this capacity, Prof. Liebig says: "Wine is a restorative. As a means of refreshment when the powers of life are exhausted—as a means of compensation where a misappropriation occurs in nutrition, and as a means of protection against transient organic disturbances, it is surpassed by no product of nature or art." That an article is useful in medicine, however, is no reason why it should be used as a beverage by those in health. It is rather an argument against such a practice. For it is generally true that the drugs used to restore the diseased system to health, are pernicious or poisonous to it when in a normal condition.

Distilled Liquors. These are whiskey, brandy, and the kindred productions of the still. Whiskey is a solution of alcohol in water, mixed with various other principles which impart to it peculiar physical properties. The amount of alcohol which it contains varies from forty-eight to fifty-six per cent. Old whiskey is more highly prized than the more recent product of the still, from the fact that when kept for some years certain volatile oils are generated which, impart to it a mellowness of flavor.

Brandy is a solution of alcohol in water, together with various other substances. It contains from fifty to fifty-six per cent. of alcohol. Pure brandy is distilled from wine, 1,000 gallons of wine yielding from 100 to 150 gallons of brandy, but a very large proportion of the brandy is made with little or no wine. It is made artificially from high wines by the addition of oil of Cognac, to give it flavor, burnt sugar to give it color, and logwood or catechu, to impart astringency and roughness of taste. The best brandy is obtained by distillation from the best quality of white wines, from the districts of Cognac and Armagnac in France.

THE CLOTHING.

There is no physical agent which exerts a more constant or more powerful influence upon health and life, than the [pg 265]atmosphere. The climate in these latitudes is exceedingly variable, ranging all the way from 110° Fahr. in summer to 40° below zero in the winter season. The body of every individual should be so protected from cold, that it can maintain a mean temperature of 98° Fahr.

When the body is warm there is a free and equal circulation of the blood throughout all the structures. When the surface is subjected to cold, the numerous capillaries and minute vessels carrying the blood, contract and diminish in size, increasing the amount of this fluid in the internal organs, thus causing congestion. The blood must go somewhere, and if driven from the surface, it retreats to the cavities within. Hence this repletion of the vital organs causes pain from pressure and fullness of the distended blood-vessels, and the organic functions are embarrassed. Besides, cold upon the surface shuts up the pores of the skin, which are among the most active and important excretory ducts of the system. It is evident, then, that we require suitable clothing, not only for comfort, but to maintain the temperature and functions essential to health and life.

The chief object to be attained by dress is the maintenance of a uniform temperature of the body. To attain this end, it is necessary that the exhalations of the system, which are continually escaping through the pores of the skin, should be absorbed or conducted away from the person. These exudations occur in the form of sensible or insensible perspiration, and the clothing, to be healthy, should be so porous as to allow them freely to escape into the air.

A substance should also be chosen which is known to be a poor conductor of heat. That generated by the system will thus be retained where it is needed, instead of being dispersed into the atmosphere.

We might add that the better the material for accomplishing these purposes, the less will be needed to be worn; for we do not wish to wear or carry about with us any more material than is necessary. It so happens that all of these qualities are found combined in flannel. The value of this article worn next to the skin cannot be over-rated, for while it affords protection from cold during the winter months, it is equally beneficial during the heat of summer, because it imbibes the perspiration, [pg 266]and being very porous, allows it to escape. The skin always feels soft, smooth, and pliable, when it is worn; but, when cotton takes its place, it soon becomes dry and harsh. Its natural adaptability to these purposes, shows that it is equally a comfort and a source of health. Where the skin is very delicate, flannel sometimes causes irritation. In such cases a thin fabric of linen, cotton, or silk, should be worn next the skin, with flannel immediately over it. Where there is a uniform and extreme degree of heat, cotton and linen are very conducive to comfort. But they are unsuitable in a climate or season liable to sudden fluctuations in temperature.

The value of furs, where people are exposed to extreme cold, cannot be overestimated. They are much warmer than wool, and are chiefly used as wraps on going outdoors. They are too cumbrous and expensive for ordinary wear in this latitude, but in places near the poles they constitute the chief clothing of the inhabitants.

The quantity of clothing worn is another important item. The least that is necessary to keep the body well protected and evenly tempered when employed is the rule of health. Some people, instead of wearing flannels next to the body, put on other material in greater abundance, thus confining the perspiration to the skin and making the body chilly. The amount of clothing is then increased, until they are so heavily clad that they cannot exercise. It is far better to wear one thickness of flannel next to the skin, and then cotton, or woolen, for outside garments, and be able to exercise, thus allowing the blood to circulate and to assist in the warming process.

One great fault in dress consists in neglecting to properly clothe the upper extremities. Some people do not reflect upon the necessity, while others are too proud to be directed by plain common sense. In the winter season, the feet should be covered with woolen stockings. The next matter of importance, is to get a thick, broad-soled shoe, so large that it will not prevent the free circulation of the blood. Then for walking, and especially for riding, when the earth is wet and cold, or when there is snow on the ground, wear a flannel-lined rubber or "Arctic" over-shoe. Be sure and keep the feet comfortable and warm at all times.

[pg 267]Our next advice is to keep the legs warm. We were called not long ago, to see a young lady who had contracted a severe cold. She had been to an entertainment where the apartments were nicely warmed, and from thence had walked home late in the evening. We inquired into the circumstances of the case, and ascertained that she wore flannel about her chest, and that she also wore rubbers over her shoes, but the other portions of the lower extremities were protected by cotton coverings. In short, her legs were not kept warm, and she took cold by going out from warm rooms into a chilly atmosphere. A good pair of woolen leggings might have saved her much suffering. The results of insufficient protection of the lower extremities are colds, coughs, consumption, headaches, pain in the side, menstrual derangements, uterine congestion and disorders, besides disablement for the ordinary and necessary duties of life. All these may be prevented by clothing the legs suitably, and wearing comfortable flannels.

Young people can bear a low temperature of the body better than old people, because they possess greater power of endurance. But that is no reason for unnecessary exposure.

The amount of clothing should be regulated according to the heat-generating power of the individual, and also according to the susceptibility to cold. No two persons are exactly alike in these respects. But it is never proper for young people to reject the counsels of experience, or treat lightly the advice to protect themselves thoroughly against the cold. Many a parent's heart has ached as he has followed the mortal remains of a darling child to the grave, knowing that if good advice had been heeded, in all human probability, the life would have been prolonged.

The most deleterious mechanical errors in clothing are those which affect the chest and body. Tight lacing still plays too important a part in dress. It interferes with the free and healthy movements of the body, and effects a pressure which is alike injurious to the organs of respiration, circulation, and digestion. The great muscle of respiration, the diaphragm, is impeded in its motion, and is, therefore, unable to act freely. The large blood-vessels are compressed, and when the pressure is excessive the heart and lungs are also subjected to restraint [pg 268]and thrown out of their proper positions. From the compression of the liver and stomach, the functions of digestion are impeded, a distaste for solid food, flatulency and pain after eating are the unmistakable proofs of the injury which is being inflicted.

The evil effects of such pressure are not confined to actual periods of time during which this pressure is applied. They continue after it has been removed and when the chest and trunk of the body have thus been subjected to long-continued pressure they become permanently deformed. These deformities necessarily entail great suffering in child-bearing.

The evil effects of mechanical pressure on other parts of the body are not uncommon. The leg is sometimes so indented by a tight garter that the returning flow of blood through the veins is prevented, and a varicose condition of these vessels is produced.

Irregular and excessive pressure on the foot by imperfectly fitting shoes or boots produce deformities of the feet and cause much suffering. The high heels which are so common on the shoes of women and children inflict more than a local injury. Every time the body comes down upon the raised heel with its full weight a slight shock or vibration is communicated throughout the entire extent of the spinal column, and the nervous mechanism is thereby injured. Furthermore, displacements of the pelvic organs frequently result from these unnatural and absurd articles of dress. Women of fashion are subjected to much annoyance from wearing long, flowing skirts suspended from their waists to trail uselessly on the floor and gather dust. It is impossible for the wearers of these ridiculous garments to exercise their limbs properly or to breathe naturally. Indigestion, palpitation, shortness of breath, and physical degeneracy are the inevitable consequences of their folly. The skirts should always be suspended from the shoulders and not from the hips. It is especially important that the clothing of children should not fit too tightly.

It is very important that the clothing should be kept clean. That which is worn for a long time becomes saturated with the excretions and exhalations of the body, which prevent free transpiration from the pores of the skin, and thereby induce mental inactivity and depression of the physical powers. Unclear clothing may be the means of conveying disease. Scarlet [pg 269]fever has been conveyed frequently by the clothing of a nurse into a healthy family. All of the contagious diseases have been communicated by clothing contaminated in laundries.

Certain dyes which are largely used in the coloring of wearing apparel are poisonous, and give rise to local disease of the skin, accompanied in some instances, with constitutional symptoms. The principal poisonous dyes are the red and yellow aniline. A case of poisoning from wearing stockings colored with aniline dyes, in which there were severe constitutional symptoms, came under our observation at the Invalids' Hotel recently.

CHAPTER III.

PHYSICAL EXERCISE. MENTAL CULTURE. SLEEP. CLEANLINESS.

A well-developed physical organization is essential to perfect health. Among the Greeks, beauty ranked next to virtue, and an eminent author has said that "the nearer we approach Divinity, the more we reflect His eternal beauty." The perfect expression of thought requires the physical accompaniments of language, gesture, etc. The human form is pliable, and, with proper culture, can be made replete with expression, grace and beauty. The cultivation of the intellectual powers has been allowed to supplant physical training to a great extent. The results are abnormally developed brains, delicate forms, sensitive nerves and shortened lives. That the physical and mental systems should be collaterally developed, is a fact generally overlooked by educators. The fullness of a great intellect is generally impaired when united with a weak and frail body. We have sought perfection in animals and plants. To the former we have given all the degree of strength and grace requisite to their peculiar duties; to the latter we have imparted all the delicate tints and shadings that fancy could picture. We have studied the laws of their existence, until we are familiar with every phase of their production; yet it remains for man to learn those laws of his own being, by a knowledge of which he may promote and preserve the beauty of the human form, and thus render it, indeed, an image of its [pg 271]Maker. When the body is tenanted by a cultivated intellect, the result is a unity which is unique, commanding the respect of humanity, and insuring a successful life to the possessor. Students are as a rule pale and emaciated. Mental application is generally the cause assigned when, in reality, it is the result of insufficient exercise, impure air, and dietetic errors. An intelligent journalist has remarked that "many of our ministers weigh too little in the pulpit, because they weigh too little on the scales." The Greek Gymnasium and Olympian Games were the sure foundations of that education from which arose that subtle philosophy, poetry, and military skill which have won the admiration of nineteen centuries. The laurel crown of the Olympian victor was far more precious to the Grecian youth than the gilded prize is to our modern genius. A popular lecturer has truly remarked, that "we make brilliant mathematicians and miserable dyspeptics; fine linguists with bronchial throats; good writers with narrow chests and pale complexions; smart scholars, but not that union, which the ancients prized, of a sound mind in a sound body. The brain becomes the chief working muscle of the system. We refine and re-refine the intellectual powers down to a diamond point and brilliancy, as if they were the sole or reigning faculties, and we had not a physical nature binding us to earth, and a spiritual nature binding us to the great heavens and the greater God who inhabits them. Thus the university becomes a sort of splendid hospital with this difference, that the hospital cures, while the university creates disease. Most of them are indicted at the bar of public opinion for taking the finest young brain and blood of the country, and, after working upon them for four years, returning them to their homes skilled indeed to perform certain linguistic and mathematical dexterities, but very much below par in health and endurance, and, in short, seriously damaged and physically demoralized." We read with reverence the sublime teachings of Aristotle and Plato; we mark the grandeur of Homer and the delicate beauties of Virgil; but we do not seek to reproduce in our modern institutions the gymnasium, which was the real foundation of their genius. Colleges which are now entering upon their career, should make ample provision for those exercises [pg 272]which develop the physical man. This lack of bodily training is common with all classes, and its effects are written in indelible characters on the faces and forms of old and young. Constrained positions in sitting restrict the movements of the diaphragm and ribs and often cause diseases of the spine, or unnatural curvatures, which prove disastrous to health and happiness. The head should be held erect and the shoulders thrown backward, so that at each inspiration the lungs may be fully expanded.

Physical exercise should never be too violent or too prolonged. Severe physical labor, and athletic sports, if indulged in to an extreme degree, produce undue excitability of the heart, and sometimes cause it to become enlarged. There is a form of heart disease induced by undue exertion which may be called a wearing out or wasting away of that organ. It is common in those persons whose occupations expose them to excessive physical labor for too many hours together. This feebleness of heart is felt but little by vigorous persons under forty years of age, but in those who have passed this age it becomes manifest. However, when any person so affected is attacked by any acute disease, the heart is more liable to fail, and thus cause a fatal termination.

Aneurism of the aorta or the large arteries branching off from it, which is a dilatation of the walls of these vessels, caused by the rupture of one or two of their coats, is generally induced by excessive physical strain, such as lifting heavy weights, or carrying weights up long flights of stairs, violent horseback exercise, or hurrying to catch a train or street car.

Fig. 104.

An Erect Carriage is not only essential to health, but adds grace and beauty to every movement. Although man was made to stand erect, thus indicating his superiority over all other animals, yet custom has done much to curve that magnificent central column, upon the summit of which rests the "grand dome of thought." Many young persons unconsciously acquire the habit of throwing the shoulders forward. The spinal column is weakened by this unnatural posture, its vertebræ become so sensitive and distorted that they cannot easily support the weight of the body or sustain its equilibrium. It is generally believed that persons of sedentary habits are [pg 273]more liable to become round-shouldered than any other class of individuals. Observation shows, on the contrary, that the manual laborer, or even the idler, often acquires this stooping posture. It can be remedied, not by artificial braces, but by habitually throwing the shoulders backwards. Deformed trunks and crooked spines, although sometimes the effects of disease are more frequently the results of carelessness. Jacques has remarked that "one's standing among his fellow-men is quite as important a matter in a physiological, as in a social sense." Walking is one of the most efficient means of physical culture, as it calls all the muscles into action and produces the amount of tension requisite for their tonicity. Long walks or protracted physical exercise of any kind should never be undertaken immediately after meals. The first essential to a healthful walk is a pleasurable object. Beautiful scenery, rambles in meadows rich with fragrant grasses, or along the flowery banks of water-courses, affords an agreeable stimulus, which sends the blood through the vital channels with unwonted force, and imparts to the cheeks the ruddy glow of health. Our poets acknowledge the silent influence of nature. Wordsworth has expressed this thought in his own sublime way:

"The floating clouds their state shall lend
To her: for her the willow bend;
Nor shall she fail to see,
E'en in the motions of the storm
Grace that shall mould the maiden's form
By silent sympathy.
The stars of midnight shall be dear
To her: and she shall lean her ear
In many a secret place,
Where rivulets dance their wayward round,
And beauty, born of murmuring sound,
Shall pass into her face."

Base Ball, Cricket, Boxing, and Fencing, are all manly exercises when practiced solely with a view to their hygienic advantages and as such have our approval.

Fig. 105.

Fig. 109.

The Art of Swimming was regarded by the Greeks as an important accomplishment. As a hygienic agency, it occupies a high place in physical culture. The varied movements impart strength and elasticity to the muscles. It is as charming a recreation for women and girls as for men and boys. Furthermore, it is not only a means of physical culture, but is often essential for self-preservation.

Fig. 110.

The Exercises of the Gymnasium are especially productive of health and longevity. The most important of these are balancing, leaping, climbing, wrestling, and throwing, all of which are especially adapted to the development of the muscles. In conclusion, we offer the following suggestions, viz: all gymnastic exercises should be practiced in the morning, and in the open air; extremes should be avoided; and it should be always borne in mind, that their chief object is to combine, in a proper proportion, mental and physical development. In every relation of life we should cultivate all those faculties which pertain to our physical, moral, and mental natures, subdue our passions, and nature will bestow upon us her richest rewards of health, beauty, and happiness.

CYCLING.

If one were asked what athletic exercise deserves to be the most popular in America to-day, the answer would of necessity be cycling. The bicycle is being used by people of all ages and conditions of health in daily life; its hygienic value as a means to healthy exercise cannot be overestimated. In this, as in everything else, immoderation is to be condemned, particularly where persons have not had sufficient training to take long "spins," or attempt racing. Beginners should ride only 10 or 12 minutes at a time—resting then to permit the circulation to become equalized. In all cyclists, at all ages, in veteran riders as well as those not practiced in the art, there is, in the beginning of each attempt, a quickened circulation; the pulse is full and bounding, and rarely falls under a hundred pulsations per minute. So long as the exercise is continued, an increase of cardiac motion is observable, and a vigorous circulation is kept up. This accounts for the astounding journeys a fully trained cyclist can accomplish, and also for his endurance without sleep. In spite of the quickened motion of the heart, rarely have riders been known to grow giddy or show symptoms of cardiac embarrassment. A good rider may climb a hill without trouble, yet be unable to climb a flight of stairs without breathlessness and palpitation. Bicycle riding as a means for acquiring strength and vigor, improving the circulation and developing the respiratory organs, is unexcelled. Fast riding, or "scorching," among those not used to physical exertion, and leaning over the handle-bars so as to ride in a stooping position, are to be heartily condemned. The latter prevents the lungs from getting their full expansion, and cultivates a tendency to round shoulders. Men or women suffering from diseases of the sexual organs should, before riding, consult the physician having their case in charge.

Fig. 112.

[pg 276]Riding on Horseback is a fine exercise for both sexes. It promotes digestion, improves the circulation, and expands and develops the respiratory organs. The pure, fresh air, pleasant scenery, and pleasurable excitement, impart renewed vigor to the equestrian. In the Southern States it is a universal accomplishment, and children are taught to ride as well as to walk.

Dancing. Notwithstanding the fact that dancing has been perverted to the basest purposes, has been made the fruitful source of dissipation, and has often laid the foundation for disease, it is yet capable of being made to minister to health and happiness. As a means of physical culture, it favors the development of the muscular system, and promotes health and cheerfulness. When practiced for this purpose, Jacques terms it "the best of all indoor exercises," as it brings to bear upon the physical system a great number of energizing and harmonious influences.

MENTAL CULTURE.

The brain, like all other organs of the body, requires alternate exercise and repose; and, in physical endurance, it is subject to general physiological laws. When exercised with moderation it acquires strength, vigor, and an accelerated activity. Excessive mental exertion is liable to result in softening of the brain, and various nervous diseases, sometimes culminating in insanity, and in many instances proving fatal to life. The mere votaries of pleasure who avoid all effort of the mind, fall into the opposite error. In all cases of intellectual activity, the exertions should be directed to some subject interesting to the student. In this manner duty will become a pleasure, which in turn will re-invigorate the mental functions.

When the mind in confined to one subject for any considerable length of time together, it becomes fatigued, and requires relaxation, recreation, rest. This may be obtained by directing the attention to some other subject, either study or amusement, the latter of which is preferable. The amusement, however, [pg 277]may be of an intellectual or physical character or both combined, and will, if properly conducted, restore vigor to both mind and body.

Prominent among physical phenomena is the mutual relation between the brain and the organs of nutrition. Mental exertion should be avoided for at least one hour after a hearty meal, and all mental labor which requires concentration of thought ought to be accomplished in the earlier portion of the day, when the brain is refreshed and repaired by the night's repose. Mental, like physical endurance, is modified by age, health and development. A person accustomed to concentration of thought, can endure a longer mental strain than one inured to manual labor only. One of the most injurious customs, is the cultivation of the intellect at the expense of the physical powers.

Mental Culture During Childhood. One of the greatest mistakes which people make in the management of their children, is to overtask their mental faculties. Although it is exceedingly gratifying to see children acquire knowledge, and manifest an understanding far beyond their years, this gratification is often purchased too dearly, for precocious children are apt to die young. The tissue of the brain and nerves of children is very delicate; they have not yet acquired the powers of endurance which older persons possess. The greater portion of the nutriment assimilated, is required for growth and organic development, and they can ill afford its expenditure for mental manifestations. They receive impressions easier and learn much more readily than in after life, but it is at the expense of the physical organization. Their mental faculties continue to be developed by the expenditure of brain nutriment, while physical growth and the powers of endurance are arrested. It is much better to give physical development the precedence in order that the mental organism may be well supported and its operations carried into effect; for it must be apparent to all that an ordinary intellect in a healthy body, is capable of accomplishing infinitely more than a strong mind in a weak body. Regularity should be observed in exercising the mental functions. For this reason a fixed order in the pursuit of any literary occupation is very essential. The pursuit of the most abstruse studies will thus become habitual and comparatively [pg 278]easy, a consequence of systematic application. Mental labor should always cease when the train of thought becomes confused, and there is the slightest sensation of depression. All distracting influences should be absent from the mind, in order to facilitate intense study, for the intellect cannot attend perfectly to two subjects at the same time. Painful sensations always have a tendency to paralyze mental exertion. Great care should be taken that the head is not subjected to injury of any kind, as it is almost invariably accompanied by some nervous derangement. Exposure to extreme heat should be carefully avoided. An attack of sun-stroke although it may not be immediately fatal, may occasion tumors in the brain, or some organic disease.

SLEEP.

For all animated beings sleep is an imperious necessity, as indispensable as food. The welfare of man requires alternate periods of activity and repose. It is a well-established physiological fact, that during the wakeful hours the vital energies are being expended, the powers of life diminished, and, if wakefulness is continued beyond a certain limit, the system becomes enfeebled and death is the result. During sleep there is a temporary cessation of vital expenditures, and a recuperation of all the forces. Under the influence of sleep "the blood is refreshed, the brain recruited, physical sufferings are extinguished, mental troubles are removed, the organism is relieved, and hope returns to the heart."

The severest punishment which can be inflicted upon a person, is to entirely deprive him of sleep. In China, a few years since, three criminals were sentenced to be kept awake until they should die. To do this it was necessary to keep a guard over them. The sentinels were armed with sharp, pointed instruments, with which to goad the victims and thus prevent them from sleeping. Life soon became a burden, and, although they were well fed during the time, death occurred sooner than it would have done had starvation been the punishment.

Sleeping Rooms. The sleeping room should be large and well ventilated, and the air kept moderately cool. The necessity for a fire may be determined by the health of the [pg 279]occupant. Besides maintaining a proper temperature in the room, a little fire is useful, especially if in a grate, for the purpose of securing good ventilation. The windows should not be so arranged as to allow a draught upon the body during the night, but yet so adjusted that the inmate may obtain plenty of fresh air.

The Bed should not be too soft, but rather hard. Feathers give off animal emanations of an injurious character, and impart a feeling of lassitude and debility to those sleeping on them. No more coverings should be used than are actually necessary for the comfort of the individual. Cotton sheets are warmer than linen, and answer equally as well.

Sleeping Alone. Certain effluvia are thrown off from our persons, and when two individuals sleep together each inhales from the other more or less of these emanations. There is little doubt that consumption, and many other diseases, not usually considered contagious, are sometimes communicated in this manner. When it is not practicable for individuals to occupy separate beds, the persons sleeping together should be of about the same age, and in good health. Numerous cases have occurred in which healthy, robust children have gradually declined and died within a few months, from the evil effects of sleeping with old people. Again, those in feeble health have been greatly benefited, and even restored, by sleeping with others who were young and healthy.

Time for Sleep. Night is the proper time for sleep. When day is substituted for night, the sleep obtained does not fully restore the exhausted energies of the system. Nature does not allow her laws to be broken with impunity.

Children require more sleep than old persons. They are sometimes stupefied with "soothing syrups," and preparations of opium, in order to get them temporarily out of the way. Such narcotics are very injurious and dangerous. We have known a young child to be killed by a single drop of laudanum. This practice, therefore, cannot be too emphatically condemned.

How to Put Children to Bed. The following characteristic lines are from the pen of Fanny Fern, and contain such good advice that we cannot refrain from quoting them: [pg 280]"Not with a reproof for any of the day's sins of omission or commission. Take any other time than bed-time for that. If you ever heard a little creature sighing or sobbing in its sleep, you could never do this. Seal their closing eyelids with a kiss and a blessing. The time will come, all too soon, when they will lay their heads upon their pillows lacking both. Let them at least have this sweet memory of happy childhood, of which no future sorrow or trouble can rob them. Give them their rosy youth. Nor need this involve wild license. The judicious parent will not so mistake my meaning. If you ever met the man or the woman, whose eyes have suddenly filled when a little child has crept trustingly to its mother's breast, you may have seen one in whose childhood's home 'dignity' and 'severity' stood where love and pity should have been. Too much indulgence has ruined thousands of children; too much love not one."

Position in Sleep. The proper position in sleep is upon the right side. The orifice leading from the stomach to the bowels being on this side, this position favors the passage of the contents into the duodenum. Lying on the back is injurious, since by so doing the spine becomes heated, especially if the person sleeps on feathers, the circulation is obstructed and local congestions are encouraged. The face should never be covered during sleep, since it necessitates the breathing of the same air over again, together with the emanations from the body.

The Amount of Sleep. The amount of sleep required varies with the age, habits, condition, and peculiarities of the individual. No definite rule can be given for the guidance of all. The average amount required, however, is eight or nine hours out of the twenty-four. Some persons need more than this, while others can do with less. Since both body and mind are recuperated by sleep, the more they are exhausted the more sleep is required. A person employed at mental labor should have more than one who is merely expending muscular strength. Six hours of unbroken sleep do more to refresh and revive than ten when frequently interrupted. If it is too prolonged it weakens and stupefies both body and mind. If an insufficient amount is taken the flagging energies are not [pg 281]restored. Persons who eat much, or use stimulants generally require more than others. To sleep regularity is desirable. If a person goes to bed at a certain hour for several nights in succession, it will soon become a habit. The same holds true with regard to rising. If children are put to sleep at a stated hour for several days in succession, it will soon become a habit with them.

CLEANLINESS.

"Cleanliness is next to godliness," and is essential to the health and vigor of the system. Its importance cannot be overestimated, and it should be inculcated early on the minds of the young. "Even from the body's purity, the mind receives a secret sympathetic aid."

When we consider the functions of the skin, with its myriads of minute glands, innumerable little tubes, employed in removing the worn-out, useless matter from the system, we cannot fail to appreciate the utility of frequent bathing with soap and water. Unless these excretions are removed, the glands become obstructed, their functions are arrested, and unpleasant odors arise. Many persons think because they daily bathe the face, neck, and hands, dress the hair becomingly and remove the dirt from their clothing that the height of cleanliness has been reached. From a hygienic point of view, bathing the entire body is of much greater importance.

Notwithstanding the necessity for cleanliness of the body, we occasionally meet with persons who, although particular about their personal appearance, permit their bodies to be for weeks and even months without a bath. Such neglect should never exceed one week. Plenty of sunlight and at least one or two general baths every week are essential to perfect health. Cleanliness is necessary to health, beauty, attractiveness, and a cheerful disposition.

CHAPTER IV.

HYGIENE OF THE REPRODUCTIVE ORGANS.

The structure and functions of organized bodies are subject to continual alteration. The changes of nutrition and growth, which are constantly taking place in the tissues render them at the same time the seat of repair and waste, of renovation and decomposition, of life and death. The plant germinates and blossoms, then withers and decays; animal life, in like manner, comes into being, grows to maturity, fades, and dies. It is, therefore, essential to the perpetuation of life, that new organisms be provided to take the place of those which are passing out of existence. There is no physiological process which presents more interesting phenomena than that of reproduction, which includes the formation, as well as the development of new beings.

Since self-preservation is Nature's first law, the desire for food is a most powerful instinct in all living animals. Not inferior to this law is that for the perpetuation of the race; and for this purpose, throughout the animal and vegetable kingdoms, we find the Biblical statement literally illustrated: "Male and female created He them."

Health is the gauge by which the prosperity of a people may be measured. Were we to trace the history of nations,—their rise and fall,—we would find that much of the barbarism and crime, degradation and vice, as well as their decline and final extinction, was due to licentiousness and sexual excesses. Since there is an intimate relation between mind and body, when the body is enfeebled the mind becomes enervated. Morbid [pg 283]conditions of the body prevent the highest mental development, and, on the other hand, when the mind is debilitated, general depravity, physical as well as mental, is the result. The highest development of the body results from the equal and harmonious cultivation of all the mental powers. The perfect development and health of the physical organs is therefore essential to the happiness of mankind. But, before health can be insured the nature and general functions of the physical system must be understood. This being done, the question naturally arises: How can health be best maintained and longevity secured?

Influence of Food. We have previously noticed the effects which food, exercise, and other hygienic agencies, have upon digestion, circulation, and respiration; and we find that they exert a not less potent influence upon the health of the generative organs. Excessive stimulation excites the sexual passions. For this reason, children should not be immoderately indulged in highly seasoned foods. Those persons who have great muscular vigor are endowed with violent passions, and unless restrained by moral considerations, are very likely to be overcome by their animal propensities.

Alcoholic stimulants have a debasing influence upon the whole system, and especially upon the sexual organs; they excite the animal and debase the moral nature; they exhaust the vitality, and, after the excitement, which they temporarily induce, has passed away, the body is left in a prostrated condition.

Physical Labor modifies the Passions. Labor consumes the surplus vitality which a person may possess, and no better protective can be found against the gratification of the passions, unless it be high moral training, than daily toil extended to such a degree as to produce fatigue. Labor determines the blood to the surface and to other parts of the body, and prevents excitement and congestion of the sexual centers. If, by education or association, the passions of children be excited, they will be increased. If, on the contrary, they be taught to avoid these social or solitary evils, they will be abated. Let them be educated to work and the intellectual faculties will assert their sway, the moral powers will be strengthened, and the body better developed, for purity of mind is the result of the perfect development of man.

[pg 284]Influences Of Climate. Individuals possess distinguishing peculiarities characteristic of the nation to which they belong. Climate exerts a powerful influence upon mankind. In tropical regions the inhabitants are enervated, effeminate, and sensual. The rich live in luxury and ease, vice is unrestrained and license unbridled. When the animal propensities are allowed to predominate, the mental faculties are kept in subjection. Hence races that inhabit those latitudes rarely produce scholars or philosophers. A warm climate hastens the development of the reproductive organs. Men and women become mature at a much earlier age in those regions, than in countries where the temperature is lower. In like manner there is a tendency to premature enfeeblement, for the earlier the system matures, the sooner it deteriorates.

Man is a Social Being. History demonstrates that when man is deprived of the society of women, he becomes reckless, vicious, depraved, and even barbarous in his habits, thus illustrating the maxim: "It is not good for man to be alone." Social intercourse promotes mental and physical development. The development of the individual implies the unfolding of every power, both physical and mental. Nothing so regulates and restrains passion as a healthy condition of the organs through which it finds expression. And every organ of the body is powerful in proportion to its soundness. The propensities play a prominent part in the education of the child. When properly disciplined and held in subordination to the higher faculties, they constitute an important factor in the economy of man. Boys are more liable to be morbidly excited when secluded from the society of girls, and vice versa. Again, when the sexes are accustomed to associate, the passions are not apt to be aroused, because of the natural antagonistic constitutional elements. The influence of the one refines, and ennobles the other. Let children be taught to understand their natures, and knowing them, they will learn self-government. "As man rises in education and moral feeling he proportionately rises in the power of self-restraint; and consequently as he becomes deprived of this wholesome law of discipline he sinks into self-indulgence and the brutality of savage life.

The passions may be aroused by the language, appearance [pg 285]or dress of the opposite sex. A word spoken without any impure intent is often construed in a very different sense by one whose passions color the thought, and is made to convey an impression entirely unlike that which was intended by the speaker. Also, the dress may be of such a character as to excite the sexual passion. The manner in which the apparel is worn is often so conspicuous as to become bawdy, thereby appealing to the libidinous desires, rather than awakening an admiration for the mental qualities.

Obscene Literature. Literature is a powerful agent either for good or evil. If we would improve the morals, choice literature must be selected, whether it be that which realizes the ideal, or idealizes the real. Obscene literature, or books written for the express purpose of exciting or intensifying sexual desires in the young, goads to an illicit gratification of the passions, and ruins the moral and physical nature.

It not unfrequently happens that a child is born with a vigorous, mental organism which promises a brilliant future, but manhood finds him incompetent, debilitated, and totally incapacitated for mental or manual labor. This may be the result of youthful indiscretion, ignorantly committed, but not unfrequently it is the effect of a pernicious literature which inflames the imagination, tramples upon reason, and describes to the youth a realm where the passions are the ruling deities.

Many persons are born into the world with disordered organizations for which they are not themselves responsible. Such individuals are entitled to the sympathy of humanity. Dyspepsia, scrofula, consumption, and a thousand ills to which mankind is heir, are inherited from parents, the results of ill-assorted marriages. Intoxicated parents often produce offspring utterly demented. Children of healthy parents, with good constitutions, are usually healthy and intelligent. There are marked varieties of character in children of the same parents. One manifests great precocity, another is below the average in mental attainments; one is amiable, another irritable in disposition; indeed, there are often as great differences between children of the same, as of different families. This is due to the physical and mental conditions of the parents, more especially the mother, not only at the time of the impregnation [pg 286]but also during the period intervening between conception and the birth of the offspring. The ancients regarded courage as the principal virtue. By us, purity is so estimated. Moral purity is an essential requisite to the growth and perfection of the character.

Self-Abuse. Untold miseries arise from the pollution of the body. Self-pollution, or onanism, is one of the most prolific sources of evil, since it leads both to the degradation of body and mind. It is practiced more or less by members of both sexes, and the habit once established, is overcome with the greatest difficulty. It is the source of numerous diseases which derange the functional activity of the organs involved, and eventually impair the constitution. This vicious habit is often practiced by those who are ignorant of its dangerous results. Statistics show that insanity is frequently caused by masturbation.

Immoderate indulgence in any practice is deleterious to the individual. Emphatically true is this with regard to sexual excesses. Not unfrequently does the marriage rite "cover a multitude of sins." The abuse of the conjugal relation produces the most serious results to both parties, and is a prolific source of some of the gravest forms of disease. Prostatorrhea, spermatorrhea, impotency, hypochondria, and general debility of the generative organs, arise from sexual excesses.

The health of the reproductive organs can only be maintained by leading a temperate life. The food should be nourishing but not stimulating. Lascivious thoughts should be banished from the mind, and a taste cultivated for that literature which is elevating in its nature, and the associations should be refining and ennobling. Let these conditions and the rules of hygiene, be observed, and virtue will reward her subjects with a fine physique and a noble character.

Woman, from the nature of her organization, has less strength and endurance than man. Much, however, of the suffering and misery which she experiences arises from insufficient attention to the sexual organs. The menstrual function is generally established between the ages of twelve and fourteen. For want of proper instruction, many a girl through ignorance has caused derangements which have enfeebled her womanhood [pg 287]or terminated her life. At this critical period the mother cannot be too considerate of her daughter's health. Preceding the first appearance of the menses, girls usually feel an aching in the back, pains in the limbs, chilliness, and general languor. The establishment of this function relieves these symptoms. Every precaution should be taken during the period to keep the feet dry and warm, to freely maintain a general circulation of the blood, to avoid exertion, and to refrain from standing or walking too much. Menstrual derangements should never be neglected, for they predispose to affections of the brain, liver, heart, and stomach, induce consumption and frequently end in death. Young women should, therefore, properly protect themselves, and avoid extremes of heat and cold.

CHAPTER V.

PRACTICAL SUMMARY OF HYGIENE.

1. The first step which should be taken for the prevention of disease, is to make provision for the health of the unborn child. Greater care should be exercised with women who are in a way to become mothers. Those who are surrounded by all the luxuries which health can bestow, indulge too much in rich food, and take too little exercise; while the poor get too little nourishment, and work too hard and too long. A woman in this condition should avoid over-exertion, and all scenes which excite the passions or powerful emotions. She should take moderate exercise in the open air; eat moderately of wholesome food, and of meat not oftener than twice a day; take tea or coffee in limited quantities, and avoid the use of all alcoholic liquors; she should go to bed early and take not less than nine hours sleep; her clothing should be loose, light in weight, and warm. She should take every precaution against exposure to contagious or infectious diseases.

2. There is no better method for preventing the spread of contagious diseases than perfect isolation of the infected, and thorough disinfection of all articles of clothing or bedding which have been in contact with the infected. Many persons erroneously believe that every child must necessarily have the measles, and other contagious diseases, and they, therefore, take no precautions against the exposure of their children. The liability to infection diminishes as age advances, and those individuals are, as a rule, the strongest and best developed who [pg 289]have never suffered from any of the contagious diseases. Although, vaccination is the great safeguard against-pox, yet it should never prevent the immediate isolation of those who are suffering from this disease.

3. To avoid the injurious effects of impure air, the following rules, should be carefully observed. The admission of air which contains anything that emits an unpleasant odor into closed rooms should be avoided. The temperature of every apartment should be kept as near 70° Fahr. as possible, and the air should not be overcharged with watery vapor. Provisions should be made for the free admission into and escape of air from the room at all times. When an apartment is not in use, it should be thoroughly ventilated by opening the windows. Those who are compelled to remain in an atmosphere tilled with dust, should wear a cotton-wool respirator.

4. To insure a healthy condition of the body, the diet of man ought to be varied, and all excesses should be avoided. The total amount of solid food taken in the twenty-four hours should not exceed two and a half pounds, and not more than one-third of this quantity should consist of animal food. Many persons do not require more than one pound and a half of mixed food. To avoid parasitic diseases, meat should not be eaten rare, especially pork. The amount of drink taken should not be more than three pints in twenty-four hours. The excessive use of tea and coffee should be avoided. Pickles, boiled cabbage, and other indigestible articles should never be eaten.

5. To avoid the evil effects of alcoholic liquors, perfect abstinence is the only safe course to pursue. Although one may use spirituous liquors in moderation for a long period of time and possibly remain healthy, yet such an indulgence is unnecessary and exceedingly dangerous. A person who abstains entirely from their use is safe from their pernicious influence; a person who indulges ever so moderately is in danger; a person who relies on such stimulants for support in the hour of need is lost.

6. While the use of tobacco is less pernicious than alcohol in its effects, et it exerts a profound disturbing influence upon the nervous system, and gives rise to various functional and organic diseases. This is the verdict of those who [pg 290]have given the subject the most study, and who have had the best opportunities for extensive observation. Suddenly fatal results have followed excesses in the use of tobacco. Therefore, the habit should be avoided, or if already acquired, it should be immediately abandoned.

7. The clothing should be light and porous, adapted in warmth to the season. It is especially important that persons in advanced life should be well protected against vicissitudes of heat and cold. Exposure is the cause of almost all those inflammatory diseases which occur during winter, and take off the feeble and the aged. The under-garments should be kept scrupulously clean by frequent changes. Corsets or bands which impede the flow of blood, compress the organs of the chest or abdomen, or restrict the movements of the body, are very injurious, and should not be worn. Articles of dress which are colored with irritating dye-stuffs, should be carefully avoided.

8. It matters not how varied a person's vocation may be, change, recreation, and rest are required. It is an error to suppose that more work can be done by omitting these. No single occupation which requires special mental or physical work, should be followed for more than eight hours out of the twenty-four. The physical organism is not constructed to run its full cycle of years and labor under a heavier burden than this. Physical and mental exercise is conducive to health and longevity, if not carried too far. It is erroneous to suppose that excessive physical exertion promotes health. Man was never intended to be a running or a jumping machine. In mental work, variety should be introduced. New work calls into play fresh portions of the brain, and secures repose for those parts which have become exhausted. Idleness should be avoided by all. Men should never retire from business as long as they enjoy a fair degree of health. Idleness and inactivity are opposed to nature.

9. The average length of time which a person ought to sleep is eight hours out of the twenty-four, and, as a rule, those who take this amount enjoy the best health. The most favorable time for sleep is between the hours of 10 P.M. and 6 A.M. All excitement, the use of stimulants, and excessive fatigue [pg 291]tend to prevent sleep. Sleeping rooms should be well ventilated, and the air maintained at a equable temperature of as near 60° Fahr. as possible. An inability to sleep at the proper time, or a regular inclination to sleep at other than the natural hours for it, is a certain indication of errors of habit, or of nervous derangement.

10. Prominent among all other measures for the maintenance of Health, is personal cleanliness. Activity in the functions of the skin is essential to perfect health, and this can only be secured by thoroughly bathing the entire body. Strictly, a person should bathe once every twenty-four or forty-eight hours. The body should be habituated to contact with cold water at all season of the year, so that warm water may not become a necessity. The simplest and most convenient bath, is the ordinary sponge-bath. An occasional hot-air, or Turkish bath, exerts a very beneficial influence. It cleans out the pores of the skin and increases its activity.

11. The emotions and the passions exert a powerful influence over the physical organism. It is important, therefore, that they be held under restraint by the reasoning faculties. This rule applies equally to joy, fear, and grief; to avarice, anger, and hatred; and, above all, to the sexual passion. They are a prolific source of disease of the nervous system, and have caused the dethronement of some of the most gifted intellects.

PART III.

RATIONAL MEDICINE.

CHAPTER I.

THE PROGRESS OF MEDICINE.

During the last half century a great change has taken place in the treatment of disease. Medicine has advanced with rapid strides, from the narrow limits of mere empiricism, to the broader realm of rationalism, until to day it comprehends all the elements of an art and a science. Scientific researches and investigations have added many valuable truths to the general fund of medical learning, but much more has been effected by observation and empirical discovery. It is of little or no interest to the invalid to know whether the prescribed remedy is organic or inorganic, simple, compound, or complex. In his anxiety and distress of body, he seeks solely for relief, without regard to the character of the remedial agents employed. But this indifference on the part of the patient does not obviate the necessity for a thorough, scientific education on the part of the practitioner. Notwithstanding all the laws enacted to raise the standard of medicine, and thus protect the public from quackery, there yet exists a disposition among many to cling to all that savors of the miraculous, or supernatural. To insure the future advancement of the healing art, physicians must instruct mankind in Physiology, Hygiene, and Medicine. When the people understand the nature of diseases, their causes, methods of prevention and cure, they will not be easily deceived, and practitioners will be obliged to qualify themselves better for their labors. The practice of medicine is every year becoming [pg 293]more successful. New and improved methods of treating disease are being discovered and developed, and the conscientious physician will avail himself of all the means, by a knowledge of which he may benefit his fellow-men. The medical profession is divided into three principal schools, or sects.

THE ALLOPATHIC, REGULAR, OR OLD SCHOOL OF MEDICINE.

This is the oldest existing branch of the profession. To it is due the credit of collecting and arranging the facts and discoveries which form the foundation of the healing art. It has done, and is doing, much to place the science of medicine on a firm basis. To the text-books of this school, every student who would qualify himself for medical practice must resort, to gain that knowledge upon which depends his future success. The early practice of this branch of the profession was necessarily crude and empirical. Conservative in its character, it has ever been slow to recognize new theories and methods of practice, and has failed to adopt them until they have been incontrovertibly established. This conservatism was manifested in the opposition to Harvey when he propounded the theory of the circulation of the blood, and to Jenner when he discovered and demonstrated the beneficial effects of vaccination. Thus has it ever defended its established opinions against innovation; yet out of this very conservatism has grown much real good, for, although it has wasted no time or energy in the investigation of theories, yet it has accepted them when established. In this manner it has added to its fund of knowledge only those truths which are of real and intrinsic value.

The history of medicine may be divided into three eras. In the first, the practice of medicine was merely empiricism. Ignorant priests or astrologers administered drugs, concerning the properties of which they had no knowledge, to appease the wrath of mythological deities. In the second or heroic era, the lancet, mercury, antimony, opium, and the blister were employed indiscriminately as the sine qua non of medical practice. The present, with all its scientific knowledge of the human structure and functions, and its vast resources for remedying disease may be aptly termed the liberal era of medicine. The allopathic [pg 294]differs from the other schools, mainly in the application of remedies. In its ranks are found men, indefatigable in their labors, delving deep into the mysteries of nature, and who, for their scientific attainments and humane principles are justly considered ornaments to society and to their profession.

HOMOEOPATHY.

Although this school is of comparatively recent origin, yet it has gained a powerful hold upon the public favor, and numbers among its patrons very many intelligent citizens. This fact alone would seem to indicate that it possesses some merit. The homeopathic differs from the allopathic school principally in its "law of cure," which, according to Hahnemann, its founder, was the doctrine of "similia similibus curantur" or "like cures like." Its method of treatment is founded upon the assumption that if a drug be given to a healthy person, symptoms will occur which, if transpiring in disease, would be mitigated by the same drug. While it may be exceedingly difficult for a member of another school to accept this doctrine and comprehend the method founded upon it, yet no one can deny that it contains some elements of truth.

Imbued with the spirit of progress, many of its most intelligent and successful practitioners have resorted to the use of appreciable quantities of medicine. This school associates hydropathy with its practice, and usually inculcates rigid dietetic and hygienic regulations. Many homoeopathic remedies are thoroughly triturated with sugar of milk, which renders them more palatable and efficacious. Whether we attribute their cures to the infinitesimal doses which many homoeopathists employ, to their "law of cure," to good nursing, or to the power of nature, it is nevertheless true that their practice is measurably successful. No doubt the homoeopathic practice has modified that of the other schools, by proving that diseases may be alleviated by smaller quantities of medicine than were formerly employed.

THE ECLECTIC SCHOOL.

This school, founded by Wooster Beach, instituted the most strenuous opposition to the employment of mercury, antimony, the blister, and the lancet. The members of this new school [pg 295]proclaimed that the action of heroic and noxious medicines was opposed to the operation of the vital forces, and proposed to substitute in their place safer and more efficacious agents, derived exclusively from the vegetable kingdom. The eclectics have investigated the properties of indigenous plants and have discovered many valuable remedies, which a kind and bounteous nature has so generously supplied for the healing of her children. Marked success attended the employment of these agents. In 1852, a committee on "Indigenous Medical Botany," appointed by the "American Medical Association," acknowledged that the practitioners of the regular school had been extremely ignorant of the medical virtues of plants, even of those of their own neighborhoods. The employment of podophyllin and leptandrin as substitutes for mercurials has been so successful that they are now used by practitioners of all schools. Although claiming to have been founded upon liberal principles, it may be questioned whether its adherents have not been quite as exclusive and dogmatic as those whom they have opposed. It cannot be denied, however, that the eclectics have added many important remedies to the Materia Medica. Their writings are important and useful contributions to the physician's library.

THE LIBERAL AND INDEPENDENT PHYSICIAN.

After this brief review of the various medical sects, the reader may be curious to learn to what sect the physicians of the Invalids' Hotel and Surgical Institute belong. Among them are to be found graduates from the colleges of all the different schools. They are not restricted by the tenets of any one sect, but claim the right and privilege, nay, consider it a duty, to select from all, such remedies as careful investigation, scientific research, and an extensive experience, have proved valuable. They resort to any and every agent which has been proved efficacious, whether it be vegetable or mineral.

And here arises a distinction between sanative remedial agents and those which are noxious. Many practitioners deplore the use of poisons, and advocate innocuous medicines which produce only curative results. We agree with them in one proposition, namely, that improper medicines not only poison, [pg 296]but frequently utterly destroy the health and body of the patient. Every physician should keep steadily in view the final effects, as well as present relief, and never employ any agent without regard to its ulterior consequences. However, an agent which is noxious in health, may prove a valuable remedy in disease. When morbid changes have taken place in the blood and tissues, when a general diseased condition of the bodily organs has occurred, then an agent, which is poisonous in health, may prove curative. For instance it is admitted that alcohol is a poison; that it prevents healthful assimilation, solidifies pepsin, begets a morbid appetite; that it produces intoxication, and that its habitual use destroys the body. It is, therefore, neither a hygienic nor a sanative agent, but strictly a noxious one; yet, its very distinct antiseptic properties render it valuable for remedial purposes, since these qualities promptly arrest that fatal form of decomposition of the animal fluids which is occasioned by snake-venom, which produces its deadly effects in the same manner as a drop of yeast ferments the largest mash. Alcohol checks this poisonous and deadly process and neutralizes its effects. Thus, alcohol, although a noxious agent, possesses a special curative influence in a morbid state of the human system; but its general remedial effects do not entitle it to the rank of a hygienic agent. We believe that medicine is undergoing a gradual change from the darkness of the past, with its ignorance, superstition, and barbarism, to the light of a glorious future. At each successive step in the path of progress, medicine approaches one degree nearer the realm of an exact science. The common object of the practitioners of all medical schools is the alleviation of human suffering. The only difference between the schools is in the remedies employed, the size of dose administered, and the results attained. These are insufficient grounds for bitter sectarianism. We are all fellow laborers in the same field. Before us lies a boundless expanse for exploration. There are new conditions of disease to be learned, new remedies to be discovered, and new properties of old ones to be examined.

We do not deplore the fact, that there are different schools in medicine, for this science has not reached perfection, and they tend to stimulate investigation. The remarks of Herbert [pg 297]Spencer on the "Multiplication of Schemes of Juvenile Culture," may be pertinently applied to the different schools in medicine with increased force. He says: "It is clear that dissent in education results in facilitating inquiry by the division in labor. Were we in possession of the true method, divergence from it would, of course, be prejudicial; but the true method having to be found, the efforts of numerous independent seekers carrying out their researches in different directions, constitute a better agency for finding it than any that could be devised. Each of them struck by some new thought which probably contains more or less of basis in facts—each of them zealous on behalf of his plan, fertile in expedients to test its correctness, and untiring in its efforts to make known its success—each of them merciless in its criticism on the rest—there cannot fail, by composition of forces, to be a gradual approximation of all towards the right course. Whatever portion of the normal method any one of them has discovered, must, by the constant exhibition of its results, force itself into adoption; whatever wrong practices he has joined with it must, by repeated experiment and failure, be exploded. And by this aggregation of truths and elimination of errors, there must eventually be developed a correct and complete body of doctrine. Of the three phases through which human opinion passes—the unanimity of the ignorant, the disagreement of the inquiring, and the unanimity of the wise—it is manifest that the second is the parent of the third."

We believe the time is coming when those maladies which are now considered fatal will be readily cured—when disease will be disarmed of its terrors. To be successful, a physician must be independent, free from all bigotry, having no narrow prejudice against his fellow-men, liberal, accepting new truths from whatever source they come, free from restrictions of societies, and an earnest laborer in the interests of the Great Physician.

CHAPTER II.

REMEDIES FOR DISEASE.

It will be our aim, throughout this book, to prescribe such remedies as are within the easy reach of all, and which may be safely employed. Many of those of the vegetable class are indigenous to this country, and may be procured in their strength and purity, at the proper season, by those residing in the localities where they grow, while all others advised may be obtained at any good drug-store. We shall endeavor to recommend such as can be procured and prepared with the least trouble and expense to the patient, when it is believed that they will be equally as efficacious as more expensive medicines.

PROPRIETARY MEDICINES.

Having the invalid's best interests in view, it will often happen that we cannot prescribe better or cheaper remedies nor those which are more effective or easily obtained, than some of our standard preparations, which are sold by all druggists. We are aware that there is a popular, and not altogether unfounded prejudice against "patent medicines," owing to the small amount of merit which many of them possess. The term "Patent Medicine" does not apply to Dr. Pierce's remedies, as no patent has ever been asked or obtained for them, nor have they been urged upon the public as "cure alls." They are simply favorite prescriptions, which, in a very extensive practice, have proved their superior remedial virtues in the cure of the diseases for which they are recommended.

From the time of Hippocrates down to the present day, [pg 299]physicians have classified diseases according to their causes, character or symptoms. It has been proved that diseases apparently different may often be cured by the same remedy. The reason for this singular fact is obvious. A single remedy may possess a variety of properties. Quinine, among other properties has a tonic which suggests its use in cases of debility; an antiperiodic, which renders it efficient in ague; and an anti-febrile property, which renders it efficacious in cases of fever. The result produced varies with the quantity given, the time of its administration, and the circumstances under which it is employed. Every practicing physician has his favorite remedies, which he oftenest recommends or uses, because he has the greatest confidence in their virtues. The patient does not know their composition. Even prescriptions are usually written in a language unintelligible to anybody but the druggist. As much secrecy is employed as in the preparation of proprietary medicines. Does the fact that an article is prepared by a process known only to the manufacturer render that article less valuable? How many physicians know the elementary composition of the remedies which they employ, some of which never have been analyzed? Few practitioners know how morphine, quinine, podophyllin, leptandrin, pepsin, or chloroform, are made, or how nauseous drugs are transformed into palatable elixirs; yet they do not hesitate to employ them. Is it not inconsistent to use a prescription the composition of which is unknown to us, and discard another preparation simply because it is accompanied by a printed statement of its properties with directions for its use?

Various journals in this country, have at different times published absurd formulæ purporting to be receipts for the preparation of "Dr. Sage's Catarrh Remedy" and Dr. Pierce's standard medicines, which, in most instances, have not contained a single ingredient which enters into the composition of these celebrated remedies.

In the manufacture of any pharmaceutical preparation, two conditions are essential to its perfection, viz: purity and strength of the materials, and appropriate machinery. The first is insured, by purchasing the materials in large quantities, whereby the exercise of greater care in selecting the ingredients can be [pg 300]afforded; and the second can only be accomplished where the business is extensive enough to warrant a large outlay of capital in procuring proper chemical apparatus. These facts apply with especial force to the manufacture of our medicines, their quality having been vastly improved since the demand has become so great as to require their manufacture in very large quantities. Some persons, while admitting that our medicines are good pharmaceutical compounds, object to them on the ground that they are too often used with insufficient judgment. We propose to obviate that difficulty by enlightening the people as to the structure and functions of their bodies, the causes, character, and symptoms of disease, and by indicating the proper and judicious employment of our medicines, together with such auxiliary treatment as may be necessary. Such is one of the designs of this volume.

PROPERTIES OF MEDICINE.

It is generally conceded that the action of a remedy upon the human system depends upon properties peculiar to it. The effects produced suggest the naming of these qualities, which have been scientifically classified. We shall name the diseases from their characteristic symptoms, and then, without commenting upon all the properties of a remedy, recommend its employment. Our reference to the qualities of any remedy, when we do make a particular allusion to them, we shall endeavor to make as easy and familiar as possible.

Dose. All persons are not equally susceptible to the influence of medicines. As a rule, women require smaller doses than men, and children less than women. Infants are very susceptible to the effects of anodynes, even out of all relative proportion to other kinds of medicines. The circumstances and conditions of the system increase or diminish the effects of medicine, so that an aperient at one time may act as a cathartic at another, and a dose that will simply prove to be an anodyne when the patient is suffering great pain will act as a narcotic when he is not. This explains why the same dose often affects individuals differently. The following table is given to indicate the size of the dose, and is graduated to the age.

The doses mentioned in the following pages are those for adults, except when otherwise specified.

The Preparation of Medicines. The remedies which we shall mention for domestic use are mostly vegetable. Infusions and decoctions of these will often be advised on account of the fact that they are more available than the tinctures, fluid extracts, and concentrated principles, which we prefer, and almost invariably employ in our practice. Most of these medical extracts are prepared in our chemical laboratory under the supervision of a careful and skilled pharmaceutist. No one, we presume, would expect, with only a dish of hot water and a stew-kettle, to equal in pharmaceutical skill the learned chemist with all his ingeniously devised and costly apparatus for extracting the active, remedial principles from medicinal plants. Yet infusions and decoctions are not without their value; and from the inferior quality of many of the fluid extracts and other pharmaceutical preparations in the market, it may be questioned whether the former are not frequently as valuable as the latter. So unreliable are a majority of the fluid extracts, tinctures, and concentrated, active principles found in the drug-stores, that we long since found it necessary to have prepared in our laboratory, most of those which we employ. To the reliability of the preparations which we secure in this way we largely attribute our great success in the treatment of disease. Tinctures and fluid extracts are often prepared from old and worthless roots, barks, and herbs which have wholly lost their medicinal properties. Yet they are sold at just as high prices as those which are good. We manufacture our tinctures, fluid extracts, and concentrated, active principles from roots, barks, and herbs which are fresh, and selected with the greatest care. Many of the crude roots, barks, and herbs found in the market are inactive because they have been gathered at the wrong season. These, together with those that have been kept on hand so long as to have lost all medicinal value, are often sold [pg 302]in large quantities, and at reduced prices, to be manufactured into fluid extracts and tinctures. Of course, the preparations made from such materials are worthless. Whenever the dose of fluid extracts, tinctures, and concentrated, active principles, is mentioned in this chapter, the quantity advised is based upon our experience in the use of these preparations, as they are made in our laboratory, and the smallest quantity which will produce the desired effect is always given. When using most of the preparations found in the drug-stores, the doses have to be somewhat increased, and even then they will not always produce the desired effect, for reasons already given.

The List of Medicines which we shall introduce in this chapter will be quite limited, as we cannot hope, by making it extensive, that the non-professional reader would be able to prescribe with good judgment any other than the simpler remedies. Hence, we prefer, since we have not space in this volume to waste, to mention only a few of the most common remedies under each head or classification.

Tinctures. Very uniform and reliable tinctures may be made of most indigenous plants, by procuring the part to be employed, at the proper season, while it is green and fresh, bruising it well, and covering it with good strong whiskey, or with alcohol diluted with one part of water to three of alcohol, corking tightly, and letting it stand about fourteen days, when the tincture may be filtered or poured off from the drugs, and will be ready for use. Prepared in this imperfect manner, they rill be found to be much more reliable than any of the fluid extracts found in the drug-stores. An excess of the crude drug should be used in preparing the tincture to insure a perfect saturation of the alcohol with its active principles.

Homoeopathic Tinctures. The tinctures prepared by several of the German and French pharmaceutists, and called by them "Mother Tinctures," to distinguish them from the dilutions made therefrom, we have found to be very reliable, so much superior to any similar preparations made in this country that we purchase from them all we use of Pulsatilla, Staphisagria, Drosera and several others. They are prepared with great care from the green, crude material, and although high in price, when compared with other tinctures, yet the greater [pg 303]certainty of action which we secure in our prescriptions by their employment more than repays for the expense and trouble in procuring them, for of what account is expense to the true physician when life may depend upon the virtue of the agent he employs?

Infusions. These are generally made by adding one-half ounce of the crude medicine to a pint of water, which should be closely covered, kept warm, and used as directed. Flowers, leaves, barks, and roots become impaired by age, and it is necessary to increase or diminish the dose according to the strength of the article employed.

Decoctions. The difference between a decoction and an infusion is, that the plant or substance is boiled in the production of the former, in order to obtain its soluble, medicinal qualities. Cover the vessel containing the ingredients, thus confining the vapor, and shutting out the atmospheric air which sometimes impairs the active principles and their medicinal qualities. The ordinary mode of preparing a decoction is to use one ounce of the plant, root, bark, flower, or substance to a pint of water. The dose internally varies from a tablespoonful to one ounce.

ALTERATIVES.

Alteratives are a class of medicines which in some inexplicable manner, gradually change certain morbid actions of the system, and establish a healthy condition instead. They stimulate the vital processes to renewed activity, and arouse the excretory organs to remove matter which ought to be eliminated. They facilitate the action of the secretory glands, tone them up, and give a new impulse to their operations, so that they can more expeditiously rid the system of worn-out and effete materials. In this way they alter, correct, and purify the fluids, tone up the organs, and re-establish their healthy functions. Alteratives may possess tonic, laxative, stimulant, or diuretic properties all combined in one agent. Or we may combine several alteratives, each having only one of these properties in one remedy. We propose to enumerate only a few alteratives, and give the doses which are usually prescribed; the list which we employ in our practice is very extensive, but it cannot be made available for domestic use.

[pg 304]Mandrake (Podophyllum Peltatum), also called May-apple, is a most valuable alterative. The root is the part used. Dose—Of decoction, one to two teaspoonfuls; of tincture, six to eight drops; of fluid extract, three to five drops; of its active principle, Podophyllin, one-twelfth to one-eighth of a grain.

Poke (Phytolacca Decandra), also called Skoke, Garget, or Pigeon-berry, is a valuable alterative. The root is the part used. Dose—Of decoction, one to three teaspoonfuls; of fluid extract, three to ten drops; of concentrated principle, Phytolaccin, one-fourth to one grain.

Yellow Dock (Rumex Crispus), The part used is the root. Dose—Of the infusion, one to three fluid ounces three times daily; of fluid extract, ten to thirty drops; of tincture twenty to forty drops.

Fig. 113. Tag Alder.

Tag Alder (Alnus Rubra), This is otherwise known as the Smooth, Common, or Swamp Alder. The bark is the part used. It is excellent in scrofula, syphilis, cutaneous and all blood diseases. Dose—Of decoction, one or two tablespoonfuls [pg 305]from three to five times daily; of tincture, one or two teaspoonfuls; of fluid extract, one-half to one teaspoonful; of concentrated principle, Alnuin, one-half to one grain.

Fig. 114. Black Cohosh.

Black Cohosh (Macrotys or Cimicifuga Racemosa) The part used is the root. Its other common names are Black Snake-root, or Squaw-root. Black Cohosh is an alterative stimulant, nervine, diaphoretic, tonic, and a cerebro-spinal stimulant. It is a useful remedy. Dose—Of decoction, one-fourth to [pg 306]one ounce; of tincture, ten to fifteen drops; of fluid extract, five to ten drops; of the concentrated principle, Macrotin, one-eighth to one-half grain.

Fig. 115. Blood-root.

Blood-root (Sanguinaria Canadensis), is also known as Red Puccoon. The part used is the root. In minute doses Blood-root is a valuable alterative, acting upon the biliary secretion and improving the circulation and digestion. Dose—Of powdered root, one-fourth to one-half grain; of tincture, one [pg 307]to two drops; of the fluid extract, one-half to one drop. When given in a fluid form it should be well diluted.

Burdock (Arctium Lappa). The root is the part used. Burdock is a valuable alterative in diseases of the blood. Dose—Of tincture, from one teaspoonful to a tablespoonful twenty minutes before meals; of fluid extract, one to two teaspoonfuls.

Blue Flag (Iris Versicolor). The part used is the root. Dose—Of the tincture, five to ten drops; of fluid extract, three to ten drops; of concentrated principle, Iridin, one-half to two grains.

Sweet Elder (Sambucus Canadensis). Sweet Elder-flowers are a valuable alterative, diuretic, mucous and glandular stimulant, excellent in eruptive, cutaneous, and scrofulous diseases of children. An infusion, fluid extract, or syrup, may be used in connection with the "Golden Medical Discovery." Both will be found valuable for cleansing the blood and stimulating the functions to a healthy condition. Dose—Of the infusion of the flowers, from one-half to one ounce, if freely taken, will operate as a laxative; of fluid extract, one-fourth to one-half teaspoonful. The flowers, or inner bark of the root, simmered in fresh butter, make a good ointment for most cutaneous affections.

Iodine. This agent, in the several forms of Iodide of Potassium, Iodide of Ammonium, Iodide of Iron, and Iodide of Lime, is largely employed by physicians, and often with most happy results. But for domestic use we cannot advise its employment, as it is liable to injure the invalid, when its action is carried too far, which is apt to be the case, when not administered under the supervision of a competent physician.

Mercury. The various preparations of mercury have a profound, alterative effect upon the system. When taken for some time, they change the quality and composition of the blood; cause a diminution in the number of red blood-corpuscles, and an increase in the various effete materials. In the vast majority of cases we prefer the vegetable alteratives, but in rare instances they exert a beneficial influence, in small doses. None of the preparations of mercury should be taken internally without the advice of a skillful physician, therefore, we shall not give their doses.

THE COMPOUNDING OF ALTERATIVES.

The efficacy of this class of remedies can be greatly increased by properly combining several of them into one compound.

This requires a knowledge of Pharmaceutical Chemistry; i.e., the preparation of compounds founded on the chemical relation and action of their several remedial, active principles. Many practitioners make combinations of remedies which neutralize each other's influence, instead of extending their efficacy and curative power.

Dr. Pierce's "Golden Medical Discovery," or Alterative Extract. This compound is a highly nutritive and tonic preparation, combining the remedial properties of the best vegetable alteratives at present known to the medical profession. In perfecting this alterative compound, and likewise other standard preparations of medicine, we have made an outlay of many thousand dollars for chemical apparatus, and special machinery by the aid of which these remedies have been brought to their present perfection. Great pains are taken to obtain the materials at the right season of the year, properly cured so that none of their remedial qualities may be impaired. We, therefore, can with great confidence recommend Dr. Pierce's "Golden Medical Discovery" as one of the best preparations of the alterative class. Like all others of this type, its action is insensible, producing gradual changes, arousing the excretory glands to remove morbid materials, and at the same time toning the secretory organs. The manufacture of this compound is under the special supervision of a competent chemist and pharmaceutist, and it is now put up in bottles wrapped with full directions for its use. We can confidently recommend this compound whenever an alterative is required to cleanse the blood, tone the system, increase its nutrition, and establish a healthy condition. For these reasons we shall often advise its employment.

Dr. Pierce's Pleasant Purgative Pellets. These pellets combine the pure, concentrated, active principles of several vegetable alteratives, and the result is, that within the small compass of a few grains he has most happily blended and chemically condensed these properties so that their action upon [pg 309]the animal economy is sanative and universal. They awaken the latent powers, quicken the tardy functions, check morbid deposits, dissolve hard concretions, remove obstructions, promote depuration, harmonize and restore the functions, equalize the circulation, and encourage the action of the nervous system. They stimulate the glands, increase the peristaltic movement of the intestines, tone the nutritive processes, while aiding in evacuating the bowels. All this they accomplish without corroding the tissues or vitiating the fluids. Their assistance is genial, helping the system to expel worn out materials, which would become noxious if retained. Having expended their remedial powers upon the various functions of the body, they are themselves expelled along with other waste matter, leaving behind them no traces of irritation. This cannot be said of mercurials, or of other harsh, mineral alteratives. These Pellets may be safely employed when the system is feeble, frail, and delicate, by giving them in less quantities. Dose—As an alterative, only one or two Pellets should be taken daily.

ALKALIES.

Alkalies. These constitute an important list of remedial agents, their administration being frequently indicated. The employment of other medicines frequently should be preceded by the administration of an agent of this class, to neutralize excessive acidity in the stomach and bowels. Unless this be done, many medicines will fail to produce their specific effects.

Sulphite of Soda (Sodæ Sulphis). This salt, as well as the Hyposulphite of Soda, is not only generally preferable for administration on account of its unirritating character and the smallness of the dose required, but also because it is a valuable antiseptic agent. The Sulphite should not be confounded with the Sulphate of Soda (Glauber's Salt). Dose—This is from three to ten grains.

Saleratus (Potassoe Bicarbonas). This is a favorite domestic antacid. Dose—Five to fifteen grains is the amount.

ACIDS.

As alkalies are important and often indicated as remedial agents, acids, so their re-agents, acids, are also frequently [pg 310]necessary to meet opposite conditions of the fluids of the system.

Hydrochloric or Muriatic Acid. This agent may be administered in doses of from five to ten drops, largely diluted in water or gruel.

Aromatic Sulphuric Acid, or Elixir of Vitriol, is the most agreeable form of Sulphuric Acid for administration, and may be given in doses of from five to fifteen drops, largely diluted with water.

In taking acids, they should be sucked through a straw, and not allowed to come in contact with the teeth, as otherwise the latter organs will be injured by their effects; or should the acid come in contact with the teeth, the mouth should be immediately rinsed with a solution of saleratus or soda, to neutralize the acid.

ANODYNES.

Anodynes are those medicines which relieve pain by blunting the sensibility of the nerves, or of the brain, so that it does not appreciate the morbid sensation. An anodyne may be a stimulant in one dose, and a narcotic in a larger one. The properties of different anodyne agents vary, consequently they produce unlike effects. The size of the dose required, differs according to circumstances and condition. An adult, suffering acute pain, requires a much larger dose to produce an anodyne effect than one who is a chronic sufferer. An individual accustomed to the use of anodynes, requires a much larger dose to procure relief than one who is not. Doses may be repeated, until their characteristic effects are produced, after an interval of thirty or forty minutes. When the stomach is very sensitive and will not tolerate their internal administration, one-sixth of a grain of Morphia can be inserted beneath the skin, by means of a hypodermic syringe. Relief is more quickly experienced, and the anodyne effect is much more lasting than when taken into the stomach.

Opium (Papaver Somniferum). Opium is a stimulant, anodyne, or narcotic, according to the size of the dose administered. Dose—Of the dry powder, one-fourth to one grain; of tincture (Laudanum), five to fifteen drops; of camphorated tincture (Paregoric), one-half to one teaspoonful; of [pg 311]Morphine, one-eighth to one-fourth grain; of Dover's Powder three to five grains.

Hyoscyamus (Hyoscyamus Niger), commonly known as Henbane. The herb is used. It is a powerful narcotic, and unlike Opium, does not constipate the bowels, but possesses a laxative tendency. Therefore, it may be employed as an anodyne for allaying pain, calming the mind, inducing sleep and arresting spasms, when opiates are inadmissible. Dose—Of alcoholic extract, one-half to two grains; of fluid extract, five to ten drops; of the concentrated principle, Hyoscyamin, one-twelfth to one-fourth of a grain.

Fig. 116. Poison Hemlock.

Poison Hemlock (Conium Maculatum). The leaves are the parts used. Poison Parsley, as it is sometimes called, is an anodyne, narcotic, and an excellent alterative. Dose—Of fluid [pg 312]extract, two to six drops; of solid extract, one-fourth to one-half grain.

Belladonna (Atropa Belladonna) or Deadly Nightshade. The herb or leaves are a valuable agent. In overdoses, it is an energetic, narcotic poison. In medicinal doses it is anodyne, antispasmodic, diaphoretic, and diuretic. It is excellent in neuralgia, epilepsy, mania, amaurosis, whooping-cough, stricture, rigidity of the os uteri, and is supposed by some to be a prophylactic or preventive of Scarlet Fever. Its influence upon the nerve centers is remarkable. It relaxes the blood vessels on the surface of the body and induces capillary congestion, redness of the eye, scarlet appearance of the face, tongue, and body. Dose—Of fluid extract, one-half to one drop; of tincture, one to two drops; of concentrated principle, Atropin, one-thirtieth to one-sixteenth of a grain; of the Alkaloid, Atropia, one-sixtieth of a grain. Even the most skillful chemists are very cautious in compounding these latter active principles, and the danger of an overdose is great.

Camphor. This drug is an anodyne, stimulant, and diaphoretic, and, in large doses, a narcotic and an irritant. It is an excellent stimulant for liniments. Dose—Of the powder, one to five grains; of the tincture, ten to twenty drops, given in simple syrup.

Hops (Humulus Lupulus). This is an excellent remedy in wakefulness, and may be used when opium is contra-indicated. A bag of the leaves, moistened with whiskey and placed as a pillow under the head, acts as an anodyne. Dose—Of the infusion of the leaves, from one to four ounces; of the fluid extract, one-fourth to three-fourths of a teaspoonful; of the concentrated principle, Humulin, one to three grains.

Dr. Pierce's Compound Extract of Smart-weed. This anodyne compound is made by uniting several of the most valuable agents of this class, and its medicinal qualities are rendered still more efficacious by the addition of certain stimulating articles. It is free from narcotic properties which are liable to produce deleterious results, and has been found to be not only harmless in its action, but very genial and effectual withal, and most reliable as a stimulant and diaphoretic remedy.

ANTHELMINTICS.

Anthelmintic means "against a worm," and is a term employed to designate those medicines which destroy or expel worms. It means the same as Vermifuge. Little is understood concerning the origin of worms. There are five distinct varieties described by authors as being more common than others. There is the long worm, the short, or pin-worm, the thread-worm, the tape-worm, and the broad tape-worm peculiar to some countries of Europe. Irritation of the alimentary canal, from whatever cause usually produces an abundant secretion of mucus, which is thought to be a condition favorable for their production. Therefore, those medicines which remove the cause of this irritation tend to diminish the number, if not to entirely destroy the worms. Some medicines kill the worms, others expel them alive. The remedies which successfully remove one kind of worm, have little effect upon another, and to meet these different conditions, we have a variety of worm-destroying medicines. The pin-worm, inhabits the rectum, and may be destroyed by injecting into it a strong solution of salt, or decoction of aloes, and when it is allowed to pass away, the rectum should be anointed with vaseline, butter, or lard. The eggs of this worm are developed around the orifice of the large intestine, and when this latter precaution is not practiced every time there is a passage from the bowels, they will multiply as rapidly as they can be destroyed. Generally, vermifuge remedies should be taken when the stomach is empty, and should be followed by the administration of a cathartic in two hours after the last dose is administered.

Santonin. This is decidedly the most reliable anthelmintic known to the medical profession. It is deservedly a popular remedy for worms, and when combined with Podophyllin, is very efficacious in removing the pin-worm. Dose—For an adult, two to three grains of the powdered Santonin, repeated every three hours until four or five doses are taken, when it should be followed by a cathartic.

Sage (Salvia Officinalis). Sage is a common and excellent domestic remedy for worms. Make an infusion of Sage and Senna leaves, and drink freely until it acts as a cathartic.

Fig. 117. Pink Root.

Pink-root (Spigelia Marilandica). Pink-root is one of the most active and certain anthelmintics for children. It is indigenous to the United States. When taken in too large quantities, it is apt to purge, give rise to vertigo, dimness of vision, and even to convulsions; therefore, it should be [pg 315]combined with some cathartic. Dose—Of the infusion, one ounce at night, followed by physic in the morning.

Common Salt (Chloride of Sodium). Common table salt is an anthelmintic, and may be used in an emergency. Salt water is a very common domestic remedy for worms. Dose—In solution, one-quarter to one-half teaspoonful.

Balmony (Chelone Glabra). This is also tonic and anthelmintic, and is valuable in debility, dyspepsia, jaundice, and hepatic affections. It also is known as Snake-head. Dose—Of the infusion, one to two ounces; of the concentrated principle, Chelonin, from half to one grain.

Male Fern (Aspidium Filix Mas). Male Fern is the anthelmintic which is considered especially effectual in removing the tape-worm. Dose—Of the powder, one to two drachms, given morning and evening in syrup, followed by a brisk cathartic. The dose of the tincture of the buds in ether is from eight to thirty drops.

Fig. 118. Aspen.

Poplar (Populus Tremuloides). The White or Aspen Poplar is a common tree, and contains active principles termed Populin and Salicin, both of which are tonic. An infusion of the bark is a remedy for worms. Dose—Of the tea made from the bark, one to four ounces; of Populin, from one-half to two grains.

ANTIPERIODICS.

It is well understood that malarial diseases are characterized by a periodicity which indicates their nature. Antiperiodics prevent the recurrence of the periodic manifestations, and hence their name.

Quinine (Sulphate of Quinia). Quinine is a tonic, febrifuge, and antiperiodic. It should generally be administered during the intervals between the febrile paroxysms. It is beneficial also in all diseases accompanied by debility. The dose varies from one to six grains according to indications. Frequently it is given in much [pg 316]larger quantities, but we cannot advise such for domestic use.

Prussian Blue (Ferri Ferrocyanidum). Ferrocyanide of Iron is an excellent tonic and antiperiodic remedy, and often is combined with quinine. Dose—From two to five grains.

Fig. 119. Boneset.

Boneset (Eupatorium Perfoliatum), or Thoroughwort. This is tonic, diaphoretic, aperient, and possesses some antiperiodic properties; the warm infusion is emetic. Dose—Of the infusion, one to four ounces; of the fluid extract, from half to one teaspoonful; of the active principle, Eupatorin, one to three grains.

The "Golden Medical Discovery" has gained an enviable reputation in malarial districts for the cure of ague. From observing its action in the cure of this and other miasmatic diseases, and knowing its composition, we are thoroughly [pg 317]satisfied that it contains chemical properties which neutralize and destroy the miasmatic or ague poison which is in the system, and, at the same time, produces a rapid excretion of the neutralized poisons. One strong proof of this is found in the fact that persons who are cured with it are not so liable to relapse as those in whom the chills are broken with Quinine or other agents. No bad effects are experienced after an attack of ague which has been cured with the "Golden Medical Discovery." This cannot be said of Quinine, Peruvian Bark, Arsenic, and Mercurials, which comprise nearly the whole list of remedies usually resorted to by physicians for arresting ague. The "Golden Medical Discovery" not only has the merit of being a certain antidote for miasmatic diseases, but is pleasant to the taste, a matter of no small importance, especially when administered to children. To break the chills, this medicine should be taken in doses of four teaspoonfuls three times a day, and if this treatment pursued for three days, does not entirely arrest the chills, these doses may be repeated in alternation with five-grain doses of quinine for the three succeeding days. But in no case should more than this amount of the "Golden Medical Discovery" be given.

ANTISEPTICS AND DISINFECTANTS.

Antiseptics prevent, while disinfectants arrest putrefaction. Oxygen is a natural disinfectant, but a powerful inciter of change. Although this element is the cause of animal and vegetable decay, yet oxidation is the grand process by which the earth, air, and sea are purified. A few substances are both antiseptic and disinfectant. Heat up to a temperature of 140° Fahr. promotes putrescence, but above that point, is a drier or disorganizer, and destroys the source of infection.

Yeast (Cerevisiæ Fermentum). Yeast is an antiseptic, and is effective in all diseases in which there is threatened putridity. Used externally, it is often combined with elm bark and charcoal, and applied to ulcers, in which there is a tendency to gangrene. Dose—One tablespoonful in wine or porter, once in two or three hours.

Creasote. This is a powerful antiseptic. It is used in a [pg 318]solution of glycerine, oil, water, or syrup. Dose—One to two drops, largely diluted.

Carbolic Acid is a crystalline substance resembling creasote in its properties. It is an antiseptic, and is used both internally and externally. Dose—One-fourth to one-half drop of the melted crystals, very largely diluted. Externally, in solution, one to five grains of the crystals to one ounce of the solvent.

White Vitriol (Zinci Sulphas). White vitriol is a valuable disinfectant, as it will arrest mortification. In solution it is employed in ulcers and cancers and also as a gargle in putrid sore throat. Dose—One-half to two grains in a pill; in solution, one to ten grains in an ounce of water.

Permanganate of Potash (Potassoe Permanganas). This substance is an energetic deodorizer and disinfectant. A solution containing from one to twenty grains in an ounce of water is used as a lotion for foul ulcers. Dose—One-eighth to one-fourth of a grain.

Wild Indigo (Baptisia Tinctoria). The root is the part used. This plant possesses valuable antiseptic properties. It is an excellent lotion for ill-conditioned ulcers, malignant sore throat, nursing sore-mouth, syphilitic ophthalmia, etc. It is sometimes administered in scarlet and typhus fevers, and in all diseases in which there is a tendency to putrescence. Dose—Of the infusion, one-fourth to one-half ounce; of the fluid extract, from three to ten drops, and of the concentrated, active principle of the plant, Baptisin, from one to two grains.

ANTISPASMODICS.

Antispasmodics are a class of remedies which relieve cramps, convulsions, and spasms, and are closely allied to nervines. Indeed some authors class them together. The following are a few of the most important antispasmodics:

Assafetida (Assafetida Ferula). This is a powerful antispasmodic. It is employed in hysteria, hypochondria, convulsions, and spasms, when unaccompanied by inflammation. Dose—Of the gum or powder, from three to ten grains, usually administered in the form of a pill; of the tincture, from one-half to one teaspoonful.

Fig. 120. Yellow Jessamine.

Yellow Jessamine (Gelseminum Sempervirens). The root is the part used. This is a valuable remedy in various diseases when associated with restlessness and a determination of the blood to the brain; also in the neuralgia. Dose—Of the [pg 320]fluid extract, three to eight drops; of the concentrated principle, Gelsemin, one-fourth to one grain. The use of this drug by non-professional persons should be attended with great caution.

Valerian (Valeriana Officinalis). The root is the part used. Valerian is an effective remedy in cases of nervousness and restlessness. Dose—Of the infusion, (one-half ounce to a pint of water) one-half ounce; of the tincture, one-half to two tablespoonfuls; of the ammoniated tincture of valerian, from one-half to two teaspoonfuls in sweetened water or milk; of the valerianate of ammonia, one-half to three grains.

Yellow Lady's Slipper (Cypripedium Pubescens). The root is the part used. This is a useful remedy in hysteria, chorea, and all cases of irritability. Dose—Of the powder, fifteen to thirty grains; of the infusion, one ounce; of the fluid extract, fifteen to thirty drops; of the concentrated principle, Cypripedin, one-half to two grains.

Wild Yam (Dioscorea Villosa). The root is the part used. This is a powerful antispasmodic, and has been successfully used in bilious colic, nausea, and spasm of the bowels. Dose—Of the infusion (two ounces to a pint of water), one to two ounces; of the fluid extract, five to fifteen drops; of the concentrated principle, Dioscorein, one-half to one grain.

High Cranberry (Viburnum Opulus.) The bark is the part used. It is also known as Cramp Bark. This is a powerful antispasmodic, and is effective in relaxing spasms of all kinds. It is a valuable agent in threatened abortion. Dose—Of the infusion, one-half to one ounce; of the fluid extract, one-half to one teaspoonful; of the concentrated principle, Viburnin, one-half to two grains. These doses may be increased if necessary.

ASTRINGENTS.

Astringents are medicines which condense and coagulate the tissues, thereby arresting discharges. When taken into the mouth, they produce the sensation known as puckering. They are used internally and locally. The term styptic is used as a synonym of astringent, but is generally employed to designate those astringents which arrest hemorrhage, or bleeding.

[pg 321]Logwood (Hoematoxylon Campechianum). Logwood is a mild astringent, well adapted to remedy the relaxed condition of the bowels after cholera infantum. Dose—Of powdered extract, five to ten grains; of the decoction, one ounce; of the fluid extract, fifteen to thirty drops.

Blackberry Root (Rubus Villosus). This astringent is a favorite, domestic remedy in affections of the bowels. Dose—Of the infusion (bruised root), one-half to one ounce, sweetened.

Fig. 121. Witch-hazel.

Witch-hazel (Hamamelis Virginica). The parts used are the leaves and bark. This is a most valuable astringent and exerts a specific action upon the nervous system. It arrests many forms of uterine hemorrhage with great promptness, is a valuable agent in the treatment of piles, and is useful in [pg 322]many forms of chronic throat and bronchial affections. Dose-Of the infusion, one-fourth to one-half ounce; of the fluid extract, eight to fifteen grains; of the concentrated principle, Hamamelin, one fourth to one grain.

Fig. 122. Cranesbill.

Cranesbill (Geranium Maculatum). The root is used. This plant is also known as Crow-foot, and Spotted Geranium. It is a pleasant, but powerful astringent. Dose—Of the fluid [pg 323]extract, ten to thirty drops; of the concentrated principle, Geranin, one to two grains.

Fig. 123. Bugle-weed.

Fig. 124. Hardhack.

Hardhack (Spirea Tomentosa), Spirea, or Meadow Sweet. The stem and leaves are used. It is a tonic and an astringent, and is used in diarrhea and cholera-infantum. Dose—Of the infusion, one-half to one ounce; of the fluid extract, three to six drops.

Bugle-weed (Lycopus Virginicus). This is variously known as Water-hoarhound and Water-bugle. It is sedative and tonic, as well as astringent, and is employed in hemorrhages [pg 324]and in incipient phthisis. Dose—Of the infusion, one to two ounces; of the fluid extract, fifteen to twenty-five drops; of the concentrated principle, Lycopin, one-half to one grain.

Fig. 125. Canada Fleabane.

Canada Fleabane (Erigeron Canadense). The leaves and flowers are used. This plant, sometimes known as Colt's-tail, Pride-weed, or Butter-weed, is astringent, and has been [pg 325]efficiently employed in uterine hemorrhages. Dose—Of the infusion (two ounces of the herb to one pint of water), one to two ounces; of the oil, five to ten drops on sugar, repeated at intervals of from one to four hours.

Catechu (Acacia Catechu). A tincture of this plant is a pure, powerful astringent, and is especially useful in chronic diarrhea, chronic catarrh, and chronic dysentery. Dose—Of the powder, five to twenty grains; of the tincture, one-half to two teaspoonfuls.

Tannin (Acidum, Tannicum). This acid has a wide range of application. It is used as an astringent. Dose—One to five grains.

Gallic Acid (Acidum Gallicum). This remedy is used chiefly in hemorrhages. Dose—Three to five grains. In severe hemorrhages, this quantity should be administered every half hour, until the bleeding is checked.

CARMINATIVES.

Carminatives are medicines which allay intestinal pain, arrest or prevent griping caused by cathartics and exert a general soothing effect. They are aromatic, and to a certain extent, stimulant.

Anise-seed (Pimpinella Anisum). Anise is a pleasant, aromatic carminative, and is used in flatulent colic. Dose—Of the powdered seed, ten to fifteen grains; of the infusion (a teaspoonful of seed to a gill of water), sweetened, may be given freely; of the oil, five to ten drops on sugar.

Fennel-seed (Anethum Foeniculum). This is one of our most grateful aromatics, and is sometimes employed to modify the action of senna and rhubarb. Dose—Same as that of anise-seed.

Ginger (Zingiber Officinale). The root is the part used. This is a grateful stimulant and carminative. Dose—Of the powder, ten to twenty grains; of the infusion, one teaspoonful in a gill of water; of the tincture, twenty to thirty drops; of the essence, ten to fifteen drops; of the syrup, one teaspoonful.

Wintergreen (Gaultheria Procumbens). The leaves are used. This plant possesses stimulant, aromatic, and astringent properties. The essence of Wintergreen is carminative, and is [pg 326]used in colics. Dose—Of the essence, one-half to one teaspoonful in sweetened water; of the oil, three to five drops on sugar.

Peppermint (Mentha Piperita). Peppermint is a powerful stimulant, carminative, and antispasmodic. It is used in the treatment of spasms, colic, and hysteria. Dose—The infusion may be used freely. The essence may be taken in doses of fifteen to thirty drops in sweetened warm water; of the oil, one to five drops on sugar.

Spearmint (Mentha Viridis). The carminative properties of spearmint are inferior to those of peppermint, and its chief employment is for its diuretic and febrifuge virtues. Dose—Same as that of peppermint.

Compound Extract of Smart-weed. Dr. Pierce's Extract of Smart-weed is a valuable carminative and aromatic stimulant, and has been employed with marked success in all diseases in which this class of remedies is required.

CATHARTICS.

Cathartics, or Purgatives are medicines which act upon the bowels and increase the secretions and evacuations. In many parts of the country, these agents are known as purges, or physics. They have been variously divided and subdivided, usually with reference to the energy of their operations or the character of the evacuations produced.

Laxatives, or Aperients, are mild cathartics. Purgatives act with more energy and produce several discharges which are of a more liquid character and more copious than the former.

Drastics are those cathartics which produce numerous evacuations accompanied by more or less intestinal irritation.

Hydragogues are those purgatives which produce copious, watery discharges.

Cholagogues are those purgatives which act upon the liver, stimulating its functions. Cathartics constitute a class of remedies which are almost universally employed by families and physicians.

Jalap (Ipomoea Jalapa). The root is used. It is a drastic and a hydragogue cathartic. Formerly it was combined with equal parts of calomel. From this fact it received the name of "ten and ten." Dose—Of the powder, five to twenty grains; [pg 327]of the fluid extract, ten to fifteen drops; of the solid extract, two to four grains; of the concentrated principle, Jalapin, one-half to two grains.

Fig. 126. Culver's-root.

Gamboge (Gambogia). The gum is used. Gamboge is a powerful drastic, hydragogue cathartic, which is apt to produce nausea and vomiting. It is employed in dropsy. It should never be given alone, but combined with milder cathartics. It accelerates their action while they moderate its violence. Dose—Of the powder, one-half to two grains. This substance combined with aloes and sometimes with scammony, constitutes the basis of the numerous varieties of large, cathartic pills found in the market.

Culver's-root. (Leptandra Virginica). The root is used. This plant, known under the various names of Culver's Physic, Black-root, Tall Speedwell, and Indian Physic, is a certain cholagogue, laxative, and cathartic. Dose—Of decoction, one to two fluid ounces; of fluid extract, ten to twenty drops; of tincture, twenty to thirty drops; of the concentrated, active principle, Leptandrin, which is but feebly cathartic, as a laxative, two to five grains.

Rhubarb (Rheum Palmatum). This is much used as a domestic remedy, and by the profession, for its laxative, tonic, and astringent effects. It is employed in bowel complaints. Dose—Of the powder, ten to thirty grains; of the tincture, one-half to two teaspoonfuls; of the fluid extract, ten to thirty drops; of the solid extract, three to five grains; of the syrup, and aromatic [pg 328]syrup, an excellent remedy for children, one-half to one teaspoonful.

Cascara Sagrada (Rhamnus Purshiana), is a very efficient remedy in chronic constipation. Dose—Of the fluid extract, from ten to twenty drops taken in a tablespoonful of water. The unpleasant taste may be disguised with the extract of liquorice.

Castor Oil (Oleum Ricini). Dose—From one to four teaspoonfuls. It may be disguised by rubbing it with an equal quantity of glycerine and adding one or two drops of oil of anise, cinnamon, or wintergreen.

Butternut (Juglans Cinerea). The bark is the part used. Butternut is a mild cathartic, which resembles rhubarb in its property of evacuating the bowels without irritating the alimentary canal. Dose—Of the extract, as a cathartic, five to ten grains; of the fluid extract, one-half to one teaspoonful; of the concentrated principle, Juglandin, one to three grains. As a laxative, one-half of these quantities is sufficient.

Aloes (Aloe). The gum is used. This cathartic acts upon the lower part of the bowels and sometimes causes piles; though some late authors claim that in small doses it is a valuable remedy for piles. Dose—In powder or pill, three to ten grains; as a laxative, one to three grains.

Epsom Salts (Magnesia Sulphas). Its common name is "Salts." Much used in domestic practice. Dose—One-fourth to one-half ounce.

Dr. Pierce's Pleasant Pellets, being entirely vegetable in their composition, operate without disturbance to the system, diet, or occupation. Put up in glass vials. Always fresh and reliable. As a laxative, alterative, or gently acting but searching cathartic, these little Pellets give the most perfect satisfaction. Sick Headache, Bilious Headache, Dizziness, Constipation, Indigestion, Bilious Attacks, and all derangements of the stomach and bowels, are promptly relieved and permanently cured by the use of Dr. Pierce's Pleasant Pellets. In explanation of the remedial power of these Pellets over so great a variety of diseases, it may truthfully be said that their action upon the system is universal, not a gland or tissue escaping their sanative influence.

[pg 329]Everybody, now and then, needs a gentle laxative to assist nature a little; or, a more searching and cleansing, yet gentle cathartic, to remove offending matter from the stomach and bowels and tone up and invigorate the liver and quicken its tardy action. Thereby the "Pleasant Pellets" cure biliousness, sick and bilious headache, costiveness, or constipation of the bowels, sour stomach, windy belchings, "heart-burn," pain and distress after eating, and kindred derangements of the liver, stomach and bowels.

Persons subject to any of these troubles should never be without a vial of the "Pleasant Pellets" at hand. In proof of their superior excellence it can be truthfully said that they are always adopted as a household remedy after the first trial.

The "Pleasant Pellets" are far more effective in arousing the liver to action than "blue pills," the old-fashioned compound cathartic pills, calomel or other mercurial preparations, and have the further merit of being purely vegetable in their composition and perfectly harmless in any condition of the system. Furthermore, no particular care is required while using them.

Being composed of the choicest, concentrated vegetable extracts, their cost of production is much more than that of most pills found in the market, yet from forty to forty-four of them are put up in each glass vial, as sold through druggists, and can be had at the price of the more ordinary and cheaper made pills. Once used, they are always in favor. Their secondary effect is to keep the bowels open and regular, not to further constipate, as is the case with other pills. Hence, their great popularity with sufferers from habitual constipation, piles and their attendant discomfort and manifold derangements.

For all laxative and cathartic purposes the "Pleasant Pellets" are infinitely superior to all "mineral waters," sediltz powders, "salts," castor oil, fruit syrups (so-called), laxative "teas," and the many other purgative compounds sold in various forms.

If people generally, would pay more attention to properly regulating the action of their bowels, they would have less frequent occasion to call for their doctor's services to subdue attacks of dangerous diseases. Hence it is of great importance to know what safe, harmless agent best serves the purpose of producing the desired action.

DIRECTIONS FOR USING DR. PIERCE'S PLEASANT PELLETS.

In all cases, the size of dose to be taken must be regulated somewhat by the known susceptibility of the individual to the action of laxative and cathartic medicines. Some persons' bowels are readily acted upon by small doses, while others require more. As a general rule, the smaller doses which we recommend, are quite sufficient, and produce the best results if persisted in for a reasonable length of time.

FOR A GENTLE APERIENT, OR LAXATIVE, take one or not more than two and preferably in the morning, on an empty stomach.

FOR A GENTLE CATHARTIC, two or three are generally sufficient, if taken in the morning, on an empty stomach.

FOR A VERY ACTIVE, SEARCHING CATHARTIC, four to six may be taken in the morning, on an empty stomach.

FOR A CHILD OF TWO TO FOUR YEARS, one-half of a Pellet given in a little sauce of some kind, or soft candy, will be sufficient for a laxative, or one for a mild cathartic.

FOR A CHILD OF FOUR TO EIGHT YEARS, one for a laxative or two for a cathartic will act nicely, if given on an empty stomach.

AS A DINNER PILL.—To promote digestion and increase the appetite, take only one Pellet each day after dinner.

To overcome the disagreeable effects of a too hearty meal, take two Pellets as soon as conscious of having overloaded the stomach.

IN ALL CHRONIC DISEASES, it is of the utmost importance that the bowels be kept regular, yet thorough purgation should be avoided, as it tends to debilitate the system. Small laxative doses of one or at most two Pellets, taken daily and continued for a long time, is the plan that we would recommend to produce the best results.

IN DROPSY, an occasional active cathartic dose of the Pellets of say 4 to 6, taken once in a week or ten days, will do good, if, in the interval between these doses, Dr. Pierce's Golden Medical Discovery be taken to invigorate and regulate the system.

TO BREAK UP SUDDEN ATTACKS OF COLDS, FEVERS, AND INFLAMMATIONS.—It is only in these sudden and severe attacks of acute diseases that we recommend the Pellets to be taken in [pg 331]active purgative doses, and in these cases only one large or cathartic dose of say 5 or 6 Pellets should be taken.

In colds, fevers, and inflammatory attacks, warm sweating teas should be taken freely, and hot foot baths, or a hot general bath, employed to assist in equalizing the circulation of the blood and restoring the equilibrium of the system.

SUPPRESSED MENSTRUATION.—This combined treatment of an active dose of Pellets, coupled with the use of a hot bath, foot bath, or, better still, a hot sitz-bath, will bring on menstruation, when suppressed from taking cold. In the latter case the effect will be insured if, in addition to the use of the Pellets and baths, a full dose of Dr. Pierce's Compound Extract of Smart-Weed, or Water Pepper, be also used.

CAUSTICS.

Caustics are substances which have the power of destroying or disorganizing animal structures. By their action they destroy the tissue to which they are applied, and form a crust, which is thrown off by a separation from the parts beneath. Their caustic property may be destroyed by dilution with other substances, to such an extent that they will only irritate or stimulate, and not destroy. Much care is necessary in their employment, and it is not expected that the unprofessional reader will have much to do with them; hence, we have deemed it best not to give a list of these agents.

COUNTER-IRRITANTS.

Counter-irritants are substances which produce irritation of the part to which they are applied, varying in degree from a slight redness to a blister or pustule. They are applied to the surface with a view of producing an irritation to relieve irritation or inflammation in some other or deeper seated part. They are a class of agents which we very seldom employ, and, hence, we shall notice only a couple of the most simple.

Mustard (Sinapis). The flour of mustard, which is best adapted for domestic use, is employed in the form of a paste spread on cloth. It takes effect in a few moments; the length of time it remains in contact with the skin and the strength of the mustard determine the effect produced.

Horse-radish (Cochlearia Armoracia). The leaves are [pg 332]the parts used. Let them wilt and bind them on the part affected. They act nearly as energetically as mustard.

DIAPHORETICS.

Diaphoretics are medicines which increase perspiration. Those which occasion profuse sweating are termed Sudorifics. The two terms indicate different degrees of the same operation. They constitute an important element in domestic practice, on account of the salutary effects which generally follow their action. Their operation is favored by warmth externally, and warm drinks, when they are not given in hot infusion.

Fig. 127. Pleurisy-root.

Pleurisy-root (Asclepias Tuberosa), is also known as White-root, and Butterfly-weed. It is a valuable remedy, well adapted to break up inflammations and disease of the chest. [pg 333]Dose—Of infusion, one to two ounces; of fluid extract, one-fourth to one-half teaspoonful; of the concentrated principle, Asclepin, one to three grains.

Saffron (Crocus Sativus). Golden Saffron. Dose—Of infusion (one drachm to a pint of water), one to two ounces.

Sage (Salvia Officinalis). The warm infusion drunk freely is a valuable, domestic diaphoretic.

Fig. 128. Virginia Snake-root.

Virginia Snake-root (Aristolochia Serpentaria), is an efficient agent. Dose—Of infusion, one to two ounces; of tincture, one-fourth to one teaspoonful; of fluid extract, one-fourth to one-half teaspoonful.

[pg 334]Jaborandi (Pilocarpus Pinnatus). Jaborandi increases the flow of saliva, causes profuse perspiration, and lowers the temperature of the body. In doses of from twenty to sixty drops of the fluid extract, administered in a cup of warm water or herb-tea on going to bed, we have found it very effectual for breaking up recent colds. We have also found it valuable in whooping-cough, in doses of from three to ten drops, according to the age of the child, given three or four times a day. The fluid extract may be obtained at almost any drug-store.

Fig. 129. May-flower.

May-Weed (Maruta Cotula), is also known as Wild Chamomile, and Dog-fennel. It is not much used, though it is a powerful diaphoretic. Dose—Of infusion, one to two ounces.

Catnip (Nepeta Cataria). A deservedly popular, domestic [pg 335]remedy, always acceptable, and certain in its action. The warm infusion is the best form for its administration. It may be drunk freely.

Ginger (Zingiber Officinale). The hot infusion may be sweetened and drunk as freely as the stomach will bear.

Dr. Pierce's Compound Extract of Smart-weed. This is unsurpassed as a diaphoretic agent, and is much more certain in its operation than any simple diaphoretic.

DILUENTS.

Any fluid which thins the blood or holds medicine in solution is called a diluent. Pure water is the principal agent of this class. It constitutes about four-fifths of the weight of the blood, and is the most abundant constituent of the bodily tissues. Water is necessary, not only for digestion, nutrition, and all functional processes of life, but it is indispensable as a menstruum for medicinal substances. It is a necessary agent in depuration, or the process of purifying the animal economy, for it dissolves and holds in solution deleterious matter, which in this state may be expelled from the body. In fevers, water is necessary to quench the thirst, promote absorption, and incite the skin and kidneys to action. Its temperature may be varied according to requirements. Diluents are the vehicles for introducing medicine into the system. We shall briefly mention some which prove to be very grateful to the sick.

Various vegetable acids and jellies may be dissolved in water, as apple, currant, quince, grape, or cranberry.

The juice of lemons, oranges, pine-apples, and tamarinds, is also found to be refreshing to fever patients.

Sassafras-pith, slippery-elm bark, flax-seed, and gum arabic make good mucilaginous drinks for soothing irritation of the bowels and other parts.

Brewers' yeast mixed with water in the proportion of from one-eighth to one-fourth is a stimulant and antiseptic.

The white ashes of hickory or maple wood dissolved in water make an excellent alkaline drink in fevers, or whenever the system seems surcharged with acidity.

DIURETICS.

Diuretics are medicines which, by their action on the kidneys, increase the flow of urine.

Fig. 130. Marsh-mallow.

Marsh-mallow (Althea Officinalis) is used in irritable conditions of the urinary organs. The infusion may be drunk freely.

Gravel-plant (Epigea Repens), is also known as Water-pink, Trailing-arbutus, or Gravel-root. Dose—Of decoction of [pg 337]the plant, one to three ounces; of fluid extract, one-fourth to one-half teaspoonful.

Fig. 131. Stone-root.

Stone-root (Collinsonia Canadensis), is also known as Knot-root, Horse-balm, Rich-weed, or Ox-balm. This is a mild diuretic, slow in action, yet effective in allaying irritation of the bladder. The root is the part used. _Dose_--If infusion, one to two ounces; of fluid extract, five to ten drops; of the concentrated principle, Collinsonin, one-half to one grain.

Foxglove (Digitalis purpurea) slows the action of the [pg 338]heart, lowers the temperature, and acts indirectly as a diuretic. It is especially valuable in the treatment of scarlet fever and in dropsy. Dose—Of infusion, one-half drachm to one-half ounce; of the fluid extract or strong tincture, from two to ten drops. It should be used with caution. A poultice made of the leaves and placed over the kidneys is an effectual method of employing the drug.

Queen of the Meadow (Eupatorium Purpureum), is also known as Gravel-weed, Gravel-root, or Trumpet-weed. This is a most valuable diuretic. Dose—Of the infusion, one to three ounces; of fluid extract, one-fourth to one-half teaspoonful; of the concentrated principle, Eupatorin (Purpu), one-half to two grains.

Buchu (Barosma Crenata). The leaves are used. This agent has been extensively employed, generally in compounds. Dose—Of infusion, (steeped for two hours or more) one to two ounces; of fluid extract, the same; of the concentrated principle, Barosmin, one to three grains.

Pipsissewa (Chimaphila Umbellata), or Prince's Pine. This is a tonic to the kidneys, as well as a diuretic and alterative, and is a mild, but very efficient remedy. Dose—Of decoction, one ounce from four to six times a day; of fluid extract, one-fourth to one-half teaspoonful; of the concentrated principle, Chimaphilin, one to two grains.

Water-melon Seeds (Cucurbita Citrullus). Dose—Of infusion, the patient may drink freely until the desired effect is secured.

Pumpkin Seeds (Cucurbita Pepo). They are mild, unirritating, yet effective diuretics. An infusion of these may be drunk freely.

Sweet Spirit of Nitre (Spiritus Ætheris Nitros), is diuretic and anodyne. Dose—One-fourth to one-half teaspoonful, diluted in water, every two or three hours.

Saltpetre (Potassæ Nitras). Dose—Powdered, five to ten grains.

Acetate Of Potash (Potassæ Acetas). Dose—Ten to fifteen grains, largely diluted in water. It is more frequently used for this purpose than the nitrate. It is a most valuable diuretic.

EMETICS.

These are medicines which cause vomiting and evacuation of the stomach. Some of the agents of this class, termed irritant emetics, produce vomiting by a local action on the stomach, and do not affect this organ when introduced elsewhere. Others, which may be termed systemic emetics, produce their effects through the nervous system, and, therefore, must be absorbed into the circulation before they can produce vomiting. In cases of poisoning, it is desirable to empty the stomach as quickly as possible, hence irritant emetics should be employed, for they act more speedily. Draughts of warm water favor the action of emetics.

Mustard (Sinapis) acts promptly and efficiently as an emetic, and may be employed in poisoning. Dose—From one to two teaspoonfuls of powdered mustard, stirred up in a glass of tepid water. It should be quickly swallowed and diluents freely administered.

Sulphate Of Copper (Cupri Sulphas) is a prompt, irritant emetic. It should be given in doses of ten grains dissolved in half a glass of water, and its action assisted by the free use of diluents.

Sulphate Of Zinc (Zinci Sulphas) is similar in its effects to sulphate of copper, but less powerful, and may be taken in the same manner, and the dose repeated if necessary in fifteen minutes.

Yellow Subsulphate of Mercury (Hydrargyri Sulphas flava), commonly known as Turpeth Mineral, is an efficient and most desirable emetic in membranous croup. It is an active poison, but, as it is quickly thrown up with the contents of the stomach, there is no danger from its administration. Dose—It should be given to a child in doses of from three to five grains, in the form of powder, rubbed up with sugar of milk.

Ipecac (Cephælis Ipecacuanha).In large doses Ipecac is a systemic emetic. In small doses, it exerts a specific influence upon the mucous membranes, relieves nausea and irritation, and subdues inflammation. In cholera infantum it is an invaluable remedy, if given in very small doses. By allaying irritation of the stomach and restoring tone and functional activity to it and [pg 340]the bowels, it gradually checks the discharges and brings about a healthy condition. It is also valuable in dysentery, and is borne in large doses. As an emetic the dose is, of powder, five to ten grains in warm water; of fluid extract, ten to twenty drops.

Fig. 132. Lobelia.

Lobelia (Lobelia Inflata), sometimes known as Indian Tobacco, or Emetic-weed. The herb and seeds are used. This is a powerful, systemic emetic, but very depressing. Dose—Of [pg 341]the powdered leaves, fifteen to twenty grains; of the infusion, one to three ounces; of the fluid extract, ten to fifteen drops.

Boneset (Eupatorium Perfoliatum). Dose—Of the warm infusion or decoction, two to three ounces; of the fluid extract, one teaspoonful in hot water: of the concentrated principle, Eupatorin, two to five grains.

EMMENAGOGUES.

Emmenagogue is a term applied to a class of medicines which have the power of favoring the discharge of the menses. We shall mention only a few of those which are best adapted to domestic use.

Fig. 133. Pennyroyal.

Pennyroyal (Hedeoma Pulegioides). Pennyroyal, used freely in the form of a warm infusion, promotes perspiration and excites the menstrual discharge when recently checked. A large draught of the infusion should be taken at bed-time. The feet should be bathed in warm water previous to taking the infusion.

Black Cohosh (Cimicifuga Racemosa). Black Cohosh, known also as Black Snake-root, is an effective remedy in uterine difficulties. Dose—Of the tincture, twenty drops; of the fluid extract, ten drops.

Tansy (Tanacetum Vulgare). Tansy is beneficial in suppressed menstruation. Dose—Of the infusion, from one to four fluid ounces.

Ergot (Secede Cornutum) in very small doses acts as an emmenagogue, and in large doses it checks hemorrhage. The dose as an emmenagogue, of the fluid extract, is from two to five drops, and to arrest hemorrhage, from half a drachm to two drachms, repeated in from one to three hours.

Life-root (Senecio Gracilis.) Life-root exerts a peculiar influence upon the female reproductive organs, and for this reason has received the name of Female Regulator It is very [pg 342]efficacious in promoting the menstrual flow, and is a valuable agent in the treatment of uterine diseases. Dose—Of the decoction, four fluid ounces three or four times a day; of the fluid extract, from one-fourth to one-half teaspoonful.

Motherwort (Leonurus Cardiaca). Motherwort is usually given in warm infusion, in suppression of the menses from cold. Dose—Of the decoction, from two to three fluid ounces every one or two hours.

Dr. Pierce's Favorite Prescription is an efficient remedy in cases requiring a medicine to regulate the menstrual function. Full directions accompany every bottle.

Dr. Pierce's Compound Extract of Smart-weed is an excellent emmenagogue. Dr. Eberle, a very celebrated medical writer, and author of a work on medicine which is very popular with the profession, says that he has used the "Extract of Smart-weed" in twenty cases of amenorrhea (suppressed menstruation), and affirms "with no other remedy or mode of treatment have I been so successful as with this." Full directions accompany every bottle. It is sold by all druggists.

EXPECTORANTS.

Expectorants are medicines which modify the character of the secretions of the bronchial tubes, and promote their discharge. Most of the agents of this class are depressing in their influence and thus interfere with digestion and healthy nutrition. Their application is very limited, hence we shall dismiss them without further consideration.

LINIMENTS.

Liniments are medicines designed for external application. The benefits arising from their use depend upon their derivative power, as well as upon the anodyne properties which many of them possess, rendering them efficacious for soothing pain. We cannot mention a more valuable agent of this class than

Dr. Pierce's Compound Extract of Smart-weed. As an external application this preparation subdues inflammation and relieves pain. For all wounds, bruises, sprains, bee-stings, insect and snake-bites, frost-bites, chilblains, caked breast, swollen glands, rheumatism, and, in short, for any and [pg 343]all ailments, whether afflicting man or beast, requiring a direct external application, either to allay inflammation or soothe pain, the Extract of Smart-weed cannot be excelled.

NARCOTICS.

A narcotic is a remedy which, in medicinal doses, allays morbid sensibility, relieves pain, and produces sleep; but which, in overdoses, produces coma, convulsions, and death. The quantity necessary to produce these results varies in different individuals. We shall mention a few of those most frequently employed.

Fig. 134. Henbane.

Henbane (Hyoscyamus Niger). The leaves and seeds are used. Henbane, in large doses, is a powerful narcotic and dangerously poisonous. In medicinal doses, it is anodyne and antispasmodic; it allays pain, induces sleep, and arrests spasms. [pg 344]Dose—Of the fluid extract, five to ten drops; of the solid extract, from one-half to one grain; of the concentrated principle, Hyoscyamin, from one-twelfth to one-fourth of a grain.

Indian Hemp (Cannabis Indica). An East Indian plant. Dose—Of the extract, from one-fourth to one-half grain, of the tincture, from three to eight drops; of the fluid extract, from two to five drops. The plant known as Indian Hemp, growing in this country, possesses very different qualities.

Fig. 135. Stramonium.

Stramonium (Datura Stramonium). Stramonium, also known as Thorn-apple, in large doses is a powerful narcotic poison. In medicinal doses it acts as an anodyne and antispasmodic. Dose—Of extract of the leaves, from one-half to one grain; of the fluid extract, from three to six drops.

NERVINES.

These are medicines which act on the nervous system, soothing excitement and quieting the condition known as "nervousness."

Hops (Humulus Lupulus). Dose—Of infusion, one to three ounces; of the fluid extract, one-fourth to one-half teaspoonful of the concentrated principle, Humulin, two to three grains.

Fig. 136. Scull-cap.

Scull-cap. (Scutellaria Lateriolia). The herb is used. It is also known as Mad-dog Weed. This is a valuable remedy. Dose—Of infusion, one to two ounces, of the fluid extract, ten to twenty drops; of the concentrated principle, Scutellarin, one to two grains.

Lady's Slipper (Cypripedium Pubescens). The root is [pg 346]used. Dose—Of the infusion, one-half to one-ounce; of the fluid extract, one-fourth to one-half teaspoonful; of the concentrated principle, Cypripedin, one to two grains.

Pulsatilla (Pulsatilla Nigricans). We employ the German tincture, prepared from the green herb. In many of the distressing nervous complications to which both males and females are subject in certain diseases of the generative organs, we have found it very effectual. The dose is from two to eight drops.

Dr. Pierce's Favorite Prescription. This is a tonic nervine of unsurpassed efficacy, combined in such a manner, that, while it quiets nervous irritation, it strengthens the enfeebled nervous system, restoring it to healthful vigor. In all diseases involving the female reproductive organs, with which there is usually associated an irritable condition of the nervous system, it is unsurpassed as a remedy. It is also a uterine and general tonic of great excellence. It is sold by all druggists.

SEDATIVES.

Sedatives are a class of agents which control excitation of the circulation, and diminish irritability of the nervous system.

Aconite (Aconitum Napellus), The parts used are the root and leaves. Aconite slows the pulse, diminishes arterial tension, and lowers the temperature of the body in fevers. It is an effectual remedy in acute inflammation of the tonsils and throat, in acute bronchitis, in inflammation of the lungs, and pleurisy, in the hot stage of intermittent and remittent fevers, in the eruptive fevers, in fever arising from a cold, and in some forms of neuralgia. Acute suppression of the menses from a cold, may be relieved by the tincture of aconite in drop doses every hour. Dose—Of the tincture of the root, from one-half of a drop to two drops, in a spoonful of water, in acute fevers and inflammations, from one-half drop to one drop should be administered every half hour or hour, according to the severity of the symptoms.

Peach Tree (Amygdalus Persica). Peach tree leaves and bark are slightly sedative, but the chief use which we have found for these articles is to control nausea and vomiting arising from irritability of the stomach. It also possesses mild, tonic properties. Dose—Of infusion at the [pg 347]bark of the small twigs or of the leaves, from two to six teaspoonfuls.

Fig. 137. American Hellebore.

American Hellebore (Veratrum Viride) is also known as White Hellebore, Indian Poke, or Swamp Hellebore. The root is the part used. It is a most valuable agent with which to [pg 348]control the frequent, strong, bounding pulse common to many febrile and inflammatory diseases. When the pulse is hard, incompressible, and bounding, this remedy is more effectual than aconite. Dose—Of the tincture and fluid extract, from one to two drops, repeated every half hour to two hours, according to the severity of the symptoms. This remedy should be given in very small doses, frequently repeated, if we would secure its best effects. Our favorite mode of administering both veratrum and aconite is to add ten drops of the tincture to ten or fifteen teaspoonfuls of water, of which one teaspoonful may be administered every hour.

Yellow Jessamine (Gelseminum Sempervirens). The root is the part used. Through its controlling effect over the sympathetic nervous system, this agent exerts a marked influence in controlling morbid excitability of the circulatory organs. It allays irritation, and determination of blood to the brain, indicated by flushed face, contracted pupils, irritability, and restlessness, a frequent condition in diseases incident to childhood. Its concentrated principle, Gelsemin, is an efficient remedy in bloody-flux or dysentery. It should be administered in very small doses to secure the best results. Only one-sixteenth to one-eighth of a grain is required, repeated every two hours. It should be triturated with sugar of milk or with common white sugar, in the proportion of one grain to ten of sugar. Dose—Of tincture, from five to fifteen drops; of fluid extract, three to six drops; of Gelsemin, as a sedative, one-fourth to one-half grain.

STIMULANTS.

Stimulants are medicines which have the power of increasing the vital activity of the body. Some have a very transient action, while others are more permanent in effect.

Cayenne Pepper (Capsicum Annuum). Cayenne Pepper is a powerful stimulant. Dose—Of the powder, from one to six grains, administered in milk; of the tincture, from five to ten drops, largely diluted in milk or water.

Black Pepper (Piper Nigrum). Black Pepper is a warm, carminative stimulant. Dose—From five to fifteen grains; of the fluid extract, from ten to fifteen drops.

Fig. 138. Prickly-ash.

Prickly-ash (Xanthoxylum Fraxineum). Prickly-ash bark is a stimulant and tonic. The parts used are the bark and leaves. Dose—Of the fluid extract, from five to fifteen drops; of the tincture, ten to twenty drops; of the active principle, Xanthoxylin, one to two grains.

Alcohol is a powerful stimulant. It is never used in its pure state in medicine, but when diluted forms a useful remedy in many diseases. It is generally employed in the form of whiskey, gin, rum, brandy, and wine.

Ammonia is an excellent stimulant. Dose—Of the carbonate, from three to five grains; of the sesquicarbonate, from five to ten grains; this is the same as the carbonate, which has been exposed to the air and slacked (powdered hartshorn); of the aromatic spirit, from one-half to one teaspoonful. The Aqua Ammonia and Liquor Ammonia are of such variable strength that they are seldom employed internally, but may be applied externally and taken by inhalation.

Dr. Pierce's Compound Extract of Smart-Weed. This quickly diffusible stimulant and genial anodyne we have spoken of under the head of Anodynes. But its medicinal properties equally entitle it to a place and mention under the class of stimulants. As a stimulant it spurs the nervous system and arouses the circulatory forces. Congestion of the lungs, liver, bowels, or uterus, embarrasses the functions [pg 350]of these organs. Frequently this congestive difficulty may be entirely obviated, and the circulation of the blood restored to the surface of the body, by the administration of a few doses of this pleasant remedy. Thus it often acts like magic in giving relief, promoting the circulation, and restoring the organs to their accustomed functional activity. Full directions accompany every bottle.

TONICS.

Tonics are remedies which moderately exalt the energies of all parts of the body, without causing any deviation of healthy function. While stimulants are transient in their influence, tonics are comparatively permanent.

Fig. 139. White Poplar.

White Poplar (Liriodendron Tulipfera), called also American Poplar, or White Wood. The part used is the inner bark. This is a mild but valuable tonic for domestic use. Dose—Of the infusion, from one-half to one ounce; of tincture, from one to two teaspoonfuls.

Chamomile (Anthemis Nobilis). The part used is the flowers. This is a mild, unirritating tonic. Dose—Of infusion (one-fourth ounce of flowers to a pint of water) one-half to one ounce.

Gentian (Gentiana Lutead). The root is the part used. This is a favorite domestic tonic in many localities. Dose—Of powdered root, five to ten grains; of the tincture, ten to twenty drops; of the fluid extract, five to ten drops, four or five times a day.

Nux Vomica (Strychnos Nux Vomica), or Dog Button. This is a powerful tonic. It increases innervation and is particularly valuable in cases marked by feeble circulation and general impairment of muscular power. In overdoses it is poisonous, and hence must be employed with much caution. Dose—Of the tincture, three to five drops; of the fluid extract, one to three drops.

[pg 351]Willow (Salix Alba). Willow is a tonic and an astringent. Dose—Of the decoction, from one to two fluid ounces; of the concentrated principle, Salicin, from two to four grains.

Fig. 140. Dogwood.

Dogwood (Cornus Florida). Dogwood, also known Boxwood, is tonic, astringent, and slightly stimulant. Dose—Of the solid extract, from three to five grains; of the infusion, from one to two ounces; of the fluid extract, from ten to twenty drops.

Wafer-ash (Ptelea Trifoliata), also called Swamp Dogwood. The bark is used. This is a pure, unirritating tonic. Dose—Of tincture, one-half to one teaspoonful; of fluid extract ten to twenty drops; of the infusion, one to two fluid ounces.

Fig. 141. Golden Seal.

Golden Seal (Hydrastis Canadensis). Golden Seal is a powerful and most valuable tonic. It is a valuable local remedy when used as a general injection in leucorrhea. Dose—Of the powder, from ten to thirty grains; of the tincture, from one-half to one fluid drachm; of the fluid extract, from ten to twenty drops; of the concentrated principle, Hydrastin, from two to three grains; of the muriate of hydrastia, from one-half to one grain.

Fig. 142. American Colombo.

American Colombo (Frasera Carolinensis). American Colombo is a simple tonic. Dose—Of the powdered root, from ten to fifteen grains; of the infusion one-half to one fluid ounce, three or four times a day; of the active principle, Fraserin, one to three grains.

Fig. 143. Gold Thread.

Gold Thread (Coptis Trifolia). Gold Thread is a pure and powerful, bitter tonic, and is also efficacious as a wash for sore mouth or as a gargle. Dose—Of the decoction, from two to six fluid drachms; of the tincture, from one-half to two teaspoonfuls; of fluid extract, from ten to twenty drops.

Iron (Ferrum). Different preparations of iron are frequently prescribed by physicians. They are particularly valuable in anæmic conditions of the system. The following are a few of the preparations of this metal most generally used:

Iron by Hydrogen (Ferri Redactum). Dose—One to two grains.

Carbonate of Iron (Ferri Carbonas). Dose—One to three grains.

Citrate of Iron (Ferri Citras). Dose—One to three grains.

Pyrophosphate of Iron (Ferri Pyrophosphas). Dose—One to three grains.

[pg 355]Tincture of Muriate of Iron (Tinctura Ferri Chloridi). Dose—Three to twenty drops.

Dr. Pierce's Favorite Prescription. The Favorite Prescription, in addition to those properties already described, likewise combines tonic properties. In consequence of the never ceasing activities of the bodily organs, the system requires support, something to permanently exalt its actions. In all cases of debility, the Favorite Prescription tranquilizes the nerves, tones up the organs and increases their vigor, and strengthens the system. Directions for use accompany every bottle.

Dr. Pierce's Golden Medical Discovery. In addition to the alterative properties combined in this compound, it possesses important tonic qualities. While the Favorite Prescription exerts a tonic influence upon the digestive and nutritive functions, the Golden Medical Discovery acts upon the excretory glands. Besides, it tends to retard unusual waste and expenditure. This latter remedy tones, sustains, and, at the same time regulates the functions. While increasing the discharge of noxious elements accumulated in the system, it promptly arrests the wastes arising from debility, and the unusual breaking down of the cells incident to quick decline. It stimulates the liver to secrete, changes the sallow complexion, and transforms the listless invalid into a vigorous and healthy being. At the same time, it checks the rapid disorganization of the tissues and their putrescent change, while it sustains the vital processes. It is, therefore, and indispensable remedy in the treatment of many diseases.

CHAPTER III.

BATHS AND MOTION AS REMEDIAL AGENTS.

The remedial effects of bathing are generally underrated. This want of appreciation is more often due to the improper manner in which it is performed than to an insufficiency of curative virtues. The term bathing not only implies a cleaning of the body or certain portions of it, but also the application of water in such a manner as to influence the nervous system, and regulate the functions of the secretory organs. Cleanliness, while it preserves health and promotes recovery, has reference only to the hygienic influences of water and not to its curative effects. There are several kinds of baths, the names of which indicate their character, manner of application, or the part of the body to which they are applied. Among others, we have Cold, Cool, Temperate, Tepid, Warm, Hot, Hot Air, Russian, Turkish, Vapor, Electric, Sea, Shower, Sponge, Douche, Foot, Sitz, Head, Medicated, Alkaline, Acid, Iodine, and Sulphur Baths. Temperature influences the properties of any bath; thus the sponge, sitz, and alkaline baths may be employed warm or cold, according to the effect desired.

The Cold Bath, used at a temperature of from 40° to 60° Fahr., is powerfully sedative, and is employed for its tonic effects. If the vital powers are low, or the individual remains in it too long (two or three minutes should be the limit), the reaction is slow and its effects injurious. While it is highly invigorating to robust persons, those who have a low standard of vitality should be cautions in its employment. A local bath [pg 357]may be followed by beneficial results, when a general bath would be inadmissible. For these reasons we advise the general use of the

Cool Bath, at a temperature of from 60° to 75° Fahr. If, in any instance, the reaction is slow, we recommend the

Temperate Bath, at a temperature of from 75° to 80° Fahr. The time of remaining in the bath should be regulated by the strength of the invalid. As a rule, it should not exceed three minutes, and the colder the water the less time should the patient be immersed. Immediately after emerging from any bath, the body should be thoroughly dried and rubbed with a moderately coarse towel until a glow is experienced and reaction is fully established. The attempt to toughen children by exposing them to low temperatures of either air or water, cannot be too emphatically condemned. This caution, however, does not apply to the employment of moderately cool water for ablutions. The cold or cool bath should be taken in the early part of the day, but never during digestion. Whenever reaction does not follow bathing, artificial means must be resorted to, as stimulating drinks, dry warmth, or exercise.

The Tepid Bath, the temperature of which is from 85° to 92° Fahr., is generally used for cleansing the body. It is prescribed in fevers and inflammatory affections for its cooling effects. It is usually medicated with some acid or alkali. The latter unites with the oily secretion of the skin and forms a soapy compound easily removed by the water. The temperature should be regulated according to the vitality of the patient; and the bath may be repeated two or three times a day. It removes superfluous heat, and keeps the skin in a condition favorable for excretion.

The Warm Bath, at a temperature varying from 92° to 98° Fahr., is always agreeable and refreshing. It equalizes the circulation and softens the skin, by removing all impurities. It moderates pain and soothes the whole system. It does not weaken or debilitate the person, but is in every way beneficial. It is an efficient, remedial agent in many chronic diseases, convulsions, spasmodic affections of the bowels, rupture, rheumatism, and derangement of the urino-genital organs. It should be employed immediately before going to bed unless [pg 358]urgent symptoms demand it at other times. It may be medicated or not, as circumstances require, but should always be taken in a warm room.

The Hot Bath at a temperature of from 98° to 110° Fahr. is a powerful stimulant. It excites the nerves, and through them the entire system. It causes a sense of heat and a constriction of the secretory organs; but perspiration, languor, and torpor soon follow. In the sudden retrocession of cutaneous diseases, it restores the eruptions to the surface and gives speedy relief. The hot bath may be applied locally when circumstances require.

The Russian Bath consists in the application of hot vapor, at a temperature varying from 112° to 200° Fahr. The patient is first subjected to a moderately warm temperature, which is gradually increased as he becomes inured to it, the head being surrounded with cloths wet in cold water. Upon emerging from it, the bather is plunged into cold water or receives a cool, shower bath. In rheumatic and cutaneous diseases, chronic inflammations, and nervous affections, the Russian bath is an effective remedy.

The Turkish Bath is a, dry, hot-air bath. The bather passes from one apartment to another, each one being of a higher temperature than the preceding. He undergoes a thorough shampooing, and, although the person may be scrupulously clean, he will be astonished at the amount of effete matter removed by this process. The bather then returns through the various apartments, and, upon emerging from that of the lowest temperature, he experiences a delightful sensation of vigor and elasticity.

As a hygienic agent, the hot-air bath has been' constantly growing in favor. Its value is now recognized by all physicians throughout the world. The judicious use of the Turkish bath serves to secure perfect equalization of the circulation. Glandular activity is increased, elasticity and power given to the muscles, and a permanent, stimulating and tonic influence imparted to the system, a condition at once conducive to the enjoyment and prolongation of life. Dr. Erasmus Wilson, of England, says, in a paper read before the London Medical Association: "The inhabitant of a large city would live as [pg 359]healthy, immured within city walls, as amid the fields and meadows of the country. His bath would be to him in the place of a country house or horse—it would give him air, exercise, freshness, health, and life."

"The bath that cleanses the inward as well as the outward man; that is applicable to every age; that is adapted to make health healthier, and alleviate disease, whatever its stage or severity, deserves to be adopted as a national institution, and merits the advocacy of all medical men; of those whose especial duty it is to teach how health may be preserved, and how disease may be averted."

The hot, dry atmosphere of the Turkish bath promotes rapid evaporation from the surface of the body, and it is well known that rapid evaporation from the surface is a cooling process. A person's finger may be frozen in one minute's time, by throwing upon it a constant, fine spray of rhigolene or sulphuric ether. The rapid evaporation of the light fluid congeals the liquids of the tissues and a film of ice is rapidly formed upon the part. In a less intense degree the same cooling process is carried on over the whole surface of a person, when in the hot room, or sudatorium, of the Turkish bath. The evaporation from the surface is so rapid that one can hardly appreciate the profuseness of the perspiration going on. The evaporation from the surface so rapidly carries off the heat from the body that one finds himself able, with little or no inconvenience, to remain in a room heated to from 180° to 200° or even 220° Fahr.

As a hygienic measure to be regularly or occasionally employed by persons in fair health, the Turkish or hot dry-air bath is far superior to the Russian or vapor-bath. (1.) It produces more profuse perspiration, and is therefore more depurating, or cleansing, in its effects. (2.) It does not relax the system, but rather produces a tonic effect, and fewer precautions are, therefore, necessary to guard against taking cold after employing it. (3.) The Turkish bath can be better ventilated than the Russian. While the air is heated to a high temperature, it can be readily kept pure by constant changes. In the Turkish hot-rooms, or sudatorium, of the Invalids' Hotel and Surgical Institute, provision is made for bringing underneath the floors a current of fresh air from without. This column of [pg 360]fresh air is carried under the centre of each room where it escapes from the conductor, is warmed, and rises into the room, from which extraction of air is constantly going on through registers opening into tubes, communicating with large ventilated shafts which are kept hot, summer and winter, to insure a draught through them. In this manner, thorough ventilation of our Turkish hot-rooms is insured.

The Turkish bath not only combines a most agreeable luxury with a decidedly invigorating and tonic influence, but also, by its stimulating power, induces proper glandular and cellular activity, producing a healthy condition.

Sallowness, tan, and freckles, the result of local or general increase of the pigment granules of the skin, soon disappear under the stimulating influence and regular use of the Turkish bath, which causes rapid development of new and transparent cells. The colored granules are thus gradually replaced and the skin assumes a beautiful clearness and purity of appearance, which transcends immeasurably the unhealthy hue that follows the frequent employment of the various cosmetics.

The value of an agent which thus improves the general health, insures immunity from coughs, colds, and other diseases, and at the same time produces a healthy and permanent beauty of complexion, is at once apparent. The purity of person, perfect circulation, increase of healthy nutrition and glandular activity produced by the Turkish bath, serve to make it of the most lasting utility.

The eminent Dr. Madden has said, and his experience is confirmed by every regular patron of the bath, that, "Wherever the Turkish bath was a national institution the hair of the women was peculiarly luxurious and beautiful. I can vouch for it that the use of the bath rendered the complexion more delicate and brilliant; that the eyes became clearer and brighter; all the personal charms were enhanced. I can recommend no hygienic measure more beneficial or effectual in preserving the health and an attractive personal appearance."

Pimples, blotches, eruptions, and other disfigurations of the skin are removed by the frequent use of the Turkish bath, leaving the integument smooth and soft.

Fig. 144. First Hot-room of the Turkish Bath.

[pg 361]How the Turkish Bath is Administered at the Invalid's Hotel and Surgical Institute. The hot-rooms, of which there are two, are exactly similar in every respect except as regards temperature. The first room has a temperature of from 110° to 120° Fahr. The bather is supplied by the attendant every few minutes with copious draughts of cool water. Gradually the relaxing influence of the elevated temperature manifests itself. The capillaries slowly dilate, the veins enlarge under its gentle stimulus, and small points of perspiration appear upon the surface, which assumes a slight, rosy blush. A delightful calm, a feeling of perfect rest and luxurious ease is imparted to the senses. From this room, after an appropriate interval, the bather enters the second room, in which the atmosphere is higher by from 20° to 30°, and it may be made still higher, its regulation requiring but an instant.

Fig. 145. One of the Shampooing rooms.

A thorough sweating occurs while the subject remains in these rooms, during a period of from ten to forty minutes. The secretions of the skin, at first impure and loaded with the débris of dead cells and extraneous matter, gradually become purer, and clearer, until, finally, all trace of color disappears and the pearly drops of sweat come full and free. Soon the attendant appears and leads the [pg 362]way to the shampooing-room, where, lying upon a warm marble slab, massage is applied most thoroughly to every portion of the body.

By the massage, shampooing, or rubbing, the superficial veins are thoroughly emptied of their contents, the muscles are given elasticity and tone, and glandular activity is promoted. Innumerable dead epithelial cells, together with other impurities, are rolled off in flakes under the skillful manipulation of the attendant.

After a thorough shampooing, the shower bath is applied, to secure a contraction of the capillaries and a diminution of the perspiration.

The Spirit Vapor-bath is very effective when employed in the earlier stages of acute, febrile, inflammatory, and painful diseases. In many forms of chronic diseases the administration of a spirit vapor-bath once in from three to fifteen days, is a valuable adjunct to the treatment of these affections. It exerts an exceedingly beneficial influence upon the entire system, and, when habitually employed, may ward off disease.

The body should be moistened with an alkaline solution before the administration of a spirit vapor-bath. After the perspiration which it occasions has subsided, which will usually be in from three to four hours, sponge the body with a mixture of the following ingredients: water, three gills; alcohol, one gill; salt, one teaspoonful. By this method the patient experiences none of the unpleasant effects which generally follow the employment of diaphoretics. Various kinds of apparatus have been devised to facilitate the application of the spirit vapor-baths. Most of them are cumbersome and expensive, and, consequently, are seldom used except in hospitals or sanitariums.

The following method described by Dr. J. King, may be advantageously employed.

"The patient is undressed, ready for getting into bed, having removed the clothing worn through the day and put on a night shirt or other clothing to be worn while sweating, and during the night, if the bath is taken at bed-time. He is then seated on a high Windsor or wooden-bottomed chair, or instead thereof, a bench or board may be placed on a common open-bottomed chair, care being taken that the bottom is so covered [pg 363]that the flame will not burn him. After seating himself, a large coverlet or blanket is thrown around him from behind, covering the back of his head and body, as well as the chair, and another must be passed around him in front, which last is to be pinned at the neck, loosely, so that he can raise it and cover his face, or remove it down from the face from time to time as occasion demands during the operation of the bath. The blankets must reach down to the floor, and cover each other at the side, so as to retain the vapor. This having been done, a saucer or tin vessel, into which is put one or two tablespoonfuls of whiskey, brandy, alcohol, or any liquor that will burn, is then placed upon the floor, directly under the centre of the bottom of the chair, raising a part of the blanket from behind to place it there; then light a piece of paper, apply the flame to the liquor, and as soon as it kindles let down the part of the blanket which has been raised, and allow the liquor to burn until it is consumed, watching it from time to time to see that the blankets are not burned. As soon as consumed, put more liquor into the saucer, about as much as before, and again set it on fire, being careful to put no liquor into the saucer while the flame exists, as there would be danger of setting fire to the blanket, and producing injury to the patient. Continue this until the patient perspires freely, which, in a majority of cases, will be in five or ten minutes."

"If, during the operation the patient feels faint or thirsty, cold water must be sprinkled or dashed in his face, or he may drink one or two swallows of it,—and in some cases the head may be bathed with cold water. As soon as free perspiration is produced, wrap the blankets around him, place him in bed, and cover him up warm, giving him about a pint of either some good store tea, ginger, or some diaphoretic herb tea to drink, as warm as he can take it. After two or three hours, remove the covering, piece by piece, at intervals of twenty or twenty-five minutes each, that he may gradually cease perspiring."

The above method may be improved by using an ordinary hoop skirt, ten to twelve inches below the bottom of which is suspended a larger and stronger hoop. The upper and smaller hoops should rest upon the patient's shoulders. A woolen blanket, large enough to reach and rest upon the floor, and [pg 364]envelop the whole person, is thrown over the hoops. Unless the bath is employed to diminish the quantity of fluids in the body (as in dropsy), the patient may drink some simple, diaphoretic infusion, to hasten or facilitate perspiration. When he perspires freely, small quantities of cold water may be frequently given. "There is little or no danger of taking cold after this process, if ordinary precaution is observed, and it is easy, agreeable, safe, and effectual."

"Occasionally we will meet with patients, upon whom it is almost impossible to produce the slightest moisture, much less perspiration. The skin of such persons is generally dry and harsh, communicating an unpleasant sensation to the touch. In most instances the skin may be restored to its normal condition, by adopting the following course: 1st. Anoint the whole surface of the body and limbs with olive oil every night upon retiring to bed. 2nd. Every morning wash the whole surface with a warm, weak, alkaline solution, employing considerable friction while drying. 3rd. Every two weeks administer a spirit vapor-bath. A perseverance in this course for a few months will accomplish the desired result."

Frequent reference to spirit vapor-baths will be made by the author of this work, in speaking of those diseases in which its employment will prove beneficial.

Sea Bathing is an excellent, remedial agent in chronic disorders, particularly in those of an atonic character, such as nervous prostration, dyspepsia, and general debility.

Much of the benefit attributed to this mode of bathing is undoubtedly due to other influences, such as pure air, exercise, change of scenery, diet, and associations which surround the patient during his sojourn at the sea-shore.

At first, the duration of a sea-bath should not exceed three or five minutes, but it may be gradually prolonged to fifteen or twenty minutes. If the patient is very feeble, one or two baths a week are sufficient, and the most robust person should never take more than one a day. They should always be taken in the earlier portion of the day, before breakfast if possible, and never during digestion.

Before entering this bath, a moderate degree of exercise should always be taken, enough to arouse the vital energies, but [pg 365]not to produce fatigue. Suitably dressed, the patient plunges into the water, in which he remains during the prescribed time. Immediately after emerging from the bath, the patient should be thoroughly dried and dressed and then moderate exercise should be taken to induce reaction. If the reaction is slow, a mild stimulant may be taken and the duration of the bath must be diminished the next time. When sea-bathing is beneficial improvement is soon manifested. The blood becomes richer, the whole system is strengthened and the functions are performed with more regularity. To the rich, sea-bathing is a luxury, but it is a remedy beyond the reach of the poorer classes unless they live near the sea-shore.

The Shower Bath produces a shock to the nervous system by suddenly coming in contact with the skin. Numerous streams of cold water fall upon the neck, shoulders, and body of the patient who stands beneath the hose or reservoir. When the patient is plethoric, feeble, or nervous, or when some internal organ is diseased, the cold, shower bath should not be employed. In simple debility unaccompanied by inflammation or symptoms of internal congestion, its use proves advantageous. By moderating the force of the shower, and substituting tepid water, the most delicate persons can endure it and profit thereby. The usual means for inducing a good reaction, friction, and exercise, should be employed.

The Douche Bath consists of a stream of water, dashed or thrown upon the patient from a moderate height or distance, with considerable force. The size, temperature, and force of the stream may be modified to suit the exigencies of the case. It is locally employed as a remedy for sprains, weak or stiff joints, old swellings, etc. The cold, douche bath is more powerful than the shower bath and should be given with the same precautions which govern the application of the latter.

The Sponge Bath admits of extensive employment in both acute and chronic diseases, and its simplicity renders it of untold value. It consists in a general or local application of water (medicated or not) at any desired temperature. The quantity may be great or small to suit the requirements of the case. If it is applied in acute diseases at a temperature agreeable to the patient, it is exceedingly grateful and may be [pg 366]repeated as often as necessary. It may be rendered alkaline by the addition of some compound of soda, in the proportion of a teaspoonful to a quart of water. A portion of the body may be bathed at a time, and quickly dried, thus avoiding any exposure to cold. It removes excessive animal heat, relaxes the capillaries, equalizes the circulation, and produces comfort, tranquility, and sleep.

Nothing is more conducive to the health and comfort of laboring men in summer than a daily bath, and it is a matter of regret that there are so few conveniences for the purpose in most homes, especially those in the country. Farmers in particular need bathing facilities, and yet in most cases they are almost entirely without them. For their benefit we will describe a device which we can recommend to all who want a cheap, convenient, and easily managed apparatus for sponge bathing in the bed-room.

The articles required are a piece of rubber-cloth a yard and a quarter square, four slats, two inches wide and three feet long, notched at the ends so as to lock together in the form of a square, and a large sponge. The slats are placed upon the floor and the rubber cloth is spread over them (there is no need of fastening it to the slats), forming a shallow square vessel a yard wide. In this the bather stands and applies the water with a sponge from a basin or bowl on a stand placed conveniently near. There need be no danger of wetting the carpet, or spoiling the furniture.

When the bath is finished, gather three corners of the rubber cloth in the left hand, take the fourth corner in the right in such a way as to form a spout when lifted or held over the slop-jar or bucket. The water may be poured out in a moment, when the cloth should be spread over the back of a chair to dry, and the slats unlocked and set away in a closet.

The Foot Bath is frequently employed, as a means of causing diaphoresis, in colds, attacks of acute diseases, and also to draw the blood from the head or some internal organ. It is a powerful auxiliary in the treatment of those chronic diseases in which inflammation, congestion, and a feeble circulation are prominent symptoms. The water should be as hot as it can be borne and the temperature kept up by additions of hot water. [pg 367]It may be made stimulating by the addition of salt, mustard, ginger, or cayenne pepper.

The Sitz Bath. A tub is so arranged that the patient can sit down in it while bathing. In this manner the lower part of the abdomen, hips, and upper part of the thighs, are immersed in whatever fluid the bath is composed of. It is applicable in diseases of the pelvic organs, and may be hot, warm, cool, cold, or medicated, according to the effect desired.

The bath tub should be large enough to permit a thorough rubbing and kneading of the diseased parts, and the patient may remain in it from ten to thirty minutes. The clothing may be wholly or partially removed, as agreeable to the individual. A warm, sitz bath is an effective, remedial adjunct in menstrual suppression and in painful menstruation, gravel, spasmodic and acute inflammatory affections generally. The cold, sitz bath is used as a tonic in cases of relaxed tissues of the pelvis, in debility of the urino-genital organs, in piles, prolapsus of the rectum, and in constipation.

The Head Bath. A shallow basin contains the fluid for the bath; and the patient, assuming a recumbent position, immerses a portion of the head, generally the back part. The temperature may be warm, cool, or cold, as desired.

Medicated Baths are infusions of vegetable or other substances in water. They are sometimes applied with the sponge, though generally the patient is immersed. The temperature at which they are usually employed is that of the tepid bath. The nature and strength of the medication depends upon the character of the disease for which it is employed.

The Alkaline Bath is prepared by dissolving half a pound of carbonate of soda in sixty gallons of water. It is useful in those diseases in which the fluids of the body are abnormally acid, as in rheumatism.

The Acid Bath is prepared by adding two pounds of muriatic or hydrochloric acid to sixty gallons of water. A much smaller quantity of the acid is sometimes used, and in some instances vinegar is substituted.

Scott's Acid Bath is composed of nitro-muriatic acid (aqua regia) and water. It should be prepared in a wooden tub, and a sufficient quantity of acid used to give the water a sour taste. [pg 368]It is extensively used in India as a remedy for disorders of the liver.

The Iodine Bath is composed of the following ingredients: tincture of iodine, two drachms; iodide of potassium, four drachms; water, forty gallons. It should be prepared in a wooden tub. It reddens the skin. For children, a much weaker solution must be employed. Its use is generally restricted to scrofulous and tubercular affections.

The Sulphur Bath is prepared by dissolving eight ounces of sulphuret of potassium and two ounces of dilute sulphuric acid in sixty gallons of water. The acid may be omitted.

A Sulphur Vapor-bath is often employed in cities where the necessary apparatus can be procured. It may be improvised by placing sulphur on a shovel over hot coals. The patient should be prepared as in the spirit vapor-bath, and burning sulphur substituted for the liquor. The patient is then enveloped in the fumes of sulphurous oxide. Heating a mixture of sulphur and sulphuric acid, produces the same result. If the gas is inhaled in large quantities it causes irritation of the respiratory passages, and suffocation. It is therefore necessary that the coverings should be securely fastened at the neck, and that the room be one which can be quickly filled with pure air This bath is used in cutaneous, rheumatic, and syphilitic disorders.

Fomentations consist of the general or local application of woolen cloths wrung out of hot water. They should not be so light as to be ineffectual, nor so heavy as to be burdensome. They should not be wet enough to drip, nor applied so as to expose the body to the surrounding air. A fresh cloth should be ready for application before the first one is removed, and the change quickly effected. Fomentations are effectual in relieving congestion and inflammation.

The Wet Sheet Pack. As this remedial appliance will be frequently recommended in the pages following, its mode of application is here described. Take a pail half filled with cold water, gather together one end of a common cotton sheet, and immerse it, allowing it to remain while preparing the bed, which may be done as follows: remove all the bed-clothes except a coverlet and the pillows, then spread upon it, in [pg 369]the following order, two ordinary comforters, one woolen blanket, one woolen sheet, (or two woolen sheets if a woolen blanket is not at hand); then wring out one-half or two-thirds of the water from the wet sheet, spread it smoothly upon the blanket, and the patient being undressed, places himself on the sheet, with his arms extended, while an assistant wraps him closely and tightly with it, as quickly as possible. Each arm may be thus covered by the wet sheet, or may lie outside of it, and be covered by wet towels, prepared in the same manner as the sheet. Then quickly and tightly cover with the blankets and comforters, tucking snugly from head to foot. The head should also be covered with a wet towel, and a bottle of warm water placed to the feet, or near enough to keep them warm.

After the first shock of the chill is over, the pack is very pleasant and refreshing, and the patient should go to sleep, if possible. The ordinary time for a patient to remain in a pack is about sixty minutes. Thirty or forty minutes is sufficient, if he is in a feeble condition. Never wring the sheet out of warm water, for one of its principal benefits comes from the vigorous reaction induced by its cold temperature. After remaining in the pack from thirty to sixty minutes, allow the patient to stand on his feet, if he is able, and have the whole surface of his body bathed. Rub briskly, and dry with towels, or by throwing over the body a dry sheet and then rubbing him. The dry sheet retains the bodily warmth and is more comfortable, but interferes with the completeness and vigor of the rubbing of the body. Be sure and establish full reaction, which may be known by the warmth of the surface. Frequently, when the patient is released from the pack, and is being bathed, rolls of scales, scurf, and skin-debris come off, thus giving palpable evidence of the utility of the pack in freeing the myriads of pores of the skin of effete matter. It is efficient in fevers, and for breaking up colds, and is a very valuable, remedial agent in most chronic diseases, assisting in removing causes which depress the bodily functions.

MOTION IS A REMEDIAL AGENT.

The stability of the planetary system depends upon the converted motion of its parts. So in the human system, motion [pg 370]is a fundamental principle which underlies every vital process. Health consists in normal, functional activity. The human system is the arena of various kinds of motions, both of fluids and of solids, and life and health depend upon these physiological movements. There are the movements incident to respiration, the expansion and contraction of the walls of the chest, bringing the oxygen of the air into contact with the blood as it circulates through the lungs. Corresponding with the movements of the chest are the motions of the abdominal walls, which promote the functions of the organs of the abdominal cavity.

There are motions of the heart and arteries, which urge the blood out to the extremities and diffuse it through every part of the system, and also motion of the blood in the capillaries, by which the blood is circulated through the tissues, that the latter may be built up from its nutritive constituents. Then there is the motion of the vital current in the veins returning towards the heart, and urged forward by the muscular and pump-like action of the chest and abdominal walls. The peristaltic motions of the stomach and bowels urge onward digesting materials, exposing them successively to different solvents and aiding the absorption of nutritive matter. No less essential to life and health are numerous other minute operations or motions, on which vital power in all its manifestations of muscular and nervous energy depends. Many other motions are consequent upon decay, growth, and repair. Oxygen, carbonic acid, watery vapors, and other gaseous matter are constantly being exchanged between the system and atmosphere. Then, the human system being a complex, chemical laboratory, there are motions consequent upon chemical action, constantly going on within it.

Muscular motion, under the direction of the will, is also absolutely necessary for the maintenance of good health.

Animal heat and muscular and nervous power are dependent upon motions of the minutest particles composing the body. The body is composed of fluid and semi-fluid matter, permitting great freedom of motion. Health requires that there shall be a constant change of place, an active transmission of material to and from vital organs and parts, through the medium of [pg 371]blood-vessels, as well as outside such vessels; that is, motion of interstitial fluids.

Nature's mode of Sustaining Health. The act of transforming latent, non-vital force which exists pent-up in food, as heat is in coal, into vital energy, requires the simultaneous elimination from the system of a like amount of worn-out matter. Assimilation of nutritive materials is impossible, unless a like amount of matter be eliminated from the system. Muscular and nervous energy are dependent upon activities which cause waste. Not only is this true in a general way, but it is also true that the energy produced by the operations of the vital system has a strict relation to the wasting products—that full energy is only attained by perfected waste. Use, waste, and power, then, sustain definite and dependent or corresponding relations, since waste is as essential to health as is supply.

Without waste, disturbance is at once produced in the system similar to that resulting from the introduction of foreign matter. These disturbances constitute disease. The more obvious effects of lack of waste and elimination are mechanical. The circulation is loaded with effete and useless matter, the vessels being thereby weakened and distended, and the circulation retarded. The capillaries become clogged and vital action is diminished. Local congestions, inflammations, effusions, morbid growths, and other pathological results follow.

Deranged or suppressed action characterizes, and, indeed, constitutes all departures from health which we call disease. Suffering indicates action, but action which is perverted into wrong channels, or action in one part at the expense of motion in other parts, constituting a disturbance in the equilibrium of forces, from which the system suffers.

Value or Mechanical Movements and manipulations for the Treatment of Chronic Diseases. To correct and restore deranged movements, thereby producing normal, functional activity of every organ and part of the system, must therefore be the chief object of the physician. All remedies, of whatever school or nature, imply motion, and depend for their efficacy upon their ability to excite motion in some one or more elements, organs, or parts of the system.

[pg 372]While we do not wish to detract from the real merits of medicine as a curative agent, yet we must admit that the remedial power of motion, transmitted either manually or mechanically, is founded upon rational and physiological principles. All systems of medicine, however much they may differ superficially, propose, as the chief end to be attained by the administration of medicine, or by other treatment, that motions identical with physiological activity should be incited or promoted. How best to accomplish this result, and with least cost to vitality, is an important consideration. Bearing in mind the conservation of forces, that energy or power is as indestructible as matter, that it may be changed into other forms but never lost, it is plain that mechanical force may be applied to the living system and transformed into vital energy; that chemical action, animal heat, and magnetism may represent in the system the mechanical force transmitted to the body. Keeping in view the transformable nature of force, and the need that our systems have of auxiliary power in different departments, when normal activity is impaired by disease, we can readily understand how undoubted, curative effects result from either the manual or the mechanical administration of motion.

Rubbing is a process universally employed by physicians of every school for the relief of a great diversity of distressing symptoms, is instinctively resorted to by sympathizers and attendants upon the sick, and constitutes one of the chief duties of the nurse. Uncivilized people resort to this process as their principal remedy in all forms of disease.

The difficulty in administering motion as a remedial agent by manual effort, such as rubbing, kneading, oscillating, flexing, and extending the limbs, lies in the impossibility of supplying the amount, intensity, and variety of movement required to make it most effective. The power of the arm and the strength of the operator are exhausted before the desired effect is produced. Inventive genius has at last overcome the obstacles to the successful and perfect administration of motion as a curative agent. We have now a series of machines propelled by mechanical power, by the use of which we rub, knead, manipulate, and apply in succession a great variety of movements to all parts of the body. These machines transmit motion to [pg 373]the body from inexhaustible sources, never tire, but are ever ready for new, remedial conquests. The movements administered by their use, while entirely under the control of the patient, are never disagreeable, and are far more rapid and intense than can possibly be given by the hands. By the application of short, quick movements of from twelve to fifteen hundred vibrations a minute, deep-seated organs and parts are reached, to which motion is transmitted and in which vital energy is thereby generated. The hands have not the power, by kneading, manipulating, or rubbing to impress the system except in a very mild degree, and deep-seated organs and parts are scarcely influenced by the comparatively slow movements thus administered. Among the most important, mechanical inventions devised for administering motion as a remedial agent, is one which has received the name of the manipulator.

The Manipulator. With this machine motion can be applied to any organ or part of the system, and intensity of the application regulated to a nicety. The rapidity of motion necessary to produce active exhilaration of any part of the body is easily secured by the use of the manipulator, but is far beyond the power of the hands. The degree of circulation given to the fluids, both inside and outside of the vessels, and of energy imparted to the organs and parts operated upon by the manipulator, is also unapproachable by the application of manual power.

Effects Upon the Circulation and Nutrition. The influence of motion on these functions is as follows: The contents of the blood-vessels are moved onward by the pressure and motion transmitted by the manipulator, all backward movement of the blood being prevented by the valves of the veins and by the propelling power of the heart and arteries. Fluids outside these vessels pass through their walls, to take the place of the stagnant blood that has been moved onward. Other blood flows into the part, and thus active and healthy circulation is induced, and nutritive material, capable of affording vital support is also brought to refresh the local part.

We have found mechanical movements especially effectual in paralysis, neuralgia, sleeplessness, and other nervous affections; in derangements of the liver, constipation, and dyspepsia; in [pg 374]displacements of the uterus, and congestion, and inflammation of the pelvic organs.

For a complete description of the mechanical movements and the machinery employed in the treatment of diseases at the Invalids' Hotel and Surgical Institute, the reader is referred to the appendix to this work.

CHAPTER IV.

HYGIENIC TREATMENT OF THE SICK.

There are two essentials requisite to the successful treatment of the sick: (1.) Medical skill; (2.) Good nursing. The former is necessary in order that the condition of the patient be fully understood, and the proper means be employed to effect his recovery. The latter is essential, in order that all influences favoring the production and development of disease may be removed, the tendencies to restoration be promoted by every possible means, and the directions of the physician be properly observed.

Success in the treatment of the sick requires good nursing. Without it, the most skillful physicians fail to effect a cure; with it, the most unqualified may succeed. If certain hygienic agencies are essential to the maintenance of health, how much more necessary it is that they be employed in sickness! If certain conditions cause disease, how great the necessity is that such conditions be obviated and hygienic ones substituted!

Notwithstanding the importance of good nursing, in the rural districts it is frequently difficult to find a professional nurse, or, if one can be obtained, it is often impossible for the invalid to procure such services, on account of the expense which must necessarily be incurred. Hence, this office usually devolves upon some relative who is considered to be the best qualified for the position; or, as is often the case, necessity demands that the patient be left to a change of nurses. A woman is generally selected for this important position. Her [pg 376]soft hand and soothing voice, her kindly, sympathetic, and provident nature, together with her scrupulous cleanliness, render her man's equal, if not his superior, in the capacity of nurse. There are circumstances, however, in which the services of a man are indispensable; hence the necessity that all should be qualified to care for the sick.

A nurse should be attentive to the requirements of physician and patient, for she sustains an intimate relation to both. She should observe the directions of the physician, and faithfully perform them. She should note all the symptoms of the patient, and do everything in her power to promote comfort and recovery. She should anticipate the wishes, and not cause the patient to ask for everything which is desired. So far as practicable, let the wishes be gratified. The senses of the sick often become morbidly acute, and those things which in health would pass unnoticed, in sickness are so magnified as to occasion annoyance and vexation. Sick persons are not all alike, and the peculiarities of each must be studied separately. The nurse must be kind, but firm, and not yield to such whims of the patient as may be detrimental to recovery; neither must she arouse dislike or anger by opposition, but endeavor to win the patient from all delusions. The feelings of the patient should never be trifled with, for idealities become realities.

The nurse should possess an inexhaustible store of patience. Disease affects the mind of the patient and fills it with strange delusions. The sick are often querulous, fretful, and unreasonable, and should be treated with kindness, forbearance, and sympathy. The nurse should always be cheerful, look on the bright side of every circumstance, animate them with encouragement, and inspire them with hope. Hope is one of the best of tonics. It stimulates the flagging, vital energies, and imparts new life to the weak and exhausted forces. Gloom, sadness, and despondency depress the vital forces and lead to death. We have seen patients rapidly sinking, who had given up all hope, and were quietly awaiting the coming of death, snatched, as it were, from its grasp, and restored to health, by words of cheer and encouragement.

The nurse should possess moral principles, which alone can [pg 377]win the confidence of the patient. She should have judgment, circumspection, intelligence, forethought, alacrity, carefulness, and neatness. In a word she should exercise common sense.

We deem it but justice to say a word in behalf of the nurse. She, too, is a human being, subject to disease, and, unless hygienic conditions be observed, will soon be stricken low by its presence. She must be relieved occasionally and get rest, or she cannot long withstand the combined influence of fatigue and disease. Her office is an arduous one at best, and the long, weary hours of night-watching should be compensated by exercise in the open air, as well as by sleep during the day. Unless this be done, the system will become exhausted, and sleep will intrude itself upon her at the time when the greatest diligence is required for the welfare of the patient, when the vital powers are at their lowest ebb. She should be supplied with plenty of suitable food during the night, to sustain her and to serve as a safeguard against the invasion of disease. She should be treated with kindness and respect, else her disposition may become morose and reflect itself upon the patient, causing peevishness and despondency.

The Sick-room should be as comfortable, cheerful, and pleasant, as circumstances will allow. Let the room be large and airy, and furnished with a stove, or better still, a fireplace. All articles of clothing and furniture, not necessary to the comfort of the patient, should be removed from the room, and in malignant or contagious diseases the carpets, even, should not be permitted to remain. The surroundings beget happiness or gloom, in proportion as they are pleasant or disagreeable. A tidy attendant, a few flowers and books, wonderfully enhance the cheerfulness of the room. Permit no unnecessary accumulation of bottles, or any thing that can in any way render the room unpleasant. Medicines, drink, or nourishment should never be left uncovered in the sick-room, since they quickly absorb the gaseous emanations from the patient, and become unfit for the purpose which they were intended to serve. Their presence gives the room an untidy appearance, suggestive of filth and slovenliness, and imparts to the patient a feeling of loathing and disgust for articles of diet.

The Bed should not be of feathers, on account of their [pg 378]undue warmth, which causes a sensation of languor throughout the system. A husk or sea-grass mattress, or even a straw bed, covered with a cotton quilt, is far preferable. The bedding should be changed frequently. It is better that the bed should be away from the wall, so as to admit of greater freedom of movement about it.

Pure Air. The air in the sick-room should be kept as pure as possible. That which is so necessary in health, is indispensable in sickness. The importance, therefore, of a perfect and free ventilation of the sick-room cannot be too thoroughly impressed; and yet to properly secure this end, may call forth a considerable amount of ingenuity on the part of the nurse. A window should be open, but the current of air must not be allowed to blow directly upon the patient. One window may be raised from the bottom and another lowered from the top. This will permit the entrance of pure air from without, and the exit of the vitiated air from within. The patient, if sufficiently covered in bed, is not liable to take cold from a proper ventilation of the room. Especially is this true, when the bodily temperature is raised by febrile or inflammatory affections. The temperature of a room is no indication of the purity of the air. It is a prevalent, but mistaken notion, that when a room is cold, the air must be pure. Cold air is as readily contaminated with impurities as warm air, therefore, it is not sufficient that the room be kept cool, but the air should be frequently changed. During convalescence, great care is necessary to protect the patient from taking cold. Air which is admitted into the sick-room should not be contaminated by passing over foul drains, privies, or other sources of infection, since, instead of invigorating, it depresses the physical forces and generates disease.

Light is as necessary to health as is pure air. Banish either for any continuous period of time, and serious results follow. The strong, robust man, when deprived of light, soon degenerates into a feeble, sickly being, and finally dies.

According to the investigations of the Massachusetts Medical Society, it was found that absence of sunlight, together with moisture, not only favor the development of tubercular consumption, but act as an exciting cause. It is well known that [pg 379]persons living in shaded dwellings often suffer from forms of disease which resist all treatment until proper admission of light is secured.

The physician to the Emperor of Russia found upon examination that patients confined in well lighted wards, were four times as liable to recover as were those in poorly lighted rooms. Children reared away from the sunlight are apt to be deformed and idiotic, while those partially deformed have been restored by being admitted to the light.

Patients sometimes wish to have their rooms darkened, because the light is painful to their weak and sensitive eyes. It is far better to shade the eyes and admit the sunlight into the room, since its rays cause chemical changes to take place, which favor the return of health. Many invalids can ascribe their recovery to the influence of a sun bath. There are, however, conditions in which the patients should be screened from the light. In such cases a little arrangement of the curtains or shutters will accomplish all that is to be desired.

Patients convalescing from acute, or suffering from chronic diseases, should receive the influence of light in the open air, and be in it several hours every day. Light and pure air stimulate a healthful development, induce cheerfulness, hope, and recovery, while darkness begets gloom, sadness, despondency, disease, and ultimately death.

Warmth is essential to the well-being of the patient, and it is necessary that a proper temperature be maintained in the room. Except in very warm weather, a little fire should be kept in the room, and at the same time fresh air should be admitted from without, and a uniform temperature thus preserved. This arrangement is especially necessary in localities where great variations in temperature are experienced during the day and night.

The normal temperature of the body ranges from 98° to 99° Fahr. The minimum occurs from 2 to 6 A.M.; the maximum, from 1 to 6 P.M. The deviation of a few degrees from this standard indicates disease, and the greater the deviation, the greater is its severity. During the early stages of acute diseases, the animal heat is generally increased, and should be allayed by bathing, and cooling or acidulated drinks. In the [pg 380]latter stages, the temperature becomes diminished and the condition of the system is favorable to congestions, which are most likely to occur between the hours of 2 and 6 A.M., when the vital powers are lowest. The patient then becomes feeble, his extremities grow cold, and he has what is termed a "sinking spell," and perhaps dies. It is during these hours that additional covering, the application of hot bricks to the feet, and bottles of hot water to the limbs and body, friction upon the surface, stimulating drinks, and increased vigilance on the part of the nurse will often save the patient's life. But, unfortunately, at these hours the nurse is apt to get sleepy and inattentive, the demands of the patient go unheeded, and a sacrifice of life is the result.

Persons suffering from chronic diseases, or those in feeble health, should preserve their vital energies by dressing warmly, by wearing flannels next to the skin, and by carefully protecting the feet from cold and moisture.

Cleanliness cannot be too thoroughly impressed upon the minds of those who have the care of the sick. Filthiness is productive of disease and favorable to its development. Bathing at least once a day, with pure, soft water and toilet-soap, is strongly urged, and as this is designed for cleanliness, the temperature of the bath should be made agreeable to the patient.

The Clothing and Bedding of the Patient in acute diseases, should be changed frequently and thoroughly aired, if not washed. As soon as removed, these articles should be taken from the room, replaced by others well aired and warmed. The hands and face of the patient should be bathed frequently, the hair combed, the teeth brushed, the nails cleaned, the lips moistened, and everything about him kept clean and tidy. These observances, although in themselves trifling, promote comfort and cheerfulness, and contribute largely to the recovery of the sick. All excretions from the patient should be buried, and not committed to privies to communicate disease to those who frequent them.

The Diet contains a very important relation to health. During the process of acute disease, the appetite is generally much impaired, if not entirely absent. It should then be the study of the nurse to devise such articles of nourishment as will [pg 381]be acceptable to the patient and suitable to the condition. The food should be light, nutritious, and easy of digestion.

Each individual disease requires a diet adapted to its peculiarities. Those of an inflammatory character require an unstimulating diet, as gruel, barley-water, toast, etc. An exhausted or enfeebled condition of the brain, unattended by irritability, demands a stimulating diet, as beef, eggs, fish, Graham bread, oysters, etc. In wasting diseases, in which the temperature of the system is low, beef, fatty substances, rich milk, sweet cream, and other carbonaceous articles of diet are recommended. In the various forms of chronic ailments, the diet must be varied according to the nature of the disease and the peculiarities of the patient. Deranged digestion is generally an accompaniment of chronic disease. A return to normal digestion should be encouraged by selecting appropriate articles of food, paying due regard to its quantity and quality, as well as to the manner and time of eating. The appearance of food, and the manner in which it is offered, have much to do with its acceptance, or rejection by the patient. Let the nourishment be presented in a nice, clean dish, of a size and shape appropriate to the quantity. More food than can be eaten by the patient should not be placed before him at one time, since a great quantity excites disgust and loathing. In taking nourishment, drink, or medicine, the patient, if feeble, should not be obliged to change his position.

Milk is one of the most important foods in fevers and acute diseases attended with great prostration, and in which the digestive powers are enfeebled. It contains within itself all the elements of nutrition.

Beef Tea furnishes an excellent nourishment for the sick, but there are few, even among professional nurses who know how to properly prepare it. We give three good recipes. One method is to chip up lean beef, put it in a porcelain or tin saucepan, cover it with cold water, and bring it up to just below the boiling point, at which temperature retain it for ten minutes, then season and serve. Another method is similar to the foregoing, with this difference, that the juices of the meat are squeezed through a piece of muslin or crash, making the tea richer. Another way, which we consider preferable to [pg 382]either of the above, is to take lean beef, cut it into fine bits, put them in a tightly covered vessel, which is placed in a kettle of water kept boiling. Thus the whole strength of the juice will be obtained from the meat without losing any of its properties. It can be seasoned to the taste, and reduced with water to suit the needs of the patient.

Sleep is "Nature's grand restorer, a balm to all mankind; the best comforter of that sad heart whom fortune's spite assails." It is necessary in health, and doubly so in sickness. During sleep, the vital energies recuperate, the forces are less rapidly expended, and the strength increases. It is the great source of rest and refreshment. Often a day's rest in bed, free from the cares and anxieties of an active life, is sufficient to ward off the approach of disease. If quiet and rest are essential to recuperation in health, their necessity in disease must be apparent. Life frequently depends on tranquility and repose, and the least noise or confusion disturbs the sufferer and diminishes the chances of recovery. Nothing annoys sick or nervous persons more than whispering and the rustling of newspapers. If conversation be necessary, let the tones be modified, but never whisper. In sickness, when the vital forces are low, the more natural rest and sleep the patient obtains, the greater is the prospect for recovery. As a rule, a patient should never be awakened when sleeping quietly, not even to take medicine, unless in extreme cases. If the patient does not sleep, the cause should be ascertained and the appropriate remedies employed; if it arise from rush of blood to the head, cooling lotions should be applied, and warmth to the feet; if, from restlessness or general irritability, a sponge bath, followed by friction should be administered; if the wakefulness is due to noise or confusion, quiet is the remedy. When these means fail, anodynes, or nervines, should be employed. Lying on the side instead of on the back should be practiced. Patients afflicted with chronic diseases, on rising, should take a cold bath, dry the surface quickly with a coarse towel, followed by friction with the hand. Great benefit may be derived by following these suggestions when the nature of the disease is not such as to forbid it.

Exercise and rest necessarily alternate with each other. [pg 383]Exercise, so necessary to health, in many forms of disease greatly contributes to recovery. It sends the sluggish blood coursing through the veins and arteries with increased force and rapidity, so that it reaches every part of the system, supplying it with nourishment. It increases the waste of old material and creates a demand for new.

Convalescing patients, or those suffering from chronic diseases, whenever the weather will permit, should take exercise every day in the open air. This should be done with regularity. The amount of exercise must be regulated by the strength of the patient; never take so much as to produce fatigue, but, as the strength increases, the exercise may be increased proportionately. Some interesting employment, commensurate with the patient's strength, should be instituted, so that the mind may be agreeably occupied with the body.

When unable to take active exercise, the invalid, properly protected by sufficient clothing, should ride in a carriage or boat, and each day a new route should be chosen, so that a change of scenery may be observed, thus arousing new trains of thought, which will be exhilarating and prove beneficial to him.

Sexual Influences. During the progress of disease or convalescence, entire continence must be observed. It is then necessary that all of the vital energies should be employed in effecting a recovery from disease, without having the additional tax imposed of overcoming the debilitating effects of sexual expenditure. This holds true with regard to all diseases, and especially those of the nervous system and genitourinary organs.

Visiting the Sick may be productive of good or evil results. Mental impressions made upon the sick exert a powerful influence upon the termination of disease. The chances of recovery are in proportion to the elevation or depression of spirits. Pleasant, cheerful associations animate the patient, inspire hope, arouse the vital energies, and aid in his recovery; while disagreeable and melancholy associations beget sadness and despondency, discourage the patient, depress the vital powers, enfeeble the body, and retard recovery.

Unless persons who visit the sick can carry with them joy, [pg 384]hope, mirth, and animation, they had better stay away. This applies equally in acute and chronic diseases. It does not matter what a visitor may think with regard to the patient's recovery, an unfavorable opinion should never find expression in the sick-room. Life hangs upon a brittle thread, and often that frail support is hope. Cheer the sick by words of encouragement, and the hold on life will be strengthened; discourage, by uttering such expressions as, "How bad you look!" "Why, how you have failed since I saw you last!" "I would have another doctor; one who knows something!" "You can't live long if you don't get help!" etc., and the tie which binds them to earth is snapped asunder. The visitor becomes a murderer! Let all persons be guided by this rule: Never go into the sick-room without carrying with you a few rays of sunshine!

If the patient is very weak the visitor may injure him by staying too long. The length of the visit should be graduated according to the strength of the invalid. Never let the sufferer be wearied by too frequent or too lengthy visits, nor by having too many visitors at once. Above all things, do not confine your visitations to Sunday. Many do this and give themselves credit for an extra amount of piety on account of it, when, if they would scrutinize their motives more carefully, they would see that it was but a contemptible resort to save time. The sick are often grossly neglected during the week only to be visited to death upon Sunday.

The use of Tobacco and Opium. The recovery of the sick is often delayed, sometimes entirely prevented, by the habitual use of tobacco or opium. In acute diseases, the appetite for tobacco is usually destroyed by the force of the disease, and its use is, of necessity, discontinued; but in chronic ailments, the appetite remains unchanged, and the patient continues his indulgence greatly to the aggravation of the malady.

The use of tobacco is a pernicious habit in whatever form it is introduced into the system. Its active principle, Nicotin, which is an energetic poison, exerts its specific effect on the nervous system, tending to stimulate it to an unnatural degree of activity, the final result of which is weakness, or even [pg 385]paralysis. The horse, under the action of whip and spur, may exhibit great spirit and rapid movements, but urge him beyond his strength with these agents, and you inflict a lasting injury. Withhold the stimulants, and the drooping head and moping pace indicate the sad reaction which has taken place. This illustrates the evils of habitually exciting the nerves by the use of tobacco, opium, narcotic or other drugs. Under their action, the tone of the system is greatly impaired, and it responds more feebly to the influence of curative agents. Tobacco itself, when its use becomes habitual and excessive, gives rise to the most unpleasant and dangerous pathological conditions. Oppressive torpor, weakness or loss of intellect, softening of the brain, paralysis, nervous debility, dyspepsia, functional derangement of the heart, and diseases of the liver and kidneys are not uncommon consequences of the excessive employment of this plant. A sense of faintness, nausea, giddiness, dryness of the throat, tremblings, feelings of fear, disquietude, and general nervous prostration must frequently warn persons addicted to this habit that they are sapping the very foundation of health. Under the continued operation of a poison, inducing such symptoms as these, what chance is there for remedies to accomplish their specific action? With the system already thoroughly charged with an influence antagonistic to their own, and which is sure to neutralize their effect, what good can medicine do?

Dr. King says, "A patient under treatment should give up the use of tobacco, or his physician should assume no responsibility in his case, further than to do the best he can for him." In our own extensive experience in the treatment of chronic diseases, we have often found it necessary to resort to the same restriction.

The opium habit, to which allusion has also been made, is open to the same objections, and must be abandoned by all who would seek recovery.

PART IV.

DISEASES AND THEIR REMEDIAL TREATMENT.

INTRODUCTION.

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

Believing that the diffusion of knowledge for the prevention of disease is quite as noble a work as the alleviation of physical suffering by medical skill, we have devoted a large portion of this volume to the subjects of physiology and hygiene. These we have endeavored to present in as familiar a style as possible, that they may be understood by every reader. Freely as we have received light upon these subjects have we endeavored to reflect it again, in hopes that a popular presentation of these matters made plain and easy of comprehension to all people, may lead the masses into greater enjoyment of life—the result of a better preservation of health. This we do in part as a public acknowledgment of our obligations to society, to whom every professional man is a debtor. He belongs to it, is a part of its common stock, and should give as well as receive [pg 387]advantages, return as well as accept benefits. We know of no better way to signify our appreciation of the public confidence and patronage, so generously accorded to us, than to offer this volume to the people at a price less than the actual cost for an edition of ordinary size. This we do as a token of the cordial reciprocation of their good will. In giving to the people wholesome advice, by which they may be enabled to ward off disease and thus preserve the health of multitudes, we believe we shall receive their hearty approval, as well as the approbation of our own conscience, both of which are certainly munificent rewards. We believe that good deeds are always rewarded, and that the physician who prevents sickness manifests a genuine and earnest devotion to the common interests of humanity.

We have no respect for the motives of those medical men who would withhold that information from the people which will direct the masses how to take care of themselves, and thereby prevent much sickness and suffering. Nor is the diffusion of such knowledge antagonistic to the best interests of the true and competent physician. The necessity for his invaluable services can no more be set aside by popularizing physiological, hygienic, and medical truths, than we can dispense with those of the minister and lawyer by the inculcation of the principles of morality in our public schools. The common schools do not lessen the necessity for colleges or universities, but rather contribute to their prosperity. Nor are we so presumptuous as to anticipate that we could possibly make this volume so instructive as to render "every man his own physician." No man can with advantage be his own lawyer, carpenter, tailor, and printer; much less can he hope to artfully repair his own constitution when shattered by grave maladies, which not only impair the physical functions, but weaken and derange the mental faculties. What physician presumes to prescribe for himself, when suddenly prostrated by serious illness? He very sensibly submits to the treatment of another, because he realizes that sickness impairs his judgment, and morbid sensations mislead and unfit him for the exercise of his skill. If this is true of the physician, with how much greater force does it apply to the unprofessional! If a sick sea-captain is unfit to stand at the helm and direct his ship, how utterly incompetent [pg 388]must the raw sailor be when similarly disqualified! Nor is the physician as competent to treat those near and dear to him, when they are suffering from dangerous illness, as another medical man not similarly situated, whose judgment is not liable to be misled by intense anxiety and affectionate sympathy.

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

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

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

Then, and not the least important, there are the various chronic or lingering diseases, from all of which few individuals indeed, who pass the meridian of life, entirely escape. In this class of ailments there is generally no immediate danger, and, therefore, time may be taken by the invalid for studying his disease and employing those remedies which are best suited for its removal. [pg 389]Or, if of a dangerous or complicated character, and, therefore, not so readily understood, he may consult either personally or by letter, some learned and well-known physician, who makes a specialty of the treatment of such cases, and whose large experience enables him to excel therein.

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

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

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

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

The apportionment of space which is made in considering the various diseases and their different stages, as well as the course which the people are advised to pursue under the different circumstances of affliction, is not always in accordance with the plans and recommendations which have been made by others who have written works on domestic medicine. Most of these [pg 390]authors have attempted, by lengthy disquisitions, to teach their readers how to treat themselves without the services of a physician, even in the most hazardous forms of disease. In such dangerous maladies as typhoid, typhus, yellow, and scarlet fevers, typhoid pneumonia, and many others, in which life is imminently imperiled, such instruction and advice is decidedly reprehensible, as it may lead to the most serious consequences. We are confident, therefore, that the manner of disposing of the different subjects which are discussed in the succeeding chapters, and the course of action which is advised, will commend themselves to our readers as being such as are calculated to promote and subserve their best interests.

MEDICAL DIAGNOSIS.

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

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

The critical investigation of symptoms, with the view of [pg 391]ascertaining their signs, is essential to successful practice. Without closely observing them, we cannot accurately trace out the diagnosis, and a failure to detect the right disease is apt to be followed by the use of wrong medicines.

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

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

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

Latterly, improved instruments greatly assist the practitioner of medicine in perfecting this art. The microscope assists the eye, and helps to reveal the appearance and character of the excretions, detecting morbid degenerations; chemistry discloses the composition of the urine, which also indicates the morbid alterations occurring in the system; by percussion we can determine the condition of an internal organ, from the sound given when the external surface is percussed; the ear, with the aid of the stethoscope, detects the strange murmurs of respiration, the fainter, more unnatural pulsations of life, and the obscurer workings of disease; with the spirometer we determine the breathing capacity of the lungs, and thus ascertain the extent of the inroads made by disease; the dynamometer records the lifting ability of the patient; the thermometer indicates the morbid variation in the bodily temperature; various instruments [pg 392]inform us of the structural changes causing alterations in the specific gravity of fluids, e.g., the urinometer indicates those occurring in the urine; and thus, as the facilities for correct diagnosis increase, the art of distinguishing and classifying diseases becomes more perfect, and their treatment more certain. While physiology treats of all the natural functions, pathology treats of lesions and altered conditions.

Fig. 146. Dr. Brown's Spirometer.

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

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

[pg 393]Symptoms are within every one's observation, but only the physician knows the nature and value of signs. We have read an anecdote of Galen, who was a distinguished physician in his day, which illustrates the distinction between sign and symptom. Once, when dangerously ill, he overheard two of his friends in attendance upon him recount his symptoms, such as "Redness of the face, a dejected, haggard, and inflamed appearance," etc. He cried out to them to adopt every necessary measure forthwith, as he was threatened with delirium. The two friends saw the symptoms well enough; but it was only Galen himself, though the patient, who was able to deduce the sign of delirium—that is, he alone was able to translate those symptoms into signs. To determine the value of symptoms, as signs of disease, requires close observation.

INTERPRETATION OF SYMPTOMS.

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

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

For example, let us change the scene, and introduce a patient with head and shoulders elevated, who prefers to sit up, and who places his hands behind him and leans back, or leans forward resting his arms and head upon a chair. The next week he is worse, and no longer tries to lie in bed, but sits up all the time; note the anxious expression of countenance, the difficult or hurried breathing, the dry and hacking cough, and observe [pg 394]that the least exertion increases the difficulty of respiration and causes palpitation of the heart. These plain symptoms signify thoracic effusion, the collection of water about the lungs.

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

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

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

Tongue. Much may be learned from the appearance, color, and form of the tongue, and the manner of its protrusion. If pale, moist, and coated white, it indicates a mild, febrile condition of the system. If coated in the center, and the sides [pg 395]look raw, it indicates gastric irritation. If red and raw, or dry and cracked, it is a sign of inflammation of the mucous membrane of the stomach. If the inflammation is in the large intestine, the tip of the tongue presents a deep red color, while the middle is loaded with a dark brown coating. When the tongue is elongated and pointed, quickly protruded and withdrawn, it indicates irritation of the nerve-centers, as well as of the stomach and bowels. If tremulous, it denotes congestion and lack of functional ability; this may be observed in congestive fevers.

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

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

Pain. The import of pain depends on its seat, intensity, nature, and duration. An acute, intense pain usually indicates inflammation of a nerve as well as the adjacent parts. Sharp, shooting, lancinating pains occur in inflammation of the serous tissues, as in pleurisy. A smarting, stinging pain attends inflammation of the mucous membrane. Acute pain is generally remittent and not fixed to one spot. Dull, heavy pain is more persistent, and is present in congestions, or when the substance of an organ is inflamed, and it often precedes hemorrhage. Burning pain characterizes violent inflammations involving the skin and subjacent cellular tissue, as in case of boils and carbuncles. Deep, perforating pain accompanies [pg 396]inflammation of the bones, or of their enveloping membranes. Gnawing, biting, lancinating pain attends cancers.

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

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

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

[pg 397]The Eye indicates morbid changes and furnishes unmistakable signs of disease. Sinking of the eye indicates waste, as in consumption, diarrhea, and cholera. In fevers it is regarded as a fatal symptom. A dark or leaden circle around the eye, seen after hard work, indicates fatigue and overdoing. If the mucous covering of the inner surface of the lids and the ball of the eye is congested and inflamed, it exhibits redness, and may indicate congestion or even inflammation of the brain.

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

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

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

The urine which is voided when the system is deranged or diseased is altered in its color and composition, showing that its ingredients vary greatly. So important an aid do examinations of the urine furnish in diagnosing many chronic ailments, that at the Invalids' Hotel and Surgical Institute, where many thousands of cases are annually treated, a chemical laboratory has been fitted up, and a skillful chemist is employed, who makes a specialty of examining the urine, both chemically and microscopically, and reporting the result to the attending physicians. His extended experience renders his services invaluable. With [pg 398]his assistance, maladies which had hitherto baffled all efforts put forth to determine their true character, have frequently been quickly and unmistakably disclosed.

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

INFLAMMATION.

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

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

[pg 399]Phlegmonous inflammation is the active inflammation of the cellular membrane, one illustration of which is a common boil. The four principal symptoms are redness, swelling, heat, and pain; and then appears a conical, hard, circumscribed tumor, having its seat in the dermoid texture. At the end of an indefinite period, it becomes pointed, white or yellow, and discharges pus mixed with blood. When it breaks, a small, grayish, fibrous mass sometimes appears, which consists of dead, cellular tissue, and which is called the core.

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

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

Inflammation may be internal as well as external, as inflammation of the brain, lungs, or stomach, and it is frequently the result of what is called a cold. No matter how the body is chilled, the blood retreats from the surface, which becomes pale and shrunken, there is also nervous uneasiness, and frequently a rigor, accompanied with chattering of the teeth. After the cold stage, reaction takes place and fever follows. The sudden change from a dry and heated room to a cool and moist atmosphere is liable to induce a cold. Riding in a carriage until the body is shivering, or sitting in a draft of air when one has been previously heated, or breathing a very cold air during the night when the body is warm, especially when not accustomed to doing so, or exposing the body to a low temperature when [pg 400]insufficiently clothed, are all different ways of producing inflammation.

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

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

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

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

Termination of Inflammation. Inflammation ends in one of six different ways. Inflammation may terminate in resolution, i.e., spontaneous recovery; by suppuration, in the formation of matter; by effusion, as the inflammation caused by a blister-plaster terminates by effusion of water; by adhesion, the part inflamed forming an attachment to some other part; by induration, hardening of the organ; or by gangrene, that is, death of the part.

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

SEVERAL PRINCIPLES FOR TREATMENT OF INFLAMMATION.

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

FEVER.

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

Most fevers are distinctly marked by four stages: 1st, the forming stage; 2d, the cold stage; 3d, the hot stage; 4th, the sweating or declining stage. During the first stage the individual is hardly conscious of being ill, for the attack is so slight that it is hardly perceptible. True, as it progresses, there is a [pg 402]feeling of languor, an indisposition to make any bodily or mental effort, and also a sense of soreness of the muscles, aching of the bones, chilliness, and a disposition to get near the fire. There is restlessness, disturbed sleep, bad dreams, lowness of spirits, all of which are characteristic of the formative stage of fever.

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

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

The patient in the hot stage is generally thirsty, and if he is allowed to drink much, it may result in nausea and vomiting. Moderate indulgence in water, however, is permissible. There is aversion to food, and if any is eaten, it remains undigested. The teeth are sometimes covered with dark sordes (foul accumulations) early in the fever, and the appearance of the tongue [pg 403]varies, sometimes being coated a yellowish brown, sometimes red and dry, at other times thickly coated and white. The condition of the bowels varies from constipation to diarrhea, although sometimes they are quite regular. The urine is generally diminished in quantity, but shows higher color.

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

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

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

Diaphoretic medicines are also indicated, and the use of Dr. Pierce's Extract of Smart-weed will prove very serviceable. [pg 404]Drinking freely of pleurisy-root tea, or of a strong decoction of boneset is frequently useful. After free sweating has been established, then it is proper to follow by the use of diuretic teas, such as that of spearmint and pumpkin seed combined, or sweet spirits of nitre, in doses of twenty to thirty drops, added to a teaspoonful of the Extract of Smart-weed, diluted with sweetened water.

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

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

To recapitulate, our treatment recommends evacuation through nature's outlets, the skin, kidneys, and bowels, maintaining warmth, neutralizing acidity, using antiseptics, tonics, [pg 405]and the hand-bath, and the fluid extract or tincture of aconite, or veratrum to moderate the pulse by controlling the accelerated and unequal circulation of the blood. It is a simple treatment, but if judiciously followed, it will often abort a fever, or materially modify its intensity and shorten its course.

FEVER AND AGUE. (INTERMITTENT FEVER.)

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

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

Treatment. During the entire paroxysm the patient should be kept in bed, and in the cold stage, covered with blankets and surrounded with bottles of hot water. The Compound Extract of Smart-weed should be administered in [pg 406]some diaphoretic herb-tea. During the hot stage, the extra clothing and the bottles of hot water should be gradually removed and cold drinks taken instead of warm. During the sweating stage the patient should be left alone, but as soon as the perspiration ceases, from two to four of the Purgative Pellets should be administered, as a gentle cathartic. A second paroxysm should, if possible, be prevented. To accomplish this, during the intermission of symptoms, the Golden Medical Discovery should be taken in doses of from two to three teaspoonfuls every four hours in alternation with three-grain doses of the sulphate of quinine. If the attack is very severe, and is not relieved by this treatment, a physician should be summoned to attend the case.

REMITTENT FEVER. (BILIOUS FEVER.)

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

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

CONGESTIVE FEVER. (PERNICIOUS FEVER.)

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

[pg 407]Treatment. This fever is so dangerous that a physician should be summoned as soon as the disease is recognized. For the benefit of those who are unable to obtain medical attendance, we will say that the treatment should be much the same as in intermittent fever, but more energetic. Quinine should be taken in doses of from five to fifteen grains every two or three hours. If it be not retained by the stomach, the following mixture may be administered by injection: sulphate of quinine, one-half drachm; sulphuric acid, five drops; water, one ounce; dissolve, and then add two ounces of starch water.

CONTINUED FEVERS.

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

TYPHOID FEVER. (ENTERIC FEVER.)

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

Cause. Typhoid fever is a specific form of fever developed from the action of a specific germ upon a susceptible system. The poison of typhoid fever is eliminated mainly through the bowels. The germs of typhoid can maintain life for months in [pg 408]water, and thus it happens that ponds, lakes, rivers and streams which receive sewage can spread the germs of typhoid fever. Well water often swarms with these poisonous germs. In some cases it has been found that privies, though twenty or forty feet away from a well, have yet drained into it—through a clay soil covered with gravel—and carried the germs to those drinking the water from the well. Next to water, milk is the most prominent carrier of contagion. Milk is apt to get infected with the germs if cooled in tanks of water which may receive drainage from outhouses and barns.

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

SCARLET FEVER. (SCARLATINA.)

This fever takes its name from the scarlet color of the eruption on the surface of the body. Sometimes it is comparatively mild, and is then called Scarlatina Simplex; when it is accompanied by a sore throat, it is termed Scarlatina Anginosa; and when the disease is of a low, putrid type, it is called Scarlatina Maligna. This disease has three distinct stages: (1), the stage of invasion; (2), the stage of eruption; and (3), the stage of desquamation. In the first stage there is pain in the head, increased heat of the skin, redness and soreness of the throat, and sometimes nosebleed, diarrhea, or vomiting. The average duration of this stage is twenty-four hours. The eruptive stage [pg 409]generally begins on the second day, though sometimes it is delayed longer, and the scarlet rash rapidly diffuses itself over the whole body. The redness is vivid and has been compared to the appearance of a boiled lobster. The stage of eruption reaches its maximum of intensity on the third day, and it is important that it does not recede. Redness of the tonsils and throat is one of the early symptoms which precedes any cutaneous eruption. The tongue also is finely spotted with numerous red points which mark its papillæ, presenting an appearance which has been compared to that of a strawberry.

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

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

Domestic treatment may be given as follows, until a physician can be obtained: Catnip, pennyroyal, or pleurisy-root tea, containing one teaspoonful of the Extract of Smart-weed, may be given, to drive the rash to the surface. Cold drinks are suitable to allay the thirst, nausea, and fever. The sick-room should be kept at a temperature of about 65° Fahr., and fresh air admitted freely. The patient ought not to be overloaded with bed-clothes; and the skin should be sponged over twice daily with tepid water, different parts being exposed successively, and carefully dried with soft cloths. Soda may be added to the water, but no soap should be used. The diet should consist of milk, extract of beef, and soups. Injections may be employed [pg 410]to relieve constipation, but purgatives should be avoided. We repeat that this disease is one which requires the attendance of the family physician, and great care should be exercised during recovery, that no bad results may follow.

SMALL-POX. (VARIOLA.)

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

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

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

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

The stage of suppuration commences thus: the pulse quickens, the skin becomes hotter, and in many cases of the confluent variety, swelling of the face, eyelids, and extremities occurs. Frequently there is passive delirium in this stage, and if diarrhea [pg 411]sets in, it is an unfavorable sign. The duration of this stage of the eruption is four or five days.

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

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

VARIOLOID. (MODIFIED SMALL-POX.)

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

VACCINIA. (COW-POX.)

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

In a few cases, in which the quality of the vaccine virus was [pg 412]deteriorated, its effect is only to slightly-modify small-pox, and then the disease resembles that caused by inoculation. The operation of infecting the blood with the kine virus is called vaccination. All that we know is that when the cow becomes affected with this disease, and it is then transferred to man, it loses its severity and serves as a protection against small-pox. In a great majority of cases this protection is absolute, and only in a very few does it leave the subject susceptible to small-pox, materially modified. The protection it affords against small-pox is found to diminish after the lapse of an indefinite number of years, and hence it is important to be re-vaccinated once or twice, for instance, after an interval of five years. Between the second and third months of infancy is the best period for vaccination, and the place usually selected is the middle of the arm above the elbow-joint.

CHICKEN-POX. (VARICELLA.)

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

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

MEASLES. (RUBEOLA.)

This is generally a disease of less severity and importance than the other eruptive fevers, but it is sometimes followed by [pg 413]serious complications. The stage of invasion is marked by the symptoms of a common cold, sneezing, watery eyes, a discharge from the nostrils, a dry cough, chilliness, and headache. This stage may last four days. Then follows an eruption of red dots or specks, which momentarily disappear on pressure. On the fourth day of the eruption the redness of the skin fades, the fever diminishes, and the vesicles dry into scales or little flakes. The eyes may be inflamed and the bowels may be quite lax at this stage.

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

False Measles (Rose Rash) is an affection of very little importance and may be treated similarly to a case of ordinary measles.

ERYSIPELAS.

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

[pg 414]Suppuration of the tissues involved is common in the severer forms. Should the tongue become dark and diarrhea set in, attended with great prostration, the case is very serious, and energetic means must be employed to save life. A retrocession of the inflammation from the surface to a vital organ is an extremely dangerous symptom. The disease is not regarded as contagious, but has been known to become epidemic.

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

DIPHTHERIA.

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

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

[pg 415]Symptoms. The symptoms vary in different cases. In some the disease comes on gradually, while in others it is malignant from the first. The throat feels sore, the neck is stiff and a sense of languor, lassitude, and exhaustion pervades the system. Sometimes a chill is experienced at the outset. Febrile disturbance, generally of a low, typhoid character, soon manifests itself. The skin is hot; there is intense thirst; the pulse is quick and feeble, ranging from 120 to 150 per minute. The tongue is generally loaded with a dirty coat, or it may be bright red. The odor of the breath is characteristic, and peculiarly offensive, and there is difficulty in swallowing and sometimes in breathing. Vomiting is sometimes persistent. If we examine the throat, we find more or less swelling of the tonsils and surrounding parts, which are generally bright red, and shining, and covered with a profuse, glairy, tenacious secretion. Sometimes the parts are of a dusky, livid hue, and, in rare instances, pallid. The false membrane, a peculiar tough exudation, soon appears and may be seen in patches, large or small, or covering the entire surface from the gums back as far as can be seen, its color varying from a whitish yellow to a gray or dark ashen tint. When it is thrown off, it sometimes leaves a foul, ulcerating surface beneath. The prostration soon becomes extreme, and small, livid spots may appear on the surface of the body. There may be delirium, which is, in fatal cases, succeeded by stupor, or coma. The extremities become cold; diarrhea, and in some cases convulsions, indicate the approach of death. Sometimes the patient dies before the false membrane forms.

Treatment. The extremely dangerous character of this disease demands that the services of a skillful physician be obtained at once; and that his efforts should be aided by the most thorough hygienic precautions, good fresh air, bathing, and a supporting diet. Prior to the arrival of the physician, lose no time in using plenty of good brandy or whiskey to offset the extremely weakening effect of the disease. The employment of alcoholic stimulation in this disease is almost always used by physicians. Control the vomiting and allay the thirst by allowing the patient to suck small pieces of ice every five or ten minutes. Hot fomentations or spirits of turpentine should be [pg 416]applied to the throat. If the physician does not take charge of the patient by this time, the use of permanganate of potash, triturated, in strength of one grain to the ounce, in a mixture of fine sugar of milk and gum acacia, and blown over the parts with an insufflater every few hours, brings the best results if thoroughly carried out; or the throat can be swabbed out with the following mixture: chlorate of potash, four drachms; tincture of muriate of iron, three drachms, syrup of orange, two ounces; water sufficient to make four ounces; administered every two or three hours. Inhaling steam or lime-water from a steam atomizer is especially good. The use of blisters, caustics, active purges, mercurials, or bleeding, should be condemned. Throughout the whole course of the disease the strength must be supported by the most nourishing diet, as well as by tonics and stimulants. Beef tea, milk, milk punch, and brandy should be freely administered. A competent physician should be called in as early as possible. The general results of the treatment with antitoxin, if given on the first, second or third day of the disease, are usually favorable. There are rarely any immediately bad results from the injections, and the published testimony of careful observers would tend to prove that recovery has followed its use in a larger percentage of cases than under former methods of treatment.

QUINSY. (TONSILLITIS.)

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

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

Symptoms. Difficulty of swallowing, soreness, and stiffness [pg 417]of the throat, are the first monitions of its approach. There is fever, quick, full pulse, and dryness of the skin; the tongue is furred, and the breath offensive. The tonsils are intensely red, swollen, and painful, the pain often extending to the ear. Sometimes but one tonsil is affected, though generally both are involved. In severe cases the patient cannot lie down, in consequence of the difficulty of breathing.

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

ENLARGED TONSILS.

Fig. 147. A A.—Enlarged Tonsils. B.—Elongated Uvula.

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

[pg 418]Causes. Repeated attacks of quinsy, scarlet fever, diphtheria, or scrofula, and general impairment of the system, predispose the individual to this disease.

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

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

(1.) To remedy the constitutional derangement.

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

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

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

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

ELONGATION OF THE UVULA.

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

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

ANÆMIA.

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

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

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

[pg 420]Anæmia may arise in consequence of low diet, or because the alimentary organs do not properly digest the food, or when there is not sufficient variety in the diet. No matter how anæmia is occasioned, whether by labor and expenditure, by hemorrhages, lead poisoning, prolonged exposure to miasmatic influences, deprivation of food, indigestion, imperfect assimilation, frequent child-bearing, or lactation, the number of the red corpuscles in the blood is materially diminished.

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

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

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

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

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

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

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

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

APNOEA.

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

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

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

LEUCOCYTHÆMIA.

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

They have been found abundant in the blood in diseases of the spleen and of the liver. Diarrhea usually attends this [pg 422]complaint, together with difficult breathing, loss of strength, gradual decline, fever, diminution of vital forces, and finally death. The recovery of a well-marked case of this disease is very doubtful. Its average duration is about one year.

DROPSIES.

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

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

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

General dropsy is commonly due to an impoverished condition of the blood, and this may be the result of albuminuria, a disease of the kidneys. Albuminuria is frequently the sequel of scarlatina. Hence, the utmost care should be taken against exposure of a patient recovering from scarlatina, and the same caution should be exercised during convalescence from measles, erysipelas, and rheumatism. Dropsies may be general, as in anasarca, or local, as dropsy of the heart, called cardiac dropsy: [pg 423]dropsy of the peritoneum, the serous membrane which lines the abdominal cavity, called ascites; dropsy of the chest, called hydrothorax; dropsy of the head, called hydrocephalus; dropsy of the scrotum, called hydrocele.

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

Treatment. Dropsy being only a symptom of various morbid conditions existing in the system, any treatment to be radically beneficial must, therefore, have reference to the diseased conditions upon which the dropsical effusion, in each individual case, depends. These are so various, and frequently so obscure, as to require the best diagnostic skill possessed by the experienced specialist, to detect them. There are, however, a few general principles which are applicable to the treatment of nearly all cases of dropsy. Nutritious diet, frequent alkaline baths to keep the skin in good condition and favor excretion through its pores, and a general hygienic regulation of the daily habits, are of the greatest importance. There are also a few general remedies which may prove more or less beneficial in nearly all cases. We refer to diuretics and hydragogue cathartics. The object sought in the administration of these is the evacuation of the accumulated fluids through the kidneys and bowels, thus giving relief. Of the diuretics, queen of the meadow, buchu, and digitalis generally operate well. As a cathartic, the Purgative Pellets accompanied with a teaspoonful or two of cream of tartar, will prove serviceable. Beyond these general principles of treatment it would be useless for us to attempt to advise the invalid suffering from any one of the many forms of dropsy. The specialist skilled by large [pg 424]experience in detecting the exact morbid condition which causes the watery effusion and accumulation, can select his remedies to meet the peculiar indications presented by each individual case. Sometimes the removal of the watery accumulation by tapping becomes necessary, in order to afford relief and give time for remedies to act. We have found it necessary to perform this operation very frequently in cases of hydrocele, and also quite often in cases of abdominal dropsy. The chest has also been tapped and considerable quantities of fluids drawn off, and this has been followed by prompt improvement and a final cure.

CASES TREATED.

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

Case II. A man aged 42, consulted us by letter, stating that he was

troubled with general bloating which had made its appearance gradually and was attended by general debility and other symptoms which have been enumerated as common to general dropsy. He had been under the treatment of several home physicians without receiving any benefit; he had steadily grown worse until he felt satisfied that if he did not soon get relief he could not live very long. He was requested to send a sample of his urine for examination, as we had suspicions, from the symptoms which he gave, that the cause of his dropsy was albuminuria, or Bright's disease of the kidneys. On examination of the urine, albumen in very perceptible quantities was found to be present. We had, about this time, come into possession of a remedy said by very good authority, to be a specific in degeneration of the kidneys when not too far advanced, and we determined to test it upon this well-marked case. We accordingly prescribed it, together with other proper tonics and alteratives, at the same time giving the patient important hygienic advice, which must be complied with if success is attained in the management of this very fatal malady. Our patient gradually improved, and in a few months' time was restored to perfect health, which he has continued to enjoy ever since. From our [pg 425]subsequent experience, embracing the treatment of quite a large number of cases of Bright's disease of the kidneys, we are satisfied that it is, in its early stage, quite amenable to treatment.

Case III. A man aged 35, single, consulted us for what he supposed

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

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

RHEUMATISM.

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

Acute Articular Rheumatism. Acute articular rheumatism implies an affection of the articulations or joints. It usually commences suddenly; sometimes pain or soreness in the joints precedes the disclosure of the disease. The symptoms are pain in the joints, tenderness, increased heat, swelling and redness of the skin. The pain varies in its intensity in different oases, and is increased by the movement of the affected parts. Swelling of the joints occurs, especially those of the knee, ankle, wrist, elbow, and the smaller joints of the hands and feet. The swelling and redness are generally in [pg 426]proportion to the acuteness of the attack. Acute articular rheumatism is always accompanied with more or less fever. Sweating is generally a prominent symptom, being strongly acid and more profuse during the night. The appetite is impaired, the tongue is coated, the bowels are constipated, or there is diarrhea.

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

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

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

[pg 427]Muscular Rheumatism. This affection is closely allied to neuralgia, and may properly be called myalgia. It exists under two forms, acute and chronic. In acute muscular rheumatism, there is at first a dull pain in the muscles, which gradually increases. When the affected muscles are not used the pain is slight, and certain positions may be assumed without inducing it constantly; but in movements which involve contraction of the muscles the pain is very violent. In some cases, the disease is movable, changing from one muscle to another, but usually it remains fixed in the muscle first attacked. The appetite and digestion are not often impaired, and there is no fever. The duration of this form of rheumatism varies from a few hours to a week or more.

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

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

One of the most marked features of muscular rheumatism, is the cramp-like pain, induced by the movements of the affected muscles, whereas the pain is slight when those muscles are uncontracted. This feature is very serviceable in distinguishing muscular rheumatism, or myalgia, from neuralgic affections. Another trait which distinguishes muscular rheumatism from neuralgia, is that the former is characterized by great soreness, while the latter is not. There is also a distinction between inflammation of the muscles and muscular rheumatism. In the case of the former, there is continued pain, swelling of the parts, occasional redness, and the presence of [pg 428]more or less fever, which conditions do not exist in the latter. Persons subject to rheumatism of the muscles, are apt to suffer from an attack, after exposure of the body to a draught of air during sleep, or when in a state of perspiration.

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

Treatment of Chronic Rheumatism. The general alkaline baths recommended in the acute affection are also valuable in the chronic. The spirit vapor-bath, the Turkish, as well as the sulphur vapor-bath, are all worthy of a trial in this obstinate and painful disease. Alternatives are a very valuable [pg 429]class of agents in chronic rheumatism. The following mixture, in teaspoonful doses three times a day, in alternation with the Golden Medical Discovery, has proved very successful in this disease: acetate of potash, one ounce; fluid extract of black cohosh, one ounce; fluid extract of poison hemlock, two drachms; simple syrup, six ounces. This thorough alterative course, if well persevered in, together with the use of alkaline and vapor-baths, will generally prove very successful. The specialist, however, dealing with chronic diseases exclusively, will occasionally meet with a case which has been the rounds of the home physicians without benefit, that will tax his skill and require the exercise of all his perceptive faculties to determine the exact condition of the patient's system, upon which the obstinacy of the disease depends. When this is ascertained, the remedies will naturally suggest themselves, and the malady will generally yield to them. But, although the treatment of this disease has entered largely into our practice at the Invalid's Hotel, and has been attended by the most happy results, yet the cases have presented so great a diversity of abnormal features, and have required so many variations in the course of treatment, to be met successfully, that we frankly acknowledge our inability to so instruct the unprofessional reader as to enable him to detect the various systemic faults common to this ever-varying disease, and adjust remedies to them, so as to make the treatment uniformly successful. If the several plans of treatment which we have given do not conquer the disease, we can not better advise the invalid than to recommend him to employ a physician of well-known skill in the treatment of chronic diseases. If such a one is not accessible for personal consultation, a careful statement of all the prominent symptoms, in writing, may be forwarded to a specialist of large experience in this disease, who will readily detect the real fault, in which the ailment has its foundation. Particularly easy will it be for him to do so, if he be an expert in the analysis of urine. A vial of that which is first passed in the morning, should be sent with the history of the case, as chronic rheumatism effects characteristic changes in this excretion, which clearly and unmistakably indicate the abnormal condition of the fluids of the body upon which the disease depends.

DISEASES OF THE SKIN.

ECZEMATOUS AFFECTIONS.

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

Eczema. (Humid Tetter, Salt-rheum, Running Scall, or Heat Eruption.) The term eczema is used to designate the commonest kind of skin diseases.

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

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

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

Plate I. Fig. 1. Fig. 2. Fig. 3. Fig. 4. Fig. 5.

Infants and young children are peculiarly subject to this disorder, and, if the disease be not promptly arrested, it will assume the severest form and eventually become chronic. The muscles are soft, the eyes are dull and expressionless, and the little sufferer experiences the [pg 431]most excruciating torments. Frequently the whole body is covered with patches of eczema, the secretions are arrested, and, where the scales fall off, the skin is left dry and feverish.

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

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

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

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

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

Lichen. (Papular Rash.) Lichen is a term used to designate an eruption of minute conical pimples, which are more or less transparent, red, and occasion great annoyance. The eruption is attended with a severe, hot, prickling sensation, as if the flesh were punctured with hot needles. The pimples contain no pus, but if opened, they exude a small quantity of blood and serum. This disease more frequently occurs between the ages of twelve and fifty, but occasionally appears [pg 432]during dentition, when it is called "tooth rash." The lichen pimples are sometimes dispersed singly over the skin and gradually subside, forming a minute scale, corresponding in position with the summit of the pimple. When the pimples appear in clusters, there is a diffused redness in the affected part, and, if they are irritated, minute scabs will be formed. Lichen generally appears on the upper portion of the body, as on the face, arms, hands, back, and chest.

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

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

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

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

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

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

Plate II. Fig. 6. Fig. 7. Fig. 8. Fig. 9. Fig. 10. Fig. 11. Fig. 12. Fig. 13.

In lichen planus, as the term indicates, the pimples are flattened. There is no sensation of itching or formation of scabs. The pimples are solitary and have an angular base, and the fresh pimples formed [pg 433]appear on the spaces between the former eruptions. This affection usually attacks some particular region, such as the abdomen, hips, or chest. Instances are recorded in which it has appeared on the tongue and the lining membrane of the mouth. Sometimes it appears in patches, but even then, the margin of each pimple can be discerned.

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

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

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

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

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

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

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

[pg 434]This eruption often appears on the face of persons addicted to intemperate habits, and has thus received the name of "rum blossom."

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

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

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

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

Treatment. In all the varieties of eczematous affections, except scabies, the treatment of which will hereafter be separately considered, remedies employed with a view to the removal of the constitutional fault are of the greatest importance. The eruption upon the skin is but a local manifestation of a functional fault, which must be overcome by alterative remedies. All the excretory organs should be kept active. To open the bowels, administer a full cathartic dose of Dr. Pierce's Pleasant Pellets. Afterwards they should be used in broken doses of one or two daily, in order to obtain their peculiar alterative effects. The use of Dr. Pierce's Golden Medical Discovery is also necessary to secure its constitutional remedial benefits. As a local corrective to relieve the itching and disagreeable dryness of the skin, add half an ounce of blood-root to half a pint of vinegar, steep moderately for two hours, strain and paint the affected parts once or twice daily with the liquid. Every night before retiring, apply glycerine freely to all the affected parts, or dissolve one drachm of oxalic acid in four ounces of glycerine and anoint the skin freely. The white precipitate ointment, obtainable at any drug store, is an excellent application is most forms of eczema. A tea, or infusion, of [pg 435]black walnut leaves, applied as a lotion to the affected parts, has also proved beneficial. The surface of the body should be kept clean by frequent bathing, and thus stimulating its capillary vessels to healthy activity. The eczematous surfaces should not be bathed frequently, and never with harsh or irritating soaps. All varieties of eczematous affections, except scabies, are only temporarily relieved by external applications, while the radical cure depends upon a protracted use of alterative, or blood-cleansing medicines. Therefore, we would again remind the reader of the necessity of keeping the bowels regular, and removing all morbid taints of the blood and faults of the secretory organs by the persistent use of Dr. Pierce's Golden Medical Discovery. The successful treatment of scabies, or common itch, generally requires only local applications, for the object to be obtained is simply the destruction of the little insects which cause the eruption. Happily, we possess an unfailing specific for this purpose. Numerous agents have been employed with success, but Sulphur enjoys the greatest reputation for efficacy, and, since it is perfectly harmless, we advise it for this class of disease. Take a quantity of pulverized sulphur and mix with sufficient vaseline or lard to form an ointment. Having first divested the body of clothing, anoint it all over freely, and rub the ointment thoroughly into the pores of the skin while standing before a hot fire. The application should be made at night before retiring, and the patient should wear woolen night-clothes or lie between woolen blankets. In the morning after the application, the patient should take a warm bath, washing the skin thoroughly and using plenty of soap. This treatment should be repeated two or three times to be certain of a perfect eradication of the disease. After this course of treatment, the wearing apparel as well as the bed-clothes should be thoroughly cleansed, as a precaution against a return of the disease.

ERYTHEMATOUS AFFECTIONS.

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

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

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

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

Plate III. Fig. 14. Fig. 15. Fig. 16. Fig. 20. Fig. 17. Fig. 19. Fig. 18.

Erysipelas. There are few adult persons in this country who have not, by observation or experience, become somewhat familiar with this disease. Its manifestations are both constitutional and local, and their intensity varies exceedingly in different cases. The constitutional symptoms are usually the first to appear, and are of a febrile character. A distinct chill, attended by nausea and general derangement of the stomach is experienced, followed by febrile symptoms more or less severe. There are wandering pains in the body and sometimes a passive delirium exists. Simultaneously with these symptoms the local manifestations of the disease appear. A red spot develops on the face the ear, or other part of the person. Its boundary is clearly marked and the affected portion slightly raised above the surrounding surface. [pg 437]It is characterized by a burning pain and is very sensitive to the touch. It is not necessary for the information of the general reader that we should draw a distinction between the different varieties of this malady. The distinctions made are founded chiefly upon the depth to which the morbid condition extends, and not on any difference in the nature of the affection.

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

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

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

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

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

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

In erysipelas a hot bath, with warm, sweating teas, or, better still. Dr. Pierce's Compound Extract of Smart-weed may be given to favor sweating. The whole person should be frequently bathed with warm water rendered alkaline by the addition of saleratus or soda. The whole should be moved by a full dose of the "Pleasant Pellets." Fluid extract of veratrum viride, in doses of a drop or two every hour will [pg 438]best control the fever. The specific treatment, that which antidotes the poison in the blood, consists in administering fifteen-drop doses of the tincture of the muriate of iron in one teaspoonful of the "Golden Medical Discovery," every three hours. As a local application, the inflamed surface may be covered with cloths wet in the mucilage of slippery elm. A preparation of equal parts of sweet oil and spirits of turpentine, mixed and painted over the surface, is an application of great efficacy.

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

BULLOUS AFFECTIONS.

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

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

The three general forms of this disease are herpes zoster, phlyctoenodes and circinatus.

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

[pg 439]In herpes circinatus, or ringworm, the vesicles appear in circular patches, or rings. This is the mildest form of herpes, and is not attended by symptoms of constitutional disorder. The various forms of herpes are represented in Colored Plate I, Fig. 3.

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

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

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

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

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

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

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

[pg 440]Miliaria is generally associated with certain febrile diseases, and its proper treatment consists in overcoming the febrile and other constitutional symptoms which accompany the disease. A hot foot-bath and small doses of tincture of aconite, say one drop in water each hour, will suffice to remove the fever. If the stomach and bowels are in a vitiated condition, as they are apt to be, a mild cathartic dose of "Pellets" should be given.

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

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

NERVOUS AFFECTIONS OF THE SKIN.

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

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

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

Treatment. To allay the itching, take glycerine, one ounce, add to it one drachm of sulphite of soda, and one ounce of rose-water, and apply this to the affected parts. A solution made with borax, two drachms, and morphine, fire grains, dissolved in six ounces of rose-water, makes an excellent lotion to allay the itching. If the disease [pg 441]be severe, it will be necessary to correct the vitiated condition of the blood by a protracted use of Dr. Pierce's Golden Medical Discovery, and to aid its effects, give one "Pleasant Pellet" every day, not to operate as a cathartic, but only to exert an alterative influence.

ALPHOUS AFFECTIONS.

(SCALY SKIN DISEASES.)

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

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

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

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

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

AFFECTIONS OF THE HAIR-FOLLICLES.

Favus (Scald Head) is a disease peculiar to the hair-follicles, and is indicated by the formation of small yellow crusts, having the form of an inverted cup. The eruption has a very offensive odor. When it appears in isolated cups, it is termed favus dispersus, but it often occurs in large clusters, as represented in Colored Plate II, Fig. 12. [pg 442]and is then termed favus confertus. It generally affects the scalp, but sometimes extends to the face and neck.

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

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

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

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

Acne or Stone-pock. In the earliest stage of congestion, acne is characterized by minute hardened elevations of the skin, as shown in Plate II, Fig. 9, and is termed acne punctata. As the affection progresses, a bright red pimple, Plate II, Fig. 11, appears, having a conical form, hence the name acne coniformis. The pimple develops into a pustule containing yellow "matter," and is then known as acne pustulosa. This is followed by a thickening of the tissues, termed acne tuberculata. When the thicker skin is removed, it leaves a deep scar, hence the term acne indurata.

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

Treatment. The treatment of favus or scald-head should be commenced by shaving the hair off close to the scalp and washing the head thoroughly with soap and water. In some severe cases, it may be necessary to soften the incrustations with poultices, following these with a free use of soap and water. Having thus exposed the scalp and thoroughly divested it of incrustations, apply to it the ointment of iodide of sulphur, which may be procured at any good drug store. It [pg 443]should be gently rubbed over the parts night and morning. The scalp ought to be kept perfectly clean throughout the treatment. Instead of the foregoing, the following may be applied: Take oxalic acid, ten grains; creosote, twenty drops; water, two ounces; mix. Half an hour after using this lotion, anoint the head freely with butter or lard; it will add greatly to the efficacy of the treatment. But while local applications will relieve many skin diseases and mitigate suffering, we cannot too strongly impress upon the minds of our readers the importance, in this as in all other chronic diseases of the skin, of perseverance in the use of the best alteratives. In this class of agents Dr. Pierce's Golden Medical Discovery stands pre-eminent. Its efficacy may be increased in this disease by adding to each bottle one ounce of the acetate of potash, and, when thus modified, it may be administered in the same manner as if no addition had been made to it.

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

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

FURUNCULAR AFFECTIONS.

(BOIL-LIKE AFFECTIONS.)

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

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

Treatment. Spirits of turpentine applied to a boll in its earliest [pg 444]stage will almost always cause it to disappear; but when suppuration has commenced it should be favored by the application of poultices. Next purify the blood to prevent subsequent returns to other parts of the body. For this purpose take Dr. Pierce's Golden Medical Discovery. One or two "Pleasant Pellets" each day will aid in the cure.

CARBUNCLE. (ANTHRAX.)

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

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

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

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

SCROFULA.

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

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

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

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

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

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

The existence of tubercular deposits in the tissues of the body, which characterizes scrofula, when fully developed, must not, however, be regarded as the primary affection. Its formation is the result of disordered nutrition. The products of digestion are not fully elaborated, and pass into the blood imperfected, in which condition they are unable to fulfill their normal destiny—the repair of the bodily tissues. Imperfectly formed albuminous matter oozes out from the blood, and infiltrates the tissues, but it has little tendency to take on cell-forms [pg 446]or undergo the vital transformation essential to becoming a part of the tissues. Instead of nutritive energy, which by assimilation produces perfect bodily textures, this function, in the scrofulous diathesis, is deranged by debility, and there is left in the tissues an imperfectly organized particle, incapable of undergoing a complete vital change, around which cluster other particles of tubercular matter, forming little grains, like millet seed, or growing, by new accretions of like particles, to masses of more extensive size. As tubercle is but a semi-organized substance, of deficient vitality, it is very prone to disintegration and suppuration. Being foreign to the tissues in which it is embedded, like a thorn in the flesh, it excites a passive form of inflammation, and from lack of inherent vital energy it is apt to decompose and cause the formation of pus. Hence, infiltration of the muscles, glands, or other soft parts with tuberculous matter, when inflammation is aroused by its presence, and by an exciting cause, give rise to abscesses, as in lumbar or psoas abscesses. When occurring in the joints, tubercles may give rise to chronic suppurative inflammation, as in white swellings and hip-joint disease. Various skin diseases are regarded as local expressions of, or as being materially modified by, the scrofulous diathesis, as eczema, impetigo, and lupus. The disease popularly known as "fever-sore" is another form of scrofulous manifestation, affecting the shafts of the bones, and causing disorganization and decay of their structure. Discharges from the ear, bronchitis, chronic inflammation of the intestinal mucous membrane, and chronic diarrhea are frequently due to scrofula, while pulmonary consumption is unanimously regarded as a purely scrofulous affectation. Scrofula shows a strong disposition to manifest itself in the lymphatic glands, particularly in the superficial ones of the neck. The most distinguishing feature of this form of the disease is the appearance of little kernels or tumors about the neck. These often remain about the same size, neither increasing nor diminishing, until finally, without having caused much inconvenience, they disappear. After a time these glands may again enlarge, with more or less pain accompanying the process. As the disease progresses, the pain increases, and the parts become hot and swollen. At length the "matter" which has been forming beneath, finds its way to the surface and is discharged in the form of thin pus, frequently containing little particles or flakes of tubercular matter. During the inflammatory process there may be more or less febrile movement, paleness of the surface, languor, impaired appetite, night sweats, and general feebleness of the system. The resulting open ulcers show little disposition to heal.

Symptoms. There is a train of symptoms characteristic of all scrofulous disease. The appetite may be altogether lost or feeble, or in extreme cases, voracious. In some instances there is an unusual disposition to eat fatty substances. The general derangement of the alimentary functions is indicated by a red, glazed or furrowed appearance of [pg 447]the tongue, flatulent condition of the stomach, and bloated state of the bowels, followed by diarrhea or manifesting obstinate constipation. Thirst and frequent acid eructations accompany the imperfect digestion. The foul breath, early decay of the teeth, the slimy, glairy stools, having the appearance of the white of eggs, and an intolerable fetor, all are indicative of the scrofulous tendencies of the system.

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

Fig. 1. A Scrofulous Tumor

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

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

Treatment. The skin should be kept clean by means of frequent baths. These assist the functional changes which must take place on the surface of the body, permit the stimulating influence of the light [pg 448]and air and facilitate the aeration of the blood, as well as the transpiration of fluids through the innumerable pores of the skin. All exposure to a low temperature, especially in damp weather, and the wearing of an insufficient amount of clothing should be avoided. Then the food should be generous and of the most nourishing character. Steady habits and regular hours for eating and sleep must be observed, if we would restore tone and regularity to the functions of nutrition. Moderate exercise in the open air is essential, in order that the blood may become well oxygenated, that the vital changes may take place. It is no doubt true that the occasion of the prevalence of scrofula among the lower classes may be ascribed to frequent and severe climatic exposures, irregular and poor diet, or want of due cleanliness. Every well-regulated family can avoid such causes and live with a due regard to the conditions of health. The proper treatment of scrofula is important, because we meet with its symptoms on every side, showing its slow actions upon different parts of the body and its influence upon all the organs. After this disease has been existing for an indefinite length of time, certain glands enlarge, slowly inflame, finally suppurate, and are very difficult to heal. These sores are very liable to degenerate into ulcers. All of these symptoms point to a peculiar taste of the blood, which continually feeds and strengthens this morbid outbreak. All authors agree that the blood is not rich in fibrinous elements, but tends to feebleness and slow inflammation, which ends in maturation. Thus we may trace back this low and morbid condition of the blood to debility of the nutritive organs, defective digestion, which may be induced by irregular habits, a lack of nourishing food, or by the acquirement of some venereal taint.

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

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

It is well known to medical men that nearly all medicines belonging [pg 449]to the class of alteratives, are capable of solution in the gastric and intestinal secretions, and pass without material change, by the process of absorption, through the coats of the stomach and intestines, as do all liquids, and so gain an entrance into the general circulation; that these same alteratives act locally to tone and strengthen the mucous surfaces, and thus promote and rectify the process of digestion before being absorbed; that alterative medicines, when in the blood, must permeate the mass of the circulation, and thus reach the remote parts of the body and influence every function; that these medicines, while in the blood, may combine with it, reconstruct it, and arrest its morbid tendencies to decomposition.

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

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

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

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

The bowels should be properly regulated. When constipation exists one or two of Dr. Pierce's Pleasant Pellets taken daily, will fulfill the indication. The patient ought not to neglect to carry out all the [pg 450]hygienic recommendations heretofore given. The treatment of running sores is very simple. Cleanse them every day with Castile-soap and water, being careful not to rub or touch the surface of the sores. Use a clean sponge or a piece of clean muslin and saturating it with the warm water, hold it a few inches above the affected part, and squeeze out the fluid, allowing the cleansing stream to fall gently upon the open sore. After thoroughly cleansing the sore, apply to it Dr. Pierce's All-Healing Salve. 25 cents in postage stamps sent to us will secure a box by return post if your druggist does not have it in stock.

HIP-JOINT DISEASE.

(COXALGIA.)

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

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

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

[pg 451]Many poor, unfortunate victims know too well, from sad experience, that the course of treatment frequently recommended and employed by physicians and surgeons is ineffectual, and cruel; they deplete the system, apply locally liniments, lotions, iodine, and hot applications; confine the patient in bed and strap his hips down immovably, thus preventing all exercise; then they attach that cruel instrument of torture, the weight and pulley, to the diseased limb.

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

In the light of our vast experience at the Invalids' Hotel and Surgical Institute, we feel that we cannot too strongly urge the employment of a suitable apparatus for supporting the hip-joint, giving it perfect rest, and enabling the patient to exercise and get the outdoor air. As much of the pain in this disease is due to the pressure of the head of the femur, or thigh-bone, in the acetabulum, or socket, steadily-applied mechanical extension, to relieve the inflamed and sensitive joint of the pressure, is of the greatest importance. By such application the patient is enabled to move about without pain, while the joint is kept perfectly at rest—a condition favorable to the reduction of inflammation within it. The surgeon specialist of the Invalids' Hotel and Surgical Institute is frequently sent for to visit cases of this disease hundreds of miles away and by the employment of suitable apparatus [pg 452]he has been enabled, in scores of cases, to relieve the suffering at once. In cases in which the head of the thigh bone, or the bony socket of the joint has become so diseased as to cause it to ulcerate and break down, all portions of diseased bone should be thoroughly removed by a surgical operation. If this be neglected or delayed, a fatal termination of the disease may be expected. Parents should not put off the employment of a competent specialist in this terrible, distressing, and fatal disease. As treated by general practitioners, it very often proves fatal; or, after causing intense suffering for a series of years, if the active condition of the disease subsides, the patient is left with a ruined and broken constitution, a result which more prompt and earlier relief would have prevented.

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

WHITE SWELLING

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

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

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

[pg 453]Synovitis may be considered under three heads; Rheumatic, Scrofulous, and Syphilitic.

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

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

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

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

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

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

RICKETS. (RACHITIS.)

Rickets is a scrofulous disease, in which there is derangement of the entire system, and it finally manifests itself in disease of the bones. It is characterized by a softening of the bony tissue, due to a deficiency of earthy or calcareous matter in their composition. It appears to be [pg 454]a disease incident to cold, damp places, ill-lighted and imperfectly ventilated rooms, and it especially attacks those who are uncleanly in their habits.

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

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

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

OLD SORES. (CHRONIC ULCERS.)

Under this head we may properly consider that class of affections known as Fever-sores, Running-sores, Ulcers, etc. These sores have common characteristics, yet each possesses certain peculiarities, which have led to their division into irritable, indolent, and varicose. These peculiarities are not constant, one form of ulcer often changing into another. One feature common to all, however, is their slowness in healing, which has sometimes led to the belief that they are incurable. Another popular notion is that their cure is detrimental to the health of the patient. With equal propriety we might say that it is dangerous to cure diarrhea, dysentery, consumption, or cancer. As a result of [pg 455]these erroneous impressions, many people suffer from chronic ulcers for years, and even for a life-time, without attempting to obtain relief. Chronic ulcers usually appear upon the lower extremities. The depth and appearance of the ulcer depend upon its character and the thickness of the tissues where it is situated. Fig. 2 shows a chronic ulcer, or fever-sore, as it appears upon the ankle.

Fig. 2. A Chronic Ulcer.

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

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

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

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

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

Constitutional treatment is of the utmost importance, and should, therefore, be thoroughly and persistently applied. The nutritive [pg 456]system, especially the absorbents, should be kept active, as these are the channels by which the broken-down tissue surrounding the sore is replaced by that of a higher grade of vitality. For this purpose, the best alteratives or blood cleansing remedies are required. If secretion and excretion are not normally performed, the blood becomes poisoned by the absorption of unhealthy "matter" from the sore, and various constitutional disturbances occur. If, at any time during treatment, constitutional disturbances are manifested by fullness or disagreeable sensations in the head, nausea, pain, cough, chills, or fever, a thorough cathartic should be given. If the patient be robust, a repetition of the same once a week will be very beneficial. Dr. Pierce's Golden Medical Discovery, and "Pellets" will be productive of the best results.

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

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

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

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

FEVER-SORE. (NECROSIS.)

By the term necrosis we mean mortification, or the state of a bone when it is deprived of life. Dunglison says: "This condition is to the bone what gangrene is to the soft parts." It is popularly known as fever-sore, there being no distinction made between this species of sore and those ulcers which affect only the soft tissues of the body. When [pg 457]any part of a bone becomes necrosed, it is treated as a foreign body. Nature makes an effort for its removal, and at the same time attempts to replace it with new and healthy materials. In consequence of this process, the dead portion is often inclosed in a case of new, sound bone, termed the involucrum; when this is the case the dead portion is termed the sequestrum. If, however, it be superficial, and separate from the parts beneath, it is called an exfoliation. This healing process, by which the involucrum is formed, cannot be completed while the dead portion remains. Hence, numerous openings are made through the involucrum, to permit the escape of the sequestrum. When a surgical operation is performed for the removal of the necrosed bone it is called sequestrotomy. The instruments which our specialists usually employ for this practice are represented in Figs. 3, 4, and 5.

Fig. 3. Hand drill for boring bone.

Fig. 4. The osteotrite, for enlarging openings and cutting carious bone.

Fig. 5. Gouge forceps for excavating bone.

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

Symptoms. The pain frequently commences in the night, and all [pg 458]the different stages succeed, until, finally, the result is frequently mortification or death. The entire bone, or only a part of it, may be affected; the parts become swollen, "matter" forms, and unless it be artificially evacuated, it will in time work its way out through a fistulous opening. As the disease progresses, the adjacent tissues become thickened and numerous openings are formed, which communicate with the bone, and often with each other, so that a probe may be passed from one to another, as represented in Fig. 6, copied from a drawing by Dr. Howe. The discharge from fever-sores varies in character, and usually has a fetid odor. The surgeon can readily distinguish between healthy and unhealthy bone by the use of a probe. The pus discharged in necrosis contains minute particles of bone, which may be felt by rubbing it between the fingers. Sometimes large pieces present themselves at the openings. The general health is seriously impaired, and the patient becomes debilitated, anæmic, and hectic.

Fig. 6. Necrosis of the tibia. A common probe is passed through the sinuses, or openings.

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

Usually the dead bone is easily removed by the skilled specialist surgeon, and, when thoroughly taken out, the parts readily heal and the patient rapidly recovers. The removal, therefore, of the dead bone which is a constant source of irritation, and the cause of protracted suffering, should not be delayed, for very rarely indeed can it be removed at all without the assistance of the surgeon. Besides, delay often results in the loss of the limb, and not unfrequently occasions [pg 459]the death of the patient. Under the influence of a reliable local anæsthetic, carefully applied, the operation of removing the decayed and offensive bone is speedily and painlessly performed, the use of chloroform or ether not generally being required.

TESTIMONIALS.

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

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

BLOOD DISEASE.

Raw Sores from Knee to Ankle.

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

Master Amasa Peck

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

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

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

A.B.P.

ANÆMIA—IMPOVERISHED BLOOD.

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

Mrs. Knight.

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

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

ERYSIPELAS.

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

J. Smith, Esq.

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

I give you the privilege of using my name

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

BLOOD AND KIDNEY DISEASE.

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

Mr. Edmundson.

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

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

ECZEMA—SUFFERINGS INTENSE.

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

J.P. Delano, Esq.

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

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

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

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

BOILS CURED.

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

Wm. Ramich, Esq.

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

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

A TERRIBLE SKIN DISEASE.

Jackson, N.C.

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

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

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

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

J.A. Buxton.

BAD CASE OF ECZEMA OR SALT-RHEUM.

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

Mrs. Foster.

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

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

ERYSIPELAS AND WOMB DISEASE.

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

Mrs. White.

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

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

ECZEMA.

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

Miss Harris.

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

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

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

SALT-RHEUM—FLESH CRACKED OPEN AND BLED.

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

Miss Clark.

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

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

INVETERATE SKIN DISEASE

M. Allen, Esq.

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

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

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

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

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

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

CURES BROWN SPOTS.

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

Mrs. Johnson.

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

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

SCROFULOUS DISEASE.

Mrs. Nichols.

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

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

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

"HEART-RENDING TO BEHOLD".

Terrible Suffering from Skin Disease.

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

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

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

SCROFULOUS ABSCESSES.

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

Mrs. Sweeney.

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

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

CROSS EYES.

Convergent Strabismus. Instant and Painless Cure.

D. Crane, Esq.

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

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

Your Hotel and skillful surgery merit every recommendation.

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

SCROFULOUS SORE EYES

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

Miss Gardner.

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

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

WEAK AND SORE EYES.

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

John Casserly.

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

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

RUNNING SCROFULOUS SORES.

H.M. Holleman, Esq.

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

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

"FEVER SORES."

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

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

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

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

GENERAL DECLINE, RUNNING SORE ON LEG.

Fort Coulonge, Pontiac Co., Quebec.

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

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

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

Yours truly,
Mrs Isaac Brady

ECZEMA.

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

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

Very respectfully,
Rebecca F. Gardner

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

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

Mr Fred Pestline.

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

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

RUNNING SORE.

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

Mrs. Kuhn.

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

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

"OLD SORES" ON LEGS.

Alexander, N.C.

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

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

Yours respectfully,
J.N. Kery Kendall

HIP-JOINT DISEASE.

Physicians Fail to Benefit.

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

E.J. Rush.

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

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

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

HIP-JOINT DISEASE CURED.

Mrs. Ridgley.

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

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

HIP-JOINT DISEASE OF 11 YEARS' STANDING.

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

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

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

Yours truly,
H.F. Giron

THICK NECK (GOITRE).

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

Master Sumner.

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

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

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

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

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

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

THICK NECK (GOITRE),

Nervous Debility and Weakness Cured.

Miss Rachel Mann.

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

GOITRE CURED.

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

Miss Rachel Mann.

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

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

CARBUNCLES LARGE AS HEN'S EGGS!

Eight or Ten Years Afflicted. Two Bottles only, Cure.

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

Col. T.U. Fogg.

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

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

THICK NECK. (GOITRE.)

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

Fig. 7.

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

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

Those who are afflicted with this disease and unable to avail themselves of special treatment, cannot do better than to take Dr. Pierce's Alterative Extract, or Golden Medical Discovery, and apply to the skin over and around the tumor, night and morning the following solution which may be prepared at any drug store: iodine, one [pg 471]drachm; iodide of potassium, four drachms; dissolve in three ounces of soft water. Apply to the tumor twice a day, with a feather or hair pencil.

MUMPS. (PAROTITIS.)

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

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

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

INFLUENZA, OR LA GRIPPE.

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

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

[pg 472]Symptoms. The attack usually resembles an ordinary catarrh of cold. In some cases the nasal catarrh is absent, or very mild, and the infection invades the general system, with much fever. A very striking manifestation of the disease is the severe nervous troubles which are present at the outset, consisting of headache, pain in the back and legs, and a general soreness of the muscles and bones as if bruised or beaten. The pulse is usually feeble and small—intermittent. The disease may center in the brain, producing delirium. Mental disorders are not uncommon, and there is usually following the disease more or less inaptitude for mental work and a tendency to depression of spirits. In many cases there is a severe diarrhea, and the individual suffers much from pain and discomfort in the abdomen. This is a gastro-intestinal irritation, and apparently favors an early recovery, and usually there are less severe sequels in such cases.

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

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

ACUTE NASAL CATARRH.

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

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

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

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

Treatment. In the mild forms of acute catarrh, or coryza, only simple treatment is required. A hot foot-bath on retiring at night, with a full dose of Dr. Pierce's Compound Extract of Smart-weed, to produce free perspiration will generally break up the attack. Should the discharge from the nostrils continue, Dr. Sage's Catarrh Remedy should be freely used four to six times each day, until the symptoms are controlled. In case the bowels do not act, a full dose of Dr. Pierce's Pleasant Pellets may he taken at bed-time. Avoidance of exposure to cold, and light vegetable diet, are advisable. In the more severe attacks, especially when complicated by laryngeal or bronchial symptoms, the most decisive measures should be employed. The Compound Extract of Smart-weed should be taken freely, together with [pg 474]hot drinks, or a hot general bath. The patient should be warmly covered in bed to encourage a continued perspiration, to equalize the circulation, and subdue the inflammation. Dr. Pierce's Golden Medical Discovery should be taken in teaspoonful doses four times each day in all cases that are complicated or protracted.

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

CHRONIC NASAL CATARRH.

OZÆNA.

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

Injury to the nose may result in a displacement of one or more of the bony structures, setting up a chronic inflammation with catarrh at that point. In the early stages of the disease, the patient may be annoyed with "only a slight dropping into the throat," as many express it, the amount of the discharges from the air-passages of the head at this stage of the disease being only slightly in excess of health. In some cases the discharge is thick, ropy, and tough, requiring frequent and strong efforts in the way of blowing and spitting, to remove it from the throat, in which it frequently lodges. In other cases, or in other stages of the same case, the discharge is thin, watery, acrid, irritating, and profuse. The nose may be "stopped up" from the swollen and thickened condition of the lining mucous membrane, so as to necessitate respiration through the mouth, giving to the voice a disagreeable nasal twang. From the nature of the obstruction in this condition, it is useless for the sufferer to endeavor to clear the passage by blowing the nose; this only tends to render a bad matter worse, by increasing the irritation and swelling of the already thickened lining membrane. The swelling of the mucous membrane does not in all cases become so great as to cause obstruction to respiration through [pg 475]the affected passages. In some cases, the patient suffers from head ache a great portion of the time, or experiences a dull, heavy, disagreeable fullness or pressure in the head, with a confusion of his ideas, which renders him quite unfit for business, especially such as requires deep thought and mental labor. Memory may be more or less affected, and the disposition of those who are otherwise amiable is often rendered irritable or morose and despondent. The mental faculties suffer to such an extent in some cases as to result in insanity. The sense of smell is in many cases impaired, and sometimes entirely lost, and the senses of taste and hearing are not unfrequently more or less affected.

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

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

COMPLICATIONS.

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

Occasionally deformities of the septum or other internal structures [pg 476]also polypi or tumors, are sources of constant irritation and accelerate catarrhal disease.

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

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

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

Fig. 8. Internal and external ear. 1, External ear. 2, Internal auditory meatus. 3, Tympanum. 4, Labyrinth. 5, Eustachian tube.

Deafness. By means of a small canal, called the eustachian tube, an air-passage and communication between the throat and middle ear is formed. (See Fig. 8.) This passage is lined by a continuation of the mucous membrane which covers the throat and nasal passages. The catarrhal inflammatory process, by continuity of surface, follows the mucous membrane, thickening its structure, until the eustachian tube is closed, and the beautiful mechanism of the internal ear is rendered useless. While the thickening of the mucous membrane is going on, and the passage is gradually becoming closed (and [pg 477]the process sometimes extends through several years), the patient will occasionally, while blowing the nose, experience a crackling in one or both ears, and hearing becomes dull, but returns suddenly, accompanied with a snapping sound. This may be repeated many times, until, finally, hearing does not return, but remains permanently injured. In other cases the hearing is lost so gradually that a considerable degree of deafness may exist before the person is really aware of the fact. Either condition is often accompanied with noises in the head of every conceivable description, increasing the distress of the sufferer. The delicate bones of the ear are sometimes detached from their articulations, the drum is ulcerated and perforated, and through the orifice thus made, the bones or small spiculæ may escape with the thick, purulent, and offensive discharge.

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

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

Symptoms. Dull, heavy headaches through the temples and above [pg 478]the eyes; indisposition to exercise; difficulty of thinking or reasoning, or concentrating the mind upon any subject; lassitude; indifference respecting business, lack of ambition or energy; obstruction of nasal passages; discharges voluntarily falling into the throat, sometimes profuse, watery, acrid, thick and tenacious, mucous, purulent, muco-purulent, bloody, concrete blood and pus, putrid, offensive, etc. In others, a dryness of the nasal passages: dry, watery, weak, or inflamed eyes; ringing in the ears, deafness, discharge from the ears, hawking and coughing to clear the throat, ulcerations, death and decay of bones, expectoration of putrid matter, spiculæ of bones, scabs from ulcers leaving surface raw, constant desire to clear the nose and throat, voice altered, nasal twang, offensive breath, impairment or total deprivation of the sense of smell and taste, dizziness, mental depression, loss of appetite, nausea, indigestion, dyspepsia, enlarged tonsils, raw throat, tickling cough, difficulty in speaking plainly, general debility, idiocy, and insanity.

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

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

Causes. Anything which debilitates the system, or diminishes its powers of evolving animal heat and withstanding cold or sudden changes of atmospheric temperature, and other disease-producing agencies, renders the individual thus enfeebled very liable to catarrh. Among the most common debilitating agencies are a scrofulous condition of the system, or other impurities of the blood, exhaustive fevers, and other prostrating acute diseases, or those badly treated; exhaustive and unnatural discharges, intemperance, excessive study, self-abuse, adversity, grief, want of sleep, syphilitic taints of the system, which may have been contracted unknowingly, or may have been inherited, having perhaps been handed down even unto the third or fourth generation, to an innocent posterity from infected progenitors; too sudden rest after great and fatiguing exercise, and living in poorly-ventilated apartments. These are among the most fruitful causes of those feeble, deranged, or impure conditions of the system to which catarrh so frequently owes its origin. Although the immediate or exciting cause is generally repeated attacks of "cold in the head," which, being neglected or improperly treated; "go on from bad to worse," yet the predisposing or real cause of the disease is in the majority of cases, [pg 479]an enfeebled, impure, or otherwise faulty condition of the system, which invites the disease, and needs only the irritation produced in the nasal passages by an attack of cold, to kindle the flame and establish the loathsome malady. Some people are convinced with difficulty that there exists in their system a weakness, impurity, or derangement of any kind, which permitted the disease to fasten itself upon them. They may not feel any great weakness, may not have any pimples, blotches, eruptions, swellings, or ulcers, upon their whole person; in fact, nothing about them that would, except to the skilled eye of the practical and experienced physician, indicate that their system is weakened or deranged with bad humors; and yet such a fault may, and generally does, exist. As an ulcer upon the leg, or a "fever-sore," or an eruption upon the skin, may be the only outward sign of a fault in the system, so frequently chronic catarrh is the only sign by which a bad condition of the system manifests itself in a manner that is perceptible to the sufferer himself, or to the non-professional observer. The finely-skilled physician, whose constant practice makes his perceptive faculties perfect in this direction, would detect the constitutional fault, as an experienced banker detects a finely-executed and dangerous bank-note which the unpracticed eye would pronounce genuine.

Fig. 9. Examination of the Nasal Passages by means of the Rhinoscope and Head Mirror.

Treatment. If you would remove an evil strike at its root. As the predisposing or real cause of catarrh is, in the majority of cases, some weakness, impurity, or otherwise faulty condition of the system, in attempting to cure the disease our chief aim must be directed to the removal of that cause. The more we see of this odious disease, the more so we the importance of combining; with the use of a local, soothing [pg 480]and healing application, a thorough and persistent internal use of blood-cleansing and tonic medicines.

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

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

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

The "Golden Medical Discovery" is the natural "helpmate" of Dr. Sage's Catarrh Remedy. It not only cleanses, purifies, regulates, and builds up the system to a healthy standard, and conquers throat, bronchial, and lung complications, when any such exist, but, from its specific effects upon the lining membrane of the nasal passages, it aids materially in restoring the diseased, thickened, or ulcerated membrane to a healthy condition, and thus eradicates the disease. When a cure is effected in this manner it is permanent. The system is so purified, regulated, and strengthened, as to be strongly fortified against the encroachments of catarrh and other diseases. The effects of the "Golden Medical Discovery" upon the system will be gradual, and the alterative changes of tissue and function generally somewhat slow. They are [pg 481]with however, less complete, radical, and lasting; and this constitutes its great merit. Under its influence all the secretions are aroused to carry the blood-poisons out of the system, the nutrition is promoted, and the patient finds himself gradually improving in flesh; his strength is built up, his lingering ailments dwindle away, and by and by he finds his whole person has been entirely renovated and repaired he feels like a new man—a perfect being.

Fig. 10. Atomizer.

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

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

Treatment of Complications. There are various complications of this disease that require modifications of the treatment to meet them successfully. The rules cannot be made that would enable non-professional readers to vary the treatment to suit peculiarities of constitution, or complications of the disease. When consulted, either the person or by letter, we have been able to so modify the treatment as to be adopt it to peculiar individuals which rejected the ordinary treatment, [pg 482]and have thus cured hundreds who had otherwise failed to find relief.

Fig. 11. Steam Atomizer, illustrating position of head during treatment.

Time Required in Effecting a Cure. Reader, if you suffer from chronic nasal catarrh, do not expect to be very speedily cured, especially if your case is one of long standing. Unprincipled quacks and charlatans, who possess no knowledge of disease, or medicine either, and whose sole design is to palm off upon you a bottle or two of some worse than worthless strong, caustic solution, irritating snuff, or drying "fumigator," "dry up," "annihilator," "carbolated catarrh cure," "catarrh specific," or other strong preparation, will tell you that the worst cases can be speedily cured by these unreasonable means. It is true that such strong, irritating, and drying preparations will many times suddenly arrest the discharge from the nose, but the thickened or ulcerated condition of the lining mucous membrane, which really constitutes the disease, is not removed by such treatment, and the discharge soon comes on again. Besides, there is danger attending the employment of such strong, irritating, or drying preparations. The disease, by their use, is frequently driven to the throat, bronchial tubes, lungs, or brain, and thus a bad matter is made worse. Not less irrational and unsuccessful is the plan of treating the disease with inhalations of "carbolized iodine," and other drags, administered through variously-devised pocket and other inhalers. Such treatment may mask or cover up catarrh for a time; [pg 483]but, by reason of the constitutional nature of the disease, it cannot effect a perfect and permanent cure. Dr. Sage's Catarrh Remedy, on the other hand, cures the disease on common-sense, rational, and scientific principles, by its mild, soothing, and healing properties, to which the disease gradually yields, when the system has been put in perfect order by the use of "Golden Medical Discovery." This is the only perfectly safe, scientific, and successful mode of acting upon and healing it. Without, we trust, being considered egotistical, we can say that this opinion is based upon a large experience and a perfect familiarity with the nature and curability of the disease. For many years our whole time and attention has been given to the study and cure of catarrh and other chronic diseases treated of in "The People's Common Sense Medical Adviser." Cases of catarrh have been treated by thousands, and our medicines for the cure of this loathsome disease, and of other chronic diseases, have met with an extensive sale in all parts of the United States, and have found their way into many foreign countries. The universal satisfaction with which their use has been attended, and the grateful manifestations received from the cured, have afforded one of the greatest pleasures of our lives. Scarcely a mail arrives that does not bring new testimony of cures effected by the treatment here recommended.

DIRECTIONS FOR USING DR. SAGE'S CATARRH REMEDY.

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

Use the fluid, prepared according to the above directions, not less than three or four times a day, the last time just before retiring, in the following manner: Without shaking the bottle to roll the fluid, pour out a teaspoonful or more into the hollow of the hand, hold it there until warmed; first gently, and afterwards forcibly, snuff the fluid up one nostril and then the other, until the nose is well filled and it passes back into the throat. No fears need be entertained that it will produce strangling or any unpleasant effect in thus using it, for, unlike any [pg 484]other fluids (simple tepid water not excepted), it does not produce the slightest pain or disagreeable feeling, but, on the contrary, leaves such a cooling, pleasant sensation that its use soon becomes a pleasure rather than a task. In a few minutes after thus using the remedy, it should be blown out gently (never forcibly), to clear the nose and throat of all hardened crusts and offensive accumulations, if any such exist. Never blow the nose violently, as it irritates the passages and counteracts, to some extent, the curative effects of the remedy. This process should be repeated until the remedy has been thoroughly applied two or three times, not blowing it out the last time of using it, but retaining the medicine in contact with the affected parts for a considerable length of time. No harm can result if the fluid be swallowed, as it contains nothing poisonous or injurious.

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

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

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

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

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

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

Fig. 12. This cut illustrates the manner of using Dr. Pierce's Nasal Douche.

To cleanse out the passages previous to applying the Catarrh Remedy fluid, take one quart of soft water, add to it two large tablespoonfuls of common salt, and shake it up occasionally until all is dissolved. Before use heat it until blood warm, or, in other words, until it gives a pleasant, mild warmth to the inserted finger. Put the reservoir on a shelf, or hang it up, so that it will be a little higher than the head: fill the reservoir with salt and water, pressing the tube between the thumb and finger so as to prevent the fluid from escaping through it; introduce the nozzle at the end of the tube into one nostril, pressing it in far enough to close the entrance of the passage so that no fluid can escape by the side of the tube, breathe through the mouth, avoid swallowing, and allow the fluid to flow. The soft palate, by the act of breathing through the mouth, is elevated so as to completely close the passage into the throat, and thus the fluid is made to flow up one nostril in a gentle stream, to pass into and thoroughly cleanse all the [pg 486]sinuses, or cavities, connected with the nasal passages, and to flow out of the other nostril. The douche should not be employed unless both nostrils are open and the flow is free. If the head is "stopped up," snuff up the warm liquid from the hand occasionally, until the passages are open and you can breathe freely through both nostrils.

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

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

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

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

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

NASAL POLYPUS.

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

Fig. 13. NASAL POLYPI. A. Anterior opening of the nostril. B. Soft Palate, C. Orifice of the Eustachian tube. D, D. Superior and inferior turbinated bodies. E. Large Polypus. F. Several small Polypi. G. Throat. H. Polypoid growth on turbinated body.

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

Symptoms. These may vary considerably in different cases due to the character and location of the polypus. In the early stages before the tumor is well developed, the symptoms may be those of nasal catarrh, and the diagnosis of polypus be possible only after a personal examination by a skillful specialist. Neither is the size of the polypus [pg 488]always in proportion to the severity of the symptoms. The nasal discharge is generally increased and of a variable character. As the tumors enlarge they cause a sense of fullness and weight between and below the eyes, with more or less headache and facial neuralgia. There is partial or complete obstruction of one or both nostrils. In some cases the obstruction changes from one nostril to the other when lying down; the stoppage generally being on the side toward the pillow. A polypus located at the junction of the nasal passages and throat by force of gravity always causes obstruction to the lower nasal cavity when lying down. Polypi often attain considerable size and by pressure upon and displacement of the surrounding structures occasion hideous facial deformity. Changes in the weather often aggravate the symptoms. By blowing the nostril the tumor sometimes may be forced forward, so that it may be seen a short distance from the anterior opening of the nostril. The voice is often affected, being muffled or harsh in tone, similar to that which accompanies a cold in the head. Respiration may be considerably embarrassed, due to the obstruction in the nasal passages, and the patient necessarily resorts to mouth breathing. In advanced cases the Larnyx is usually much congested, being constantly irritated, not only reflexly through the nervous system, but directly by the inspired air, and excoriating discharges dropping in the throat from behind the palate. Thus it is plain to understand how chronic Pharyngitis, Laryngitis, Bronchitis, and Asthma may result from a small polypus in the nasal cavity.

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

OUR OPERATION FOR NASAL TUMORS.

Having operated with unvarying success upon a very large number and variety of nasal tumors at the Invalids' Hotel and Surgical Institute we are positively assured that the means and methods which we employ are neither severe or dangerous; no pain, consequently no shock; recovery rapid and permanent. Many forms of injection and local treatment are in use for the removal of nasal polypi, none of which have proven to be curative; recurrence of the tumor many times following such treatment. Many cases have presented themselves after having been treated by the heroic method of seizing the polypus with a pair of forceps and forcibly tearing it loose, bringing with it segments of healthy tissue, leaving bone exposed, and a ragged, uneven surface of diseased membrane. It is much easier to properly [pg 489]treat a case from the beginning than to undertake it in such a rendition.

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

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

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

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

1st. Our operation is absolutely painless.

2d. No chloroform or ether is required.

3d. We insure perfect removal of growth.

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

5th. The operation is bloodless.

6th. The recovery is rapid.

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

DEFORMITY OF THE NASAL SEPTUM.

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

Fig. 14. Anterior view of the healthy nasal passages as seen with the projecting portion of the nose removed. A. Vertical septum or bony plate separating nostrils. B, B. Turbinated bodies. C, C. Nasal passages.

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

Symptoms. The location and extent of the deformity of the nasal septum necessarily gives opportunity for a variety of symptoms. In aggravated cases the nose appears to be bent toward one side. In the earlier stages there is an excess of mucous secretion, often dropping [pg 491]into the throat from behind the palate. The discharge is variable as in nasal catarrh with more or less difficult nasal breathing, the stoppage changing from one nostril to the other. Sneezing and frequent attacks of nose bleed are often common symptoms. The tendency of the disease is to extend backward often causing headache, deafness, roaring in the ears and post-nasal disease which results in a chronic sore throat, the latter disease often being the one for which the patient seeks advice. If allowed to progress uninterruptedly the throat gradually becomes more irritable, associated with an annoying cough, and the voice becomes harsh and has a nasal tone. The general health is impaired, the nervous system excitable; laryngitis, asthma, and lung disease become complications, which render the existence of the individual miserable.

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

OUR PAINLESS OPERATION.

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

[pg 492]Our specialists were among the first surgeons in this country to employ this newly-discovered anæsthetic. We regard it as a great boon to our patients, and never withhold it in any case where it can be employed to prevent suffering. Its use is attended with no danger, nor is it followed by bad or disagreeable results.

OUR OPERATION.

Fig. 15. Anterior view of deformed nasal passages as seem with the projecting portion of the nose removed. A. Deformed and thickened septum or bony plate separating nostrils. B, B. Irregular and obstructed nasal passages. C. Diseased and swollen turbinated body. D, D. Turbinated bodies crowded back by septum.

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

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

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

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

All treatments are carried out under strict aseptic precautions, thus reducing the danger from absorption of poisonous secretions to the minimum. By our skillful and ingenious management of these cases we never have had a single patient manifest any serious symptoms after operation. In such cases we consider this the only safe, practical, and permanent cure. Every year hundreds pass out of existence [pg 493]the victims of incurable disease of the air-passages resulting from morbid nasal conditions, who might be saved by proper and timely treatment.

PHARYNGITIS AND POST-NASAL CATARRH.

Fig. 16. Use of the Post-nasal Syringe in the treatment of Post-nasal Catarrh. A. Tongue. B. Epiglottis. C. Soft palate. D. Anterior opening of the nostril. E, E, E. Turbinated bodies. F. Junction of the nasal passage and throat. G. Diseased and roughened mucous membrane. H. Throat or Pharynx. I, I. Interior of nasal passage.

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

Treatment To rationally treat a disease, attack the cause. Therefore, in an uncomplicated case of post-nasal disease of the pharynx the medicine should be applied at this point. For this purpose we recommend [pg 494]the regular and continuous use of Dr. Sage's Catarrh Remedy administered preferably by means of the post-nasal syringe as illustrated in Fig. 16.

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

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

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

ENLARGED TONSILS.

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

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

Symptoms. The voice is often husky, nasal or guttural, and disagreeable. When the patient sleeps, a low moaning is heard, accompanied with snoring and stentorian breathing, and the head is thrown back so as to bring the mouth on a line with the windpipe, and thus facilitate the ingress of air into the lungs. When the affection becomes serious it interferes with breathing and swallowing. The [pg 495]chest is liable to become flattened in front and arched behind, in consequence of the difficulty of respiration, thus predisposing the patient to pulmonary disease. On looking into the throat, the enlarged tonsils may be seen, as in the Fig. 17. Sometimes they are so greatly increased in size that they touch each other.

Fig. 17. A. A. Enlarged Tonsils. B. Elongated Uvula.

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

(1.) To remedy the constitutional derangement.

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

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

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

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

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

ELONGATION OF THE UVULA.

Chronic enlargement, or elongation of the uvula or soft palate, as shown at B in Fig. 17, may arise from the same causes as enlargement of the tonsils. It subjects the individual to a great deal of annoyance [pg 496]by dropping into or irritating the throat. It causes tickling and frequent desire to clear the throat, also change, weakness and loss of voice, and often gives rise to a very persistent and aggravating cough. Constriction of the throat, cough and difficult breathing are more prominent symptoms in complicated cases.

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

CHRONIC LARYNGITIS.

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

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

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

Treatment. The patient should avoid using his voice as much as possible. At the same time, attention should be paid to the diet, the bathing, and the clothing. Every thing should be done that is calculated to build up and improve the general health. Dr. Pierce's Golden Medical Discovery is well adapted to remove morbid states of the disease, in consequence of its direct action on the mucous membranes of the air-passages, and its efficacy in allaying irritation of the [pg 497]laryngeal, pharyngeal, and pneumogastric nerves. It should be perseveringly employed. Iodine inhalations, administered with the pocket inhaler, illustrated by Fig. 3, and the application of tincture of iodine to the forepart of the neck, are efficacious in many cases. Inhalations of chloride of ammonia, administered with a steam-atomizer, Fig. 11, in the form of spray, are frequently of great benefit. Perseverance is necessary, and the afflicted are cautioned against discontinuing the treatment too soon, for the disease is very liable to return.

CONSUMPTION.

PHTHISIS PULMONALIS.

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

Some idea of its prevalence may be formed when we consider that, of the entire population of the globe, one in every three hundred and twenty-three persons annually dies of consumption. It may not be definitely known just what proportion of all the deaths in this country and Europe occurs from this one disease. Those who have gathered statistics differ somewhat, some claiming one-fourth, while others put the ratio at one-sixth, one-seventh, and even as low as one-ninth. A fair estimate, and one probably very near the truth, would be one-sixth or one-seventh of the whole number. In New York City, for five consecutive years, the proportion was three in twenty. In New England, about twenty thousand annually succumb to this destroyer, and in the State of New York as many more. These figures may appear to be exaggerations, but investigations of the subject prove them to be the simple truth. Epidemics of cholera, yellow fever, and other diseases of similar character, so terrible in their results, occasion wide-spread alarm, and receive the most careful considerations for their prevention and cure, while consumption receives scarcely a thought. Yet the number of their victims sinks into insignificance when compared with those of consumption. Like the thief in the night, it steals upon its victim unawares. In a large proportion of cases, its approach is so insidious that the early symptoms are almost wholly disregarded; indeed, they excite but little, if any, attention, and perhaps for a time [pg 498]disappear altogether. Thus the patient's suspicions, if they have been aroused, are allayed and appropriate measures for his relief are discontinued. This may be the case until renewed attacks firmly establish the disease, and before the patient is fully aware of the fatal tendency of his malady, he is progressing rapidly towards that "bourne from which no traveler returns."

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

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

The most plausible theory in regard to them is, that they are the result of imperfect nutrition. Such a substance cannot be produced in the blood when this fluid is perfectly formed. It is an unorganized particle of matter, resulting from the imperfect elaboration of the products of digestion, which is not, therefore, properly fitted for assimilation with the tissues. The system being unable to appropriate it, and powerless to cast in off through the excretory channels, deposits it in the lungs or other parts of the body. There it remains as a foreign substance, like a splinter or thorn in the flesh, until ejected by suppuration and sloughing of the surrounding parts. It might be supposed by some that when the offending matter was thus eliminated from the lungs, they would heal and the patient recover; but, unfortunately, the deposition of tubercular matter does no cease. Owing to the morbid action of the vital forces, it is formed and deposited as fast [pg 499]or faster than it can be thrown off by expectoration. Hence arises the remarkable fatality of pulmonary consumption.

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

The Predisposing Causes, then, are hereditary predisposition, scrofula, debility of the parents, climatic influences, sedentary habits, depressing emotions, in fact, anything which impairs the vital forces and interferes with the perfect elaboration of nutritive material.

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

Symptoms. The symptoms of consumption vary with the progress of the disease. Writers generally recognize three stages, which so [pg 500]gradually change from one to the other that a dividing line cannot be drawn. As the disease progresses, new conditions develop, which are manifested by new symptoms. Prior to the advent of pulmonary symptoms, is the latent period, which may extend over a variable length of time, from a few months to several years; and, indeed, may never be developed any farther. Until sufficient tubercular matter has been deposited in the lungs to alter the sounds observed on auscultation and percussion, a definite diagnosis of tubercular consumption cannot be made, even though there may have been hemorrhage. Nevertheless, when we find paleness, emaciation, accelerated and difficult breathing, increased frequency of the pulse, an increase of temperature, and general debility coming on gradually without any apparent cause, we have sufficient grounds for grave suspicions. These are increased if tenderness under the collar-bone, with a slight, hacking cough is present. These symptoms should be sufficient to warn any individual who has the slightest reason to believe that he is disposed to consumption, to lose no time in instituting the appropriate hygienic and medical treatment, for it is at this stage that remedies will be found most effective. Unfortunately, this period is too apt to pass unheeded, or receive but trifling attention; the patient finds some trivial excuse for his present condition, and believes that he will soon be well. But, alas for his anticipations! The disease goes onward and onward, gradually gaining ground, from which it will be with great difficulty dislodged.

The cough now becomes sufficiently harassing to attract attention, and is generally worse in the morning. The expectoration is slight and frothy; the pulse varies from ninety to one hundred and twenty beats in a minute, and sometimes even exceeds this. Flushes of heat and a burning sensation on the soles of the feet and palms of the hands are experienced. A circumscribed redness of one or both cheeks is apparent. These symptoms increase in the afternoon, and in the evening are followed by a sense of chilliness more or less severe. The appetite may be good, even voracious; but the patient remarks that his food "does not seem to do him any good," and, to use a popular expression, "he is going into a decline." As the strength wanes the cough becomes more and more severe, as if occasioned by a fresh cold, in which way the patient vainly tries to account for it. Expectoration increases, becomes more opaque, and, perhaps, yellow, with occasionally slight dots or streaks of blood. The fever increases, and there is more pain and oppression of the chest, particularly during deep respiration after exercise. Palpitation is more severe. There may now be night-sweats, tire patient waking in the morning to find himself drenched in perspiration, exhausted, and haggard. Bleeding from the lungs occurs, and creates alarm and astonishment, often coming on suddenly without warning. The hemorrhage usually ceases spontaneously, or on the administration of proper remedies, and in a few days the patient feels better than he has felt for some time previously. [pg 501]The cough is less severe, and the breathing less difficult. Indeed, a complete remission sometimes occurs, and both patient and friends deceive themselves with the belief that the afflicted one is getting well.

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

If the patient is a female, and deranged or suppressed menstruation has not marked the accession of pulmonary symptoms, the flow now becomes profuse and clotted, or is scanty and colorless, sometimes ceasing altogether. In the male, the sexual powers diminish, and copulation is followed by excessive and long-continued prostration. From this time onward, the progress of the disease is more rapid. The liver and kidneys are implicated. In addition to the pallor, the complexion becomes jaundiced, giving the patient, who is now wasting to a mere skeleton, a ghastly look. The urine is generally copious and limpid, though occasionally scanty and yellow. The pulse increases to one hundred and thirty or one hundred and forty beats in the minute, and is feeble and thread-like. The cough harasses the patient so that he does not sleep, or his rest is fitful and unrefreshing; whenever sleep does occur, the patient wakes to find himself drenched with a cold, clammy perspiration. The throat, mouth, and tongue now become tender, and occasionally ulcerate. Expectoration is profuse, purulent, and viscid, clinging tenaciously to the throat and mouth, and the patient no longer has strength to eject it. The hair now falls off, the nails become livid, and the breathing difficult and gasping; the patient has no longer strength to move himself in bed and has to be propped up [pg 502]with pillows, and suffocates on assuming the recumbent position. Drinks are swallowed with difficulty. Diarrhea takes the place of constipation. The extremities are cold, swollen, and dropsical; the voice feeble, hollow, grating, husky, the patient gasping between each word; the respiration is short and quick. A slight remission of these symptoms occurs. The patient is more comfortable, lively, cheerful, and perhaps forms plans for the future. But it is the last effort of expiring vitality, the last flicker of the lamp of life, the candle burns brilliantly for a moment, and with one last effort goes out, and death closes the scene.

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

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

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

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

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

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

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

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

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

Auscultation and Percussion constitute valuable means of diagnosis from the time tubercular matter begins to be deposited to the very last, and, when correctly practiced, reveal the extent and progress of the disease. As a knowledge of the sounds elicited can only be acquired by practical experience with proper instruments, they will not [pg 503]be described here. The only diseases with which consumption is likely to be confounded are general debility in the early stage, bronchitis, chronic pleurisy, chronic pneumonia, and abscess in the lungs, after the advent of pulmonary symptoms.

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

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

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

No farther back than 1866, on page 145, of the proceedings of the Connecticut Medical Society, we find "Observations, Ante-mortem and Post-mortem, upon the case of the late President Day by Prof. S.G. [pg 504]Hubbard, M.D., New Haven," from which we learn that Jeremiah Day, LL. D., who was for twenty-nine years President of Yale College, was, while a mere youth, a victim of pulmonary consumption. During his infancy and boyhood his vitality was feeble. He entered Yale College as a student in 1789, "but was soon obliged to leave the institution on account of pulmonary difficulty, which was doubtless the incipient stage of the organic disease of the lungs which subsequently developed itself." He remained in feeble health for two years, but returned to college, and graduated in 1797. For the next six years his lung difficulties were quite severe, and he repeatedly bled in large quantities, but he had so far recovered in 1803, as to accept a Professorship. He was afterwards chosen President of the college, which office he held for many years, in the enjoyment of good health. He died from "old age," as we are told, in 1867, aged 94 years.

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

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

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

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

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

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

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

[pg 505](4.) The relief of local symptoms, and the complications arising from other diseases.

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

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

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

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

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

Derangement of the process of nutrition requires careful attention, [pg 506]and, if necessary, correction. For this purpose, nothing can excel Dr. Pierce's Golden Medical Discovery. It increases the appetite, favors the nutritive transformation of the food, enriches the blood, and thus retards the deposition of tubercular matter. It is so combined that, while it meets all these indications, it relieves or prevents the development of those distressing symptoms so common in this disease.

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

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

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

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

Improvement of the general health is always attended with amelioration of the cough. If the patient did not cough at all, the lungs would soon fill up with broken-down tissue, and death from suffocation would result. Irritation of the nerves supplying the lungs sometimes occurs, and causes the patient to cough immoderately, when it is [pg 507]not necessary for the purpose of expectoration. This condition is readily controlled by Dr. Pierce's Golden Medical Discovery, which exerts a decidedly quieting and tonic influence upon the pneumogastric nerve, which, with its ramifications, is the one involved. An infusion of the common red clover, in tablespoonful doses, will also be found a valuable adjunct in overcoming this condition.

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

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

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

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

Derangement of the Liver is often a complication requiring attention, and the timely relief of which goes very far in ameliorating the general condition of the patient. The "Golden Medical Discovery" is generally sufficient to relieve this complication. Its influence, however, may be considerably increased in this direction by the use of Dr. Pierce's Pleasant Pellets, according to the directions which accompany [pg 508]them. They should only be taken in the smallest doses, one or two "Pellets" every day, just enough to produce a natural movement of the bowels each day.

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

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

CHRONIC BRONCHITIS.

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

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

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

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

Treatment. Thorough attention to hygiene, with the avoidance of the causes concerned in the production and perpetuation of the disease, is necessary. The patient must be protected from the vicissitudes of the weather by plenty of clothing; flannel should be worn next to the [pg 510]skin, with a pad of flannel or buckskin over the chest, and the feet should be kept warm and dry. Exercise in the open air is essential. When the weather is so cold as to excite coughing, something should be worn over the mouth, as a thin cloth, handkerchief, muffler, or anything which will modify the temperature of the atmosphere before it comes into contact with the mucous lining of the lungs. Good ventilation of sleeping-rooms is all-important; not that the air should be cold, but that it should be as pure as possible.

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

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

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

ASTHMA.

PHTHISIC.

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

UNPARALLELED SUCCESS.

Persons affected with asthma or phthisic are numerous. With such an amount of suffering in our midst is it not a marvel, if not a disgrace, that the medical profession of to-day endorse the opinions of a half century ago and pronounce it incurable, rather than make stupendous and laudable efforts to discover plans of medication that will [pg 512]result in certain and permanent cure? Almost single handed we undertook this field of investigation, and we take pleasure in reporting that our labors have been crowned with success. The large experience furnished us has led to the discovery of remedies for this distressing malady of more than ordinary efficacy. Through the agency of these means we have been enabled to cure hundreds, who had suffered untold tortures for twelve, fifteen, or twenty-five years. Some whom we have been successful in curing had suffered from childhood to middle and even old age. The treatment of asthma, or phthisic, still continues to be a prominent specialty at the Invalids' Hotel and Surgical Institute.

NATURE OF THE DISEASE.

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

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

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

POPULAR REMEDIES USED FOR SELF-TREATMENT OF ASTHMA.

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

1. Equal parts of the tinctures of lobalis capsicum and skunk [pg 513]cabbage root. Dose.—Take a half teaspoonful in a little water every ten or fifteen minutes until relieved.

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

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

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

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

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

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

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

These recipes are given to the public as being the principal agents employed by the medical profession throughout the world. It must be distinctly understood that they are not curative but merely palliative, and used to relieve paroxysms. We object to them wholly and unqualifiedly because they contain NARCOTICS. It is a fundamental principle in our treatment not to use this class of remedies. They stupefy the brain, debilitate the nervous system, and have, in not a few instances, formed an unfortunate appetite and habit, most difficult to overcome. We are of the opinion that one of the chief reasons why this malady has been considered incurable is the fact that physicians have almost universally relied upon narcotic drugs. With such medication a cure is the exception. A cure can only be effected under such circumstances when the powers of nature are sufficient to overcome both the NARCOTIC and the DISEASE. That they will relieve we do not deny, but they will never cure. It reminds us of an old country doctor who advised a lady to smoke tobacco to cure acid dyspepsia. She followed the prescription for over thirty years and at last accounts was not cured [pg 514]yet. In all seriousness we ask would any other remedy except a narcotic or stimulant be used with such persistency for anything like this length of time? Is it not apparent that such agents form a habit which is often worse than the disease, and yet fail to effect a cure? We appreciate the necessity for relief, and do not blame sufferers for availing themselves of any means for this purpose. But they should not be satisfied with relief only, but should look about for such a system of medication as will rid them of the disease completely and permanently. If a week's or a month's exemption is a "foretaste of heaven," how incomparable are the comforts and happiness to be derived from a life-time immunity?

MILLIONS OF DOLLARS

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

HAY ASTHMA, OR HAY FEVER.

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

Some feather beds give off an odor which excites all the aggravated symptoms of this disease. Thus it appears that certain emanations [pg 515]have the power of inciting these inflammatory conditions in certain sensitive constitutions. In all individuals suffering from this disease there is an over sensitiveness of the nervous system which admits of the appearance of such sudden and severe manifestations. Many cases suffering only mild symptoms for the first few seasons, annually become aggravated until severe spasmodic asthma is a regular, and sometimes continuous complication. A case or two are on record in which the odor from the body of a horse so induced these symptoms that the individual could never ride or drive him.

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

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

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

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

TESTIMONIALS.

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

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

BLEEDING FROM LUNGS, CONSUMPTION

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

(Before) C.H. HARRIS, ESQ.

(After) C.H. HARRIS, ESQ.

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

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

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

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

SEVERE CHRONIC COUGH.

Wilbar, Wilkes Co., N.C.

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

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

Yours very truly,
Mrs. Anna Parsons

SPITTING OF BLOOD. LUNG DISEASE.

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

J.M. Hite, Esq.

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

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

LUNG DISEASE.

Mrs. McGill.

Blue Rock, Muskingum Co., Ohio.

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

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

MR. THOMAS McGILL.

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

CURES WHEN COD LIVER OIL FAILS.

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

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

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

MALARIA, CHILLS, AND LUNG DISEASE.

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

R. Williams, Esq.

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

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

CONSUMPTION.

Almost Raised From the Grave.

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

MRS. VANSICKLIN.

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

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

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

CONSUMPTION.

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

J.A. Henson, Esq.

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

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

IT "FILLS THE BILL." LUNG DISEASE.

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

A.D. Simmons, Esq.

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

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

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

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

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

CONSUMPTION.

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

Mrs. Smith.

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

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

DYSPEPSIA AND NASAL CATARRH.

DR. PIERCE, Buffalo, N.Y.:

J. Larson, Esq.

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

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

LUNG DISEASE.

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

J.J. Hume, Esq.

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

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

A BAD COUGH.

Vanburen, Kalkaska Co., Mich.

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

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

Respectfully yours,
Jennie Dingman

SEVERE COUGH.

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

Mrs. Jewell.

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

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

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

SPITTING OF BLOOD.

Olanta, Clearfield Co., Pa.

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

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

Yours truly,
D.Y. Rowles

DESPONDENCY.

Nervous Prostration—Threatened with Consumption.

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

H. Cummins, Esq.

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

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

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

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

LUNG DISEASE.

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

Mrs. Fisher.

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

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

CHILLS AND LINGERING COUGH

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

H. Dietzel, P.M.

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

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

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

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

HEREDITARY CONSUMPTION.

Home Doctors Opposed His Coming to Us (they often do) Although Unable to Help Him Themselves.

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

J.F. Jones, Esq.

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

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

ABSCESS OF LUNG. REDUCED ALMOST TO A SKELETON.

Bisbee, Cochise Co., Ariz.

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

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

Your true friend,
Mrs. Sarah A. Kelly

LUNG DISEASE.

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

Mrs. Sickles.

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

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

REDUCED TO A SKELETON.

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

Mrs. Mills.

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

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

COUGH AND NIGHT SWEATS.

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

H.M. Detels and Wife.

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

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

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

PULMONARY DISEASE. A WONDERFUL CURE.

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

Chas. E. Lees, Esq.

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

The doctor told me it would be useless again to use the aspirator, but that he would be obliged to make an incision in my side and treat it till I got well. [pg 524]On the 28th day of March. 1890, my doctor and his partner and three other doctors undertook the operation, and, after removing about two inches of one of my ribs, withdrew 16 pints of pus. This came near being too much for me though I slowly recovered and in three months the doctors thought I was able to come home. I arrived home in June and was very poorly all summer, and did not sit up but very little, and had fever every day. In the latter part of the summer of '90 I commenced to take "Golden Medical Discovery" and although my side had been discharging for TWENTY-THREE MONTHS it healed up sound and well. I am now able to do considerable hard work. I would advise all who are afflicted as I was, to give your medicine a trial. I am glad I have out-lived my friends' expectations.

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

THROAT AND LUNG DISEASE.

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

Mrs. White.

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

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

WEAK LUNGS, COUGH, PROFUSE EXPECTORATION AND CATARRH.

A. Kratz, Esq.

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

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

LUNG DISEASE.

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

Mrs. Lincoln.

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

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

CONSUMPTION AND GENERAL DEBILITY.

Cured by Special Home Treatment.

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

Mrs. F. Nienhuis.

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

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

"COMPLETELY WRECKED."

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

Mrs. Lindsey.

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

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

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

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

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

BRONCHITIS OF TWENTY YEARS' STANDING.

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

B.F. Wiley, Esq.

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

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

BRONCHITIS.

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

M.M. Alexander, Esq.

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

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

LUNG DISEASE.

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

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

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

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

Yours gratefully,
Lulu E. Baugs

CHRONIC SORE THROAT, COUGH HOARSENESS.

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

Mrs. Traphagen.

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

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

CONSUMPTION. BAD COUGH, SPIT UP BLOOD.

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

K.C. McLin, Esq.

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

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

LUNG DISEASE.

Coughed Day and Night.

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

Mrs. Steinmann.

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

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

BILIOUSNESS, CONSTIPATION, BAD COUGH.

G.I. Wilder, Esq.

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

Gentlemen—Some twenty-five years since I was feeling very miserable all summer; I was very bilious; sometimes my bowels would not move once in sixty or seventy hours, and then almost impossible. I would take some bitters, which would help to move the matter, but as soon as the bitters were gone, I had to buy more or I would be as bad as before, and sometimes worse; but none of them appeared to do me any good except to move the bowels, until thirty years since a druggist called my attention to Dr. Pierce's Golden Medical Discovery, and before I had taken half a bottle of the "Golden Medical Discovery" I felt much better and by the time I had taken all, I could eat three hearty meals per day and had not felt so well for a long time. Soon after I was called to do a job some miles from home, and one night the old lady there was speaking about her daughter, (Mrs. Brooks) who had been under the doctor's care for five months and did not get any better, and I learned by asking a few questions that she had no appetite, and no ambition to do anything. Then I told her what the "Golden Medical Discovery" had done for me. The next day the old lady drove down to her daughter's, and got Mr. Brooks to send to Rutland—ten miles away—for two bottles of the "Golden Medical Discovery," and the next day the doctor came, and when about to take leave, Mr. Brooks told the doctor he did not want him any more at present and would send for him if necessary. I saw the old lady about ten days later and her daughter was improving, and Mr. Brooks had great faith in the "Golden Medical [pg 528]Discovery," and had not sent for the doctor, but had gone to Rutland for more of the "G.M.D."

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

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

THROAT AND LUNG DISEASE.

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

Mrs. Bringer.

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

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

SEVERE LUNG AND BRONCHIAL DISEASE.

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

E. Campbell, Esq.

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

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

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

DYSPEPSIA AND CONSUMPTION.

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

Mrs. Ferguson.

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

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

LUNG DISEASE CURED.

Miss M.H. Snead.

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

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

DISEASE OF LUNGS AND STOMACH.

Locust Lane, Scott County, Va.

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

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

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

Yours truly,
Milton Ramry

DOCTORS ENDORSE IT.

An Eminent Physician of Arkansas Tells of Some Remarkable Cures of Consumption.

Mrs. Rogers.

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

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

CHRONIC BRONCHITIS AND DYSPEPSIA.

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

A. Rosenberger, Esq.

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

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

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

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

"SORE THROAT."

Palatka, Putnam Co., Florida.

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

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

Yours Truly,
Mrs. Ellen Calvert

LUNG AND WOMB DISEASE,

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

Mrs. Knavel.

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

When I first commenced with Dr. Pierce's medicines, I could not walk half [pg 531]a mile without a pain. The other day I walked to Mercersburgh post-office, a distance of twelve miles, and the next day walked back again, and felt no bad results from the Journey. I am now 51 years old.

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

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

BRONCHITIS AND LUNG DISEASE.

Mrs. Neal.

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

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

BLEEDING FROM LUNGS; CHRONIC CATARRH; VERY LOW.

Cured by Special Home-Treatment

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

G.R. Sprinkle.

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

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

LUNG DISEASE.

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

Mrs. Van Baskirk.

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

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

"COMPLETELY BROKEN DOWN"

From Dyspepsia, Catarrh, Spinal Disease—Nervous Prostration.

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

C.M. Niles, Esq.

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

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

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

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

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

At last I thought I would write you what I could of my symptoms, and get your opinion of my case, but it took me about two days to write the letter. My head felt so bad that I could not collect myself enough to describe my feelings. You wrote me that my trouble was caused by indigestion, dyspepsia, catarrh, and spinal affection, and that you could cure me, and in fact, make a new man of me if I would send for your special treatment and follow your advice. My son sent for the medicine for me. I took it and followed your directions as near as I [pg 533]could; the first week I could not see much of any change—the second week I could see that I was improving some, the third week I could look back and see that I had gained considerable. I could sleep better; the bloating in my bowels did not trouble me so bad; my stomach did not distress me so much and I could eat different kinds of food and my digestion seemed to be improving fast; and by using your Special Catarrh Remedy my nose began to run (it had been nearly six months that my nose was perfectly dry) and one day it felt as though something gave way in my head—it seemed to be back, in behind my eyes, and I blowed a large amount of filth out of my head that looked like the yolk of an egg, and it was nearly as thick as jelly; after that my head began to improve rapidly and I began to gain in flesh and strength, and the best of all is, I have kept right on gaining until at the present time I feel as well as I ever did in my life. Sleep well, can eat three hearty meals every day and digest them too, and eat anything I want, and seven days in a week.

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

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

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

CATARRH, INDIGESTION, AND NERVOUSNESS.

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

E.A. Baldwin, Esq.

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

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

NASAL CATARRH.

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

Miss Pollak.

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

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

CHRONIC NASAL CATARRH

Resulted In lung Disease. Despaired of Obtaining Relief.

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

H.J. Converse, Esq.

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

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

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

A TERRIBLE CASE OF CATARRH.

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

Mrs. Lansing.

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

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

CATARRH AND GENERAL DEBILITY.

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

Thos. Lewis, Esq.

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

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

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

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

CATARRH AND LIVER COMPLAINT.

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

Wm. King, Esq.

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

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

CATARRH, BRONCHITIS, LIVER COMPLAINT AND DYSPEPSIA.

Ely, White Pine Co., Nevada.

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

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

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

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

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

D.D. Phillips

BRONCHITIS; CATARRH.

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

Mrs. Osborne.

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

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

NASAL CATARRH, LUNG DISEASE, INDIGESTION, ETC.

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

H.A. Milne, Esq.

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

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

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

CONSUMPTION.

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

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

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

Sincerely yours,
Clura McIntyre

CHRONIC NASAL CATARRH.

DR. R.V. PIERCE, NO. 663 Main St., Buffalo, N.Y.:

Mrs. Flemming.

Dear Sir—I had been troubled with chronic nasal catarrh for a year; could not sleep at night or rest in the day, because I could not breathe through my nose. I tried everything I was told of, and all failed to cure. I read about Dr. Pierce's remedies and thought I would try them. I used three bottles of Dr. Pierce's Golden Medical Discovery, four of Dr. Sage's Catarrh Remedy, and I was relieved within two weeks. I continued these medicines for four weeks, and am perfectly cured. I would advise any one who is troubled with catarrh to use Dr. Pierce's medicines. I am very thankful for the remedies.

Yours respectfully,
MRS. M. FLEMMING,
698 17th Ave., Milwaukee, Wis.

NASAL CATARRH AND DYSPEPSIA.

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

Mrs. Nuckolls.

Gentlemen—Twenty years ago I was nearly dead with nasal catarrh. I had it several years before I knew what it was, then I read Dr. Pierce's description of catarrh. I felt as he described. No one else had ever been able to tell me anything of the symptoms he described. I simply concluded that if he could so minutely describe, he could also relieve, and I immediately placed myself under his treatment—by correspondence. In a few months I was entirely relieved and have not suffered from it since.

At the time I placed myself under his care I could not breathe with my mouth closed. My friends thought I could live only a few months more. I have had no return of catarrh and enjoy good health. I believe Dr. Pierce's treatment will cure any case of catarrh.

Nine years ago I was under Dr. Pierce's treatment (by correspondence) for dyspepsia. After a few months' treatment I was entirely cured of that terrible disease.

Yours respectfully,
MRS. HENRY NUCKOLLS,
Rockville, Hanover County, Va.

CATARRH OF TWENTY YEARS' STANDING.

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

J. Weaver, Esq.

Gentlemen—My catarrh was of about twenty years' standing; my left nostril closed, I could not breathe through it; had a constant pain above my left eye night and day. I commenced using Dr. Sage's Catarrh Remedy, at the same time using the "Golden Medical Discovery"; I used one package and one bottle of "Golden Medical Discovery" and I found great relief; after using the second I thought all was right, but I began to feel the effects of it again, so I got the third and fourth packages, and I am satisfied I am rid of it. Since I commenced using your medicines, I have taken six bottles of Dr. Pierce's Golden Medical Discovery.

Yours respectfully, JOHN WEAVER,
West Carrollton,
Montgomery Co., Ohio.

CHRONIC NASAL CATARRH CAUSES GREAT SUFFERING.

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

Mrs. Crocker.

Gentlemen—I had been a great sufferer from nasal catarrh for a number of years which greatly debilitated my system, and in consequence, have been in poor health for the last five years.

Slight exposure would cause bronchial trouble, but kept up under it until a little more than two years ago when I was taken with "La Grippe," which greatly aggravated my other troubles; and for more than six months before consulting you was scarcely able to do anything; could not breathe through my nostrils only a little while at a time either day or night; I suffered dreadfully, having at times terrible pains in my head being unable to sleep some nights more than two hours and then not without dreaming, and when I awoke my head felt worse then when I retired. Had indigestion, chronic constipation and stomach trouble.

A little more than a year ago, while reading in one of your Memorandum Books I decided to try your Dr. Pierce's Golden Medical Discovery, "Favorite Prescription" and "Pellets;" and after using several bottles, I began to get better and to get some strength, but my catarrh remained about the same until I consulted you by letter and the remedy prescribed proved effectual; after three months' treatment, I am able to do most of my house work.

Yours respectfully, MRS. SARA M. CROCKER.
P.O. Box 332. Niantic, New London Co., Ct.

CHRONIC NASAL CATARRH.

Thought His Case Hopeless—Two Bottles Care.

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

A.G. Meise, Esq.

It gives me great pleasure to testify to the merits of Dr. Sage's Catarrh Remedy. I can say honestly and candidly that it is the grandest medicine ever compounded for catarrh. I suffered terribly with that dreadful disease and thought my case a hopeless one. I have expended on my case about forty dollars for different remedies guaranteed to cure catarrh in its worst form, but received no benefit therefrom. I also received treatment from two physicians, but they did me no good. Having read a great deal about Dr. Sage's Catarrh Remedy, I concluded to try it. The first bottle gave the most pleasing results, and the second bottle completely cured my case, which I considered hopeless. I most heartily recommend Dr. Sage's Catarrh Remedy to all suffering from catarrh, with the assurance that it will surely cure. It is a great boon to suffering humanity. Hoping that this humble testimony may be the means of leading many sufferers to try your most valuable medicine with the same happy results as I experienced, and wishing you the best of success, I am,

Yours sincerely, AUGUST G. MEISE,
Vincennes, Ind.

NASAL CATARRH.

Naples, Uinta Co., Utah.

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

Gentlemen—I have been using Dr. Sage's Catarrh Remedy and have been taking "Golden Medical Discovery" since I last wrote to you. I am well pleased with the result. I feel better than I have for years. The "Golden Medical Discovery" caused a very unpleasant sensation to pass through my body at first but I do not feel it much now. I have recommended it to others and the only complaint I hear now is that our druggist cannot keep a supply on hand.

I take pleasure in reporting my case to you, and I feel that the interest you have taken in my case has been a blessing unto me.

My mother has suffered with bad legs for over twenty years and last fall they got so bad she was unable to walk. She has taken "Golden Medical Discovery" all winter and is now able to walk a little. She says she feels better in body than she has for years. She has spent the most of her life among the sick and speaks very highly of your medicines.

Yours truly,
Geo A. Slough

IMPURE BLOOD AND CATARRH.

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

Rev. J.H. Tate.

Gentlemen—My health is better now than it has been in ten years. I used six bottles of "Golden Medical Discovery," and three bottles Doctor Sage's Catarrh Remedy, and since using your medicines I have been able to do more work than before. I have been teaching school since my health got better and last year I was able to travel and preach fifty-nine sermons, besides my work of teaching.

For four years I suffered with catarrh in my head, and impure blood, until my health was very feeble. Dr. Pierce's Golden Medical Discovery I found to be the best blood-purifier I ever used. Had I not used your remedies I believe that I would have been dead to-day, or at least not able to say anything. But instead of that I am able to walk one and one-half miles and teach school every day.

Yours truly,
REV. J.H. TATE,
Wahoo, Sullivan Co., Tenn.

CATARRH AND DYSPEPSIA

Cured by Special Home-Treatment.

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

B. Eberhardt, Esq.

Gentlemen—I am happy to inform you that my catarrh and dyspeptic symptoms have all vanished. I am no longer troubled with headache and stoppage of the nose, my stomach is in good order, and I enjoy three hearty meals daily without any bad feelings.

I have gained in almost every respect, particularly in weight and strength, since beginning the use of your specially prepared medicines. By continuing to follow your special hygienic rules, I believe no relapse will occur.

Yours respectfully,
BERTHOLD EBERHARDT,
N.E. Cor. 10th and Callowhill Streets,
Philadelphia, Pa.

NASAL CATARRH

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

M.D. Ingram, Esq.

Gentlemen—I have used your Dr. Sage's Catarrh Remedy and Dr. R.V. Pierce's Golden Medical Discovery and they cured me of a severe Catarrh in the Head. I can honestly recommend them to all who may suffer from that distressing disease.

Yours truly.
M.D. INGRAM,
Ingram, Bell Co., Ky.

Mr. Ingram had suffered for many years from the most distressing symptoms, such as profuse offensive discharge from nose, stopping up of nose, sneezing, weak eyes and frequent headache.

CHRONIC NASAL CATARRH AND LUNG DISEASE.

Marlow, Baldwin Co., Ala.

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

Gentlemen—I had catarrh in the head for years, and trouble with my left lung at the same time. You put so much faith in your remedies that I concluded to try one bottle or two, and I derived much benefit therefrom. I used up three bottles of Dr. Sage's Catarrh Remedy, five bottles of your "Golden Medical Discovery," and in four months I was myself again. I could not sleep on my left side, and now I can sleep and eat heartily. So long as I have your medicines on hand I have no need of a doctor; I do not think my house in order without them.

Yours truly,
A.H. Heard

A DEBT OF GRATITUDE.

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

Prof. W. Hausner, Famous Mesmerist.

Gentlemen—Some ten years ago I suffered untold agony from chronic nasal catarrh. My family physician gave me up as incurable, and said I must die. At this time I weighed 110 pounds. My case was such a bad one, that every day, towards sunset, my voice would become so hoarse I could barely speak above a whisper. In the morning my coughing and clearing of my throat would almost strangle me. By the use of Dr. Sage's Catarrh Remedy in three months I was a well man; the cure has been permanent, and I now weigh 148 pounds.

Yours truly, PROF. W. HAUSNER,
Ithaca, Tompkins Co., N.Y.

CATARRH, DEAFNESS AND OTHER COMPLICATIONS.

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

M.C. Weaver, Esq.

Gentlemen—I take pleasure in announcing to you that I have been greatly benefited by your medicines; my trouble began with nasal catarrh and extended to my throat and ears; my bowels were inactive and my general health became impaired; my worst trouble, however, was dullness of hearing. I had an uncomfortable, bad feeling in my ears—akin to earache; I had a watery discharge from the nose; I had to hawk and spit a great deal at times; my mind was greatly affected also and had a great deal of pain in the head. Upon advice of friends to try your medicines I resolved to do so. Have used six bottles of your "Golden Medical Discovery" and two bottles of Sage's Catarrh Remedy. The pain in my head is gone and my health is greatly improved and am working every day, something I could not do before. My appetite is good.

Yours truly,
MORRIS C. WEAVER,
No. 171 E. Genesee St., Buffalo, N.Y.

BRONCHIAL DISEASE.

Clifford, Susquehanna Co., Penna.

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

Gentlemen—The doctors said I had bronchitis, and I doctored with five different physicians before taking your medicines. My throat would bleed from three to five times a day—half a dozen mouthfuls perhaps—as fresh as if you had cut your finger, and I was in a generally weakened state although able to be about the house, but the least exertion would make me tremble. Finally I purchased one of Dr. Pierce's Common Sense Medical Advisers, and read it a good deal, and so was induced to take your medicines. I took in all seven bottles of the "Golden Medical Discovery," one of the "Favorite Prescription," and one bottle of Dr. Sage's Catarrh Remedy, and some of the "Pellets," and they did everything for me—more than anything else I ever tried. In about six months' time I was well. Now, my throat does not trouble me unless I take cold. It has been about six years since I took your medicines, and I think they cured me.

I think there are no medicines equal to your medicines, and would recommend them to all suffering ones.

Yours truly,
Mrs. Lewis Johnson

CATARRH.

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

D. Miner, Esq.

Gentlemen—I had the catarrh in the head for about fifteen years; my head was always stopped up and I had pains almost constantly. My nose would run, and stuff would fall into my throat whenever I would lie down, and at other times it seemed dry and crusty, and then my head would become stopped up and I would suffer again.

I used cubebs and glycerine for a long time; they only relieved me while I was using them. I used several other kinds of stuff, but I received no benefit from them. I had nearly given up in despair. At last I came across one of your advertisements of Dr. Sage's Catarrh Remedy in one of your Memorandum Books, and I thought I would try it. It is the grandest thing on earth. I was thankful to God I found something at last to stop my suffering. May God bless you, dear friends, for saving my life.

I used your medicine about eight weeks: it only took two bottles to cure me sound and well after all the rest had failed.

Yours truly,
DAVID MINER,
Bridgeport, Marion Co., Ind.

CHRONIC NASAL CATARRH.

Half a Dozen Bottles of Dr. Sage's Catarrh Remedy with Dr. Pierce's Golden Medical Discovery Cures Permanently a Bad Case of Chronic Nasal Catarrh.

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

N.M. Hodges.