Usually the dead bone is easily removed by the skilled specialist

surgeon, and, when thoroughly taken out, the parts readily heal and the

patient rapidly recovers. The removal, therefore, of the dead bone which

is a constant source of irritation, and the cause of protracted

suffering, should not be delayed, for very rarely indeed can it be

removed at all without the assistance of the surgeon. Besides, delay

often results in the loss of the limb, and not unfrequently occasions

the death of the patient. Under the influence of a reliable local

_anæsthetic_, carefully applied, the operation of removing the decayed

and offensive bone is speedily and painlessly performed, the use of

chloroform or ether not generally being required.

* * * * *

TESTIMONIALS.

If the following letters had been written by your best known and most

esteemed neighbors they could be no more worthy of your confidence than

they now are, coming, as they do, from well known, intelligent and

trustworthy citizens, who, in their several neighborhoods, enjoy the

fullest confidence and respect of all who know them.

Out of thousands of similar letters received from former patrons, we

have selected these few at random, and have to regret that we can find

room only for this comparatively small number in this volume.

BLOOD DISEASE.

RAW SORES FROM KNEE TO ANKLE.

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

[Illustration: 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.:

[Illustration: 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.:

[Illustration: 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.:

[Illustration: 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.

[Illustration: 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.:

[Illustration: 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.:

[Illustration: 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.:

[Illustration: 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.:

[Illustration: 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.:

[Illustration: 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 WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main

St., Buffalo, N.Y.:

[Illustration: 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.:

[Illustration: 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.

[Illustration: 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.:

[Illustration]

_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.

[Illustration: 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.

[Illustration: 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.:

[Illustration: 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.:

[Illustration: 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.

[Illustration: 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.:

[Illustration]

_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.:

[Illustration: 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.:

[Illustration: 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.:

[Illustration: 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.

[Illustration: 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.:

[Illustration: 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.

[Illustration: 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.:

[Illustration: 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.:

[Illustration: 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.

[Illustration: 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 drachm; iodide of

potassium, four drachms; dissolve in three ounces of soft water. Apply

to the tumor twice a day, with a feather or hair pencil.

MUMPS. (PAROTITIS.)

This is an inflammation of the parotid glands and generally occurs in

childhood. It is often epidemic, and is manifestly contagious. It

usually, though not always, appears on both sides of the neck at the

same time.

SYMPTOMS. An external, movable swelling, just below and in front of the

ear, near the angle of the jaw, is the prominent symptom. The

enlargement is not circumscribed, but hard and painful, and attended

with more or less fever, derangement of the secretions, and difficulty

in swallowing. The swelling increases until the fourth and fifth day,

when it gradually diminishes, and by the eighth or tenth is entirely

gone. Sometimes the disease is accompanied by swelling of the breasts in

the female, or the testicles in the male.

TREATMENT. Usually but little treatment is necessary. Exposure to cold

should be avoided. If severe or painful, with febrile symptoms, a hot

foot-bath and small doses of the "Compound Extract of Smart-Weed," in

some diaphoretic infusion, to induce sweating, together with small doses

of aconite, will produce good results. If swelling of the testicles

threatens (which seldom happens except on taking cold), resort should be

had to mild cathartics, the spirit vapor-bath, stimulating liniments to

the neck, and warm fomentations to the part attacked If delirium occurs,

a physician should be summoned.

INFLUENZA, OR LA GRIPPE.

This is an infectious disease, characterized by depression, and usually

associated with a catarrhal condition of the mucous membrane. It may

affect the respiratory organs or the intestinal canal. There is a marked

liability to serious complications, of which pneumonia is the most

dangerous. The disease is evidently due to a specific virus of great

infectiveness, and is more active and contagious at certain seasons and

under certain conditions of the atmosphere. By some it has been supposed

that it is due to a miasma in the air, but the character of its

infection indicates that the true virus is of a germinal nature.

Uncomplicated cases recover, but in the aged and in the delicate we may

see fatal results, due usually to the profound depression or the high

temperature to which the individual is subjected. There is much redness

and swelling of the mucous membranes of the nose and throat--a

bronchitis--and a catarrhal state of the stomach and intestines. These

may all be present, or the disease may center upon one particular

portion of the animal economy, and manifest its ravages there alone.

SYMPTOMS. The attack usually resembles an ordinary catarrh of cold. In

some cases the nasal catarrh is absent, or very mild, and the infection

invades the general system, with much fever. A very striking

manifestation of the disease is the severe nervous troubles which are

present at the outset, consisting of headache, pain in the back and

legs, and a general soreness of the muscles and bones as if bruised or

beaten. The pulse is usually feeble and small--intermittent. The disease

may center in the brain, producing delirium. Mental disorders are not

uncommon, and there is usually following the disease more or less

inaptitude for mental work and a tendency to depression of spirits. In

many cases there is a severe diarrhea, and the individual suffers much

from pain and discomfort in the abdomen. This is a gastro-intestinal

irritation, and apparently favors an early recovery, and usually there

are less severe sequels in such cases.

The most dangerous complication is pneumonia. These cases may follow

bronchitis, or the grip may begin with well-characterized symptoms of

this disease, for which see the chapters upon this trouble. The sputa

may not be rusty until after several days. The crisis is usually slow,

and a considerable proportion recover, the disease frequently showing a

sudden change for the better, and the patient being up and around in a

few days. Cases complicated with pneumonia are the most indefinite in

their symptoms, and require the closest attention.

TREATMENT. In every case the disease must be regarded as a dangerous

one, and the patient be confined to bed and indoors until all fever has

disappeared, otherwise sudden and serious manifestations are liable to

appear at any time. The patient must be well fed and nourished from the

outset. The bowels should be acted upon by mild laxatives, such as

castor oil or Dr. Pierce's Pleasant Pellets, using from one to three. It

is also of advantage afterward to move them twice each day, by the

injection of warm water, to which has been added a teaspoonful of table

salt to each pint. This injected into the rectum, using the water

slightly tepid, or cool if the patient is feverish, will tend to soften

the actions from the bowels and favor the escape of poisonous matter.

The cool water has also a soothing effect upon the fever and nervous

system. If the fever is high, and there is delirium, small doses of

aconite, with water, should be used every half hour or hour, but all

depressing agents of this kind must be used with caution, as profound

prostration sometimes develops. Warm baths, repeated frequently, and

followed by hot lemonade, are of the greatest benefit in reducing the

feverish condition and quieting the patient. The bed should be warmed

after these are administered and the patient given hot lemonade to bring

on free action of the skin, kidneys, and bowels. Where the pulse is

weak, the free use of stimulants, as wine, coffee, tea, and brandy or

whiskey, are required, as the great danger of the disease is a

depression of the heart. In severe bronchitis, pneumonia, and other

complications, appropriate treatment should be applied.

* * * * *

ACUTE NASAL CATARRH.

Acute Nasal Catarrh, or cold in the head, is an acute inflammation of

the mucous membrane lining the nasal passage which may confine itself to

these parts or extend to the pharynx, larynx, and air-passages below, or

affect the auxiliary sinuses or cavities communicating with the nasal

passages.

The most frequent cause of cold in the head is exposure to sudden

changes in temperature, or draughts of cool air, without taking proper

precaution to protect the body so as to prevent the rapid radiation of

animal heat. In most cases there is an inherited tendency or acquired

weakness, which frequently may be associated with a scrofulous condition

of the whole system, that render these points less resistant, and

consequently invite the morbid changes which result from exposure and

cold. Acute Catarrh also occurs during the initial stage of such

eruptive diseases as measles, typhus, typhoid, erysipelas, etc.

Seldom do we meet with an otherwise healthy individual, who is subjected

to a frequent cold in the head. Impure blood, inherited scrofulous

taints, enfeebled circulation, debility, either general or nervous, are

all advance agents, inviting catarrhal disease, and preventing rapid

recovery from an acute attack, so that a low grade of Chronic Catarrh is

generally the sequence.

SYMPTOMS. The attack is visually ushered in by a chill, or chilly

sensation, feeling of lassitude, followed by a slight fever. These

symptoms are not as distressing as the sense of fullness about the eyes

and frontal region, and prickling dry heat, with more or less

obstruction in the nostrils. A few hours later follows a copious, acrid

watery discharge, which gradually becomes thick and yellow. Often the

inflammatory action may extend to the orifice of the eustachian tube,

causing obstruction with temporary deafness, or ringing in the ears.

Severe facial neuralgia may be caused by the pressure from the swollen

parts upon the branches of sensitive nerves.

TREATMENT. In the mild forms of acute catarrh, or coryza, only simple

treatment is required. A hot foot-bath on retiring at night, with a full

dose of Dr. Pierce's Compound Extract of Smart-weed, to produce free

perspiration will generally break up the attack. Should the discharge

from the nostrils continue, Dr. Sage's Catarrh Remedy should be freely

used four to six times each day, until the symptoms are controlled. In

case the bowels do not act, a full dose of Dr. Pierce's Pleasant Pellets

may he taken at bed-time. Avoidance of exposure to cold, and light

vegetable diet, are advisable. In the more severe attacks, especially

when complicated by laryngeal or bronchial symptoms, the most decisive

measures should be employed. The Compound Extract of Smart-weed should

be taken freely, together with hot drinks, or a hot general bath. The

patient should be warmly covered in bed to encourage a continued

perspiration, to equalize the circulation, and subdue the inflammation.

Dr. Pierce's Golden Medical Discovery should be taken in teaspoonful

doses four times each day in all cases that are complicated or

protracted.

Individuals suffering from frequent colds will do wisely to fortify

their systems by taking a few bottles of the "Golden Medical Discovery"

to improve nutrition, purify the blood, and thus aid nature in

overcoming such inherited tendency or required weakness as may be their

misfortune to possess. Remember frequent attacks of Acute Catarrh

prepare fertile soil for the chronic form which oftentimes is so

loathsome and destructive.

* * * * *

CHRONIC NASAL CATARRH.

OZAENA.

In consequence of repeated attacks of acute catarrh, or "cold in the

head," as it is usually termed, the mucous membranes of the nose and the

air-passages of the head become permanently thickened, the mucous

follicles or glands diseased, and their functions either destroyed or

very much deranged. Although chronic catarrh is most commonly brought on

in the manner above stated, it sometimes makes its appearance as a

sequel of typhoid fever, scarlet fever, measles, or other eruptive

fevers, or shows itself as a local manifestation of scrofulous or

syphilitic taints in the system.

Injury to the nose may result in a displacement of one or more of the

bony structures, setting up a chronic inflammation with catarrh at that

point. In the early stages of the disease, the patient may be annoyed

with "only a slight dropping into the throat," as many express it, the

amount of the discharges from the air-passages of the head at this stage

of the disease being only slightly in excess of health. In some cases

the discharge is thick, ropy, and tough, requiring frequent and strong

efforts in the way of blowing and spitting, to remove it from the

throat, in which it frequently lodges. In other cases, or in other

stages of the same case, the discharge is thin, watery, acrid,

irritating, and profuse. The nose may be "stopped up" from the swollen

and thickened condition of the lining mucous membrane, so as to

necessitate respiration through the mouth, giving to the voice a

disagreeable nasal twang. From the nature of the obstruction in this

condition, it is useless for the sufferer to endeavor to clear the

passage by blowing the nose; this only tends to render a bad matter

worse, by increasing the irritation and swelling of the already

thickened lining membrane. The swelling of the mucous membrane does not

in all cases become so great as to cause obstruction to respiration

through the affected passages. In some cases, the patient suffers from

head ache a great portion of the time, or experiences a dull, heavy,

disagreeable fullness or pressure in the head, with a confusion of his

ideas, which renders him quite unfit for business, especially such as

requires deep thought and mental labor. Memory may be more or less

affected, and the disposition of those who are otherwise amiable is

often rendered irritable or morose and despondent. The mental faculties

suffer to such an extent in some cases as to result in insanity. The

sense of smell is in many cases impaired, and sometimes entirely lost,

and the senses of taste and hearing are not unfrequently more or less

affected.

OZÆNA. The ulcerous or more aggravated stage of the disease, from the

offensive odor that frequently attends it, is denominated _Ozæna_.

The secretion which is thrown out in the more advanced stages of chronic

catarrh becomes so acrid, unhealthy, and poisonous, that it produces

severe irritation and inflammation, which are followed by excoriation

and ulceration of the delicate membrane which lines the air-passages in

the head. Although commencing in this membrane, the ulceration is not

confined to it, but gradually extends in depth, until it frequently

involves all the component structures of the nose--cartilage and bone,

as well as fibrous tissues. As the ulceration extends up among the small

bones, the discharge generally becomes profuse and often excessively

fetid, requires the frequent use of the handkerchief, and renders the

poor sufferer disagreeable to both himself and those with whom he

associates. Thick, tough, brownish incrustations, or hardened lumps, are

many times formed in the head, by the evaporation of the watery portion

of the discharge. These lumps are sometimes so large and tough that it

is with great difficulty that they can be removed. They are usually

discharged every second, fourth, or fifth day, but only to be succeeded

by another crop. Portions of cartilage and bone, or even entire bones,

often die, slough away, and are discharged, either in large flakes, or

blackened, half-decayed, and crumbly pieces; or, as is much more

commonly the case, in the form of numerous minute particles, that escape

with the discharge and are unobserved. It is painfully unpleasant to

witness the ravages of this terrible disease, and observe the extent to

which it sometimes progresses. Holes are eaten through the roof of the

mouth, and great cavities excavated into the solid bones of the face; in

such cases only the best and most through treatment will check the

progress and fatal termination of the disease.

COMPLICATIONS.

Catarrh, or ozaena, is liable to be complicated, not only by the system,

blood, and fluids, suffering from scrofulous or other taints, as has

already been pointed out, but also by an extension of the diseased

conditions to other parts beyond the air-passages of the head.

Occasionally deformities of the septum or other internal structures also

polypi or tumors, are sources of constant irritation and accelerate

catarrhal disease.

DISEASE OF THE THROAT. The acrid, irritating and poisonous discharge,

which, in some stages of disease, almost constantly runs down over the

delicate lining membrane of the _pharynx_ (throat), is liable to produce

in this sensitive membrane a diseased condition similar to that existing

in the air-passages of the head. The throat may feel dry, husky, and at

times slightly sore or raw; or, from the muco-purulent discharge that is

almost constantly dropping down over its surface, the patient may feel

very little inconvenience from the disease of the throat until it is far

advanced--the moistening and lubricating effect of the matter that drops

on the surface tending to blunt the sensibility of the parts. (_See

pharyngitis for symptoms and treatment_.)

THE EXTENSION OF THE DISEASE TO THE LARYNX. The larynx, situated

directly below the pharynx (throat), is subjected to the influence of

the same irritation from acrid and poisonous discharges dropping into

the throat from the head. More or less of it is removed by hawking and

spitting, but some remains and is drawn into the larynx, or still lower

into the trachea (windpipe), with the inspired air. Thus the disease

creeps along the continuous mucous surfaces of the air-passages, the

acrid poisonous discharge arousing in its track the irritation,

inflammation, ulceration, and thickening of the lining membrane which

characterize the disease in other portions of the air-passages. The

symptoms and treatment of laryngitis will be found under its appropriate

classification.

BRONCHITIS AND CONSUMPTION. We have already detailed the manner in which

the throat, larynx, and trachea, in succession, become affected from

catarrh, or ozaena. By the same process of extension, the bronchial

tubes, and lastly, the _parenchyma_, or substance of the lungs, in their

turn, become diseased, and bronchitis and consumption are firmly

established. Tightness in the chest, with difficulty of breathing;

soreness; darting, sharp, or dull, heavy pain, or a prickly, distressing

sensation, accompanied with more or less cough and expectoration--are

evidences that the bronchial tubes have become affected, and they should

admonish the sufferer _that he is now standing on the stepping-stone to_

CONSUMPTION, over which thousands annually tread, in their slow journey

to the grave.

[Illustration: 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 the process sometimes

extends through several years), the patient will occasionally, while

blowing the nose, experience a crackling in one or both ears, and

hearing becomes dull, but returns suddenly, accompanied with a snapping

sound. This may be repeated many times, until, finally, hearing does not

return, but remains permanently injured. In other cases the hearing is

lost so gradually that a considerable degree of deafness may exist

before the person is really aware of the fact. Either condition is often

accompanied with noises in the head of every conceivable description,

increasing the distress of the sufferer. The delicate bones of the ear

are sometimes detached from their articulations, the drum is ulcerated

and perforated, and through the orifice thus made, the bones or small

_spiculæ_ may escape with the thick, purulent, and offensive discharge.

CLOSURE OF THE TEAR DUCT. The lachrymal duct, or passage (tear duct),

which, when in a healthy condition, serves to convey the tears from the

eye into the nose, may be closed by the same inflammatory and thickening

process which we have already explained. This condition is usually

attended with watery and weak eyes, the tears escaping over the cheeks,

and sometimes producing irritation and excoriation. The nasal branch of

the ophthalmic nerve sometimes participates in the ulceration going on

in the head, so that the eyes are sympathetically affected. They

sometimes become congested or inflamed, and sharp pain in the eyeballs

may be experienced.

INDIGESTION, DYSPEPSIA, ETC. A large portion of the acrid, poisonous,

purulent discharge, which drops into the throat during sleep, is

swallowed. This disturbs the functions of the stomach, causing weakness

of that organ, and producing indigestion, dyspepsia, nausea, and loss of

appetite. Many sufferers complain of a very distressing "gnawing

sensation" in the stomach, or an "all gone," or "faint feelings," as

they often express it.

SYMPTOMS. Dull, heavy headaches through the temples and above the eyes;

indisposition to exercise; difficulty of thinking or reasoning, or

concentrating the mind upon any subject; lassitude; indifference

respecting business, lack of ambition or energy; obstruction of nasal

passages; discharges voluntarily falling into the throat, sometimes

profuse, watery, acrid, thick and tenacious, mucous, purulent,

muco-purulent, bloody, concrete blood and pus, putrid, offensive, etc.

In others, a dryness of the nasal passages: dry, watery, weak, or

inflamed eyes; ringing in the ears, deafness, discharge from the ears,

hawking and coughing to clear the throat, ulcerations, death and decay

of bones, expectoration of putrid matter, _spiculæ_ of bones, scabs from

ulcers leaving surface raw, constant desire to clear the nose and

throat, voice altered, nasal twang, offensive breath, impairment or

total deprivation of the sense of smell and taste, dizziness, mental

depression, loss of appetite, nausea, indigestion, dyspepsia, enlarged

tonsils, raw throat, tickling cough, difficulty in speaking plainly,

general debility, idiocy, and insanity.

All the above symptoms, as well as some others which have been

previously given, and which it is not necessary here to repeat, are

common to this disease in some of its stages or complications; yet

thousands of cases annually terminate in consumption or chronic

bronchitis, and end in the grave, without ever having manifested

one-half of the symptoms enumerated.

VARIETIES. People often suppose that there are a great many varieties or

species of catarrh. This is an error. The nature of the disease is the

same in all cases, the symptoms only varying with the different stages

of the disorder, and the various complicated conditions which are liable

to arise, and which have already been pointed out.

CAUSES. Anything which debilitates the system, or diminishes its powers

of evolving animal heat and withstanding cold or sudden changes of

atmospheric temperature, and other disease-producing agencies, renders

the individual thus enfeebled very liable to catarrh. Among the most

common debilitating agencies are a scrofulous condition of the system,

or other impurities of the blood, exhaustive fevers, and other

prostrating acute diseases, or those badly treated; exhaustive and

unnatural discharges, intemperance, excessive study, self-abuse,

adversity, grief, want of sleep, syphilitic taints of the system, which

may have been contracted unknowingly, or may have been inherited, having

perhaps been handed down even unto the third or fourth generation, to an

innocent posterity from infected progenitors; too sudden rest after

great and fatiguing exercise, and living in poorly-ventilated

apartments. These are among the most fruitful causes of those feeble,

deranged, or impure conditions of the system to which catarrh so

frequently owes its origin. Although the immediate or exciting cause is

generally repeated attacks of "cold in the head," which, being neglected

or improperly treated; "go on from bad to worse," yet the predisposing

or real cause of the disease is in the majority of cases, an enfeebled,

impure, or otherwise faulty condition of the system, which invites the

disease, and needs only the irritation produced in the nasal passages by

an attack of cold, to kindle the flame and establish the loathsome

malady. Some people are convinced with difficulty that there exists in

their system a weakness, impurity, or derangement of any kind, which

permitted the disease to fasten itself upon them. They may not feel any

great weakness, may not have any pimples, blotches, eruptions,

swellings, or ulcers, upon their whole person; in fact, nothing about

them that would, except to the skilled eye of the practical and

experienced physician, indicate that their system is weakened or

deranged with bad humors; and yet such a fault may, and GENERALLY DOES,

exist. As an ulcer upon the leg, or a "fever-sore," or an eruption upon

the skin, may be the only outward sign of a fault in the system, so

frequently chronic catarrh is the only sign by which a bad condition of

the system manifests itself in a manner that is perceptible to the

sufferer himself, or to the non-professional observer. The

finely-skilled physician, whose constant practice makes his perceptive

faculties perfect in this direction, would detect the constitutional

fault, as an experienced banker detects a finely-executed and dangerous

bank-note which the unpracticed eye would pronounce genuine.

[Illustration: 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 and

healing application, a thorough and persistent internal use of

blood-cleansing and tonic medicines.

As a local application for healing the diseased condition in the head,

Dr. Sage's Catarrh Remedy is beyond all comparison the best preparation

ever invented. It is mild and pleasant to use, producing no smarting or

pain, and containing no strong, irritating, or caustic drug, or other

poison. Its ingredients are simple and harmless, yet when scientifically

and skillfully combined, in just the right proportions, they form a most

wonderful and valuable healing medicine. Like gunpowder, which is formed

of a combination of saltpeter, sulphur, and charcoal, the ingredients

are simple, but the product of their combination is wonderful in its

effects. The Remedy is a powerful antiseptic, and speedily destroys all

bad smell which accompanies so many cases of catarrh, thus affording

great comfort to those who suffer from this disease.

The reader's mind cannot be too strongly impressed with the importance

of combining thorough constitutional with the local treatment of this

disease. Not only will the cure be thus more surely, speedily, and

permanently, effected, but you thereby guard against other forms of

disease breaking out, as the result of humors in the blood or

constitutional derangement or weakness.

In curing catarrh and all the various diseases with which it is so

frequently complicated, as throat, bronchial, and lung diseases, weak

stomach, catarrhal deafness, weak or inflamed eyes, impure blood,

scrofulous and syphilitic taints, the wonderful powers and virtues of

the "Golden Medical Discovery" cannot be too strongly extolled. It has a

specific effect upon the lining mucous membranes of the nasal and other

air passages, promoting the natural secretion of their follicles and

glands, thereby softening the diseased and thickened membrane, and

restoring it to its natural, thin, delicate, moist, healthy condition.

As a blood-purifier, it is unsurpassed. As those diseases which

complicate catarrh are diseases of the lining mucous membranes, or of

the blood, it will readily be seen why this medicine is so well

calculated to cure them.

The "Golden Medical Discovery" is the natural "helpmate" of Dr. Sage's

Catarrh Remedy. It not only cleanses, purifies, regulates, and builds up

the system to a healthy standard, and conquers throat, bronchial, and

lung complications, when any such exist, but, from its specific effects

upon the lining membrane of the nasal passages, it aids materially in

restoring the diseased, thickened, or ulcerated membrane to a healthy

condition, and thus eradicates the disease. When a cure is effected in

this manner it is permanent. The system is so purified, regulated, and

strengthened, as to be strongly fortified against the encroachments of

catarrh and other diseases. The effects of the "Golden Medical

Discovery" upon the system will be gradual, and the alterative changes

of tissue and function generally somewhat slow. They are with however,

less complete, radical, and lasting; and this constitutes its great

merit. Under its influence all the secretions are aroused to carry the

blood-poisons out of the system, the nutrition is promoted, and the

patient finds himself gradually improving in flesh; his strength is

built up, his lingering ailments dwindle away, and by and by he finds

his whole person has been entirely renovated and repaired he feels like

a new man--a perfect being.

[Illustration: 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, and have thus cured hundreds who had otherwise failed to find

relief.

[Illustration: 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; but, by reason of the

constitutional nature of the disease, it cannot effect a perfect and

permanent cure. Dr. Sage's Catarrh Remedy, on the other hand, cures the

disease on common-sense, rational, and scientific principles, by its

mild, soothing, and healing properties, to which the disease gradually

yields, when the system has been put in perfect order by the use of

"Golden Medical Discovery." This is the only perfectly safe, scientific,

and successful mode of acting upon and healing it. Without, we trust,

being considered egotistical, we can say that this opinion is based upon

a large experience and a perfect familiarity with the nature and

curability of the disease. For many years our whole time and attention

has been given to the study and cure of catarrh and other chronic

diseases treated of in "The People's Common Sense Medical Adviser."

Cases of catarrh have been treated by thousands, and our medicines for

the cure of this loathsome disease, and of other chronic diseases, have

met with an extensive sale in all parts of the United States, and have

found their way into many foreign countries. The universal satisfaction

with which their use has been attended, and the grateful manifestations

received from the cured, have afforded one of the greatest pleasures of

our lives. Scarcely a mail arrives that does not bring new testimony of

cures effected by the treatment here recommended.

DIRECTIONS FOR USING DR. SAGE'S CATARRH REMEDY.

To prepare the medicine ready for use, put the whole quantity of powder

contained in the package, as put up for sale, into a bottle; pour into

it one pint of cool, soft water. Rain water or melted snow is good.

Ordinary lake, river, well or spring water will do if only _slightly_

hard. Cork the bottle tightly and shake it thoroughly, after which allow

it to stand six or eight hours to settle. Two of the ingredients of

which the remedy is composed do not entirely dissolve, but their

medicinal properties are completely and speedily extracted and taken up

by the water. These settlings have lost their medicinal properties and

should not be allowed to enter the nasal cavity. It should be kept

tightly corked, not allowing it to freeze in winter, or be kept where it

is very warm in summer. This we term the "Catarrh Remedy Fluid."

Use the fluid, prepared according to the above directions, not less than

three or four times a day, the last time just before retiring, in the

following manner: Without shaking the bottle to roll the fluid, pour out

a teaspoonful or more into the hollow of the hand, hold it there until

warmed; first gently, and afterwards forcibly, snuff the fluid up one

nostril and then the other, until the nose is well filled and it passes

back into the throat. No fears need be entertained that it will produce

strangling or any unpleasant effect in thus using it, for, unlike any

other fluids (simple tepid water not excepted), it does not produce the

slightest pain or disagreeable feeling, but, on the contrary, leaves

such a cooling, pleasant sensation that its use soon becomes a pleasure

rather than a task. In a few minutes after thus using the remedy, it

should be blown out gently (never forcibly), to clear the nose and

throat of all hardened crusts and offensive accumulations, if any such

exist. Never blow the nose violently, as it irritates the passages and

counteracts, to some extent, the curative effects of the remedy. This

process should be repeated until the remedy has been thoroughly applied

two or three times, not blowing it out the last time of using it, but

retaining the medicine in contact with the affected parts for a

considerable length of time. No harm can result if the fluid be

swallowed, as it contains nothing poisonous or injurious.

A BETTER WAY. The manner of using Dr. Sage's Catarrh Remedy, advised

above, is somewhat imperfect and not nearly so thorough a mode as the

one to which the reader's attention will now be directed.

In a very large number of bad cases of catarrh, or those of long

standing, the disease has crept along and extended high up in the nasal

passages, and into the various sinuses or cavities, and tubes

communicating therewith. The act of snuffing the fluid _carries it along

the floor of the nose and into the throat_, but does not carry it _high

enough_, or fill the passages _full enough_, to reach all the chambers,

tubes, and surfaces, that are affected with the disease.

The fluid may seem, from the sensation produced, to pass high up between

the eyes, or even above them, but it does not. It is only a sensation

transmitted to these parts by nerves, the filaments of which are

distributed to that portion of the mucous membrane which the fluid does

not reach, just as a sensation is transmitted to the little finger by a

blow upon the elbow.

Now, in order to be most successful in the treatment of catarrh, it is

necessary that _the remedy should reach and be thoroughly applied to all

the affected parts_. This can be accomplished in only one way, which is

by _hydrostatic pressure_. The anatomy of the nasal passages, and the

various chambers and tubes that communicate therewith, is such that they

cannot be reached with fluid administered with any kind of syringe or

inhaling tube, or with any instrument, except one constructed to apply

it upon the principle above stated. Such an instrument is Dr. Pierce's

Nasal Douche.

By the use of this instrument, the fluid enters every portion of the

air-passages of the head by its own weight, no snuffing being required.

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

[Illustration: 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

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.)

[Illustration: 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 always in

proportion to the severity of the symptoms. The nasal discharge is

generally increased and of a variable character. As the tumors enlarge

they cause a sense of fullness and weight between and below the eyes,

with more or less headache and facial neuralgia. There is partial or

complete obstruction of one or both nostrils. In some cases the

obstruction changes from one nostril to the other when lying down; the

stoppage generally being on the side toward the pillow. A polypus

located at the junction of the nasal passages and throat by force of

gravity always causes obstruction to the lower nasal cavity when lying

down. Polypi often attain considerable size and by pressure upon and

displacement of the surrounding structures occasion hideous facial

deformity. Changes in the weather often aggravate the symptoms. By

blowing the nostril the tumor sometimes may be forced forward, so that

it may be seen a short distance from the anterior opening of the

nostril. The _voice_ is often affected, being muffled or harsh in tone,

similar to that which accompanies a cold in the head. _Respiration_ may

be considerably embarrassed, due to the obstruction in the nasal

passages, and the patient necessarily resorts to mouth breathing. In

advanced cases the Larnyx is usually much congested, being constantly

irritated, not only reflexly through the nervous system, but directly by

the inspired air, and excoriating discharges dropping in the throat from

behind the palate. Thus it is plain to understand how chronic

Pharyngitis, Laryngitis, Bronchitis, and Asthma may result from a small

polypus in the nasal cavity.

TREATMENT. In mild cases correcting the constitutional derangement may

check the morbid process in the nostrils and cause absorption of the

polypus growth. For this purpose Dr. Pierce's Golden Medical Discovery

is unequaled. The removal of the polypus may sometimes be accomplished

by snuffing powdered blood-root. When these measures fail it is

necessary to seek surgical assistance. After the removal of the polypus

Dr. Sage's Catarrh Remedy should be used to prevent a recurrence.

OUR OPERATION FOR NASAL TUMORS.

Having operated with unvarying success upon a very large number and

variety of nasal tumors at the Invalids' Hotel and Surgical Institute we

are positively assured that the means and methods which we employ are

neither severe or dangerous; _no pain_, consequently _no shock_;

recovery rapid and permanent. Many forms of injection and local

treatment are in use for the removal of nasal polypi, none of which have

proven to be curative; recurrence of the tumor many times following such

treatment. Many cases have presented themselves after having been

treated by the heroic method of seizing the polypus with a pair of

forceps and forcibly tearing it loose, bringing with it segments of

healthy tissue, leaving bone exposed, and a ragged, uneven surface of

diseased membrane. It is much easier to properly treat a case from the

beginning than to undertake it in such a rendition.

Owing to the fact that these nasal tumors grow directly from the lining

membranes it is necessary not only to thoroughly remove the tumor but to

treat the diseased membrane at the point from which the polypus springs;

otherwise another tumor may develop at the same point. The nasal passage

having been thoroughly anæsthetized, or benumbed, by the use of

cocaine, the nasal speculum is introduced, and by means of reflected

light from the head mirror worn by the operator, the interior of the

nostril is brought into view. (See Fig. 9, p. 479.)

Often the attachment of the growth is entirely hidden behind the

irregular bony structures of the nostril so that it requires the skill

of an expert specialist, deft in the manipulation of these parts, to

operate properly.

Many styles and shapes of delicately devised instruments are necessary

to completely remove the growth without doing injury to the adjacent

structures. By our newly devised operation the tumor is at once removed,

without pain, and with the loss of only a few drops of blood. Further,

because the tumor is entirely removed and the base properly treated

there is not the offensive discharge for a long time afterward and the

danger from infection and blood-poison to which the patient is subjected

in other forms of treatment.

In conclusion we would say that we claim for our operation the following

points that are worthy of the careful consideration of every one who may

be so unfortunate as to require the services of a specialist for the

removal of growths in the nasal or upper air passages.

1st. Our operation is absolutely painless.

2d. No chloroform or ether is required.

3d. We insure perfect removal of growth.

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

5th. The operation is bloodless.

6th. The recovery is rapid.

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

blood-poisoning.

* * * * *

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.

[Illustration: 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 into the throat

from behind the palate. The discharge is variable as in nasal catarrh

with more or less difficult nasal breathing, the stoppage changing from

one nostril to the other. Sneezing and frequent attacks of nose bleed

are often common symptoms. The tendency of the disease is to extend

backward often causing headache, deafness, roaring in the ears and

post-nasal disease which results in a chronic sore throat, the latter

disease often being the one for which the patient seeks advice. If

allowed to progress uninterruptedly the throat gradually becomes more

irritable, associated with an annoying cough, and the voice becomes

harsh and has a nasal tone. The general health is impaired, the nervous

system excitable; laryngitis, asthma, and lung disease become

complications, which render the existence of the individual miserable.

TREATMENT. In mild cases where the deformity is slight, and the

obstruction is not a constant symptom, the nasal cavities should be

cleansed (See treatment of nasal catarrh) after inhaling dust, and

special attention given to the prompt treatment of cold in the head.

Should there be irritability, sneezing, or a constant discharge, it is

advisable to use Dr. Sage's Catarrh Remedy as directed on p. 483 to

soothe the excitability and lessen the inflammatory action in and about

the thickened and deformed septum. As an auxiliary to promote the

absorption of the thickened tissues and restore them to a healthy

activity, a number of bottles of the "Golden Medical Discovery" should

be taken while using the local treatment. Any dormant condition of the

liver or digestive tract may be corrected by taking Dr. Pierce's

Pleasant Purgative Pellets. In advanced cases after the structures are

so diseased and thickened that it renders local treatment hopeless, only

surgical interference can prove curative.

OUR PAINLESS OPERATION.

By the application of a few drops of a solution of cocaine in the

nostril, at the point to be treated, we are now able to produce such

local anæsthesia as to render the operation entirely painless without

the administration of either chloroform or ether. This is an important

consideration as many are adverse to taking chloroform or ether, and now

that we possess an agent that produces, locally, complete insensibility

to pain, we are very glad to dispense with their use in all such minor

operations. There is no pain caused even by the application of the

cocaine to deaden the sensibility of the part. Many examinations of the

upper air-passages heretofore very annoying and even painful to the

patient and sometimes unsatisfactory, are rendered entirely painless,

and carried out with a thoroughness that would be impossible without the

use of this wonderful agent. Not only in surgery of the nose and throat,

but alike in other departments, our surgeon-specialists employ the same

local anæsthetic in all minor operations, none of which are attended

with the least pain.

Our specialists were among the first surgeons in this country to employ

this newly-discovered anæsthetic. We regard it as a great boon to our

patients, and never withhold it in any case where it can be employed to

prevent suffering. Its use is attended with no danger, nor is it

followed by bad or disagreeable results.

OUR OPERATION.

[Illustration: 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 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.

[Illustration: 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 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 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.

[Illustration: 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 by

dropping into or irritating the throat. It causes tickling and frequent

desire to clear the throat, also change, weakness and loss of voice, and

often gives rise to a very persistent and aggravating cough.

Constriction of the throat, cough and difficult breathing are more

prominent symptoms in complicated cases.

TREATMENT. The treatment already laid down for enlarged tonsils, with

which affection, elongation of the uvula is so often associated, is

generally effectual. When it has existed for a long time, and does not

yield to this treatment it may be removed by any competent surgeon.

* * * * *

CHRONIC LARYNGITIS.

This is of much more frequent occurrence than the acute form, and is

often associated with tubercular affections, and constitutional

syphilis. It is characterized by an inflammatory condition, ulceration,

or hardening of the mucous membrane of the larynx, most frequently the

latter. There is also a chronic form, known as _follicular laryngitis_,

or _clergymen's sore throat_, to which public speakers are subject.

THE CAUSES of chronic laryngitis are various, as prolonged use of the

vocal organs in reading or speaking; using them too long on one pitch or

key, without regard to their modulation; improper treatment of acute

diseases of the throat; neglected nasal catarrh; the inordinate use of

mercury; syphilis; repeated colds which directly cause sore throat,

injuries, etc. It is also frequently due to tubercular deposits, and in

these cases it generally terminates in consumption.

SYMPTOMS. The affection often comes on insidiously. There is soreness of

the throat, noticeable particularly when speaking, and immediately

thereafter; a "raw" and constricted feeling, leading to frequent

attempts to clear the throat, in order to relieve the uneasy sensation.

The voice becomes altered, hoarse, and husky, and there is a slight,

peculiar cough, with but little expectoration. At first, the matter

expectorated is mucus, but as the disease advances, and ulceration

progresses, it becomes muco-purulent, perhaps lumpy, bloody, or is

almost wholly pure pus. The voice becomes more and more impaired, and is

finally lost. In the latter stages, it resembles consumption, being

attended with hectic fever, night-sweats, emaciation, cough, profuse

expectoration, and sometimes hemorrhage.

TREATMENT. The patient should avoid using his voice as much as possible.

At the same time, attention should be paid to the diet, the bathing, and

the clothing. Every thing should be done that is calculated to build up

and improve the general health. Dr. Pierce's Golden Medical Discovery is

well adapted to remove morbid states of the disease, in consequence of

its direct action on the mucous membranes of the air-passages, and its

efficacy in allaying irritation of the laryngeal, pharyngeal, and

pneumogastric nerves. It should be perseveringly employed. Iodine

inhalations, administered with the pocket inhaler, illustrated by Fig.

3, and the application of tincture of iodine to the forepart of the

neck, are efficacious in many cases. Inhalations of chloride of ammonia,

administered with a steam-atomizer, Fig. 11, in the form of spray, are

frequently of great benefit. _Perseverance_ is necessary, and the

afflicted are cautioned against discontinuing the treatment too soon,

for the disease is very liable to return.

* * * * *

CONSUMPTION.

PHTHISIS PULMONALIS.

By this we understand a constitutional affection, characterized by a

wasting away of the body, attended by the deposition of tubercular

matter into the lung tissue. Hence the appellations, _Phthisis

Pulmonalis; Pulmonary Tuberculosis; Tubercular Consumption_. Tubercles

may form in other organs and result in a breaking down of their tissues,

but the employment of the term _Consumption_ in this article is

restricted to the lungs. The general prevalence, the insidious attack,

and the distressing fatality of this disease, demand the special

attention and investigation of every thinking person. It preys upon all

classes of society. Rich and poor alike furnish its victims.

Some idea of its prevalence may be formed when we consider that, of the

entire population of the globe, one in every three hundred and

twenty-three persons annually dies of consumption. It may not be

definitely known just what proportion of all the deaths in this country

and Europe occurs from this one disease. Those who have gathered

statistics differ somewhat, some claiming one-fourth, while others put

the ratio at one-sixth, one-seventh, and even as low as one-ninth. A

fair estimate, and one probably very near the truth, would be one-sixth

or one-seventh of the whole number. In New York City, for five

consecutive years, the proportion was three in twenty. In New England,

about twenty thousand annually succumb to this destroyer, and in the

State of New York as many more. These figures may appear to be

exaggerations, but investigations of the subject prove them to be the

simple truth. Epidemics of cholera, yellow fever, and other diseases of

similar character, so terrible in their results, occasion wide-spread

alarm, and receive the most careful considerations for their prevention

and cure, while consumption receives scarcely a thought. Yet the number

of their victims sinks into insignificance when compared with those of

consumption. Like the thief in the night, it steals upon its victim

unawares. In a large proportion of cases, its approach is so insidious

that the early symptoms are almost wholly disregarded; indeed, they

excite but little, if any, attention, and perhaps for a time disappear

altogether. Thus the patient's suspicions, if they have been aroused,

are allayed and appropriate measures for his relief are discontinued.

This may be the case until renewed attacks firmly establish the disease,

and before the patient is fully aware of the fatal tendency of his

malady, he is progressing rapidly towards that "bourne from which no

traveler returns."

As has already been stated, consumption is a constitutional disease,

manifested by feeble vitality, loss of strength, emaciation--symptoms

which are too often classed under the name of _general debility_, until

local symptoms develop, as _cough, difficult breathing_, or

_hemorrhage_, when examination of the chest reveals the startling fact

that tubercular deposits have been formed in the lungs. Invalids are

seldom willing to believe that they have consumption, until it is so far

advanced that all medicine can do is to smooth the pathway to the grave.

Another characteristic of this disease is _hope_, which remains active

until the very last, flattering the patient into expectation of

recovery. To the influence of this emotion, the prolongation of the

patient's life may often be attributed.

NATURE OF THE DISEASE. It is an error to suppose that the disease under

consideration is confined to the lungs. "Pulmonary Consumption," as has

been remarked, "is but a _fragment_ of a great constitutional malady."

The lungs are merely the stage where it plays its most conspicuous part.

Every part of the system is more or less involved, every vital operation

more or less deranged; especially is the _nutritive_ function vitiated

and imperfect. The circulation is also involved in the general morbid

condition. Tubercles, which constitute a marked feature of the disease,

are composed of unorganized matter, deposited from the blood in the

tissue of the lungs. They are small globules of a yellow, opaque,

friable substance, of about the consistency of cheese. After their

deposition, they are increased in size by the accretion of fresh matter

of the same kind. They are characteristic of all forms of scrofulous

disease.

The most plausible theory in regard to them is, that they are the result

of imperfect nutrition. Such a substance cannot be produced in the blood

when this fluid is perfectly formed. It is an unorganized particle of

matter, resulting from the imperfect elaboration of the products of

digestion, which is not, therefore, properly fitted for assimilation

with the tissues. The system being unable to appropriate it, and

powerless to cast in off through the excretory channels, deposits it in

the lungs or other parts of the body. There it remains as a foreign

substance, like a splinter or thorn in the flesh, until ejected by

suppuration and sloughing of the surrounding parts. It might be supposed

by some that when the offending matter was thus eliminated from the

lungs, they would heal and the patient recover; but, unfortunately, the

deposition of tubercular matter does no cease. Owing to the morbid

action of the vital forces, it is formed and deposited as fast or

faster than it can be thrown off by expectoration. Hence arises the

remarkable fatality of pulmonary consumption.

CAUSES. The causes of consumption are numerous and varied, but may all

be classed under two heads, viz: _Constitutional_, or _predisposing_,

and _local_, or _exciting_. Of just what tubercular matter consists, is

still a subject of controversy, but that its existence depends upon

certain conditions, either _congenital_ or _acquired_, is generally

conceded; and one of these conditions is impaired vitality.

Constitutional predisposition must first give rise to conditions which

will admit of the formation of tubercular matter, before any cause

whatever can occasion its local deposition. It must modify the vitality

of the whole system, when other causes may determine in the system thus

impaired, the peculiar morbid action of which tubercular matter is the

product. The general division of causes into predisposing and exciting,

must ever be more or less arbitrary. Individuals subject to predisposing

causes may live the natural term of life and finally die of other

disease. Indeed, when predisposing causes are known to exist, they

should constitute a warning for the avoidance of other causes. Again,

among the so-called exciting causes, some may operate in such a manner,

with some individuals, as to predispose them to consumption, and the

result will be the same as if the disposition had been congenital. The

causes which in one individual are _exciting_, under other circumstances

and in other individuals, would be _predisposing_, because they act so

as to depress the vitality and impair the nutritive processes.

THE PREDISPOSING CAUSES, then, are hereditary predisposition, scrofula,

debility of the parents, climatic influences, sedentary habits,

depressing emotions, in fact, _anything_ which impairs the vital forces

and interferes with the perfect elaboration of nutritive material.

THE EXCITING CAUSES are those which are capable of arousing the

predisposing ones into activity, and which, in some instances, may

themselves induce predisposition; as dyspepsia, nasal catarrh, colds,

suppressed menstruation, bronchitis, retrocession of cutaneous

affections, measles, scarlatina, malaria, whooping-cough, small-pox,

continued fevers, pleurisy, pneumonia, long-continued influence of cold,

sudden prolonged exposure to cold, sudden suspension of long-continued

discharges, masturbation, excessive venery, wastes from excessive mental

activity, insufficient diet, both as regards quantity and quality,

exposure to impure air, atmospheric vicissitudes, dark dwellings,

dampness, prolonged lactation, depressing mental emotions, insufficient

clothing, improper treatment of other diseases, exhaustive discharges,

tight lacing, fast life in fashionable society, and impurity and

impoverishment of blood from any cause. This list might be greatly

extended, but the other causes are generally in some manner allied to

those already named.

SYMPTOMS. The symptoms of consumption vary with the progress of the

disease. Writers generally recognize three stages, which so gradually

change from one to the other that a dividing line cannot be drawn. As

the disease progresses, new conditions develop, which are manifested by

new symptoms. Prior to the advent of pulmonary symptoms, is the latent

period, which may extend over a variable length of time, from a few

months to several years; and, indeed, may never be developed any

farther. Until sufficient tubercular matter has been deposited in the

lungs to alter the sounds observed on auscultation and percussion, a

definite diagnosis of tubercular consumption cannot be made, even though

there may have been hemorrhage. Nevertheless, when we find _paleness,

emaciation, accelerated and difficult breathing, increased frequency of

the pulse, an increase of temperature_, and _general debility_ coming on

gradually without any apparent cause, we have sufficient grounds for

grave suspicions. These are increased if tenderness under the

collar-bone, with a slight, hacking cough is present. These symptoms

should be sufficient to warn any individual who has the slightest reason

to believe that he is disposed to consumption, to lose no time in

instituting the appropriate hygienic and medical treatment, for it is at

this stage that remedies will be found most effective. Unfortunately,

this period is too apt to pass unheeded, or receive but trifling

attention; the patient finds some trivial excuse for his present

condition, and believes that he will soon be well. But, alas for his

anticipations! The disease goes onward and onward, gradually gaining

ground, from which it will be with great difficulty dislodged.

The cough now becomes sufficiently harassing to attract attention, and

is generally worse in the morning. The expectoration is slight and

frothy; the pulse varies from ninety to one hundred and twenty beats in

a minute, and sometimes even exceeds this. Flushes of heat and a burning

sensation on the soles of the feet and palms of the hands are

experienced. A circumscribed redness of one or both cheeks is apparent.

These symptoms increase in the afternoon, and in the evening are

followed by a sense of chilliness more or less severe. The appetite may

be good, even voracious; but the patient remarks that his food "does not

seem to do him any good," and, to use a popular expression, "he is going

into a decline." As the strength wanes the cough becomes more and more

severe, as if occasioned by a fresh cold, in which way the patient

vainly tries to account for it. Expectoration increases, becomes more

opaque, and, perhaps, yellow, with occasionally slight dots or streaks

of blood. The fever increases, and there is more pain and oppression of

the chest, particularly during deep respiration after exercise.

Palpitation is more severe. There may now be night-sweats, tire patient

waking in the morning to find himself drenched in perspiration,

exhausted, and haggard. Bleeding from the lungs occurs, and creates

alarm and astonishment, often coming on suddenly without warning. The

hemorrhage usually ceases spontaneously, or on the administration of

proper remedies, and in a few days the patient feels better than he has

felt for some time previously. The cough is less severe, and the

breathing less difficult. Indeed, a complete remission sometimes occurs,

and both patient and friends deceive themselves with the belief that the

afflicted one is getting well.

After an indefinite length of time, the symptoms return with greater

severity. These remissions and aggravations may be repeated several

times, each successive remission being less perfect, each recurrence

more severe, carrying the patient further down the road toward the "dark

valley." Now the cough increases, the paroxysms become more severe, the

expectoration more copious and purulent, as the tubercular deposits

soften and break down. The voice is hollow and reverberating, the chest

is flattened, and loses its mobility; the collar-bones are prominent,

with marked depression above and below. Auscultation reveals a bubbling,

gurgling sound, as the air passes through the matter in the bronchi,

with the click, to the air cells beyond. Percussion gives a dull sound

or if there are large cavities, it is hollow, and auscultation elicits

the amphoric sound, as of blowing into a bottle. Hectic fever is now

fully established; the eye is unusually bright and pearly, with dilated

pupils, which gives a peculiar expression; the paroxysms of coughing

exhaust the patient, and he gasps and pants for breath. The tongue now

becomes furred, the patient thirsty, the bowels constipated, and all the

functions are irregularly performed. Another remission may now occur,

and the patient be able to resume light employment, for an indefinite

length of time, which we have known to extend over three or four years,

when the symptoms again return.

If the patient is a female, and deranged or suppressed menstruation has

not marked the accession of pulmonary symptoms, the flow now becomes

profuse and clotted, or is scanty and colorless, sometimes ceasing

altogether. In the male, the sexual powers diminish, and copulation is

followed by excessive and long-continued prostration. From this time

onward, the progress of the disease is more rapid. The liver and kidneys

are implicated. In addition to the pallor, the complexion becomes

jaundiced, giving the patient, who is now wasting to a mere skeleton, a

ghastly look. The urine is generally copious and limpid, though

occasionally scanty and yellow. The pulse increases to one hundred and

thirty or one hundred and forty beats in the minute, and is feeble and

thread-like. The cough harasses the patient so that he does not sleep,

or his rest is fitful and unrefreshing; whenever sleep does occur, the

patient wakes to find himself drenched with a cold, clammy perspiration.

The throat, mouth, and tongue now become tender, and occasionally

ulcerate. Expectoration is profuse, purulent, and viscid, clinging

tenaciously to the throat and mouth, and the patient no longer has

strength to eject it. The hair now falls off, the nails become livid,

and the breathing difficult and gasping; the patient has no longer

strength to move himself in bed and has to be propped up with pillows,

and suffocates on assuming the recumbent position. Drinks are swallowed

with difficulty. Diarrhea takes the place of constipation. The

extremities are cold, swollen, and dropsical; the voice feeble, hollow,

grating, husky, the patient gasping between each word; the respiration

is short and quick. A slight remission of these symptoms occurs. The

patient is more comfortable, lively, cheerful, and perhaps forms plans

for the future. But it is the last effort of expiring vitality, the last

flicker of the lamp of life, the candle burns brilliantly for a moment,

and with one last effort goes out, and death closes the scene.

The duration of the active stage of consumption varies from a few weeks

to several years, the average time being about eighteen months.

_Cough_ is always a prominent symptom throughout the entire course of

the disease, varying with its progress.

_Expectoration_, at first scanty, then slightly increased, colorless,

frothy, and mucous, is also a characteristic. After a time it becomes

opaque, yellow, and more or less watery; then muco-purulent and finally

purulent, copious, and viscid. When tubercular matter is freely

expectorated, with but little mucus, it sinks in water. This symptom

continues to the very last.

_Haemoptysis_ (bleeding from the lungs) may occur at any stage of the

disease, often being the first pulmonary symptom noticed, again being

delayed until late; and there are cases in which it does not happen at

all. It seldom occurs in any other disease.

_Night-sweats_ may occur at any stage, though they are rarely

experienced until the disease is pretty well established, and are very

exhausting.

_Hectic Fever_ generally occurs soon after the pulmonary symptoms are

developed, and increases in intensity with the progress of the disease.

There are usually two paroxysms in twenty-four hours, one of which

occurs towards evening and is followed by night-sweats.

_Dyspnoea_ (difficult breathing) is at first slight, except after

exertion, amounting to only a sense of oppression; but it becomes more

and more severe as the disease advances, until the very last, when it is

agonizing in the extreme.

_Aphthæ_, sometimes extending to the pharynx and larynx, generally

occurs towards the last. The mouth and throat become so very sore and

tender that nourishment and medicine are taken with difficulty.

_Emaciation and Debility_ are characteristic of the disease. They

fluctuate as the disease advances or is retarded, increasing to the very

last.

_Auscultation and Percussion_ constitute valuable means of diagnosis

from the time tubercular matter begins to be deposited to the very last,

and, when correctly practiced, reveal the extent and progress of the

disease. As a knowledge of the sounds elicited can only be acquired by

practical experience with proper instruments, they will not be described

here. The only diseases with which consumption is likely to be

confounded are general debility in the early stage, bronchitis, chronic

pleurisy, chronic pneumonia, and abscess in the lungs, after the advent

of pulmonary symptoms.

CURABILITY. Notwithstanding the prevailing opinion that consumption is

incurable, there exists ample, incontrovertible evidence to the

contrary. Its curability is established beyond the shadow of a doubt.

Individuals have recovered in whom there was extensive destruction of

pulmonary tissue, and, indeed, entire destruction of one lung. Numerous

instances are on record in which persons have suffered from all the

symptoms of confirmed consumption, and have regained their health and

subsequently died of other diseases. The case of the late Dr. Joseph

Parish, of Philadelphia, affords a striking example of this kind. In

early life, he manifested all the symptoms of confirmed consumption,

including frequent hemorrhages, yet he fully regained his health, and,

after a very useful life, died at an advanced age of another disease.

Post-mortem examination revealed the existence of cicatrices, or scars,

in his lungs where tubercular matter had been deposited. Dr. Wood, in

his Practice of Medicine, mentions another instance of a medical

gentleman in Philadelphia, who in early life suffered from consumption

with hæmoptysis, from which he recovered, and afterwards died, at an

advanced age, of typhoid fever, when the knife revealed the presence of

cicatrices. Post-mortem examinations of individuals who have died of

other diseases, have revealed, in numerous instances, the presence of

consumption at some period of their existence. In these cases the lungs

were perfectly healed by cicatrization, or by the deposit of a chalky

material. A French physician made post-mortem examinations of one

hundred women, all of whom were over sixty years of age, and who had

died of other diseases, and in fifty of them he found evidences of the

previous existence of consumption.

Professor Flint says that consumption sometimes terminates in recovery,

and that his observations lead him to the conclusion that the prospect

of recovery is more favorable in cases characterized by frequent

hemorrhages. Drs. Ware and Walshe are also led to the same conclusion.

Professor J. Hughes Bennett, of Edinburgh, has thoroughly investigated

the subject, and adds his testimony to that of others, citing numerous

cases that have resulted in perfect recovery. If such testimony is not

sufficient, we may mention the following, whose names are well known and

respected in professional circles, and all of whom declare that

consumption is a curable disease. The list includes Laennec, Andral,

Cruveilhier, Kingston, Presat, Rogée, Boudet, and a host of others.

No farther back than 1866, on page 145, of the proceedings of the

Connecticut Medical Society, we find "Observations, Ante-mortem and

Post-mortem, upon the case of the late President Day by Prof. S.G.

Hubbard, M.D., New Haven," from which we learn that Jeremiah Day, LL.

D., who was for twenty-nine years President of Yale College, was, while

a mere youth, a victim of pulmonary consumption. During his infancy and

boyhood his vitality was feeble. He entered Yale College as a student in

1789, "but was soon obliged to leave the institution on account of

pulmonary difficulty, which was doubtless the incipient stage of the

organic disease of the lungs which subsequently developed itself." He

remained in feeble health for two years, but returned to college, and

graduated in 1797. For the next six years his lung difficulties were

quite severe, and he repeatedly bled in large quantities, but he had so

far recovered in 1803, as to accept a Professorship. He was afterwards

chosen President of the college, which office he held for many years, in

the enjoyment of good health. He died from "old age," as we are told, in

1867, aged 94 years.

Statistics show that under the improved methods of treating this

disease, the mortality, as compared with previous years, has been

greatly reduced. Clinical observation proves that injuries to the lungs

are not so fatal as was once supposed.

The People's Common Sense Medical Adviser in Plain English or, Medicine Simplified, 54th ed., One Million, Six Hundred and Fifty Thousand · 第 21 / 34 章